Dyspnoea in Dogs and Cats: Causes and Treatment of Symptoms of Diseases,

Dyspnoea in a dog

Dyspnoea in dogs and cats it is an example of a disturbing disease symptom that should never be underestimated.

A clinically healthy organism does not show any disease symptoms that would worry the owner and its behavior does not differ from the generally accepted norm for a given species.

Each disease symptom, regardless of its severity, should quickly be the reason for a veterinary consultation and none of them should be underestimated.

It is better to be reassured during the examination in the clinic than to overlook even the seemingly harmless symptom of a developing serious pathology.

In veterinary medicine, as in human medicine, a symptom noticed faster may lead to an earlier accurate diagnosis, and as we know well, it allows us to implement a more effective therapy leading to a full recovery or alleviation of the animal's well-being.

Many diseases also start innocently and do not immediately run among the typical, characteristic symptoms on the basis of which we will make an error-free diagnosis and implement appropriate treatment.

Hence, each change in the behavior of our pet should be treated very seriously and as soon as possible go to the clinic in accordance with the principle that "it is better to do more than necessary so as not to regret it later when it is too late ".

Working many times in the clinic, I have encountered a situation where the pet owner calling out describes the symptoms and asks:

"Does it have to be immediately or maybe wait a while? ".

The answer in this situation is obvious and obvious.

In fact, you need a lot of knowledge, clinical experience and a lot of intuition to bear some risk, you can say "we are waiting until tomorrow, maybe it will pass ".

It is much safer to invite the patient for the examination immediately and to calm down the owner or recognize the disease and implement the treatment.

However, some symptoms should immediately, without hesitation and doubts, direct our steps to the veterinarian immediately, because delaying the visit may end tragically in a short time and our pet will not wait until the next day's visit.

This is what happens in many situations where it is absolutely impossible to wait, allowing the animal to suffer unnecessarily.

Let us use the symptom as an excellent example of such a pathology breathlessness that is, a pathology commonly associated with respiratory diseases.

So let's take a look at the various disease states with the aforementioned dyspnea and explain clearly why it is not worth waiting for help. In the case of this symptom, delaying the intervention may end tragically quickly.

• What is dyspnea in a dog / cat?
• Types of dyspnea in animals
• Clinical symptoms of dyspnea
• Diagnosis of dyspnea, differential diagnosis
• With what diseases does shortness of breath occur?
• Oxygen therapy and ventilation as important supportive treatments
• Treatment of diseases associated with dyspnoea
  • Upper respiratory tract obstruction
  • Obstruction of the lower respiratory tract
  • Parenchymal diseases of the lungs
  • Pleural diseases

What is dyspnea in a dog / cat?

What is dyspnea

Dyspnoea, called dyspnoea in Latin, is an individual, subjective feeling of breathlessness, lack of air, difficulty in breathing, which occurs in a situation that is inadequate to physical exertion.

It can even appear at complete rest, when the body is not making any movement.

It is often associated with a lot of effort from the respiratory muscles.

Otherwise known as the feeling of "air hunger " or "short breath ".

As the perceptive reader will notice, it is not the most accurate term in relation to animals, which, after all, cannot tell us about their feelings or breathing difficulties.

Dyspnoea, therefore, is a breathing disorder that is clearly visible, which is an expression of failure of proper ventilation leading to disturbances in blood oxygenation.

The concept of dyspnea is inherently associated with such terms as tachypnea, i.e. a higher than normal respiratory rate (increased respiratory rate), hyperventilation, i.e. breathing in excess of metabolic requirements, reducing the concentration of carbon dioxide.

As a result of shortness of breath, the body will have too little oxygen to the cells and thus the excretion of carbon dioxide will be impaired.

Therefore, the basic physiological processes in every cell of the body will be disturbed.

Dyspnea, as it is easy to guess, will always be a serious threat to the life and health of the system and therefore should never be underestimated.

