• 1.

    Schmidt R, Markart P & Ruppert C, et al. Time-dependent changes in pulmonary surfactant function and composition in acute respiratory distress syndrome due to pneumonia or aspiration. Respir Res [serial online] 2007;8:55. Available at: respiratory-research.com/content/pdf/rr86.pdf. Accessed Nov 1, 2007.

    • Search Google Scholar
    • Export Citation
  • 2.

    Mitsushima H, Oishi K & Nagao T, et al. Acid aspiration induces bacterial pneumonia by enhanced bacterial adherence in mice. Microb Pathog 2002;33:203210.

  • 3.

    Genné D, Sommer R & Kaiser L, et al. Analysis of factors that contribute to treatment failure in patients with community-acquired pneumonia. Eur J Clin Microbiol Infect Dis 2006;25:159166.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    van Westerloo DJ, Knapp S & van't Veer C, et al. Aspiration pneumonitis primes the host for an exaggerated inflammatory response during pneumonia. Crit Care Med 2005;33:17701778.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 2001;344:665671.

  • 6.

    Furuya ME, Moreno-Córdova V & Ramírez-Figueroa JL, et al. Cutoff value of lipid-laden alveolar macrophages for diagnosing aspiration in infants and children. Pediatr Pulmonol 2007;42:452457.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Mukhopadhyay S, Katzenstein AL. Pulmonary disease due to aspiration of food and other particulate matter: a clinicopathologic study of 59 cases diagnosed on biopsy or resection specimens. Am J Surg Pathol 2007;31:752759.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Sharma S, Maycher B, Eschun G. Radiological imaging in pneumonia: recent innovations. Curr Opin Pulm Med 2007;13:159169.

  • 9.

    Shigemitsu H, Afshar K. Aspiration pneumonia: under-diagnosed and under-treated. Curr Opin Pulm Med 2007;13:192198.

  • 10.

    King LG, Vite CH. Acute fulminating myasthenia gravis in five dogs. J Am Vet Med Assoc 1998;212:830834.

  • 11.

    MacPhail CM, Monnet E. Outcome of and postoperative complications in dogs undergoing surgical treatment of laryngeal paralysis: 140 cases (1985–1998). J Am Vet Med Assoc 2001;218:19491956.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Kane-Gill SL, Olsen KM & Rebuck JA, et al. Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. Ann Pharmacother 2007;41:549555.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Poncet CM, Dupre GM & Freiche VG, et al. Long-term results of upper respiratory syndrome surgery and gastrointestinal tract medical treatment in 51 brachycephalic dogs. J Small Anim Pract 2006;47:137142.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    King LG, Anderson JG & Rhodes WH, et al. Arterial blood gas tensions in healthy aged dogs. Am J Vet Res 1992;53:17441748.

  • 15.

    Bernard GR, Artigas A & Brigham KL, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818824.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Amis TC, McKiernan BC. Systematic identification of endobronchial anatomy during bronchoscopy in the dog. Am J Vet Res 1986;47:26492657.

    • Search Google Scholar
    • Export Citation
  • 17.

    Kogan DA, Johnson LR & Sturges BK, et al. Etiology and clinical outcome in dogs with aspiration pneumonia: 88 cases (2004–2006). J Am Vet Med Assoc 2008;233:17481755.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Reza Shariatzadeh M, Huang JQ, Marrie TJ. Differences in the features of aspiration pneumonia according to site of acquisition: community or continuing care facility. J Am Geriatr Soc 2006;54:296302.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Carratalà J, Mykietiuk A & Fernández-Sabé N, et al. Health care-associated pneumonia requiring hospital admission: epidemiology, antibiotic therapy, and clinical outcomes. Arch Intern Med 2007;167:13931399.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Fraisse A, Bregeon F & Delpierre S, et al. Hemodynamics in experimental gastric juice induced aspiration pneumonitis. Intensive Care Med 2007;33:300307.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Thayer GW, Robinson SK. Bacterial bronchopneumonia in the dog: a review of 42 cases. J Am Anim Hosp Assoc 1984;20:731735.

  • 22.

    Radhakrishnan A, Drobatz KJ & Culp WT, et al. Community-acquired infectious pneumonia in puppies: 65 cases (1993–2002). J Am Vet Med Assoc 2007;230:14931497.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Johnson LR, Lappin MR, Baker DC. Pulmonary thromboembolism in 29 dogs (1985–1995). J Vet Intern Med 1999;13:338345.

  • 24.

    Cvitanic O, Marino PL. Improved use of arterial blood gas analysis in suspected pulmonary embolism. Chest 1989;95:4851.

  • 25.

