Risk factors, characteristics, and outcomes of acute respiratory distress syndrome in dogs and cats: 54 cases

Ludivine Boiron, Katrina Hopper, Angela Borchers

Research output: Contribution to journalReview article

Abstract

Objective: To characterize the clinical features of the acute respiratory distress syndrome (ARDS), risk factors, and outcome in dogs and cats. The study also aimed to evaluate the current veterinary criteria for the diagnosis of ARDS by comparison of clinical diagnostic criteria with necropsy findings. Design: Retrospective study. Animals: Fifty-four client-owned animals, 46 dogs and 8 cats. Interventions: Medical records were reviewed for patients with the diagnosis of ARDS based on previously published clinical criteria or necropsy diagnosis. Signalment, clinical findings, and outcome were recorded. Measurements and Main Results: Animals were grouped according to a clinical or necropsy diagnosis: 43/54 (80%) were diagnosed with ARDS based on clinical criteria (group 1) and 11/54 (20%) were diagnosed with ARDS based on necropsy only (group 2). In group 1, 22/43 (51%) had a necropsy, which confirmed ARDS in 12/22 (54%). Direct (pulmonary) causes of ARDS were more common than indirect causes in dogs, while cats had a similar occurrence of direct and indirect causes. The most common risk factors identified in dogs were aspiration pneumonia (42%), systemic inflammatory response syndrome (SIRS) (29%), and shock (29%). All cats diagnosed clinically with ARDS had SIRS with or without sepsis. Of the animals with a clinical diagnosis of ARDS, 49% received mechanical ventilation and 58% received treatment (with or without mechanical ventilation) for 24 hours or longer. The overall case fatality rate was 84% in dogs and 100% in cats. Conclusions and Clinical Relevance: As described in human literature, pneumonia was the most common risk factor in dogs with ARDS, whereas it was SIRS for the cat population. The high mortality rate and discrepancy between the clinical diagnosis and necropsy findings may highlight limitations in the clinical criteria for the diagnosis of ARDS and treatment in dogs and cats.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
JournalJournal of Veterinary Emergency and Critical Care
Volume29
Issue number2
DOIs
StatePublished - Mar 1 2019

Fingerprint

Adult Respiratory Distress Syndrome
Cats
risk factors
Dogs
cats
dogs
necropsy
Systemic Inflammatory Response Syndrome
inflammation
Artificial Respiration
pneumonia
animals
acute respiratory distress syndrome
Aspiration Pneumonia
Mortality
retrospective studies
Medical Records
Shock
Sepsis
Pneumonia

Keywords

  • acute lung injury
  • aspiration pneumonia
  • mechanical ventilation
  • sepsis

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Risk factors, characteristics, and outcomes of acute respiratory distress syndrome in dogs and cats : 54 cases. / Boiron, Ludivine; Hopper, Katrina; Borchers, Angela.

In: Journal of Veterinary Emergency and Critical Care, Vol. 29, No. 2, 01.03.2019, p. 173-179.

Research output: Contribution to journalReview article

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abstract = "Objective: To characterize the clinical features of the acute respiratory distress syndrome (ARDS), risk factors, and outcome in dogs and cats. The study also aimed to evaluate the current veterinary criteria for the diagnosis of ARDS by comparison of clinical diagnostic criteria with necropsy findings. Design: Retrospective study. Animals: Fifty-four client-owned animals, 46 dogs and 8 cats. Interventions: Medical records were reviewed for patients with the diagnosis of ARDS based on previously published clinical criteria or necropsy diagnosis. Signalment, clinical findings, and outcome were recorded. Measurements and Main Results: Animals were grouped according to a clinical or necropsy diagnosis: 43/54 (80{\%}) were diagnosed with ARDS based on clinical criteria (group 1) and 11/54 (20{\%}) were diagnosed with ARDS based on necropsy only (group 2). In group 1, 22/43 (51{\%}) had a necropsy, which confirmed ARDS in 12/22 (54{\%}). Direct (pulmonary) causes of ARDS were more common than indirect causes in dogs, while cats had a similar occurrence of direct and indirect causes. The most common risk factors identified in dogs were aspiration pneumonia (42{\%}), systemic inflammatory response syndrome (SIRS) (29{\%}), and shock (29{\%}). All cats diagnosed clinically with ARDS had SIRS with or without sepsis. Of the animals with a clinical diagnosis of ARDS, 49{\%} received mechanical ventilation and 58{\%} received treatment (with or without mechanical ventilation) for 24 hours or longer. The overall case fatality rate was 84{\%} in dogs and 100{\%} in cats. Conclusions and Clinical Relevance: As described in human literature, pneumonia was the most common risk factor in dogs with ARDS, whereas it was SIRS for the cat population. The high mortality rate and discrepancy between the clinical diagnosis and necropsy findings may highlight limitations in the clinical criteria for the diagnosis of ARDS and treatment in dogs and cats.",
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N2 - Objective: To characterize the clinical features of the acute respiratory distress syndrome (ARDS), risk factors, and outcome in dogs and cats. The study also aimed to evaluate the current veterinary criteria for the diagnosis of ARDS by comparison of clinical diagnostic criteria with necropsy findings. Design: Retrospective study. Animals: Fifty-four client-owned animals, 46 dogs and 8 cats. Interventions: Medical records were reviewed for patients with the diagnosis of ARDS based on previously published clinical criteria or necropsy diagnosis. Signalment, clinical findings, and outcome were recorded. Measurements and Main Results: Animals were grouped according to a clinical or necropsy diagnosis: 43/54 (80%) were diagnosed with ARDS based on clinical criteria (group 1) and 11/54 (20%) were diagnosed with ARDS based on necropsy only (group 2). In group 1, 22/43 (51%) had a necropsy, which confirmed ARDS in 12/22 (54%). Direct (pulmonary) causes of ARDS were more common than indirect causes in dogs, while cats had a similar occurrence of direct and indirect causes. The most common risk factors identified in dogs were aspiration pneumonia (42%), systemic inflammatory response syndrome (SIRS) (29%), and shock (29%). All cats diagnosed clinically with ARDS had SIRS with or without sepsis. Of the animals with a clinical diagnosis of ARDS, 49% received mechanical ventilation and 58% received treatment (with or without mechanical ventilation) for 24 hours or longer. The overall case fatality rate was 84% in dogs and 100% in cats. Conclusions and Clinical Relevance: As described in human literature, pneumonia was the most common risk factor in dogs with ARDS, whereas it was SIRS for the cat population. The high mortality rate and discrepancy between the clinical diagnosis and necropsy findings may highlight limitations in the clinical criteria for the diagnosis of ARDS and treatment in dogs and cats.

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KW - acute lung injury

KW - aspiration pneumonia

KW - mechanical ventilation

KW - sepsis

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