Can someone read these x rays?

[SASHA-]

Hi there,
My 4 year old ground squirrel is overweight and has had pneumonia/ a uri for a few weeks. I’ve posted a few times trying to figure out what’s going on. I got her an x ray at the vet after the antibiotics seemed to not be working to figure out what’s going on and the vet basically concluded she was too fat. I don’t think thats really explaining the lasting pneumonia and would appreciate a second opinion. She is currently on a diet to lose weight and getting extra calcium and vitamin c.

She is on baytril every 12 hours.

[SASHA-]

I should add she is a round tailed ground squirrel. A small squirrel from the desert

[SamtheSquirrel2018]

Hi there,
My 4 year old ground squirrel is overweight and has had pneumonia/ a uri for a few weeks. I’ve posted a few times trying to figure out what’s going on. I got her an x ray at the vet after the antibiotics seemed to not be working to figure out what’s going on and the vet basically concluded she was too fat. I don’t think thats really explaining the lasting pneumonia and would appreciate a second opinion. She is currently on a diet to lose weight and getting extra calcium and vitamin c.

She is on baytril every 12 hours.

Hi Sasha:
What is the name of your Squirrel?

First off; I am not a Veterinarian nor am I radiologist (a Vet or physician who specializes in interpreting x-ray studies) but I will offer my opinions for what they may be worth (hopefully a Vet will comment also) and I would like to ask some questions as well.

Performing x-ray studies on most animals can be very difficult because every x-ray study begins with ensuring that the animal is positioned optimally so that the x-ray beam will pass through the area of the body (such as the chest for evaluating for a possible pneumonia). Positioning is critical for any every x-ray procedure. Also, there cannot be any interference for other parts of the body such as the tail or a limb getting in the way of the x-ray beam and the animal must be positioned so that it is perfectly aligned with how the x-ray beam is to penetrate the region of the body in question!

Facilitating proper positioning usually requires that the Squirrel is sedated (usually with an inhaled anesthetic agent such as isoflurane) so that they are not moving during the procedure. Also, in almost every x-ray study, it is best to have a view taken of the area to be studied from at least two different directions. These are usually a lateral view which is taken from the side with the x-ray beam entering one side and exiting the Squirrel on the other side directly opposite to where it entered and the other is a Dorsoventral (DV) view or a Ventrodorsal (VD) view. With the DV view, the x-ray beam passes through the animal from the top and exits from the bottom and with the VD view, it just the opposite; the beam passes from the bottom and exits the top of the animal.

Nowadays, almost all x-ray studies are performed using digital technology which makes the technical aspects of interpreting the films optimal (assuming that the beam was directed through the area of the body in question and proper positioning had been accomplished). With digital films, the images can be enlarged while maintaining considerable detail, contrast can be varied, and the images are easily transmitted to others or kept in the medical records. When a digital film is transmitted; invariably it accompanied by a small program that permits the viewer to manipulate the images as if they were the one who took the original films!

This is all leading up to the problems with the films that you posted. I suspect that they are photos of the original images rather than uploaded digital films because the detail is not clear and is already pixilated to a significant degree even before any attempts are made to enlarge the images which immediately become pixilated to the extent that interpretation becomes very difficult and except possibly for a very obvious condition; its value for diagnosis in suboptimal. The VD or DV (the beam passes through the same region with either so it is not possible to tell which of the two views this is unless they are marked) does show the chest region but it is so pixilated that I would hesitate to make any comments about because it is just NOT of diagnostic quality. The other two views are even worse from a technical standpoint and my recommendation would be to try to see if you can actually upload the digital films for review. IF you have concerns about the Vet's interpretation, you can ask the Vet to send the films to a Veterinary Radiologist (it would necessitate another fee most likely).

Incidentally, the above is begging the question of what your Vet had to say about these films and what if anything they revealed to him!

I read you prior Thread on TSB about this Squirrel and I read on the medical records that the Vet recommended "a variety of nuts to promote nutrition" and diagnosed your Squirrel with "scurvy!" Scurvy is secondary to insufficient Vitamin C (ascorbic acid)! Most rodents do NOT require additional ascorbic acid in their diet as they make their own! I respectfully question the advice of adding nuts for "nutrition" and the diagnosis of scurvy! Some of the signs of scurvy are similar to the signs of Metabolic Bone Disease (MBD). MBD is quite common among captive Squirrels and it is cause by not enough Calcium, too much phosphorus or what is usually the case and that some of both! Nuts and other treats contain relatively high concentrations of phosphorus and a diet consisting of mostly nuts WILL result in MBD!

