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Lung: pulmonary hemorrhage
Introduction
- Cause: pulmonary contusion, coagulopathies, thrombocytopenia, rodenticide toxicity, neoplasia.
- Signs: cough, may be hemoptysis, may be normal unless severe blood loss and secondary bacterial bronchopneumonia. Also tachypnea / respiratory distress.
- Diagnosis: history, signs, radiography, endoscopy, coagulation studies.
- Treatment: oxygen / blood transfusion, plasma volume expanders, treat underlying pathology.
- Prognosis: fair to good if response to treatment.
Presenting signs
- Cough.
- Hemoptysis.
- Tachypnea.
- Collapse.
- May be asymptomatic.
Acute presentation
- Collapse with marked respiratory distress.
- Fatal hemoptysis.
Cost considerations
- Radiography.
- Intravenous fluids.
Special risks
- Anesthesia General anesthesia: overview.
- Restraint, eg for radiography in dyspneic and/or anemic animal.
Pathogenesis
Etiology
- Pulmonary contusion.
- Coagulopathy:
- Acquired Hemostatic disorders: acquired.
- Congenital Hemostatic disorders: inherited.
- Thrombocytopenia Immune-mediated thrombocytopenia.
- Neoplasia Lung: pulmonary neoplasia.
Predisposing factors
General
- Predisposers to DIC:
- Liver disease Liver: chronic disease.
- Neoplasia.
- FIP Feline infectious peritonitis.
- Predisposers to secondary coagulopathy:
- FeLV Feline leukemia virus disease.
- Neoplasia.
- Some drugs.
Specific
- Congenital coagulopathies rare but may cause profound bleeding especially after trauma.
Pathophysiology
- Pulmonary contusion, eg post-trauma → bleeding → hemoptysis in some rare cases (most cats hit hard enough to have contusions are killed).
- Coagulopathy or thrombocytopenia → intrapulmonary hemorrhage.
- Metastatic/invasive neoplasia → destroying blood vessels → bleeding into lung → hemoptysis.
Timecourse
- Usually sudden onset with history of trauma.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Sigrist N E, Doherr M G, Spreng D E (2004) Clinical findings and diagnostic value of posttraumatic thoracic radiographs in dogs and cats with blunt trauma. J Vet Emerg Crit Care 14 (4), 259-268 Wiley Online Library.
- Hackner S G (1995) Emergency management of traumatic pulmonary contusions. Comp Cont Ed Pract Vet 17 (5), 677-686 VetMedResource.
- Caylor K B (1994) Pulmonary contusion in a cat - case report. JAVMA 205, 561-562.
- Murtaugh R J (1994) Acute respiratory distress. Vet Clinic North Am 24 (6), 1041-1055 PubMed.