{"id":34324,"date":"2024-08-09T19:01:19","date_gmt":"2024-08-09T19:01:19","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=34324"},"modified":"2026-02-26T15:07:03","modified_gmt":"2026-02-26T15:07:03","slug":"treating-bacterial-pneumonia-in-dogs-and-cats","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/respiratory-medicine\/treating-bacterial-pneumonia-in-dogs-and-cats\/","title":{"rendered":"Treating Bacterial Pneumonia in Dogs and Cats"},"content":{"rendered":"<p><div class=\"su-spacer\" style=\"height:10px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><strong>Abstract<\/strong><\/p>\n<p class=\"p1\">Bacterial pneumonia in dogs and cats can be caused by inhalation of pathogens, aspiration of bacteria, or (less likely) hematogenous spread or inhalation of foreign bodies. Before initiating empiric broad-spectrum antibiotics for patients requiring hospitalization or those predisposed to multidrug-resistant bacterial infections, airway sampling is recommended, if possible. After culture and sensitivity results are available and depending on patient response to treatment, antimicrobial therapy should be de-escalated. Adjunctive therapeutics include supplemental oxygen, intravenous fluids, and physiotherapy aimed at promoting clearance of mucus. The treatment, presentation, and approach to pneumonia frequently differ between species, and the disease is less common in cats than in dogs.<\/p>\n<p class=\"p1\"><strong>Take-Home Points<\/strong><\/p>\n<ul>\n<li class=\"p1\">Bacterial pneumonia is a common cause of pulmonary parenchymal disease in dogs and, to a lesser extent, cats.<\/li>\n<li class=\"p1\">The gold standard for guiding antimicrobial therapy is airway sampling (e.g., by endotracheal wash) to collect specimens for cytology and culture\/sensitivity.<\/li>\n<li class=\"p1\">Pneumonia in dogs and cats can be caused by gram-positive bacteria (e.g., <i>Streptococcus<\/i> species, <i>Staphylococcus<\/i> species, <i>Enterococcus<\/i> species), gram-negative bacteria (e.g., <i>Escherichia coli<\/i>,<i> Pasteurella<\/i> <span class=\"s1\">species), and <i>Mycoplasma<\/i> species.<\/span><\/li>\n<li class=\"p1\"><i>Bordetella bronchiseptica<\/i> infection, a common cause of infectious bronchopneumonia in puppies, can be treated with oral doxycycline (for patients well enough for outpatient treatment) or intravenous azithromycin (for hospitalized patients requiring IV fluids and oxygen supplementation).<\/li>\n<li class=\"p1\">Human medicine has transitioned to shorter-duration (5\u20137 days) antibiotic therapy for treatment of pneumonia, and early evidence in veterinary medicine suggests that shorter durations of antibiotics may be safe and effective for some cases of bacterial pneumonia in dogs and cats.<\/li>\n<li class=\"p1\">If bacterial pneumonia is treated and managed appropriately, the prognosis in most dogs and cats is good.<\/li>\n<\/ul>\n<p><\/div><\/div><\/p>\n<p><iframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" allow=\"autoplay\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/soundcloud%253Atracks%253A2273748350&#038;color=%23ff5500&#038;auto_play=false&#038;hide_related=false&#038;show_comments=true&#038;show_user=true&#038;show_reposts=false&#038;show_teaser=true\"><\/iframe><\/p>\n<div style=\"font-size: 10px; color: #cccccc;line-break: anywhere;word-break: normal;overflow: hidden;white-space: nowrap;text-overflow: ellipsis; font-family: Interstate,Lucida Grande,Lucida Sans Unicode,Lucida Sans,Garuda,Verdana,Tahoma,sans-serif;font-weight: 100;\"><a href=\"https:\/\/soundcloud.com\/vetfolio\" title=\"VetFolio\" target=\"_blank\" style=\"color: #cccccc; text-decoration: none;\">VetFolio<\/a> \u00b7 <a href=\"https:\/\/soundcloud.com\/vetfolio\/treating-bacterial-pneumonia\" title=\"Treating Bacterial Pneumonia in Dogs and Cats\" target=\"_blank\" style=\"color: #cccccc; text-decoration: none;\">Treating Bacterial Pneumonia in Dogs and Cats<\/a><\/div>\n<p class=\"p1\"><span class=\"s1\">Pneumonia is a common cause of pulmonary parenchymal disease in dogs and less so in cats. Pneumonia most commonly falls into the categories of aspiration or infectious bronchopneumonia. Aspiration pneumonia is caused by inhalation of orogastric secretions and\/or ingesta containing enteric bacterial organisms. Infectious bronchopneumonia (also called community-acquired pneumonia) is caused by inhalation of pathogens spread by other animals. Less frequent causes of bacterial pneumonia include infections from hematogenous spread or contaminated inhaled foreign bodies. