Opinion on chest X-ray please

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 13 Oct 2016 17:17:05 GMT

[quote user="Mike Martin"]

Sorry for your loss.

I could not PM my own dog when died with a heart defect either. So I understand.

Strange cases can be frustrating too.

Best wishes

[/quote]Thank you for taking the time Mike , I very much appreciated being able to ask for opinions from colleagues. I find it very supportive being part of this vet community.

RE: Opinion on chest X-ray please

Mike Martin — Thu, 13 Oct 2016 17:13:27 GMT

Sorry for your loss.

I could not PM my own dog when died with a heart defect either. So I understand.

Strange cases can be frustrating too.

Best wishes

RE: Opinion on chest X-ray please

Hannah Wynne Richards — Tue, 11 Oct 2016 08:54:19 GMT

I'm so sorry - devstating, especially coming so soon.

Wynne

RE: Opinion on chest X-ray please

Virginia Campbell — Mon, 10 Oct 2016 22:20:39 GMT

Sorry to hear about your dog Clare. I remember you posting about the horse too. I hope for better times for the rest of your four legged friends now.

RE: Opinion on chest X-ray please

mariette asselbergs — Mon, 10 Oct 2016 19:51:56 GMT

So sorry to hear that. You always feel almost extra helpless as an ex-clinician when your own animals get ill. All the best

Mariette

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Mon, 10 Oct 2016 19:19:10 GMT

Just to bring you up to date on this case , my dog Gnasher . Stable for five days then very sudden onset collapse, all signs of hypovolaemic shock but no abdominal bleeding on abdomenal tap. in view of all her other problems with severe arthritis and bilateral carpal collapse opted for PTS. Couldn't face PM , sorry

Correct decision I'm convinced but frustrating as still not entirely sure of diagnosis. can only assume drastic reduction in cardiac output so must have been heart. It's been a bad year , lost two dogs and a horse. Things can only get better

RE: Opinion on chest X-ray please

grumpyoldman — Sun, 25 Sep 2016 11:37:41 GMT

Maybe worth an ultrasound guided FNA of the splenic mass . Not always what they seem ,we had a splenitis recently . Also revisit the Right Atrium .

RE: Opinion on chest X-ray please

Hannah Wynne Richards — Sat, 24 Sep 2016 10:19:48 GMT

Don't apologise. I can't think straight when it's one of my beloved animals..............and the prospect of losing them is hell.

Wynne

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Sat, 24 Sep 2016 09:17:29 GMT

Thanks everyone for comments on and off list. Gnasher is much more comfortable and I'm going back in Monday for reassessment. It's challenging when all your animals become geriatric at the same time and I apologise for being a repeat offender seeking advice.

RE: Opinion on chest X-ray please

ruths — Fri, 23 Sep 2016 21:21:02 GMT

I thought there was a generalised bronchial pattern on both X-rays tbh

agree with everyone else re the Pcv - I think it's a ventricular dysrhythmia with gastric and it splenic issues

RE: Opinion on chest X-ray please

Thomas Johnson — Fri, 23 Sep 2016 15:01:54 GMT

[quote user="Clare Tapsfield-Wright"]I thought the same re the trachea. I will ask for repeat bloods on Monday. She's brighter today and eating but my neoplasia antennae on the back of my neck are on high alert [/quote]

What position was the head in for the lateral views? If the neck is a bit flexed it can cause the trachea to look like that.

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Fri, 23 Sep 2016 14:39:37 GMT

[quote user="Bob Russell"]

I would be watching that mass in the spleen. Any bleed may be uncomfortable and dogs are nearly as good as cats at masking where it hurts. As I have pancreatitis on the brain, would probably be inclined to check for that as well.

Depresses me when I look at an X-rays and see an obvious 'abnormality' that turns out to be normal! I would have said heart was normal size but definitely would have suspected something was pushing up the trachea. Hey-ho!

Sorry unable to help!

