CT case report details bronchopericardial fistulas in a dog: full analysis
A case report newly published in Veterinary Radiology & Ultrasound details what the authors describe as the first reported CT findings of bronchopericardial fistulas in a dog. The case involved a 7-year-old Afghan Hound presented for fever, lethargy, and cough; thoracic CT identified multiple bronchopericardial fistulas arising from a secondary bronchus of the caudal subsegment of the left cranial lung lobe and extending to the pericardial space. After surgery, the dog recovered uneventfully, and follow-up ultrasound 2 weeks later showed no residual pericardial effusion. (lifescience.net)
What makes the report notable is how little comparable veterinary literature exists. Canine bronchial fistulas have been reported before, but mostly in other forms, such as bronchocutaneous, bronchopleural, and bronchoesophageal fistulas. A 2000 Veterinary Radiology & Ultrasound report described bronchocutaneous fistula in a dog and highlighted contrast-enhanced CT as useful for diagnosis and treatment planning, while a later report on bronchopleural fistulas in two dogs similarly emphasized CT's role in defining the communication and associated pulmonary changes. (pubmed.ncbi.nlm.nih.gov)
In this new case, the imaging findings appear to have been central to both diagnosis and management. Available publication summaries report that the fistulas measured up to 6.0 mm in diameter and were associated with disease in the left cranial lung lobe. Definitive treatment involved left cranial and partial left caudal lung lobectomies with subtotal pericardiectomy, after which the dog's clinical signs resolved. That combination suggests the lesion was not simply an incidental imaging finding, but a surgically actionable cause of cardiothoracic disease. (lifescience.net)
The broader clinical backdrop also matters. Although bronchopericardial fistula is rarely discussed in veterinary medicine, related canine reports show that septic pericardial disease and abnormal thoracic communications can arise from migrating foreign material or other destructive thoracic processes. For example, a Journal of Veterinary Cardiology case report described septic pericarditis and a pericardial abscess secondary to a migrating foreign body in a dog, and a more recent JAVMA case report documented successful subtotal pericardiectomy and epicardiectomy for septic pericarditis and constrictive epicarditis. Those reports don't describe bronchopericardial fistulas specifically, but they support the clinical importance of identifying unusual causes of pericardial infection or effusion early. (sciencedirect.com)
Direct outside commentary on this specific report was limited in public sources, which isn't unusual for a single veterinary imaging case report. Still, the available literature points in a consistent direction: when thoracic signs, pericardial abnormalities, and respiratory disease overlap, CT can reveal anatomic explanations that are difficult to confirm otherwise. Human literature also treats bronchopericardial fistula as an uncommon but serious condition, often linked to infection, surgery, or malignancy, underscoring why clear cross-sectional imaging matters when air or infection tracks into the pericardial space. (pubmed.ncbi.nlm.nih.gov)
Why it matters: For general practitioners, emergency clinicians, radiologists, cardiologists, and surgeons, this case is a reminder to keep rare bronchial-pericardial communications on the list when a dog presents with cough plus unexplained pericardial disease, especially if there are signs of infection, pneumopericardium, or focal left cranial lung pathology. It also strengthens the case for referral imaging in selected thoracic cases: CT didn't just confirm that something was wrong, it appears to have mapped the lesion well enough to support surgical planning. In practice, that's the difference between treating presumed pneumonia or idiopathic pericardial effusion and identifying a lesion that may require lobectomy and pericardiectomy. (lifescience.net)
What to watch: The next question is whether additional reports will show consistent causes, breed patterns, or imaging clues, and whether bronchopericardial fistulas are truly exceptionally rare in dogs or simply underrecognized without CT. For now, this report mainly gives clinicians a new diagnostic precedent, and a concrete reminder that unusual thoracic fistulas can sit behind familiar signs. (lifescience.net)