COMPUTED TOMOGRAPHIC CHARACTERISTICS OF EOSINOPHILIC PULMONARY GRANULOMATOSIS IN FIVE DOGS

Canine pulmonary eosinophilic granulomatosis is a rare inflammatory pulmonary disease characterized by formation of eosinophilic granulomas that tend to obliterate the normal pulmonary architecture. The purpose of this retrospective study was to describe the CT characteristics of confirmed idiopathic pulmonary eosinophilic granulomatosis in a group of dogs. Five dogs met inclusion criteria. All patients were young adult dogs of variable breeds. No dog had concurrent occult heartworm disease. Computed tomographic characteristics most commonly included pulmonary masses and nodules of variable size, and lesions were most commonly located in the caudal lung lobes. Four dogs had large pulmonary masses with or without additional nodules and one dog had nodular lesions disseminated throughout the entire lung parenchyma. All large eosinophilic granulomas were smoothly margined, heterogeneous pulmonary masses displaying heterogeneous contrast enhancement. A honeycomb‐like enhancement pattern was observed in all but one mass and consisted of multiple hyperattenuating rims delineating central hypoattenuating areas, suggestive of bronchiectatic lung with peripheral enhancing airway walls and fluid‐filled, necrotic bronchial lumen. One dog had evidence of tracheobronchial lymphadenopathy. Findings indicated that canine eosinophilic pulmonary granulomatosis should be included as a differential diagnosis for dogs with CT characteristics of multiple pulmonary masses and/or nodules in caudal lung lobes, and a honeycomb‐like enhancement pattern in masses after intravenous administration of iodinated contrast medium.     

Study of lobation and vascularization of the lungs of wild boar (Sus scrofa)

The purpose of this study was to describe the anatomy of the lungs of wild boars for comparison with those of domestic swine. It was found that the right lung of the wild boar is divided into four lobes: cranial, median, caudal and accessory, whereas the left lung is divided into two lobes: cranial and caudal. In 93.4% of the cases, right pulmonary artery separates into the ascendant, descendant, median, accessory and caudal branches. In 73.3% of the cases, left pulmonary artery separates most frequently to form three branches to the cranial lobe, whereas the median lobe is generally supplied by only one arterial branch. There is a single pattern of bronchial distribution: in the right lung a tracheal bronchus leads to the cranial lobe, where it separates into the cranial and caudal bronchi and there are also bronchi to the median, caudal and accessory lobes. In the left lung, the large bronchus separates to form two branches, one of which further separates to form two branches to the cranial lobe whereas the other forms a single branch to the caudal lobe.     

PULMONARY ANGIOGRAPHY WITH 64‐MULTIDETECTOR‐ROW COMPUTED TOMOGRAPHY IN NORMAL DOGS

Pulmonary angiography using 64‐multidetector‐row computed tomography (MDCT) was used to evaluate pulmonary artery anatomy, and determine the sensitivity of pulmonary artery segment visualization in four Beagle dogs using images reconstructed to 0.625 mm and retro‐reconstructed to 1.25 and 2.5 mm slice thickness. Morphologically, characteristic features included a focal narrowing in the right cranial pulmonary artery in all dogs, which should not be mistaken as stenosis. While the right cranial pulmonary artery divided into two equally sized branches that were tracked into the periphery of the lung lobe in all dogs, only a single left cranial (cranial portion) lobar artery was present. Compared with 1.25 and 2.5 mm retro‐reconstructions, 0.625 mm reconstructions allowed for detection of significantly (P≤0.05) more pulmonary artery segments and sharper depiction of vessel margins. Clinical applications such as prevalence and significance of diameter changes, and detection of pulmonary arterial thrombembolism on lobar and sublobar level, using pulmonary angiography with 64‐MDCT applying 0.625 mm reconstruction slice thickness remain to be established.     

COMPUTED TOMOGRAPHY BRONCHIAL LUMEN TO PULMONARY ARTERY DIAMETER RATIO IN DOGS WITHOUT CLINICAL PULMONARY DISEASE

Bronchiectasis is diagnosed in humans using multiple computed tomography (CT) criteria, the most important being dilatation of the bronchi. The most widely used criterion for detection of bronchial dilatation is a bronchial lumen to pulmonary artery diameter (bronchoarterial [BA]) ratio >1.0. No studies have been performed to determine the BA ratio in normal dogs. Thoracic CT images of 24 dogs without clinical pulmonary disease were reviewed. The BA ratio of the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes was measured. The mean of the mean BA ratio for all dogs was 1.45±0.21 (99% confidence interval [CI]=1.34–1.56). The mean of the mean BA ratio as determined by lung lobe was 1.45±0.04 (99% CI=1.41–1.49). The range of individual BA ratios was 0.8–2.0. There was no significant difference in mean BA ratios as a function of lung lobe ( P =0.60). The BA ratio in these clinically normal dogs was consistent and may be a useful tool in evaluating for bronchiectasis on CT images. BA ratios >2.0 were not identified in this population, suggesting a threshold to differentiate normal from abnormal bronchi.     

