Potential risks, prognostic indicators, and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005–2008)
Article first published online: 11 MAY 2010
DOI: 10.1111/j.1476-4431.2010.00542.x
© Veterinary Emergency and Critical Care Society 2010
Issue
Journal of Veterinary Emergency and Critical Care
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Abstract
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.
| Treatment modality | Survivors (n=102) | Nonsurvivors (n=23) | P-values |
|---|---|---|---|
| |||
| Oxygen | 45 (44.1%) | 15 (65.2%) | 0.08 |
| Ampicllin | 51 (50%) | 14 (60.9%) | 0.34 |
| Ampicillin-sulbactam | 43 (42.2%) | 8 (34.8%) | 0.77 |
| Enrofloxacin | 66 (64.7%) | 16 (69.6%) | 0.67 |
| Cefazolin | 7 (6.9%) | 0 (0%) | 0.44 |
| Colloids | 8 (7.8%) | 8 (34.8%) | 0.001* |
| Nebulization | 60 (58.8%) | 11 (47.8%) | 0.53 |
| Coupage | 57 (55.9%) | 11 (47.8%) | 0.68 |
| Famotidine | 54 (52.9%) | 13 (56.5%) | 0.84 |
| Sucralfate | 26 (25.5%) | 6 (26%) | 0.89 |
| Metoclopramide | 28 (27.5%) | 8 (34.8%) | 0.62 |
| Dolasetron | 8 (7.8%) | 5 (21.7%) | 0.10 |
| Glucocorticoids | 14 (13.7%) | 4 (17.4%) | 0.92 |
| Nonsurvivors with radiographs (n=19) | Survivors with radiographs (n=96) | P-value | |
|---|---|---|---|
| |||
| 1 lobe | 3 (15.8%) | 44 (45.8%) | |
| >1 lobe | 16 (84.2%) | 52 (54.2%) | 0.03* |
| 2 lobes | 9 (47.4%) | 31 (32.3%) | |
| >2 lobes | 7 (36.8%) | 21 (21.9%) | 0.37 |
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