Content continues after advertisement

Respiratory Distress: Diagnosis & Treatment at a Glance

Stacey Leach, DVM, & Deborah Fine, DVM, MS, Diplomate ACVIM (Cardiology)

Respiratory Medicine

|
February 2011
|
Peer Reviewed

Sign in to Print/View PDF

Respiratory Distress: Diagnosis & Treatment at a Glance

DX AT A GLANCE

Upper Airway Obstruction

  • Clinical Signs: Inspiratory dyspnea, stridor
  • Differentials: Laryngeal paralysis, extrathoracic tracheal collapse, compressive masses, foreign bodies, brachycephalic syndrome

Lower Airway Obstruction

  • Clinical Signs: Expiratory dyspnea with auscultable expiratory wheezes
  • Differentials: Bronchoconstriction/spasms, bronchial wall inflammation (feline asthma, chronic bronchitis), intraluminal exudative/mucoid debris, intrathoracic tracheal collapse & bronchomalacia, bronchial compression secondary to left atrial enlargement

Thoracic Wall Disorders

  • Clinical Signs: Paradoxical respiration with the affected area of the thorax collapsing inward on inspiration & forced outward on expiration
  • Differentials: Flail chest, “sucking” chest wounds

Pleural Space Disorders

  • Clinical Signs: Rapid, shallow breathing patterns with inspiratory distress
  • Differentials: Pleural effusion, pneumothorax

Pulmonary Parenchymal Disorders

  • Clinical Signs: Inspiratory & expiratory difficulty; presence of heart murmurs, gallops, or arrhythmias may suggest underlying heart disease
  • Differentials: Pneumonia, edema (cardiogenic or noncardiogenic), pulmonary contusions, interstitial lung disease, neoplastic or fungal infiltration

Pulmonary Vascular Disorders

  • Clinical Signs: Hemoptysis, coughing, dyspnea, syncope; split heart sounds possible if concurrent pulmonary hypertension
  • Differentials: Pulmonary thrombo-embolism, heartworm disease

Severe Abdominal Distension

  • Clinical Signs: Inspiratory distress typically characterized by slow, exaggerated pattern
  • Differentials: Ascites, gastric dilatation-volvulus, organomegaly, pregnancy

TX AT A GLANCE

Upper Airway Obstruction

  • Sedation with acepromazine (eg, 0.025–0.2 mg/kg IV or IM) or butorphanol (eg, 0.1–0.4 mg/kg IV or IM)
  • Intubation, tracheostomy, etc if patent airway cannot be maintained
  • Glucocorticoids (eg, dexamethasone, 0.1–0.25 mg/kg IV) to reduce laryngeal & pharyngeal inflammation & edema
  • Active cooling for hyperthermic patients

Lower Airway Obstruction

  • Bronchodilators (eg, terbutaline, 0.01 mg/kg IM) to relieve bronchospasm
  • Glucocorticoids (eg, dexamethasone, 0.1–0.25 mg/kg IV or IM) for acute asthma in cats

Thoracic Wall Disorders

  • Parenteral opioids in combination with local anesthetics; NSAIDs may be used if no contraindications
  • Stabilization of flail segment to improve ventilation & facilitate evaluation & treatment; can impede inspiratory effort
  • Intermittent thoracocentesis to relieve concurrent pneumo/hemothorax

Pulmonary Parenchymal Disorders

  • Empirical therapy in extremely unstable patients
  • Thoracic radiographs for definitive diagnosis and treatment
  • Broad-spectrum antibiotics (eg, ampicillin, 22 mg/kg IV Q 8 H; enrofloxacin, 10–20 mg/kg IV Q 24 H for dogs & 5 mg/kg IV Q 24 H for cats), if pneumonia suspected
  • Loop diuretic (furosemide, initially 2–6 mg/kg IV or IM) at repeated dosing intervals for cardiogenic pulmonary edema 
  • Supportive care, oxygen supplementation, and mechanical ventilation for noncardiogenic pulmonary edema

Pulmonary Vascular Disorders

  • Anticoagulants, antiplatelet medications, thrombolytics
  • Bronchodilators (eg, theophylline, 10 mg/kg PO Q 12 H)
  • Pulmonary arterial vasodilators (eg, sildenafil, 1 mg/kg PO Q 8–12 H; pimobendan, 0.25 mg/kg PO Q 8–12 H) for concurrent pulmonary hypertension

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Podcasts

Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | Privacy Policy | Acceptable Use Policy