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Canine Aspiration Pneumonia

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Aspiration Pneumonia
Aspiration Pneumonia in Dogs

Aspiration Pneumonia

Aspiration pneumonia may occur when dogs or cats vomit then inhale the vomitus into their lungs. The inhaled stomach contents are highly acidic causing chemical burn to the lung tissue. Secondary bacterial infection may result. The presence of food material further complicates the pneumonia. Severe illness resulting in physical weakness will increase the risk for aspiration pneumonia should vomiting occur. Aspiration pneumonia may occur when animals vomit after surgery because anesthetic drugs depress the swallowing reflex, especially if they have not been properly fasted before surgery. Recurrent aspiration pneumonia is common in dogs with a condition called megaesophagus (where there is a large dilated esophagus and lung inflammation occurs in the lower part of the lungs causing lack of motility of the esophagus). Some diseases of the nerves that normally control swallowing can also allow entry of food into the lungs. Aspiration Pneumonia is a frequent and often lethal complication in dogs with Megaesophagus.

Aspiration pneumonia is a frequently diagnosed lung disorder in young puppies, especially those that are orphaned. Orphaned puppies fed milk replacers by the tube method are most at risk because they are frequently overfed, or the tube is passed into the trachea rather than the esophagus. A malpositioned feeding tube will result in milk formula entering the lungs; this causes congestion and pneumonia. A puppy with a cleft palate may also aspirate milk or milk formulas into its lungs.

Inhalation of any material other than air will constitute aspiration, after which a secondary inflammatory process will ensue. Commonly vomit, dusts, smoke, oral secretions, water if near drowning and foreign objects like foxtails or other plant materials can all become aspirated. These substances, when inhaled, damage the lung tissue and lead to inflammation, possibly infection, and overall the disruption of normal air exchange between lung tissue and the blood supply. If the amount of foreign material is large enough, as in a near drowning, the dog may immediately suffocate.

What are the symptoms?
Clinical signs of aspiration pneumonia include trouble breathing, which may be severe, cough, weakness, gagging or choking, blue lips or gums, noise upon expiration or movement, fever, depression, nasal discharge and loss of appetite. Some dogs may develop pleuritis or pyothorax if the insult was some type of foreign object. Diagnosis is based on history, physical exam, blood counts, serum chemistries, X-rays, cytology and culture of material from the lungs.

A puppy that aspirates milk formula will usually have milk flow out the nostrils as well as have fluid entering the lungs. In severe instances, the puppy will have immediate difficulty in breathing.

What are the risks?
The prognosis for aspiration pneumonia depends on the ability to correct the cause of the vomiting and on the severity of the pneumonia. All cases of aspiration pneumonia are potentially very serious. Even puppies that only get 'a little' milk formula in their lungs frequently develop a bacterial lung infection within several days. They may recover or die depending on the severity.

What is the management?
If the aspiration is due to a congenital malformation such as cleft palate, then surgical intervention to repair the defect may be needed. Care should be taken if milk replacers are artificially fed so as not to get any into the puppy's trachea or lungs. The same is true when administering other medications such as liquid wormers, laxatives, or vitamins. If one suspects a puppy has aspirated a foreign substance, consult your veterinarian. The puppy must be observed closely for several days for signs of an infection such as respiratory distress, coughing and/or fevers. Antibiotics are given if bacteria invade the fluid-filled lung areas.

Removal and clearance of as much material from the lungs is a first priority. Secondly, prevention of further aspiration may also be needed, especially in cases of vomiting. Hospitalization with oxygen therapy, mechanical respiration in extreme cases, antibiotics and anti-inflammatory medications are all important. IV fluids and nutritional support may be necessary, and most patients who survive a few days will survive. Repeat chest X-rays can be used to determine the degree of healing and if secondary complications are occurring.
 

