Pneumonia after intracranial surgery in dogs

Objective-To determine factors associated with the occurrence of pneumonia after intracranial surgery in dogs. Study Design-Retrospective cohort study. Animals-Forty-nine client-owned dogs. Methods-The medical records of 49 dogs with space-occupying intracranial di sease that underwent craniotomy were reviewed. Development of pneumonia aft er surgery was considered highly likely in 12 dogs (affected dogs) based on clinical signs, including acute dyspnea or coughing in association with ty pical radiographic findings or abnormal transtracheal wash results. Pneumon ia was confirmed in 6 dogs based on necropsy findings. Affected dogs were c ompared with 37 dogs that did not develop pneumonia (unaffected dogs) subse quent to intracranial surgery. Based on the medical records of affected dog s, determinations were made regarding tithe between development of pneumoni a and surgery, surgical procedure, intracranial lesion type, and intracrani al lesion location. Risk factors examined for both affected and unaffected dogs included level of consciousness, body position during the postoperativ e recovery period, duration of anesthesia, occurrence of vomiting or regurg itation, presence of seizures, cranial nerve deficiencies, and the presence of megaesophagus before and after surgery. We also compared the feeding pr otocol after surgery for each group. Results-Pneumonia typically occurred within the first week after surgery (m edian, 6.5 days); however, this was variable (range, 1-96 days). Of the fac tors that were present within 24 hours before the clinical signs of pneumon ia, vomiting or regurgitation and megaesophagus were found to be significan t risk factors. Dogs that vomited or regurgitated were 2.71 times more like ly to develop pneumonia than dogs that did not. Vomiting or regurgitation o ccurred in 63% of the dogs that developed pneumonia in this cohort. Dogs wi th megaesophagus were 9.25 times more likely to develop pneumonia than dogs without megaesophagus. Seven dogs with pneumonia died. Five of these 7 dog s appeared to have died as a direct sequel td pneumonia. Conclusions-Dogs undergoing craniectomies for space-occupying intracranial disease may be at higher risk for development of pneumonia due to several f actors, including vomiting, regurgitation, and megaesophagus. (C) Copyright 2001 by The American College of Veterinary Surgeons.