Name: Marvin
Age: 2 years
Sex: Male, neutered
Breed: Feline, domestic short hair

Please review Marvin’s clinical history.

Two-day history of not eating and drinking, and hiding under the bed. The owners noticed that he has started to breathe more heavily in the past 24 hours.

View Marvin's right lateral radiograph View Marvin's ventrodorsal radiograph

Technical details
Location of images: Thoracic radiographs obtained.
Views of images: Right lateral view and ventrodorsal view.Radiographic findings
Technical issues: Exposure is good, positioning is acceptable.
Cardiac size including VHS: VHS 8.5 (moderate cardiomegaly), elongated cardiac silhouette on lateral view indicative of left ventricular enlargement. On VD view the left atrium appears to be enlarged.
Other findings: Alveolar infiltrates are present in the cranial ventral and caudal ventral pulmonary fields on the lateral view, and can be seen in the caudal fields bilaterally on the VD view. The pulmonary arteries and veins are enlarged, and a small amount of pleural effusion can be seen “outlining” the caudal dorsal lung lobes.

Radiographic interpretation: Probable congestive heart failure with pulmonary edema.
Discussion: The combination of cardiomegaly, alveolar infiltrates and enlargement of pulmonary arteries and veins in a dyspneic feline patient is suggestive of congestive heart failure. In the patient, only a small amount of pleural effusion is noted, but pleural effusion is a common finding in cats with congestive heart failure. Echocardiographic examination in this patient revealed the presence of hypertrophic cardiomyopathy.
Treatment/management: Immediate therapy with oxygen supplementation and parenteral furosemide resulted in clinical improvement in dyspnea within 2 hours. The patient was released from the hospital the following day receiving oral furosemide and enalapril for chronic management of congestive heart failure.