Thoracic radiography is one of the most commonly ordered imaging studies in small-animal practice — and one of the easiest to get subtly wrong. A consistent protocol pays off in fewer repeats, better diagnoses and lower cumulative dose for the patient.
The minimum standard study
A complete thoracic study includes three projections:
- Right lateral — patient in right lateral recumbency, dependent side down
- Left lateral — patient in left lateral recumbency, dependent side down
- Ventrodorsal (VD) or Dorsoventral (DV) — VD when the patient tolerates it; DV for dyspnoeic or unstable patients
Why both laterals matter
When the patient is in lateral recumbency, the dependent lung partially collapses (atelectasis) and fluid relocates downward. Small soft-tissue nodules in the dependent lung can be silently obscured. Imaging both sides ensures that any region appearing abnormal in one view can be cross-referenced in the non-dependent view of the opposite study.
Inspiration matters more than you think
Every effort should be made to acquire the image at peak inspiration. An expiratory film can mimic interstitial disease, exaggerate cardiac silhouette and obscure pulmonary detail. Watch the chest rise, ask the technician to count the breath cycle, and time the exposure accordingly.
Positioning quality marks
- Thoracic limbs pulled cranially so the elbows don’t superimpose over the cranial thorax
- Sternum and spine equidistant on the VD/DV view (no rotation)
- Diaphragm clearly visible on the lateral views
- Field of view includes the thoracic inlet cranially and the entire diaphragm caudally
Documentation
Mark every film with patient ID, date and side marker (R/L). A modern DR workstation captures this metadata automatically — but always verify before saving, especially when handing off cases for telemedicine review.
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