Aspiration Pneumonia (AP) is a usual cause of bacterial pneumonia in veterinary practice. It is currently diagnosed based on compatible anamneses, clinical signs, and imaging.
There is a lack of evidence on optimal antibiotic treatment duration in dogs with AP. The role of thoracic radiographies and lung ultrasonography in follow-ups is not well reported in dogs. Also, the use of C-reactive protein (CRP) as a monitoring factor for bacterial pneumonia could prove useful in AP.
In this prospective observational study, it was investigated if antimicrobial interruption could be done relying on clinical recovery and CRP normalization. The usefulness of thoracic radiographs and lung ultrasound in follow-ups was also assessed.
Seventeen dogs diagnosed with AP had their antibiotics stopped based on clinical improvement and serum CRP normalization. At each control consultation a questionnaire on quality of life, a thorough physical examination, serum CRP, thoracic x-rays and lung ultrasound were evaluated. Possible relapses were monitored through short- and long-term follow-up consults after treatment cessation.
The authors concluded that in dogs with suspected AP, antimicrobial therapy can be safely discontinued based on clinical improvement and normalization of CRP values. In this study, none of the animals needed more than 3 weeks of antimicrobial therapy.
Regarding imaging techniques, although they are very useful for the diagnosis of this disease, they do not give much information that affects treatment adjustment. Short-term follow-up of both thoracic x-rays and lung ultrasonography was not useful as lesions persisted on 88% of cases during the recovery period. Imaging can be helpful in assessment of long-term relapsing cases.
However, this study has a major limitation. The lack of sample collection from these dogs diagnosed with AP, make it impossible to differentiate bacterial pneumonia from pneumonitis, which does not necessarily necessitate antibiotic treatment. More prospective studies with collection of bronchoalveolar lavage fluid and culture are necessary.
Rodrigues, NF, Giraud, L, Bolen, G, Fastrès, A, Clercx, C, Gommeren, K, Billen, F, Antimicrobial discontinuation in dogs with acute aspiration pneumonia based on clinical improvement and normalization of C-reactive protein concentration, 2022, Journal of Veterinary Internal Medicine DOI: 10.1111/jvim.16405