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Many comorbidities are associated with increased risk for certain types of pneumonia (<\/span><span class=\"s2\"><b>TABLE 1<\/b><\/span><span class=\"s1\">). Dogs frequently exposed to other dogs are at a higher risk for infectious bronchopneumonia. A definitive diagnosis of bacterial pneumonia requires cytology and\/or culture.<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-34332\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1.png\" alt=\"\" width=\"2097\" height=\"2337\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1.png 2097w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1-269x300.png 269w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1-919x1024.png 919w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1-768x856.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1-1378x1536.png 1378w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table1-1838x2048.png 1838w\" sizes=\"(max-width: 2097px) 100vw, 2097px\" \/><\/a><\/p>\n<p class=\"p1\"><span class=\"s1\">This article explores common questions regarding the treatment and management of bacterial pneumonia and focuses on aspiration pneumonia and infectious bronchopneumonia. The authors direct readers to other sources regarding the diagnosis of pneumonia as well as treatment of nonbacterial pneumonias (e.g., viral, protozoal, fungal), which are beyond the scope of this article.<sup>1-3<\/sup><\/span><\/p>\n<h2 class=\"p2\">How is an antimicrobial plan developed?<\/h2>\n<p class=\"p1\"><span class=\"s1\">Antimicrobial selection is ideally based on culture and sensitivity testing of airway samples, particularly for patients that require hospitalization. Airway sampling with culture is most indicated for patients with suspected infectious pneumonia and patients at risk for infection with multidrug-resistant organisms (e.g., those with <a href=\"https:\/\/todaysveterinarynurse.com\/infectious-disease\/preventing-hospital-infections\/\" target=\"_blank\" rel=\"noopener\">hospital-acquired infections<\/a>, recent antibiotic receipt, or chronic pulmonary disease). Samples can be collected via tracheal wash (endotracheal or transtracheal) or by bronchoalveolar lavage (which requires bronchoscopy). Endotracheal wash requires the least specialized equipment and is most feasible in a general practice setting (<\/span><span class=\"s2\"><b>FIGURE 1, BOX 1<\/b><\/span><span class=\"s1\">). Deep oral swabs do not usually yield the same sensitivity as tracheal washes.<sup>4<\/sup> In addition, canine- and feline-specific respiratory polymerase chain reaction panels can detect common respiratory viruses and bacteria in nasopharyngeal and nasal swab samples. A retrospective study of airway sampling and culture from dogs with pneumonia found that for 57.4% of dogs that recently received antimicrobials, bacteria with resistance to empirically selected antimicrobials were isolated.<sup>5<\/sup><\/span><\/p>\n<div id=\"attachment_34330\" style=\"width: 509px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-34330\" class=\" wp-image-34330\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1.png\" alt=\"\" width=\"499\" height=\"186\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1.png 1296w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1-300x112.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1-1024x382.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig1-768x286.png 768w\" sizes=\"(max-width: 499px) 100vw, 499px\" \/><\/a><p id=\"caption-attachment-34330\" class=\"wp-caption-text\">Figure 1. An endotracheal wash being performed by using a red rubber catheter, Luer lock \u201cChristmas tree\u201d style adapter, and a 20-mL syringe.<\/p><\/div>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Equipment and Steps for Performing an Endotracheal Wash<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ol>\n<li><strong>Equipment:<\/strong> Gather a sterile endotracheal (ET) tube, sterile saline, 2\u20133 sterile 10-mL to 20-mL syringes, sterile gloves, 2 sterile red rubber catheter tubes (longer than the chosen ET tube\/largest size that will fit), anesthesia\/sedation equipment and drugs. <strong>Optional (but preferred):<\/strong> Suction, suction catheter, and mucus trap<\/li>\n<li><strong>Setup:<\/strong> Don sterile gloves and, using sterile technique, draw up sterile saline into 10-mL syringes, filling the rest of the syringe with air. <strong>Recommended volumes:<\/strong> Cats\/dogs &lt;\u200910 kg, 3 mL of saline; dogs \u2265\u200910 kg, 3\u20135 mL of saline<\/li>\n<li><strong>Preoxygenation:<\/strong> Preoxygenate the patient with 100% oxygen via flow-by or mask delivery system. <em>Note: Some patients will require light sedation.