Nebulizing our dog for Aspiration Pneumonia

Miscellaneous and Personal Stuff I Must Share
1

Sorry this will be long but I can’t sleep and just felt like writing.

We have a 13 year old Chihuahua named Lucky who is very sick. He was diagnosed with Collapsing Trachea earlier this year. He’s been on meds for it and they help, but still has coughing spells. Not uncommon for the breed.

We went out to dinner on NYD and when we got home about an hour later we found him laying in his bed in a puddle of his vomit, shaking all over, with shallow rapid breathing. It was late at night, about 9pm, so we had to take him to the 24 hr emergency vet. I scooped him up in a towel and held him the whole ride there.

After exams and X-rays, the doc said he apparently got a sick tummy, threw up, and inhaled some of it into his lungs, possibly because of his frequent coughing. His X-ray looked bad. His lungs were about 50% milky white. They told us the plan, and gave us an estimate of $850-$1600. I’m just glad we have the money. We had to sign a DNR directive decision. Ug! That was so hard. I cried like a child.

They kept him overnight in case he needed oxygen. He had blood work and IV meds. And a breathing treatment. This morning he ate a little soft food and kept it down so around 1pm they said come pick him up. We can treat the rest from home.

What a long day! Since it’s an emergency place, those were tended to first. There were lots of emergencies. After a 2 hour wait, they finally called us in and gave us all his meds and instructions. 2 antibiotics, 1 anti-nausea, a prescription for a nebulizer, and the nebulizer fluid. They answered the ton of questions we had. They brought him out and he was so weak looking. But we got him home and I stayed with him while my hubby went out to find the nebulizer machine.

Not an easy task. It took him hours. Either they had it in stock but the pharmacy closed at 6pm, or it wasn’t in stock. He drove about 40 minutes to a 24/7 pharmacy that finally had one, and picked up some food for us since we hadn’t eaten since breakfast.

I had been trying to get him to eat some rice as directed but he kept looking for his regular food. He had to take meds though so it was totally stressing me out. He finally ate some soft cheese and a little turkey. This is a dog who never gets people food so he was confused.

The nebulizer was a challenge too. The instructions don’t say or show where the filter goes. I spilled the first dose of liquid onto the counter trying to find it, so that’s a wasted dose, and they told us to put him in a crate with a towel over it which sent him into a panic and coughing fit. I think he thought he was in trouble. And the thing makes noise so he just paced in circles the whole time. Hardly relaxing! But I do think I got him to inhale enough for the first try. Every 8 hours. Not looking forward to it.

He’s doing ok when he’s asleep. Wheezing a bit, and pneumonia makes you feel sickly, but hopefully within a few days he’ll improve.

Anyone else ever nebulize a pet? They said I could hold him and just fog near his mouth as an alternative. I may try that this morning. Pills were so much easier. But we’d do anything for the little guy.

Oh, and it wasn’t $1600. We’re glad, but we would have paid that and more if needed. Make sure you put aside some savings for your pets… You wouldn’t want to be stuck with a difficult decision when something comes up.

2

Sorry your little guy is so sick, it’s traumatizing to everybody! I don’t know what it is with the ER this week, I work in one and it’s been NUTS all week, so busy. New Year’s Day when my crew got in at 4pm, there were patients that had already been waiting since 1pm, and we had to keep prioritizing sicker animals coming in, so some waited nearly 6 hours before we could see them. A “normal” night is maybe 5 in the rack that we whittle down to 2 or 0, maybe another rush, and then clear the rack by midnight or 1am. Not the last 4 nights! 8 in the rack all night, and when I left at 1am on the 2nd (that’s the end of my new year’s day shift) there were still 4 in the rack. Tonight wasn’t too nuts after about 9pm and we were able to clear the rack and still leave before 1am, but still it was nuts when we got there at 4. I’m sure tomorrow will be worse again, Sundays always are.

Anyway, yeah, just hold him and do the fogging in front of his nose. However you can get it to work for him. Some patients just hang out in their cage and let us hold the nebulizer in front of them, some need to he held.

And hold on to those dollars you were able to save, he may need surgical correction for the collapsing trachea. It’s basically a spring that gets implanted to hold it open. Looks pretty cool on an xray. I hope he’s better in no time, don’t worry too much about the food unless he’s having bad diarrhea (stress colitis from hospitalization is definitely a thing and should get better now that he’s home - also, some antibiotics can cause issues, they should be given with food whenever possible), and getting whatever nutrition into him is more important than the “right” food right now.

