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Aspiration Pneumonia

4K views 17 replies 5 participants last post by  jarn 
#1 ·
I was going to post this in the senior forum but as it's not exclusively a senior thing I thought I'd try here.

Luc, who turns 14 in July, has laryngeal paralysis. For the most part its asymptomatic, though he had a heat related scare 3 weeks ago. We got him cooled down, took him to the vet, he checked out fine.

He has developed a heart murmur (grade 4). So we've been monitoring his respiratory rate.

Saturday he was tearing around our yard like a puppy, playing 'chase and be chased'. Sunday night (last night), we went out, and as we were getting ready for bed noticed he was breathing heavily. I took his respiratory rate and it was 70+. Normally it's under 20.

Our vet had indicated 30 or higher was a concern for congestive heart failure, so we went to the e-vet (despite my husband's objections...he said I was a hypochondriac where Luc is concerned).

The vet examined Luc and didn't seem too concerned - pulse good, gums good, heart sounded fine aside from murmur - he presented normal - so left to monitor him at home, and got to bed about 2 am.

Got up just before 7 (it's a holiday in Canada today), checked his respiratory rate three times - 40, 34, 48 - called the e-vet. She suggested seeing how he ate, and he did, but wasn't as enthusiastic as normal (read: did not bark and spin like an idiot <3 ).

Much to my husband's annoyance, I insisted we go in for diagnostics. I think even the vet thought it was dumb. But we had x-rays and a scope done.

Results: Some white on his heart, likely calcification due to old age. Some of the left lobes of his lungs are white, so it could be cancer, but given that he has laryngeal paralysis, the likelihood is that it's aspiration pneumonia. The scope showed a small edema.

We are treating with antibiotics (the first dose was a nightmare to get in, as he was sedated and not hungry, and tried to bite us when we tried to pop peanut-buttery pills into his mouth). We left him to sleep it off and I just got him to eat the pills.

Question: I've read the survival rate of aspiration pneumonia is 77-81%. Which is apparently 'good' though doesn't seem that good to me. Does anyone know what the survival rate is for senior dogs? Does it change?

But I KNEW something was wrong. The e-vet kept saying 'Well, he's awake when you're looking at the respiratory rate, and 40 isn't bad for an awake dog' and I was like 'IT IS NOT NORMAL FOR HIM!!!!' I'm friends with our regular vet and even before we knew the results she was like 'I'm glad you're getting the x-rays done'.

Aspiration pneumonia experiences, good and bad, would be appreciated. Thanks all!
 
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#2 ·
Was the oxygen content of the blood measured? I know it can be done with dogs
Using pulse oximetry in veterinary medicine | VetGirl CE Blog

Antibiotics are called for in pneumonia and she has a chance. Girl, please try to relax and be calm, she knows your energy. This is why nurses and doctors don't take care of their own families. I know its hard but whatever happens you are doing your best.
 
#3 ·
I don't think so. I'll ask our regular vet tomorrow. That's a great thing to ask about, thanks. His gums looked pretty good so I think the vet felt that his blood was well oxidized.

He is on antibiotics, and finally taking them. Clavamox.

Thanks. I'm being pretty calm I think - talking to him upbeat, telling him what a good, brave boy he is. He is my heart dog, but I also know he's a had a good long life with me even if his puppy-3.5 years old years all spent in a shelter probably sucked, he's come through it well. I know we won't have him forever, but I was hoping to get a few more years out of him as he's pretty good for almost 14, and I'm sure we will. I can't imagine him dying, to be honest. I am hoping we caught this early enough, and he's healthy enough otherwise, that he'll be fine.

Though a friend just lost a larpar dog to aspiration pneumonia. But he'd been having other issues, so we're hopeful Luc's outcome will be different.
 
#5 ·
Oh thank you! I had no idea of that! (I'm taking a pet first aid course in June, I wish I'd taken it before).

We're going camping for 10 days in August, we were going to backpack, but as Luc has been slowing down decided not too. Pretty remote camping on the north shore of Lake Superior, a couple of different places, each about 1.5-2 hours from the nearest towns with regular vets, but I've contacted vets in those towns to see where we'd take him, just in case he has a heat issue.