Not only because of the great discomfort of the animal, but also and perhaps above all because of the potential disease risks and their possible effects, we cannot allow the animal to feel it.

Not every accelerated breathing or "gasping" must mean shortness of breath, which should be clearly stated at the outset.

The dog breathes faster after intense physical exertion, running, a long stay on a retrieve walk, after training it will breathe faster, which is obvious, but it will quickly return to proper breathing after a short rest.

Then we are not talking about dyspnea and the condition of the dog subjected to intense work is completely natural.

If, however, after walking a few steps, our pet does not have the strength to go further and gasps at the same time, it is a clear signal of pathology, which should urgently force us to diagnose and help.

Shortness of breath or rapid breathing must not be confused with gasping, which is the body's natural thermoregulatory mechanism that allows the body to lose heat as a result of exercise.

Remember that under physiological conditions, the dog breathes through the nose or mouth, and the cat breathes only through the nose, so breathing with an open mouth is always a pathology in this species (cats).

From the layman's point of view, shortness of breath is associated with the animal's great effort to breathe, hence other terms of this condition as increased respiratory effort or hyperpnoea.

Dyspnoea is certainly a heavy strain on the body, especially its respiratory muscles, and requires a lot of energy. It is also a huge stress not only for the patient who is unable to catch the air, but also for its owner, who, often panicking, does not know how to help his ward quickly.

The term orthopnoea, i.e. such a breathing disorder, shortness of breath that forces the suffering animal to assume a specific, relaxed body position that facilitates breathing is also a concept that is worth explaining when describing dyspnea (more on that later).

Types of dyspnea in animals

From a clinical point of view, we can distinguish dyspnea:

• inspiratory,
• exhaust,
• mixed.

Inspiratory dyspnea is associated with a prolongation of the inspiratory phase and may be accompanied by wheezing and wheezing.

Importantly, its occurrence indicates the existence of pathology, e.g. narrowing of the upper respiratory tract and therefore outside the thoracic organs.

Pathological changes in the upper respiratory tract lead to the occurrence of a respiratory noise called a stridor, and disturbances in the flow of air through the nasal cavity and throat are manifested by a hoarse noise called a stertor.

Expiratory breathlessness, which may be with or without tracheal murmurs, is recognized by the prolonged exhalation phase and sometimes the so-called exhalation two-beat (before abdominal muscle contraction, the abdominal wall first moves outwards).

Such shortness of breath will appear in pathologies that are located in the lower respiratory tract.

The air retained in the lungs stimulates the appropriate receptors, which translates into the prolongation of the exhalation phase.

These disorders do not directly concern the alveoli and impaired gas exchange, but they appear, for example, in cancer, tracheal collapse or feline asthma.

And finally, a mixed type of dyspnea, i.e. inhalation-expiratory dyspnea with accelerated breathing, widening of the chest and low breathing volume, also known as restrictive dyspnea; it occurs with many pathologies located not only in the chest area, about which a bit further.

In a nutshell, we could divide the various types of dyspnea, which, however, is rarely distinguished by the animal keepers themselves, hence a visit to the clinic is always advisable.

The diagnosis of a given type of dyspnea narrows down the subsequent diagnosis.

Clinical symptoms of dyspnea

Clinical symptoms of dyspnea

Dyspnea, as we know, is a subjective feeling, therefore, if we want to find it in our pupils, we must carefully observe them, sometimes noticing subtle changes in their behavior.

Because animals will not tell us about their difficulties with air intake, but very often through their posture and symptoms they will manifest it. Hence the need to know the symptoms associated with the dyspnea.

A dog or cat showing difficulty in breathing may adopt special relief postures that may make it easier for it to breathe, at least to some extent.

Dyspnoea animals stand with elbows exposed, sit down, avoid physical exertion that increases oxygen demand, and have neck stretched frequently.

They can also lie on the breastbone.

