chest xray advice

RE: chest xray advice

Thomas Johnson — Wed, 18 Apr 2018 08:29:12 GMT

[quote user="Claire Godfrey"]Have always struggled to get inspiratory views....[/quote]

Over recent years I've started doing pretty much all of my chest radiographs under GA so I can do forced inspiratory views, the slight delay from pressing the button to taking the radiograph makes it so frustrating otherwise!

RE: chest xray advice

Claire Godfrey — Wed, 18 Apr 2018 06:34:17 GMT

Thanks Liz,

Will take that all on board.

Haematology was normal but was a month ago....

Think will suggest treating for lung worm and go from there.

RE: chest xray advice

Claire Godfrey — Wed, 18 Apr 2018 06:29:46 GMT

Thank you,

Have always struggled to get inspiratory views....

Haematology was run and normal. No coughing but owner says.not doing the running normally would. Did mention was making a honking noise about a year ago but this settled and has not done for some time.

Just always worry about border terriers, seem so stoic.

RE: chest xray advice

Liz Barton — Tue, 17 Apr 2018 21:53:59 GMT

Hi Claire

These radiographs are very difficult to interpret on here as there's so many interference lines, the views are inspiratory (diaphragm overlapping heart), and the DV is rotated and the spine isn't straight. Can't say enough how much more useful inflated views under GA are, but I know it's much harder to obtain them in practice.

DV: It does look a bit weird, but you may just be seeing outline of aorta on the right (as you look at it); this would be the dogs left obv (no primary markers so I presume this is where you mean). Maybe also some thin pleural fissure lines between left cranial lobe cranial/caudal parts, and R caudal mediastinum (can be normal in an older dog).

Lat: The arrow you've placed caudal to the heart base on the R lateral looks to me like composite shadow of caudal VC overlying rib. You're getting white out caudo-dorsal lung fields on the lateral, but I presume this is artefact from the photo as it extends outside the dog! The sternal contact is often increased in older dogs and definitely on inspiratory views. The heart itself is top end, but I would still think normal size; 3 to 3.5 rib spaces (though hard to make out cranial border), divergence of trachea from spine and VHS of 11 (top end normal).

Typical imager - blaming the quality! Could you get dicom images on here, or jpeg? It would be ideal to repeat them, and always take a left lateral too if you're at all unsure. Often things leap out on the contralateral.

Agree with others - treat for lungworm (were eosinophils wnl?). Next step could be trial NSAIDs provided colitis isn't flaring, pardale if it is; a lot of lethargic dogs seem to just be painful somewhere and respond to pain trails even if it can't be localised.

RE: chest xray advice

Julie Innes — Tue, 17 Apr 2018 21:37:29 GMT

Does your wellness profile include haematolology? If so, was it normal?

No cough or exercise intolerance? (Sorry, more questions than answers!)

If I have any doubts about the possibility of lungworm I generally just treat for it, cheaper and easier and quicker than getting a diagnosis, and no harm in it.

RE: chest xray advice

Niall Taylor — Tue, 17 Apr 2018 21:15:55 GMT

Hi Claire - the x-rays haven't come across very well but the heart seems very large to me on both views. Were they inspiratory shots? You might get more information if you could upload some jpegs.

Niall