Please, describe your Squirrel's diet in detail! Is she getting any Blocks and if so, which ones! Also, please describe in detail what appears to be going on with your Squirrel (examples could be decreased appetite or decrease activity level to name just a couple of possibilities)? Does you Squirrel have an "always available" source of clean fresh water and if this is hanging bottle; is it functioning well and do you check this functioning at least daily?

Thank you so much for you care and love for this little Ground Squirrel!

Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
Thank you for taking the time to read through my previous posts. This is the only vet I’ve been able to find who will help and I’m a little concerned about the advise too. I’ve added some pumpkin seeds and almonds into her diet by the vet recommendation. Since she was young her diet has been of squirrel blocks with greens like dandelions, collard greens and broccoli and diffrent fruits like oranges grapes and apple. Her main diet does consist of Henry’s healthy squirrel blocks tho and she gets about one a day that she eats and usually enjoys. Since my last post I have been adding extra calcium to her diet with about 100 mg of time nightly. A few weeks ago I went into the emergency vet because my squirrel was breathing heavily and had some clicking noises. I’ve worked with small animals who had URIs and it seemed just like one. I got a weeks worth of tmz and went home with her. She was on that every 12 hours and she seemed better and the initial dose was finished. A few days later I go to a vet that takes exotics because she seems to be feeling sick again and I’m hearing clicking, she’s spending a lot of time in her bed and looks not well. They diagnose her with pneumonia and prescribe cephalexin for three weeks which I did. it didn’t seem to be doing anything other than lessen the heavy breathing and I was then told on here it wasn’t a good choice. The vet kept saying that baytril oral suspension was on back order which seems weird. I asked for it repeatedly and was able to get some pills crushed and mixed up into a oral suspension. So she is now on baytril every 12 hours and this is the second week currently. Her activity levels have seemed to rise. She is running on her wheel again and exploring out her cage. She is eating normally, when she was eating last week I would hear a lot of noise like crackling and gasping. The baytril does seem to be working but she still having issues. I still am hearing an occasional cracking in her lungs and when she is woken up she sounds wheezy as well as when she is sleeping. She has less sneezing but is still sneezing hear and there. She still has what looks to be heavy breathing. She does not have a waterbottle as she never really got the concept but has a fresh water bowl that’s always clean and she can always get too. Her name is baby

[Mel1959]

I’m not sure where you’re located, nor do I know the range of the mobile wildlife vet near L.A. The vets name is Dr. Cauble 818-242-5576. Maybe give a call and see if this vet is an option.

[SASHA-]

I’m currently located in Atlanta
Here are a few clearer images of it helps at all.

[SamtheSquirrel2018]

Hi Sam,
Thank you for taking the time to read through my previous posts. This is the only vet I’ve been able to find who will help and I’m a little concerned about the advise too. I’ve added some pumpkin seeds and almonds into her diet by the vet recommendation. Since she was young her diet has been of squirrel blocks with greens like dandelions, collard greens and broccoli and diffrent fruits like oranges grapes and apple. Her main diet does consist of Henry’s healthy squirrel blocks tho and she gets about one a day that she eats and usually enjoys. Since my last post I have been adding extra calcium to her diet with about 100 mg of time nightly. A few weeks ago I went into the emergency vet because my squirrel was breathing heavily and had some clicking noises. I’ve worked with small animals who had URIs and it seemed just like one. I got a weeks worth of tmz and went home with her. She was on that every 12 hours and she seemed better and the initial dose was finished. A few days later I go to a vet that takes exotics because she seems to be feeling sick again and I’m hearing clicking, she’s spending a lot of time in her bed and looks not well. They diagnose her with pneumonia and prescribe cephalexin for three weeks which I did. it didn’t seem to be doing anything other than lessen the heavy breathing and I was then told on here it wasn’t a good choice. The vet kept saying that baytril oral suspension was on back order which seems weird. I asked for it repeatedly and was able to get some pills crushed and mixed up into a oral suspension. So she is now on baytril every 12 hours and this is the second week currently. Her activity levels have seemed to rise. She is running on her wheel again and exploring out her cage. She is eating normally, when she was eating last week I would hear a lot of noise like crackling and gasping. The baytril does seem to be working but she still having issues. I still am hearing an occasional cracking in her lungs and when she is woken up she sounds wheezy as well as when she is sleeping. She has less sneezing but is still sneezing hear and there. She still has what looks to be heavy breathing. She does not have a waterbottle as she never really got the concept but has a fresh water bowl that’s always clean and she can always get too. Her name is baby

Thank you for your response Sasha!
I have some comments and suggestions but I will need to get back with you later for further suggestions.

