|The Dog's Health>Puppies>Pneumonia in Shar Pei pups|
Pneumonia in Shar Pei pups
Jeff Vidt, DVM
(Published with permission)
you come in the door that afternoon, you know something is wrong. Your
three-month-old Shar Pei pup is not at the door to greet you. You search the
house and find him in the family room huddled in the corner - ears down, tail
limp, droopy eyes, breathing heavily and coughing softly. He feels warm to the
touch. His temperature is 41° and you know you’ve got trouble.
above scenario is pretty typical for pneumonia in the Chinese Shar Pei. It often
occurs in pups 8 - 16 weeks old and seems to come out of nowhere. The only
specific signs which may suggest pneumonia are heavy breathing, usually with an
abdominal component and sometimes a productive cough. By the time these signs
are present, you have a very sick puppy and generally have very little time to
do much about it.
must be quick, accurate and specific. A minimal database must include a CBC and
chest photograph. We are primarily interested in the white blood cell count (WBC).
What we want to see in the sick pup is a high WBC with some young white blood
cells called “bands”. This would signal an appropriate response and that the
pup is fighting the infection. A bad sign would be a normal or low WBC with high
numbers of bands. This indicates the infection is winning and the pup may die.
signs of pneumonia are pretty classic and usually apparent on chest x-rays.
Positioning may be less than ideal as the pups will resist being put on their
side and we don’t want to fight them too much - depending on the degree of
lung involvement, stress may overwhelm them. It is also helpful to try to
stretch out the wrinkles over the chest when radiographs is taken. These folds
can often obscure the lung changes seen in pneumonia.
appears as fluid in the lungs seen in the ventral (lowest) lung fields and
located in the cranial (forward) lung lobes. Fluid may accumulate in one lung
lobe, cover multiple lobes and also occur in both sides of the chest. The fluid
will often obscure the heart shadow on a chest radiograph. The definitive
diagnosis is based on a tracheal wash. In this procedure, a catheter is
introduced into the trachea and sterile water is flushed into the tracheas and
then aspirated back out, hopefully with the offending bacteria in it. This
sample can then be cultured and an antibiotic sensitivity done. This procedure
is usually done under sedation or light anesthesia and has some risk involved in
it, especially in a sick pup, but the information gathered is critical to
instituting the appropriate antibiotic therapy.
causes pneumonia in Shar Pei pups? By the time we have a sick pup, the lungs
have been infected by bacteria. These are usually Gram (-) bacteria such as E.
Coli, Klebsiella and Bordetella.
(+) cocci such as Streptococcus may
also be isolated. It is also know that viruses such as canine distemper,
adenovirus and parainfluenza can also cause pneumonia. Shar Pei also have an IgA
deficiency which occurs in the vast majority of dogs. IgA is a protective
immunoglobulin found in body secretions such as tears, mucous, saliva, etc. It
is responsible for local immunity in the respiratory, gastrointestinal and
urogenital systems as well as the skin. IgA deficiency may predispose an animal
to bacterial pneumonia.
dyskinesis is a condition that has been reported in the Shar Pei in which the
cilia of the respiratory tract are abnormal or not present. Cilia are hair-like
projections on the lining of the trachea and larger bronchi which are involved
in the clearance of debris-laden mucous out of the bronchi. This mechanism is
vital in preventing accumulation of bacteria in the bronchi and subsequent
development of bacterial pneumonia. It appears that this is a heritable
Shar Pei are prone to megaesophagus. This is an abnormality involving the
esophagus or “food tube” which can result in accumulation of food and
secretions in the esophagus.
is a common finding in puppies with this condition and this can lead to
aspiration pneumonia. Megaesophagus can often be picked up on chest radiographs
underlining the importance of doing chest x-rays in any pneumonia work-up.
to the wide range of underlying causes of bacterial pneumonia, it is very
important to autopsy any Shar Pei who dies of pneumonia.
of pneumonia involves the use of antibiotic therapy based on the culture and
sensitivity results obtained via the tracheal wash. Pending getting these
results back from the laboratory which may take two or three days, it is
necessary to use “Four Quadrant Therapy”. This is antibacterial therapy
against all bacterial groups - Gram
(+) aerobes and anaerobes and Gram (-) aerobes and anaerobes.
initial choice is an aminoglycoside and a penicillin. Use of injectable
medications is indicated initially. Another choice is the use of quinolone and a
penicillin. This has the advantage of being given orally. Once the culture and
sensitivity results are back, specific therapy is based on those results. I like
to use a different antibiotic every two weeks for at least four to six weeks.
The therapy should be continued for two weeks after the chest radiographs appear
normal. There is a very real danger of not treating pneumonia long enough and
having it recur with the possibility that the antibiotic therapy used either
selected for a strain of bacteria or a new bacteria is causing the problem. A
“amoldering-type” pneumonia develops and can cause respiratory problems for
a long time. This is more apt to occur when a tracheal wash-culture/sensitivity
is not done. Injectable antibiotics may be used in a nebulizer which allows the
antibiotics to be breathed into the deeper airways and reach the lungs. The use
of a humidifier is useful in this regard.
(IV or subcutaneous) are very important to maintain hydration in the sick pup
and to keep secretions thin. This allows the normal respiratory defense
mechanisms, such as coughing and ciliary function to clear the bacteria from the
lungs. Use of a humidifier is useful in this regard.
nutrition is vital to maintain energy levels in the pup and prevent secondary
disease. Coupage (thumping the chest) is useful to stimulate coughing,
mobilising fluid in the chest and to stimulate deep breaths to prevent collapsed
lungs (atelectasis). Mild, frequent periods of exercise help to mobilise
secretions and maintain the pup’s interest and mental well-being.
centers around decreasing the pup’s exposure to infectious agents. Check your
vaccines and be sure they are in date and stored properly. Be aware of the
adverse effects of stress on puppies. Puppy matches (shows), travelling, etc.,
may not be in the best interest of the young Shar Pei pup. Isolate puppies from
visiting adult dogs. Clean puppy areas with disinfectant frequently. Isolate any
sick puppies and care for them last - always going from healthy puppies to the
use of Bordetella vaccine may be useful, although this bacterial agent probably
represents a small number of the pneumonia cases.
a high index of suspicion for pneumonia in the 8 - 16 week-old puppy is the best
way to discover the problem early and get treatment fast. Also remember,
pneumonia isn’t the only condition which can result in a fever in pups. Every
fever is not pneumonia, especially if not confirmed by the complex blood count
and chest radiographs.