A case of electrocution-induced non-cardiogenic pulmonary edema in a six-month-old beagle
A six-month-old male castrated beagle presented to the Cornell University Hospital for Animals Emergency Service on 8/18/17 for a recent history of witnessed electrocution. The patient was immediately presented to his referring veterinarian and administered intravenous dexamethasone, butorphanol, fluids, and furosemide, as well as 1% isoflurane by mask. Thoracic radiographs showed evidence of severe pulmonary edema, and he was referred to Cornell. On presentation, the patient was dull and non-responsive. He was extremely tachypneic with a respiratory rate of greater than 120 breaths per minute, and his lung sounds were very harsh with bilaterally auscultable crackles. Heart sounds could not be auscultated at this time, but femoral pulses were strong. His mucous membranes were very pale and there was significant ulceration of his oral mucosa, with bloody saliva noted on oral exam. Focused thoracic ultrasound assessment (TFAST) showed evidence of severe pulmonary edema (many B-lines), and his arterial blood gas showed a marked respiratory acidosis and poor arterial oxygen saturation of 90%. This presentation was consistent with non-cardiogenic pulmonary edema, most likely due to electrocution. The patient was placed on the ventilator for approximately 36 hours, shortly after which the patient was able to breathe comfortably on room air. Radiographs obtained the following day showed almost full resolution of his pulmonary edema. The patient was discharged the following morning, and his prognosis is excellent.