X Ray on chest

One of our poms was set up for spaying and removal of a small lump we found next to one of her teats. When they did the X-Rays they cancelled the whole thing due to they considering there's a risk of cancer in her lungs. We have been waiting on the oncologist for two days now but she's just out of office and I would appreciate other's opinions. We have consulted 2 other vets who have both agreed simultaneously that is not nodules. Our local vet seems to be very slow in giving us any directives of what this is. She is a 4yo Pomeranian Thank you.

Hello.   I'm a bit confused what's going on with all these vets.  Who were the other vets that you consulted in the 2 days since the radiographs were taken (I wish I could get good quality second opinions that quickly)?  Presumably they were professional enough to get the permission of and radiographs / history from  the first vet before reading the radiographs for you.  If this has happened, you might want to clarify with the first vet that you still want the referral to go ahead, because if another vets had called me for consent to give an opinion on a case, I might not proceed any further with the referral I was already arranging, at least until I'd gad it confirmed whether you wanted me to act on your behalf or not.

It is normal for vets to conttact one another for permission before reading radiographs and as you know from having read our Ts and Cs, we are not referral vets and in no permission to give out second opinions on this forum. Your vet can look at the radiographs in close detail, has the full context and history of the case and any decisions they make are likely to be more to the point than mine.  This vet has already stated an intention to get a second opinion elsewhere, which they ought to be in the process of arranging.  After two days, I think it's reasonable to call the receptionist, explain that you are waiting for a call about a referral and ask how long you can reasonably expect it to take before you have any news.  That way, if there has been any confusion, your vet is reminded that you are still waiting for a referral.  Furthermore, the vets can help to set your expectations as to when you can expect to know anything.

To my understanding, it is extremely difficult to give a reliable answer as to the presence or absence of chest mets from a radiograph.  For this reason, a referral for further testing or imaging may be a good idea.   I am always encouraged when vets seek higher advice about a case - it implies that they are interested in getting things right for you and your animal.  Best of luck moving forward with thid case - please will you let us know how you get on?

Hi Liz The issue here I had my vet had no idea and asked someone else who never really got back to us. Seems there is a 'change of opacity' in Luna's right lung which needs further investigation. She is booked in for a CT scan on Wednesdat next week then have to way a week for answers My vet finally did say its not necessarily cancer which have given me a tad of hope but I'm still worried sick. When Luna was younger, 2021 she had a serious pseudomonas pneumonia infection which almost killed her..So I'm hopeful the change in opacity (what does that even mean?) is possible scar tissue or damage to her lung. She has zero symptoms of any of this either! Cheers

Hello - I also have my fingers crossed that there's a good outcome for Luna.  Opacity is difficulty is seeing through something - eg when looking through a window, one usually expects to be able to see through to the other side, but some windows are frosted and therefore more opaque.  An opacity in the lungs on a radiograph is usually an area that the x-rays didn't pass through so easily, probably because there was something in the way.  X-rays usually pass through lung tissue easily, turning the film black.  When there is sonething in the way - a fluid or soft tissue lump - this looks white on the film.  So patches of lung tend to show up too white, as 'opacities,' but it doesnt explain what the opacity - the stuff innthe way of the x-ray beam - actually is.  Does that help?

Things that cause opacities in the lung fields include fluid, inflammation, cancers, infection, even foreign bodies or on occasion loops of intestine from the abdomen (diaphragmatic hernia).  The shape usually gives a few clues, but its hard to tell between one roundish opacity (cancer) and another (eg infection) from the shape alone;  context and biopsy are important.

Yeah thats the thing, I guess because she has a 1cm mammary lump that is seemingly being ignored I guess the vet wonders if the opacity change is mets or cancer in her right lung. Can scarring also cause opacity changes? She did have a pseudomonas pneumonia 2 years ago that almost killed her. She had breathing difficulties and ended up in the vets having a throat scrape and all the gunk sucked from her trachea. A throat culture showed it was some very rare pseudomonas variant of pneumonia that's transmitted in soil apparently!

Update on Luna CT Scan showed mild atelectasis from the GA..No nodules or anything sinister anywhere. No mets or swollen lymph nodes. The changes in the lungs on the x-ray matched the atelectasis during the GA for the scan. Shes finally had her spay and nodulecemey and now on the road to recovery.