Pulmonary Emphysema

Introduction: Animal Pulmonary Emphysema is the swelling of the animal lungs due to excess air. Increased air in the alveoli is called alveolar emphysema. The alveoli rupture, and gas enters the loose connective tissue of the interstitium, causing the interstitium to expand, which is called interstitial emphysema. The principle of treatment is to strengthen nursing care, prevent and treat the primary disease, improve ventilation and ventilation function, and control heart failure.

Pulmonary emphysema is the expansion of the lungs due to excess air. Increased air in the alveoli is called alveolar emphysema. The alveoli rupture, and gas enters the loose connective tissue of the interstitium, causing the interstitium to expand, which is called interstitial emphysema.

Etiology

1. Primary emphysema

It is caused by strong breathing during strenuous exercise, rapid running, and long-term struggle. Especially in elderly dogs, the elasticity of the alveolar wall is reduced, and emphysema is prone to occur.

2. Secondary emphysema

Often due to chronic bronchitis, persistent cough in diffuse bronchitis, or when the bronchi are narrowed and obstructed, due to obstruction of bronchial gas passage.

Diagram of emphysema and chronic obstructive pulmonary disease

Diagram of emphysema and chronic obstructive pulmonary disease
Resource description: Chronic obstructive pulmonary disease is sometimes called "emphysema" or "chronic bronchitis." Emphysema usually refers to damage to the small alveoli at the end of the airways in the lungs. Chronic bronchitis refers to a chronic cough caused by inflammation of the airways, accompanied by sputum production. Chronic obstructive pulmonary disease is the third leading cause of death globally, causing 3.23 million deaths in 2019, and more than 80% of COPD deaths occurred in low- and middle-income countries. Environmental exposure to tobacco smoke, indoor air pollution, and occupational dust, smoke, and chemicals are important risk factors for COPD. File source: Internet

3. Interstitial emphysema

Due to severe coughing, or foreign matter strayed into the lungs, the air pressure in the alveoli increases sharply, causing the alveolar wall to rupture.

Symptom

The main manifestations are dyspnea, severe panting, and sometimes mouth breathing. Mucous membrane cyanosis, easy to fatigue, rapid pulse, normal body temperature. Interstitial emphysema may be accompanied by subcutaneous emphysema.

Lung percussion was hypervoiceless, and the percussion boundary shifted backward. On lung auscultation, alveolar sounds are weakened, and crackling rales and crepitus can be heard. In the compressed part of the lung tissue, bronchial breath sounds can be heard. X-ray examination of the entire lung area is abnormally transparent, bronchial images are blurred, and the diaphragm is moved back.

Diagnosis

The diagnosis can be made based on history, wheezing, changes in lung percussion and auscultation, and X-ray findings.

X-ray film of emphysema complicated by pneumothorax

X-ray film of emphysema complicated by pneumothorax
Resource description: From: A puppy with tension pneumothorax complicated by lung hypoplasia and congenital emphysema: a rare congenital lung abnormality. Right (a) and dorsal (b) chest radiographs before emergency thoracentesis. A large amount of air is trapped in the left pleural cavity, manifested by loss of sternal contact with the heart, gas in the left hemithorax, displacement of the right mediastinum, and caudal displacement of the posterior diaphragm. The cranial and caudal lobes of the left lung are collapsed, while the cranial lobe of the left lung is lucent with less vascular labeling (white arrow) compared with other collapsed lobes. Document source: https://actavetscand.biomedcentral.com/articles/10.1186/s13028-019-0472-2/figures/1

Treat

The principle of treatment is to strengthen nursing care, prevent and treat the primary disease, improve ventilation and ventilation function, and control heart failure.

First of all, let the sick dog absolutely rest, put it in a clean, dust-free, well-ventilated house, and give it nutritious food.

To improve ventilation and ventilation function, bronchodilators such as theophylline, adrenergic drugs, cholinergic M receptor blockers, and adrenergic α-receptor blockers can be taken orally or inhaled by nebulization. Adrenal corticosteroid preparations should be used with caution.

In order to enhance respiratory function, respiratory regulators can be used, such as 50-80 mg of forminobenzene hydrochloride, taken orally, 3 times/d, which can increase the partial pressure of blood oxygen and reduce the partial pressure of carbon dioxide in sick dogs. Do not use sleeping pills, sedatives, etc.

When edema occurs, diuretics can be used, such as hydrochlorothiazide 10-20 mg, orally, twice a day, or furosemide 10 mg, twice a day. When taking the medicine, it is necessary to supplement potassium 0.1~lg/d, orally, 4 times/d. If diuretics such as spironolactone and triamterene are used, potassium supplementation may not be necessary.

Low-concentration oxygen therapy several times a day can relieve dyspnea and control heart failure. For larger localized emphysema, surgical resection can be performed to inflate the compressed normal lung tissue and enhance the elastic return of the lung.