IMAGING DIAGNOSIS—SPONTANEOUS PNEUMOMEDIASTINUM SECONDARY TO PRIMARY PULMONARY PATHOLOGY IN A DALMATIAN DOG

A 1.5‐year‐old, 23 kg intact male Dalmatian dog was evaluated for acute respiratory insufficiency without a previous history of trauma or toxic exposition. Imaging revealed pneumomediastinum, pneumothorax, diffuse unstructured interstitial pulmonary pattern, pulmonary interstitial emphysema, and pneumoretroperitoneum. Histopathological evaluation of the lungs revealed perivascular and peribronchial emphysema, mild lymphocytic interstitial pneumonia with atypical proliferation of type II pneumocytes in bronchioles and alveoli. A lung disease resembling fibrosing interstitial pneumonia in man and cats has been previously reported in Dalmatians and should be included as a differential diagnosis for Dalmatians with this combination of clinical and imaging characteristics.     

Does the computed tomographic appearance of the lung differ between young and old dogs?

In computed tomographic (CT) images of humans, decreased lung attenuation, bronchial dilation, and/or thickening, air trapping, cysts, and thickened interlobular septa have been associated with increasing age. To determine if there are differences in the CT appearance of the lungs of young and old dogs that could affect interpretation of diagnostic studies, pulmonary CT images of dogs with conditions unrelated to the thorax were reviewed retrospectively in a case–control study. Computed tomography studies of 42 young dogs (range 0.3–4.8 years) and 47 old dogs (range 9–15.1 years) were jumbled and reviewed by an observer blinded to dog age. Computed tomography was performed under sedation in 62 (70%) dogs and under general anesthesia in 27 (30%). Heterotopic bone was more prevalent (62% vs. 14%) in old dogs. Lung collapse was significantly associated with old age, greater body weight, and anesthesia. There were no significant differences in median lung attenuation or occurrence of ground glass pattern, cysts, bronchial thickening, bronchial dilation, or degree of tracheal calcification. No examples of reticular pattern, emphysema, pleural thickening, or septal thickening were observed in any dog. Despite previous studies describing age‐related changes in the radiographic appearance of the lungs of old dogs, it appears that there are minimal observable differences in CT images. Old dogs are more likely to have visible foci of heterotopic bone and may be more prone to lung lobe collapse than young dogs, but neither of these differences should contribute to misdiagnosis of pulmonary disease.     

IMAGING DIAGNOSIS—PULMONARY ALVEOLAR PROTEINOSIS IN A DOG

A young dog was presented for cyanosis and right heart failure. Radiographic and CT characteristics included right heart/pulmonary artery enlargement, hepatomegaly, abdominal effusion, and severe, generalized air‐space filling. Focal increased opacities were present in the peripheral lung, as were multiple pulmonary blebs and bullae. Echocardiographic findings were consistent with cor pulmonale and pulmonary hypertension. Bronchoscopic findings were consistent with chronic inflammation. Pulmonary alveolar proteinosis (PAP) was confirmed at necropsy. Pulmonary alveolar proteinosis is an interstitial lung disease that results in accumulation of phospholipoproteinaceous material and should be included as a differential diagnosis for dogs with these clinical and imaging characteristics.     

Use of computed tomography and minimum intensity projection in the detection of lobar pneumonia mimicking lung lobe torsion in a dog

A 10‐year‐old female spayed Dachshund was referred with progressive coughing for 1 month. The dog was tentatively diagnosed with right middle lung torsion based on pleural effusion, vesicular emphysema, abruptly ending bronchus in consolidated right middle lung, and no contrast enhancement of the affected lobe on radiography and computed tomography (CT). There was no evidence of torsion upon thoracotomy, and histological examination confirmed lobar pneumonia. The CT images were reevaluated using minimum intensity projection and revealed normal bronchial courses. The minimum intensity projection technique can be to assist in evaluation of the bronchial tree for dogs with suspected lung lobe torsion and other pulmonary diseases.     

Pulmonary edema and emphysema in cattle after intraruminal and intravenous administration of 3-methylindole.

