A case in 4 sentences!
High five to any students able to follow this, if you have anything to add feel free to contribute!
1: 12 year old scottish terrier has a 3 month history of coughing, you examine and find laboured breathing on expiration (dyspnoea), and a grade 3 heart murmur (systolic left apical).
2: Given the lack of systemic signs, no abnormal (adventitious) lung sounds and a heart murmur, top of our list of different diseases (differentials) is compression of bronchus due to atrial enlargement or chronic bronchitis.
3: X-rays show a slight enlargement of the left atrium with lung patterns (bronchointerstitial), a slight enlargement should not induce a cough and although the lung patterns can be consistent with ageing the coughing suggests a chronic bronchitis.
4: Treatment of bronchitis involved elimination of airborne pollutants, cough suppression using an anti-tussives and a bronchodilator inhalers.