    Schneider RF, Ntimba FD & Hourizadeh A, et al. Massive pulmonary embolism: a comparison of radiological and clinical characteristics and outcomes. Emerg Radiol 2002;9:7981.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Eom K, Seong Y & Park H, et al. Radiographic and computed tomographic evaluation of experimentally induced lung aspiration sites in dogs. J Vet Sci 2006;7:397399.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Adams R, Ruffin R, Campbell D. The value of the lipid-laden macrophage index in the assessment of aspiration pneumonia. Aust N Z J Med 1997;27:550553.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Savchenko O, Dhadwal AK & Pagala M, et al. Lipid-laden macrophage index in healthy canines. Eur J Clin Invest 2006;36:419422.

  • 29.

    Savchenko O, Vastola P & Pagala M, et al. Lipid laden macrophage indices and reflux finding score in canine gastroesophageal reflux model. Pediatr Pulmonol 2007;42:11811186.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Farrell S, McMaster C & Gibson D, et al. Pepsin in bronchoalveolar lavage fluid: a specific and sensitive method of diagnosing gastrooesophageal reflux-related pulmonary aspiration. J Pediatr Surg 2006;41:289293.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Clinical, clinicopathologic, and radiographic findings in dogs with aspiration pneumonia: 88 cases (2004–2006)

David A. KoganVeterinary Medical Teaching Hospital and the Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Lynelle R. JohnsonDepartment of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Karl E. JandreyDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Rachel E. PollardDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Abstract

Objective—To evaluate clinical, clinicopathologic, and radiographic findings in dogs with aspiration pneumonia.

Design—Retrospective case series.

Animals—88 dogs with aspiration pneumonia.

Procedures—History, physical examination findings, and clinicopathologic data were obtained from medical records and analyzed for all 88 dogs. Thoracic radiographic findings for all dogs were reviewed to determine the type and location of pulmonary infiltrates.

Results—Aspiration pneumonia was evident at admission to the hospital in 65 (74%) dogs and developed during hospitalization in 23 (26%) dogs. Less than half of these affected dogs had high values for rectal temperature, heart rate, or respiratory rate; however, most (68%) affected dogs had increased, decreased, or adventitious lung sounds. Neutrophilia with a left shift was a common finding. Hypoalbuminemia was detected in 31 of 58 (53%) dogs. Hypoxemia and a high alveolar-arterial gradient in partial pressure of oxygen were detected in 22 of 28 (79%) dogs and 27 of 28 (96%) dogs, respectively. Among the 88 dogs, thoracic radiography revealed a predominantly alveolar infiltrate in 65 (74%) dogs and an interstitial pattern in 23 (26%) dogs; a single lung lobe was affected in 46 (52%) dogs, most commonly the right middle lung lobe (21/46 [46%] dogs).

Conclusions and Clinical Relevance—In dogs, aspiration pneumonia was often associated with abnormalities in pulmonary auscultation in the absence of objective changes in physical examination findings. However, neutrophilia, hypoalbuminemia, and hypoxemia were frequently detected, and radiographic evidence of infiltrates in the right middle lung lobe was common.

Abstract

Objective—To evaluate clinical, clinicopathologic, and radiographic findings in dogs with aspiration pneumonia.

Design—Retrospective case series.

Animals—88 dogs with aspiration pneumonia.

Procedures—History, physical examination findings, and clinicopathologic data were obtained from medical records and analyzed for all 88 dogs. Thoracic radiographic findings for all dogs were reviewed to determine the type and location of pulmonary infiltrates.

Results—Aspiration pneumonia was evident at admission to the hospital in 65 (74%) dogs and developed during hospitalization in 23 (26%) dogs. Less than half of these affected dogs had high values for rectal temperature, heart rate, or respiratory rate; however, most (68%) affected dogs had increased, decreased, or adventitious lung sounds. Neutrophilia with a left shift was a common finding. Hypoalbuminemia was detected in 31 of 58 (53%) dogs. Hypoxemia and a high alveolar-arterial gradient in partial pressure of oxygen were detected in 22 of 28 (79%) dogs and 27 of 28 (96%) dogs, respectively. Among the 88 dogs, thoracic radiography revealed a predominantly alveolar infiltrate in 65 (74%) dogs and an interstitial pattern in 23 (26%) dogs; a single lung lobe was affected in 46 (52%) dogs, most commonly the right middle lung lobe (21/46 [46%] dogs).

Conclusions and Clinical Relevance—In dogs, aspiration pneumonia was often associated with abnormalities in pulmonary auscultation in the absence of objective changes in physical examination findings. However, neutrophilia, hypoalbuminemia, and hypoxemia were frequently detected, and radiographic evidence of infiltrates in the right middle lung lobe was common.

Contributor Notes

Dr. Kogan's present address is Veterinary Medical and Surgical Group, 2199 Sperry Ave, Ventura, CA 93003.

Supported in part by the S.T.A.R. (Students Training in Advanced Research) program, School of Veterinary Medicine, University of California, Davis, and the Bailey Wrigley Fund.

Address correspondence to Dr. Johnson.