Histologic patterns of chronic interstitial lung disease in dogs

Chronic interstitial lung disease (cILD) is uncommon in dogs and little is known of the pathogenesis, apart from the condition in West Highland White Terriers. This study aimed to characterize histologic lesions of canine cILD, compare the lesions and clinical features, and classify the histopathologic patterns according to criteria used in humans. The study included 24 postmortem cases of subacute or chronic ILD in >6-month-old dogs with respiratory signs. Histologic lung lesions included attenuated bronchiolar epithelium, alveolar edema, type II pneumocyte proliferation, fibrosis of alveolar septa, fibrin or fibrous tissue within alveoli or bronchioles, and hyaline membranes. Of the 24 cases, 8 were classified as organizing diffuse alveolar damage, 4 as organizing pneumonia, and 3 as acute fibrinous and organizing pneumonia; 9 were unclassifiable and considered as nonspecific interstitial lung disease. None fulfilled criteria for usual interstitial pneumonia. Potential causes included aspiration of gastric or foreign material, prior acute respiratory distress syndrome, or failed healing of pneumonia. Left-sided heart failure was identified in 12 of 24 cases but was not considered to directly cause the interstitial lung lesions. Gross lesions of cor pulmonale were associated with organizing pneumonia and longer clinical duration. The cases had diverse histologic lesions and patterns of lung fibrosis, but the results suggested that these may represent divergent responses to overlapping causes of lung injury rather than distinct diseases. These findings clarify the pathogenesis of cILD in dogs, the mechanisms of initial damage, and the future development of approaches to delay or predict disease progression.