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

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

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

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Valérie Chetboul Université 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-Sechi Université 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 Pouchelon Université 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 Gouni Université 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. Reynolds Department 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.

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