Use of high-flow oxygen therapy in a cat with cardiogenic pulmonary edema

Abstract

Case summary A 7-month-old female spayed domestic shorthair cat was presented for respiratory distress due to cardiogenic pulmonary edema. Despite initial treatment and oxygen delivery in an oxygen tent, the cat still showed signs of severe respiratory effort and oxygen saturation measured via pulse oximetry was below 85%. Because the owners declined mechanical ventilation, the cat was transitioned to high-flow oxygen therapy (HFOT). HFOT allowed significant improvement of the respiration parameters within 15 mins without causing clinical complications. The cat was briefly anaesthetised for the placement of the nasal cannula on initiation of HFOT, and the interface was well tolerated thereafter. The cat was transitioned to an oxygen cage after 16 h, weaned from oxygen 4 h later and was discharged after 3 days of hospitalisation. Long-term follow-up showed no abnormalities, and the leading hypothesis was transient myocardial thickening. Relevance and novel information The first use of HFOT in a dyspneic cat is described in this study. HFOT could be a life-saving option for cats with severe hypoxemia or do-not-intubate orders that fail to respond to conventional oxygen therapies.

High-flow nasal cannula oxygen therapy in seven cats with respiratory failure

“…In addition, a recent case report involving a cat with cardiogenic pulmonary edema treated with HFNOT highlighted the usefulness of sedation for initiating HFNOT. 10 Although the cat had accepted the placement of the HFNOT cannula without sedation, starting the HFNOT flow rate (1.8 l/kg/min) necessitated a short period of heavy sedation with propofol. In line with the previous reports, five cats in this study received sedation for both HFNOT cannula placement and flow rate initiation, highlighting the need for sedation for the smooth initiation of HFNOT in cats.…”

“…A recent case report has highlighted the significant improvement in a cat’s respiratory parameters within 15 mins of the initiation of HFNOT. 10 In scenarios where cats do not adequately respond to COT, such as oxygen cages, HFNOT may serve as a bridging therapy to MV. Therefore, further study is warranted to establish the practicality of utilizing HFNOT in cats.…”