By adopting relief postures, they are very reluctant to change them, which of course is associated with increased dyspnea and discomfort.

In the event of dyspnea, the animals breathe through the mouth.

Dyspnoea may be accompanied by rapid breathing (e.g. over 30 per minute) or with their deepening.

Animals with shortness of breath retract the corners of their mouths, puff their cheeks, breathe through their mouths. Their appearance expresses the fear and anxiety associated with the need to maintain a relieved position, i.e. standing.

They avoid repositioning and any movement that would increase their breathing requirements.

The adoption of relief positions, i.e. the already mentioned orthopnoea, indicates a very severe pathology and rather advanced dyspnea.

A suffering dog or cat engages all possible muscles to breathe, i.e. the pectoral and abdominal muscles, only to improve breathing.

Choosing forced positions to facilitate breathing in the event of shortness of breath does not have to be associated only with standing position, but also sometimes sternum or sitting.

Air deficiency leads to the blue color of the available mucous membranes, which may be blue red or pale blue.

The consequence of dyspnea may therefore be cyanosis, i.e. insufficient oxygenation of the blood in the lungs.

During dyspnea, we also hear whistling sounds and sounds that are not considered correct even by a layman.

An animal in a state of severe dyspnea is often weakened or even exhausted.

In fact, an animal with shortness of breath at first glance looks sick, often in a serious condition, but sometimes especially in cats, despite severe breathing disorders, the symptoms may not be very strongly expressed.

Diagnosis of dyspnea, differential diagnosis

The diagnosis of dyspnea, or rather its causes, in an animal may only seem simple, because we must remember about any respiratory disorders that may be confused and classified as dyspnea.

Of course, due to the multitude of potential causes that may cause dyspnea, we should implement the most effective diagnostics to detect the potential cause of dyspnea, bearing in mind that some of them require very quick intervention.

Diagnostics will therefore be based on all these methods used in the diagnosis of diseases of the respiratory system, blood system or even blood.

Therefore, we start each diagnosis with an interview focused on finding out about the potential cause of breathlessness.

Conversation with the animal's guardian will allow you to learn about the animal's medical history, used medications, comorbidities, injuries, accidents, etc.

In a situation of severe dyspnea, we should simultaneously implement symptomatic treatment bringing relief to breathing (the interview must not be too long and the animal must not suffer).

Then we proceed to a thorough examination of the patient (full medical examination - e.g. auscultation, temperature, available lymph nodes, the appearance of mucous membranes, chest movements, etc.) and performing any necessary additional tests, which we can certainly include and any additional tests (blood tests, imaging tests, including X-ray or ultrasound, endoscopic tests - rhinoscopy, bronchoscopy) or echocardiography.

We assess breathing by focusing on the frequency of breathing, depth, regularity, evenness, type of breathing (thoracic, abdominal), assessment of inhalation and exhalation.

We evaluate abnormal breathing noises, if any (murmurs, panting, wheezing, wheezing, wheezing).

The assessment of breathing, if the patient's condition allows it, is performed at rest and after exercise.

Remember that the dyspnea accompanying a given disease will run with parallel symptoms affecting a given part of the respiratory system or another organ.

For example, in diseases of the trachea we can find a barking, loud cough caused by palpation of the larynx, dyspnea at rest or exercise with wheezing sounds, and in diseases of the nose:

• abnormal discharge of secretions,
• sneezing,
• rubbing the nose against objects or limbs,
• change in the outline of the nose,
• deformities or pain symptoms when palpating.

We perform all tests as far as possible after the patient has stabilized so that our interventions, changes in position do not increase the animal's dyspnea and anxiety.

The tests carried out should always be tailored to the disease that we suspect, therefore it is impossible to describe them all in detail in this collective article.

Determining the cause of dyspnea seems to be a key issue, as the causal treatment depends on it.

