Drenching Pneumonia

Drenching pneumonia is a serious respiratory condition that occurs when liquids administered orally to livestock are accidentally inhaled into the lungs rather than swallowed into the digestive tract. This condition, also known as aspiration pneumonia from drenching, represents a significant iatrogenic complication that can occur during routine farm management procedures. The condition develops when oral medications, dewormers, nutritional supplements, or other liquid preparations enter the trachea and subsequently the lungs, causing immediate chemical irritation and creating conditions favorable for bacterial infection. Understanding the mechanisms, prevention, and treatment of drenching pneumonia is essential for all livestock producers who regularly administer oral treatments to their animals.

Drenching pneumonia affects multiple species of farm animals, with cattle, sheep, and goats being most commonly affected due to the frequent need for oral deworming and medication administration in these species. The prevalence of this condition varies significantly based on management practices, handler experience, and the techniques employed during drenching procedures. While exact statistics are difficult to obtain due to underreporting, veterinary practitioners estimate that improper drenching technique contributes to a notable percentage of respiratory disease cases in production animals, particularly in operations where large numbers of animals are processed quickly during routine treatments.

The economic and welfare impact of drenching pneumonia extends beyond the immediate costs of treatment. Affected animals often experience reduced growth rates, decreased milk production in dairy animals, and may require extended treatment periods that increase labor and medication costs. In severe cases, drenching pneumonia can result in death, representing a complete loss of the animal's value. Additionally, the welfare implications are significant, as affected animals experience respiratory distress, reduced appetite, and general malaise that compromises their quality of life. The condition also creates ethical concerns regarding proper animal handling and the responsibility of caretakers to minimize iatrogenic harm.

Drenching pneumonia is treatable when detected early, though outcomes depend heavily on the volume and nature of the aspirated material, the speed of intervention, and the overall health status of the affected animal. Early detection is critical because the inflammatory response in the lungs progresses rapidly, and secondary bacterial infections can become established within hours of aspiration. Producers and veterinarians must be vigilant for signs of respiratory distress following any oral drenching procedure, as prompt treatment significantly improves survival rates and reduces the likelihood of permanent lung damage. Prevention through proper technique remains the most effective approach to managing this condition in farm animal populations.

The primary cause of drenching pneumonia is the misdirection of orally administered liquids into the respiratory tract instead of the esophagus. This occurs when liquid preparations intended for the digestive system are deposited too far back in the mouth, administered too rapidly, or given while the animal's head is positioned incorrectly. The anatomical arrangement of the pharynx in ruminants and other livestock creates a situation where liquids can easily enter the trachea if proper drenching technique is not followed. Additionally, the use of rigid drenching guns or inappropriate equipment can cause trauma to the pharyngeal tissues, disrupting normal swallowing reflexes and increasing aspiration risk. The nature of the aspirated material also influences disease severity, with oil-based preparations, caustic substances, and contaminated liquids causing more severe lung damage than water-based solutions.

While drenching pneumonia is not a hereditary condition, certain individual animal characteristics can predispose them to aspiration during drenching procedures. Animals with pre-existing respiratory conditions, those recovering from illness, or individuals with anatomical variations in their throat structure may be at increased risk. Weak or debilitated animals often have compromised swallowing reflexes that make them more susceptible to aspiration. Young animals that have not been handled frequently may struggle excessively during restraint, increasing the likelihood of improper liquid placement. Similarly, older animals with reduced muscle tone or neurological conditions affecting swallowing coordination present higher risks during oral medication administration.

Environmental and management factors play a substantial role in the development of drenching pneumonia. Operations that process large numbers of animals quickly often see higher incidence rates due to reduced attention to individual animal positioning and technique. Inadequate restraint facilities that fail to properly immobilize animals contribute to struggling and improper head positioning during drenching. Poor lighting conditions can prevent handlers from accurately placing drenching equipment, while rushed processing schedules encourage shortcuts in technique. The training and experience level of personnel performing drenching procedures directly impacts aspiration rates, with inexperienced handlers more likely to cause iatrogenic injury.

