Identification of ventilator‐associated pneumonia in dogs and evaluation of empiric antimicrobial therapy: 13 cases (2012–2016)

Abstract

AbstractObjectiveTo evaluate criteria used for diagnosis of ventilator‐associated pneumonia (VAP) in dogs and to determine whether appropriate empiric antimicrobial therapy affects outcome.DesignRetrospective observational study from 2012 to 2016.SettingPrivate small animal emergency and specialty center.AnimalsThirteen client‐owned dogs requiring positive‐pressure ventilation for over 48 hours.Measurements and main resultsMedical records of dogs requiring mechanical ventilation (MV) were reviewed. Dogs receiving MV for over 48 hours that had endotracheal lavages (ETL) and thoracic radiographs performed both at initiation of MV and at 48 hours were included. Signalment, body weight, temperature, reason for MV, WBC count, cytology, and semiquantitative aerobic cultures obtained via ETL were recorded. Outcome was defined as survival to discharge or nonsurvival (euthanasia). Six patients (46.2%) were diagnosed with VAP based on the presence of a new bacterial isolate identified on ETL culture at 48 hours. All patients with VAP had new pulmonary infiltrates present on radiographs. The majority of patients with VAP had a leukocytosis (4/6; 66.7%). Six patients (46.2%) survived to discharge. Of the survivors, 3 of 6 (50%) had VAP.ConclusionsBacterial cultures should be obtained at initiation of MV and at 48 hours. A diagnosis of VAP should be suspected in patients that have a new bacterial isolate identified by ETL culture at 48 hours. Radiographic changes and an increase in WBC count may help support a diagnosis of VAP, while culture results are pending. Further studies are needed to evaluate the effect of appropriate antimicrobial therapy on patient outcome.