Riscos potenciais, indicadores prognosticos, diagnostico e modalidades terapeuticas que afetam a sobrevida de cães com suposta pneumonia aspirativa / Potential risks, prognostic indicators, and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005–2008)
Potential risks, prognostic indicators, and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005–2008)
Objective – To evaluate a clinical population of dogs diagnosed with presumptive aspiration pneumonia (AP) and determine diagnostic and treatment modalities contributing to survival.
Design – Retrospective study.
Setting – A university veterinary teaching hospital in an urban setting.
Animals – One hundred and twenty-five dogs with presumed AP treated from 2005 to 2008.
Interventions – None.
Measurements and Main Results – Dogs with presumptive AP identified by a review of medical records had an overall survival of 81.6% (102/125). Male large-breed dogs (mean 24.9 kg; 82/125) were overrepresented and were more likely to develop AP in this study population. Recent anesthesia had been performed in 16% (20/125), and vomiting was reported in 64% (80/125). The most common radiographic findings were a predominantly alveolar pattern (187/272, [68.8%] total lung lobes) in the right middle lung lobe (80/115, [69.6%]). A mean of 2 lung lobes were involved radiographically, and the relationship between survival and the number of lung lobes affected was statistically significant (P=0.04). Neutrophilia with a left shift was common with no significant change on consecutive daily evaluations. The mean PaO2 was 77.7 mm Hg (SD, 17.5 mm Hg) (range, 40.7–100 mm Hg) with a median alveolar-arterial gradient of 41.1 mm Hg (range, 8.1–81.8 mm Hg). In this study population, 37.6% (47/125) of dogs had microbial cultures performed and of these, 76.6% (36/47) were positive for growth; Escherichia coli (38.8%), Mycoplasma spp. (21.3%), Pasturella spp. (19.1%), and Staphylococcusspp. (17%) were the most common isolates in either single or multiagent infections. No treatment modality was statistically associated with increased survival. Colloid therapy was a negative prognostic indicator.
Conclusions – In this study the overall prognosis for AP was good. Patients with only 1 affected lung lobe appeared more likely to survive. Supportive treatment modalities are warranted for the hospitalized patient, although no individual treatment method was found to be clearly superior to others.
Table 5. Treatment modalities evaluated between survivors and nonsurvivors
A P-value <0.05 was considered statistically significant.