Small Animal Clinical Sciences (Storer, Yankin) and Veterinary Pathobiology (Stranahan), School of Veterinary Medicine and Biomedical Sciences, Texas A&M University (Manzano Arvayo), Veterinary & Biomedical Education Complex, 660 Raymond Stotzer Pkwy, College Station, Texas 77843, USA.
Can Vet J. 2024 Aug;65(8):751-757.
A 16-year-old castrated male shih tzu dog was brought to the emergency service because of an acute (24 h) history of gagging, coughing, and lethargy. Physical examination revealed dyspnea concurrent with diffuse, bilateral, pulmonary crackles and wheezes. Oxygen saturation, measured with a pulse oximeter, was < 95%. Thoracic radiographs revealed a multifocal alveolar pattern superimposed over a diffuse interstitial pattern with normal heart size. The dog continued to be dyspneic despite oxygen therapy. In accordance with the radiographic findings, further supportive care was recommended. Due to the unknown prognosis and financial constraints, the owner elected humane euthanasia. Necropsy confirmed a pheochromocytoma and lung changes without evidence of congestive heart failure. Findings were consistent with diffuse alveolar damage. These findings correlated with the dog's clinical diagnosis of acute respiratory distress syndrome (ARDS). No other disease processes associated with ARDS were identified. The purpose of this case report is to describe an unusual presentation of ARDS likely associated with a pheochromocytoma and confirmed by necropsy. Acute respiratory distress syndrome associated with a pheochromocytoma has been described in medical literature but has never been reported in veterinary medicine. Key clinical message: Pheochromocytomas should be added to the list of risk factors associated with ARDS in dogs. Dogs with a suspected diagnosis of pheochromocytoma whose owners elect against surgical removal should be closely monitored for an acute onset of respiratory distress, which could suggest the development of ARDS.
一只 16 岁已去势的雄性西施犬因突发（24 小时）呛咳、咳嗽和嗜睡而被带到急诊室。体格检查发现呼吸困难，同时有弥漫性双侧、肺爆裂音和哮鸣音。使用脉搏血氧仪测量的血氧饱和度<95%。胸部 X 光片显示弥漫性间质模式上有多发肺泡模式，心脏大小正常。尽管进行了氧疗，该犬仍持续呼吸困难。根据放射学发现，建议进一步进行支持性治疗。由于未知的预后和经济限制，主人选择了安乐死。尸检证实存在嗜铬细胞瘤和肺部变化，但没有充血性心力衰竭的证据。结果与弥漫性肺泡损伤一致。这些发现与犬的急性呼吸窘迫综合征（ARDS）的临床诊断相符。未发现与 ARDS 相关的其他疾病过程。本病例报告的目的是描述一种可能与嗜铬细胞瘤相关的不常见 ARDS 表现，并通过尸检证实。医学文献中已描述了与嗜铬细胞瘤相关的 ARDS，但在兽医医学中从未报道过。关键临床信息：应将嗜铬细胞瘤添加到与犬 ARDS 相关的风险因素列表中。怀疑患有嗜铬细胞瘤但主人选择不进行手术切除的犬，应密切监测其是否有急性呼吸窘迫的发生，这可能提示 ARDS 的发展。
