Section: Veterinary Care In-depth
Diagnosis In-depth
Veterinary care should include diagnostic tests and subsequent treatment recommendations. Diagnostic tests are needed to recognize bronchopneumonia and exclude other diseases.
A complete medical history and thorough physical examination should be performed by your veterinarian. Clinical signs, radiography and a hemogram are usually sufficient to make a presumptive diagnosis of bacteria pneumonia. Airway cytology and culture can confirm the diagnosis.
Radiography (chest x-rays) can often check for increased lung density (lung consolidation). Lung changes may differ with bacterial versus fungal, viral or parasitic infections.
A complete blood count (CBC) may indicate signs of infection with an elevated white blood cell count and an increased number of immature cells (increased band count). The magnitude of change is not consistently related to the extent of infection. Overwhelming bacterial pneumonia may cause a low neutrophil cell count.
A tracheal wash is a procedure in which a fluid sample from the trachea is analyzed. This test is also called a trans-tracheal wash (TTW). Fluid samples can be obtained by placing a small needle into the trachea in a lightly sedated patient. Transtracheal or endotracheal aspiration cytology determines infection based on the examination of the cells present. Bronchoalveolar lavage is a test in which fluid samples of the bronchus and alveolar (lung tissue) is obtained.
Further diagnostic testing may be needed to diagnosis a concurrent condition or eliminate other causes of similar symptoms (such as heart disease). These tests may include:
Bronchoscopy, which consists of placing a small flexible fiberoptic tube into the airway. This test may establish the diagnosis and rule out other diseases such as inflammatory disease, lungworms, fungal infections and neoplasia.
Biochemistry tests (serum blood tests) may be recommended to determine general health and check for secondary conditions.
Checking arterial blood gases is a method to determine oxygen levels. This sensitive test verifies the presence of significant lung disease. Many veterinary hospitals do not have the equipment to run this test but blood can be analyzed easily at a local human hospital.
Blood cultures may be useful to determine bacteria levels present in the blood.
Fine needle lung aspiration, using a fine needle or instrument to evacuate fluid or tissue by suction
Fecal (stool) examination may be necessary to evaluate for evidence of parasites and aid in diagnosis of lungworms
Conditions that are predisposed to bronchopneumonia may be evident from the history, physical and neurological examinations or may require additional studies such as a barium swallow to identify swallowing disorders and bronchoscopy to identify a bronchial foreign body. Caution: further aspiration may worsen pneumonia
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