Care of a seizuring brachycephalic dog with aspiration pneumonia A case study and patient care proposal

Abstract

A 4-year-old French bulldog presented with status epilepticus. Blood tests revealed hyperlactataemia, hyperglycaemia and respiratory alkalosis. The dog later developed aspiration pneumonia. Risk factors for aspiration pneumonia in veterinary patients include decreased mentation, neurological diseases and brachycephaly. Oxygen therapy is imperative, with oxygen cages being most effective. An oxygen hood would be unsuitable for this patient due to the risk of hyperthermia. Nasal prongs would also be unsuitable due to the risk of increased intracranial pressure and the difficulty of placing them in brachycephalic breeds. Oxygenation should be monitored, as dogs with aspiration pneumonia can decompensate quickly; if unresponsive to oxygen supplementation, more intensive support should be considered. Humidification is required for long-term oxygen therapy, which can be provided through nebulisation. Veterinary nurses (VNs) can use the modified Glasgow Coma Scale to monitor the patient's neurological status. The patient's blood abnormalities may be caused by seizure activity; these parameters should be rechecked to ensure improvement. Cooling measures may be required to treat the hyperthermia. The obtunded patient requires additional nursing interventions, such as padded bedding, position changes, urinary catheterisation or bladder expression, and eye lubrication. Treatment for aspiration pneumonia includes intravenous fluid therapy. VNs can calculate and provide fluids, monitor the patient's hydration and perfusion status and adjust the fluid rate as necessary. Urine output can aid this assessment. Blood pressure may be raised as a consequence of status epilepticus, which can increase intracranial pressure. If this occurs, immediate action must be taken to reduce intracranial pressure, which may include the administration of hyperosmolar agents and nursing interventions such as elevating the head and minimising stimulation. The VN plays a significant role in in-patient care, which can be intensive for the emergency patient. The dedicated VN can contribute significantly to patient wellbeing and recovery.