Several risk factors increase the likelihood of drenching pneumonia occurrence. Animals that are stressed, exhausted, or recently transported may have suppressed protective reflexes that normally prevent aspiration. Concurrent illness, particularly conditions affecting the nervous system or causing general weakness, significantly elevates risk. The physical properties of the administered liquid matter considerably, with highly viscous preparations, large volumes, and oil-based products presenting greater hazards. Administering multiple oral treatments in rapid succession without allowing adequate swallowing time between doses compounds aspiration risk. Animals restrained in positions that compromise normal swallowing mechanics, such as excessive head elevation or lateral recumbency, face substantially increased danger.

The pathophysiology of drenching pneumonia involves multiple mechanisms that cause progressive lung damage. Initial aspiration triggers an immediate inflammatory response as foreign material contacts the delicate lung tissue. Chemical pneumonitis develops when aspirated substances directly damage alveolar epithelium and bronchial tissues. The disruption of normal lung surfactant and the presence of foreign material create an ideal environment for bacterial colonization, typically by organisms already present in the upper respiratory tract or gastrointestinal system. As infection establishes, abscess formation, consolidation of lung tissue, and impaired gas exchange develop. In severe cases, systemic inflammatory response syndrome can occur, leading to multi-organ dysfunction and death.

Early warning signs of drenching pneumonia typically appear within minutes to hours following the drenching procedure. Immediate coughing during or after liquid administration is the most obvious initial indicator that aspiration may have occurred. Affected animals may display nasal discharge, which can range from clear and frothy to discolored depending on the aspirated material. Increased respiratory rate and effort become apparent as the animal attempts to compensate for compromised lung function. Subtle changes in behavior, such as reluctance to move, standing with an extended neck, or separating from the group, often precede more obvious clinical signs. Alert producers who observe these early indicators can initiate treatment before significant lung damage develops.

Common symptoms vary somewhat between species, though the general presentation remains consistent across affected livestock. Cattle typically display obvious respiratory distress with audible breathing sounds, nostril flaring, and mouth breathing in severe cases. Affected cattle often stand with their front legs spread wide and their neck extended to facilitate breathing. Sheep and goats may show similar respiratory signs but often demonstrate more rapid deterioration due to their smaller body size and lung capacity. In all ruminant species, cessation of rumination and cud chewing serves as an important indicator of systemic illness. Swine affected by aspiration pneumonia display labored abdominal breathing and may adopt a dog-sitting position to ease respiratory effort.

Behavioral changes associated with drenching pneumonia reflect the animal's discomfort and compromised respiratory function. Affected animals typically go off feed immediately or within hours of aspiration, as the effort required for eating competes with respiratory demands. Isolation from herd mates and seeking sheltered areas are common behaviors in gregarious species. Reduced activity and reluctance to move indicate both respiratory compromise and general malaise. Animals may display anxiety or distress behaviors, particularly when respiratory obstruction is severe. Depression and lethargy progress as the condition advances, with severely affected animals becoming recumbent and unresponsive to stimulation.

Physical examination findings in drenching pneumonia cases reveal characteristic abnormalities. Elevated body temperature is common, particularly once bacterial infection becomes established, with fevers ranging from mild to dangerously high depending on disease severity. Auscultation of the chest reveals abnormal lung sounds, including crackles, wheezes, and areas of diminished breath sounds where consolidation or abscess formation has occurred. The respiratory rate is invariably elevated, often dramatically so in severe cases. Mucous membrane color may progress from normal pink through pale to cyanotic as oxygen exchange becomes increasingly compromised. Heart rate elevation reflects both fever and the cardiovascular system's attempt to compensate for impaired oxygenation.