Partial anomalous pulmonary venous connection with portosystemic shunt in a cat

A nine-month-old castrated male domestic shorthair presented for evaluation with a three-month history of hematuria. Portosystemic shunts and calculi within the bladder were suspected, and computed tomography angiography was performed. Computed tomography angiography identified an extrahepatic portosystemic shunt and a partial anomalous pulmonary venous connection, with the lobar vein of the right caudal lobe draining into the caudal vena cava. After anesthesia was administered to the cat, tachypnea and wheezing respiratory sounds were observed, and thoracic radiography revealed the right middle lung lobe atelectasis and an unstructured interstitial pattern in the left cranial lobe. Echocardiography showed left and right atrial enlargement and slight interventricular septal flattening in diastole. Based on these findings, cardiogenic pulmonary edema was suspected, and the cat was treated with furosemide. The clinical symptoms were resolved the next day. Closure of the extrahepatic portosystemic shunt was performed on days 47 and 157. Left atrial enlargement and interventricular septal flattening were attenuated after the procedure. At the time of writing this report (seventeen months after diagnosis), the cat exhibited no clinical signs, but subjective right atrial enlargement remained at approximately the same level. This report represents the first case of a partial anomalous pulmonary venous connection and a portosystemic shunt in a cat.     

Extensive Dystrophic Pulmonary Calcification in a Welsh Pony Mare

A 12-year-old Welsh pony mare was presented to the Ontario Veterinary College Teaching Hospital for signs of intermittent lethargy and increased abdominal breathing effort of 6 months duration. After physical examination, blood work, bronchoscopy, bronchoalveolar lavage, and diagnostic imaging of the thorax and attempted lung biopsy, pulmonary mineralization of unknown origin was suspected. The pony was treated palliative for 7 months with nonsteroidal anti-inflammatories and inhaled corticosteroids to treat accompanying airway inflammation before being euthanized because of poor prognosis and deterioration of clinical signs. On postmortem examination, the pulmonary architecture of the right and left cranioventral lung lobes, accessory lobe, and cranial potions of the left caudal lung lobe was replaced by hard mineralized tissue. No other organs other than a mediastinal lymph node and the lung were affected by mineralization. After decalcification, thick sheets of fibrous connective tissue organized into layers and lamellae replaced the normal architecture of the pulmonary parenchyma in more than 90% of the lung lobe examined on histopathology. The findings were consistent with generalized severe pulmonary fibrosis and dystrophic calcification.     

Pulmonary lipoma in a dog

An eight‐year‐old, neutered, male German short‐haired pointer was presented for a chronic cough and an intrathoracic mass. Computed tomography revealed a mass with low attenuation in the right caudal lung lobe that invaded the principal bronchi. The mass was removed by right caudal and accessory lung lobectomy. The histopathological diagnosis was pulmonary lipoma. The clinical signs resolved following surgery. There was no evidence of recurrence or de novo lesions on computed tomography performed 12 months post‐surgery. To the authors’ knowledge, this is the first report of a pulmonary lipoma in a dog.     

Unusual congenital pulmonary anomaly with presumed left lung hypoplasia in a young dog

A seven‐month‐old, entire, male miniature schnauzer dog was referred with acute vomiting, inappetence and depression primarily as a result of a gastric foreign body (pine cones). During investigations, thoracic radiographs revealed increased volume of the right lung lobes, deviated cardiomediastinal structures and elevation of the heart from the sternum. Thoracic computed tomography revealed left cranial lung lobe hypoplasia and extension of the right cranial lung parenchyma across the midline to the left hemithorax. Branches of the right pulmonary vessels and bronchi also crossed the midline and extended to the left caudal lung lobe. These findings suggested that the right and left lungs were fused. In humans this finding is consistent with horseshoe lung, which is an uncommon congenital malformation. To the authors’ knowledge, this case represents the first report of such a pulmonary anomaly in a dog.     

Use of computed tomography and silicon endocasts to identify pulmonary veins with echocardiography

The pulmonary veins were identified from the silicone endocast heart models of 19 dogs. Although variation in the number of the more peripheral veins on each specimen existed, all of the casts had a consistency with regards to the most proximal coalescence of the pulmonary veins as they entered the body of the left atrium. That is, the confluence of the veins formed three ostia at the atrial entry point that consisted of 1) right cranial and right middle pulmonary lobe veins; 2) right caudal, accessory, and left caudal pulmonary lobe veins; and 3) both the left cranial and left caudal pulmonary lobe veins of the left cranial lung lobe. The location of these structures identified by the 3-dimensional endocasts were then used to assist in the identification of the pulmonary veins using computed tomography of 2 dogs. Slices were made that approximated those commonly performed during echocardiographic examination. Understanding which pulmonary veins are seen by echocardiography in the different imaging planes will permit prospective evaluations of pulmonary vein size and abnormal flow patterns.     

