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  • Author or Editor: Joan C. Hendricks x
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Abstract

Intermittent positive-pressure ventilation (ppv) is an invasive means of respiratory support that is indicated in animals with central and peripheral neuromuscular disease, as well as in those with primary disorders of the lung parenchyma. We reviewed the medical records of 34 dogs and 7 cats treated with ppv. The animals could be allotted to 2 groups; group 1 (21/41) had primary failure of ventilation attributable to neuromuscular disease or airway obstruction, and group 2 (20/41) had primary pulmonary parenchymal disease.

Mean inspiratory time was 1.02 ± 0.2 seconds (range, 0.6 to 1.5 seconds). Mean inspiratory flow was 26.9 ± 18.5 L/min (range, 7 to 87 L/min), and was positively correlated with body weight (R = 0.57). Mean set respiratory rate was 19.6 ± 10 breaths/min (range, 5 to 60 breaths/min), with mean tidal volume of 15.5 ± 6.2 ml/kg of body weight. Positive end-expiratory pressure (peep) was required in 14 of 20 dogs in group 2. Mean peak airway pressure in group 1 was 21.6 ± 6.3 cm of H2O, whereas in group 2 it was 32.9 ± 12.5 cm of H2O. The higher peak airway pressure in group-2 dogs reflected poor lung compliance and the use of peep in dogs with parenchymal lung disease. Mean duration of ppv was 28.2 ± 29.4 hours (range, 2 to 137 hours).

The overall survival rate was 39% (16/41). Factors that appeared to correlate with survival included age, with higher mortality in animals < 1 year old or > 11 years old (P < 0.01); body weight, with mortality highest in animals < 10 kg (P < 0.05); reason for ventilation, with survival in group 1 being 57%, and in group 2, 20%; and development of complications, with 28% of animals that developed major complications surviving, compared with 48% of those that did not develop major complications. Two major complications of ppv were documented: pneumothorax and pneumonia. Twelve of 41 animals developed pneumothorax and had been ventilated by use of peak airway pressures > 25 cm of H2O, or peep. An additional 6 animals developed subclinical pneumonia during treatment with ppv.

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

Thoracic compliance measurements by use of readily available equipment were determined to be practical and safe in dogs. Twenty healthy dogs (age 1 to 16 years, weight 2.3 to 49.5 kg) were anesthetized for routine procedures such as dentistry or neutering. The animals were first hyperventilated to reduce pulmonary atelectasis, to check for leakage at the endotracheal tube cuff, and to induce mild hypocarbia, thus minimizing voluntary respiratory efforts. Total thoracic compliance measurements were calculated as the difference between exhaled volumes at static inspiratory pressures of 15 and 20 cm of H2O, divided by the pressure difference, and expressed as a function of body weight. The procedure was easy, took 5 to 10 minutes, and caused no recognizable ill effects in any of the dogs studied. Mean total thoracic compliance was 42.25 ± 32 ml/cm of H2O. There was a significant correlation with weight, but no significant relationship was seen between compliance and age, or gender. The mean weight-adjusted total thoracic compliance was 1.85 ± 0.56 ml/cm of H2O/kg. In studies in a small group of dogs with documented respiratory tract disease, 4 of 7 had a mean compliance > 2 sd below the normal range. Thus, this test may become part of the routine workup of any animal being anesthetized for procedures such as bronchoscopy to evaluate respiratory tract disease. Routine monitoring of animals on ventilators could provide early warning of complications such as pneumonia, pleural effusion, or pulmonary edema.

Free access
in American Journal of Veterinary Research
in Journal of the American Veterinary Medical Association

Objective

To evaluate clinical findings, prognostic variables, and clinical course of dogs exposed to smoke.

Design

Retrospective study.

Animals

27 dogs exposed to smoke in residential fires.

Procedure

Medical records were reviewed for 1988–1997. Time of year, signalment, interval from fire to arrival at veterinary hospital, duration of smoke exposure, clinical signs at the fire scene, physical examination findings, changes in respiratory tract signs, radiographic findings, hematologic and arterial blood gas analyses, initial treatment, clinical course, and outcome were recorded.

Results

27 dogs (16 uncomplicated and 11 complicated cases) were identified. In the complicated group, 4 dogs died, 4 were euthanatized, and 3 had a complicated clinical course. Stupor or coma (8 of 17 dogs), coughing or gagging (6), and respiratory difficulty (6) were commonly observed at the fire scene. Substantial improvement was evident within 5 to 30 minutes after dogs were given supplemental oxygen at the fire scene. More severely affected dogs had a higher median PCV (58%) than less severely affected dogs (50%). Most common thoracic radiographic findings were an alveolar (10 dogs) or an interstitial (3) pattern.

