Aspiration Pneumonia /Drenching Pneumonia

Aspiration pneumonia is a lung disease characterized by inflammation due to inhalation of

foreign material. The most common material aspirated in large animals is a large volume of
liquid, due to weakness from a different primary problem during oral administration of fluids
or other treatments. Aspiration may also occur during induction of general anesthesia if the
airway is inadequately protected.

In severe cases in which large volumes of liquid have been aspirated, death can occur swiftly.
Other cases present with clinical signs consistent with bronchopneumonia , including absent
respiratory sounds cough, fetid and/or mucopurulent nasal discharge, fever, dehydration, and
anorexia.
Treatment mainstays start with administration of broad-spectrum(including anaerobic)
antimicrobial treatment for a minimum of 10–14 days. Supportive care, including anti-
inflammatory medications, oral or intravenous fluids, and nutritional supplementation, may be
needed and is assessed on a case-by-case basis. Some patients require oxygen supplementation,
placement of a chest tube, and more invasive measures.

Prognosis is guarded to grave and depends on how quickly treatment is instituted and how
extensive this is.

Inappropriate administration of therapeutic agents is a common cause of aspiration pneumonia

in large animals and more common than in dogs and cats. Liquids given by via nasogastric
tube or oral dose syringe should not be delivered faster than the animal can swallow. Oral
fluids or treatments should be administered to ruminants with an oral esophageal tube that is
passed into the rumen; the location should be checked via auscultation.

Oral fluids and treatments administered to horses by means of a nasogastric tube should be
done only by a veterinarian and with the horse properly restrained. In horses, negative pressure
should be present while passing the nasogastric tube down the esophagus. If the tube is passed
into the trachea, negative pressure will not develop, and the horse should cough. Additionally,
it is advisable to start oral administration with water only to ensure the nasogastric tube is in
the stomach and not the lung. Horses should cough if fluid is delivered into the lung.

The animal may regurgitate in the tube if the rumen or stomach is full. Administration of fluids
should be stopped immediately if this occurs. Administration of fluids via
nasogastric/esophageal tube is particularly dangerous when the patient’s tongue is drawn out,
when the head is held high, or when the patient is coughing or bellowing.

In sheep, poor dipping technique with repeated immersion of the patient’s head may cause
aspiration of fluid. Calves and lambs may inhale inflammatory debris if affected with
diphtheritic stomatitis/laryngitis. The muscles of deglutition may be affected in lambs with
nutritional myopathy. 

Affected animals separate from the rest of the group and present with fever 104°–105°F (40°–
40.5°C) early in disease; however, fever may not be detected later in the course of disease,
especially in patients with severe dehydration. Animals often show visible signs of pain, such
as arched back, and reluctance to move. Animals are also typically anorexic, mentally dull.
They can present with increased respiratory rate (>40–60 breaths/minute), with a shallow
abdominal component or extended head and neck and fulminant respiratory distress.
Respiratory disease is often associated with a purulent nasal discharge that sometimes is tinged
reddish brown or green, with a fetid smell. Milk yield is greatly reduced sometimes to zero in
lactating animals.

The main focus of treatment is to treat early and aggressively with broad-spectrum
antimicrobials that include anaerobic activity. For food animals, drug choices include penicillin
or oxytetracycline.

Anti-inflammatory therapy is also indicated for pain and to combat toxemia.