This week we had a great mix of large and small animal cases.
Case 1 – Mature dog with history of vomiting.
There was a soft tissue opacity structure in the pylorus and duodenum on the v/d and left lateral projection. The descending duodenum was dilated and plicated in the right cranial abdomen. Several loops of small intestine appeared enlarged with plication and angular gas bubbles. Everyone thought this was a linear foreign body obstruction. There was some debate as to whether requesting an ultrasound was appropriate. There was certainly enough evidence of obstruction to send the dog straight to surgery. However, ultrasound could help with prognosis and surgical planning by detecting focal effusion or gas indicating GI rupture, and sampling fluid if it existed.
Key points to diagnosing linear foreign body:
- Focal dilation of small intestine with plication and angular gas bubbles
- Foreign body lodged in the pylorus acting as an anchor -surrounded by gas on the left lateral projection
Case 2 – 9 year old German Shepherd Dog with coughing
On this thoracic series, there was a mixed pulmonary pattern throughout the lungs with a strong bronchial component. The right middle lobe was affected with an ill-defined alveolar pattern causing a lobar sign. Differentials included metastatic carcinoma (primary lung or distant), hemangiosarcoma, infectious/inflammatory disease, and pulmonary edema. Diagnosis – pulmonary carcinoma (R middle lobe) with pulmonary metastasis. Carcinomas of many types can cause diffuse metastasis in the lung. It tends to have a more bronchointerstitial pattern. Primary carcinomas can also appear as diffuse lobar disease rather than a well-defined mass.
Case 3 – 1 year old Thoroughbred filly 3/5 lame on the right front limb which blocks to a PD.
On radiographs of the fetlock, there was an osseous cyst-like lesion in the distal medulla of P2. On the dorsoproximal-palmarodistal oblique projection, the cyst was superimposed on the navicular bone. You needed to check on the dp and lateral projections to make sure that the cyst was not in the navicular bone itself.
Case 4 – Unknown age gelding with head swelling.
On these skull radiographs, there was increased soft tissue surrounding the skull without a mass effect. There was no alveolar bone surrounding the tooth roots, nor was there any cortical bone in any bone of the skull. The teeth were much more opaque than the rest of the skull. Differentials included primary and secondary hyperparathyroidism with fibrous osteodystrophy. Diagnosis – nutritional secondary hyperthyroidism caused by an imbalance of calcium and phosphorus. This horse was fed an all-bran diet, which is high in phosphorus. Tip – stand back from the radiographs to see the difference in opacity between the bones and the teeth.
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