title: Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005-2014.
abstract: OBJECTIVE
  To describe clinical canine patients with naturally occurring pulmonary hypertension and radiographic pulmonary alveolar infiltrates before and after treatment with sildenafil.
  
  
  METHODS
  Ten client-owned dogs.
  
  
  METHODS
  A retrospective analysis of dogs with echocardiographically-determined pulmonary hypertension and pulmonary alveolar infiltrates on thoracic radiographs was performed before (PRE) and after (POST) sildenafil therapy. Clinical scores, pulmonary alveolar infiltrate scores and tricuspid regurgitation gradients were analyzed PRE and POST sildenafil.
  
  
  RESULTS
  Pulmonary alveolar infiltrates associated with pulmonary hypertension developed in a diffusely patchy distribution (10/10). Sixty percent of dogs had a suspected diagnosis of interstitial pulmonary fibrosis as the etiology of pulmonary hypertension. Median PRE clinical score was 4 (range: 3-4) compared to POST score of 0 (0-2) (p = 0.005). Median alveolar infiltrate score PRE was 10 (5-12) compared to POST score of 4 (0-6) (p = 0.006). Median tricuspid regurgitation gradient PRE was 83 mmHg (57-196) compared to 55 mmHg POST (33-151) (p = 0.002).
  
  
  CONCLUSIONS
  A subset of dogs with moderate to severe pulmonary hypertension present with diffuse, patchy alveolar infiltrates consistent with non-cardiogenic pulmonary edema. The typical clinical presentation is acute dyspnea and syncope, often in conjunction with heart murmurs suggestive of valvular insufficiency. This constellation of signs may lead to an initial misdiagnosis of congestive heart failure or pneumonia; however, these dogs clinically and radiographically improve with the initiation of sildenafil.
authors: University of Wisconsin, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA. Electronic address: kellihanh@vetmed.wisc.edu.
authors: Heidi B
authors: HB
authors: Kellihan
authors: University of Wisconsin, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA.
authors: Kenneth R
authors: KR
authors: Waller
authors: University of Wisconsin, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA.
authors: Alyssa
authors: A
authors: Pinkos
authors: University of Wisconsin, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA.
authors: Howard
authors: H
authors: Steinberg
authors: University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics and the John Rankin Laboratory of Pulmonary Medicine, 600 Highland Avenue, Madison, WI 53792, USA; University of Iowa, Department of Health and Human Physiology, 225 S. Grand Avenue, Iowa City, IA 52242, USA.
authors: Melissa L
authors: ML
authors: Bates
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011650:Pulmonary Alveoli / Q000473:pathology*; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D000068677:Sildenafil Citrate / Q000627:therapeutic use*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D000068677:Sildenafil Citrate
keywords: Interstitial pulmonary fibrosis; Pulmonary edema; Pulmonary infiltrate score; Quality of life score; Tricuspid regurgitation