Presentation
One episode of acute onset collapse. Inability to support himself on the hind limbs and disorientation.
Patient Data
There is severe generalized cardiomegaly with dorsal deviation of the trachea on the lateral projection. The cardiac enlargement and mild rotational position on the d/v has caused the cardiac apex to shift to the right. There is a severe alveolar pattern present within the right caudal lung lobe, as well as air bronchograms indicating a milder alveolar pattern in the left cranial and left caudal lung lobes. The pulmonary vasculature is difficult to assess due to overlying alveolar infiltrates. Within the viewable abdomen, there is a small amount of foreign material within the stomach.
Case Discussion
Left heart failure with asymmetric pulmonary edema caused by advanced myxomatous mitral valve diesease. The severe generalized cardiomegaly is the main imaging sign. Differentials for this finding should include severe valvular disease or dilated cardiomyopathy. Alveolar pulmonary infiltrates are attributed to cardiogenic edema.
Eccentric jets in dogs with mitral valve disease may cause asymmetric pulmonary edema in approximately 1/3 of cases, usually worse on the right side.
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