Bromide-associated lower airway disease: a retrospective study of seven cats

Abstract

Seven cats were presented for mild-to-moderate cough and/or dyspnoea after starting bromide (Br) therapy for neurological diseases. The thoracic auscultation was abnormal in three cats showing increased respiratory sounds and wheezes. Haematology revealed mild eosinophilia in one cat. The thoracic radiographs showed bronchial patterns with peribronchial cuffing in most of them. Bronchoalveolar lavage performed in two cats revealed neutrophilic and eosinophilic inflammation. Histopathology conducted in one cat showed endogenous lipid pneumonia (EnLP). All cats improved with steroid therapy after Br discontinuation. Five cats were completely weaned off steroids, with no recurrence of clinical signs. In one cat, the treatment was discontinued despite persistent clinical signs. The cat presenting with EnLP developed secondary pneumothorax and did not recover. Br-associated lower airway disease can appear in cats after months of treatment and clinical improvement occurs only after discontinuing Br therapy.

Figure 1

A right lateral thoracic radiograph of cat 7, showing generalised peribronchial cuffing, nodular lesions (black arrows) and homogeneous increase in density in the caudal part of the left cranial lung lobe (white arrows)

Figure 2

A severe bronchial pattern with peribronchial cuffing in cat 3 at the initial evaluation (a) and persistent moderate lesions after 7 months of treatment and bromide therapy cessation (b)

Figure 3

Multiple nodular lesions on the lung parenchyma (white arrows) observed during thoracoscopy in cat 7

Figure 4

A granulomatous infiltrate associated with multinucleated giant cells (white arrow) and multiple cholesterol clefts (black arrow). Haematoxylin and eosin stain, magnification 20×