INTERACTIVE RADIOGRAPHIC CASE STUDIES

 
 

MaurieCase Background

 
Name Maurie
Age 11 years
Sex Male, neutered
Breed Feline, domestic short hair
 

Please review Maurie's clinical history.

Patient was presented for acute onset of difficulty breathing. On physical examination, the patient was tachypneic, dyspneic and had a heart rate of 220 bpm with a regular rhythm and poor femoral pulses. Jugular distension was noted.

View Maurie's left lateral radiograph
View Maurie's dorsoventral radiograph  

TECHNICAL DETAILS

Location of images: Thoracic radiographs obtained.

Views of images: Left lateral view and dorsoventral (DV) views.

RADIOGRAPHIC FINDINGS

Technical issues: Both views have good positioning and good exposure.

Cardiac size including VHS: The cardiac silhouette is obscured by moderate to severe pleural effusion. Vertebral heart scale cannot be calculated, but the heart appears to be enlarged, especially on the lateral view.

Other Findings: The lung lobes are partially retracted and appear to be rounded, which may be an indication of pleural fibrosis.

 Radiographic Interpretation: Severe pleural effusion with evidence of chronicity. Probable congestive heart failure.

 Discussion: The orgin of pleural effusion can be challenging to identify based on thoracic radiographs alone. Cardiac size and shape, as well as pulmonary vessels, may be obscured by the effusion. Other differential diagnoses for this type of appearance on thoracic radiographs includeds chylothorax, pyothorax, or neoplastic effusions. In this cat, the presence of distended jugular veins on physical examination supports a cardiac origin for the effusion (i.e. congestive heart failure).
Treatment/Management: After thoracocentesis and stabilization, echocardiographic examination revealed restrictive cardiomyopathy. The rounded appearance of the lung lobes may reflect pleural fibrosis, and in this cat, likely indicates that the onset of effusion was more chronic than it appeared based on clinical signs. The cat responded well to chronic therapy with furosemide, benazepril and pimobendan.