Intraruminal and intravenous administration of 3-methylindole (3MI; skatole) caused interstitial pulmonary edema and emphysema in cattle. In 3 adult heifers given the intraruminal dose of 0.2 g of 3 MI per kilogram of body weight, clinical signs of respiratory disease appeared between 6 and 12 hours after dosing, and death due to pulmonary edema and emphysema occurred at 33, 69, and 72 hours. The mean plasma concentration of 3MI became maximal (18.5 mug/ml) at 3 hours and then decreased to low concentrations by 48 hours. In 2 heifers given an intraruminal dose of 0.1 g of 3MI/kg, clinical signs developed, but they did not die during the 96-hour experiment. The mean plasma concentration of 3 MI became maximal (16.8 mug/ml) at 3 hours and decreased to 1.6 and 0.4 mug/ml at 12 and 36 hours, respectively. At necropsy of the heifers, the lung were large, firm, dark red, and heavier than normal. Diffuse pulmonary edema was the predominant change in cattle which died early, and interstitial emphysema was more severe at later stages of the disease. During the early stages, alveoli were overdistended, and a few more ruptured. Most alveolar spaces were filled with proteinaceous residue, but the alveolar septums were smooth and of normal thickness. At later stages, proliferation of alveolar cells was observed, and alveolar septums were thickened. In 3 cows given 0.06 g of 3MI/kg by jugular infusion, clinical signs appeared in all cows, and 1 cow died of pulmonary edema and emphysema 56 hours after the infusion was started. Severe pulmonary lesions seen in all of the cows given a 3MI infusion were similar to those in the cows given an intraruminal dose of 3MI. The mean plasma concentration of 3MI increased to 10.7 mug/ml at 9 hours after starting the infusion and decreased to 0.5 mug/ml at 18 hours. The results indicate that 3MI, a product of ruminal tryptophan fermentation, can cause pulmonary edema and interstitial emphysema in cattle and support the hypothesis that 3MI is the causative agent in tryptophan-induced pulmonary disease.     

Chronic obstructive pulmonary disease in a dog

Chronic obstructive pulmonary disease was diagnosed in a 3-year-old Basset Hound that was referred to the hospital because of respiratory distress. Results of radiography, bronchoscopy, and pulmonary function tests indicated lung hyperinflation, airflow restriction, and loss of elastic recoil of the lungs. Because of the poor response to treatment, the dog was euthanatized. Postmortem findings revealed emphysema, bronchiectasis, and bronchitis, which comprise chronic obstructive pulmonary disease.     

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.     

Chronic idiopathic pulmonary fibrosis in five dogs

Five dogs presented with chronic and progressive pulmonary illness characterized by progressive dyspnea, exercise intolerance, and significant inspiratory crackles on auscultation. Radiographically, there was a widespread and diffuse interstitial lung pattern with varying degrees of bronchial involvement. Histopathological changes included thickened alveolar septa, interstitial fibrosis, and pneumocyte hyperplasia. Based on the clinical, radiographic, and histopathological changes, a diagnosis of idiopathic pulmonary fibrosis was made. Idiopathic pulmonary fibrosis is a chronic disease characterized by inflammation and fibrosis of the pulmonary interstitium and peripheral airspaces, which has been poorly characterized in the dog.     

RADIOGRAPHY REVIEW: THE VASCULAR AND BRONCHIAL PATTERNS OF PULMONARY DISEASE

Pulmonary blood vessels account for the majority of radiographically visible structures in normal lung. The vascular pattern of pulmonary disease is characterized by changes in vessel size, shape, contour. Changes in size can be classified as hypo vasularity (decreased size) or hyper vascularity (increased size). The pulmonary arteries and veins may be affected separately or simultaneously. In normal lung, the bronchial structures peripheral to the hilar area are not seen clearly. The bronchial pattern of pulmonary disease is characterized by alteractions in bronchial wall thickness and dinsity, or in bronchial lumen diameter. Mixtures of the four lung patterns, i.e. , alveolar, interstitial, bronchial, and vascular, occur frequently. The lung radiographic pattern in an individual animal depends not only on the disease process present, but also on the stage of the disease during which they are radiographed.     

Idiopathic pulmonary fibrosis in a Staffordshire bull terrier with hypothyroidism

Radiographic evidence of chronic interstitial lung changes, usually believed to be attributable to lung fibrosis, is readily recognised in canine practice. Furthermore, there is a body of anecdotal evidence suggesting that a specific clinical entity consistent with chronic lung fibrosis occurs in specific breeds of terrier dogs. However, there is little pathological data to confirm these radiographic and clinical findings and, therefore, chronic interstitial lung disease of dogs is poorly characterised. In this report, a case of chronic pulmonary fibrosis is described in which histopathological confirmation was possible, and suggested that the condition might be analogous to idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis) in humans.     