<\/em><\/li>\n<li><strong>Induction:<\/strong> Induce a light plane of anesthesia by using desired anesthetic protocol to allow ET intubation.<\/li>\n<li><strong>Intubation:<\/strong> Perform ET intubation by using sterile technique and taking care to avoid contaminating the tube with the oral cavity. If possible, do not use lubricant as it can confound cytologic interpretation of airway samples. Routinely tie in the tube and inflate the cuff.<\/li>\n<li><strong>Saline administration:<\/strong> Sterilely insert the red rubber catheter as far as it can advance. Attach and flush entire saline syringe contents into the catheter, following the saline with remaining air to push the fluid out of the catheter. Additional air may be needed.<\/li>\n<li><strong>Coupage and suction:<\/strong> Have a nonsterile assistant gently coupage the chest to loosen mucus and\/or elicit a cough reflex. During coupage, firmly aspirate the syringe to collect fluid from the airway. Perform several times, and detach the syringe between attempts to expel excess air. Use care to avoid loss of sample fluid when removing air. <strong>Optional:<\/strong> If the equipment is available, attach a suction catheter to a mucus trap that is connected to portable or central suction to collect the sample.<\/li>\n<li><strong>Repeat:<\/strong> If an insufficient sample has been collected, repeat the process with another syringe of sterile saline and air.<\/li>\n<li><strong>Patient recovery:<\/strong> After a sufficient sample has been collected (~50% or less of initial saline volume), attach the patient\u2019s ET tube to oxygen and monitor until the patient can be safely extubated.<\/li>\n<li><strong>Sample submission:<\/strong> Samples collected from the ET wash can be submitted for cytology, culture and sensitivity, or other infectious disease testing. In-house Gram stain and cytology are recommended to guide the initial antimicrobial decision making.<\/div><\/div><\/li>\n<\/ol>\n<p class=\"p1\"><span class=\"s1\">While culture results are pending or if airway sampling cannot be performed due to patient, practitioner, or client limitations, empiric antimicrobial therapy should be initiated. Antimicrobial selection should be based on signalment, likely route of infection, and patient risk factors. For example, puppies exposed to other dogs are at particular risk for infectious bronchopneumonia caused by <i>Bordetella bronchiseptica.<\/i> For adult dogs, common bacterial isolates include <i>Escherichia coli<\/i>,<i> Pasteurella<\/i> species, <i>Staphylococcus <\/i>species, <i>Streptococcus <\/i>species, and enteric bacteria such as <i>Klebsiella<\/i> species or <i>Enterococcus<\/i> species.<sup>6,7<\/sup> <i>Mycoplasma <\/i>species are often present as opportunistic coinfections; their relevance as a primary pathogen is unclear but should be treated if cultured.<sup>8<\/sup> Bacterial pneumonia does not develop in all patients after aspiration; aspiration of gastric acid or food material can lead to sterile pneumonitis. This distinction is difficult to ascertain without airway sampling, and potential infection should be treated if aspiration pneumonia is diagnosed, particularly if the patient is showing clinical signs. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Given that gram-positive and gram-negative bacteria commonly cause pneumonia, broad-spectrum coverage is indicated. De-escalation to a narrower antimicrobial spectrum is based on culture and sensitivity results when available, but further escalation may be needed if the patient worsens while culture results are pending. Doxycycline is a reasonable empiric choice for infectious bronchopneumonia as both <i>B bronchiseptica<\/i> and <i>Mycoplasma <\/i>species<i> <\/i>are generally susceptible.<sup>9<\/sup> <\/span><span class=\"s3\">\u03b2<\/span><span class=\"s1\">-Lactam antibiotics (e.g., amoxicillin, cephalexin) are not recommended for treatment of <i>B bronchiseptica <\/i>due to poor penetration into the larger airways where <i>B\u00a0bronchiseptica <\/i>tends to colonize. Instead, if the dog is clinically ill (e.g., fever, systemic clinical signs) with suspected infectious bronchopneumonia or aspiration pneumonia, broader-spectrum coverage should be started (<\/span><span class=\"s2\"><b>TABLE 2<\/b><\/span><span class=\"s1\">).<sup>10<\/sup> Hospitalized patients should initially receive parenteral antibiotics, and treatment should transition to oral administration after the patient clinically improves and is eating. Penetration through the pulmonary epithelium varies by antibiotic class, but inflammation can disrupt the blood\u2013alveolar barrier and allow some drugs that would otherwise be excluded (e.g., penicillins, cephalosporins) to reach therapeutic concentrations in the alveoli.