Just a couple of additional questions to help with my forthcoming response to you:
How long has Baby been on this sort of diet with one Henry's Block and the fruits, vegetables, nuts and whatever?
What is Baby's weight?
What kind of Calcium (calcium carbonate, calcium citrate or whatever) are you using for the 100mg of nightly Calcium. Just in case you may not be aware of this; when Calcium is given orally, it is not in the form of plain Calcium (this is what is called Elemental Calcium); it is combination with other components (this combination is called a Calcium Salt). Examples of Calcium salts are Calcium carbonate and Calcium citrate and there are a number of others as well. The issue I am leading up to is that the Elemental Calcium contained in lets say Calcium Carbonate is NOT the same as that contained in Calcium citrate. Of the usual calcium salts; Calcium carbonate contains the most Elemental Calcium but that is only 40% of the weight. Calcium citrate contains far less Elemental Calcium at 21%. SO, if your Calcium preparation is Calcium Carbonate, 100mg of that will provide only 40mg of Elemental Calcium!

My concern from what I have heard about Baby's diet, she may have Metabolic Bone Disease! This is actually a very serious condition and there are treatments for this. A good thing about the treatment is that even if MBD is later ruled out; following the treatment protocol will have done no harm! Henry's Pets has a concise but very good Information page on MBD and they have an Emergency Treatment Protocol! I will post a link to each of these pages from Henry's and I would like to respectfully ask that you read them (they are both concise and are quick reads) as my humble opinion is that if Baby is not already showing clinical signs of MBD, these are just around the corner with her diet. Link to Henry's Information page on MBD; https://henryspets.com/what-is-metabolic-bone-disease/
Link to Henry's Emergency Treatment of MBD (and for now, this is only meant to facilitate your understanding and for further specific recommendations; it would be good to have the answers to my few additional questions); https://henryspets.com/emergency-treatment-for-mbd/

Again, MBD can develop with excessive Phosphorus or with a balance of calcium to phosphorus that favors the phosphorus! If the overall Calcium to phosphorus ratio is reversed (ideal would be in the neighborhood of 2:1, Calcium to phosphorus); MBD can develop no matter how much Calcium a Squirrel is given!

I will get back with you in an hour or two after I deal with some issues and others are here to help as well (THANKS Mel!)!

Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
She is on 100 mg of calcium a night from some tums that’s been crushed. She currently weighs about 280 grams. She has been eating different fruits and veggies but her base diet has always been a rodent block and calcium rich green. She has been on a base diet of Henry’s healthy blocks for 3 years and she gets very occasional other things like, chicken, a piece of dry cat food or some insects for protein.

[SamtheSquirrel2018]

Hello again Sasha:
I did not get back home until much later than expected. Just a couple of comments from your recent posts.

These are just some things that may be considered. I am NOT attempting to write or rewrite Baby's "program" for you or for her!

A captive Squirrel should get at least 80% of her nutrition through quality Blocks! What may be worth considering is to give Baby 1-1/2 to even 2 HHBs in the morning. HHBs must NOT be free-fed (this is where the Squirrel would be permitted to eat as much as she wants) as these are quite concentrated and they have no preservatives either so they will easily spoil if left out. This brings up another issue and that is that as Squirrels instinctively stash food and whatnot; it is good practice to check for stashes at least once per day after all the feeding is over. Remnants or entire HHBs will easily spoil if left in Baby's enclosure!

