1
|
McDonald A, Agarwal A, Williams B, Liu NC, Ladlow J. Neural network analysis of pharyngeal sounds can detect obstructive upper respiratory disease in brachycephalic dogs. PLoS One 2024; 19:e0305633. [PMID: 39172898 PMCID: PMC11340978 DOI: 10.1371/journal.pone.0305633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/03/2024] [Indexed: 08/24/2024] Open
Abstract
Brachycephalic obstructive airway syndrome (BOAS) is a highly prevalent respiratory disease affecting popular short-faced dog breeds such as Pugs and French bulldogs. BOAS causes significant morbidity, leading to poor exercise tolerance, sleep disorders and a shortened lifespan. Despite its severity, the disease is commonly missed by owners or disregarded by veterinary practitioners. A key clinical sign of BOAS is stertor, a low-frequency snoring sound. In recent years, a functional grading scheme has been introduced to semi-objectively grade BOAS based on the presence of stertor and other abnormal signs. However, correctly grading stertor requires significant experience and adding an objective component would aid accuracy and repeatability. This study proposes a recurrent neural network model to automatically detect and grade stertor in laryngeal electronic stethoscope recordings. The model is developed using a novel dataset of 665 labelled recordings taken from 341 dogs with diverse BOAS clinical signs. Evaluated via nested cross validation, the neural network predicts the presence of clinically significant BOAS with an area under the receiving operating characteristic of 0.85, an operating sensitivity of 71% and a specificity of 86%. The algorithm could enable widespread screening for BOAS to be conducted by both owners and veterinarians, improving treatment and breeding decisions.
Collapse
Affiliation(s)
- Andrew McDonald
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Anurag Agarwal
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Ben Williams
- Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Nai-Chieh Liu
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- Queen’s Veterinary School Hospital, Cambridge, United Kingdom
| | - Jane Ladlow
- Queen’s Veterinary School Hospital, Cambridge, United Kingdom
| |
Collapse
|
2
|
Chang W, Lin C, Chang C, Lo P, Chen H, Wu H. Assessing breathing effort by barometric whole-body plethysmography and its relationship with prognosis in client-owned cats with respiratory distress. J Vet Intern Med 2024; 38:1718-1724. [PMID: 38666546 PMCID: PMC11099772 DOI: 10.1111/jvim.17069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Cats in respiratory distress have limited tolerance for manipulation, hindering clinical monitoring. Minute volume (MV) can be utilized to rate dyspnea in humans, but its relationship with respiratory distress in cats remains poorly investigated. HYPOTHESIS Cats with respiratory distress will show higher MV per kg body weight (MV/BW) than normal cats, and the MV/BW increase will correlate with survival. ANIMALS Fifty-two cats with respiratory distress from lung parenchymal disease, pleural space disease, lower airway obstruction (LAO), or upper airway obstruction were recruited since 2014. METHODS This is a prospective observational study. Study cats were placed in a transparent chamber, allowing clinicians to easily observe their breathing status and record ventilation using barometric whole-body plethysmography (BWBP). Ventilatory variables of the 52 cats were compared with those of 14 historic control cats. Follow-up data, including disease category, clinical outcomes, and survival, were prospectively collected. RESULTS Cats in respiratory distress demonstrated significantly higher MV/BW (397 mL/kg; range, 158-1240) than normal cats (269 mL/kg; range, 168-389; P < .001). Among the etiologies, cats with LAO, parenchymal, and pleural space disease exhibited higher-than-normal MV/BW trends. A cutoff value of 373 mL/kg (1.4-fold increase) indicated abnormally increased breathing efforts (sensitivity, 67%; specificity, 93%). MV/BW was independently associated with increased cardiorespiratory mortality in cats with respiratory distress (adjusted hazard ratio 1.17, 95% confidence interval [CI] 1.02-1.35; P = .03). CONCLUSIONS AND CLINICAL IMPORTANCE Breathing efforts in cats can be noninvasively quantified using BWBP. Measurement of MV/BW could serve as a prognostic index for monitoring cats experiencing respiratory distress.
