Acute Respiratory Distress Syndrome in Dogs: What ARDS Is and How To Treat It

Acute respiratory distress syndrome in dogs is a serious medical emergency. But what causes it, and how can pet parents prevent it? 

Let’s look at everything you need to know. 

What Is Acute Respiratory Distress Syndrome in Dogs?

Acute respiratory distress syndrome (ARDS) in dogs is a serious medical condition that can develop because of inflammation in the lungs or elsewhere in the body. 

The inflammation causes fluid to leak into the lungs, leading to poor oxygenation. This condition is also known as “shock lung.” 

ARDS can be caused by an infection in the lungs (pneumonia) or in the blood (sepsis), or by inflammation from an underlying disease, such as pancreatitis, or by trauma, such as internal injuries from being hit by a car. 

This syndrome is considered a medical emergency, as ARDS is extremely dangerous and often leads to death. 

Symptoms of Acute Respiratory Distress Syndrome in Dogs

Symptoms of ARDS in dogs include: 

• Increased effort breathing 

• Rapid breathing rate 

• Blue-tinted gums (cyanosis) 

• Coughing 

• Pink frothy discharge from the mouth or nose 

• Open-mouth breathing 

Causes of Acute Respiratory Distress Syndrome in Dogs

ARDS in dogs can develop following lung damage or serious inflammation elsewhere in the body. 

Direct lung damage can occur from a bout of pneumonia, a near-drowning, or smoke inhalation from a house fire. Aspiration pneumonia, which can develop if a dog accidentally inhales stomach contents, food, or liquid, is the most common lung-related disease that leads to ARDS in dogs. 

Systemic (body-wide) inflammation is another possible cause of ARDS in dogs. Dogs that develop sepsis (a bacterial infection of the bloodstream) can develop ARDS, which may be fatal. 

ARDS can also develop several days after a major trauma. This is sometimes seen in dogs with multiple broken bones or other serious injuries after being hit by a car, kicked by a large animal, or falling from a height. 

Other sources of inflammation, such as snake bites, electrical shock, and significant burns, can also lead to the development of ARDS in dogs. 

Systemic inflammatory response syndrome (SIRS) is another serious medical condition that can develop following inflammation such as that caused by pancreatitis, immune-mediated disease, or cancer. 

SIRS can lead to multiple organ failure and ARDS in dogs. Simply put, severe inflammation can lead to serious secondary conditions that can have life-threatening consequences. 

How Veterinarians Diagnose Acute Respiratory Distress Syndrome in Dogs

To diagnose ARDS in dogs, a vet will start with a physical exam. 

It’s important to let your vet know if your dog experienced any recent trauma or injury that is not immediately obvious. They will look for signs of sudden-onset respiratory distress, as difficulty breathing caused by ARDS develops quickly (within 24 to 72 hours). 

If your vet suspects ARDS, they may recommend the following tests: 

• Blood work. Blood testing can reveal signs of inflammation in the body or other organ involvement. 

• X-rays.  These may be taken to assess changes in the lungs and look for signs of pneumonia or fluid accumulation.   

• Pulse oximetry. This non-invasive test, which involves placing a clip-like sensor on your dog’s tongue or ear flap, determines how well your dog’s lungs are supplying the blood with oxygen. 

• Echocardiography. An echocardiogram, which is an ultrasound scan of the heart, may be recommended to rule out heart involvement and ensure the fluid in your dog’s lungs is not due to congestive heart failure. 

• Blood gas measurement. After collecting an arterial blood sample, a veterinarian can measure the amount of oxygen and carbon dioxide in your dog’s blood to determine the extent of lung damage. Due to the serious nature of ARDS, your family vet will likely refer you to an emergency or referral hospital with veterinary specialists who can perform this test. 

• Blood culture. If sepsis is suspected, your vet may recommend a bacterial culture of your dog’s blood. 

Treatment of Acute Respiratory Distress Syndrome in Dogs

Treatment for ARDS in dogs focuses on addressing the underlying cause while simultaneously providing supportive care. 

If your dog’s ARDS was caused by an underlying infection in their lungs or body, they will be given antibiotic injections during hospitalization. 

If your dog survives ARDS, they may be sent home on oral antibiotics, such as: 

• Clavamox 

• Doxycycline 

• Baytril 

• Clindamycin 

Follow all directions on the label and reach out to your veterinary team right away if your dog’s condition seems to be getting worse. 

Supportive care is critical during ARDS treatment. 

It’s important to understand that the syndrome is serious, and many dogs don’t survive. Affected dogs require 24-hour care and must be hospitalized with round-the-clock oxygen support. In addition, fluids and nutrition may be administered through IV lines and/or feeding tubes. 

Anti-inflammatory medications, such as injectable non-steroidal or steroid drugs, may be given in some cases. 

Unfortunately, there’s no one medication to treat ARDS in dogs. 

Lung compromise is often severe enough that a ventilator is required to help affected dogs breathe. For this reason, treatment of ARDS is usually expensive and often heartbreaking. 

Recovery and Management of Acute Respiratory Distress Syndrome in Dogs

While ARDS in dogs typically carries a grave prognosis, a small percentage of dogs will successfully recover and be discharged from the hospital. 

It’s important to understand that your dog’s lungs will take several weeks to heal from the inflammation and damage. 

When your dog returns home, it’s important that they get plenty of rest and are kept in a calm environment. Avoid any stressful stimuli, such as multiple visitors or interaction with other pets that might want to play and roughhouse. 

Limit outdoor time and exercise to short walks for bathroom breaks. 

Avoid exposure to inhaled irritants, such as air fresheners, diffusers, or cigarette smoke. 

Talk to your vet about possibly supporting your dog with probiotics, like FortiFlora, to boost their gut health following the administration of medications in the hospital. 

This can be especially helpful for dogs who received antibiotics, which can upset their normal gut bacteria. 

Some dogs may benefit from medications that reduce the risk of gastric ulcers after a bout of ARDS. 

Omeprazole or sucralfate may be recommended for several weeks during your dog’s recovery. 

If your dog has a feeding tube or is struggling to get enough nutrition, they may benefit from a nutrient-dense, critical care veterinary diet like Royal Canin Recovery or Hill’s a/d. 

These diets can be mixed with water to form a thin slurry and are given through a feeding tube. They are also very palatable and high in calories, which is helpful for dogs with a decreased appetite. 

Alternatively, if pancreatitis was a concern, your dog may need to eat a low-fat diet for the rest of their life. 

Purina EN Gastroenteric Low Fat diet and Hill’s i/d Low Fat are excellent choices for these pups. 

Prevention of Acute Respiratory Distress Syndrome in Dogs

Preventing ARDS in dogs can be tricky because, like most trauma, it can occur when least expected. 

To minimize your dog’s risk of aspiration pneumonia, address any cough or illness right away. Seek veterinary care sooner rather than later if you notice your furry family member isn’t feeling right. 

Use a leash when taking your dog outside a fenced area. 

This can help reduce their risk of being hit by a car. 

Ensure your home is equipped with smoke detectors, outlet covers, and cord covers (like Protecto Chew-Proof Cord Protector) for basic safety. 

Avoid feeding your dog fatty treats or letting them have access to scraps or garbage.   

People who smoke have a significantly higher risk of developing ARDS than those who don’t, and this risk factor likely exists for dogs as well. 

If you use tobacco, smoke outside your home and don’t smoke near your dog. Always ensure your home is well-ventilated to protect them and their health.