Hello, I was hoping for some opinions on the lung pattern in this cat as well as some differentials. This is Squeaker an 11 year old DSH who has not been doing well for the last 2 weeks. Eating is decreased, losing weight and difficulty breathing.
She is a fractious cat so Physical exam was somewhat limited but the dyspnea was obvious. Managed to get xrays with some oxygen and found these findings on the xrays.
From afar at first glance I was thinking nodular interstitial pattern and metastasis but on closer inspection it appears to be a marked bronchiolar/interstitial pattern. There is marked inflammation of the interstitium surrounded by obvious bronchi.
We later changed our top rule out to airway disease possibly asthma. We have toxoplasma on the list but lower and we have moved away from neoplasia. I was hoping for some opinions on these rads and the pattern present. Thanks so much. Brent.
p.s Try as I might I could not get the other 2 views to load. The only one that posted was the teaser image. They all loaded fine but don’t seem to be showing up in the post. I tried file attachments and everything. I’m not sure what I’m doing wrong.
Comments
can you try and upload an
can you try and upload an orthogonal view?
Hello there! Can you send
Hello there! Can you send your video clips to me so I can see what the issue may be? If I can view them I will get them into your post thx! -Kelly, SonoPath 🙂
Great! I will.Â
Thanks
Great! I will.
Thanks
I can see where you are
I can see where you are coming from as far as the peribronchial infiltrate. However, I would not disregard bronchoalveolar neoplasia at all here since the infiltrate appears to be so solid and localized as well as in a position that is atypically far dorsal for an inflammtory infiltrate. I would expect pneumonia to sink down unless its granulomatous (where Toxo is a possibility for sure), this would be a very unusual amount of peribronchial infiltrate for Asthma as i see consolidation to a degree that has alveolar components with airbronchograms. It defninetely has generalized parenchymal disease with differential ventilation and bronchiectasia.
I would try and aspirate the consolidated areas under US guidance as an alternative to bronchoscopy as some of the seem to be in the lung periphery. Just be sure to monitor the patient well afterwards as cats have a slightly greater risk to develop pneumothorax as compared to dogs.
Thanks for the advice. Much
Thanks for the advice. Much appreciated!! Brent