Emergency diagnosis and treatment of congenital lobar emphysema in a puppy

Abstract

Congenital lobar emphysema is a rare condition in dogs. A three-month-old pug presented with acute dyspnoea and radiographic findings diagnosed congenital lobar emphysema. Due to the patient’s rapidly deteriorating ventilation, an emergency right middle lung lobectomy was performed and recovery was uneventful. This case report describes the importance of making a prompt and accurate diagnosis of this condition, based on radiographic findings, to facilitate immediate treatment.

Radiographic, computed tomographic and histopathological characteristics of multilobar congenital pulmonary emphysema in a puppy

“…In infants suffering from CLE, surgical excision with compensatory lung growth results in a favourable prognosis, as does conservative symptomatic therapy in mildly affected individuals 17 20. Surgical removal of the affected lung lobe is currently the only treatment option in affected veterinary patients 4 6–9. In the present case, as all lung lobes were equivalently affected, the decision was made to humanely euthanase the dog.…”

“…CLE is a rare malformation which has been well described in young infants and dogs, and sparsely reported in cats 1–9. In the veterinary literature, CLE has predominantly been reported in young patients between six weeks and six months of age 2–11. However, a few reports have also been described in adult dogs and cats 1 12–14…”

“…CLE is defined as a congenital overexpansion of one or multiple pulmonary lobes, most commonly due to congenital bronchial cartilage dysplasia, hypoplasia or aplasia, resulting in a valve mechanism (dynamic collapse). The air is trapped in the lower respiratory tract and peripheral emphysematous bullae form via gas accumulation 1 5–9 11 12 15 16…”

“…In the vast majority of CLE cases, only one lung lobe is involved. The right middle lung lobe has been reported to be the most commonly affected in dogs and cats, followed by the left cranial lung lobe 1–9. Previous scant reports also described CLE of multiple lobes in dogs 11 12.…”

“…Congenital lobar emphysema (CLE) is a rare malformation previously described in people, dogs and cats, predominantly at a young age. It is characterised by overexpansion of one or, rarely, multiple lung lobes, and affects most commonly the right middle lung lobe followed by the left cranial lung lobe 1–9. Surgical removal of the affected lung lobe is currently the only treatment option in affected veterinary patients.…”