In the afternoon, Baby could be given quality Blocks such as Teklad 2018 or Mazuri Rat and Mouse Diet. These can be free-fed! Baby can eat as much as she wants and with her having eaten 1-1/2 or 2 HHBs in the morning, her dietary needs including daily Calcium will have been met with the HHBs! The Mazuri Blocks are available at most Pet store. I use Teklad Blocks as a base for making blocks for wilds and any Squirrels in my care who are able to eat hard extruded Blocks. Teklad is available from the manufacturer but only in very large bags. I have use an eBay seller for many year who buys Teklad Blocks in the large quantities and sell smaller amounts. Her eBay name is EcoSandy. If you would want to try Teklad Block; I would recommend Teklad 2018 for Baby. Here is a link to EcoSandy's page for Teklad 2018 Blocks;

https://www.ebay.com/itm/33559954224...Bk9SR97a2pm-ZQ

In response to your listing of other foods you are providing for Baby; if I may gently make some comments about those. Again, quality Blocks should be the mainstay of nutritional support for a captive Squirrel! If you do want to add some healthy vegetables and rare treats such as nuts and fruits (yes, for a captive Squirrel; that is an option! It is important though to view nuts and fruits as TREATS and that is why I have a respectful disagreement with your Veterinarian as apparently his view is that these, at least nuts, are an important and primary nutritional constituent!

Collards have a very high (GOOD!) Calcium to phosphorus ratio and dandelion greens also have a positive (more Calcium than Phosphorus) Ca:Phos Ratio although not as high as the Collards. Broccoli has a slightly negative Ca:Phos ratio and pumpkin seeds and pumpkins have a very Negative Ca:Phos Ratio. "Negative" in this context is less Calcium than Phosphorus. Again, we would like a Ca:Phos Ratio of around 2:1!

I have looked at your enlarged x-ray images and they seem quite similar to those previously posted except larger. I did copy the original photos and enlarged them to the same degree as your new images and met with the same limitations due to pixilation. With my same disclaimers of NOT being a Veterinarian (I'm a vegetarian but not a veterinarian) or a Radiologist; looking at the films; especially the DV or VD view (again, I'm not sure which but it makes not real difference); I cannot discern a definitive and large enough infiltrate (a pneumonia) to show up on this technically insufficient film but that is at least somewhat encouraging to me. There may still be scattered, less dense or smaller infiltrates that could easily be "hiding" on the films! Where was the pneumonia seen by your Vet?

Thanks again for your care for this little Squirrel! Please tell Baby that I said hello! Please continue with updates! Have you considered and tried to contact the other Vet suggested by Mel?
Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
Thank you again for your response. She usually only gets one cause she only finishes one she is quite a small little thing. I currently have some rodent blocks that I allow to stay in her cage and replenish as they go ( which they really don’t. I will look at buying some Mazuri blocks. The seeds and nuts will be removed untill she starts getting better than will be fed very occasionally as a treat. The pneumonia was seen in the back of her lungs and the vet said she had about 80 percent capacity for her lungs atm. He did say she’s having trouble getting it into her lungs and some is going into her other insides. I feel like mbd which is now being addressed would not be the only reason she still is having these respiratory issues. Regarding the other vet I am located in Atlanta and would not be able to see him. If anyone knows a vet near Atlanta who knows squirrels and doesn’t need a rehab license I would love that info. Thanks again Sam I really appreciate you.

[SamtheSquirrel2018]

Hi Sam,
Thank you again for your response. She usually only gets one cause she only finishes one she is quite a small little thing. I currently have some rodent blocks that I allow to stay in her cage and replenish as they go ( which they really don’t. I will look at buying some Mazuri blocks. The seeds and nuts will be removed untill she starts getting better than will be fed very occasionally as a treat. The pneumonia was seen in the back of her lungs and the vet said she had about 80 percent capacity for her lungs atm. He did say she’s having trouble getting it into her lungs and some is going into her other insides. I feel like mbd which is now being addressed would not be the only reason she still is having these respiratory issues. Regarding the other vet I am located in Atlanta and would not be able to see him. If anyone knows a vet near Atlanta who knows squirrels and doesn’t need a rehab license I would love that info. Thanks again Sam I really appreciate you.

Thanks Sasha!
When your Vet states that Baby is "having trouble getting it (air?) into her lungs;" does this person mean that Baby has some restriction to air flow in her nasal passages? Also, I really do NOT understand the rest of that sentence where your Vet said "and some (air?) is going into her other insides!" What did the Vet mean by that?!?

