interstitial lung disease

• Interstitial pulmonary fibrosis typically presents in West Highland White Terrier and other terriers (Staffordshire Bull Terrier) that are middle-aged or older. The history will describe an insidious onset and can include…

  • Chronic breathlessness which is slowly progressive
  • Coughing can be a feature
  • Exercise intolerance
  • The owner may notice cyanosis
  • Syncope

  The clinical examination will often reveal crackles throughout the lung fields and a prolonged expiratory phase with expiratory effort
• diagnosis of IPF…

  • Thoracic radiographs
  • generalised interstitial lung pattern
  • +/-right sided cardiomegaly secondary to pulmonary hypertension. (pulmonary hypertension means that the R side ventricle has to work harder and hence becomes enlarged)
  • CT (method of choice in humans)
  • Typical ground glass appearance –diffuse increase opacity without loss appearance of blood vessels.
  • Bronchoscopy
  • BAL samples are either normal or show low cellularity, this rules out other inflammatory conditions –primarily CB

  However, lung biopsy is the only method of definitive diagnosis.
• Treatment of IPF can be split into five groups. The prognosis of IPF is guarded as it is a progressive disease. Long-term palliation of clinical signs may be possible with combination therapy.

  A) symptomatic

  B) bronchodilator

  C) corticosteroids

  D) immunosuppressive

  E) phosphodiesterase

  
• Severe subacute multifocal to coalescing interstitial pneumonia. This is uncommon and isn't diagnosed until post-mortem of animals that have died due to acute respiratory difficulty. The disease affects the interstitium – to some extent, the alveoli and airways are relatively spared.
• Metastatic disease can be incidental finding (e.g. imaging the chest prior to mammary tumour removal) or present with cough/ tachypnoea.

  • It can even be the first an owner knows about animal having cancer.

  The most common neoplasia include osteosarcomas, hemangiosarcoma, thyroid carcinoma and melanoma of the mucocutaneous junction.
• When imaging the lung be sure to take both laterals as you can miss tumours in the lung. If the tumour is on the R, when the animal is placed in R lateral this lung collapses and will not be seen on the image