Conclusions and Clinical Relevance

Dogs exposed to smoke can develop respiratory or neurologic complications. Monitoring progression of respiratory problems on the day after the fire may provide clinicians with clues about the severity of each dog's condition. (J Am Vet Med Assoc 1999;215:1306–1311)

Free access
in Journal of the American Veterinary Medical Association

Objective

To review clinical findings and clinical course for cats exposed to smoke in residential fires and to determine clinical variables that may have prognostic importance.

Design

Retrospective study.

Animals

22 cats admitted to our veterinary teaching hospital between 1986 and 1997 with a history of smoke exposure during a residential fire.

Procedure

Medical records were reviewed for history, clinical signs, physical examination findings, changes in respiratory tract signs, initial hematologic analysis, treatment, results of thoracic radiography, and outcome.

Results

Fifteen of 22 (68%) cats were categorized in the uncomplicated group, 5 (23%) in the complicated group, and 2 (9%) were discharged after a short period because of financial considerations. Twenty (91%) cats survived, but 2 (9%) were euthanatized because of severe respiratory compromise or neurologic changes. Predominant thoracic radiographic changes were diffuse interstitial pattern (6 cats) and focal alveolar pattern (5). The majority (8/13) of cats that were stable or had improved by the day after admission had an uncomplicated clinical course while hospitalized, whereas cats that were worse on the day after admission tended to have a complicated clinical course.

Conclusions and Clinical Relevance

Cats that survive a residential fire and are admitted to a hospital have a good chance to be discharged. Cats that do not have signs of respiratory tract dysfunction at admission probably will not develop severe respiratory complications. For cats with signs of respiratory dysfunction at admission, better prognostic information will be determined by monitoring progression of the respiratory condition on the day after admission. (J Am Vet Med Assoc 1999;215:1312–1316)

Free access
in Journal of the American Veterinary Medical Association

Summary

Medical records of 23 dogs and 3 cats treated for noncardiogenic pulmonary edema (npe) resulting from airway obstruction (n = 8), cranial trauma (7), electric shock (7), or seizures (4) between 1987 and 1993 were reviewed. There were 18 purebred dogs, 5 mixed-breed dogs, 2 domestic shorthair cats, and 1 Siamese. Sixteen animals were male, and 10 were female. All but 7 were less than 1 year old. Time between the inciting incident and onset of respiratory tract signs ranged from minutes to several hours. Respiratory distress was the primary clinical sign for all animals with npe resulting from airway obstruction, cranial trauma, or seizures, and for 2 of the 7 animals with npe resulting from electric shock. The only consistent clinicopathologic abnormality was hyperglycemia, which was detected in 12 animals. Arterial blood gas partial pressures were measured in 11 animals; 10 were hypoxemic. On thoracic radiographs, the predominant pattern of pulmonary infiltration was alveolar. Symmetry of involvement, which was assessed by examining dorsoventral or ventrodorsal radiographic projections, could be determined for 23 animals. In 18, involvement was asymmetric, and in 13 of those 18, the right side was predominantly involved. On lateral radiographic projections, the caudodorsal quadrant of the lung field was involved primarily or as part of a diffuse distribution in all but 1 animal. Generally, animals with npe resulting from airway obstruction had the greatest degree of radiographic involvement, followed in decreasing order, by animals with npe resulting from cranial trauma, animals with npe resulting from seizures, and animals with npe resulting from electric shock. Overall, 9 animals died. Four of the 8 animals with npe resulting from airway obstruction and 2 of the 7 animals with npe resulting from cranial trauma died or were euthanatized because of the severity of the pulmonary compromise. One animal with npe resulting from electric shock developed seizures and died. Two of the 4 animals with npe resulting from seizures were euthanatized because of the underlying cause of the seizures. Overall, 20 of the 26 animals were discharged, died, or were euthanatized within 48 hours of admission to the hospital.

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

Twenty-four healthy dogs > 8 years old were recruited. In each instance, arterial blood gas tensions were analyzed. The alveolar-to-arterial oxygen gradient (P[a-a]o 2) was calculated to assess adequacy of pulmonary gas exchange. Thoracic radiographs were evaluated to ensure lack of visible signs of pulmonary disease and that lung features were similar to those in aged dogs of previous reports. Unlike findings in aged human beings, arterial partial pressure of oxygen (Pao 2) was not decreased in this group of aged dogs (mean ± sd, 102.9 ± 7.8 mm of Hg). Similarly, P[a-a] o 2 also was not increased. The thoracic radiographic findings were consistent with those of previous reports of pulmonary changes in aged dogs. The extent of radiographic abnormalities and the Pa o 2 were not correlated.

Free access
in American Journal of Veterinary Research