Maltese dog Lizzy, 5 months
Images courtesy of Tierklinik Hofheim. Dres Kessler, Kosfeld, Tassani-Prell, Bessmann, Rupp, Delfs, Schmohl, von Klopmann
Thin animal with with a body condition score (BCS) of 3/9. Expiratory lateral and inspiratory ventro-dorsal radiographs. The diaphragm is not clearly visible due to silhouetting with the pulmonary changes. The liver is of homogenous soft tissue opacity.
The caudo-ventral liver margin extends beyond the costal arch, the caudal end is not included on the radiograph.
The lung parenchyma is increased in opacity. The periphery of the lung, especially close to the diaphragm, shows a patchy, confluent soft tissue opacity. The lung vessels cannot be identified in these areas and airbronchogramms are present. Centrally the lung is less severely affected. Thick and ill-defined doughnuts and tramlines are present. However, faint airbronchogramms are also evident.
The bronchus for the cranial lung lobe is wide and tapers late, suggestive of dyspnoea.
Ribs 1-8 are parallel with large intercostal spaces compatible with dyspnoea. The lung lobes extend to rib 12 on the lateral and rib 11 on the DV.
- Peripheral alveolar infiltrates with a central broncho-alveolar lung pattern
- Ribs 1-8 are parallel with large intercostal spaces compatible with dyspnoea. The lung
lobes extend to rib 12 on the lateral and rib 11 on the DV, also compatible with dyspnea
The list of differential diagnoses for peripherally accentuated alveolar infiltrate is short and includes infection with Angiostrongylus vasorum and lung infarcts. Centrally, in the less severe affected areas, peribronchial infiltrate is present. The combination of peripheral alveolar and a central peribronchial infiltrate is highly suspicious for an infection with Angiostrongylus vasorum. Bronchial changes are not expected in a case of lung infarcts.
Fine needle aspirate of the lung confirmed infection with lung worms. Lissy was dewormed and showed a full recovery.