Page 408 - Small Animal Internal Medicine, 6th Edition

380 PART II Respiratory System Disorders

TABLE 25.1
VetBooks.ir Drugs Used to Decrease Stress in Animals With Respiratory Distress

Upper Airway Obstruction: Decreases Anxiety and Lessens Respiratory Efforts, Decreasing Negative Pressure Within
Upper Airways
Acepromazine Dogs and cats 0.01-0.2 mg/kg IV, IM, SC (no more than 3 mg total dose)
Morphine Dogs only, particularly 0.2-2.0 mg/kg IM, SC; CRI, 0.1-0.3 mg/kg loading dose, then
brachycephalic dogs 0.1-0.3 mg/kg/h
Pulmonary Edema: Decreases Anxiety
Morphine Dogs only 0.2-2.0 mg/kg IM, SC; CRI, 0.1-0.3 mg/kg loading dose, then
0.1-0.3 mg/kg/h
Acepromazine Dogs and cats 0.01-0.2 mg/kg IV, IM, SC (no more than 3 mg total dose)

Rib Fractures, After Thoracotomy, Other Trauma: Pain Relief
Hydromorphone Dogs and cats 0.1-0.2 mg/kg IV, IM, SC; CRI, 0.025-0.050 mg/kg IV loading dose,
then 0.01-0.04 mg/kg/h
Butorphanol Dogs and cats 0.1-0.8 mg/kg IV, IM, SC; CRI, 0.1-0.2 mg/kg IV loading dose, then
0.1-0.2 mg/kg/h
Buprenorphine Dogs and cats 0.005-0.020 mg/kg IV, IM

CRI, Continuous-rate infusion; IM, intramuscularly; IV, intravenously; SC, subcutaneously.
Dosage recommendations from Quandt J: Analgesia, anesthesia, and chemical restraint in the emergent small animal patient, Vet Clin North
Am Small Anim Pract 43:214, 2013.

TABLE 25.2
Localization of Respiratory Tract Disease by Physical Examination Findings in Dogs and Cats With Severe
Respiratory Distress
LARGE AIRWAY DISEASE PULMONARY PARENCHYMAL DISEASE
OBSTRUCTIVE
EXTRATHORACIC AND PLEURAL
(UPPER) INTRATHORACIC OBSTRUCTIVE RESTRICTIVE RESTRICTIVE SPACE DISEASE
Respiratory Nl-↑ Nl-↑ ↑↑↑ ↑↑↑ ↑↑↑ ↑↑↑
rate
Relative ↑↑↑Inspiration ↑↑Expiration ↑Expiration ↑↑Inspiration No difference ↑Inspiration
effort
Audible Inpiratory stridor, Expiratory Rarely expiratory None None None
sounds stertor cough/wheeze wheeze
Auscultable Referred upper End expiratory Expiratory ↑↑Breath ↑↑Breath ↓Breath sounds
sounds airway sounds; click; ↑↑breath wheezes or sounds; sounds,
↑↑breath sounds ↑↑breath ±crackles crackles,
sounds sounds; rarely, and/or
↓breath wheezes
sounds with
air trapping

↑, Slightly increased; ↑↑, increased; ↑↑↑, markedly increased; ↓, decreased; Nl, normal. Normal respiratory rates for dogs and cats at rest
are ≤ 20/min. In the hospital setting, rates of ≤ 30/min are generally accepted as normal.

be increased (i.e., deep breaths are taken). Breath sounds are inspiration, which is generally prolonged relative to expira-
often increased. tion. Stridor or stertor is usually heard, generally during
inspiration. A history of voice change may be present with
Extrathoracic (Upper) Airway Obstruction laryngeal disease.
Patients with extrathoracic (upper) airway obstruc- Laryngeal paralysis and brachycephalic airway syndrome
tion typically exhibit the greatest breathing effort during are the most common causes of upper airway obstruction