Retrospective evaluation of noncardiogenic pulmonary edema in dogs and cats (2000-2021): 31 cases

Abstract

Objective: To characterize the clinical features of noncardiogenic pulmonary edema (NCPE), etiology, and outcome in dogs and cats. The study also aimed to evaluate associations with mortality.

Design: Retrospective study.

Setting: University teaching hospital.

Animals: Thirty dogs and 1 cat, all client owned.

Interventions: None.

Measurements and main results: Data collected included animal characteristics, clinical history, evaluation of oxygenation, radiographic features, treatments, and outcomes. Causes of NCPE included upper airway obstruction, electrocution, drowning, neurogenic etiology, and unknown. The etiology was known in 21 of 31 cases (68%), while the etiology of the remaining 10 cases (32%) was classified as unknown. The most common cause for NCPE was upper airway obstruction, found in 14 of 31 cases (45%). The majority of thoracic radiographs showed a mixed interstitial-to-alveolar pulmonary pattern with a diffuse distribution (52%). Oxygen therapy was administered to 27 dogs (90%). Furosemide was administered to 12 dogs (40%). The median duration of hospitalization was 48 hours (range: 1-192). Twenty-three animals (74%) survived to discharge. Six dogs were mechanically ventilated, with only 2 of them (33%) surviving to discharge. The requirement for mechanical ventilation was the only parameter associated with mortality (P = 0.03).

Conclusions: NCPE is a heterogenous disease process that is most common in dogs. There are a variety of causes, but upper airway obstruction appears to be the most common. The overall prognosis is good in animals that do not require mechanical ventilation.

Keywords: airway obstruction; choking; drowning; electrocution; mechanical ventilation; neurogenic edema; strangulation.