Congenital cardiac disease in dogs

Thoracic conformation, age, amount of body fat, and stage of respiration and cardiac contraction affect the cardiac silhouette. Deep-chested dogs have an upright, narrow cardiac silhouette about 2 1/2 intercostal spaces wide, while barrel-chested dogs have a round, wide silhouette about 3 1/2 intercostal spaces wide. On LAT films the vessels to a lung lobe should be of equal size and 0.25-1.2 times the diameter of the upper third of the 4th rib at the 4th intercostal space. On DV projections, vessels to the caudal lung lobe should be no larger than the diameter of the 9th rib. Signs of right ventricular enlargement include loss of the cranial waist, increased width of the cardiac silhouette, increased sternal contact of the heart, and an elevated cardiac apex. Signs of left ventricular enlargement include an elevated carina, loss of the caudal waist, and a more perpendicular caudal cardiac border. Signs of left atrial enlargement include separation of mainstem bronchi, compression of the bronchus to the left caudal lung lobe, and an increased distance from the carina to the dorsal border of the caudal vena cava. Enlargement of the aorta and main pulmonary artery segment on a LAT view appears as a soft tissue density obscuring the cranial waist. Pulmonary vascular fields are usually hypervascular in patent ductus arteriosus and interventricular septal defects, normal in uncomplicated aortic or pulmonic stenosis, and hypovascular in tetralogy of Fallot.     

COMPUTED TOMOGRAPHIC FEATURES OF LUNG LOBE TORSION

The imaging features of lung lobe torsion in 10 dogs (nine complete, one partial torsion) acquired with a helical single‐slice computed tomography (CT) unit are described. Attenuation values of normal, rotated, and adjacent collapsed lung lobes before and after intravenous contrast medium administration were compared. Affected lung lobes were: left cranial (5), right middle (3), right cranial (1), and left caudal (1). CT findings in nine dogs with complete lung lobe torsion included pleural effusion and an abruptly ending bronchus. In eight of these dogs, enlargement, consolidation, emphysema of the affected lung lobe, and mediastinal shift to the contralateral side were present. Rotated lung lobes did not enhance, whereas adjacent collapsed and aerated lung lobes did (P<0.05). Apnea induced with hyperventilation or breath‐hold is essential to reduce motion artefacts and obtain a diagnostic study.     

Scintigraphic evaluation of pulmonary perfusion in dogs experimentally infected with Dirofilaria immitis

Pulmonary arterial perfusion was evaluated by perfusion lung scans in ten dogs experimentally infected with heartworm. After larval inoculation, scans were done once a month for 11 months. In 8 of 10 dogs, pulmonary arterial perfusion deficits were detected. The perfusion deficits involved the left cranial, right cranial, and right caudal lung lobes. Generally, there was a poor correlation between vascular abnormalities detected on the survey thoracic radiographs and the perfusion deficits detected by lung scanning. The perfusion deficits did not produce clinical signs or pulmonary infarction.     

RADIOGRAPHIC CHARACTERIZATION OF PRIMARY LUNG TUMORS IN 74 DOGS

Primary pulmonary neoplasia is well recognized in dogs and prognosis depends upon the tumor type. The purpose of this retrospective study was to characterize the radiographic appearance of different primary lung tumors with the goal of establishing imaging criteria to separate the different types. Three‐view thoracic radiographs of 74 dogs with histologically confirmed pulmonary anaplastic carcinoma (n = 2), adenocarcinoma (n = 31), bronchioalveolar carcinoma (n = 19), histiocytic sarcoma (n = 21), and squamous cell carcinoma (n = 1) were evaluated. Radiographs were assessed for tumor volume, affected lobe, location within lobe, overall pulmonary pattern, presence of cavitation, mineralization, air bronchograms, lymphadenomegaly, and pleural fluid. Histiocytic sarcomas were significantly larger than other tumor types (271 cm³; P = 0.009) and most likely to be found in the left cranial (38%; 8/21) and right middle (43%; 9/21) lung lobes, whereas adenocarcinomas were most likely to be found in the left caudal (29%; 9/31) lung lobe. Fifty‐seven percent (12/21) of histiocytic sarcomas had an internal air bronchogram. Findings indicate that a large mass in the periphery or affecting the whole lobe of the right middle or left cranial lung lobe with an internal air bronchogram is likely to be an histiocytic sarcoma.     

