Diagnosing Aspiration Pneumonia in Cats

Diagnosing aspiration pneumonia relies on your cat’s medical history provided by the owner, observed symptoms, and lung radiographs. Typically, lesions appear in the front lobes of the lungs.

Blood tests may reveal either an increase or decrease in inflammatory cells; however, their absence does not exclude pneumonia. Confirmation requires microbial cultures obtained via tracheal or bronchoalveolar lavage.

Tracheal lavage can be performed in two ways:

• Without anesthesia or mild sedation: A needle inserted between tracheal rings injects saline solution. Induced coughing helps retrieve secretions for analysis.
• Under general anesthesia: A tube is placed in the trachea, administering saline solution. This method prevents aspiration if regurgitation occurs but complicates secretion retrieval.

Bronchoalveolar lavage, under anesthesia using an endoscope, explores smaller airways, providing superior visualization and accurate secretion sampling.

Mechanism of Aspiration Pneumonia

When a cat regurgitates or vomits, digestive material can enter its airways. This irritating or caustic material can lead to aspiration pneumonia.

Disease Progression

• Initial phase (0-6 hours after aspiration): Immediate lung tissue damage, inflammation, pulmonary hemorrhage, and mucus accumulation.
• Inflammatory phase (4-48 hours after aspiration): Inflammation spreads, worsening lung damage and causing partial lung collapse.
• Infectious phase: If bacteria colonize the lungs, inflammation progresses to pneumonia, often originating from oral flora.

Observed Symptoms

Cats with aspiration pneumonia may display:

• Regurgitation or vomiting
• Persistent coughing
• Panting or respiratory difficulty
• Fatigue and loss of appetite
• Fever and increased respiratory rate
• Abnormal lung sounds during examination (sometimes undetectable)

Risk Factors

Factors increasing aspiration pneumonia risk include:

• Anesthesia or deep sedation
• Neurological conditions affecting the esophagus or pharynx
• Seizures or head trauma
• Tube feeding
• Anxiety or pain causing frequent vomiting

Preoperative fasting helps reduce aspiration risk during anesthesia.

Treatment of Aspiration Pneumonia in Cats

Antibiotic Therapy

Broad-spectrum antibiotics are administered pending culture results. Initially intravenous if the condition is severe, shifting to oral medication as soon as feasible.

Hydration and Respiratory Support

Cats often become dehydrated from fever and excessive mucus production. Intravenous fluid therapy is crucial for hydration and thinning pulmonary secretions. Careful monitoring is required to prevent fluid overload and pulmonary edema.

Techniques to Facilitate Secretion Clearance

• Nebulization: Inhaling saline vapor moistens lung secretions, facilitating their removal. Antibiotics may be added.
• Chest coupage: Gentle tapping on the chest mobilizes secretions.
• Patient mobilization: Encouraging movement or regularly changing positions prevents mucus buildup.
• Mucolytics: Medications that thin mucus and reduce lung inflammation.

Bronchodilators: Use with Caution

Bronchodilators open airways, aiding mucus clearance, but may suppress coughing, potentially allowing deeper bacterial penetration into lungs. They are cautiously used and avoided in cats with heart conditions.

Oxygen Therapy

If respiratory distress occurs, oxygen therapy via oxygen cage, nasal cannula, or mask is indicated. Severe respiratory failure might necessitate assisted ventilation.

Monitoring and Post-treatment Follow-up

Close monitoring ensures effective treatment adjustments. Excessive pulmonary inflammation may cause systemic complications affecting organs such as the liver and kidneys (systemic inflammatory response syndrome). Regular monitoring of vital signs and blood tests detects deterioration early.

Once stable, injectable treatments shift to oral medications. Cats can go home when breathing normally, maintaining proper oxygen levels independently, and resuming eating. Radiographs should be repeated bi-weekly until lesions fully resolve. Antibiotics continue for at least 3-4 weeks, extending 1-2 weeks after radiographic normalization to prevent relapse.

Prompt, appropriate management generally provides a guarded to favorable prognosis. Increased vigilance and regular veterinary follow-ups are essential for optimal recovery.