Case Studies In Small Animal

Cardiovascular Medicine

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Case 24

Recheck examination 2.5 months later

At the time of reexamination, Nitro was feeling great. The owners were delighted with his progress and his physical examination was essentially normal. Thoracic radiographs were repeated. Unfortunately, two small lesions in the cranial lung lobes were noted that were highly suggestive of metastatic disease (the easiest one to see is between the second and third ribs, just above the costochondral junctions).

An abdominal ultrasound exam revealed no abnormalities. Chemotherapy was again discussed with the owners but again they declined.

Follow-up telephone conversation

The owners told Dr. Adin that Nitro died about a month after his last examination at the VMTH. He was doing very well and then acutely became paraparetic. The following day he became dyspneic and died soon after. No post mortem examination was performed. However, it is reasonable to speculate that a metastatic lesion in Nitro's spinal cord acutely bled, causing his paraparesis.

Below are post mortem pictures from another dog with a right atrial hemangiosarcoma and the more common evidence of metastatic lesions in its lungs.

Mark D. Kittleson, D.V.M., Ph.D. All rights reserved.