The aim of this study was to evaluate the application, tolerability and outcome of continuous positive airway pressure (CPAP) compared to another non-invasive oxygen therapy (flow-by), in dogs diagnosed with cardiogenic pulmonary oedema secondary to severe mitral valve disease (MVD).

Records of dogs diagnosed with cardiogenic pulmonary oedema based on clinical findings, thoracic radiographs and echocardiography were retrospectively evaluated. Newly diagnosed dogs with MVD and dogs already in treatment for MVD were included in the study.

Thirty dogs were included in the study between February 2016 and 2017. All dogs received medical treatment based on clinical status and echocardiography results and were divided into 2 groups: group 1 (14 dogs) received oxygen administration by CPAP-helmet at a positive expiratory pressure (PEP) of 5 cm H₂O and group 2 (16 dogs) received oxygen flow-by (2–15 L/min).

Oxygen administration was discontinued based on clinical improvement, decreased respiratory labour and RR (respiratory rate), emogas-analysis parameters (PaCO₂, or PaO₂and PaO₂/FiO₂) and improvement of radiographic signs of pulmonary oedema.

In group 1 the mean age was 12.5 years (2–16) and mean body weight was 6 kg (3–39). Eleven dogs (78%, 11/14) showed improvement of RR, respiratory labour, blood gas parameters within 30 minutes after CPAP treatment initiation; radiographic signs of pulmonary oedema improved within 8 hours. Treatment with CPAP was intermittent, mean wearing time of the CPAP-helmet was 13.4 h/day (3–12) for 50 hours (3–23 h). Butorphanol was administered only at the time of application of the CPAP-helmet. The mortality rate was 35% (5/14).

In group 2, the mean age was 11.3 years (8–15) and mean body weight 8 kg (2–22). In seven dogs (43%, 7/16), RR, respiratory labour and blood gas parameters improved within 30 minutes after oxygen flow-by administration. Radiographic signs of pulmonary oedema improved after a median of 19 h (12–26 h). Oxygen delivery was continuous. Butorphanol administration was necessary more than three times per day. The mortality rate was 62% (10/16).

Respiratory failure due to cardiogenic pulmonary oedema secondary to MVD is a very common disease in dogs; in this study, CPAP-helmet interface was a valid alternative to oxygen flow-by therapy. Though clinical improvement was similar in the first 30 minutes, CPAP-helmet reduced the need for butorphanol administration, quickened both clinical and radiographic signs of pulmonary oedema improvement and showed a decrease of the mortality rate compared to oxygen flow-by. CPAP-helmet was well tolerated by all dogs.

Disclosures

No disclosures to report.