Case Study

RAD – Non-cardiogenic pulmonary edema in a Norwich Terrier

This Norwich Terrier dog has a history of seizure activity. Have been increasing in frequency over the last 6 months. MRI unremarkable, CSF non-inflammatory. Abdominal ultrasound showed renal calculi, pylectasia, bladder sand and minor left adrenal swelling.

Physical exam – increased respiratory rate and effort. Crackles bilaterally, dental disease

Urinalysis – USPG 1.010, pH 8.0, protein +1

Physical exam – increased respiratory rate and effort. Crackles bilaterally, dental disease

Urinalysis – USPG 1.010, pH 8.0, protein +1

DX

Mild non-specific generalized cardiomegaly suggestive for biventricular enlargement; caudodorsal alveolar pattern

Image Interpretation

Rads of thorax and abdomen – The patient is obese. The abdominal wall is pendulous. Moderate generalized hepatomegaly is noted. The serosal detail is within normal limits. Both renal pelvises and the renal diverticuli contain multifocal small mineral opacities. Faint amorphous mineralization is seen in the retroperitoneal space that is likely to be associated with the kidneys as well.

The trachea appears to be elevated (views moderately rotated) suggesting enlargement of the left ventricle. Left atrial enlargement and venous congestion is not definitely seen. The sternal contact of the heart is increased indicating enlargement of the right ventricle. The pulmonary vasculature is largely obscured by a marked caudodorsal alveolar pattern.