Lung ring-down artifact as a sign of pulmonary alveolar-interstitial disease

Three dogs with presumptive cardiogenic pulmonary edema underwent a thoracic ultrasonographic examination. Multiple ring-down artifacts involving both sides of the thorax emanating from the pleural-lung interface were detected. When clinical and radiographic signs of pulmonary edema were resolved, ring-down artifacts were not observed. The ring-down artifact may be a useful diagnostic sign for screening the lung of animals with acute respiratory distress where radiographs are not feasible.     

EVALUATION OF DIAPHRAGMATIC MOTION IN NORMAL AND DIAPHRAGMATIC PARALYZED DOGS USING M‐MODE ULTRASONOGRAPHY

Diagnosis of unilateral diaphragmatic paralysis in dogs is currently based on fluoroscopic detection of unequal movement between the crura. Bilateral paralysis may be more difficult to confirm with fluoroscopy because diaphragmatic movement is sometimes produced by compensatory abdominal muscle contractions. The purpose of this study was to develop a new method to evaluate diaphragmatic movement using M‐mode ultrasonography and to describe findings for normal and diaphragmatic paralyzed dogs. Fifty‐five clinically normal dogs and two dogs with diaphragmatic paralysis were recruited. Thoracic radiographs were acquired for all dogs and fluoroscopy studies were also acquired for clinically affected dogs. Two observers independently measured diaphragmatic direction of motion and amplitude of excursion using M‐mode ultrasonography for dogs meeting study inclusion criteria. Eight of the clinically normal dogs were excluded due to abnormal thoracic radiographic findings. For the remaining normal dogs, the lower limit values of diaphragmatic excursion were 2.85–2.98 mm during normal breathing. One dog with bilateral diaphragmatic paralysis showed paradoxical movement of both crura at the end of inspiration. One dog with unilateral diaphragmatic paralysis had diaphragmatic excursion values of 2.00 ± 0.42 mm on the left side and 4.05 ± 1.48 mm on the right side. The difference between left and right diaphragmatic excursion values was 55%. Findings indicated that M‐mode ultrasonography is a relatively simple and objective method for measuring diaphragmatic movement in dogs. Future studies are needed in a larger number of dogs with diaphragmatic paralysis to determine the diagnostic sensitivity of this promising new technique.     

PULMONARY MINERALIZATION IN FOUR DOGS WITH CUSHING'S SYNDROME

The clinical and imaging features of four dogs with Cushing's syndrome and pulmonary mineralization are reviewed. Three dogs presented with a primary complaint of respiratory distress/dyspnea. Three dogs had pituitary dependent Cushing's syndrome, while the remaining one dog had iatrogenic Cushing's syndrome. Each dog had clinical features typical for Cushing's syndrome. Two of the dogs were euthanized due to progressive hypoxemia. In each dog, the serum calcium, phosphorous, blood urea nitrogen and creatinine were normal.
A generalized increase in unstructured interstitial pulmonary opacity with diffuse mineralization was noted on thoracic radiographs of all dogs. In one dog, an ill-defined nodular interstitial pattern of mineralization was present. Delayed bone phase scintigraphy using ^99mTechnetium methylene diphosphonate documented generalized pulmonary uptake in two dogs. ^99mTechnetium labeled microaggregated albumin lung perfusion scans were normal in these two dogs. ^99mTc-MDP scintigraphy can provide useful information in diagnosing pulmonary mineralization in Cushingoid dogs.     

