• 1.

    Padrid P. Canine and feline pleural disease. Vet Clin North Am Small Anim Pract 2000; 30:12951307.

  • 2.

    Mellanby RJ, Villiers E, Herrtage ME. Canine pleural and mediastinal effusions: a retrospective study of 81 cases. J Small Anim Pract 2002; 43:447451.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    De Troyer A, Leduc D. Role of pleural pressure in the coupling between the intercostal muscles and the ribs. J Appl Physiol 2007; 102:23322337.

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

    De Troyer A, Brunko E, Leduc D, et al. Reflex inhibition of canine inspiratory intercostals by diaphragmatic tension receptors. J Physiol 1999; 514:255263.

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

    al-Kaisy AA, Chan VW, Perlas A. Respiratory effects of low-dose bupivacaine interscalene block. Br J Anaesth 1999; 82:217220.

  • 6.

    Kohyama J, Shiiki T, Shimohira M, et al. Asynchronous breathing during sleep. Arch Dis Child 2001; 84:174177.

  • 7.

    Hendricks JC. Respiratory muscle fatigue and failure. In: King LK, ed. Textbook of respiratory disease in dogs and cats. St Louis: WB Saunders Co, 2004;6165.

    • Search Google Scholar
    • Export Citation
  • 8.

    Pereira MC, Mussi RF, Massucio RA, et al. Idiopathic bilateral diaphragmatic paresis. J Bras Pneumol 2006; 32:481485.

  • 9.

    Hartley L, Kinali M, Knight R, et al. A congenital myopathy with diaphragmatic weakness not linked to the SMARD1 locus. Neuromuscul Disord 2007; 17:174179.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Piastra M, De Luca D, Zorzi G, et al. Noninvasive ventilation in large postoperative flail chest. Pediatr Blood Cancer 2008; 51:831833.

  • 11.

    McKenzie DK, Butler JE, Gandevia SC. Respiratory muscle function and activation in chronic obstructive pulmonary disease. J Appl Physiol 2009; 107:621629.

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

    Schilero GJ, Spungen AM, Bauman WA, et al. Pulmonary function and spinal cord injury. Respir Physiol Neurobiol 2009; 166:129141.

  • 13.

    Matsumoto H, Nakayama T, Hamaguchi H, et al. Diaphragmatic paralysis in a patient with spinal cord infarction. Intern Med 2009; 48:17631766.

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

    Konagaya M, Yasuma F, Kuru S. Multiple system atrophy with paradoxical respiration. Respiration 2001; 68:527.

  • 15.

    Aliverti A, Quaranta M, Chakrabarti B, et al. Paradoxical movement of the lower ribcage at rest and during exercise in COPD patients. Eur Respir J 2009; 33:4960.

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

    Resta O, Barbaro MP, Giliberti T, et al. Sleep related breathing disorders in adults with Down syndrome. Downs Syndr Res Pract 2003; 8:115119.

  • 17.

    Yamakage M, Kamada Y, Toriyabe M, et al. Changes in respiratory pattern and arterial blood gases during sedation with propofol or midazolam in spinal anesthesia. J Clin Anesth 1999; 11:375379.

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

    Anzai Y, Ohya T. A case of effective gastrostomy for severe abdominal distention due to breathing dysfunction of Rett's syndrome: a treatment of autonomic disorder. Brain Dev 2001; 23(suppl 1):S240S241.

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

    Wang LM, Cherng JM, Wang JS. Improved lung function after thoracocentesis in patients with paradoxical movement of a hemidiaphragm secondary to a large pleural effusion. Respirology 2007; 12:719723.

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

    Blaxter A. Differential diagnosis of dyspnoea in the cat. In Pract 1986; 8:225233.

  • 21.

    Davies C, Forrester SD. Pleural effusion in cats: 82 cases (1987 to 1995). J Small Anim Pract 1996; 37:217224.

  • 22.

    Barbone F, Bovenzi M, Cavallieri F, et al. Cigarette smoking and histologic type of lung cancer in men. Chest 1997; 112:14741479.

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Relationship between paradoxical breathing and pleural diseases in dyspneic dogs and cats: 389 cases (2001–2009)

Kevin Le BoedecDepartment of Clinical Sciences, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 Toulouse cedex 03, France.

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Catherine ArnaudInserm and Toulouse III University, UMR 1027, Toulouse, F-31073, France.
Clinical Epidemiology Unit CHU, Toulouse, F-31000, France.

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Valérie ChetboulUniversité Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort, 7 Ave du Général de Gaulle, 94704, Maisons-Alfort cedex, France.
INSERM, U955, Equipe 03, 51 Ave du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France.