Collapse
Affiliation(s)
- Wei‐Tao Chang
- National Taiwan University Veterinary HospitalNational Taiwan UniversityTaipeiTaiwan
- Lab of Small Animal Respiratory and Cardiovascular Medicine, TACS‐Alliance Research CenterTaipeiTaiwan
| | - Chung‐Hui Lin
- National Taiwan University Veterinary HospitalNational Taiwan UniversityTaipeiTaiwan
- Lab of Small Animal Respiratory and Cardiovascular Medicine, TACS‐Alliance Research CenterTaipeiTaiwan
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Chin‐Hao Chang
- Department of Medical Research, National Taiwan University HospitalNational Taiwan UniversityTaipeiTaiwan
| | - Pei‐Ying Lo
- Lab of Small Animal Respiratory and Cardiovascular Medicine, TACS‐Alliance Research CenterTaipeiTaiwan
| | - Hui‐Wen Chen
- Department of Veterinary MedicineNational Taiwan UniversityTaipeiTaiwan
- Animal Resource CenterNational Taiwan UniversityTaipeiTaiwan
| | - Huey‐Dong Wu
- Section of Respiratory Therapy, Department of Integrated Diagnostics and TherapeuticsNational Taiwan University Hospital, National Taiwan UniversityTaipeiTaiwan
| |
Collapse
|
3
|
Suspected Primary Spontaneous Asymptomatic Pneumothorax in a Cat. Case Rep Vet Med 2022; 2022:2827118. [PMID: 35198260 PMCID: PMC8860558 DOI: 10.1155/2022/2827118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/06/2021] [Accepted: 02/03/2022] [Indexed: 11/18/2022] Open
Abstract
Spontaneous pneumothorax (SPT) is a documented emergency of the respiratory tract condition classified as either primary or secondary based on the presence of underlying pulmonary conditions. All reported SPT in the feline literature are evaluated for respiratory clinical signs. Primary SPT without underlying pathology or without clinical signs is not reported in cats. This case report describes a 10-year-old domestic longhair cat that was referred for evaluation of chronic lethargy with severe azotemia and placement of a subcutaneous ureteral bypass (SUB) system. Prior to presentation, the cat was diagnosed with renal insufficiency and treated medically with no resolution. Clinical examination under sedation revealed right-sided renomegaly. Thoracic radiographs revealed gas in the caudodorsal pleural space and concurrent pulmonary atelectasis. No respiratory clinical signs were present. Thoracic CT showed two pulmonary bullae, one located in the right caudal lung lobe and one in the cranial segment of the left cranial lung lobe. Abdominal ultrasound showed a right-sided ureteral obstruction. Medical management was elected for the spontaneous pneumothorax. A SUB was placed to address the ureteral obstruction; no complications were noted during recovery. The cat was free of clinical signs of respiratory disease after a follow-up time of nine months. This is the first reported case of a cat diagnosed with a nonclinical suspected primary spontaneous pneumothorax with no concurrent predisposing pulmonary pathology.
Collapse
|
4
|
Chalifoux NV, Drobatz KJ, Reineke EL. Predictors of inflammatory lower airway disease in cats presented to the emergency room in respiratory distress: a case-control study. J Feline Med Surg 2021; 23:1098-1108. [PMID: 33645320 PMCID: PMC10812157 DOI: 10.1177/1098612x21996145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of the study was to identify whether venous blood gas (VBG) variables may serve as a predictor of inflammatory lower airway disease (ILAD) in cats presenting with respiratory distress. A secondary objective of this study was to compare the diagnostic utility of patient signalment, history and physical examination findings, as compared with VBG variables. METHODS The medical records of cats presenting with respiratory distress secondary to ILAD (54 cases) and non-ILAD (121 controls) were retrospectively reviewed. RESULTS No admission VBG variables were predictive of a final diagnosis of ILAD. Comparatively, multivariable analysis identified a history of a cough (P <0.001), increased respiratory rate (P = 0.001), the presence of an abdominal component to respiration (P = 0.007) and the absence of pleural effusion (P <0.01) to be independently associated with a final diagnosis of ILAD. Cats with a history of a cough and an abdominal component to respiration had 7.86 and 5.81 greater odds of being diagnosed with ILAD, respectively. Cats with pleural effusion had 7.43 lower odds of having this final diagnosis. For every 10 breaths/min increase in respiratory rate, cats had 1.48 greater odds of being diagnosed with ILAD. Cats diagnosed with ILAD had a survival rate of 94% (95% CI 84-99%) vs 61% (95% CI 51-70%) for non-ILAD controls (P <0.001). CONCLUSIONS AND RELEVANCE The results of this study found patient history and physical examination findings to be more useful predictors of a final diagnosis of ILAD in comparison with VBG variables at presentation. A history of a cough, an abdominal component to respiration and a lack of pleural effusion were found to be significant predictors of this diagnosis. Further investigation into the role of respiratory rate in ILAD is warranted.
