Chest X-ray
Examination of the lungs, heart, trachea and oesophagus in a dog or cat with a cough, breathing difficulty or cancer. Three views, assessment on site, supplemented with a heart ultrasound if needed.
What it involves
A chest X-ray shows the lungs, the outline of the heart and great vessels, the trachea, oesophagus, diaphragm and the bones of the chest. It is the first-choice examination in animals with cough or breathlessness, because within minutes it establishes whether the problem involves the lungs, the heart, the airways or the pleural cavity.
We usually take it in three views — on the right side, the left side, and on the back or belly — because some changes in the lungs are visible in only one of them. This is particularly important when looking for tumour metastases, where missing a small nodule changes treatment decisions.
X-ray assesses the size and shape of the heart, but not how it functions or its valves — that is what echocardiography is for. That is why, when the heart outline is enlarged, we recommend adding an echo examination, which we also perform on site.
When it is used
We perform the examination for chronic or sudden cough, rapid or laboured breathing, exercise intolerance, a heart murmur, after chest injuries, when pneumonia is suspected, and when assessing the stage of a cancer (looking for metastases) before an oncological procedure.
It is also part of the pre-anaesthetic assessment in older, brachycephalic and cardiac patients, and of monitoring treatment — for example, of heart failure or pneumonia.
Indications: symptoms that should prompt a visit
- A dog has been coughing for more than two weeks, especially at night or after exertion.
- A cat breathes quickly and shallowly at rest, with its mouth open or with obvious abdominal effort.
- An animal tires more quickly on walks, stops or sits down.
- The veterinarian has heard a heart murmur or an irregular rhythm.
- A cat or dog has been hit by a vehicle, has fallen from a height or has been bitten in the chest area.
- A dog has a diagnosed tumour (for example, a mast cell tumour or mammary tumour) and surgery is planned — the lungs need to be checked.
- A dog has choked or aspirated and since then has had a fever and a cough.
Conditions for which we use it in particular
Diagnostics beforehand
The examination requires no preparation. We start with a clinical examination, listening to the heart and lungs; in a patient with breathlessness we first give oxygen and stabilise, and take images only when it is safe — in a cat with severe breathlessness lying on its back can be dangerous, so we limit ourselves to the lateral view or first perform a quick ultrasound scan of the chest.
Depending on the findings, we add echocardiography, ECG, a blood count and blood biochemistry, or bronchoscopy with bronchoalveolar lavage, when the cause of the cough requires material for testing.
How it proceeds
We place the animal in turn on both sides and on its back or belly; staff wearing protective clothing hold it gently, and we take the image at the moment of inhalation so that the lungs are well filled with air. In the vast majority of patients it is done without sedation; in very restless or painful animals we use light sedation after assessment. The examination takes 10–15 minutes.
The veterinarian assesses the images straight away — measures the heart outline, evaluates the lung pattern, the vessels, trachea and oesophagus — and goes through the result with you. You receive the images in digital form. Where changes call for a second opinion, we send them to a radiologist; when looking for metastases, we compare the images with those from subsequent check-ups.
Aftercare
After an examination without sedation there are no restrictions. We go through the result and the plan at the same visit: treatment, further tests, or a follow-up X-ray after 1–3 weeks if we are assessing how well therapy is working (for example, for pneumonia).
Call immediately if, while you are waiting for the check-up, the animal's breathing clearly worsens, the gums turn blue-tinged, or a cat starts to breathe with its mouth open — this is an emergency.
Frequently asked questions
Why three images rather than one?
The lung on the side the animal is lying on is less well aerated, and changes in it can disappear from the image. Three views minimise the risk of missing something — especially important when looking for metastases.
Is an X-ray enough to assess the heart?
X-ray shows the size and shape of the heart and the effects of heart disease in the lungs. The function of the valves and the heart muscle is assessed by echocardiography — if the outline is abnormal, we recommend both examinations.
A cat is breathing with difficulty — is an X-ray safe?
A cat struggling to breathe is a very fragile patient. We first give oxygen, calm the cat and perform a quick ultrasound scan, and take an X-ray in limited views when its condition allows. Call before you set off.
Will every metastasis be visible on the image?
No — X-ray detects nodules from a few millimetres in size; if smaller lesions are suspected, the veterinarian will discuss the next steps in diagnosis.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Do you have questions about chest X-ray?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.