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Background: Prolonged slow expiration (PSE) and assisted cough (AC) are airway clearance techniques feasible and well tolerated in dogs. Objectives: To evaluate the effectiveness of PSE and AC as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation. Animals Thirty‐one client‐owned dogs hospitalized in an intensive care unit from October 2014 to May 2018. Methods: Prospective randomized controlled trial. Dogs presented with or developing acute dyspnea during hospitalization associated with airway fluid accumulation were assigned to CP group (medical treatment and CP, 15 dogs) or control group (medical treatment alone, 16 dogs). The arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (FiO2) ratio (P/F ratio; PaO2/FiO2 × 100) was calculated daily for the 1st 48 hours of hospitalization and using the last arterial blood gas performed before discharge or death. The ratio of days of hospitalization with oxygen/total number of hospitalization days (ratio of oxygen‐free‐days [O2Free]) was calculated. Results: During the 1st 48 hours, the P/F ratio increased significantly in the CP group compared to the control group (+ 35.1 mm Hg/day; 95% confidence interval [CI] = 0.4‐57.5; P =.03). The (median; 1st quartile to 3rd quartile) difference between the P/F ratio at discharge and inclusion was significantly higher in the CP group (178 mm Hg; 123‐241) than in the control group (54 mm Hg; −19 ‐ 109; P =.001). Mean O2Free increased by 46.4% in the CP group compared with control group (95% CI = 16‐59; P =.001). Mortality was 13% (2/15) in the CP group and 44% (7/16) in the control group (P =.07). Conclusions and Clinical Importance: Prolonged slow expiration and AC improved P/F ratio within 48 hours and decreased need for oxygenation in dyspneic dogs with acute airway fluid accumulation. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the feasibility, benefits, and adverse effects of prolonged slow expiration (PSE) and assisted cough (AC) as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation. Design: Prospective interventional study. Settings: University teaching hospital. Animals: Intervention group of 30 client‐owned dogs and retrospective control group of 71 client‐owned dogs. Interventions: PSE was performed on dogs with evidence of airway fluid accumulation, identified based on physical examination and thoracic radiographs. AC was performed if spontaneous cough or swallowing were not evident. The PSE treatment was performed every 6 hours until normalization of respiratory status or hospital discharge. Animals were monitored for respiratory distress, discomfort, and SpO2 during the procedure. A retrospective control group was identified by computer search. Measurements and Main Results: One hundred thirty‐three sessions of CP were performed on 30 dogs. Discomfort frequency during physiotherapy was low (9%). The most commonly used position for CP was in lateral recumbency (95%) and this was well tolerated in most cases. There was no significant difference in the median SpO2 before and after CP sessions (P = 0.24). Sixty percent of sessions had a spontaneous cough or swallowing evident, 21% had successful AC performed, and no cough or swallowing occurred in the remaining (19%) sessions despite attempts of AC being made. The length of hospitalization was significantly longer in the intervention group (6 days vs 4) (P = 0.02). There was no difference in survival between the intervention (76.7%) and the control (57.7%) group (P = 0.055). Conclusions: PSE associated with AC are easily adaptable, well‐tolerated techniques in dogs. The benefit of CP in dogs with airway fluid accumulation remains to be determined and it is hoped that future randomized controlled prospective studies may help answer this line of inquiry. [ABSTRACT FROM AUTHOR]