Lung Disease with a Twist

“I’m sorry, but you need to take your dog to see a cancer specialist.” These are words no pet owner wants to hear, but despite their anguish about their beloved dog’s illness, Muneca’s (a name which means “pretty baby doll” in Spanish) family followed the recommendation of their primary care and emergency room veterinarians and brought the little poodle to be examined by the Oncology Service at The Animal Medical Center. This photo shows what a happy dog she was before her illness. Muneca’s story starts with a trip to her primary care veterinarian who, using an x-ray, discovered that fluid was accumulating around her lungs. Shortly after seeing her primary care veterinarian, Muneca’s appetite decreased and she had trouble breathing, so she was brought to the to the ER by her owners.

Emergency room visit
The ER doctors found Muneca had a blue tongue. She was not getting any oxygen into her bloodstream because the fluid surrounding her lungs prevented them from expanding. Carefully, the ER doctors administered a light sedative to allow nearly one liter of bloody fluid to be removed from around the lungs of this 25 pound tan poodle. Immediately she was her old self, but the ER doctors again recommended Muneca be examined by an oncologist.

A new diagnosis
Although cancer is a very common cause of fluid accumulation around the lungs, there are other causes. When I saw Muneca, another x-ray was taken to determine if the fluid had returned since it had been removed by the ER doctors. The fluid had returned, but when Dr. Anthony Fischetti, one of The AMC’s board certified radiologists, reviewed the new films with me, he saw something that intrigued him – bubbles of air trapped within the right middle lung lobe. Immediately he became optimistic that Muneca could be saved! The diagnosis was revised to lung lobe torsion. A lung lobe torsion is a rare disorder seen in dogs, cats and humans. The lung lobe twists around the bronchus, or air tube, and the blood vessels supplying the lung. This traps air and blood in the lung lobe, explaining the bubbles seen on the x-ray and the accumulation of fluid around the lungs. Fluid leaks out of the lung because the blood cannot exit though the twisted vessels.

Muneca recovering after surgery Muneca recovering after surgery

 

Major surgery
The treatment for a lung lobe torsion is surgery to remove the twisted lung lobe, but this is a major procedure. In Muneca’s case, The AMC provided more than just the diagnostic and surgical expertise. One of our Community Funds, the Patient Assistance Fund, covered the majority of the cost for Muneca’s surgery. Muneca’s surgeon, Dr. Janet Kovak, entered Muneca’s chest on the right side between the third and fourth ribs and removed the right middle lung lobe, which was swollen and adhered to the diaphragm. Muneca recovered rapidly and was discharged from the hospital to her happy and grateful family two days later. In the second photograph, you see her completely recovered and resting at home in her favorite spot.

A winning team
Muneca is just one patient example of why I love working at The AMC – it’s all about the team. Without The AMC team of specialists, that includes board certified radiologists and surgeons, Muneca would not be healthy once again and home with her family and what’s not to like about that!

Day at the Museum: The Animal Medical Center Sequel

The Animal Medical Center has a computer system to manage our diagnostic imaging, including x-rays, ultrasound, CT scans and MRIs. The Picture Archiving and Communications System (PACS) lists all the images for any given day. If you looked at the list for June 17, you would see my patient Dakota, who got a chest x-ray, Chippie, the dog who had a full series of dental x-rays, and BooBoo who had a brain MRI — a typical list for a Friday.

But reading down the list you get to Croc 1, Bird 2, Snake 3 and Ibis 4. These images come from the oldest patients ever seen at The AMC. No, not a 25 year old dog or a 30 year old cat. These 32 patients are 2,500 year old animal mummies.

Like many AMC patients, these animals came to The AMC across the Brooklyn Bridge into Manhattan. Unlike any other AMC patients, these patients belong to the Brooklyn Museum’s Egyptian collection.

Like all patients who come to The AMC, they came for our diagnostic expertise, utilizing our state of the art equipment. In this case, the animal mummies came to The AMC for CT scanning in our 64-slice CT scanner.

The AMC’s 64-slice CT scanner rapidly produces high quality images. So fast, all 32 were scanned in one day as outpatients! Rapid is better for our usual patients, since the faster the scan, the shorter the anesthesia time. For the animal mummies, the high quality images are critical in helping AMC’s board certified radiologist, Dr. Anthony Fischetti, collaborate with the curators from the Brooklyn Museum to decipher the mummy’s contents. The 64-slice CT scanner can recreate three dimensional and multiplanar images of the patient. In our usual patients, we use these features to better diagnose and treat illnesses. Our colleagues at the Brooklyn Museum plan to use the reconstructed CT images to study the mummies’ contents without disrupting the intricate linen wrapping.

If our CT scanner is so fast and can scan thirty two mummies in one day, you might wonder why your AMC veterinarian wanted your pet here all day when it had a CT scan. A CT scan in one of our usual patients requires administration of a short-acting anesthetic. Obviously, an animal mummy does not require anesthesia, the associated monitoring of the heart, respiration and blood pressure and does not have to recover from anesthesia. All these differences shorten the procedure time.

Most of our usual patients have two CT scans back to back. The first scan is before and the second is after administration of a contrast agent. The contrast agent highlights abnormalities the veterinarians are hunting for, such as inflammation and tumors. Administration of contrast was not possible or necessary in the animal mummies.

This animal mummy project between The Animal Medical Center and the Brooklyn Museum will culminate in an exhibition in 2013, so mark your calendars now!

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.