Radiographic diagnosis: pericardioperitoneal diaphragmatic hernia and cholelithiasis in a dog.

The dog had a history of abdominal pain and vomiting of five days duration. An umbilical hernia had been surgically repaired years earlier. The dog was depressed, lethargic, and had painful palpations of the cranial abdomen. Body temperature (39"C), heart rate (1 10 bpm) and respiratory rate (44 breathdmin.) were normal. Heart sounds were clearly audible on the right side and muffled on the left side. There was a neutrophilia with a left shift (1 5,690 segmented neutrophils/Fl (69%) and 9,100 bands/pl (4%)). Abnormalities on the serum chemistry profile included elevated values for liver enzymes (alkaline phosphatase: 562 I U L (1-90 IUL), aspartate transferase: I90 I U L (10-62 IU/L), alanine transferase: 99 IU/L (1-94 IU/L), hypoalbuminemia of 2.4 g/dl (3.2-4.7 g/dl) and elevated creatinine kinase: 2862 I U L (51-529 IUL)). Radiographs of the thorax and abdomen were obtained (Figs. 1-4).