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FEATURES JULY/AUGUST 2018 45 Practice Step by Step: Providing Supplemental Oxygen to Patients RESPIRATORY MEDICINE Alex Lynch, BVS, DACVECC, MRCVS North Carolina State University, Raleigh, NC Supplemental oxygen is an important treatment for animals with signs of respiratory distress. Hypoxia refers to low tissue oxygen concentrations and can occur for several reasons ( TABLE 1 ). Depending on the cause of hypoxia, oxygen supplementation may be very helpful (e.g., for heart failure or pulmonary fibrosis). Other causes of hypoxia are not especially oxygen-responsive, however, and require alternative treatment strategies to provide a benefit (e.g., red cell transfusion to an anemic patient). In the short term, oxygen supplementation is always appropriate until further data have been acquired to understand the specific case more deeply. In the long term, oxygen toxicity could occur if an animal is exposed to high concentrations of oxygen for several consecutive days. 1 This article concentrates on a practical approach to providing supplemental oxygen to small animal patients. WOULD THIS PATIENT BENEFIT FROM SUPPLEMENTAL OXYGEN? In the triage setting, several clues may prompt the clinician to provide oxygen, including tachypnea, shortness of breath and orthopnea ( FIGURE 1 ), cyanosis, and abnormal respiratory noises. With further examination, some of the causes of respiratory distress may ultimately prove to be "nonrespiratory lookalikes." 2 These are patients without cardiopulmonary disease that breathe rapidly or with effort, such as animals with large-volume abdominal effusion, pain, or SUPPLEMENTAL OXYGEN TECHNIQUE For larger dogs, nasal lines can be easily placed using a cathether inserted via the ventral meatus to the level of the medial canthus. FIGURE 1. Bulldog puppy that had aspiration pneumonia and demonstrated orthopnea receiving oxygen via facemask.

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