THORACIC RADIOGRAPHIC FEATURES OF ANTICOAGULANT RODENTICIDE TOXICITY IN FOURTEEN DOGS

Thoracic radiographs and clinical records from 14 dogs with confirmed anticoagulant rodenticide toxicity were reviewed. Twelve of the 14 dogs were presented with a chief complaint of respiratory distress, and 12 had elevated prothrombin and activated partial thromboplastin times consistent with a coagulopathy secondary to a clotting factor deficiency. Thoracic radiographs of the 14 dogs were reviewed and abnomalities included increased mediastinal soft tissue opacity with extra and intrathoracic tracheal narrowing (4/14), increased mediastinal soft tissue opacity without tracheal narrowing (8/14), variable degrees of pleural effusion (13/14) and generalized, patchy interstitial/alveolar pulmonary infiltrates (8/14). Radiographic evidence of cardiomegaly and pulmonary artery abnormalities consistent with concurrent heartworm infestation were detected in one dog. In four dogs, dramatic tracheal narrowing was identified on the lateral thoracic radiograph caused by either mediastinal hemorrhage compressing the trachea or submucosal hemorrhage within the tracheal lumen. The trachea was displaced in a ventral direction in two dogs, and extra and intrathoracic luminal diameter narrowing was evident cranially in all four dogs. Two of these four dogs had soft tissue opacity within the dorsal trachea that extended from the larynx to the intrathoracic trachea. Twelve of the 14 dogs survived with standard treatment protocols utilizing injectable and oral vitamin K₁. One dog died from pancreatitis and disseminated intravascular coagulopathy. The other dog died soon after presentation due to severe, disseminated hemorrhage. Follow-up thoracic radiographs were made in four dogs that survived and showed resolution of the mediastinal, pleural and pulmonary changes within one to five days after the initiation of vitamin K₁ therapy.     

RADIOGRAPHIC FINDINGS IN THE THORAX OF DOGS WITH LEPTOSPIRAL INFECTION

Thoracic radiographs of 4 dogs with confirmed and 1 dog with suspected leptospirosis were reviewed. In all dogs a reticulonodular pulmonary opacity was noted, affecting the entire lung in 3 and predominantly the caudodorsal lung field in 2 dogs. The radiographic lung pattern described is associated with pulmonary hemorrhage probably due to endothelial damage and vasculitis. Pulmonary manifestations in dogs with leptospirosis may be misinterpreted and attributed to neoplasia, pneumonia, edema, hemorrhage due to disseminated intravascular coagulopathy, adult respiratory distress syndrome and pulmonary thromboembolism.     

RADIOGRAPHIC CHARACTERIZATION OF PRESUMED PLATE‐LIKE ATELECTASIS IN 75 NONANESTHETIZED DOGS AND 15 CATS

Discrete discoid or linear areas of increased soft opacity have been observed within the pulmonary parenchyma in thoracic radiographs of dogs and cats. Similar radiographic findings have been described in humans and termed plate‐like atelectasis. The purpose of this retrospective study was to describe locations and characteristics of presumed plate‐like atelectasis, presence of concurrent thoracic disease(s), and presence of persistent pulmonary changes on recheck thoracic radiographic studies in a cohort of dogs and cats. Hospital records between 2004 and 2011 were searched and a total of 90 cases were included (75 dogs and 15 cats, 2–17 years of age). Plate‐like atelectasis was most commonly found in left lateral radiographs. Plate‐like atelectasis was observed in the cranial thorax and was oriented in a dorsocranial to ventrocaudal direction in 68 (75%) patients. Plate‐like atelectasis averaged 29.6 ± 14.4 mm in length and 2.6 ± 1.3 mm in width. In 57 of the 90 patients (63%), plate‐like atelectasis was the only abnormality found. Plate‐like atelectasis was present in 7 of 22 cases where follow‐up radiographs were available. Findings from the current study indicated that, while the etiology of plate‐like atelectasis remains unknown, anatomic variations in sublobar pulmonary anatomy might account for pleural areas of atelectasis. The authors propose that the presence of plate‐like atelectasis may represent areas of atelectasis that track along sublobar lung lobe separations, an area of hypoventilation or decreased collateral ventilation, and/or area of decreased localized surfactant deficiency.     

