Here is the Radiology report.
HISTORY:
PATIENT RECENTLY ARRIVED FROM OKLAHOMA, WAS PART OF BREEDING COLONY. UPON ARRIVAL, OVER LAST MONTH, NEW OWNERS STATE PATIENT HAS COUGHING (INTERMITTENT) WITH INTERMITTENT VOMITING AS WELL. ON PE, PATIENT HAS EAR MITES, BLOOD WORK TO RULE OUT HW DISEASE PENDING, PATIENT HAS DRY HAIRCOAT. NO HEART MURMUR AUSCULTATED AT THIS TIME
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WHOLE BODY March 29, 2015: Orthogonal projections are available for review (3 views).
FINDINGS: Moderate generalized cardiomegaly is present. The caudal lobar pulmonary vessels are moderately enlarged and tortuous. There is a soft tissue opacity identified cranial and ventral to the heart on the lateral projections, caudal to the region of the sternal lymph nodes. A moderate diffuse bronchial pattern is present. The right middle lung lobe is collapsed. The included osseous structures are normal.
The liver is moderately enlarged, extending beyond the costal arch. The spleen is moderately enlarged. The kidneys and urinary bladder are normal. There is an ovoid soft tissue opacity present in the left caudal abdomen on the VD projection that could represent a colonic mural mass or represents fluid in the colon/overlying intestines. The small intestines are normal in diameter. There is mild decreased serosal detail secondary to crowding from the organomegaly. The mamillae are prominent.
CONCLUSIONS:
Moderate cardiomegaly and enlargement of the pulmonary arteries are most likely secondary to heartworm disease or less likely pulmonary hypertension. Less likely, this could represent a cardiomyopathy (hypertrophic, restrictive, unclassified, or dilated) with early heart failure.
Moderate hepatosplenomegaly, equivocal colonic mural mass, and sternal lymphadenopathy may represent neoplasia, such as lymphoma or mast cell tumor. Alternatively, these could represent non-hyperplastic processes of inflammatory or infectious etiologies or separate processes such as congestion of the spleen from sedation, hepatic lipidosis involving the liver, and fluid in the colon or overlying small intestine.
Moderate diffuse bronchial pattern may represent bronchitis of inflammatory (asthma, idiopathic) or infectious (lungworm, mycoplasma, bacterial, heartworm) etiologies. Atelectasis of the right luminal lung lobe is likely secondary to mucous plug formation.
RECOMMENDATIONS: If further evaluation of the soft tissue opacity in the left caudal abdomen, the liver and the spleen are desired, an abdominal ultrasound is recommended. A thoracic ultrasound could also be considered for the soft tissue opacity identified cranial ventral to the heart. Fine-needle aspirates should also be considered given the potential for neoplasia. If further evaluation of the heart is desired or if the heartworm test is normal, an echocardiogram would be recommended.
Recommended medical management for feline bronchial disease (asthma) or a BAL or transtracheal wash, with cytology, culture, and sensitivity pending the results of the above tests. A baermann fecal could also be considered to evaluate for potential infectious causes.
If you have any questions or if this report does not correlate with your clinical impression, please do not hesitate to contact me directly at
dawn-brumfield@idexx.com (preferred) or 1-888-RADVETS to discuss the case. I greatly appreciate any follow-up on cases. This contact information is for veterinarian use only please. Thank you.