Symptom progression in drenching pneumonia follows a predictable pattern without intervention. Initial chemical irritation and inflammation give way to bacterial infection, typically within 24 to 48 hours of aspiration. As infection establishes, fever spikes, respiratory distress worsens, and nasal discharge often becomes purulent or blood-tinged. Lung consolidation progresses, reducing functional lung capacity and causing increasingly severe hypoxia. Affected animals lose body condition rapidly due to increased metabolic demands combined with anorexia. In untreated cases, progression to septicemia, respiratory failure, or both typically occurs within days to a week of the initial aspiration event.

Emergency symptoms requiring immediate veterinary intervention include severe respiratory distress characterized by open-mouth breathing, extreme neck extension, and cyanosis of visible mucous membranes. Collapse or inability to rise indicates critical compromise and requires urgent attention. High fevers exceeding 106 degrees Fahrenheit suggest severe systemic infection requiring aggressive treatment. Bloody or foul-smelling nasal discharge indicates significant lung tissue damage or anaerobic infection. Any animal displaying signs of shock, including cold extremities, weak pulse, and profound depression, requires emergency care. Producers observing these severe symptoms should contact a veterinarian immediately while initiating supportive care measures to stabilize the animal.

Clinical examination forms the foundation of drenching pneumonia diagnosis, with the history of recent oral drenching providing crucial context. Veterinary examination begins with observation of the animal's respiratory pattern, posture, and general demeanor from a distance before hands-on assessment. Physical examination includes thorough auscultation of all lung fields, comparison of breath sounds between sides, and identification of areas with abnormal sounds or absent airflow. Temperature measurement confirms the presence or absence of fever, while assessment of hydration status, mucous membrane color, and capillary refill time provides information about systemic health. Examination of nasal discharge, including odor and consistency evaluation, offers clues about the nature and severity of lung involvement.

Diagnostic testing supports clinical findings and helps guide treatment decisions in drenching pneumonia cases. Complete blood count often reveals elevated white blood cell counts with a left shift indicating active bacterial infection, though very acute cases may show normal values before the inflammatory response fully develops. Blood chemistry panels assess organ function and help identify complications such as dehydration or metabolic derangement. Transtracheal wash or bronchoalveolar lavage provides samples for cytology and bacterial culture with sensitivity testing, enabling targeted antibiotic selection. In valuable animals or diagnostic uncertainty, thoracic radiography or ultrasonography can visualize lung consolidation, abscess formation, and pleural involvement. Post-mortem examination in fatal cases reveals characteristic lesions including cranioventral consolidation, abscess formation, and often evidence of the aspirated material within airways.

Differential diagnosis for drenching pneumonia includes other causes of acute respiratory disease in livestock. Infectious pneumonias caused by viral or bacterial pathogens can present similarly but typically lack the temporal association with recent drenching and often affect multiple animals simultaneously. Acute interstitial pneumonia in cattle, sometimes called fog fever or atypical interstitial pneumonia, causes severe respiratory distress but has different predisposing factors. Foreign body pneumonia from inhaled plant material or other debris may present identically and requires careful history taking to distinguish. Allergic or hypersensitivity pneumonitis can cause acute respiratory signs but usually has a different clinical progression. Cardiac disease causing pulmonary edema may mimic aspiration pneumonia in some presentations.

Herd-level diagnostic considerations are generally less applicable to drenching pneumonia since it represents an individual animal event rather than an infectious disease outbreak. However, when multiple animals develop respiratory signs following group drenching procedures, systematic review of technique, equipment, and personnel training becomes essential. Documentation of cases helps identify patterns that may indicate systemic problems with drenching protocols. Comparison of incidence rates across different handlers, time periods, or products can reveal contributing factors. In cases where drenching pneumonia occurrence seems unusually high, review of the drenching products themselves for contamination or inappropriate formulation may be warranted.

Emergency and immediate treatment for drenching pneumonia focuses on stabilizing the animal and limiting further lung damage. Positioning the animal with the head slightly lowered can help drainage of any remaining material from the airways, though this must be balanced against the animal's respiratory comfort. Administration of anti-inflammatory drugs reduces the inflammatory cascade triggered by aspiration and helps maintain airway patency. Bronchodilators may provide relief by opening constricted airways, though their use should be guided by veterinary assessment. Oxygen supplementation benefits severely hypoxic animals when available, though this is often impractical in field settings. Immediate veterinary consultation is essential for developing an appropriate treatment plan based on the specific case presentation.

