Decreased Thoracic Excursions (ventilatory failure)

The neurological patient that develops respiratory failure usually has obvious neurological disease. Intubation is always indicated in respiratory failure associated with decreased ventilation. Once the patient has been stabilized, the lesion must be localized. This will help the clinician establish a list of differential diagnoses and the general prognosis for the patient. If the disease is treatable owner commitment and expectations need to be explored as these cases can require long-term intensive management.

Brain Sedative drugs (opiods), trauma, edema, neoplasia herniation, thromboemboli, hypoxia, hypoglycemia, encephalopathy
Cervical cord Trauma, disc,fractures, polyradiculoneuritis, myelography, laminectomy
Neuromuscular Myasthenia gravis, polyneuropathy, botulism


Intubating the patient and initiating ventilation is the first step. The next stage is planning the diagnostic work up and treatment procedures. This helps establish whether a resolution of the underlying disease process is feasible and may aid in providing owners with an estimated time for successful weaning from the ventilator.

Unless … Continue reading

Central cyanosis due to respiratory disorders

Cyanosis associated with respiratory causes are often found at later stages of disease processes. The presence of cyanosis in respiratory distress requires rapid decision. The clinician must determine whether the patient is likely to respond to medical therapy (typically — oxygen supplementation, sedation, bronchodilators) or require intubation and possible ventilation.

Respiratory failure is typically classified into dysfunction of oxygenation (inability to oxygenate – most common problem in our veterinary patients) or ventilatory failure (inability to eliminate CO2). Additionally, it is further characterized as to whether it is acute or chronic.

This is a more precise classification scheme however, while oxygenation can be estimated in the awake patient not receiving oxygen supplementation by a pulse oximeter, it does require access to blood gas analysis for CO2 measurement.

Another possible classification is to define the respiratory failure according to the patients breathing pattern. The advantages of this classification is that it is … Continue reading