Signalment & History
A 9 year old MN mixed breed dog presents with a acute history of cough and exercise intolerance. On physical examination, there is crackling lung sounds cranially, on the right side.
Findings
There is an area of increased soft tissue opacity mainly on the ventral aspect of the right cranial lung lobe. This is an example of an alveolar pulmonary pattern. Some of the features of this pattern include: Indefinition of the pulmonary vessels, air bronchograms, lobar sign, and (in this case, discrete) border effacement of the lobar opacification with the cardiac silhouette. Remember: It does not have to have all these features to be considered an alveolar pattern!
Diagnosis
Your findings now include: increased soft tissue pulmonary opacity within the right cranial lung lobe, with presence of indefinition of the pulmonary vessels, air bronchograms, lobar sign, and (in this case, discrete) border effacement of the lobar opacification with the cardiac silhouette. This represents an alveolar pulmonary pattern, which, in this case, is mainly ventral. Aspiration pneumonias are usually ventral, due to gravitational forces. This also goes along with the acute clinical signs.
Conclusions
Some causes of aspiration pneumonia
- Regurgitation and vomiting, especially if esophageal dilation is present;
- Iatrogenic aspiration: force feeding, medication, anesthesia and oral administration of contrast medium;
- Swallowing disorders;
- Weakness and debilitation;
- Cleft palate;
- Tracheo-esophageal or broncho-esophageal fistula.
References
Dennis, Kirberger, Barr, Wrigley: Handbook of Small Animal Radiology and Ultrasound, 2nd ed., 2010