Collapse
Affiliation(s)
- Nolan V Chalifoux
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| | - Kenneth J Drobatz
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| | - Erica L Reineke
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| |
Collapse
|
5
|
Abstract
PRACTICAL RELEVANCE The feline cardiomyopathies are the most prevalent type of heart disease in adult domestic cats. Several forms have been identified (see Parts 2 and 3), with hypertrophic cardiomyopathy (HCM) being the most common. Clinically the cardiomyopathies are often indistinguishable. Cats with subclinical cardiomyopathy may or may not have characteristic physical examination findings (eg, heart murmur, gallop sound), or radiographic cardiomegaly. Cats with severe disease may develop signs of heart failure (eg, dyspnea, tachypnea) or systemic arterial thromboembolism (ATE; eg, pain and paralysis). Sudden death is possible. Treatment usually does not alter the progression from subclinical to clinical disease and often the treatment approach, once clinical signs are apparent, is the same regardless of the type of cardiomyopathy. However, differentiating cardiomyopathy from normal variation may be important prognostically. PATIENT GROUP Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. Mixed-breed cats are most commonly affected but certain breeds are disproportionately prone to developing HCM. DIAGNOSTICS Subclinical feline cardiomyopathies may be suspected based on physical examination findings, thoracic radiographs and cardiac biomarker results but often the disease is clinically silent. The definitive clinical confirmatory test is echocardiography. Left heart failure (pulmonary edema and/or pleural effusion) is most commonly diagnosed radiographically, but point-of-care ultrasound and amino terminal pro-B-type natriuretic peptide (NT-proBNP) biomarker testing can also be useful, especially when the stress of taking radiographs is best avoided. KEY FINDINGS Knowledge of pathophysiological mechanisms helps the practitioner identify the feline cardiomyopathies and understand how these diseases progress and how they manifest clinically (heart failure, ATE). Existing diagnostic tests have strengths and limitations, and being aware of these can help a practitioner deliver optimal recommendations regarding referral. CONCLUSIONS Several types of feline cardiomyopathies exist in both subclinical (mild to severe disease) and clinical (severe disease) phases. Heart failure and ATE are the most common clinical manifestations of severe cardiomyopathy and are therapeutic targets regardless of the type of cardiomyopathy. The long-term prognosis is often guarded or poor once overt clinical manifestations are present. AREAS OF UNCERTAINTY Some cats with presumed cardiomyopathy do not have echocardiographic features that fit the classic cardiomyopathies (cardiomyopathy - nonspecific phenotype). Although no definitive treatment is usually available, understanding how cardiomyopathies evolve remains worthy of investigation.
Collapse
Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| |
Collapse
|
6
|
Domínguez-Ruiz M, Reinero CR, Vientos-Plotts A, Grobman ME, Silverstein D, Le Boedec K. Interclinician agreement on the recognition of selected respiratory clinical signs in dogs and cats with abnormal breathing patterns. Vet J 2021; 277:105760. [PMID: 34655789 DOI: 10.1016/j.tvjl.2021.105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 11/26/2022]
Abstract
In humans, classification of abnormal breathing patterns (ABP) and recognition of ancillary respiratory signs are difficult, as reflected by poor-to-moderate interclinician agreement. The aims of this study were to assess interclinician agreement for respiratory sign recognition in dogs and cats and evaluate the influence of clinical experience on agreement. Dogs and cats with ABP were recruited from three hospitals. Included animals were evaluated by three clinicians at each hospital before therapeutic intervention. Consensual definitions for each respiratory clinical sign were provided to all clinicians. Interclinician agreement was measured via Fleiss' kappa and intraclass correlation coefficient statistics. Influence of clinical experience on interobserver agreement was studied via mixed-effects logistic regression. One-hundred and fifteen dogs and 49 cats with ABP were recruited. Out of 12 clinical signs evaluated, only stertor (kappa, 0.80), stridor (kappa, 0.64), attenuation of heart/lung sounds (kappa, 0.60), and goose honking (kappa, 0.84) in dogs, and stertor (kappa, 0.65) and open-mouth breathing (kappa, 0.75) in cats, were considered sufficiently reliable among clinicians. Agreement on respiratory rate estimation was good in both species (intraclass correlation coefficient, 0.75). The greater the difference in clinical experience between two clinicians, the lower the odds of agreement between the two clinicians' respiratory physical examination findings. Interclinician agreement was demonstrated to be poor for recognition of most respiratory clinical signs in dogs and cats. Teaching and clinical experience acquisition should be encouraged to improve respiratory clinical sign recognition.
