Case Study

RAD – Healed but recurrent aspiration pneumonia with chronic airway disease and scarring in a 10 year old MN Golden Retriever

This 10 year old MN Golden Retriever dog has a history of chronic pneumonia. the patient presented today with a mild cough.

DX

Healed aspiration pneumonia • Chronic/remaining airway disease and pneumonia scarring

Image Interpretation

right lateral, left lateral and VD thorax – The known peripheral alveolar infiltrate within the right cranial and middle lobe has further cleared when compared with the previous radiographs dating 10/6/15. The right cranial lobar bronchus presents cylindrical bronchiectasis. A mild to moderate generalized branchial pattern has remained throughout. Mild pleural thickening is noted emphasizing the right middle lobe. The esophagus contains a mild amount of air but is not dilated.

Outcome

There is no evidence of active pneumonia at this point. The chronic bronchitis may be
a self-sustaining entity as some of the changes are irreversible. The radiograohic signs
are mild. Superinfection is not likely. However, it is known that the radiographic signs
may lag behind the clinical course of possible lung/airway disease.

Comments

Repeat rads 8/15/16 (3 months later),presented for anorexia and lethargy:

Alveolar lung pattern left cranial lung lobe
Moderate interstitial lung pattern
Bronchiectasis with stationary

The findings are compatible with recurring aspiration pneumonia. The interstitial lung pattern is also compatible with generalized active pneumonia emphasizing the left lung lobes. The known chronic changes – pleural thickening, bronchiectasis and bronchial pattern of the lung – are irreversible and radiographic improvement is not expected. Antibiotic treatment and supportive care are advised.

Repeat rads 9/13/16 (one month later)

No evidence of active pneumonia; remaining bronchietasia and pleural and interstitial scarring; regressive bronchial pattern

Repeat rads 10/14/16 (one month later)

Mildly increased bronchial pattern with moderate peribronchial cuffing. Mild increase of the unstructured reticular pattern. Recurring active aspiration pneumonia, with regression of findings inthe left cranial lung lobe.

Repeat rads 10/18

Active aspiration and broncho-peumonia