Treatment In-depthTreatment of bronchopneumonia is usually individualized based on the severity of your pet's condition, the cause, secondary diseases or conditions and other factors that must be analyzed by your veterinarian.
Pneumonia can be a severe and progressive condition that causes difficulty breathing. Severely ill pets with a fever, not eating, lethargic and/or difficulty breathing may require hospitalization with oxygen, intravenous fluids and antibiotics and supportive care.
Mildly affected pets that are well hydrated and eating properly may be treated as an outpatient with frequent follow-ups to monitor the progression of the infection.
Treatment of bronchopneumonia may include the following:
Keep your pet well hydrated and warm. Fluid therapy is often required to prevent dehydration, which can cause thickening of respiratory secretions.
Coupage (clapping on the chest to mobilize/loosen secretions) is recommended 4 to 6 times daily. Once the patient feels better, brief walks (followed by coupage) help to mobilize tracheobronchial secretions.
Airway humidification may assist in expectoration (productive coughing) of secretions.
Expectorants like guaifenesin are of uncertain value and are not typically prescribed.
Bronchodilator therapy is not of proven effectiveness but may reverse irritative bronchoconstriction and strengthen respiratory muscle effort in pets having difficulty breathing.
Antibiotics should be prescribed for at least three weeks; duration of therapy may be longer pending clinical results and radiographs. Antibiotic choice should be based on culture and sensitivity (obtained by transtracheal washing) or on likelihood of empiric success and with consideration of current or prior antibiotic therapy. Antibiotics recommended may include cephalexin(Keflex®; Keflin®; Kefzol®), sulfadiazine-trimethoprim (Bactrim®; Septra®), enrofloxacin (Baytril®), amoxicillin-clavulanic acid (Clavamox®), tetracycline (mature dogs), chloramphenicol or cefadroxil. In life-threatening blood contamination (sepsis), the combination of intravenous cephalothin or ampicillin plus enrofloxacin should be considered. Newer generation cephalosporins (e.g. moxalactam) are very expensive and usually reserved for resistant infections.
Bronchodilator drugs include xanthine derivatives and beta adrenergic (sympathomimetic) agonists. Bronchodilators also may increase the vigor of contraction of the respiratory muscles, which may be useful in dogs with dyspnea. Theophylline and its various salts are most commonly chosen. Some dogs cannot tolerate the adverse effects of xanthines, which include anxiety, restlessness, tachycardia (abnormally rapid heart rate), polyuria (frequent urination) and emesis (vomiting).
Cough suppressants are inadvisable.
Humidified oxygen should be administered to dyspneic, severely cyanotic or hypoxemia pets.
Management of bacterial pyothorax (pus in the cavity around the lungs) requires thoracostomy tube drainage and antibiotics. Since anaerobic organisms are commonly involved in pyothorax, treatment with alone or in combination with sulfadiazine-trimethoprim or clindamycin is recommended.
Encourage appetite with good quality food.
