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Tracheobronchitis, Infectious (Dog) 987

scapulae, requiring retaking radiographs with • Coverage against skin organisms (Staphylococ- • Small areas of tracheal granulation tissue
the forelimbs repositioned. cus or Streptococcus spp) is considered most may be removed through a bronchoscope
VetBooks.ir peritracheal air accumulation, subcutaneous ○ Ampicillin 22 mg/kg PO or IV q 8-12h, • Removal of tubes/stents is indicated when Diseases and Disorders
important.
at periodic exams during the healing period.
• Cervical and/or thoracic radiographs may show
cefazolin 22 mg/kg PO or IV q 12h, or
emphysema, and/or pneumomediastinum.
the mucosal surface is healed.
○ Pneumothorax is rare.
○ Tracheal stenosis can occur with chronicity. clavulanic acid/amoxicillin 12.5-25 mg/ PROGNOSIS & OUTCOME
kg PO q 8-12h (dogs), 62.5 mg PO q
8-12h (cats)
Advanced or Confirmatory Testing ○ Enrofloxacin 5-20 mg/kg PO or IV q 24h • Good for long-term resolution of clinical
• Tracheoscopy (p. 1074) can confirm tracheal if concerned about gram-negative organisms signs
rupture, especially of the dorsal tracheal (maximum 5 mg/kg PO q 24h in cats) • Tracheal stricture may be a complication
membrane, if a radiographic diagnosis is ○ Pradofloxacin 7.5 mg/kg PO q 24h in postoperatively.
not definitive. cats • Nerve damage postoperatively has been
• Thoracic CT may be more sensitive for reported in rare cases.
detecting tracheal injury than thoracic Chronic Treatment
radiographs based on studies in human Closure and debridement of tracheal laceration: PEARLS & CONSIDERATIONS
patients. • Surgery is indicated for repair of tracheal
defects if Comments
TREATMENT ○ The cause is from injury associated with • Trauma is the most common cause of tracheal
contamination (e.g., bite wounds or other tear in small dogs.
Treatment Overview penetrating injury). • Overinflation of the endotracheal tube is
• The goals of treatment are to stabilize the ○ The animal is not improving or getting worse the most common cause of tracheal tear in
patient and if necessary, repair or resect with conservative (nonsurgical) treatment cats.
damaged trachea or stenosis to resolve (see Acute General Treatment above). ○ Tears can occur from overinflation of
respiratory distress. ○ There is stenosis or stricture causing low-volume/high-pressure cuffs or high-
• Surgery is not always needed; see guidelines respiratory difficulty. volume/low-pressure cuffs.
below (Chronic Treatment) Resection of damaged or stenotic trachea and
anastomosis of normal ends: Technician Tips
Acute General Treatment • Minimize tension. • When managing a patient with a suspected
• Oxygen supplementation if dyspneic (p. • May need to use tracheal tubes/stents tracheal tear intraoperatively, have a sterile
1146) • Use a tape neck splint to hold the neck in endotracheal tube readily available in case the
• For animals in respiratory distress, induction a flexed position to reduce tension on the trachea within the sterile field needs to be
of anesthesia or heavy sedation with intuba- trachea postoperatively. Try to keep the splint intubated. Have an extra-long endotracheal
tion per os or through a cervical tracheal in place for 2 weeks if it is needed. tube handy in case the avulsed trachea needs
laceration (if present) is indicated to quickly to be temporarily bridged.
gain control of the airway: Behavior/Exercise • Be very careful not to overinflate endotracheal
○ Intubation through a cervical laceration/ Restrict exercise for 2-4 weeks. cuffs during general anesthesia.
avulsion is accomplished in similar fashion
to tracheostomy (p. 1166). Possible Complications Client Education
○ Distal cervical tracheal lacerations may • Dehiscence if excessive tracheal suture tension Recurrence of clinical signs is possible secondary
require retrieval of the distal trachea from is present to tracheal stenosis.
the thoracic inlet by traction sutures. • Narrowing of the tracheal lumen (stricture)
• Thoracocentesis may be indicated if pneu- due to scar tissue secondary to tracheal SUGGESTED READING
mothorax is present (p. 1164). anastomosis White RN, et al: Surgical management of intratho-
• Prepare the animal for exploration of all • Infection racic tracheal avulsion in cats: long-term results
structures in the injured area to determine in nine consecutive cases. Vet Surg 29:430, 2000.
extent of injury and provide the opportunity Recommended Monitoring AUTHOR: Michael B. Mison, DVM, DACVS
for primary repair. • Monitor for respiratory distress. EDITOR: Megan Grobman, DVM, MS, DACVIM
• Treat any additional wounds. • Drainage of peritracheal area may be indi-
• Antibiotics are indicated, especially if cated if area is contaminated.
traumatic injuries are present.

Tracheobronchitis, Infectious (Dog) Bonus Material Client Education
Online
Sheet
Epidemiology
BASIC INFORMATION lethargy, decreased appetite, and occasionally
bronchopneumonia. More information on this SPECIES, AGE, SEX
Definition disease in cats is provided on p. 1006. • Common in dogs of all ages, with puppies
The common, acute, highly contagious respira- prone to more severe disease
tory disease complex of dogs is caused by a Synonyms • Brachycephalic breeds may be more
number of potential pathogens alone or in Canine infectious respiratory disease complex susceptible.
combination. The common manifestations (CIRDC); infectious tracheobronchitis; kennel
include cough, sneezing, oculonasal discharge, cough

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