ACCURACY OF A COMPUTED TOMOGRAPHY BRONCHIAL WALL THICKNESS TO PULMONARY ARTERY DIAMETER RATIO FOR ASSESSING BRONCHIAL WALL THICKENING IN DOGS

Computed tomography is increasingly being used in veterinary medicine to evaluate animals with pulmonary signs such as coughing, tachypnea, and exercise intolerance, however, a quantitative measure of bronchial wall thickening has yet to be validated in veterinary medicine. Canine chronic bronchitis is a disease that is characterized histologically by thickening of the bronchial walls. Thoracic CT images of 16 dogs with chronic bronchitis and 72 dogs presenting for conditions unrelated to cough were evaluated. A ratio comparing the bronchial wall thickness to the adjacent pulmonary artery diameter was obtained in the right and left cranial and caudal lung lobes. There was no significant difference in dogs with chronic bronchitis or unaffected dogs between the left and right hemithorax, patient weight, patient age, image slice thickness, or CT machine used. Dogs with chronic bronchitis were found to have a significantly greater ratio than unaffected dogs (P < 0.001). The ratios in the cranial lung lobes were found to be significantly greater than the caudal lung lobes in both chronic bronchitis and unaffected dogs (P < 0.001). A receiver operating characteristic curve of the ratios in the cranial lung lobes had an area under the curve of 0.912, indicating high accuracy in predicting for bronchial wall thickening. A ratio of ≥0.6 in the cranial lung lobes was found to have a sensitivity of 77% and specificity of 100% in predicting for the presence of chronic bronchitis, and we propose using this cut‐off as supportive of bronchial wall thickening on CT.     

COMPUTED TOMOGRAPHIC APPEARANCE OF PRIMARY LUNG TUMORS IN DOGS

Canine primary lung tumors typically appear radiographically as a well‐circumscribed solitary mass in the periphery of a caudal lung lobe. Consolidated and diffuse forms of primary lung tumors have also been described. Nineteen dogs with computed tomographic (CT) images of the thorax and a histological diagnosis of primary lung tumor (17 primary carcinomas and two primary sarcomas) were evaluated retrospectively to characterize the CT findings. All primary lung tumors were bronchocentric in origin with internal air bronchograms. The bronchi were typically narrowed, displaced, and often obstructed by the tumor. Eighteen of 19 (95%) of the tumors were solitary and there was one pneumonic/alveolar form. Most solitary tumors were well circumscribed (17/18), located in the central to periphery of the lung (14/18), and in a cranial or caudal lobe (16/19). Most primary lung tumors (11/17) had mild to moderate heterogeneous contrast enhancement. Five of 19 dogs (26%) had evidence of pulmonary metastasis. Internal mineralization (3/19) and tracheobronchial lymphadenopathy (4/19) were also identified. On CT examination, solitary, well circumscribed, bronchocentric masses with internal air bronchograms are consistent with a primary pulmonary tumor in dogs.     

Cavitary pulmonary lesion associated with Aspergillus fumigatus infection in a German shepherd dog

A two-year-old female German shepherd dog was presented with chronic cough and haemoptysis. Thoracic radiographs revealed a thin-walled cavitary lesion within a consolidated left cranial lung lobe. Bronchoalveolar lavage confirmed a concurrent bacterial infection; however, despite antibiotic and anthelmintic therapy the clinical signs failed to resolve. A left cranial lung lobectomy was performed. Histopathology and fungal culture confirmed the presence of Aspergillus fumigatus. The necrotic cavity had features compatible with a bronchial origin, possibly a form of cystic bronchiectasis, arising either as a congenital anomaly or acquired secondary to infection. Surgery provided resolution of clinical signs for just over a year before the dog deteriorated again and was subsequently euthanised. Necropsy was declined by the owners. This case report presents a unique presentation in which the predominant clinical sign was coughing due to pulmonary involvement. Aspergillus fumigatus was isolated from the left cranial lung lobe.     

Successive torsion of the right middle and left cranial lung lobes in a dog

This case report describes the torsion of two lung lobes in a dog. The animal was first presented for a torsion of the right middle lung lobe. Following the surgical resection of that lobe, the dog suffered another torsion of the left cranial lung lobe (cranial and caudal segments).     

Asymptomatic anomalous pulmonary veins in a Siberian Husky

A 2-year-old, neutered male Siberian Husky presented with depression, weight loss and an inability to prehend food and water. Cerebrospinal fluid was collected under general anaesthesia prior to euthanasia. The elevated white cell count comprised mostly mononuclear cells. Histological changes within the brain were variable and multifocal. Non-suppurative meningitis secondary to lymphoma was diagnosed. At necropsy, abnormal venous drainage of the right cranial and middle lung lobes was found. A dilated major pulmonary vein from these lobes passed across the lateral aspect of the right caudal lung lobe prior to entering the heart, and subpleural veins from the affected lobes were enlarged and tortuous. These vascular abnormalities were considered incidental. There were no apparent congenital abnormalities of the heart and the animal's clinical signs were related to lymphoma of the brain.