Case Study

RAD – Spontaneous symmetric pneumothorax with pulmonary bullae, lung lobe collapse in a 4 year old MN Dalmation dog

This 4 year old MN Dalmation dog presented with spontaneous acute respiratory distress, foaming at mouth, short shallow breathes. Decompensated within 10 min and crashed.

Noted the pneumothorax. Was unable to get DV or VD fast enough.

Test tapped for air but with this patient just wasn’t quick enough. No punctures noted. Have you ever seen a spontaneous pneumothorax like this before?

No known sharp object ingestion.

This 4 year old MN Dalmation dog presented with spontaneous acute respiratory distress, foaming at mouth, short shallow breathes. Decompensated within 10 min and crashed.

Noted the pneumothorax. Was unable to get DV or VD fast enough.

Test tapped for air but with this patient just wasn’t quick enough. No punctures noted. Have you ever seen a spontaneous pneumothorax like this before?

No known sharp object ingestion.

Image Interpretation

Rads of the thorax and abdomen- Extrathoracic structures/thoracic boundaries:
There is no evidence of traumatic bone injury.
A moderate amount of free air is noted within both pleural cavities. The diaphragmatic cupola is flattened, the course of the diaphragm is undulating which both indicates increased tension within the pleural cavities.
All lung lobes are retracted from the chest wall and reveal a moderate degree of collapse.
Associated with the cranial lung lobes multiple thin walled air filled cavitary lesions of varying size consistent with pulmonary bullae are noted.
The cardiac silhouette is upright and thin and in a centralized position. The caudal vena cava and pulmonary vasculature are thin as well.
Moderate aerophagia is noted as a function of respiratory distress. Extraabdominal structures/abdominal boundaries:
The spleen is volume contracted.

DX

Bilaterally symmetric moderate pneumothorax.  Increased pleural cavity tension and moderate generalized lung lobe collapse.  Multiple pulmonary bullae.  Hypovolemia with microcardia, underperfusion of the lung and volume contracted spleen.  Aerophagia owing to the respiratory distress.

Outcome

There is no evidence of traumatic pneumothorax, bone or lung injury.
The radiograpahic findings are consistent with a spontaneous pneumothorax as a consequence of rupture of one or multiple air filled cavitary lung lesions.
This is especially common in young medium to large breed dogs (as is in adolescent males in people). The exact etiology is unknown. The degree of spontaneous pneumothorax with lung collapse may range between mild and severe.