Case Report
Extensive Dystrophic Pulmonary Calcification in a Welsh Pony Mare

https://doi.org/10.1016/j.jevs.2014.07.002Get rights and content

Highlights

  • A Welsh pony mare was evaluated for lethargy and increased inspiratory effort.

  • A presumptive diagnosis of extensive pulmonary mineralization was made.

  • The pony was euthanized because of progression of clinical signs after 7 months.

  • Autopsy confirmed extensive pulmonary dystrophic calcification.

Abstract

A 12-year-old Welsh pony mare was presented to the Ontario Veterinary College Teaching Hospital for signs of intermittent lethargy and increased abdominal breathing effort of 6 months duration. After physical examination, blood work, bronchoscopy, bronchoalveolar lavage, and diagnostic imaging of the thorax and attempted lung biopsy, pulmonary mineralization of unknown origin was suspected. The pony was treated palliative for 7 months with nonsteroidal anti-inflammatories and inhaled corticosteroids to treat accompanying airway inflammation before being euthanized because of poor prognosis and deterioration of clinical signs. On postmortem examination, the pulmonary architecture of the right and left cranioventral lung lobes, accessory lobe, and cranial potions of the left caudal lung lobe was replaced by hard mineralized tissue. No other organs other than a mediastinal lymph node and the lung were affected by mineralization. After decalcification, thick sheets of fibrous connective tissue organized into layers and lamellae replaced the normal architecture of the pulmonary parenchyma in more than 90% of the lung lobe examined on histopathology. The findings were consistent with generalized severe pulmonary fibrosis and dystrophic calcification.

Introduction

Dystrophic pulmonary calcification is a rare clinical syndrome associated with varying underlying disorders in humans, dogs, and horses. This case report describes a case of extensive generalized dystrophic pulmonary calcification involving both cranioventral lung lobes to an extent not reported before. No signs of neoplasia, previous respiratory disease, or metabolic disease were present.

Section snippets

Case Presentation

A 12-year-old Welsh pony mare was presented for a history of lethargy and increased respiratory effort. The pony was used as a show hunter up until the time of presentation. For 6 months before presentation, the pony began tiring easily when being ridden and intermittent increased abdominal effort during breathing was observed. No coughing or other signs were observed. Appetite and fecal output were normal. The referring veterinarian reported no abnormalities on repeated physical examination.

Discussion

Ectopic calcification, which is defined as inappropriate formation of mineral crystals in soft tissue, which normally do not mineralize, occurs as squeal to varying underlying disorders and is divided broadly into metastatic and dystrophic calcification. Deposition of calcium in dead or dying tissue is termed dystrophic calcification, whereas metastatic calcification is defined as mineralization as a sequel to an underlying abnormality in regulatory mechanisms that prevent and activate

Acknowledgments

The authors have no conflict of interest to declare. All authors declare that they contributed substantially to the acquisition of data of this case, drafting, and revising of the manuscript. All authors have read and approved the submission of the manuscript.

Submission declaration: The presented paper is original, has not been published previously (except in the form of an abstract or academic thesis), is not under consideration for publication elsewhere, and its publication is approved by all

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