[/quote]me too , I thought the same re the trachea. I will ask for repeat bloods on Monday. She's brighter today and eating but my neoplasia antennae on the back of my neck are on high alert

RE: Opinion on chest X-ray please

vs0u — Fri, 23 Sep 2016 11:38:24 GMT

PCV I mean oops

RE: Opinion on chest X-ray please

vs0u — Fri, 23 Sep 2016 11:38:06 GMT

Can splenic masses sometimes make the heart do weird things? Saw a case once where I was convinced it had a heart problem and turned out to be due to splenic tumour.

Is PVC low end of normal or well within range?

RE: Opinion on chest X-ray please

Bob Russell — Fri, 23 Sep 2016 10:59:20 GMT

Sorry unable to help!

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 22 Sep 2016 22:41:41 GMT

The heart sounds are definitely not muffled. Lurcher so I can see her heart beat. Pulse deficit and dysrhythmia was present before sedation this morning. She is eating, drinking etc but definitely not A happy dog. Thanks for asking Silvio

RE: Opinion on chest X-ray please

Silvia Maldonado — Thu, 22 Sep 2016 21:38:18 GMT

I guess that a muffled heart would have been obvious on auscultation... Even in a deep chest dog? I'm asking

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 22 Sep 2016 19:00:44 GMT

Thank you Mike , that's very helpful.I am in a slightly odd situation as a client attending what used to be my own practice but the vet concerned was very happy for me to ask our colleagues upon this list for their opinions.

RE: Opinion on chest X-ray please

Mike Martin — Thu, 22 Sep 2016 17:22:35 GMT

I think the heart looks normal on the lateral. It does look big on the VD, but I think I see some narrow chested breeds were this is a normal-variant, more so on a VD view than a DV view (maybe the heart falls back to be silhouetted larger). I'm not convinced by a mass under the trachea, there is a reasonably normal mediastinum for me. But one cannot be certain with ultrasound - but doing chest ultrasound would be low on my priority list. The heart block under Domitor is the Domitor.

I presume there was no abdominal fluid on the abdo scan with the splenic mass? Might be worth a repeat haematology 2 days after the first to screen for blood loss?

The arrow on your the 3rd rad added, shows fat between the two cranial lung lobes, the left lobe reaches more cranially than the right.

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 22 Sep 2016 17:20:48 GMT

[quote user="Hannah Wynne Richards"]

Heart very enlarged on DV view, and also looks globular on lat.

What's it like on aucsultation?

Wynne

[/quote]no murmur but very dysrhythmic apparently. On ECG runs of P waves without QRS following. Heart block no signs of congestive hear failure, no cough, no fainting. I though heart looked larger than normal but other vet who knows more than me thought not markedly.

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 22 Sep 2016 17:11:58 GMT

The vet measured it and it was a normal sized heart , I was In the room but am not practising. I will upload another view as it might be the photo .

RE: Opinion on chest X-ray please

Hannah Wynne Richards — Thu, 22 Sep 2016 17:09:05 GMT

Heart very enlarged on DV view, and also looks globular on lat.

What's it like on aucsultation?

Wynne

RE: Opinion on chest X-ray please

Anthony Dennison — Thu, 22 Sep 2016 17:01:37 GMT

That cardiac silhouette seems very enlarged, did you pop the ultrasound probe on the chest to check for a pericardial effusion?

RE: Opinion on chest X-ray please

Clare Tapsfield-Wright — Thu, 22 Sep 2016 16:25:18 GMT

Twelve year old female lurcher bitch, my own dog, two episodes of complete inappetance and reluctance to move though not collapsed, rapid heart beat, pulse rate rapid, tacky mucus membranes but no pallor or cyanosis. Thought it was pain as has severe arthritis both carpi after poor repair of fractures before I adopted her. Has had increased exercise recently since arrival of new pup. Is on metacam long term . Apparent response to tramadol first time , within twenty four hours was back to normal but recurred five days later.

Today Xray under sedation, possible mediastinal mass pushing trachea dorsally ? ECG reveals heart block , was under Dom and torb at time , bloods all within normal parameters, no anaemia. Ultrasound scan of abdomen revealed discrete splenic mass but no evidence of metastasis in liver.

Any comments grateful received , sorry about poor quality photos taken on my phone while I was at the surgery