Dee, a 12 year old mongrel dog, was presented to us because his appetite had gradually reduced over the previous six weeks, and more recently his owners had noticed that he had developed a soft cough. His local vets had recommended a series of chest X-rays which unfortunately had shown that he had a tumour in one of his lung lobes. The rest of his lungs looked clear, so it was decided that he should see our soft tissue surgeons with the aim of having his tumour removed. Even though his lungs were otherwise clear on the X-rays taken at his local vets, we recommended that he have a CT scan done of his lungs before his surgery. This was primarily to help the surgeons plan the surgery, but also as a final check to make sure that the remainder of his lungs really were clear of any signs of cancer, as CT is a more sensitive means of detecting small lung lesions that traditional X-rays. Unfortunately, the CT scan showed metastases (sites of spread of the tumour) in his lungs that were not visible on the X-rays, and after discussing these findings with Dee’s owners, it was felt that he would not benefit from major chest surgery. Although an unfortunate outcome, the results obtained by performing the CT scan avoided Dee going through a difficult time that would not have been in his best interests, and allowed his owners to make the best informed decisions on his behalf.

 

 

The first CT scan image is a post-processing reformatted (computer reconstructed) image through the chest. The heart is the oval-shaped structure in the middle of the picture, and is surrounded by darker lungs. Small circular end-on airways (bronchi) can be seen scattered throughout the lung fields. To the left of the heart is a smaller round light grey structure with a small black hole in the middle of it. This is the lung mass that was visible on the vet’s X-rays, surrounding a bronchus. The second CT scan image is a slice through the lower part of the lungs (below the heart). Several round black structures with thin white walls around them can be seen within the lungs, and these represent bronchi. Unfortunately several solid white nodules with hazy white edges can be seen out towards the edges of the lungs on this (and other) images. These are areas of spread (metastatic nodules) from the larger tumour, which were not visible on the original X-rays.

 

 

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