Medical management of drenching pneumonia centers on antibiotic therapy to address bacterial infection, with drug selection ideally guided by culture and sensitivity results. Broad-spectrum antibiotics effective against common respiratory pathogens are typically initiated immediately, then adjusted based on diagnostic findings and treatment response. Common choices include tulathromycin, florfenicol, ceftiofur, or oxytetracycline, depending on regional resistance patterns and product availability. Treatment duration typically extends for a minimum of five to seven days and often longer, depending on disease severity and response. Producers must carefully observe withdrawal times for all medications used in food-producing animals, as treated animals cannot enter the food supply until appropriate intervals have passed. Non-steroidal anti-inflammatory drugs such as flunixin meglumine or meloxicam provide fever reduction and anti-inflammatory effects that support recovery.

Surgical intervention is rarely indicated for drenching pneumonia but may be considered in specific circumstances. Lung abscess drainage can be attempted in cases where large, accessible abscesses fail to respond to medical management alone. Thoracocentesis may be necessary if significant pleural effusion develops, causing additional respiratory compromise. Tracheostomy, while rare, may be life-saving in cases of severe upper airway obstruction. These surgical options require appropriate facilities, expertise, and must be weighed against the animal's value and prognosis. In most cases, medical management remains the primary treatment approach.

Supportive care plays a crucial role in drenching pneumonia recovery and should not be underestimated. Ensuring adequate hydration through oral or intravenous fluid administration supports mucus clearance and maintains organ function. Providing easily digestible, palatable feed encourages intake in anorexic animals. Housing affected animals in well-ventilated but draft-free areas with appropriate temperature and humidity supports respiratory function. Reducing stress through quiet handling, separation from aggressive herd mates, and minimizing unnecessary disturbance promotes healing. Maintaining the animal in sternal recumbency if recumbent helps optimize lung function compared to lateral positioning.

Herd treatment protocols are not applicable in the traditional sense for drenching pneumonia since it is not a contagious condition. However, when a case occurs, systematic review and correction of drenching procedures should be implemented for all remaining animals requiring treatment. This includes evaluation of equipment, restraint facilities, handler technique, and product administration protocols. Training or retraining of personnel on proper drenching technique should follow any incident. Documentation of the case and corrective actions supports continuous improvement in farm management practices. Prophylactic treatment of other recently drenched animals is not indicated unless they show clinical signs.

Treatment decisions in drenching pneumonia cases must balance multiple factors including animal value, prognosis, treatment costs, and welfare considerations. Early, aggressive treatment offers the best prognosis, making prompt intervention economically sensible in most cases. However, animals with severe lung damage, those that fail to respond to initial treatment, or cases complicated by abscess formation carry guarded to poor prognoses. The economics of extended treatment, including medication costs, labor for nursing care, withdrawal times delaying marketing, and reduced future productivity, must be honestly assessed. In some cases, humane euthanasia may be the most appropriate decision for animal welfare and economic reasons. These difficult decisions should involve veterinary consultation and honest assessment of likely outcomes.

Recovery timeline for drenching pneumonia varies considerably based on the severity of initial aspiration, promptness of treatment, and individual animal factors. Mild cases where aspiration involved small volumes of relatively innocuous material and treatment began promptly may show significant improvement within 48 to 72 hours, with full recovery occurring over one to two weeks. Moderate cases typically require three to four weeks for clinical resolution, though some degree of lung scarring may persist. Severe cases with extensive lung consolidation or abscess formation may require six weeks or longer for recovery, and some animals never fully regain normal respiratory function. Complete resolution of radiographic or ultrasound abnormalities often lags behind clinical improvement by several weeks.