<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2.png\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-34333\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2.png\" alt=\"\" width=\"2060\" height=\"1272\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2.png 2060w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2-300x185.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2-1024x632.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2-768x474.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2-1536x948.png 1536w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Table2-2048x1265.png 2048w\" sizes=\"(max-width: 2060px) 100vw, 2060px\" \/><\/a><\/p>\n<p class=\"p1\"><span class=\"s1\">In human medicine, the recommended treatment of uncomplicated pneumonia is a 5- to 7-day course of antimicrobials. Longer courses are considered for nosocomial infections, for <i>Pseudomonas aeruginosa<\/i> infections, or for patients that remain clinically unstable.<sup>11<\/sup> Veterinary medicine has historically recommended treatment with antibiotics for several weeks. However, recent evidence has found that shorter courses of antibiotics (7 to 10 days) may be acceptable for dogs with uncomplicated pneumonia, particularly aspiration pneumonia.<sup>12,13<\/sup><\/span><\/p>\n<h2 class=\"p2\">What other treatments should be considered?<\/h2>\n<p class=\"p1\"><span class=\"s1\">Patients with moderate to severe pneumonia are often hypoxemic and require supplemental oxygen, which can be provided via nasal prongs or cannulae, an oxygen hood made from an Elizabethan collar (<\/span><span class=\"s2\"><b>FIGURE\u00a02<\/b><\/span><span class=\"s1\">), or an oxygen cage. Some patients may require additional support, such as <a href=\"https:\/\/todaysveterinarynurse.com\/emergency-medicine-critical-care\/veterinary-high-flow-oxygen-therapy\/\" target=\"_blank\" rel=\"noopener\">high-flow nasal oxygen<\/a> or mechanical ventilation.<\/span><\/p>\n<div id=\"attachment_34331\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig2.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-34331\" class=\" wp-image-34331\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig2.png\" alt=\"\" width=\"350\" height=\"421\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig2.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/WaddellRheingold_TVPSepOct24_PneumoniaFAQ_Fig2-249x300.png 249w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-34331\" class=\"wp-caption-text\">Figure 2. An oxygen hood made of plastic wrap and an Elizabethan collar. The upper 25% of the collar opening has been left open to allow for warmer, exhaled carbon dioxide to escape.<\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">For pneumonia patients sick enough to require hospitalization, fluid therapy is usually indicated, aimed at preventing dehydration and maintaining normal perfusion parameters. The mucociliary escalator, a vital component of the respiratory immune system, relies on proper hydration for normal function. Overzealous fluid administration should be avoided as it can lead to interstitial or pulmonary edema and worsened respiratory signs and hypoxemia.<sup>14<\/sup> Nebulization with 0.9% saline can be used to hydrate respiratory secretions to promote mucus clearance, although this practice is not guided by any published clinical evidence. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Use of several other adjunctive therapies is supported by varying degrees of evidence. For humans, corticosteroid use may offer a mortality benefit for those with severe community-acquired pneumonia.<sup>15<\/sup> For veterinary patients, the theoretical anti-inflammatory effects of steroids must be weighed against patient contraindications and risk for immunosuppression. Early mobilization may be somewhat beneficial for humans with pneumonia, and veterinary patients should be frequently taken for walks or have recumbency changed, if tolerated.<sup>16<\/sup> Because the cough reflex is an essential means of clearing respiratory pathogens, administration of cough suppressants is contraindicated. Also contraindicated are furosemide or other diuretics because they can cause dehydration of the airway surface liquid layer and decrease systemic perfusion. <\/span><\/p>\n<h2 class=\"p2\">How does pneumonia differ for cats?<\/h2>\n<p class=\"p1\"><span class=\"s1\">Bacterial pneumonia is less common in cats than in dogs but is probably underdiagnosed because noninvasive diagnostic testing is often not very sensitive for the disease. Cats with histologic evidence of pneumonia may not demonstrate hematologic or radiographic changes typical of canine pneumonia.