You are likely familiar with pneumonia, and may have experienced this serious lung infection yourself at some point. Although most pneumonia types your pet may develop result from a bacterial, viral, or fungal infection, aspiration pneumonia develops for a different reason. A common sequelae of bottle feeding, chronic vomiting or regurgitation, and anesthesia without prior fasting, aspiration pneumonia can interfere with critical oxygen delivery to your pet’s tissues and cells, and become life-threatening. And, because lung changes that lead to diagnosis can be seen on X-rays only late in the disease process, accurate diagnosis can be challenging. 

Red Bank Veterinary Hospitals is prepared to treat your pet’s most serious and emergent conditions, including aspiration pneumonia, with the most advanced critical care services available, including oxygen therapy, ventilation therapy, and blood gas monitoring. Our board-certified veterinary criticalists and highly trained support team is available 24 hours per day to treat and monitor the sickest patients. 

What is aspiration pneumonia in pets?

Aspiration pneumonia is a lung infection that can develop if your pet inhales foreign material, such as food, liquid, or stomach contents. Foreign material that contacts the delicate tissue lining the lung’s airways causes inflammation, and the lungs become susceptible to infection. Inflammation and infection cause fluid build-up in the lung’s air sacs, interfering with their most critical functions—oxygen delivery to the blood and carbon dioxide elimination. Advanced aspiration pneumonia can lead to death if your pet’s body cannot adequately perform gas exchange.

Why do pets develop aspiration pneumonia?

Aspiration pneumonia can develop any time your pet accidentally breathes foreign material into their lungs (i.e., aspirates), but is commonly caused by these situations:

• Bottle feeding — When puppies and kittens are bottle-fed, the milk replacement is often fed more quickly than the newborn can swallow, and some may be aspirated into the lungs. Aspiration pneumonia is a common cause of death in bottle-fed newborns.
• Cleft palate — When a puppy or kitten has a hole in their palate, which separates their oral and nasal cavities, milk can easily travel into the nasal passages, and be aspirated while they are nursing.
• Force-feeding — Any time food, liquid, or medication is forced into a pet’s mouth too quickly, some may be aspirated, and cause pneumonia.

• Chronic vomiting or regurgitation — When stomach contents repeatedly pass through the throat area, the aspiration risk increases. Aspiration pneumonia develops commonly in pets with esophageal motility disorders that cause frequent regurgitation, such as megaesophagus, geriatric onset laryngeal paralysis polyneuropathy (GOLPP), and myasthenia gravis, and is a common cause of death in these pets.
• Regurgitation under anesthesia — Anesthetized pets do not have a swallow reflex, and cannot protect their airway while they are unconscious. During anesthesia, pets are typically positioned with their stomach at the same level as their esophagus and throat, and stomach contents can easily be aspirated, but they commonly are fasted prior to anesthesia to prevent this complication. Pets who are unexpectedly placed under anesthesia for emergency procedures often are administered anti-vomiting medications.  

What are aspiration pneumonia signs in pets?

Aspiration pneumonia causes signs similar to other pneumonia types, including:

• Coughing
• Nasal discharge
• Tiring easily
• Labored breathing
• Fever
• Increased heart rate
• Blue-tinged mucous membranes

If your pet develops signs consistent with aspiration pneumonia after you know they have aspirated foreign material, they should be evaluated by your family veterinarian or our emergency service immediately. Any time your pet has trouble breathing or blue gums, their condition is serious and requires immediate attention. Aspiration pneumonia can rapidly progress to become life-threatening.

How is aspiration pneumonia diagnosed in pets?

Aspiration pneumonia is diagnosed following a thorough evaluation, including history, physical exam, and appropriate tests. Exam and test results that indicate aspiration pneumonia include:

• Wheezing on auscultation — Harsh breathing sounds, particularly wheezing, heard through your veterinarian’s stethoscope indicate airway inflammation characteristic of pneumonia.
• Positive airway cytology — A transtracheal wash (TTW) can collect an airway sample, which is evaluated for inflammatory cell and bacteria presence. The sample can also be analyzed to determine the most effective antibiotics against the bacteria present.
• Increased lung density on X-rays — In later pneumonia stages, X-rays can show any increased lung density caused by inflammation. X-rays taken in the early stages often appear normal, making early diagnosis challenging.

Other tests, such as bloodwork to detect infection and blood gas analysis to evaluate blood oxygen levels, may be used to gain additional information.

How is aspiration pneumonia treated in pets?

Pets with aspiration pneumonia often require hospitalization and aggressive treatment, since the disease can quickly become life-threatening. Antibiotics are administered to combat infection, with the specific antibiotic chosen based on a patient’s culture and sensitivity results. Breathing treatments and oxygen therapy may be needed, and severe cases may require round-the-clock ventilator support. Throughout treatment, intensive monitoring, including blood gas assessment and serial X-rays, is often required.

RBVH in Tinton Falls is designated an American College of Veterinary Emergency and Critical Care (ACVECC) Level 2-certified facility, which means that we are equipped with advanced tools and trained specialists who are prepared to handle the most complex aspiration pneumonia cases, to give your pet the best chance of recovery.If you think your pet may have aspiration pneumonia, or your family veterinarian has made a diagnosis, RBVH can provide 24-hour critical care to help them recover. Bring your pet to our emergency service, or contact us, to discuss a treatment plan.