Management of respiratory failure from tick paralysis

Abstract

Objective The primary objective of this review is to improve the recognition and management of respiratory failure in dogs and cats treated for tick paralysis in veterinary practice.Outline We review the definitions of respiratory failure in dogs and cats, differentiating hypoxaemic lung failure and hypercapnic ventilation failure. We also identify unsustainable breathing effort, despite normal blood gas values, as a form of respiratory failure. We analyse the research into possible mechanisms of respiratory failure in dogs and cats with tick paralysis and propose strategies that may aid in identification and management of respiratory failure when it develops in small animal patients affected by tick paralysis.Conclusions Dogs and cats with tick paralysis may develop respiratory failure despite management with tick antiserum. Prompt recognition and effective support strategies should improve the survival of these patients.

Acute Lower Motor Neuron Tetraparesis

“…The main cause of the respiratory signs seems to be pulmonary edema, but aspiration pneumonia secondary to pharyngeal and laryngeal dysfunction is also a common finding. 71,72 Although signs are most commonly symmetric, recent reports describe asymmetrical focal signs in several dogs and cats, including unilateral facial paralysis, anisocoria, unilateral loss of cutaneous trunci reflex, and Horner syndrome. 70 Removal of the tick does not result in improvement in Australian tick paralysis, with deterioration ensuing despite absence of ticks in the animal's body.…”

“…Although rare in North American cases, Australian dogs and cats with tick paralysis may need mechanical ventilation for survival. 71,75 Tick paralysis in North America is a disease with a good prognosis after the removal of the offending tick. In Australia, tick paralysis is a potentially fatal disease with an estimated mortality rate of 5% despite treatment.…”

In this issue – December 2013

“…The second study is a review aimed at improving the management of respiratory failure in dogs and cats treated for tick paralysis . The authors define the different forms of respiratory failure and describe the respiratory assessment of tick paralysis patients.…”

Elective cricothyrotomy in a dog with transient laryngeal paralysis secondary to Australian paralysis tick (Ixodes holocyclus) envenomation

“…5,6 Experts in the field recommend a surgical airway using TT to manage laryngeal paralysis causing temporary upper airway obstruction secondary to tick paralysis. 7,8 The aim of this report is to describe the clinical management and outcome of a dog with laryngeal paralysis secondary to tick paralysis managed with elective CTT. A secondary aim is to discuss potential management advantages of CTT in light of the current standard of practice of TT for surgical airway access in veterinary medicine.…”