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Clinicopathologic and radiographic features in 33 cats with aspiration and 26 cats with bronchopneumonia (2007–2017)

Jonathan D. Dear, William Vernau, Eric G. Johnson, Sean E. Hulsebosch, Lynelle R. Johnson

Background
Aspiration pneumonia (AP) and bronchopneumonia (BP) are respiratory conditions in cats that share clinical similarities with inflammatory airway disease (IAD), making diagnosis challenging. Limited data exist on the clinical, radiographic, and microbiologic characteristics of these conditions. This study aimed to describe and compare the clinicopathologic features of AP and BP in cats and assess differences from IAD.

Methods
A retrospective case-control study included 33 cats with AP, 26 with BP, and 44 control cats with IAD from a veterinary teaching hospital database (2007–2017). Signalment, clinical signs, diagnostic test results, and potential risk factors were analyzed. Bronchoalveolar lavage (BAL) fluid cytology and microbial cultures were evaluated. Thoracic radiographs were reviewed in a masked fashion and scored for severity.

Results
Cats with AP had a shorter median duration of clinical signs (12 days) compared to BP (270 days) and IAD (180 days) (P = 0.01). AP cats were less likely to present with cough (P < 0.001) and more likely to be hypothermic (P = 0.01). Radiographically, AP was associated with alveolar patterns and higher total severity scores. Mycoplasma spp. were commonly isolated in BP cases (42%) but were absent in AP cases. Gastrointestinal disease (76%) and recent anesthesia (27%) were significant risk factors for AP. Pasteurella spp. were the most frequently isolated bacteria in both AP and BP.

Limitations
The study's retrospective design limited control over case selection, and not all cats underwent bronchoscopy or BAL fluid analysis. Observer variability in radiographic interpretation and the lack of long-term follow-up for some cases were additional constraints.

Conclusions
Pneumonia must be differentiated from IAD in coughing cats, with AP considered in cases of acute tachypnea, particularly when risk factors like gastrointestinal disease or recent anesthesia are present. Mycoplasma spp. appear to play a role in BP, while AP may be primarily associated with acid aspiration rather than infection. These findings emphasize the importance of airway sampling for accurate diagnosis and targeted treatment.

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