Post-treatment care and monitoring requirements extend beyond the acute treatment phase. Continued observation for respiratory rate and effort, appetite, and general demeanor helps detect relapse or treatment failure early. Temperature monitoring should continue until fever has been absent for several days. Follow-up veterinary examination approximately one week after initiating treatment allows assessment of response and determination of whether antibiotic therapy should be extended or modified. Affected animals should be maintained in clean, low-dust environments with good ventilation throughout the recovery period. Activity restriction during early recovery prevents overexertion of compromised respiratory systems.

Prognosis factors in drenching pneumonia include multiple variables that influence likely outcomes. The volume and nature of aspirated material significantly impact prognosis, with large volumes and caustic or oil-based substances carrying worse outlooks. Time to treatment initiation strongly correlates with outcomes, as delays allow bacterial infection to establish and lung damage to progress. The animal's overall health status and immune function affect ability to fight infection and heal damaged tissue. Development of complications such as lung abscessation or pleuritis worsens prognosis considerably. Age plays a role, with very young and very old animals generally having reduced resilience and healing capacity compared to healthy adults in their prime.

Return to production considerations must account for both the animal's recovery status and any medication withdrawal requirements. Animals should demonstrate normal respiratory function under exertion before returning to full production demands. Dairy animals must complete withdrawal periods for all administered medications before milk can enter the food supply. Meat animals similarly require completion of tissue withdrawal times before slaughter eligibility. Breeding animals should be fully recovered before undergoing the stress of breeding or pregnancy. Reduced lung capacity from residual scarring may permanently limit the animal's ability to meet high production demands, requiring adjustment of expectations or culling from the breeding herd. Documentation of the illness episode and treatment supports informed decision-making about the animal's future role in the operation.

Vaccination protocols do not directly apply to drenching pneumonia prevention since it is a mechanically induced rather than infectious condition. However, maintaining overall respiratory health through appropriate vaccination against common respiratory pathogens may reduce the severity of secondary bacterial infections should aspiration occur. Ensuring animals are current on clostridial vaccinations and other routine preventive care supports immune function and general resilience. Some producers choose to include respiratory pathogen vaccines in their protocols specifically because the population regularly undergoes procedures like drenching that carry aspiration risk.

Biosecurity measures in the context of drenching pneumonia focus on preventing contamination of drenching equipment and products rather than preventing disease transmission between animals. Drenching guns and other equipment should be cleaned and sanitized between uses to prevent bacterial contamination of products. Storage of oral medications and supplements should follow manufacturer guidelines to prevent degradation or contamination. Use of individual animal equipment or thorough cleaning between animals reduces cross-contamination risk. Inspection of products before use for signs of contamination, separation, or degradation prevents administration of compromised materials.

Nutritional prevention strategies support drenching pneumonia avoidance by maintaining animals in good body condition with robust immune function. Well-nourished animals with adequate protein and energy intake maintain stronger protective reflexes and more vigorous immune responses. Ensuring appropriate mineral and vitamin supplementation supports overall health and resilience. Avoiding drenching procedures during periods of nutritional stress, such as late gestation or early lactation, reduces risk in vulnerable animals. When possible, alternative methods of delivering nutritional supplements that avoid oral drenching altogether eliminate aspiration risk.

Management practices represent the cornerstone of drenching pneumonia prevention. Proper technique is paramount: the animal's head should be held in a natural position, not elevated, and liquids delivered slowly into the side of the mouth, allowing adequate time for swallowing. Appropriate restraint that immobilizes the animal without causing excessive stress prevents struggling that leads to improper liquid placement. Equipment selection matters, with flexible-tipped drenching guns or bottles preferred over rigid metal equipment that can cause pharyngeal trauma. Training all personnel who perform drenching procedures on proper technique, and periodic retraining to prevent drift from best practices, significantly reduces incidence.