For example, the diagnosis of short-lived dog syndrome through appropriate surgical treatment allows for the elimination of dyspnea, the introduction of bactericidal drugs allows to control pneumonia, and the removal of a foreign body or polyp eliminates the obstruction within the upper respiratory tract.

With what diseases does shortness of breath occur?

With what diseases does shortness of breath occur?

Dyspnoea is a non-specific symptom occurring in numerous diseases affecting not only the respiratory system, hence it is difficult to assign it to a specific disease entity.

It will be a mistake to say that dyspnea is associated only with respiratory diseases, although many pathologies located in this system may give symptoms of respiratory disorders and shortness of breath.

And so, inspiratory dyspnea, as we already know, concerns pathologies located in the upper respiratory tract.

So they are all diseases that constrict the airways and thus obstruct the natural flow of air.

Examples of these pathologies include:

• nose and throat polyps,
• nose tumors,
• infections involving the nasal cavity, pharynx and larynx,
• respiratory syndrome of short-skulled dogs:
  • narrowing of the nostrils,
  • elongated soft palate,
  • abnormal structure of the larynx,
• larynx diseases:
  • laryngeal paralysis (breathlessness may increase with exertion and excitement),
  • laryngeal tumors,
  • foreign bodies in the upper respiratory tract.

Expiratory dyspnea accompanies pathologies rather affects the lower respiratory tract.

So it occurs in:

• feline asthma,
• collapse of the trachea,
• tumors,
• bronchial diseases,
• bronchopneumonia,
• foreign bodies aspirated in the respiratory tract,
• bronchiectasis,
• pneumonia,
• mycoses of the respiratory system,
• lung cancer,
• pulmonary embolism,
• pulmonary haemorrhage due to poisoning with rodenticides,
• contusion of the lungs,
• emphysema, etc.

Dyspnoea can occur suddenly when the underlying cause has acted quickly and has caused the pathology.

An example of this could be bites or gunshots that lead to obstruction of the airways with blood clots, damaged tissues or foreign bodies.

Dyspnoea will also be present in diseases of the pleura and mediastinal structures.

As an excellent example of what he writes about, let us use the pleural fluid, pneumothorax, chest wounds, diaphragmatic hernia or neoplastic processes.

Another example of a pathology with dyspnea is pulmonary fibrosis.

Dyspnoea is associated with a serious threat to life, which is pulmonary edema, which is most often a consequence of left ventricular congestive insufficiency. It is a state of immediate threat to life.

It can also occur with numerous pathologies within the abdominal cavity and causing severe pain.

An example of this is:

• inflammation of the pancreas,
• a sharp twist of the stomach,
• strong ascites,
• sometimes even pregnancy.

Respiratory disorders, including dyspnoea, may occur in hypothermia, cardiac tamponade, anemia, enlargement of the abdominal organs, ascites or disorders of the breathing regulation center due to drugs or diseases of the central nervous system.

It can also appear as a consequence of chest injuries causing contusion, fracture of ribs, damage to the diaphragm, or as a result of severe soreness of damaged muscle structures.

Breathing deep but slow (i.e. Kussmalula breathing) can very much resemble dyspnea appears as an expression of compensatory processes in metabolic acidosis which occurs in kidney failure or ketoacidosis.

Dyspnoea can also occur when breathing and blood supply are not matched, i.e. when breathing is incompatible with lung perfusion.

Such a situation occurs, for example, in pulmonary embolism, atelectasis or pneumonia.

Then the lung area may be properly aerated but not properly supplied with blood, or vice versa, the lung area is properly supplied with blood but not properly aerated.

Accelerated breathing resembling dyspnea symptoms will occur in fever or shock, which we must absolutely remember.

So we can only see by listing, without describing in detail, how many different diseases can give symptoms of dyspnea.

Oxygen therapy and ventilation as important supportive treatments

Oxygen therapy

Oxygen therapy is a very helpful method of treatment among patients with dyspnoea and respiratory disorders.

