Pulmonary Contusion in Dogs

What Is Pulmonary Contusion in Dogs?

A pulmonary contusion in dogs is an injury or bruising to the lungs that results from a blunt trauma to the dog’s chest (thoracic cavity) due to an impact with a dull, firm surface or object—such as when the dog is hit by a car. This injury causes a hemorrhage, or uncontrolled bleeding, from the damage done to the blood vessels in and around the lungs.

Pulmonary contusions can range from mild bruising in one lung lobe to severe hemorrhage of the entire lung. Contusions can develop and progress for up to 24–48 hours after a blunt force trauma to the thoracic cavity and the lungs. Dogs that have suffered such a trauma might initially appear to be breathing normally, but this bleeding can rapidly worsen as time goes on and cause your dog to develop serious respiratory distress and even death.

If your dog has any trauma to the chest or body, it should be considered and treated as a medical emergency. Your dog should go to their veterinarian or an emergency vet as soon as possible and remain there for treatment and observation for at least 48–72 hours.

Symptoms of Pulmonary Contusion in Dogs

The following are clinical signs associated with pulmonary contusions in dogs. The severity of the signs and symptoms will depend on the extent of the trauma and how much lung tissue is affected.

• Rapid, abnormal breathing (tachypnea)

• Trouble breathing

• Coughing, with or without blood or blood-tinged fluid

• Blood from the nose (epistaxis)

• Signs of thoracic trauma, such as broken ribs

• Vomiting, retching

• Wheezing, especially during exhalation

• Wobbly gait or inability to stand

• Blue or purple gums

• Pale gums

• Vocalizing excessively

Causes of Pulmonary Contusion in Dogs

Pulmonary contusions can occur after any blunt trauma, such as:

• Being hit by a car

• Falling from a significant height

• Abuse or cruelty by humans

• Being kicked by another animal

• Non-penetrating bite wounds

• Crushing injury

Motor vehicle accidents (where a dog is hit by a car) are the most common cause of pulmonary contusion in dogs. Pulmonary contusions occur in 40–50% of dogs with chest injuries and should be suspected if your dog has been hit by a car.

How Veterinarians Diagnose Pulmonary Contusions in Dogs

Diagnosis of pulmonary contusions in dogs is based on a recent history of trauma to the thorax/chest, symptoms of respiratory distress, or diagnostic testing. Since pulmonary contusions can take up to 48 hours to develop, your dog might initially have no clinical signs. X-rays of the chest might initially be within normal limits, but as time goes on, they can start to become abnormal and show signs of fluid in or around the lungs.

After a complete medical history is taken and a physical exam is done, other diagnostic testing in addition to X-rays might be needed to assess your dog’s injuries and susceptibility to developing pulmonary contusions. Your veterinarian will also run baseline blood work to look for evidence of anemia or other adverse effects from having a traumatic accident. If possible, a blood gas analysis will be done to assess your dog’s ability to breathe normally and oxygenate their blood.

If your dog has sustained blunt force trauma, it should be taken to the vet right away. While you are on the way to the vet, it’s best to have your dog in a crate or doggy car seat to ensure their safety. Ideally, have another person sit in the car near the dog to give them extra love and attention and keep them as calm as possible.

Treatment of Pulmonary Contusion in Dogs

Pulmonary contusions require aggressive treatment, including keeping your dog in the hospital for at least a few days. In mild cases, oxygen therapy is needed by putting small tubes into your dog’s nose or having them wear a special mask. If your dog does not tolerate this, most hospitals have a special oxygen cage to place them in.

In severe cases, blood in the lungs is suctioned through the mouth, and then your dog will need to be intubated. Intubation is when a tube is placed, via the mouth, down into the lungs to provide oxygen to the body. Intubation will also require sedation for your dog, so the tube stays in position.

If the dog is severely affected, and especially if they are having trouble breathing, a chest tube might be needed to drain the blood accumulation. This tube is placed in your dog’s chest under anesthesia or heavy sedation.

An IV catheter will need to be placed so your dog can get both the medications they need for the symptoms they have and supportive fluids for hydration and a healthy blood pressure. Pain medications are also an important part of treatment. Depending on the severity of your dog’s pulmonary contusions, they might even need to be put on a ventilator to assist them with breathing.

Even in mild cases of pulmonary contusion, your dog will likely need to spend some time under strict cage rest to allow them to recover from their contusions as well as any other injuries they sustained from the trauma. In dogs that have injuries such as broken bones or air buildup in the chest, surgery may be necessary.

After being stabilized and hospitalized until they are breathing normally, your dog will be able to go home to continue recovering with strict rest and any needed medications, such as pain medication, antibiotics, and anti-inflammatories.

Recovery and Management of Pulmonary Contusion in Dogs

Pulmonary contusions usually get worse before they get better. Respiratory issues often get worse 24–48 hours after the trauma, but then hopefully begin to improve. Although your dog might be feeling much better, pulmonary contusions typically take seven to 10 days to fully resolve. That’s why  your dog needs to be on strict cage rest for a few weeks after their injury.

If your dog has sustained a blunt injury to the chest and has not developed any signs of troubled breathing after 48 hours, they are unlikely to develop any. Dogs that do not have other bodily injuries will have a better prognosis than those with secondary issues such as rib fractures or damage to other organs.

If your dog has trouble breathing or they need to be temporarily intubated or put on a ventilator, their prognosis is less favorable for a complete recovery.

After pulmonary contusions, your dog might have a compromised respiratory system, meaning you should be cautious with their exercise and other activities that put excess strain on the lungs. In a case like this, and depending on the severity of their injuries, a dog might need to be on lifelong medications to help keep the airway open as well as to manage pain.