Evaluating animals in respiratory distress and developing a therapeutic plan requires keen physical examination skills, knowledge of common respiratory diseases, and an understanding of the risks and benefits of various diagnostic and therapeutic options. A large number of potential etiologies for respiratory distress exist, and can include disorders of the airways, lung parenchyma, chest wall, or “look-alike” diseases (eg, hyperthermia or anemia), resulting in a clinical appearance of respiratory distress. Careful physical examination is essential and signalment and history may give important clues to the etiology. Special attention should be paid to noises made while breathing, effort and speed of breathing, and auscultation abnormalities. The diagnostic plan will depend on initial findings and may include hemoglobin saturation measurement, arterial blood gas, and/or thoracocentesis with cytologic analysis and culture of pleural fluid. Once the patient is stable, thoracic radiographs provide valuable information. Therapeutic goals are to maximize oxygen delivery to tissues and optimize carbon dioxide removal. Positive pressure ventilation should be considered in animals with life-threatening dyspnea or impending fatigue. Depending on the underlying disease or suspected etiology, further treatment and diagnostics may include an endoscopic exam, chest tube placement, surgical exploration, and medications (eg, bronchodilators, steroids, antibiotics, furosemide).
COMMENTARY: Respiratory emergencies can be stressful even to a seasoned practitioner. This presentation will help localize diseases that can cause increased respiratory effort by using an anatomic basis to logically lead you to a diagnosis. Discussion of commonly available diagnostics, therapeutics, and medications will also be included. This presentation is an excellent overview of treating a patient with respiratory distress.
NAVC: Deborah Silverstein, DVM, Diplomate ACVECC /Saturday, January 16 • 8:00–8:50, Gaylord