COMPARISON BETWEEN CRANIAL THORACIC INTERVERTEBRAL DISC HERNIATIONS IN GERMAN SHEPHERD DOGS AND OTHER LARGE BREED DOGS

Cranial thoracic intervertebral disc herniations have been reported to be rare in dogs due to the presence of the intercapital ligament, however some studies have proposed they may not be uncommon in German Shepherd dogs. The purpose of this retrospective study was to compare cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs (control group). Medical records at the Ontario Veterinary College were searched for German Shepherd dogs and other large breed dogs that had magnetic resonance imaging studies including the T1‐T9 region. For each dog and each disc space from T1‐T9, three variables (compression, disc degeneration, and herniation) were recorded and graded based on review of sagittal T2‐weighted images. Twenty‐three German Shepherd dogs and 47 other large breed dogs met inclusion criteria. The German Shepherd dog group had higher scores than the control group for compression (P = 0.0099) and herniation (P < 0.001), but not disc degeneration (P = 0.97). In the German Shepherd dog group, intervertebral discs T2‐T3 and T4‐T5 had an increased risk for compression and T3‐T4 had an increased risk for compression and herniation. Findings from this study indicated that German Shepherd dogs may be more likely than other large breed dogs to have spinal cord compression due to cranial thoracic disc herniations. Imaging of the cranial thoracic spine, including T2‐T3, is recommended for German Shepherd dogs with T3‐L3 neurological signs.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.     

THORACIC BLASTOMYCOSIS: A REVIEW OF ITS RADIOGRAPHIC MANIFESTATIONS IN 40 DOGS

Thoracic radiographs of 40 dogs with confirmed blastomycosis were reviewed to determine the incidence of the associated radiographic signs. The predominant patterns of disease were determined in each dog and were as follows: nodular interstitial densities, 13 dogs; a mixed lung pattern not localized to any particular part of the lung, ten dogs; a bronchointerstitial pattern, five dogs; a nonspecific hazy interstitial pattern, four dogs; a mixed alveolar and interstitial density, two dogs; a cavitary lesion, one dog. The lungs appeared normal in four dogs. Concurrent findings included eight dogs with thoracic lymphadenopathy, two dogs with pneumomediastinum, and one dog with pleural effusion. None of the lesions appeared mineralized.     

QUANTITATIVE AND QUALITATIVE COMPUTED TOMOGRAPHIC CHARACTERISTICS OF BRONCHIECTASIS IN 12 DOGS

Bronchiectasis is an irreversible dilatation of the bronchi resulting from chronic airway inflammation. In people, computed tomography (CT) has been described as the noninvasive gold standard for diagnosing bronchiectasis. In dogs, normal CT bronchoarterial ratios have been described as <2.0. The purpose of this retrospective study was to describe quantitative and qualitative CT characteristics of bronchiectasis in a cohort of dogs with confirmed disease. Inclusion criteria for the study were thoracic radiography, thoracic CT, and a diagnosis of bronchiectasis based on bronchoscopy and/or histopathology. For each included dog, a single observer measured CT bronchoarterial ratios at 6 lobar locations. Qualitative thoracic radiography and CT characteristics were recorded by consensus opinion of two board‐certified veterinary radiologists. Twelve dogs met inclusion criteria. The mean bronchoarterial ratio from 28 bronchiectatic lung lobes was 2.71 ± 0.80 (range 1.4 to 4.33), and 23/28 measurements were >2.0. Averaged bronchoarterial ratios from bronchiectatic lung lobes were significantly larger (P < 0.01) than averaged ratios from nonbronchiectatic lung lobes. Qualitative CT characteristics of bronchiectasis included lack of peripheral airway tapering (12/12), lobar consolidation (11/12), bronchial wall thickening (7/12), and bronchial lumen occlusion (4/12). Radiographs detected lack of airway tapering in 7/12 dogs. In conclusion, the most common CT characteristics of bronchiectasis were dilatation, a lack of peripheral airway tapering, and lobar consolidation. Lack of peripheral airway tapering was not visible in thoracic radiographs for some dogs. For some affected dogs, bronchoarterial ratios were less than published normal values.     

