Acute respiratory distress syndrome

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Chest radiograph of a 5-year-old mixed breed dog presented for penetrating bite wounds to the head, neck and thorax, showing complete transverse fractures of ribs 5 and 6 on the left side (white arrows), a mild increase in pulmonary interstitial markings medial to the fractured ribs, and subcutaneous emphysema (black arrows)[1]

Acute respiratory distress syndrome (acute lung injury, ARDS) is a relatively common disorder of dogs characterized by sudden-onset respiratory inflammatory response that compromises alveolar-capillary membrane integrity[2].

Two genetic forms have been recognized; one in neonatal pups[3] and an adult form in the Dalmatian[4], both of which have differing etiologies and clinical presentations. The adult form in Dalmatians is characterized by interstitial pneumonia.

This condition commonly occurs as a result of pulmonary insults which lead to varying degrees of respiratory compromise and failure that can range along a continuum from dyspnea to acute death[5].

This disease is frequently seen in association with:

Clinical signs in neonatal pups is characterized by non-febrile respiratory distress immediately following birth that is often fatal and is thought to be due to poor pulmonary maturity or multiple organ dysfunction.

The adult form of acute respiratory distress has many presenting symptoms depending on cause but the respiratory component of signs is frequently characterized by fever, dyspnea and cyanosis.

Diagnosis is based on presenting clinical signs, thoracic radiographs and exclusion of other causes of respiratory disease. Radiographs may show pericardial effusion, thoracic effusion, air bronchograms and free air within the lung cavity.

A differential diagnosis would include pulmonary interstitial fibrosis, chronic bronchitis, kennel cough, tracheal collapse, bronchomalacia and bronchial carcinoma.

Most cases are treated as emergencies and dogs are usually anesthetized and placed on positive-pressure ventilation with 100% oxygen. Specific treatment should focus on addressing underlying disease states.

The use of aminophylline or terbutaline may improve symptoms in acute lung injury[19].


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  3. LIDA
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