The Efficacy of Nebulized Budesonide in Dexamethasone-treated Outpatients With Croup

Klassen, Terry P; Watters, Lise K.; Feldman, Mark; Sutcliffe, Teresa; Rowe, Peter C.

doi:10.1542/peds.97.4.463

Cited by 54 publications

(1 citation statement)

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“…The cat was discharged the next day on prednisolone (5 mg PO q24h) and inhaled dexamethasone (0.2 ml dexamethasone SP diluted in one vial of Addipak saline (Saline; Teleflex) placed in a nebulizer cup and administered for 10-15 mins q12h). 14 The re-check examination 2 days later was unchanged. Five days later, the cat was re-examined due to a recurrence of respiratory distress and the owner elected euthanasia.…”

Section: Case Descriptionmentioning

confidence: 94%

Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone

Philp,

Johnson,

Choi

et al. 2024

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 10-year-old male castrated domestic shorthair cat was presented for evaluation of a 3-day history of increased inspiratory effort. The cat had received prednisolone 1 mg/kg PO q24h for 1 year due to chronic diarrhea. On physical examination, the patient exhibited severe stridor, intermittent open-mouth breathing and bilateral mucopurulent nasal discharge. Subcutaneous emphysema was palpated over the dorsal cervical region. Mild hypoventilation (PvCO2 55.1 mmHg; approximate reference interval 35–45 mmHg) was identified. Cervicothoracic radiographs showed marked gas tracking within cervical soft tissues with concurrent laryngeal thickening, pulmonary nodules, a bronchial pulmonary pattern, pneumomediastinum and aerophagia. The cat was hospitalized and treated overnight with oxygen and intravenous fluid therapy before anesthesia the next day. On laryngoscopy, a large tracheal mass was observed arising from the right subglottic region and was removed using biopsy forceps. CT revealed an additional mass at the level of the tracheal bifurcation causing marked luminal narrowing of the trachea and proximal main bronchi. The cat made a good initial recovery, although moderate stridor persisted. Five days later, the cat was re-examined due to recurrence of respiratory distress and orthopnea, and the owner elected euthanasia. Histopathology revealed severe nodular obstructive eosinophilic plasmacytic laryngotracheitis with intranuclear inclusion bodies positive for feline herpesvirus-1 on immunohistochemistry. Relevance and novel information This report describes the presentation and management of a cat with respiratory distress secondary to intratracheal eosinophilic masses caused by feline herpesvirus-1. Although the outcome was ultimately unsatisfactory, to the authors’ knowledge, this clinical presentation has not been previously reported.

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Section: Case Descriptionmentioning

confidence: 94%

Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone

Philp,

Johnson,

Choi

et al. 2024

Journal of Feline Medicine and Surgery Open Reports

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Nebulized Budesonide and Oral Dexamethasone for Treatment of Croup

Klassen

Craig

Moher

et al. 1998

JAMA

132

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Context.-The effectiveness of glucocorticoids for patients with croup is well established but it remains uncertain which glucocorticoid regimen is most effective. Objective.-To determine the effectiveness of 3 glucocorticoid regimens in patients with croup. Design.-Randomized controlled trial with parallel design. Setting.-Emergency departments of 2 Canadian pediatric tertiary care hospitals. Participants.-Children with a clinical syndrome consistent with croup, aged 3 months to 5 years, with a croup score of 2 or greater following at least 15 minutes of mist therapy. Interventions.-Oral dexamethasone, 0.6 mg/kg, and nebulized placebo; oral placebo and nebulized budesonide, 2 mg; or oral dexamethasone, 0.6 mg/kg, and nebulized budesonide, 2 mg. Main Outcome Measures.-Westley croup score (primary outcome), hospital admission rates, time spent in the emergency department, return visits to the emergency department, or ongoing symptoms at 1 week. Results.-The mean change in the croup score from baseline to the final study assessment was −2.3 (95% confidence interval [CI], −2.6 to −2.0) in the budesonide group (n = 65), −2.4 (95% CI, −2.6 to −2.2) in the dexamethasone group (n = 69), and −2.4 (95% CI, −2.7 to −2.1) in the budesonide and dexamethasone group (n = 64, P = .70). Conclusions.-Based on the similar outcomes in the 3 groups, oral dexamethasone is the preferred intervention because of its ease of administration, lower cost, and more widespread availability.

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Effects of inhaled fluticasone propionate administered with metered dose inhaler and spacer in mild to moderate croup: a negative preliminary report

Roorda

Walhof²

1998

Pediatr. Pulmonol.

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The Efficacy of Nebulized Budesonide in Dexamethasone-treated Outpatients With Croup

Cited by 54 publications

References 0 publications

Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone

Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone

Nebulized Budesonide and Oral Dexamethasone for Treatment of Croup

Effects of inhaled fluticasone propionate administered with metered dose inhaler and spacer in mild to moderate croup: a negative preliminary report

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