Abnormal cat x-rays

Breed: DSH, Age: 7 months, Sex: Female/unnuetered, Weight: 2.4 Kg I need your help. I live in a west Asian country. My cat was rescued as a stray when she was 2 months old. A month ago, her ability to exercise started to decrease slowly and gradually, and her resting breathing rate began to increase. One vet ordered chest x-rays. After doing the images, he gave me a diagnosis, but I've decided to ask for a second opinion just to make sure he was right, but then it became a third and fourth opinion, because each vet saw something different in the images. I don't know what to do now and which vet is right, so I need your help with those x-rays. I'm not asking for a differential diagnosis, because I now how hard is this over the internet. What am asking for is to confirm some findings in those x-rays. Thanks in advance, and any help is greatly appreciated. My questions:

• How clear are the images?
• Do the images confirm or rule out pulmonary edema?
• Do the images confirm or rule out pleural effusion?
• Is the heart enlarged?
• Do you see anything abnormal about her abdomen?

  AP view:

Hello!  I'm afraid that it is generally seen as inappropriate to give unasked for second opinions on another vet's radiographs and that most vets, having taken these radiographs, would have relatively clear answers to some of the questions you ask.  I am surprised to see human hands on the picture as the human would have been inappropriately exposed to x-ray radiation and certainly in the UK, such images would almost never be taken. For me to attempt to diagnose this cat in this manner would be seen as unprofessional.  However based on the picture, I  do strongly reccommend that the cat and the radiograph are presented to a vet for assessment and treatment as soon as possible.  

I reread the part of your post about the third and fourth opinions;  are you getting these from different vets at different surgeries, or online, or different individuals within one practice?  If the vet is unable to offer a diagnosis, they can usually offer an opinion and explanation as to what the best thing is to do next.  After all, the pets' safety in the immediate future is the most important thing.

Whichever vet you stick with, it pays to explain the other vets' findings to them or (its late in the UK) the emergency vets, in order that they can be sure they are not missing something.

Thank you very much for taking time to read and answer my post. I'm sure you got a bad first impression of me, but please let me clarify a few things. First, my country is so poor and undeveloped. It's classified as a third world country. I can provide you with a proof that I live in it if you want to. Most vets here are young and underexperienced (a symptom of brain drain). The range of available veterinary drugs is very limited, there's no cat's specific blood tests, and x-rays is the most advanced medical modality available for small animals (there's no CT or echo). Additionally, there's no emergency clinics, and even the most basic therapies like oxygen therapy is unavailable for animals.

Second, the vets didn't have clear answers to my questions.  All vets had  conflicting views. The first vet said that the images show fluid accumulation in the lungs (edema), while the second vet insisted that lung tissue are healthy and there are no signs of fluids or infiltrates. Another vet said that the lungs are good but the heart is slightly enlarged, which is something that the first vet didn't mention, while the second ruled it out. You see how confusing the situation is!

"are you getting these from different vets at different surgeries, or online, or different individuals within one practice? " All opinions were got from "certified vets" in my city. There are no veterinary specializations in my country, that is, vets here are responsible for everything from general treatments, to surgery and radiography.

"what the best thing is to do next." The problem is that every vets suggested a different course of treatment. The vet who ruled out heart and lung disease ordered blood tests. Another vet suggested a course of corticosteroid and antibiotic. The third vet prescribed "Prednisolone" for a vet, while the fourth vet recommended giving the cat "Furosemide" and a medication for heart disease. Can you believe it?

Lastly, I'm not sure if this is a case of emergency or not (I wish it's not). I don't know if this reassuring a bit or not, but the cat, although suffering from the former symptoms, is healthy otherwise. Her appetite is very good, she's drinking a normal amount of water and passing a proportional amount of urine. She's not lethargic at all, not oversleeping, and still wants to play as usual. Additionaly, a week ago, her situation has stabilized and is not getting any worse. You're my cat's only hope. She's paying the price for being born in the worse part of the world. I resorted to online forums out just because I had no other choices left. I know that this is unprofessional and inappropriate, but what would you do if you were in my shoes? Thanks again.

As I explained, we cannot comment on these radiographs.  However I disagree that a person on the Internet in a different country is your cat's only hope.  Unless an animal is eating, drinking, urinating, deafecating and breathing normally, they need reliable, continued medical care from a vet.  I do not know the system for choosing veterinary care in your country but I understand from your messages that you do not trust the care you have been offered and that your cat remains ill. I wonder if your current vet will work with you to send the radiographs away for a professionally-obtained second opinion - this can now be done quickly, online, via specialists. Best of luck.

I'm sorry for saying that your only my hope. I think I got a little bit emotional. Anyway, my point was that local vets had conflicting opinions that are mutually exclusive and this prevents me from knowing whom to trust, and that seeking foreign opinion from a medically advanced country might be the only viable option.

"I wonder if your current vet will work with you to send the radiographs away for a professionally-obtained second opinion - this can now be done quickly, online, via specialists." Forget about my current vet for a moment. Could you please name any website, medical center, or vet that offer this service online? I'm looking for paid professional service.

This is a UK site.  In the UK, it is seen as inappropriate to take a referral that does not come from the patient's own vet.  The vet would then set up a video consult with the necessary team eg emergency experts specialists etc.   This may be different where you are (and if you find out that it is I am keen to know), but as far as I am aware, is not done the way you suggest in the UK.   Of course you could always contact UK specialist Hospitals (you want a medical / emergency specialist) and ask if - or how - they would take such a referral, then pay your first opinion vet to arrange it.   The Vet schools may be able to  help you or suggest someone for example.  Best of Luck.

The situation here is galaxies away from whay you might imagine. It's rare to find someone, vet or otherwise, who can hold a conversation in English, yet to be able to set up a video consult (including me). Anyway, I think you did every thing you could for me. I really, really appreciate you taking the time to write these replays. It means a lot for me and my cat. Thanks a lot for everything and for your suggestions. I'll try to contact hospitals and schools to see if they can help.

Hello Dr. Buchanan. I managed to get an assessment of the radiographs from a veterinary radiologist using a US-based teleradiology service. According to him, the lungs, heart, and vessels looks good and withing normal limits. However, in your first reply, you said that "based on the picture, I do strongly reccommend that the cat and the radiograph are presented to a vet for assessment and treatment as soon as possible. " I know that you won't comment on the pictures, but your "based on the picture" worried me, so do you recommend consulting another radiologist? Do you think that this one missed something (no need to name what he missed)?