Thoracic x ray interpretation

RE: Thoracic x ray interpretation

Danny cazabon — Mon, 21 Sep 2015 20:19:06 GMT

[quote user="David Mills"] nature of cough. Resp coughs are usually harsh, like KC.[/quote]

His cough would be a harsh sounding one.

Thanks, they are useful pointers.

Danielle

RE: Thoracic x ray interpretation

David Mills — Mon, 21 Sep 2015 17:49:57 GMT

[quote user="Danielle Dillon"]sinus tachycardia or sinus arrythmia[/quote]

Competing cardiac and resp disease can somewhat cancel each other out in dogs - the heart is pushing for tachycardia (sympathetic), the resp for bradycardic (vagal irritation, parasympathetic). 65bpm sounds lower for cardiac dz but is still possible.

Other pointers, no particular order:

- grade of murmur, usually 3+ for CHF

- nature of cough. Resp coughs are usually harsh, like KC. Often with significant lower airway disease can elicit a cough with trach pinch. Cardiac/oedema coughs are usually soft rather than hacking. Lungworm can, as ever, blur these lines as it tends IME to produce a soft cough (finger up the bum and spread on a smear is an inexpensive test).

RE: Thoracic x ray interpretation

Danny cazabon — Mon, 21 Sep 2015 17:33:55 GMT

Heart rate recorded at 65bpm, neither sinus tachycardia or sinus arrythmia present.

Unfortunately, owner could not afford too many radiographs and refused to do diagnostic bloods. I will definitely push for more radiographs after a couple of days on furosemide.

RE: Thoracic x ray interpretation

Danny cazabon — Mon, 21 Sep 2015 17:25:16 GMT

Thank you,

Danielle

RE: Thoracic x ray interpretation

Thomas Johnson — Mon, 21 Sep 2015 15:23:25 GMT

[quote user="Kate Richardson"]

Looks like pulmonary oedema to me. I don't think the heart is particularly small. I would treat with frusemide and pimobendan and assess response to this

[/quote]

I agree that the heart looks enlarged, particularly with increased sternal contact.

RE: Thoracic x ray interpretation

Robin Grimmer — Mon, 21 Sep 2015 13:36:26 GMT

I don't think you can really interpret this radiograph as it's expiratory and there is movement blur. Get some expiratory views (lateral and d/v) under GA. Is there sinus tachycardia as well as the heart murmur? This would indicate likely heart problem or is there a sinus arryythmia present? This would inidicate likely respiratory problem. A heart murmur in itself doesn't necessarily mean the heart is the cause of the cough.

RE: Thoracic x ray interpretation

David Mills — Mon, 21 Sep 2015 13:31:25 GMT

Cardiogenic oedema, likely expiratory phase film. LA is straight, alveolar pattern and whilst cant assess vasculature, suspect congestion. Frus/pimo and re-rad in 24-48h.

If cough longer standing likely some airway disease also. Current thinking (in some cardiologists) is that LA enalrgement alone is insufficient to cause cough, need to have underlying airway path too (makes physiological sense).

RE: Thoracic x ray interpretation

Kate Richardson — Mon, 21 Sep 2015 13:27:57 GMT

Looks like pulmonary oedema to me. I don't think the heart is particularly small. I would treat with frusemide and pimobendan and assess response to this