Comparison of lung ultrasound, chest radiographs, C‐reactive protein, and clinical findings in dogs treated for aspiration pneumonia

Abstract

Background Comparison of clinical findings, chest radiographs (CXR), lung ultrasound (LUS) findings, and C‐reactive protein (CRP) concentrations at admission and serial follow‐up in dogs with aspiration pneumonia (AP) is lacking. Hypothesis Lung ultrasound lesions in dogs with AP are similar to those described in humans with community‐acquired pneumonia (comAP); the severity of CXR and LUS lesions are similar; normalization of CRP concentration precedes resolution of imaging abnormalities and more closely reflects the clinical improvement of dogs. Animals Seventeen dogs with AP. Methods Prospective observational study. Clinical examination, CXR, LUS, and CRP measurements performed at admission (n = 17), 2 weeks (n = 13), and 1 month after diagnosis (n = 6). All dogs received antimicrobial therapy. Lung ultrasound and CXR canine aspiration scoring systems used to compare abnormalities. Results B‐lines and shred signs with or without bronchograms were identified on LUS in 14 of 17 and 16 of 17, at admission. Chest radiographs and LUS scores differed significantly using both canine AP scoring systems at each time point (18 regions per dog, P < .001). Clinical and CRP normalization occurred in all dogs during follow up. Shred signs disappeared on LUS in all but 1 of 6 dogs at 1 month follow‐up, while B‐lines and CXR abnormalities persisted in 4 of 6 and all dogs, respectively. Conclusion and Clinical Importance Lung ultrasound findings resemble those of humans with comAP and differ from CXR findings. Shred signs and high CRP concentrations better reflect clinical findings during serial evaluation of dogs.

A retrospective study on parapneumonic effusion in 130 dogs with a clinical diagnosis of pneumonia

“…Thoracic POCUS was performed in 91/130 (70.0%) dogs, either as described by Fernandes Rodrigues et al ( 4 ) or according to the PLUS technique ( 5 ). Pleural effusion was described in 29/91 (31.8%) that had thoracic POCUS performed.…”

“…Parapneumonic effusion was diagnosed in 44 out of 130 patients (33.8%) in this single center retrospective study. Previous veterinary publications on bacterial pneumonia did not report on the presence of pleural effusion in dogs (4,8,9). It is unclear whether this was due to a true lack of parapneumonic effusion, or whether this was not assessed in these cases.…”

“…Secondly, several protocols have been used to perform thoracic POCUS. The technique described by Fernandes Rodrigues et al was specifically designed to study dogs with aspiration pneumonia and compare thoracic POCUS findings with thoracic X-rays ( 4 ). The PLUS protocol describes a technique that is guided by the landmarks of the thoracic cavity and aims to allow for identification of small amounts of free air or fluid ( 5 ).…”

Change over time and agreement between clinical markers of disease resolution in dogs with aspiration‐induced lung injury

“…For example, reported high C-reactive protein (CRP) concentrations in dogs with bacterial pneumonia have led to others investigating CRP normalisation as a marker to guide antibiotic treatment durations. [21][22][23][24][25][26][27] In addition, TXR as a marker of disease resolution in dogs with pneumonia has been challenged, with a recent study suggesting thoracic ultrasound as an alternative imaging tool. 22,24,26 Much of this recent work has focused on dogs with pneumonia of varying aetiologies, with only a few studies focused explicitly on dogs with aspiration pneumonia.…”

“…[21][22][23][24][25][26][27] In addition, TXR as a marker of disease resolution in dogs with pneumonia has been challenged, with a recent study suggesting thoracic ultrasound as an alternative imaging tool. 22,24,26 Much of this recent work has focused on dogs with pneumonia of varying aetiologies, with only a few studies focused explicitly on dogs with aspiration pneumonia. Of those studies with cohorts of dogs with aspiration pneumonia, the underlying pathology contributing to an aspiration event was not always well described.…”