Bacterial Pneumonia and Bronchopneumonia in Dogs

What is the respiratory system?

The respiratory system is divided into two parts. The upper respiratory tract consists of the nose, nasal sinuses, throat, and trachea (windpipe), while the lower respiratory tract consists of the small airways (bronchi and bronchioles) and the alveoli (the small air sacs deep in the lung tissue where oxygen exchange occurs).

Pneumonia is inflammation of the lower respiratory tract. The term, bronchopneumonia often refers to inflammation that starts in the airways (bronchi and bronchioles), while alveolar pneumonia or interstitial pneumonia describes inflammation deeper in the lung tissue. The terms are often used interchangeably.

What is pneumonia?

Bronchopneumonia is an inflammation of both the lungs and the airways (bronchi and bronchioles), while pneumonia is an inflammation of the lungs or lower respiratory tract. However, the terms are often used interchangeably.

What causes pneumonia?

Most cases of pneumonia in dogs are caused by infection, often bacterial. The most common bacteria that cause pneumonia in dogs are Bordetella bronchiseptica and Streptococcus species. Other bacteria may include Pasteurella multocida, Pseudomonas species, Klebsiella pneumoniae, Escherichia coli, Staphylococcus species, and Mycoplasma species. Viral infections that can directly cause pneumonia include canine influenza virus, canine parainfluenza virus, and canine distemper virus.

B. bronchiseptica is highly contagious and may spread easily to other dogs. It usually causes “kennel cough”, an infection of the trachea and bronchi, but can spread deeper into the lungs, especially in young or old dogs, or dogs with compromised immune systems. Most other causes of bacterial pneumonia are not particularly contagious to other dogs.

Sometimes, dogs develop bacterial pneumonia as a secondary infection. In some of these cases, the primary or underlying cause is a viral infection, such as influenza, parainfluenza, or canine adenovirus type 2. In other cases, irritants such as tobacco smoke, smog, or other inhaled pollutants may have predisposed the dog to a bacterial infection.

Are there any risk factors for developing bacterial pneumonia?

Any disease or condition that affects the respiratory tract can predispose a dog to bacterial pneumonia. Some risk factors include conditions that cause difficulty swallowing and problems with regurgitation (such as laryngeal paralysis, megaesophagus, cleft palate, chronic vomiting, altered states of consciousness, and tumors of the respiratory system).

"Any disease or condition that affects the respiratory tract can predispose a dog to bacterial pneumonia."

Dogs with an immune system disease or those that are taking immunosuppressive drugs are at an increased risk of bacterial pneumonia, as are dogs with severe metabolic disorders, such as kidney failure, uncontrolled diabetes mellitus, Cushing's disease, or Addison's disease.

What are the clinical signs of bacterial pneumonia?

Dogs that have bacterial pneumonia usually show the following signs:

• high fever,
• difficulty breathing,
• decreased exercise tolerance (tire easily),
• lethargy, and/or
• cough.

Other signs may include nasal discharge, loud breathing, rapid breathing, weight loss, anorexia, and dehydration.

Some of these signs are common and are not specific to any one disease. Non-infectious respiratory disease (e.g., chronic obstructive pulmonary disease), heart disease that causes pulmonary edema, and lung cancer can also cause some of these symptoms. Before reaching a diagnosis of bacterial pneumonia, your veterinarian will conduct a thorough physical examination and recommend a series of diagnostic tests.

How is bacterial pneumonia diagnosed?

Your veterinarian may suspect bacterial pneumonia based on the presence of the signs listed above, combined with the results of a physical examination, especially if they hear abnormal lung sounds when listening to your dog’s chest with a stethoscope. Your veterinarian may also suspect pneumonia if your dog has a history of staying in boarding or shelter facilities or a history of general anesthesia or trauma.

A series of tests may be required to confirm the diagnosis and exclude other diseases that could be causing the symptoms. These tests may include:

• Complete blood count (CBC), biochemistry profile and urinalysis: These blood tests assess the general health of your dog. Specific blood or fecal tests may be recommended to rule out parasitic diseases such as heartworm or lungworm. Specific blood tests to rule out serious metabolic diseases may be necessary.
• Chest X-rays (thoracic radiography): X-rays often show characteristic changes in the lungs and may help eliminate other types of heart or lung disease.
• Cytology using bronchoscopy: This procedure uses a small, fiber-optic camera, called a bronchoscope, to directly examine the inner surfaces of the airways in an anesthetized dog. After the visual examination, cytology samples (samples of the cells lining the bronchi and bronchioles) can be collected for microscopic examination and for bacterial culture and sensitivity testing.
• Tracheal lavage: The pet is usually placed under sedation or anesthesia and a thin, flexible, sterile catheter is passed into the area being investigated. A small amount of sterile fluid is flushed forcefully into the area and promptly suctioned or aspirated out. The recovered fluid contains mucus and cells that can be cultured for microorganisms and examined under the microscope.

What is the treatment for bacterial pneumonia?

The appropriate antibiotic treatment is determined by the results of the culture and sensitivity tests. These tests identify the specific bacterial species causing the infection and which type of antibiotic will combat this infection.

Since the results of culture and sensitivity testing are not available immediately, your veterinarian may begin treatment with a broad-spectrum antibiotic, such as doxycycline (Vibramycin®) or amoxicillin (Amoxi-Tabs®, Amoxi-Drops® or Robamox®), while awaiting the test results. It may be necessary to change the medication once the results are available. Your veterinarian will choose the appropriate antibiotics for your dog's particular situation.

If your dog has respiratory distress or is dehydrated or anorexic (complete loss of appetite), hospitalization for oxygen therapy and/or intravenous fluids and medications may be necessary.

"Your veterinarian will choose the appropriate antibiotics for your dog's particular situation."

Your veterinarian may also recommend several daily sessions of brief exercise to help loosen secretions and help your dog cough out inflammatory debris. Apart from these short sessions, your dog's activity should be restricted. Another helpful home treatment is to place your dog in a closed bathroom with a warm shower running for about 15 minutes, up to three times per day. This increase in humidity helps thin out the mucus in the airways so it is coughed up more readily (see handout "Techniques for Nebulization and Coupage in Dogs" for more information).

What is the prognosis for bacterial pneumonia?

The prognosis depends on the severity of the disease and whether there are any predisposing factors. The prognosis is generally good for uncomplicated bacterial pneumonia. The prognosis for animals with predisposing factors depends on whether the risk factor can be treated or resolved. If the risk factors cannot be resolved, recurrent infections may occur. The prognosis for young or geriatric animals, patients with immunodeficiency diseases, or patients that are debilitated is guarded.