RADIOGRAPHIC APPEARANCE OF CONFIRMED PULMONARY LYMPHOMA IN CATS AND DOGS

Herein we describe the thoracic radiographic appearance of confirmed pulmonary lymphoma. Patients with thoracic radiographs and cytologically or histologically confirmed pulmonary lymphoma were sought by contacting American College of Veterinary Radiology members. Seven cats and 16 dogs met the inclusion criteria, ranging in age from 4 to 15 years. Method of diagnosis was via ultrasound‐guided cytology (four), surgical biopsy (two), ultrasound‐guided biopsy (one), and necropsy (16). Radiographic findings varied but ranged from normal (one) to alveolar (six) and/or unstructured interstitial infiltrates (11), nodules and/or masses (eight), and bronchial infiltrates (four). Additional thoracic radiographic findings included pleural effusion and lymphadenopathy. The results of this evaluation indicate a wide variability in thoracic radiographic abnormalities in cats and dogs with pulmonary lymphoma.     

Evaluation of thoracic radiographs as a screening test for dogs and cats admitted to a tertiary‐care veterinary hospital for noncardiopulmonary disease

Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence‐based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology. Any notable thoracic change in the radiology report was considered important and evaluated in this study. One hundred and sixty‐six of these included patients were dogs and 65 were cats. Of the 166 dog radiographs evaluated, 120 (72.3%) had normal thoracic radiographs, while 46 (27.7%) had radiographic abnormalities. Of the sixty‐five cats included, 36 (55.4%) had normal radiographs, while 29 (44.6%) had abnormal radiographs. Canine patients with abnormal radiographs had a significantly higher lactate level (P‐value 0.0348) and feline patients with abnormal radiographs had a significantly lower packed cell volume (P‐value 0.012). A large proportion of patients that had screening thoracic radiographs (32.5%) had documented abnormalities, but a relatively low percentage (6.5%) of our total population had their clinical plan changed as a consequence of detection of these abnormalities. Findings indicated that abnormal screening thoracic radiographs are more likely in dogs with an elevated lactate and cats with anemia, or a low normal hematocrit.     

FREQUENCY AND NUMBER OF ULTRASOUND LUNG ROCKETS (B‐LINES) USING A REGIONALLY BASED LUNG ULTRASOUND EXAMINATION NAMED VET BLUE (VETERINARY BEDSIDE LUNG ULTRASOUND EXAM) IN DOGS WITH RADIOGRAPHICALLY NORMAL LUNG FINDINGS

Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B‐lines, representing interstitial edema) versus dry lung (A‐lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A‐lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B‐lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8‐view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left‐sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6–19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74–100%) in those with left‐sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions.     

RADIOGRAPHIC FEATURES OF AORTIC BULB/VALVE MINERALIZATION IN 20 DOGS

The radiographic features of aortic bulb/valve mineralization in 20 dogs were reviewed. Extent, shape, number, and location of mineralization were recorded. Five of the dogs had additional alternate imaging examinations, including bone scintigraphy, echocardiography, and thoracic computed tomography. A necropsy was done on one dog, and the area of mineralization was evaluated using routine histology. The median age was 10 (mean 9.7; SD +/- 2.7) years. There were five males, seven neutered males, one female, and seven neutered females. The breeds were: Irish setter (6); rottweiler (7); chow-chow (1); miniature dachshund (1); borzoi (1); English setter (1); English springer spaniel (1); great Dane (1); and greyhound (1). Dogs with both right and left lateral radiographs (n = 17) had mineralization visible on both views, more conspicuously on the right lateral radiograph (n = 12). Aortic bulb mineralization was identified on the ventrodorsal radiograph of only one dog. On lateral radiographs, the aortic bulb mineralization was localized within the 4th intercostal space and in the craniodorsal quadrant of the cardiac silhouette. In nine of the dogs, there were complex or multiple mineralizations and in 11 dogs, there was a single curvilinear mineral opacity oriented in a caudoventral to craniodorsal direction. In all radiographs, the mineralization was in the expected position of the aortic bulb, and echocardiography (n = 4), spiral computed tomography (n = 2), and necropsy (n = 1) confirmed that the mineralization was within the aortic bulb. Clinical pathologic data of the dogs suggested no reason for metastatic mineralization. Exact etiopathogenesis of the lesions were not determined in this study. Based on the histologic findings in one dog, the mineralization seen in the aortic root is similar to a form of dystrophic mineralization called Monckeberg's calcific arteriosclerosis in humans. No clinical signs attributable to the mineralization were observed.     