Did they recommend just rice? We always recommend 50/50 rice and a lean protein, all boiled (no browned meats, just bland, bland, bland, and fat drained off the top of the boiling liquid), the protein being ground chicken, ground beef, or cottage cheese. But seriously if he doesn’t want that, then whatever works. Gerber makes baby food that’s just meat and enough broth to make it puree, and that’s considered bland too. Or try mixing rice with his regular food to make it milder for his tummy. I don’t tell everyone to use their best judgement, because not everyone is good at that, but I’ve seen enough of your posts to know it’s an appropriate recommendation in your case, sometimes you just need someone to tell you that you’re instinctively doing fine! Smaller, more frequent meals will be easier on him - feed small amounts 4-6 times a day rather than the typical 2 meals.

3

I can’t imagine working there. So many tragic endings in one day! I saw my first Great Pyrenees. Monster of a big beauty. Huge paws. He was brought in by his owners and a lady that he bit. He got her hand pretty bad. They stood in the drive for a long time discussing the plan with the dog sitting in the back of a van. They eventually anesthetized him right there in the van. The owners sat petting him for a half hour or so. Then they rolled out a gurney and it took 3 people to hoist him onto it. It was like lifting a sleeping buffalo. Gorgeous snow white like a polar bear. He was euthanized. The bite victim was very kind to the couple. I saw them offer to pay her but she refused. I wonder if they voluntarily made the decision to put him down or if it’s law? Anyway, just one of many difficult cases we saw in just a few hours of being there.

Thanks for the words of encouragement. We just finished getting Lucky to eat some more food and did pills. He ate good this time. They gave us a list of bland foods. I tried just the rice first, being overly cautious. But an added complication is that rice has no odor, and he can’t see closeup anymore. So we look like a fool telling him to eat and he stares up at us like, but there’s no food there. We added turkey bits to it and that worked. The baby food is a good idea.

My husband is worried we haven’t seen him drink since he’s been home. I said maybe he had enough IV fluids that he’s just not thirsty yet. He sure peed like a horse when we left the hospital to come home! I might try making his food soupy next time.

4

Scary, PurpleClogs! I’m glad your little guy is OK. I had a Rottweiler get aspiration pneumonia once - he caught a case of kennel cough which usually isn’t a big deal but he probably had a coughing fit while eating or drinking, and then couldn’t breathe. So scary. He spent the night at the ER vet on oxygen but I didn’t have to do any follow-up care.

I agree with adding some lean cooked meat to the rice, and making it mushy and watery so Lucky stays hydrated. Watch out for onion as an added ingredient to baby food. Occasionally is OK, but too much at one time, or as a regular part of the diet, can cause life-threatening anemia.

5

Might try some defatted chicken broth with the rice? I’ve used the jelly that’s left after boiling chicken, too.

Such a tiny wee thing to be so sick.

6

You can also try making a little blanket fort to sit in with him while he does his treatments. If you’re in with him, he won’t think he’s being isolated and punished. He’s going to cough during and after his treatments, though. It’s just part of it.

As for working at the emergency clinic, I used to work in the emergency room at a specialty clinic–we saw emergencies and took care of the hospitalized patients from the surgery and internal medicine departments. And yeah, some days it’s just horrific, nothing but a relentless stream of pain and grief and fear and death. Other days are a mixed bag, with a little bad stuff that ends badly, and a lot of minor stuff that ends well. But some days…once in a while you get something at death’s door that you manage to pull through, and you get to send a family home with a pet they would have lost if you hadn’t been there. Once in a very great while, you get two or three of those cases in the same week. And that’s pretty damn awesome.

7

So it’s getting a bit easier now. We’re finding a routine. And I started a log to write down all the times of fog (that’s what I’ve been calling the nebulizer treatments) meds and food. It gets confusing since it’s all done at different intervals.