It allows you to maintain the appropriate partial pressure of oxygen (over 60 mm Hg).

It should also be used in patients who show signs of cyanosis.

It is a "supportive" treatment because it is always necessary to determine what is the direct cause of dyspnea and, if possible, by eliminating it, improve the breathing capacity of the body.

Oxygen therapy is largely based on administering to the patient through an oxygen mask air that is more saturated with oxygen. This is done by:

• mask,
• nasal catheter,
• tracheal tube,
• endotracheal catheter,
• oxygen cage.

The administered 100% oxygen is often anhydrous, so it causes drying of the respiratory tract, especially when it bypasses the nasal cavity, therefore patients who are oxygenated longer should have moistened respiratory tract.

Modern devices designed for longer oxygenation are factory-equipped with a humidifying function.

Long-term administration (more than 12 hours) oxygen in a concentration of more than 50% is toxic to lung epithelial cells, therefore oxygen therapy with pure oxygen should not be long-term.

Rather, we should treat it as a method to improve the well-being of a dog or cat in acute dyspnea, so that the body, after removing the cause, returns to normal independent breathing and gas exchange as soon as possible.

We perform oxygen therapy in the simplest way using oxygen masks that stress animals the least.

They should fit snugly against the nose.

Oxygen hoods placed over the patient's head can also be helpful.

However, not all dogs and cats tolerate them well, hence immobilization is sometimes required. For obvious reasons, their use is limited in restless dogs and cats that would require sedation.

Mostly well tolerated nasal catheters seem to be a good idea in animals.

They are introduced into the patient's nasal cavity and the animal is put on the collar so that it does not remove it.

Intubation tubes, on the other hand, are used in patients undergoing surgical procedures, i.e. patients undergoing anesthesia.

Conscious animals do not tolerate endotracheal tubes, therefore an endotracheal tube seems to be a better idea here. Sometimes the animal should be pharmacologically calmed down by administering sedatives or painkillers.

Finally, oxygen cages are a very practical method of supporting breathing, minimizing the stress on the part of the patient.

We lock the animal in a cage where we give oxygen or air enriched with it.

However, we must monitor the environmental conditions in them so as not to worsen the patient's condition.

Support ventilation with turn is a medical measure aimed at reducing the concentration of carbon dioxide in the blood and increasing its oxygen saturation.

It is a method reserved for really advanced and severe clinical cases, so in animals that are unlikely to be able to ventilate on their own.

Positive pressure ventilation is used, which is different from normal negative pressure breathing.

There are distributional changes in the lungs in it.

This method, due to the need for constant monitoring and monitoring of the patient (e.g. blood gas, color of mucous membranes, pulse wave, capillary time, blood pressure, respiratory murmurs) is less frequently used and requires appropriate equipment.

Therefore, it is used in large, well-equipped clinics or reference centers.

Treatment of diseases associated with dyspnoea

Treatment of diseases associated with dyspnoea

At the beginning, it is worth realizing once again that dyspnoea is a symptom that occurs in a number of various diseases, hence the lack of a single treatment regimen tailored to all clinical cases of dyspnea.

The treatment will differ in each disease, for obvious reasons, hence it is impossible to describe one universal treatment algorithm that fits all cases.

So in order to effectively help a dog or cat suffering from dyspnea, it must begin with determining the cause, i.e. determining the causative factor. Without such a procedure, it is very often impossible to obtain permanent help.

However, if we were to very generalize, we could describe the management of diseases of the upper and lower respiratory tract as well as diseases of the lung parenchyma or pleura.

Do not be surprised, however, that dyspnea also occurs in pathologies of the cardiovascular system or neurological diseases.

It is beyond the scope of this article to describe the treatment of each specific disease that causes dyspnea.

Upper respiratory tract obstruction

Patients with this type of pathology find it difficult to inhale that takes longer than exhalation.

A hoarse voice or wheezing is often heard and sometimes the voice changes (e.g. larynx diseases).