COMPARISON OF RADIOGRAPHY AND ULTRASONOGRAPHY FOR DIAGNOSING SMALL‐INTESTINAL MECHANICAL OBSTRUCTION IN VOMITING DOGS

A cross‐sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small‐intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small‐intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small‐intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small‐intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small‐intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small‐intestinal dilatation. The ultrasonographic presence or absence of moderate‐to‐severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small‐intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small‐intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography.     

RADIOGRAPHIC LIVER SIZE IN PEKINGESE DOGS VERSUS OTHER DOG BREEDS

Differential diagnoses for canine liver disease are commonly based on radiographic estimates of liver size, however little has been published on breed variations. Aims of this study were to describe normal radiographic liver size in Pekingese dogs and to compare normal measurements for this breed with other dog breeds and Pekingese dogs with liver disease. Liver measurements were compared for clinically normal Pekingese (n = 61), normal non‐Pekingese brachycephalic (n = 45), normal nonbrachycephalic (n = 71), and Pekingese breed dogs with liver disease (n = 22). For each dog, body weight, liver length, T11 vertebral length, thoracic depth, and thoracic width were measured on right lateral and ventrodorsal abdominal radiographs. Liver volume was calculated using a formula and ratios of liver length/T11 vertebral length and liver volume/body weight ratio were determined. Normal Pekingese dogs had a significantly smaller liver volume/body weight ratio (16.73 ± 5.67, P < 0.05) than normal non‐Pekingese brachycephalic breed dogs (19.54 ± 5.03) and normal nonbrachycephalic breed dogs (18.72 ± 6.52). The liver length/T11 vertebral length ratio in normal Pekingese (4.64 ± 0.65) was significantly smaller than normal non‐Pekingese brachycephalic breed dogs (5.16 ± 0.74) and normal nonbrachycephalic breed dogs (5.40 ± 0.74). Ratios of liver volume/body weight and liver length/T11 vertebral length in normal Pekingese were significantly different from Pekingese with liver diseases (P < 0.05). Findings supported our hypothesis that Pekingese dogs have a smaller normal radiographic liver size than other breeds. We recommend using 4.64× the length of the T11 vertebra as a radiographic criterion for normal liver length in Pekingese dogs.     

INTRAOPERATIVE SPINAL ULTRASONOGRAPHY IN DOGS: NORMAL FINDINGS AND CASE-HISTORY REPORTS

Intraoperative spinal ultrasonography was performed in cervical and lumbar spine of 2 and 5 normal dogs, respectively, following ventral slot technique or dorsal or hemilamenectomy. The dura was hyperechoic, while the parenchyma was hypoechoic. The subarachnoid space was anechoic. An echogenic line was present in the center of the spinal cord, as seen in human. Pulsation of the spinal cord was noted during M-mode imaging. Clinical findings of one dog with thoracolumbar disk herniation and one with thoracic vertebral fracture/subluxation confirmed the usefulness of intraoperative spinal ultrasonography for real time evaluation of spinal canal spatial abnormalities (mass lesion and degree of spinal cord compression on scanning planes) and spinal cord motion. Follow-up ultrasound examinations were possible from 6 days postoperatively.     

