Pulmonary edema is defined as a pathologic accumulation of fluid in the extravascular space of the lung.
The development of pulmonary edema is divided in cardiogenic and non-cardiogenic.
- Cardiogenic edema - due to elevated hydrostatic pressure in the pulmonary capillaries due to left sided congestive heart failure (e.g. dilated cardiomyopathy)
- Non-cardiogenic edema - due to upper airway obstruction e.g. laryngeal paralysis, strangulation, leptospirosis, acute respiratory distress syndrome, seizures, brain trauma, electrocution
Cardiogenic pulmonary edema and noncardiogenic pulmonary edema both cause interstitial edema, which is associated with perivascular and peribronchial expansion and increased lymphatic flow. Interstitial edema may progress into alveolar edema with alveolar flooding and secondary respiratory compromise.
Diagnosis is usually established from thoracic radiographs but brain natriuretic peptide concentration may help distinguish between cardiogenic and noncardiogenic cases.
The differentiation between cardiogenic versus non-cardiogenic genesis is not always straightforward, but most relevant, because treatment markedly differs between the two. Of further importance is the identification of the specific underlying cause in non-cardiogenic edema, not only for therapeutic but particularly for prognostic reasons. Depending on the cause the prognosis ranges from very poor to good chance of complete recovery.
Treatment for noncardiogenic pulmonary edema is mainly supportive, with oxygen therapy and diuretics.
- Long Beach Animal Hospital
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