This week at KCC we had some interesting and unusual cases. They were all on film, so I’m afraid there aren’t any radiographs to look at. Read the description and decide what you would do before reading the answer. In these types of cases, you aren’t expected to get “the answer” but to provide a logical analysis and appropriate differentials.
Mature domstic short hair cat with 3 week history of respiratory distress
Thoracic radiographs showed a flattened diaphragm and hyperlucent lungs. On the d/v projection, the ribs were nearly perpendicular to the spine and the diaphragm had scalloped edges. The esophagus was markedly dilated with air, as was the stomach and small intestine. These findings of hyperinflation and aerophagia suggested an upper airway obstruction so neck radiographs were requested. In the larynx, there was a soft tissue opacity mass that was responsible for the upper airway obstruction. Differential diagnoses included neoplasia (lymphoma, squamous cell carcinoma), granulomatous disease, and edema. Diagnosis: lymphoma.
9 month old domestic long hair cat with a heart murmur
The heart was markedly enlarged on both the lateral and d/v projections. The shape of the cardiac silhouette resembled a peanut with a waist between the enlarged atria and ventricles. The heart occupied more than 50% of the thorax on the d/v projection. The pulmonary arteries and veins were enlarged. On the edge of the radiograph, the fundus of the stomach was visible on the right side. Differential diagnoses included congenital heart disease such as vsd and abnormal valves, as well as PDA or VSD causing a left to right shunt. Secondary diagnosis: Situs inversus. Echocardiography revealed a single atrium and single ventricle with a VSD. Note: This type of case is not well diagnosed on radiographs beyond severe, congenital heart disease. Complex cardiac anomalies can be associated with situs inversus.
23 year old Morgan gelding with anorexia and weight loss
Thoracic ultrasound: There was marked echogenic pleural effusion with visible strands of the pericardial-diaphragmatic ligament. In the cranial thorax, there was a lobular mass with relatively uniform echogenicity. Differential diagnoses for the mass were neoplasia, most likely lymphoma, hemangiosarcoma, melanoma, or other neoplastic disease. Pleural fluid was non-diagnostic. A tissue sample was obtained by thoracoscopy. Diagnosis: anaplastic carcinoma.
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