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Thoracic Foxtail Foreign Body in 4-year-Old Intact Male Labrador: Our Case Of the Month December 2020

Patient Information

Age
4 Years
Gender
Male, Intact
Species
Canine

Keywords

Blood Chemistry

Clinical Signs

CBC

Images

Enlarged, BPH prostate.
Slightly enlarged spleen with micronodular changes.
Prominent mesenteric lymph node.
Pleural effusion.
Foxtail.

Ninja move pays off after a check of the right auricle was done following an unremarkable abdominal ultrasound on a 4-year-old dog. A special thank you to Dr. Kris Willlaman from South Willamette Veterinary Clinic in Creswell, Oregon for the wonderful management of this case and Heidi Putnam from Animal Sounds NW for her ninja ultrasound skills!

History

A 4-year-old intact male labrador retriever was presented for depression, weight loss, intermittent vomiting bile, decreased appetite, and greenish, mucoid ocular discharge. Blood work revealed mild leukocytosis and mild hyperglobulinemia.

Image Interpretation

The prostate was uniformly enlarged with lobar swelling appearing to impinge upon the urethra and mildly deviate the descending colon. The spleen was slightly enlarged with minor scalloping contour. The mesenteric lymph nodes were mildly enlarged. The length to width ratio was maintained and measured 2.0 x 1.0 cm. Rapid view of the heart revealed no evidence of pathology. The extracardiac space revealed a 5.0 cm lung consolidation with regional pleural effusion. A 1.5 cm linear structure was noted in the lung field.

DX

BPH prostate. Enlarged, scalloping spleen. Mesenteric lymphadenopathy. Foxtail foreign body suspected in lung. Lung necrosis and pleuritis is suspected.

Outcome

CT evaluation of the chest would be ideal. Ultrasound-guided FNA of the pleural effusion and area of the lung is recommended to ensure that this is not a neoplastic presentation. FNA of the spleen would also be warranted to assess for splenitis. There may be multiple issues in this patient including suspected fox tail; however, underlying neoplasia is a potential. Sampling and CT evaluation +/- thoracotomy would be warranted. The patient was transferred to a specialty facility for surgical removal of the foxtail and concurrent lung lobectomy. The patient recovered and is doing well.

Videos

BPH prostate.
Foxtail foreign body.
SDEP® ECHO position 3, right auricle view with extra cardiac space showing pleural effusion and lung consolidation.