5-year-old intact female Mixed Breed

History of having a heart murmur since a puppy (never diagnosed or treated) but now lethargic, weak, and inappetant for 48 hours

  • a triangular-shaped, bone density foreign object in the region of the mid-thoracic esophagus
  • generalized cardiomegaly; the cardiac silhouette is taller than normal and the left atrium is enlarged
  • “bumps” on the VD view indicating enlargements of the main pulmonary artery, aortic arch, and left auricular appendage
  • overall increased pulmonary vasculature (“hypervascular” pattern/over-circulation)
  • Esophageal foreign body, explaining the recent lethargy, weakness, inappetance
  • Patent ductus arteriosus with left to right shunting
  • Echocardiography
  • Endoscopy to evaluate esophagus and remove FB; points were not deducted for esophagram to confirm esophageal FB, but candidate was expected to discuss benefits/disadvantages of iodinated vs. barium contrast agents if esophagram was recommended