I certainly hope for no worse health issue than that, and I think we'll be smarter about avoiding heat issues in the future - we have a better idea of his limits now, he'd never had a larpar heat issue before 3 weeks ago (my husband was hiking with the dogs while I trail ran) but we're beefing up our doggy first aid kit, and I figure learning how to stabilize a medical issue is a good thing with a geriatric dog, and Neb is 9 now so not young either. We're also getting some dog field/wilderness first aid guide. And my husband is certified in advanced wilderness and remote first aid, so hopefully between us we could keep him okay until we got him to a vet. 3 weeks ago we successfully cooled him once we regrouped, as we were 3 hours away from the city, and he was fine by the time we got home. We took him to the vet 2 days later on the Monday and he checked out great.
 
#6 · (Edited)
With regular bacterial pneumonia and severe URIs in rescue dogs, we sometimes have used Doxycycline + Clavamox combo (both drugs together) OR Bayril (which is very expensive, but the biggest gun in the arsenal...IV-administered Baytril has saved a few dogs I know that were at death's door). I've treated fosters with both Doxy and with Clav singly, too. When we're up against life-threatening pneumonia, our vet often treats aggressively, with both. If you feel like you aren't seeing an improvement in 48 hours, I woudl ask the vet what he or she thinks about maybe adding Doxy too. They can even get it in a compounded pill that tastes like chicken from Wedgewood Veterinary Compounding Pharmacy in NJ -- they ship fast.

We've saved several pneumonia dogs in rescue....but it always depends how far gone they are when we get them. Your odds are much better for having caught it early! My biggest challenge with them is sometimes getting nutrition and fluids into them when they're severely sick -- they stop taking anything in sometimes, and once that happens, we're in trouble. They often need a few days of sub-Q fluids, while the abx are starting to work.

If your dog stops drinking, your vet might be willing to show you how to give sub-Q fluids at home....or you can have them do it for you. That hydration often makes the dog feel a lot better. It's something to keep an eye on, at least.

Does your vet have an oxygen crate? Keep it in mind as an option if there's a downturn, as staying in one can be really helpful when things are touch-and-go. I know the fastest driving route to the closest emergency clinic oxygen crate...and had to use that route (I called on the way, and they were wait at the door for me to get the dog into the crate -- no stopping to do paperwork). The dog pulled through. You may not need it, but plan it out in advance in case you do so that you will not have to pause to look up where to go.
 
#7 ·
With regular bacterial pneumonia and severe URIs in rescue dogs, we sometimes have used Doxycycline + Clavamox combo (both drugs together) OR Bayril (which is very expensive, but the biggest gun in the arsenal...IV-administered Baytril has saved a few dogs I know that were at death's door). I've treated fosters with both Doxy and with Clav singly, too. When we're up against life-threatening pneumonia, our vet often treats aggressively, with both. If you feel like you aren't seeing an improvement in 48 hours, I woudl ask the vet what he or she thinks about maybe adding Doxy too. They can even get it in a compounded pill that tastes like chicken from Wedgewood Veterinary Compounding Pharmacy in NJ -- they ship fast.

We've saved several pneumonia dogs in rescue....but it always depends how far gone they are when we get them. Your odds are much better for having caught it early! My biggest challenge with them is sometimes getting nutrition and fluids into them when they're severely sick -- they stop taking anything in sometimes, and once that happens, we're in trouble. They often need a few days of sub-Q fluids, while the abx are starting to work.

If your dog stops drinking, your vet might be willing to show you how to give sub-Q fluids at home....or you can have them do it for you. That hydration often makes the dog feel a lot better. It's something to keep an eye on, at least.

Does your vet have an oxygen crate? Keep it in mind as an option if there's a downturn, as staying in one can be really helpful when things are touch-and-go.
The e-vet said if he wasn't improving they would add antibiotics, or that our regular vet would. But it's good to know what antibiotics they should be adding, thanks. I hope we've caught this early enough.

I've given sub-q fluids before to cats (had a cat with renal failure for 6 years, and when I worked in rescue and we had ferals taking a long time to come out from sedation in neuter recovery, I gave them fluids too) and rabbits (if any of my rabbits went off their food I automatically gave them fluids; it seemed to help stabilize until we could get a vet...hard to find good bunny vets) so I would imagine it would be similar for a dog though I could see Luc being super pissy about the needle.

