Fibrosing alveolitis and pulmonary arterial hypertension in a West Highland White Terrier

Haematology and biochemistry screens were also performed as a baseline prior to drug therapy and revealed a sole mild elevation of alkaline phosphatase. The BAL showed chronic active bronchitis characterised by mixed inflammatory cell population (macrophages, small numbers of neutrophils, reactive small lymphocytes and rare mast cells). There was no evidence of inhaled foreign material or parasites. Culture of the fluid was negative. Pending BAL results Angus improved on a combination of theophylline (Corvental D, Novartis) 200 μg q 24h and doxycycline (Ronaxan, Merial) 120 mg q 24h. CASE Angus was a nine year old male neutered West Highland White Terrier who presented with a history of progressively increasing panting and coughing on exercise/excitement. On examination, resting respiratory rate and effort were very slightly increased. Cardiac auscultation revealed no heart murmurs, a heart rate of 90 beats per minute and an obvious respiratory sinus arrhythmia. The most dramatic findings were very harsh inspiratory and expiratory crackles over all lung fields, loudest towards the hilus. There was also an intermittent, occasionally productive, cough. Although the presentation was consistent with fibrosing alveolitis, further investigation was strongly advised because frequent coughing does not, typically, accompany simple fibrosis unless there is concomitant small airway disease (Corcoran et al., 1999). Angus was anaesthetised for a CT scan of his chest. This showed a generalised increase in soft tissue density with a ground glass appearance and obvious dilation and thickening of some of the major airways (Fig. 1). Overall these findings were consistent with pulmonary interstitial disease (fibrosis) and Clive M Elwood MA VetMB MSc PhD MRCVS CertSAC Dip ACVIM Dip ECVIM Nathaniel T Whitley BVMS PhD MRCVS CertVC Dip ACVIM Dip ECVIM DAVIES VETERINARY SPECIALISTS LIMITED MANOR FARM BUSINESS PARK HIGHAM GOBION HERTS SG5 3HR Fibrosing alveolitis and pulmonary arterial hypertension in a West Highland White Terrier