Collapse
Affiliation(s)
- M Domínguez-Ruiz
- Centre Hospitalier Vétérinaire Frégis, 43, Av. Aristide Briand, 94110, Arcueil, France
| | - C R Reinero
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr, Columbia, MO 65211, USA
| | - A Vientos-Plotts
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr, Columbia, MO 65211, USA
| | - M E Grobman
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr, Columbia, MO 65211, USA
| | - D Silverstein
- University of Pennsylvania, Ryan Veterinary Hospital, 3900 Spruce St, Philadelphia, PA 19104, USA
| | - K Le Boedec
- Centre Hospitalier Vétérinaire Frégis, 43, Av. Aristide Briand, 94110, Arcueil, France.
| |
Collapse
|
7
|
Domínguez-Ruiz M, Reinero CR, Vientos-Plotts A, Grobman ME, Silverstein D, Gomes E, Le Boedec K. Association between respiratory clinical signs and respiratory localization in dogs and cats with abnormal breathing patterns. Vet J 2021; 277:105761. [PMID: 34655790 DOI: 10.1016/j.tvjl.2021.105761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 11/25/2022]
Abstract
The diagnostic values of respiratory signs have been under-investigated in pets. The study aim was to explore commonly assumed associations between respiratory signs and disease localization in pets with abnormal breathing patterns (ABP). Dogs and cats with ABP presenting to three hospitals were included if investigations permitted disease localization. Hypothesized associations between respiratory signs and disease location were evaluated via mixed-effects logistic regression. Sensitivity, specificity, and positive diagnostic likelihood ratio were calculated. One-hundred and fifteen dogs and 49 cats with ABP were recruited. Confirmed associations included: inspiratory effort with extra-thoracic airway disease (odds ratio [OR], 9.1; 95% confidence interval [95% CI] 3.0-27.2); expiratory effort with intra-thoracic airway disease (OR, 6.5; 95% CI, 2.3-18.1); paradoxical breathing and attenuation of heart/lung sounds with pleural space disease (paradoxical breathing: OR, 4.5; 95% CI 1.7-12.1; sound attenuation: OR, 11.5; 95% CI 4.0-33.3); decreased nasal airflow and stertor with nasal/pharyngeal disease (nasal airflow: OR, 26.2; 95% CI 8.1-84.8; stertor: OR, 155.2; 95% CI 24.9-968.8); stridor with laryngeal or tracheal disease (laryngeal disease: OR, 39.9; 95% CI 7.6-209.0; tracheal disease: OR, 32.4; 95% CI 4.2-248.0); tracheal sensitivity with bronchial disease (OR, 3.8; 95% CI 1.5-9.6); crackles with pulmonary or bronchial disease (pulmonary disease: OR, 5.4; 95% CI 2.1-13.8; bronchial disease: OR, 3.9; 95% CI 1.6-9.8); and goose honking with tracheal disease (all dogs with goose honking had tracheal involvement). Select respiratory signs provide guidance to localize and prioritize causes of the underlying respiratory disease in pets, allowing targeted interventions in animals with ABP.