Luc did get IV fluids at the e-vet today to help clear the sedation from his system. He's sleeping on the carpet now and I could be imagining it but he seems to be breathing better (though that may be due to him being asleep). I'm waking him up every two hours and getting him to walk around a bit.

The e-vet has an oxygen crate, and said that if he worsens, we should bring him for that. I don't know if our regular vet has one (I don't want to ask my friend who already was nice enough to check in several times on a holiday Monday...let her enjoy her day off, I'll call the office tomorrow) but if they don't, the e-vet is actually not that far away - just a 15 minute drive.

I will keep in mind the nutrition and fluids though. Luc generally has a very GOOD appetite - you'd think we starve him - he ate all his food this morning, we'll see if his appetite rebounds tonight, when I finally got the pills in him this afternoon, he didn't eat the kibble I'd mixed in (Neb 'helped' with that). But he was pretty dopey still.
 
#9 ·
Appetite is such a huge signifier! If you feel well enough to eat well, you're feeling alright! (More or less)
 
#12 ·
My girl had aspiration pneumonia. She was hospitized for a few days, IV antibiotics and frequent coupage. She started eating well and got to come home.

She got it for a different reason. But it's very common in dogs with larpar.
 
#13 ·
His stomach's not upset at this stage, if it is, we'll start probiotics.

Thanks gsdsar. I'm glad your girl got better.

Luc just ate all his dinner, so that's good.
 
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#15 ·
Thanks kr16.

I'm not sure Luc needs a nebulizer. He's recovering well - could antibiotics already be working after one day?????? He was breathing rapidly when he got up this morning, but I just took his respiratory rate 20 minutes ago while he was sleeping and it was 23. Which is WAY better - still high for him as despite his age he's a fairly fit dog, but normal for other dogs.

My husband didn't work until 1pm today, and my manager said I could work from home this afternoon so that we can keep an eye on him today which will cover the first 48 hours.

He goes through periods of breathing heavily, but they're short and he returns to better respiration.

I still wonder if this isn't lung cancer. He has no symptoms of aspiration pneumonia beyond rapid breathing. But it's getting better, and I wouldn't expect it to if it was cancer. But I didn't think the antibiotics would work this quickly either.

Unless it's just that we caught it so quickly he's recovering rapidly.

I spoke to our vet this morning and they said to continue with at-home treatment, as long as he continues to improve. They also have oxygen there, or at the e-vet, so we have two options.

But Luc LOOKS sick. It's around his eyes, and his posture. One of my best friends who is a wildlife biologist in Costa Rica has been in town for a week and a half - yesterday was her last night and we were supposed to go out, but she came over instead. After she buzzed in I went to the door and when she got off the elevator Neb ran down the hallway like a shot all excited - Luc would normally run too, but he just slowly walked. Broke my heart.

But he spun and barked a little bit before being fed this morning! And threw Neb's antler chew! (When Luc is excited, he throws stuff that's on the floor) So all of that is a good sign.
 
#16 ·
Glad he is getting better. AP does not always have symptoms that are visible. The drooping foggy eyes is a sign that something is off.

Yes, the antibiotics kick right in. Usually takes a day or so if its not severe. This is where some people make mistakes, they think its over and stop the treatment to early. With AP it needs to be given for about 4 weeks. Ask the vet that. If you stop and the bad bacteria is not killed it comes back stronger and than that antibiotic wont work and you have to switch to a different one sometimes.
 
#17 ·
Thanks. He's overall been getting better but I don't love how he's doing today. Can't all be straight up though I suppose.

Turns out his x-rays show moderate to severe arthritis too :( Poor dude. He's on pain meds for that and to help with breathing, plus a vet-recommended probiotic, his thyrotabs, and the antibiotic. He's all med-ed up!
 
#18 ·
Luc had his follow up x-rays today (2 weeks from diagnosis) and...

HIS X-RAYS ARE TOTALLY CLEAR!

Like, no more pneumonia, at all! Though we are continuing him on antibiotics another two weeks.

Probably because we caught it in the first day or two (as opposed to after a week or two) he's recovered really well.

SO HAPPY!!!!
 
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