VERTEBRAL HEART SIZE RANGES SPECIFIC FOR WHIPPETS

To assess the influence of breed, breeding lines, and training on heart size, the vertebral heart size (VHS) was evaluated on left-to-right lateral, right-to-left lateral, dorsoventral, and ventrodorsal thoracic radiographs from 44 whippets free from cardiac and pulmonary disease. In lateral views, the VHS was 11.0 +/- 0.5 vertebrae (mean +/- SD) on right-to-left lateral and 11.3 +/- 0.5 vertebrae on left-to-right lateral radiographs, being larger than the 9.7 +/- 0.5 vertebrae proposed by Buchanan (P<0.0001). The VHS on left-to-right lateral views was larger than on right-to-left lateral views (P<0.0001). The VHS was 10.5 +/- 0.6 vertebrae on dorsoventral radiographs and 11.1 +/- 0.6 vertebrae on ventrodorsal radiographs. Both values were larger than the 10.2 +/- 1.5 vertebrae (dorsoventral) (P<0.0082) or 10.2 +/- 0.8 vertebrae (ventrodorsal) (P<0.0001) proposed by Buchanan. In addition, the VHS on ventrodorsal views was larger than on dorsoventral views (P<0.0001). Dogs out of racing pedigree lines had a significantly larger VHS than those out of show pedigree lines, and trained dogs had a significantly larger VHS than nontrained dogs. Because most trained dogs came out of racing pedigree lines, and all nontrained dogs came out of show pedigree lines, however, it is difficult to determine whether the higher VHS for trained dogs is due to genetic influences or training, or both. In conclusion, it is important to take into account the breed and the radiographic view when evaluating heart size in thoracic radiographs of whippets to avoid overinterpretation of cardiac enlargement in these dogs.     

RADIATION PNEUMONITIS IN THREE DOGS

Radiation pneumonitis developed within the radiation treatment field in three dogs with soft tissue sarcomas located on or adjacent to the thoracic wall. Radiographic signs compatible with a diagnosis of radiation pneumonitis developed from one (n = 2 dogs) to two (n = 1 dog) months after completion of therapy. The initial radiographic sign was an alveolar infiltrate in all three dogs. At subsequent examinations at variable time periods after treatment, radiographic findings included: bronchiectasis (n = 3 dogs), alveolar infiltrate (n = 2 dogs), decreased lung volume (n = 2 dogs), and unstructured interstitial opacification (n = 1 dog). Necropsy examination of one dog at fourteen months after the completion of radiotherapy showed evidence of pulmonary fibrosis within the irradiated lung. Necropsy examination of the second dog did not show any evidence of radiation induced changes. It is possible that histopathologic examination did not include irradiated lung. No clinical signs that could be attributed to the radiation pneumonitis were observed in any dog. It appears that approximately 25% of the lung can be safely irradiated to high doses, if indicated, in order to deliver an adequate dose of radiation to a primary tumor site.     

Comparison of thoracic radiographs and single breath-hold helical CT for detection of pulmonary nodules in dogs with metastatic neoplasia

Imaging studies in people indicate that x-ray computed tomography (CT) is a more sensitive technique than thoracic radiography for the detection of pulmonary metastasic neoplasia. Systematic studies comparing CT and thoracic radiographic techniques in veterinary patients have not been performed. The present retrospective study was designed to directly compare the efficacy of these 2 techniques in detecting pulmonary nodules in dogs. Eighteen dogs with histologically confirmed pulmonary metastatic neoplasia had contemporaneous thoracic radiographs and pulmonary CT scans compared. Quantitative analyses included estimation of pulmonary nodule size, number, and lobar distribution on thoracic radiographs and CT images. Only 9% of CT-detected pulmonary nodules were identified on thoracic radiographs (P < .003). The lower size threshold was approximately 1 mm to detect pulmonary nodules on CT images and 7-9 mm to reliably detect nodules on radiographs (P < .0001). Additionally, pulmonary nodules were detected in a significantly greater number of lung lobes using CT as compared with thoracic radiographs (P < .0001). These data indicate that CT is significantly more sensitive than thoracic radiography for detecting soft-tissue nodules in dogs. As such, thoracic CT should be considered in any patient with neoplasia that has potential for pulmonary metastasis to more reliably stage the disease, particularly when accurate characterization of the extent and distribution of pulmonary metastatic disease affects therapeutic planning.