Canine-Thorax : A case of uremic pneumonia in a bitch with a pyometra

Labrador retriever intact female 9-year-old dog presented for an acute onset of lethargy, vomiting and polyuro-polydipsie. On clinical exam, the patient demonstrates abdominal pain and distension, as well as dyspnea. Her last heat was 1.5 month ago. Abdominal ultrasound showed a pyometra. In order to investigate the dyspnea, chest xrays were performed.
Radiographic examination of the thorax in right lateral and ventrodorsal projections.
We notice a severe diffuse peribronchic opacification of the lung. No other radiographic abnormality detected.
Given the anamnesis, these radiographic signs are consistent with a uremic pneumonia, which is an uncommon complication of pyometra. It is linked to the acute renal failure and belongs to the group of “non-cardiogenic edema” or “acute respiratory distress syndrome”. The lung field should regain its normal radiographic appearance when the renal failure is stopped. The common pitfall with this uremic pneumonia is to misunderstand that the peribronchic opacification corresponds to micro-nodules and metastatic disease.
The radiographic signs are similar with those previously described in case “canine thorax 6”.