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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33284
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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my 20 month old Labrador has pneumonia isolated to a small

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my 20 month old Labrador has pneumonia isolated to a small specific area of the left lobe. she is currently on IV cefuroxime 600mg three times a day. has had 4 doses so far which has resolved her pyrexia and eased her laboured breathing and she is now eating and drinking relatively normally. She has come home this afternoon and is playing with her toys and my cats. The vet thinks the pneumonia has been caused by inhalation of a foreign body, the X-ray shows the infection but nothing else. The vet has suggested surgery to remove the suspected foreign body. my concerns are that this is major surgery, without a definite foreign body to find, which has risks in its own right. obviously if there was something confirmed I would be more inclined to go ahead but feel reluctant to put her through this on suspicion alone. what are the risks of watching and waiting? maybe until the infection has cleared and a repeat X-ray be done? I realise the object could migrate to another area causing more damage and infection in its wake.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. If the focal pneumonia were present in the left cranial lung lobe, either aspiration pneumonia or a foreign body are reasonable considerations. There are two more diagnostics to consider before making your decision about how to proceed. The first is an ultrasound of that lung. The second - more pricey and involved but more sensitive - is a CT of that lung.
Yes, you can treat as you've done and repeat X-rays at weekly intervals to see if the pneumonia resolves. I don't see a problem doing so. A foxtail is my primary concern vis a vis migration but I don't know if you have this plant awn where you live. Please let me know:
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Customer: replied 3 years ago.

Thanks for your reply. I live in Worthing West Sussex UK. I'm not sure about this plant but will find out if it is something that grows here. The vet was concerned about grass horn as the object. He seems keen to do the surgery today but I would prefer a more conservative approach in veiw of her improvement on iv antibiotics providing this doesn't give her unacceptably high risk of further harm. I have recently moved home to the coast and she has been enjoying playing in the sea, could this have been caused by inhaling sea water with maybe a grain of sand? If so I imagine surgery would be inappropriate as the water would have been absorbed and surely it would incredibly hard to identify something as small as sand even under microscopic conditions. Would a bronchoscopy be of any diagnostic value? Obviously much more invasivebut has the advantage being a treatment option too.

Thank you for the additional information. "Grass horn" is unfamiliar to me but, then again, I don't live in the UK. No, sea water/sand would be unlikely. We're looking for organic material. I believe that the X-rays revealed lung parenchymal involvement rather than airway involvement and so bronchoscopy wouldn't be a first-choice diagnostic.

You're quite welcome. Thank you for your kind accept. I appreciate it. I'm going to check back with you in a few weeks for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.