Does it seem that Baby is having problems getting air in through her nose? Does she ever try to breath through her mouth? Mouth breathing is ALWAYS abnormal for a Squirrel because they are what is called Obligate Nose Breathers and while they may be able to breath through their mouths; they do not do so naturally. We as adult humans can just as easily breath through our mouths or noses and we can change as we see fit. A Squirrel (and a human infant) are unable to do so and they will mouth breath with difficulty only is unable to get adequate air exchanged through there noses. IF part of Baby's problem seems to be difficulty breathing through her nose; while Squirrel can certainly get a URI but if the symptoms persist for weeks; this is often a sign of a dental related infection which can spread to involve the jaw bones, nose and sinuses. A relatively common dental associated condition is an odontoma. Odontomas are NOT cancer but are tumors that usually develop at the base or root area of teeth and are made from normal dental tissues that are very disorganized! When these involve the upper teeth (usually on or both upper incisors), they can also eventually restrict air exchange through one or both nasal passages and if they grow large enough can even completely block the nasal passages. Again, when a Squirrel has difficulty breathing through her nose; a dental condition must be considered in the list of possibilities. This is actually quite common! We can usually see an odontoma on properly performed skull x-ray studies but a "simple" dental abscess is not usually visible on plain film x-ray studies.
Regards,
SamtheSquirrel

[SASHA-]

He stated that she is not able to get her full lung capacity and is only getting air to 80 percent of her lungs. When I said inside, I was referring that when she is breathing some of the air is reaching her organs, which the vet didn’t seem concerned about but I’m worried could mean something about her heart. I’ve brought up odontoma to the vet but he did not think that was the case. She is not mouth breathing and is able to breathe through her nose. she had sniffles and some mucus a few weeks ago but that’s mostly cleared up. I will reach out to the vet tomorrow and ask if he can see her teeth or any signs of a tumor. I don’t know if the vet knows what he is talking about and I’m feeling concerned that’s why I’m looking for another vet.

[SamtheSquirrel2018]

He stated that she is not able to get her full lung capacity and is only getting air to 80 percent of her lungs. When I said inside, I was referring that when she is breathing some of the air is reaching her organs, which the vet didn’t seem concerned about but I’m worried could mean something about her heart. I’ve brought up odontoma to the vet but he did not think that was the case. She is not mouth breathing and is able to breathe through her nose. she had sniffles and some mucus a few weeks ago but that’s mostly cleared up. I will reach out to the vet tomorrow and ask if he can see her teeth or any signs of a tumor. I don’t know if the vet knows what he is talking about and I’m feeling concerned that’s why I’m looking for another vet.

Thanks Sasha:
The Vet may have stated stuff as he did because he may have felt this would be easier for you to understand; I just don't know!

If you might be further interested; air, which is a mixture of gases in comprised mostly of Nitrogen (around 78%), oxygen (at around 21%), Carbon dioxide or CO2 (at around 0.04%) and others. One major purpose of breathing is to take in oxygen which the cells in the body require and to remove CO2 that is generated by these cells and must be removed from the body. Air itself is normally present ONLY in the lungs and the breathing passages to the lungs. Very tiny sacs called alveoli are in the lungs at the ends of the terminal branches of tiny airways and this is where the oxygen in the air is exchanged for CO2 to be exhaled. Exhaled air contains around 15% oxygen, about the same percentage of Nitrogen as was breathed in and around 4% CO2 (quite a bit more than was breathed in). Again, air itself is NOT transported to organs! The Vet may have felt that Baby was not getting adequate oxygen delivered to some organs or tissues or felt that certain areas of the lung (possibly where he saw the pneumonia) were not able to adequately participate in the exchange of oxygen for CO2. This is often a big concern with pneumonias or other lung conditions where alveoli may be filled with fluid or other material which will hinder gas exchange!

If there seems to be a persistent nasal restriction in a Squirrel; it is often worth considering the possibility of a dental problem such as an abscess or odontoma or even a sinus infection. An x-ray study of the skull with a DorsoVentral or VentroDorsal view and a true lateral view would aid greatly in assessing for an odontoma! The photos already present in your thread are inadequate for this and IMHNVO; are in general suboptimal.
As I mentioned, these films may have been taken digitally and if the digital films themselves can be uploaded to your thread, it could help us at least point our non-professional eyes at them!

Please let us know what your Vet has to say tomorrow!

Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
So I called the vet and they said she had periodontal disease ( the first of which I’m hearing about). I asked about management for that and was told to watch what she eats and keep her from chewing on woods. She does make noise when she is eating. I asked about sending the x rays off to a radiologist and it can be done. The vet himself did not see any signs of a tumor and doesn’t think she would eat as much as she does if there was one. I’m willing to send the x rays off to a radiologist and I can go to another state near Georgia if there’s a vet that can help with teeth issues in squirrels. I asked about getting new images that could be shared with a rehabber and I was sent the same ones I shared before. I know you are not a vet but Does it seem like my vet is giving me correct information? What can I do for her other than the antibiotics she is on and does this sound like it could be odontoma. Thank you again for your non vet opinion I appreciate your time.

