Pulmonary Contusions

Ronald M. Bright, DVM, MS, DACVS

BASIC INFORMATION supportive care, rest, and treatment of other trauma-related prob- Description and Causes lems. Bronchodilator drugs may be helpful in some cases. A pulmonary contusion is a form of bruise that occurs from bleed- Fluid therapy is often administered to animals in shock. When ing within the lungs. The collection of blood deep within lung tis- pulmonary contusions are suspected, the rate of fluid therapy must sue usually results from blunt trauma to the chest, and it can occur be carefully monitored, because overly aggressive therapy can even if there is no outward evidence of trauma. make the contusions worse, especially in cats. To help decrease the amount of fluid that escapes into the lungs associated with the Clinical Signs contusion, a transfusion of plasma, blood, or synthetic starch (col- With mild or localized pulmonary contusions, no visible respira- loid agent) may be considered. tory signs may be present. Acute onset of panting and some degree Corticosteroids may be administered, but this must be done of respiratory distress are common with moderate to severe contu- soon after the traumatic event or they may be of little benefit. sions. External signs of trauma may be seen around the chest or Antibiotics are often given to animals with severe contusions or elsewhere on the body. Sometimes other clinical signs produced open wounds on the body to minimize the potential for second- by the blunt trauma can overshadow those associated with mild to ary bacterial pneumonia. Good nursing care and medications to moderate pulmonary contusions. relieve pain and distress are also important. Diagnostic Tests Follow-up Care A known history of trauma combined with finding abnormal lung Animals with moderate to severe pulmonary contusions require sounds on the physical examination may allow a tentative diagnosis. intensive monitoring for several days. Chest x-rays are often X-rays of the lungs often show characteristic changes of pulmonary repeated every 24 hours to monitor resolution of the contusions. contusions. Other abnormalities may also be seen on the x-rays, X-ray changes often worsen during the first 24 hours following the such as broken ribs, fluid or air (or both) in the chest cavity, and col- injury and may take several days to improve. lapse of one or several lung lobes. Other x-rays and laboratory tests Other vital signs, such as respiratory rate, heart rate, and blood may be recommended depending on the extent of the injuries. oxygen levels, are also commonly monitored. If respiratory signs worsen despite treatment, the animal may placed on a mechani- TREATMENT AND FOLLOW-UP cal ventilator for a short period of time, if one is available. Other monitoring and follow-up testing depends on the presence of other Treatment Options trauma-related injuries. Most animals with pulmonary contusions are hospitalized for Prognosis therapy and monitoring. Depending on the degree of respiratory Animals with mild pulmonary contusions have a good prognosis compromise, supplemental oxygen may be needed. (See the hand- if their other injuries can be successfully treated. Prognosis is poor out on Oxygen Therapy .) No specific therapy exists for pulmo- for animals with severe contusions or contusions complicated by nary contusions, and treatment usually involves oxygen therapy, other serious injuries to the chest or body.