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Emilie Trehiou-SechiUniversité Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort, 7 Ave du Général de Gaulle, 94704, Maisons-Alfort cedex, France.

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Jean-Louis PouchelonUniversité Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort, 7 Ave du Général de Gaulle, 94704, Maisons-Alfort cedex, France.
INSERM, U955, Equipe 03, 51 Ave du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France.

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Vassiliki GouniUniversité Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort, 7 Ave du Général de Gaulle, 94704, Maisons-Alfort cedex, France.
INSERM, U955, Equipe 03, 51 Ave du Maréchal de Lattre de Tassigny, 94010 Créteil cedex, France.

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Brice S. ReynoldsDepartment of Clinical Sciences, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 Toulouse cedex 03, France.
Clinical Research Unit, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 Toulouse cedex 03, France.

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Abstract

Objective—To determine the strength of the relationship between paradoxical breathing (PB) and spontaneous pleural diseases in dyspneic dogs and cats.

Design—Cross-sectional study.

Animals—Dogs (n = 195) and cats (194) with a recorded diagnosis of dyspnea examined at the National Veterinary Schools of Alfort and Toulouse (France) between January 2001 and October 2009.

Procedures—Dogs and cats were divided into 2 groups according to the presence or absence of PB. Stratified analysis by species was performed. Signalment of affected animals and occurrence of PB were recorded. The relationship between PB and pleural diseases among dyspneic dogs and cats was analyzed.

Results—A strong relationship between PB and pleural diseases was highlighted in multivariate analysis (dogs, OR = 12.6 and 95% confidence interval = 4.6 to 31.2; cats, OR = 14.1 and 95% confidence interval = 6.0 to 33.5). Paradoxical breathing prevalence among dyspneic dogs and cats was 27% and 64%, respectively. Occurrence of pleural diseases in dyspneic animals with and without PB was 49% and 9% in dogs and 66% and 13% in cats, respectively. The sensitivity and specificity of PB as a predictor of pleural diseases were 0.67 and 0.83 in dyspneic dogs and 0.90 and 0.58 in dyspneic cats, respectively. The positive and negative predictive values of PB were 0.49 and 0.91 in dyspneic dogs and 0.66 and 0.87 in dyspneic cats, respectively. Age, sex, feline breeds, and canine morphotypes in patients with PB were not significantly different from those of other dyspneic animals.

Conclusions and Clinical Relevance—PB was strongly associated with pleural diseases in dyspneic dogs and cats. The presence of this clinical sign should prompt small animal practitioners to implement appropriate emergency procedures and guide their diagnostic strategy.

Abstract

Objective—To determine the strength of the relationship between paradoxical breathing (PB) and spontaneous pleural diseases in dyspneic dogs and cats.

Design—Cross-sectional study.

Animals—Dogs (n = 195) and cats (194) with a recorded diagnosis of dyspnea examined at the National Veterinary Schools of Alfort and Toulouse (France) between January 2001 and October 2009.

Procedures—Dogs and cats were divided into 2 groups according to the presence or absence of PB. Stratified analysis by species was performed. Signalment of affected animals and occurrence of PB were recorded. The relationship between PB and pleural diseases among dyspneic dogs and cats was analyzed.

Results—A strong relationship between PB and pleural diseases was highlighted in multivariate analysis (dogs, OR = 12.6 and 95% confidence interval = 4.6 to 31.2; cats, OR = 14.1 and 95% confidence interval = 6.0 to 33.5). Paradoxical breathing prevalence among dyspneic dogs and cats was 27% and 64%, respectively. Occurrence of pleural diseases in dyspneic animals with and without PB was 49% and 9% in dogs and 66% and 13% in cats, respectively. The sensitivity and specificity of PB as a predictor of pleural diseases were 0.67 and 0.83 in dyspneic dogs and 0.90 and 0.58 in dyspneic cats, respectively. The positive and negative predictive values of PB were 0.49 and 0.91 in dyspneic dogs and 0.66 and 0.87 in dyspneic cats, respectively. Age, sex, feline breeds, and canine morphotypes in patients with PB were not significantly different from those of other dyspneic animals.

Conclusions and Clinical Relevance—PB was strongly associated with pleural diseases in dyspneic dogs and cats. The presence of this clinical sign should prompt small animal practitioners to implement appropriate emergency procedures and guide their diagnostic strategy.

Contributor Notes

Dr. Le Boedec's present address is Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

The animals described in the study were evaluated and treated at the National Veterinary School of Alfort and the National Veterinary School of Toulouse.

Presented as a poster at the 20th European College of Veterinary Internal Medicine—Companion Animal Congress, September 2010, Toulouse, France.

Address correspondence to Dr. Reynolds (b.reynolds@envt.fr).