[SamtheSquirrel2018]

Hi Sam,
So I called the vet and they said she had periodontal disease ( the first of which I’m hearing about). I asked about management for that and was told to watch what she eats and keep her from chewing on woods. She does make noise when she is eating. I asked about sending the x rays off to a radiologist and it can be done. The vet himself did not see any signs of a tumor and doesn’t think she would eat as much as she does if there was one. I’m willing to send the x rays off to a radiologist and I can go to another state near Georgia if there’s a vet that can help with teeth issues in squirrels. I asked about getting new images that could be shared with a rehabber and I was sent the same ones I shared before. I know you are not a vet but Does it seem like my vet is giving me correct information? What can I do for her other than the antibiotics she is on and does this sound like it could be odontoma. Thank you again for your non vet opinion I appreciate your time.

Hi Sasha:
When one our members has a Veterinarian for their Squirrel(s); it is ordinarily as much a rarity and it is a decided advantage! None of us try to even want appear to be getting between this relationship a Squirreler might have with a Veterinarian! That being said, not all Veterinarians are the same and not all Veterinarians are Squirrel friendly or Squirrel experienced and it appears to be that you have some reservations and concerns about your Vet and have expressed such in this and other posts! Oftentimes, these "gut" feelings can be valuable in evaluating not just a Veterinarian but other professionals as well such as Physicians, plumbers, and whatever! In the case of Baby, there have also been some other more tangible issues that you have identified regarding your Squirrel's evaluation by this Vet! I believe also; from what you have written even from your first post that you have "questions" about your Vet and it really appears to me that IF another Squirrel Vet was available within a reasonable distance; you would have taken Baby there by this time! Enough said about this from me!

About periodontal disease; certainly this is possible but I have the same question that you had and that is IF this is what's going on; why was this not mentioned at the time of your initial visit with this Vet? Another; associated but overall of much greater concern in my opinion would be for this Vet to answer what are the unasked questions of what specifically does this diagnose mean and what is the extent of involvement AND what means were utilized in order to rule out other possibilities and finally render this particular diagnosis! I truly feel that there are some inconsistencies in what you have seen and heard and just prom the periphery; I share these with you!

Did your Vet sedate Baby for the x-ray studies and for an exam including a very detailed and focused examination of the mouth and teeth? Such an examination is a necessity in the process of formulating and then rendering such a diagnosis as periodontal disease. Sedation via an inhaled anesthetic agent is almost always required to facilitate all but a very cursory examination of an active Squirrel!

I would respectfully suggest that you ask this Vet (NOT the office staff!) about how this diagnosis came about and since periodontal disease has wide variations in what in particular about the periodontium (the surrounding and supporting structures of the teeth) is involve; just what is it that is involved (the gums, the surrounding bone or whatever)! These are important questions and IMHO, should have been answered by the Vet even if they were not asked!

In regard to the x-ray films, Sasha; have you been given a disc or a download on some media of the actual digital x-ray films with the usual accompanying "mini-program" for manipulating the images? What I suspect when I see the images you you have posted is that you have taken photos of the images rather than posting an actual digital x-ray image! I'm certainly not a radiologist but IF the ACTUAL radiographic study is of the level of quality shown in the photos; it will be difficult for even a radiologist to optimally interpret these! A consultation from a Veterinary Radiologist does cost money and one option might be to send the images to a radiologist with two questions to be answered; are these images and views adequate for making a valid radiographic diagnosis and if so, what are the diagnoses? More to the point of the the first question would be; if these images and/or views are not adequate; what specific views, positioning of the Squirrel and specific radiologic protocol would the radiologist recommend so that he could best utilize the images to render a radiographic diagnosis or impression!

By the way, do you have the actual x-ray studies on a disc or other media?

Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
For the x rays I got them through my email as a jpeg. After doing some further research I realize that dicom file upload is needed. It does not seem like they are able to do this over the phone so I will request a disk when I next go in on Wednesday. The squirrel was not put under for the x rays. They used some foam blocks to keep her in place I believe. For the examination of periodontal disease she was also not put under. The vet wrapped her in a towel and opened her mouth to examine her teeth. The top two teeth were wiggly and her gums were bleeding this is when he diagnosed scurvy, I believe this is why the vet tech told me periodontal disease yesterday. I feel like he was able to examine her mouth pretty closely, My squirrel is somewhat cooperative with them. It seems there is only so much I can do over the phone, on Wednesday I have an appointment and will request some more answers. Is there anything I should have him look at specifically or answer specifically?