Collapse
Affiliation(s)
- M Domínguez-Ruiz
- Centre Hospitalier Vétérinaire Frégis, 43, Av. Aristide Briand, 94110, Arcueil, France
| | - C R Reinero
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr. Columbia, MO 65211, USA
| | - A Vientos-Plotts
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr. Columbia, MO 65211, USA
| | - M E Grobman
- University of Missouri, Veterinary Health Center, 900 E. Campus Dr. Columbia, MO 65211, USA
| | - D Silverstein
- University of Pennsylvania, Ryan Veterinary Hospital, 3900 Spruce St. Philadelphia, PA 19104, USA
| | - E Gomes
- Centre Hospitalier Vétérinaire Frégis, 43, Av. Aristide Briand, 94110, Arcueil, France
| | - K Le Boedec
- Centre Hospitalier Vétérinaire Frégis, 43, Av. Aristide Briand, 94110, Arcueil, France.
| |
Collapse
|
8
|
Respiratory Emergencies. Vet Clin North Am Small Anim Pract 2020; 50:1237-1259. [PMID: 32891440 DOI: 10.1016/j.cvsm.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Respiratory distress is commonly seen in dogs and cats presenting to the emergency room. Rapid identification of respiratory difficulty with strategic stabilization and diagnostic efforts are warranted to maximize patient outcome. This article focuses on the relevant anatomy and physiology of the respiratory system and the clinical recognition, stabilization, and initial diagnostic planning for small animal patients that present for respiratory emergencies.
Collapse
|
9
|
Dijkstra E, Teske E, Szatmári V. Respiratory rate of clinically healthy cats measured in veterinary consultation rooms. Vet J 2018; 234:96-101. [PMID: 29680402 DOI: 10.1016/j.tvjl.2018.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 10/18/2022]
Abstract
Respiratory rate is commonly recorded during physical examinations. However, reference intervals are only available for resting and sleeping respiratory rates in cats at home. This observational study aimed to establish reference intervals for the respiratory rate in clinically healthy adult cats at primary-care veterinary clinics. Respiratory rates were recorded from 131 cats, in 6 primary-care veterinary clinics, by observation under four circumstances: by the investigator in the consultation room prior to and during a physical examination, by the owner at home when the cat was resting or sleeping, and by the investigator when watching a video-film of the cat recorded by the owner at home. The respiratory rate of the 88 clinically healthy adult (≥12 months) cats in the consultation room ranged 28-176breaths/min (median 64) with a calculated reference interval of 32-135breaths/min. Based on video-recordings, the resting (n=32) and sleeping (n=38) respiratory rates of the same cats were determined: median 27 (range 16-60)breaths/min and median 20 (range 9-28)breaths/min, respectively, which were lower than the respiratory rates recorded in the consultation room (both P<0.0001). We conclude that the reference intervals proposed for cats in textbooks reflect the resting respiratory rate at home. These values are inappropriate for using in the veterinary consultation room, because based on such reference intervals, many cats would erroneously be categorized as having tachypnea. Since the resting and sleeping respiratory rates at home show less variation, owners should be encouraged to film their pets before they visit their veterinarian.
Collapse
Affiliation(s)
- E Dijkstra
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM, Utrecht, The Netherlands
| | - E Teske
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM, Utrecht, The Netherlands
| | - V Szatmári
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM, Utrecht, The Netherlands.
| |
Collapse
|
10
|
|
11
|
Abstract
Acute liver injury and acute liver failure are syndromes characterized by a rapid loss of functional hepatocytes in a patient with no evidence of pre-existing liver disease. A variety of inciting causes have been identified, including toxic, infectious, neoplastic, and drug-induced causes. This article reviews the pathophysiology and clinical approach to the acute liver injury/acute liver failure patient, with a particular emphasis on the diagnostic evaluation and care in the acute setting.
