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Do radiographic changes of lower airway disease in cats correlate with clinical signs?

JVIM 2023 -37(6): 2443–2452

Author

Obi Veterinary Education
December 29, 2023

Background: Feline lower airway disease (FLAD) is a common condition that causes respiratory signs in cats. It is often associated with radiographic abnormalities, such as bronchial and interstitial patterns, pulmonary hyperinflation, and lobar atelectasis.

Study: The aim of this study was to evaluate whether radiographic changes in cats with FLAD improve with individualized treatment and correlate with clinical signs. The study included 24 cats with FLAD, diagnosed based on medical history, clinical signs, and bronchoalveolar lavage fluid (BALF) examination.

Methods: The cats were examined at two time points (days 0 and 60), and assigned a 12-point clinical score and a 10-point radiographic score. The cats received individualized treatment, consisting of systemic and/or inhaled glucocorticoids, with or without bronchodilators. The clinical and radiographic scores were compared statistically and evaluated for correlation.

Results: The results showed significant improvement in both clinical and radiographic variables during the study period. However, no clinically relevant correlation was found between the improvement of clinical and radiographic findings. The percentage of neutrophils in BALF correlated with the total clinical score, auscultation findings, and severity of bronchial pattern on day 0.

Limitations: The study had some limitations, such as the lack of a standardized treatment protocol, the subjective interpretation of radiographs by a single radiologist, and the absence of a second BALF examination on day 60.

Conclusions: The study concluded that, in addition to clinical signs, repeated radiographic examination can be used to assess treatment response in cats with FLAD. However, differences exist in how clinical and radiographic variables improve in cats with FLAD undergoing treatment.

Lateral (A, C) and ventrodorsal (B, D) thoracic radiographs of a cat, demonstrating improvement in radiographic abnormalities. (A, B) Radiographs at presentation (day 0) show a marked generalized bronchial and unstructured interstitial pattern with a focal caudal dorsal alveolar infiltrate (circle) and pulmonary hyperinflation. The total radiographic score was 8. (C, D) On recheck radiographs (day 60), the bronchial and unstructured interstitial pattern are decreased in severity and is now considered moderate. The focal alveolar pattern is no longer visible. Pulmonary hyperinflation persists. The total radiographic score was 5. During the radiographic examination, the cat was unsedated, which did not always allow for optimal positioning.

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