Thoracic CT incidental pulmonary bullae in dogs: Characterization, interobserver variability, and general anesthesia risks

Won Suk Kim, Michael Ward, Elizabeth Huynh, Lynn Griffin, Jin Heo, Arathi Vinayak

Background: Pulmonary bullae are air-filled spaces within the lung that can rupture and cause spontaneous pneumothorax, a life-threatening condition. The characteristics and implications of incidental bullae in dogs are not well known.

Study: The authors conducted a retrospective study of 74 dogs that had incidental bullae detected on thoracic CT scans performed for non-pneumothorax related reasons. They analyzed the number, size, location, and wall thickness of the bullae, as well as the interobserver agreement among three radiologists and the anesthesia risks associated with the bullae.

Methods: The authors reviewed the medical records and CT images of the dogs and collected data on signalment, weight, concurrent pulmonary disease, number of anesthesia procedures, and adverse anesthesia events. They also measured the bullae characteristics on the CT images and calculated the correlation coefficients among the radiologists.

Results: The authors found that incidental bullae were more common in older, large-breed dogs, with no sex predilection. Most dogs had a solitary bulla of less than 1 cm in size, with no preference for a particular lung lobe. There was strong agreement among the radiologists for the number, size, and location of the bullae, but weak agreement for the wall thickness. There was no association between the type or number of bullae and the presence of concurrent pulmonary disease. There were no adverse anesthesia events reported in the dogs with incidental bullae, even in those that underwent repeated anesthesia procedures.

Limitations: The authors acknowledged the limitations of the retrospective design, the lack of surgical or necropsy confirmation of the bullae, the subjective assessment of the wall thickness, and the incomplete medical records of some dogs.

Conclusions: The authors concluded that incidental pulmonary bullae in dogs are not associated with adverse anesthesia events and do not require preventive treatment. They suggested that further studies are needed to evaluate the long-term outcomes and the histopathologic features of these lesions.

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