The most common causes of obstructed airflow in the upper respiratory tract include:

• brachycephalic canine respiratory syndrome,
• laryngeal paralysis.

Most diseases causing obstruction of the upper respiratory tract are chronic in nature, but are accompanied by acute dyspnea.

This is a consequence of a somewhat vicious cycle of increasing breathlessness in case of, increasing the degree of obstruction due to deeper inhalations.

Conservative management therefore consists of administering sedative drugs, placing the animal in a cooler oxygen-enriched environment.

In the case of patients with dyspnea, we administer drugs to reduce stress in animals.

They can be:

• acepromazine (dogs and cats 0.05 mg / kg m. c. NS. c),
• morphine (dogs 0.1 mg / kg i. v. ),
• butorphanol (e.g. cats 0.1 mg / kg m. c. NS. c every 4-6 hours - tolerates pain and stress).

We can give dogs morphine or acepromazine and glucocorticosteroids to reduce local inflammation (e.g. dexamethasone or prednisolone).

In most cases, such management leads to a remission or a significant reduction in the symptoms of dyspnea.

Next, we try to bypass the site of obstruction by inserting an endotracheal tube, endotracheal tube or performing a tracheotomy.

Obstruction of the lower respiratory tract

Dyspnoea due to obstruction of the lower respiratory tract is less common.

In such patients, it takes longer to breathe out than to breathe in and is associated with greater effort.

The most common cause of obstruction is the collapse of the main bronchus or the thoracic part of the trachea with chronic bronchitis, cancer of the trachea, foreign bodies or pressure exerted by enlarged lymph nodes.

Stabilization of the patient's condition with such dyspnea is achieved by sedation, oxygen administration and sedation. Sometimes it is helpful to give:

• antitussive drugs,
• bronchodilators,
• glucocorticosteroids.

Parenchymal diseases of the lungs

Parenchymal diseases are a huge group of diseases that cause shortness of breath in dogs and cats.

Animals with such dyspnea show increased respiratory frequency, increased respiratory effort, wheezing, crackling, shortness of breath.

Therefore, first of all, it is worth using oxygen therapy, which should bring about an improvement in the clinical condition.

Diuretics (e.g. in pulmonary edema), bronchodilators (e.g. terbutaline in cats) or glucocorticosteroids.

We also administer broad-spectrum antibiotics (e.g. in case of sepsis, pneumonia, including aspiration), in case of fever, leukocytosis.

Pleural diseases

And finally, pleural diseases leading to shortness of breath due to difficulties in the proper expansion of the lung tissue.

In these cases, the frequency of breathing usually increases significantly and respiratory murmurs are suppressed, and the work of the abdominal cavity compressor increases.

This can happen because there is fluid build-up in the pleural cavity or a pneumothorax.

Therefore, puncture of the pleural cavity may be helpful, i.e. performing thoracocentesis and draining the fluid, sometimes with the placement of a drain.

At the same time, we give the patient oxygen, which improves breathing comfort. We suck off as much air or liquid as possible.

In the case of hemorrhage into the pleural cavity as a result of rodenticide poisoning or mechanical trauma, we do not remove the entire volume of blood accumulated in the cavity, but only a part of it, thus facilitating breathing.

What is recommended is causal treatment and appropriately selected fluid therapy.

Summary

Dyspnoea, as we already know, is a pathological condition that occurs in many different diseases.

It is not a disease in itself, but a serious clinical symptom that should never be underestimated due to very dangerous health consequences, including death.

And although it is a subjective feeling, so animals will not tell us about it, it is absolutely necessary and requires an urgent medical consultation.

Only quick interference creates a greater chance not only to improve the animal's comfort but, above all, to save life in many cases.

Therefore, it is worth carefully observing your pupils every day and reacting whenever it is necessary. In this way, we provide them with proper care and show concern for their health, in other words, we are responsible owners.

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