Hemorrhage of the Lung in Dogs

A pulmonary contusion can be a life-threatening injury, depending on the severity of the hemorrhage so it is important to get your dog checked out thoroughly by your veterinarian if you suspect he has this injury. Since the pulmonary contusion is often caused by a traumatic injury, you should check your dog for other injuries right away. You should always be careful when moving your dog after a motor vehicle accident or any other traumatic injury in case of spinal injury or broken bones. A pneumothorax (collapsed lung from air in the chest cavity), hemothorax (blood in the chest cavity), broken ribs, and flail chest (2 or more broken ribs) can all be possible side effects from a pulmonary contusion, even if you do not see any visible injuries.

A hemorrhage of the lung (pulmonary contusion) is referring to lesions on the lungs that can happen after an injury to the chest wall. This can lead to hemorrhage and swelling which leads to the collapse of the lung. The pulmonary contusion is one of the most common wounds caused by a blunt chest trauma, which is most often from being hit by a vehicle or from a bite injury.

• Rapid breathing
• Difficulty breathing
• Loud breathing
• Pain in the chest and abdomen
• Coughing
• Vomiting
• Blue or pale skin and mucous membranes
• Fainting
• Collapse
• Lung crackles
• Bloody nose or blood in the mouth
• Irregular heartbeat

• Vehicular trauma
• Bite from another animal
• Animal abuse (usually by owners)
• Falling from a high area
• Gunshot
• Stabbing or other wound that breaks the skin

The first thing the veterinarian will do is make sure your dog is stable and has a clear airway while he does a thorough physical examination. This may require that your dog be sedated and provided with oxygen and fluid therapy so he may need to be hospitalized. As with any visit, you will need to provide your veterinarian will your dog’s complete medical history and any illnesses or changes in behavior. It is impossible to give a definite diagnosis of a pulmonary contusion with just a physical examination so your veterinarian will have to run some tests. These tests include:

• Blood pressure
• Complete blood count (CBC)
• Blood gases
• Urinalysis
• Blood clotting test
• Digital radiographs (x-rays) of the chest and abdomen

The radiographs may be enough to diagnose the severity of your dog’s pulmonary contusion, but it sometimes does not show the true damage, so the veterinarian may decide to do some more tests, such as:

• Bronchoscopy
• Electrocardiography (ECG) to check for arrhythmia or tachycardia 
• CT scan for a 3-D assessment
• Ultrasound to see the true extent of damage
• MRI for further details

The treatment plan will depend on the severity of the pulmonary contusion and any other injuries that your dog may have sustained. Your veterinarian will want to keep your dog on oxygen for some time to increase the oxygen in the blood that may have been lost. Many times, the damage to the lung does not completely show for 24-48 hours, so the veterinarian may want to keep your dog for one or two days for observation.

Pain medication such as Fentanyl or Morphine will be administered if your dog is in pain. The veterinarian may also prescribe corticosteroids to reduce swelling and antibiotics to prevent infection. Other treatment may be necessary for injuries sustained with the pulmonary contusion, such as:

Pneumothorax

If your dog has pneumothorax, the veterinarian will have to perform a thoracentesis, which means relieving the air from the chest with a needle. After three attempts to drain the air, a thoracostomy tube will be placed in your dog’s chest.

Hemothorax

In the case of a hemothorax, the blood between the chest wall and the lung causes the lung to be compressed, causing pain and shortness of breath. Your veterinarian will want to keep your dog in the hospital on oxygen and IV fluids for 24 to 48 hours for observation. If the blood continues to be a problem or increases, the veterinarian may want to do surgery to find the cause of the bleeding and fix it.

Broken Ribs and Flail Chest (Two or more broken ribs)

If your dog has one or more broken ribs, the veterinarian may want to wrap the chest to stabilize the ribs and help them to heal. Cage rest and a short hospital stay are necessary if the injury is severe.

The veterinarian will probably keep your dog for at least 24 hours for observation, and possibly longer if there are any complications or if your dog has surgery. Once you get home, your dog may be on cage rest for several days to keep him from hurting himself. You will have to take your dog on a leash to go to the bathroom when necessary. Be sure to follow your veterinarian’s instruction and do not miss your follow-up appointment. The chances of a full recovery for your dog is excellent if the damage was mild and was treated right away. Otherwise, your dog’s recovery depends on the severity of the damage and whether it could be treated in time.