Something Is Just Not Right

About a month ago, an 8 yr old very sweet Husky came in after getting into the garbage. He was acting a bit off but not too ill. The only thing I found on his exam was that he had some mild pain when I palpated his abdomen. We ran some basic diagnostics on him: an abdominal radiograph and some blood work. It was all normal. So we treated him for gastroenteritis and sent him home. He soon recovered and was back to normal. 


I saw him last week for his semi-annual senior wellness exam and a few vaccines. He was doing and looking great.


Then on Monday, he came in and was again, "not right" - but this time, there was no history of garbage ingestion or other dietary indiscretion. He was pretty normal on physical exam. He was acting very much like his he was during his bout the prior month but given that it had recurred, we set him up for an ultrasound later in the week.  In the meantime, we put him back on the medications that had helped him before.  


However, this time, by the next day, he seemed worse. He was restless and panting. He has a wonderful and astute owner so I knew if she was concerned, we should be concerned. I had her bring him in and our plan was to repeat an abdominal radiograph and my boss would come in and ultrasound him later in the day.  Well, the radiograph was non remarkable but I figured we should take a chest rad too. Why not? 


So we did and got this:

The problem here is that the heart (the white "object" in the center of the black areas - lung fields) is not contacting the sternum. There should not be a space there. There are only a few reasons this happens: trauma which can cause bleeding and/or pneumothorax (not the case with this dog), fluid, infection or a mass of some type.  You can actually see the edges of the lung lobes on either side of this gap. 


Other than an elevated heart rate, this dog's chest sounded just fine!


I don't know what it is. The dog is going to a specialist tomorrow for a continued workup. Ultrasounding this area is difficult at best unless you are very experienced in it. He may require an MRI or CT scan, etc. In any case, I will let you know when I find out. 


I am also planning on updating a few other cases I had posted about in earlier blogs - some surgical cases that I finally have pathology back on! So keep reading!


Thanks!!