Dana Dietrich, DVM
Trouble breathing is a common emergency encountered by veterinarians in small animal medicine. Getting a pet into a veterinarian so they can quickly identify and address life-threatening problems will help achieve a positive outcome. When the animal comes into the hospital, the veterinarian will immediately observe the animal’s breathing pattern. This initial assessment only takes ten to twenty seconds. Evaluating the animal’s breathing pattern can help determine if the animal is having trouble breathing because of problems with the nasal passages or trachea, chest cavity disease, or lung disease. Is there noisy breathing, blue instead of pink gums, and/or an increased rate or effort to the animal’s breathing? Is there an abdominal movement or postures of relief including an extended neck, extended elbows, or open mouth breathing? These clues help the veterinarian determine why the animal is having trouble breathing. After the initial evaluation, the veterinarian will perform testing and provide oxygen supplementation. If the animal is stable enough, a full physical exam will be performed at this time.
Listening to the animal’s chest, evaluating the breathing pattern, and a thorough history can help localize the problem. The upper airway includes the nasal passages, the throat, or the trachea (the windpipe). Upper airway distress can be caused by nerve damage to the airway opening in the throat, windpipe compression, foreign bodies, cancer, infection, trauma, and polyps, to name a few. Animals with trouble breathing due to upper airway distress can have noisy breathing, decreased airflow through the nasal passages, neck extension, blue gums, and an elevated body temperature. Other findings can include nasal discharge, narrowed nostrils, bulging eyes, trouble swallowing, loss or change of voice, and a distended stomach with air. Nasal discharge can be clear, green, and/or bloody. Trouble breathing due to the upper airway can lead to fluid accumulation within the lungs or even pneumonia. Treatment includes oxygen supplementation, sedation, temperature monitoring, fluids, and anti-inflammatories. If there is no response to this initial treatment, the animal may need to have a tube placed into the airway to assist with breathing.
Chest cavity disease includes collapsed lungs, fluid surrounding the lungs, cancer, and/or when organs normally found within the belly have pushed through the diaphragm and are compressing the lungs. If your pet has collapsed lungs or fluid compressing the lungs, treatment involves inserting a needle into the chest to remove the air or fluid. Even removing a small amount of air or fluid from the chest can greatly improve the animal’s breathing. At times, a chest tube may need to be placed.
Lung disease includes asthma, pneumonia, heart failure, and fluid accumulation within the lungs secondary to trauma. Findings on physical examination can include trouble breathing, coughing, and in cases of pneumonia, a fever. Treatment depends on the cause of the lung disease. Treatment of asthma includes oxygen therapy, medication to help open the airways within the lungs, anti-inflammatories, and antibiotics. Treatment for pneumonia includes oxygen therapy, medication to help open the airway within the lungs, nebulization, coupage, and antibiotics. Nebulization provides hydration to the respiratory tract by delivering sterile water to the lungs. Medication to help open the airways within the lungs can also be delivered by nebulization. Coupage is a technique performed to help loosen secretions within the lungs that cause coughing to aid in removing the secretions from the lungs. Treatment for heart failure includes oxygen therapy and medication to help remove fluid from within the lungs. Inserting a needle into the chest can only remove fluid surrounding the lungs, but cannot remove fluid within the lungs. Treatment for fluid accumulation within the lungs due to trauma includes oxygen therapy, fluids, medication to help open the airways within the lungs, and pain medication. Animals with trouble breathing due to lung disease may need to be placed on a machine (ventilator) to assist with breathing until the lungs have time to heal.
When a pet has trouble breathing, it is a true medical emergency. An evaluation by a veterinarian as soon as possible is essential for a chance at a good outcome and continued good quality of life.