PULMONARY ACTINOMYCOSIS IN A DOG

A six-year-old spayed female mixed-breed dog was evaluated for coughing, dyspnea, exercise intolerance, and intermittent fever of four month's duration. Extensive alveolar, interstitial, and peribroncial infiltration was observed throughout the lung fields, Pulmonary actinomycosis was diagnosed by isolation of Actinomyces from anaerobic cuture of a transtracheal aspirate. Therapy for Actinomycs resulted in clinical remission; however, radiographic evidence of a severe pulmonary pathologic condition remained 45 days after the initiation of therapy. The dog was asymptomatic for pulmonary disease two years following treatment.     

COMPUTED TOMOGRAPHIC CHANGES ASSOCIATED WITH THE PREPATENT AND EARLY PATENT PHASE OF DIROFILARIASIS IN AN EXPERIMENTALLY INFECTED DOG

Evolution of pulmonary arterial and parenchymal changes as assessed with computed tomography (CT) is described in a dog experimentally infected with Dirofilaria immitis. The dog was imaged 125, 168, 216, and 402 days after infection. Initial changes during the prepatent phase of infection included enlargement of the peripheral caudal lobar pulmonary arteries and intermittent periarterial interstitial infiltrates. The changes were progressive, involving additional arteries over time, but remained mild. With the presence of adult filariae a filling defect was observed in the caudal lobar pulmonary artery using CT angiography. Recognizing thoracic CT findings associated with the prepatent phase of canine heartworm infection may be important in endemic areas.     

Chronic pulmonary interstitial fibrosis in a blue-fronted Amazon parrot (Amazona aestiva aestiva)

A 30-yr-old blue-fronted Amazon parrot (Amazon aestiva aestiva) was presented to the clinic with a history of sneezing more often during the last 2 mo. Physical examination revealed only a mild nasal discharge. Complete hematologic and plasma biochemical examination showed no abnormalities. Computerized tomography (CT) of the complete bird showed generalized lung alterations consistent with lung fibrosis. Two lung biopsies were taken. The results of the histologic examination of the biopsies confirmed the tentative CT diagnosis of pulmonary interstitial fibrosis. To our knowledge this is the first reported case of chronic pulmonary interstitial fibrosis diagnosed by means of a lung biopsy in an avian species. The histologic characteristics are discussed and compared with those of human idiopathic pulmonary fibrosis.     

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.     

Chronic respiratory disease in the dog.

This paper describes the essential features of the conditions causing chronic respiratory disease in the dog including: chronic bronchitis, bronchiectasis, primary and secondary lung tumours, filaroidiasis, actino-mycotic infections and tuberculosis. Epidemiology, diagnostic clinical signs and methods of treatment are emphasized. A consideration of hypertrophic pulmonary osteoarthropathy is included since it frequently occurs in conjunction with chronic respiratory disease and may be a useful diagnostic marker.     

Bronchoalveolar lavage affects computed tomographic and radiographic characteristics of the lungs in healthy dogs

Bronchoalveolar lavage is a common diagnostic test for dogs with suspected pulmonary disease, however there is no published information on whether this procedure could affect the imaging characteristics of the lungs. Aims of this prospective experimental study were to describe computed tomography (CT) and radiographic features of the lungs after bronchoalveolar lavage in a sample of healthy dogs. Thoracic CT and radiographic images of eight healthy Beagles were acquired at the following time points: before bronchoalveolar lavage, immediately following bronchoalveolar lavage, and at 2, 4, 8, 12, and 24 h following bronchoalveolar lavage. Lung consolidation or interstitial patterns were seen in CT and radiographic images immediately after the procedure. Radiographic lung patterns resolved within 2 h and CT patterns resolved within 24 h. Resolution of the CT pulmonary patterns in the ventral areas of the lungs was delayed compared to the dorsal areas. Mean CT imaging scores differed over time (P < 0.001), while mean radiographic imaging scores did not differ over time. This study suggests that thoracic radiography and CT imaging assessments should precede bronchoalveolar lavage procedures if possible, or be performed at least 24 h afterward.