Thank you,
Sasha

[SamtheSquirrel2018]

Hi Sam,
For the x rays I got them through my email as a jpeg. After doing some further research I realize that dicom file upload is needed. It does not seem like they are able to do this over the phone so I will request a disk when I next go in on Wednesday. The squirrel was not put under for the x rays. They used some foam blocks to keep her in place I believe. For the examination of periodontal disease she was also not put under. The vet wrapped her in a towel and opened her mouth to examine her teeth. The top two teeth were wiggly and her gums were bleeding this is when he diagnosed scurvy, I believe this is why the vet tech told me periodontal disease yesterday. I feel like he was able to examine her mouth pretty closely, My squirrel is somewhat cooperative with them. It seems there is only so much I can do over the phone, on Wednesday I have an appointment and will request some more answers. Is there anything I should have him look at specifically or answer specifically?

Thank you,
Sasha

Just a quick question, Sasha. Tt sounds from what you have written that all that was sent to you from the Vet in regard to Baby's x-ray images was a jpeg file sent by email. IF they may have actually sent the DICOM file to you (a DICOM file is used for viewing, manipulating, saving and printing digital radiographs and a DICOM viewer will be able to produce jpegs and often images in other file formats such as pdf) as well as the jpeg you posted; most likely this downloaded file has a viewer incorporated with it and these are usually quite adequate for manipulating and viewing the images! IF there is no viewer but you do have the original DICOM file; would you be willing to send the file to me? I do have a DICOM Viewer and I would be glad review the images and search for some that might be better for diagnostic purposes and then save those and send them to you and/or post them to your thread. Just let me know!
Regards,
SamtheSquirrel

[SASHA-]

Hi Sam,
I’m working on getting this files and when I do it would be greatly appreciated if I could send them to you. Where should I send them to when I get them?

[SamtheSquirrel2018]

Hi Sam,
I’m working on getting this files and when I do it would be greatly appreciated if I could send them to you. Where should I send them to when I get them?

I sent a PM to you!
Regards,
SamtheSquirrel

[SamtheSquirrel2018]

Just so those who might be following this Thread can be kept current; I received copies of the digital file for the x-ray films and looked at these with with a high quality specialized viewer program and sent a PM back to Sasha with some the comments below;

IF these are the original files, IMHNRO (in my humble non-radiologist opinion); their appearance is still very grainy! One very critical variable in producing high quality digital x-ray images is what is termed the Milliampere-second setting. This is in a very real sense, a measure of the number of photons "shot" in the x-ray beam. When an image is made with a low milliampere-second setting, the details of the image can easily become grainy and mottled. There is much more to this in the way of the science but the bottom line is that this image mottle (which is termed Quantum Mottle as summary term for all that does take place) cannot be effectively corrected through utilization of even the most sophisticated viewing program and the only means to rectify a mottled image to take another image with an increased milliampere-second setting!

IF (and this is NOT the case with these images) there is a high milliampere-second setting, often manipulating the viewer's settings can compensate at least somewhat. Again, I am not a radiologist nor am I anything but an amateur physicist but that is how things with these images appear to me! It may be that these are some sort of copies and somewhere is still a high quality series of images and we just didn't get those. It may be worth your Vet querying a radiologist about whether or not they may see these films as being of diagnostic quality if somehow manipulated with their viewer and let the radiologist render an opinion. Another option may be to repeat the films with an increased milliampere-second setting. If that is going to be undertaken, I would suggest that since the concerns have been URI symptoms and along with a concern for evaluation of the possible presence of an odontoma AND the possibility of a pneumonia; that TWO sets of images be obtained. One set would be of the SKULL with setting based upon bone densities and the other would be a set of images with focus on the chest and in particular, the lung fields. The settings for this would be made to favor interpretation of air rather than bone. Another suggestion would be for there to be two images made in each set; one would be a true lateral view (directly from the side) and the other would be either a Dorsoventral ("top to bottom") view OR a Ventrodorsal ("bottom to top") view.

Regards,
SamtheSquirrel