Collapse
Affiliation(s)
- Vincent Thawley
- Emergency and Critical Care Medicine, Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
12
|
Lamb CR, Jones ID. Associations between respiratory signs and abnormalities reported in thoracic CT scans of cats. J Small Anim Pract 2016; 57:561-567. [DOI: 10.1111/jsap.12530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/15/2016] [Accepted: 05/13/2016] [Indexed: 01/12/2023]
Affiliation(s)
- C. R. Lamb
- Department of Clinical Science and Service; The Royal Veterinary College; Hawkshead Lane North Mymms Hertfordshire AL9 7TA
| | - I. D. Jones
- Department of Clinical Science and Service; The Royal Veterinary College; Hawkshead Lane North Mymms Hertfordshire AL9 7TA
| |
Collapse
|
13
|
Lisciandro GR. The use of the diaphragmatico-hepatic (DH) views of the abdominal and thoracic focused assessment with sonography for triage (AFAST/TFAST) examinations for the detection of pericardial effusion in 24 dogs (2011-2012). J Vet Emerg Crit Care (San Antonio) 2015; 26:125-31. [PMID: 26426980 DOI: 10.1111/vec.12374] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 04/09/2014] [Accepted: 05/16/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the clinical usefulness of the diaphragmatico-hepatic (DH) view of the abdominal and thoracic focused assessment with sonography for triage (AFAST/TFAST) in detecting pericardial effusion (PE) in dogs. DESIGN Retrospective case series from 2011 to 2012. SETTING Private practice emergency and critical care hospital. ANIMALS Twenty-four dogs with PE diagnosed by FAST. INTERVENTIONS None. MEASUREMENT AND MAIN RESULTS Fifty-two medical records from October 1, 2011 through September 30, 2012 had the terms "PE" within the medical record. Twenty-four dogs were diagnosed with PE by FAST with entries for the DH view. Of the 24 dogs, 7 had abdominal FAST, 6 had thoracic FAST (TFAST), and 11 had both exams performed. PE was noted on the DH view in 20 of 24 (83%) cases. Subjective PE volume assessment ranged from trivial (<5 mm) to severe. Of the 4 cases in which PE was absent via the DH view, PE was seen during the same exam at the TFAST pericardial views (n = 2) or detected on serial exam at the DH view (n = 2). The PE volume that was missed via the DH view was characterized as trivial (<5 mm; n = 1), mild (n = 1), and moderate (n = 2). CONCLUSIONS The DH view of FAST was found to be clinically helpful for the detection of PE. Veterinarians should make it routine practice and part of FAST training to look into the thorax via the DH view during both abdominal FAST and TFAST exams.
Collapse
|
14
|
Smith KF, Quinn RL, Rahilly LJ. Biomarkers for differentiation of causes of respiratory distress in dogs and cats: Part 1 - Cardiac diseases and pulmonary hypertension. J Vet Emerg Crit Care (San Antonio) 2015; 25:311-29. [DOI: 10.1111/vec.12318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 03/22/2015] [Indexed: 12/18/2022]
|
15
|
Abstract
This article reviews the approach to a patient with respiratory distress, with a focus on clues obtained from the physical examination. Respiratory distress is a common reason for presentation of a companion animal to a veterinarian on an emergency basis, and thus the clinician should have a comfort level with the approach to these patients. Our discussion includes a basic review of respiratory pathophysiology and the differential diagnoses for hypoxemia. In the majority of cases, physical examination should allow localization of the cause of the respiratory problem to the upper airways, lower airways, pleural space, or pulmonary parenchyma. Such localization, coupled with signalment and historical clues, guides additional diagnostics and therapeutics based on the most likely differential diagnoses. Although managing a patient with respiratory distress can be challenging, a systematic approach such as the one presented here should ensure appropriate intervention in a timely fashion and maximize the chance of a good outcome.
Collapse
Affiliation(s)
- Claire R Sharp
- Section of Critical Care, Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | | |
Collapse
|
16
|
Boysen SR, Lisciandro GR. The Use of Ultrasound for Dogs and Cats in the Emergency Room. Vet Clin North Am Small Anim Pract 2013; 43:773-97. [DOI: 10.1016/j.cvsm.2013.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
17
|
Sumner C, Rozanski E. Management of respiratory emergencies in small animals. Vet Clin North Am Small Anim Pract 2013; 43:799-815. [PMID: 23747261 DOI: 10.1016/j.cvsm.2013.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Management of respiratory distress involves careful consideration of the history, physical examination, and diagnostic testing. Supplemental oxygen is useful. Urgent procedures, such as intubation, thoracococentesis, or tracheostomy, may be required. The prognosis is dependent on the underlying disease, but is often favorable. This article reviews the approach, differential diagnoses, and the approach to management for dogs and cats with respiratory distress.
Collapse
Affiliation(s)
- Catherine Sumner
- Emergency and Critical Care Section, Tufts VETS, 525 South Street, Walpole, MA 02081, USA
| | | |
Collapse
|
18
|
Firth A, Boag A. Managing the dyspnoeic emergency Patient. IN PRACTICE 2012. [DOI: 10.1136/inp.e7376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|