Probably doesn’t sound very difficult to some, but Lucky is partially blind, mostly deaf, has no teeth left, and a bad back too. We don’t know exactly how old he is because he was a stray picked up by the pound and was our first foster dog back when we did a couple years of rescuing. Now we just have him, one other chi who is smaller and maybe a couple years younger, and an indoor cat. Luckily the dogs are trained to also use pee pads, but Lucky really prefers to go outside and can’t understand why I won’t let him out the door. Such a good boy. Anyway, feeding is a challenge too because with no teeth, he gets food everywhere! There’s always more food on the floor in a 2 foot circle around him than he eats out of his bowl. So then he spends 5 minutes sniffing around the floor for the good bits. Meanwhile, the little one will scarf down too much and get fat easily so I’m trying to keep him away from Lucky’s feelings, can’t just make him stand outside because it’s too cold for him, so I hold him while Lucky tries to eat. The little one cries because he’s not getting to eat when Lucky does, Ugh! It’s not impossible to juggle, just isn’t as easy as putting the same food in two bowls and stand back and watch.

I boiled some chicken and hamburger meat and mix a bit chopped up fine into the rice. He’s eating pretty good and drinking ok now. But he’s protesting his pills in cheese. Tonight we hid a pill in a bit of meat and it worked the 2nd try. The first time he swallowed the meat and spit out the pill. Joy!

I’ve been holding him to fog. But tonight I tried the crate again because he gets a better dose of fog like that. This time it went well. I think he’s learning how much better he feels after the fog so he’s more willing. Near the end he’s even falling asleep. His coughing gets more infrequent and less violent. Poor guy.

We’re still so puzzled how this even happened… What made him throw up in the first place… And why did he inhale it? I guess it’s just a freak accident like when you go to drink something from a glass, which you do several times a day all your life, but it goes down wrong and you choke and cough for 5 minutes like a fool. Oh well. He’s sleeping peacefully right now, no coughing. :slight_smile:

8

Aspiration pneumonia is more common in brachycephalic breeds, but I’ve seen all types end up with it. He could have coughed due to the collapsing trachea and gagged, making him regurgitate then gasp, and voila, inhaled stomach contents. Since his trachea is constricted, coughing out foreign material is also harder to do and less effective, so a small inhalation of something that would make you or me just hack for a while, makes him hack but without getting the material back out as well. Mucous builds up as a protectant, bacteria builds up from foreign material that won’t move out properly, and there’s pneumonia.

Poor little guy. He has no idea how lucky is indeed, having found you! Glad you found a routine that sort of works for you. It’s such a disruptive thing to the normal household day-to-day, that’s pretty much the best you can ask for.

9

Thank goodness I’m not working so I can stay home with him all day and get up with him in the wee hours too.

10

Here’s an idea for the pills, if they’re not time-release (check with your vet if this is OK.) Either try dissolving them in a little water and mixing with his food - some will melt into a slurry - or grind into powder and mix it in.

Lucky really is lucky. :slight_smile: I hope he continues to improve.

11

Today’s not going as well, tummy-wise.
I tried to get him to eat a little around midnight… No luck.
I tried again around 7 this morning… No luck.
I needed him to take 3 pills, one of which I broke in half because it’s a bit large for what I’m sure is a sore throat… So 4 pill pieces…No luck with cheese…no luck with turkey…no luck with melted cheese…no luck with hamburger meat… Not even if I stuck a piece of his regular dry food in with the chunk (for the sniff factor).
If I got it in, he’d spit it out. I tried giving him a break…no luck. I tried just giving him plain food again… No luck. I made my hubby late for work so he could try… No luck. He went out to the store and got a jar of peanut butter and we were able to get an anti-nausea pill and one of the antibiotic halves. Yay! But then he started turning his head again. He did drink a couple sips of water and got maybe a tablespoon of hamburger down, so we gave him a rest.

I called the vet who worked on a liquid form of the 2 antibiotics and syringes which I can pick up this afternoon. That should be much easier!

Meanwhile, around 11:30 we finally succeeded (after several tries) to just shove pills down his throat & used the nebulizer syringe (well rinsed of course) to fill his mouth with water so he’d swallow. Success! Sort of.

He’s starting to look thin. I had a couple old cans of wet food from when he first had his teeth out but assumed it was expired. Hubby looked and it expires Feb 2015! yay! So I’ll try that this afternoon with some burger meat.

Right now, I need a nap.

12

Success! He ate real good around 4:30. :slight_smile:

13

Not a pet, but a baby :smiley:

I would just hold her, and blow the fog from the nebulizer right at her face - she was often nursing at the time so that would settle her right down.

If your dog will sit still on your lap for cuddles and scritchies, that might work. The newer machines are much quieter so there might not even be enough noise to bother the poor pup.

14

Glad he finally ate well, hope he keeps it up!