<sup>17<\/sup> The clinical presentations of inflammatory airway disease and infectious bronchopneumonia in cats (e.g., wheezing) substantially overlap.<sup>18<\/sup> Bronchodilators such as terbutaline, <a href=\"https:\/\/todaysveterinarypractice.com\/pharmacology\/albuterol-sulfate-for-cats\/\" target=\"_blank\" rel=\"noopener\">albuterol<\/a>, or aminophylline may be somewhat beneficial for cats by reducing bronchoconstriction. Airway sampling (e.g., by endotracheal wash) can help differentiate between causes of pulmonary parenchymal disease. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Cats with pneumonia should be tested for feline immunodeficiency virus and feline leukemia virus because both retroviral diseases can lead to immunocompromise and a predisposition to secondary infections.<sup>3<\/sup> Common bacteria associated with pneumonia in cats include <i>Pasteurella multocida<\/i>, <i>B\u00a0bronchiseptica<\/i>, and <i>Mycoplasma<\/i> species.<sup>19<\/sup> Cats are prone to both viral and bacterial upper respiratory infections, but secondary pneumonia is not a common sequela.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Antimicrobial dosing and adverse effects differ between dogs and cats. In cats, enrofloxacin should be used only at doses of 5 mg\/kg\/day due to the risk for retinal degeneration with higher dosages. Enrofloxacin can also increase the serum concentration of the bronchodilators aminophylline and theophylline and lead to systemic signs of toxicity in both species.<sup>20<\/sup> When given without concurrent food or water, clindamycin and doxycycline both carry a risk for esophagitis and subsequent esophageal stricture formation. That risk is greater in cats than dogs, but it is possible in any animal.<\/span><\/p>\n<h2 class=\"p2\">What is the prognosis for dogs and cats with pneumonia?<\/h2>\n<p class=\"p1\"><span class=\"s1\">The prognosis for treatment of bacterial and aspiration pneumonia is generally good. Reported survival rates for dogs range from 77% to 88% with appropriate treatment, and rates for cats (according to 1 study) are 89%.<sup>6,21-23<\/sup> Dogs that experience multiple episodes of pneumonia or have previously received antimicrobials may be at higher risk for infection with multidrug-resistant bacteria. Infectious bronchopneumonia caused by <i>B bronchiseptica<\/i> often responds well to appropriate antibiotic therapy. Regardless of the cause of pneumonia, complications (e.g., pulmonary abscesses, sepsis, acute respiratory distress syndrome) carry a guarded prognosis and should be considered for patients that do not respond to treatment. Vaccination for communicable diseases and a focus on early diagnosis and appropriate treatment optimizes outcomes. <i>B bronchiseptica <\/i>vaccination should be considered for all dogs at risk for exposure. <\/span><\/p>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p1\"><span class=\"s1\">The cornerstone of bacterial pneumonia treatment is a targeted antimicrobial plan, ideally guided by cytology and\/or airway sample culture and sensitivity testing and adequate supportive care. The rise of multidrug-resistant bacteria in humans and animals emphasizes the need to <a href=\"https:\/\/todaysveterinarypractice.com\/respiratory-medicine\/antibiotic-stewardship-in-canine-and-feline-respiratory-infections\/\" target=\"_blank\" rel=\"noopener\">avoid unnecessary antibiotic use and excessive treatment durations<\/a>.<sup>24<\/sup> If possible, an initial broad-spectrum approach followed by culture-guided de-escalation is recommended. This along with supportive care, including supplemental oxygen (if needed), fluids, and other adjunctive therapies, provides the best chance for a full recovery. Treatment or correction of underlying disease processes that led to the development of pneumonia should reduce the likelihood of future episodes of pneumonia. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The cornerstone of bacterial pneumonia treatment is a targeted antimicrobial plan, ideally guided by cytology and\/or airway sample culture and sensitivity testing and adequate supportive care.<\/p>\n","protected":false},"author":236,"featured_media":34334,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":19164,"footnotes":""},"categories":[546],"tags":[13],"class_list":["post-34324","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-september-october-2024","tag-peer-reviewed","column-ask-a-specialist","clinical_topics-respiratory-medicine"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- 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