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Aspiration Pneumonia in Dogs

         http://www.petplace.com
     Dr. Bari Spielman
 
Section: Overview
Aspiration pneumonia is an inflammatory lung disorder that occurs when your dog inhales a foreign substance. This most commonly occurs with disorders that cause regurgitation or vomiting. But, neuromuscular disorders that cause difficulty swallowing or paralysis of the esophagus can also lead to aspiration pneumonia. Dogs are more often affected than cats, and depending on the underlying cause, different ages and breeds are affected.

Causes
Oropharyngeal (mouth and throat) disorders

Cleft palate

Diseases of the larynx or laryngeal surgery

Brachycephalic syndrome – upper airway obstruction that occurs in short nosed breeds of dogs

Esophageal disorders, such as esophageal obstruction from foreign bodies or masses, inflammation of the esophagus, or paralysis and enlargement of the esophagus (megaesophagus)

Polyneuropathy – a dysfunction of many different nerves

Polymyopathy – an inflammatory or immune disorder of the muscles

Decreased mentation or alertness causing a decrease in the swallowing reflex, caused by general anesthesia, sedation, head trauma, or a seizure

Accidental administration of medications, fluids, or foodstuffs into the wind pipe rather than the esophagus, especially during force feeding or tube feeding

Vomiting, especially chronic vomiting

What to Watch For
Coughing

Respiratory distress, with rapid breathing and a high heart rate

Cyanosis (blue color to the mucus membranes)

Exercise intolerance, weakness

Nasal discharge

Fever

Depression

Loss of appetite

Diagnosis
A thorough physical examination with auscultation of the chest (listening to the chest through a stethoscope) and palpation of the abdomen are very helpful in detecting changes that could indicate the presence of aspiration pneumonia. Additional tests may include:

Your veterinarian may choose to run some laboratory tests such as a complete blood count (CBC), biochemical profile, and urinalysis to search for evidence of infection and the presence of an underlying cause.

Chest X-rays can show changes in the lung that may indicate aspiration pneumonia.

Fluid may be retrieved from the lower airway and lungs for examination under the microscope, and it may be cultured to isolate causative bacteria and identify a proper antibiotic to use in treatment.

If the animal is in respiratory distress, a blood gas analysis may be considered.

Various other tests may be needed to identify an underlying cause of vomiting, regurgitation, or dysfunction. Such tests include abdominal X-rays, an esophagram or barium swallow, and fluoroscopy ( a video X-ray) to assess the esophagus in motion.

If a megaesophagus is discovered, then further testing is indicated to search for the cause of the esophageal paralysis.

Treatment
Severely ill patients may require hospitalization with oxygen, intravenous fluids, antibiotics and supportive care. Mildly affected pets that are well hydrated and eating properly may be treated as outpatients, with frequent follow-up examinations to monitor the progression of the infection. Additional treatments may include:

Cage rest or exercise restriction

Loosening of secretions. This can be done with a humidifier or by thumping the chest wall (coupage).

Bronchodilator therapy to help open up the airways

Bronchoscopy to remove a foreign body if present

Surgery. In a handful of cases, removal of the affected lung lobe, foreign body, or tumor may be done.

Treatment or correction of any underlying problem

Home Care and Prevention
Aspiration pneumonia, particularly of stomach contents, can be a serious, life-threatening condition. The animal may require several days in intensive care before it stabilizes, and some animals have great difficulty recovering from this condition, particularly if the underlying problem is due to paralysis of the esophagus. Once the animal is discharged from the hospital, administer all medications as directed by your veterinarian. Return for follow up examinations, blood work, and radiographs as recommended by your veterinarian.

Many times, aspiration pneumonia cannot be prevented. However, treating and controlling the underlying disorder can greatly reduce the risk of aspiration pneumonia or prevent the condition from recurring.
© Copyright 1999-2008 Intelligent Content Corp., All Rights Reserved
This article has been provided courtesy of PetPlace.com
(www.petplace.com), the definitive online source for pet news, health, and wellness information."

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Aspirated Pneumonia


chloebutton   talabutton

The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.