Tonight we had some good thorax cases, including one of a 3 year old cat that was missing for three months, and turned up dyspneic. The thoracic radiographs showed an increased soft tissue opacity throughout the lungs. The pattern was mixed, with a prominent bronchial component and multiple ill-defined cavitary lesions. Just to confuse things, the heart was enlarged.
The trick with presenting an oral case is to try to address all of the problems and tie them together if possible. The differential diagnoses for the lung pattern included the “o” diseases (toxo, crypto, histo), parasitic causes, and pneumonia or severe asthma. The cardiomegaly also had to be addressed, and could have been cardiomyopathy with atypical appearing pulmonary edema, or a second problem. Several of the emeriti felt that any type of cavitary lesion is likely to be fungal or parasitic. The young age of the cat and lack of hyperinflation also made the fungal and parasitic causes more likely. The answer? Aelurostrongylus (lungworm) infection. The heart disease was incidental.
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