C09990743 / invoice 10000

chest rads

radiographs:

tracheal measurments:
widest (at cervical vertebrae) 9.7mm
narrowest (thoracic inlet): 6.69mm

normal variation = < 25% reduction in diameter 
25% = 7.28mm should be the minimum diameter
32% variation therfore is grade 1 (mild tracheal collpase) - can be incidental finding or normal variation in some breeds however given history could be clinically significant. Best practice would be flouroscope or tracheal scope. 

Lungs:
mild to miderate focal lung opacities  in caudal dorsal lung lobes - bronchial lung pattern. 
 - DDX;
- bronchitis 
- allergic bronchitis 
- canine infectious respiratory disease complex 
less likely:
- bacterial infection
- mycoplasmal infecion
- pulmonary parasites. 

Heart: 
VHS 10.2 (normal) 
VLAS 1.88 (normal) 

vessel width appears normal

ASSESSMENT:
low grade tracheal collapse and mild caudodoral bronchitis
suspicious of allergic cause (environmental or autonomic) 
can't rule out infectious
doesn't appear to be cardiogenic 

TX;
bronchodiators (neulin): 20mg/kg SID (100mg) 
antihistamines: iramine tabs (half 4mg tab BID) 
low dose steroids short course.5mg tabs (half BID for 3 days then HALF once daily for 7 days then HALF EOD) 

coughing
been off/on - more today



Verified: NO

HISTORY
Presenting for: Tansii, a 5.5 year old female dog presented for coughing that was particularly severe this morning with attempts to bring up phlegm, and also occurs at night sometimes.
Diet: Primary diet consists of Coles chicken (cooked chicken and sometimes raw or cooked meats), occasional egg, dry kibble available constantly which she eats including at 2am, not primarily a dog food dog
V/D/C/S: Coughing episodes particularly severe this morning with attempts to expectorate, also occurs at night, described as a hack with distinctive sound at the end
Skin: Constipation noted, anal area protrusion observed when cleaning faecal matter from fur, scooting behaviour, difficulty defecating noted over weekend in Cairns
Other: Air conditioning used most nights, recent construction work with sawdust exposure from cutting wood and windows, waterproofing work ongoing, builders and tradespeople frequently in home

EXAM
Wt: 5.9 kg
Behavioural: Cooperative during examination
Rectal: Anal glands expressed - significant impaction present bilaterally, malodorous discharge expressed, no infection present

ASSESSMENT
Collapsing trachea - Most likely cause of coughing episodes based on characteristic hack sound, particularly common in smaller dogs, exacerbated by potential sawdust irritation from construction work
Anal gland impaction - Bilateral impaction with significant accumulation, likely contributing to scooting behaviour and constipation issues

PLAN
Diagnostics:
- Sedated chest radiographs scheduled for Thursday 5th at 8am to evaluate tracheal collapse and assess for heart enlargement or other thoracic abnormalities
- Fasting required from 9pm Wednesday night, water allowed until presentation

New Meds/Tx:
- Children's Panadol liquid (paracetamol 100mg/mL) 0.6mL Monday, Tuesday and Wednesday afternoons for anti-inflammatory effect and cough suppression
- Steam therapy recommended - have dog in steamy bathroom during showers to help clear potential mucous from dust accumulation

Additional Discussion:
- Anal gland recheck in one month, can be performed by nurse initially
- Discussed potential for antitussive medication or inhaler therapy depending on radiograph results
- Construction dust exposure likely contributing to coughing episodes
- Explained anal gland anatomy and expression mechanism, risk of abscess formation if left untreated
- Discussed relationship between stool consistency and anal gland expression

stitches out

Looks good

Results given