Hunting dog coughing up blood

RE: Hunting dog coughing up blood

Dave Dickson — Tue, 02 Jun 2020 12:08:06 GMT

Hi Fable

Heard back from my colleague about Hunting Oedema. Given Mark's response, this may be irrelevant now, but I'll post her reply anyway (it's from Liva Vatne, a Cardiologist who works in Oslo, Norway).

“Hunting oedema” in my experience:

Certain breeds of dog seem to be predisposed to exercise induced oedema.

The oedema usually develops during the hours following strenuous exercise, and commonly in dogs that vocalise during hunting sessions. In the Drever dog it has been proven to be genetic, but the paper is quite old. Other breeds affected are The Norwegian Elk hound, Støver and Dachshounds. Possibly more.

https://pubmed.ncbi.nlm.nih.gov/12779172/

The paper I sent a link to states that post mortem shows myocardial lesions, however I have never seen any obvious changes on echo. No LA enlargement, no systolic dysfunction, nor PHT. The oedema resolves spontaneously with a few days rest, also without diuretics.

It is believed to be a result of catecholamine surge, and in my anecdotal experience “highly strung” dogs are particularly sensitive.

I never take these cases lightly, as it is important to rule out all sorts of other causes of dyspnea. The dogs that vocalise can develop laryngitis, responsive to diuretics to a degree, purely due to the barking.

I tend to do bloods including haematology and CRP (to rule out pneumonia), rads, echo - and if no evidence of pulm oedema- laryngoscopy +/- bronchoscopy/ BAL.

The “Swedish protocol” is to give furosemide 1 mg/kg and atenolol 1 mg/kg on the morning of hunting.

My protocol is as follows:

Advice owner to exercise their dogs regularly throughout the year, not just in hunting season + to keep dog lean.

On the hunting day: Give atenolol in the morning whilst the owners are “still wearing their pyjamas” - ie before the dogs starts getting excited about hunting.

I give prescription for furosemide, but tell the owners to only give this if high SRR after the hunt. (In my experience the atenolol makes the dog able to hunt, without developing PE). And teach the owners how to assess breathing pattern as well as count SRR.

I advice against breeding from them, but not to take them out of hunting unless life threatening oedema.

I don’t see the use for Vetmedin or ACE-i as beta blockers really effective in my experience.

I’ve often wondered if this condition is similar to exercise induced epistaxis in horses, but I don’t know.

For what it’s worth!

Hope that is helpful. Do let us know if you get any followup.

As an aside, I worked in NZ (Tauranga) for a year and saw loads of hunting dogs with various wounds. One famous one I remember was a pig dog who walked in with his owner, dog had a massive bandage around his neck. Owner told me "ah mate he was caught in the neck 3 days ago, bloody pig ripped out his jugglar vein, so I've bandaged it up". I rolled my eyes, removed the bandage and with it came a 10cm length of tubular clot that had been blocking his jugular. Large quantities of blood spilled everywhere, I ran to theatre with the dog an did an emergency stitch up, whilst the owner rolled his eyes at me for not believing him.

Moral of the story - occasionally, owners tell the truth. And be wary of removing clots from the "jugglar" vein!

Dave

RE: Hunting dog coughing up blood

Fable — Sun, 24 May 2020 23:47:10 GMT

Thank you Mark for your answer, I greatly appreciate your detailed explanation of what you saw on the radiographs. I took these films in a bit of a hurry during a Saturday morning clinic so unfortunately wasn't able to GA the dog. I will discuss it with the owner, but I believe a referral for ultrasound would be the way to go or as you say CT, if I can convince them.

RE: Hunting dog coughing up blood

Mark Patteson — Thu, 21 May 2020 08:34:49 GMT

OK so I am going to appraise these films so please don't feel its a personal criticism - they arent fully inflated - It makes a huge difference. I am worried that there is a mass although I confess I can't be certain If you look at the right lateral you can see some air bronchograms overlying the caudal aspect of the heart It's harder because it is also over the back of a pair of ribs bit I think there is an infiltrate there Air bronchograms mean an alveolar pattern and that means pus, blood, oedema or tumour - but also could be orthostatic collapse. Especially if the dog is sedated and has been lying on its side If you look at the left lateral I an concerned that there could be a mass overlying the heart and just elevating the bronchi And if you look at the DV there is a deviation of the bronchus medially. There are other reasons for compound shadows and collapsed lungs on a chest film are a recipe for people sticking their necks out and losing their heads, so I am happy to be wrong here

I am afraid that I am less convinced about the "He has right sided heart enlargement with enlarged lobar pulmonary arteries suggesting pulmonary hypertension." the cranial lobe vessels look WNL to me, the width of the heart is < 3 ics and its an athletic dog so I think it's reading the left lateral or having underinflated films that can lead to a concussion of right-sided enlargement
Diagnosis pulmonary hypertension from radiographs is really, really hard - and has lots of pitfalls (unless you live somewhere where there are spaghetti sizes worms ie Dirofilaria) It needs an echo to sensitively and specifically diagnose right-sided enlargement (even then it's a hard call at times) but diagnosing pulmonary hypertension then echo is essential in my view (OK you could catheterise them but don't) It's not an easy echo because you need to align well with the TR and PR jets but its by far the best way (OK CT is also useful)

usually, lung masses are pulmonary carcinomas, the dog is very young for that =, that's why I asked the age before I stupidly stick my neck out like this
But it could also be foreign body (unusual location) or haemorrhage - I have seen some focal areas of haemorrhage form a pulmonary haematoma

So for me what would help would be an ultrasound scan of that area, and or a repeat radiograph with fully inflated films - I can't see an ET tube This is best under GA,
or for us - I am afraid we have the easy option - CT which is so far ahead of plain radiographs for lung detail that you wish they didn't exist because you can't bear to look at plain rads once you know what CT does

I confess to having no experience of the hunting dog oedema that Dave refers to

RE: Hunting dog coughing up blood

Fable — Wed, 20 May 2020 20:04:57 GMT

Yes, we are in NZ! The dog is 5 years old and a mix of whippet/bully breeds.

RE: Hunting dog coughing up blood

Mark Patteson — Wed, 20 May 2020 11:46:34 GMT

how old is this dog?

RE: Hunting dog coughing up blood

Dave Dickson — Wed, 20 May 2020 09:17:26 GMT

Hi Fable

I have no experience of this at all but I've just asked a colleague who works in Scandinavia, where hunting dogs are common and they see a lot of 'hunting oedema'. I'll update you when I hear back.

Also - what part of the world are you in where there are pig hunting dogs? I'm assuming New Zealand but may be way off...

Dave