# A High Number of Ring-Down Artefacts and an Irregular Pleural Surface Are More Commonly Observed in WHWTs Suffering from Idiopathic Pulmonary Fibrosis Compared to Control WHWTs

## TL;DR

This study shows that thoracic ultrasound can help identify West Highland white terriers with idiopathic pulmonary fibrosis by detecting specific lung abnormalities.

## Contribution

The study introduces a non-invasive ultrasound-based method to differentiate CIPF-affected WHWTs from healthy ones.

## Key findings

- CIPF WHWTs showed significantly higher overall ultrasound scores compared to controls.
- A cut-off of 15 ring-down artefacts predicted CIPF with 76.5% sensitivity and 80% specificity.
- Irregular pleural surfaces and ring-down artefacts were more common in CIPF WHWTs.

## Abstract

Canine idiopathic pulmonary fibrosis is an interstitial lung disease reported in West Highland white terriers. Thoracic CT is part of the diagnosis of idiopathic fibrosis in human patients and dogs. However, some patients are presented for acute dyspnoea, preventing a CT scan from being performed under general anaesthesia. Thoracic ultrasound is used in human medicine as an adjunct tool for interstitial lung disease, including idiopathic pulmonary fibrosis. In veterinary medicine, thoracic B-mode US has been described for the diagnosis of various pulmonary diseases. The aim of this study was to describe the thoracic ultrasound findings in West Highland white terriers suffering from canine idiopathic pulmonary fibrosis, compared with presumably exempted West Highland white terriers. The presence of pulmonary lesions was higher in West Highland white terriers suffering from canine idiopathic pulmonary fibrosis compared to the presumably exempted group. Thoracic ultrasound is a non-invasive and well-tolerated tool that helps to differentiate West Highland white terriers with or without canine idiopathic pulmonary fibrosis.

Canine idiopathic pulmonary fibrosis (CIPF) is an interstitial lung disease reported in West Highland white terriers (WHWTs). B-mode ultrasonography (US) is used in human medicine as an adjunct tool for interstitial lung disease, including idiopathic pulmonary fibrosis. In veterinary medicine, thoracic US has been described as helpful for the diagnosis of various pulmonary diseases. The aim of this study was to describe the thoracic B-mode US findings in CIPF WHWTs, compared with those in control WHWTs. Twenty-seven WHWTs, including CIPF and control WHWTs, were prospectively enrolled. Standardised thoracic B-mode US was performed. The presence of an irregular pleural surface, ring-down artefact and peripheral nodules was assessed and scored for each location. An overall cumulative score was calculated by adding the individual scores of each location. WHWTs affected with CIPF had significantly higher overall scores compared to the control group. The ring-down artefact score was significantly higher in the CIPF group compared to the control group. No preferential location for the lesions was observed. A cut-off value of 15 ring-down artefacts for the entire thorax predicted CIPF in WHWTs with a sensitivity of 76.5% and a specificity of 80% (AUC 0.815). The present study describes B-mode US findings in CIPF WHWTs.