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Steven Berkowitz, DVM
Chief, Emergency and Critical Care
Saint Francis Veterinary Center
Outline Anatomy
Common Diseases
Interventions
Oxygen Therapy
Medications
Nebulization
Coupage
Respiratory Tract
Lower Respiratory Tract
Airways
Common Diseases of Lower Airways Pneumonia
Infectious
Aspiration
Infiltrative Neoplasia
Asthma
Chronic Obstructive Pulmonary Disease
Common Diseases of Lower Airways Allergic/Anaphylaxis
Pulmonary Contusions
Smoke Inhalation
Pulmonary Bullae
Pulmonary Blebs
Acute Respiratory Distress Syndrome
ARDS
Outline Anatomy
Common Diseases
Interventions
Oxygen Therapy
Medications
Nebulization
Coupage
Interventions Oxygen Therapy
Room air = 21% O2
Flow by Oxygen
Oxygen Cage
O2 Tent
Nasal Oxygen
Intubation
Medications Classes of Medications
Bronchodilators
Mucinolytics
Expectorants
Anti-tussives
Anti-Inflammatories
Pulmonary Arterial Vasodilator
Medications- Bronchodilators Drugs: Aminophylline and Theophylline
Doses: Dogs: Aminophylline 7-10mg/kg q8-12hr
Theophylline 20mg/kg q12-24hrs
Cats: Aminophylline 7-10mg/kg q8-12hr
Theophylline 12.5-25mg/cat q12-24hrs
Onset of Action: approx. 30-60 minutes if injected
Side effects: (think chocolate toxicity- increased heart rate, anxiousness, increased gastric acid secretions)
Medications- Bronchodilators Drug: Albuterol
Doses: Dogs: 0.05mg/kg q8-12hr or 90-180mcg (2 puffs) total dose
Cats: same
Onset of Action: approx. 5 minutes if inhaled
Side effects: CNS excitement, increased heart rate,
hypokalemia (low potassium)
Inhalers
Medications- Bronchodilators Drug: Terbutaline
Doses: Dogs: 0.01mg/kg q4hr IM, 0.03mg/kg q8hr PO
Cats: 0.01mg/kg q4hr IM, 0.312-0.625mg per cat q8-12hr PO
Onset of Action: approx. 15-30 minutes if injected
Side effects: CNS excitement, increased heart rate, hypokalemia (low potassium)
Medications Drug: Epinephrine
relaxes bronchial smooth muscle
inhibits histamine release
Doses: Dogs: 0.01-0.02mg/kg, CRI 0.1-1mcg/kg/min
Cats: same
Onset of Action: almost immediate
Side effects: increased heart rate, increased blood pressure, arrhythmias
Medications- Mucinolytics Drug: N-Acetylcysteine (Mucomyst)
Doses: Dogs: 140mg/kg, then 70mg/kg q6-8hrs for 7 treatments(PO/IV)
Nebulized: 50mL/hr for 30-60mins q6-12hr
Cats: same
Onset of Action: approx. 5-10 minutes if inhaled, 1-2 hours if injected
Side effects: nausea, vomiting, can cause bronchospasms if sensitive and inhaled
Medications- Expectorant Drug: Guaifenesin
Doses: Dogs: 44-88 mg/kg q8-12hr
Cats: not labeled for cats
Onset of Action: within hours
Side effects: nausea, vomiting, gagging
Medications- Anti-Tussives NOT ALWAYS OK TO USE!!!!
Drug: Narcotics (Codeine, butorphanol, etc.)
Doses: depends on choice
Onset of Action: depends on choice
Side effects: CNS depression, nausea, ileus, respiratory depression
Medications- Anti-Inflammatories Drug: Prednisone/Prednisolone
Doses: Dogs: 0.5-1mg/kg q24hr
Cats: 1-2mg/kg q24hr
Onset of Action: several hours
Side effects: PU/PD/PP, weight loss, water retention, immune suppression, bone marrow suppression, GI bleeding
Medications- Anti-Inflammatories Drug: Dexamethasone
Doses: Dogs: 0.07-0.14mg/kg q24hr
Cats: 0.14-3mg/kg q24hr
Onset of Action: minutes to hours
Side effects: PU/PD/PP, weight loss, water retention, immune suppression, bone marrow suppression, GI bleeding
Medications- Anti-Inflammatories Drug: Fluticasone (Flovent ®)
Doses: Dogs: 110mcg q12-24hr
Cats: same
Onset of Action: approx. 2 weeks to reach peak effects
Side effects: very little systemic absorption, may increase potential for local infections
Medications- Pulmonary Arterial Hypotensive Agent Drug: Viagra ® (Sildenafil)
Doses: Dogs: 1-3mg/kg q8-12hr
Cats: no documented dosing
Onset of Action: within 30minutes- several hours
Side effects: systemic hypotension, headaches, weakness, sinusitis
Outline Anatomy
Common Diseases
Interventions
Oxygen Therapy
Medications
Nebulization
Coupage
Interventions Nebulization
Nebulizer Saline
Mucomyst ®
Antibiotics (Gentamicin)
Coupage Percussion of the thorax
to aid in the removal of secretions
Summary Lower Airway Disease is a Common Problem
Oxygen Therapy can be Life Saving
Multiple Types of Medications Used for Treatment
Nebulization and Coupage are Often Quite Helpful
Limit stress!!!
Any Questions???
Works cited available on request