Quarantine and testing protocols have limited direct application to drenching pneumonia prevention, as it is not an infectious disease. However, newly acquired animals should be observed for signs of existing respiratory compromise before undergoing drenching procedures, as animals with pre-existing conditions face elevated aspiration risk. Animals recovering from illness, transport stress, or other challenges should be allowed to stabilize before non-emergency oral treatments are administered. Systematic recording of drenching events, including any complications, supports quality improvement efforts and helps identify animals or situations associated with increased risk.

Daily management and monitoring of animals recovered from drenching pneumonia should include observation for any signs of respiratory compromise or relapse. Caretakers should observe respiratory rate and effort during both rest and mild exertion, watching for any indication of exercise intolerance or persistent respiratory difficulty. Feed intake monitoring ensures recovered animals maintain adequate nutrition for ongoing healing and production. Animals with known history of drenching pneumonia should be noted in herd records so that future drenching procedures can be performed with extra care or alternative delivery methods employed when possible. Regular assessment of body condition helps detect any chronic impact on the animal's ability to maintain weight and productivity.

Housing and environmental management significantly impacts both prevention of drenching pneumonia and recovery of affected animals. Well-designed handling facilities that allow safe, efficient restraint reduce stress and struggling during drenching procedures. Adequate lighting in treatment areas enables handlers to accurately position drenching equipment. Maintaining low dust levels in housing areas supports respiratory health in general and is especially important for animals with compromised lung function. Appropriate ventilation provides fresh air without creating drafts that stress animals. During recovery from drenching pneumonia, housing that allows easy observation while protecting from extreme weather supports healing.

Herd health programs should incorporate drenching pneumonia awareness into their protocols for routine treatments. Standard operating procedures for oral medication administration should be documented and followed consistently. Regular review of drenching procedures, including periodic observation of technique and refresher training, maintains high standards. Integration of drenching pneumonia prevention into new employee training ensures all personnel understand proper technique from the start. Veterinary consultation on alternative delivery methods for commonly used oral products may identify opportunities to reduce aspiration risk through product selection or administration route changes.

Record keeping and monitoring systems support drenching pneumonia management at both individual animal and herd levels. Documentation of all oral treatments administered, including product, dose, date, and personnel, enables tracking of any incidents. Recording of any observed complications during or after drenching allows identification of patterns. Maintaining treatment records for affected animals ensures proper withdrawal period compliance and informs future management decisions. Analysis of records over time can reveal whether protocol changes effectively reduce incidence or whether additional interventions are needed.

Economic considerations in drenching pneumonia management include both prevention and treatment cost-benefit analysis. Investment in proper handling facilities, quality equipment, and thorough personnel training pays dividends through reduced incidence. When cases occur, early treatment generally proves more economical than delayed intervention that allows disease progression. The cost of treatment must be weighed against the animal's value and likely productivity post-recovery. Chronically affected animals with permanent lung damage may warrant culling decisions based on reduced productivity and increased future health risks. Insurance considerations may be relevant for high-value animals or operations with significant risk exposure.

No specific breeds demonstrate inherent predisposition to drenching pneumonia, as this condition results from procedural factors rather than genetic susceptibility. However, certain animal types face increased exposure risk due to management practices associated with their production system. Sheep breeds raised in extensive grazing systems typically undergo more frequent drenching for parasite control than those in intensive systems with other management approaches. Goat breeds kept for dairy production may receive more oral treatments than meat goats due to more intensive management and longer productive lives. Cattle breeds used in cow-calf operations experience drenching procedures during routine processing events that create potential exposure.

Production type considerations significantly influence drenching pneumonia risk profiles. Dairy cattle and dairy goats face extended productive lives with repeated oral treatment events over years, creating cumulative exposure opportunities. Animals in feedlot settings may be processed through handling facilities rapidly with less individual attention, potentially increasing technique-related risk. Extensive range operations may perform drenching under field conditions without optimal facilities, increasing procedural challenges. High-producing animals under metabolic stress may have compromised protective reflexes that increase vulnerability during drenching. Young stock being processed for the first time often struggle more than experienced animals accustomed to handling, elevating their risk.

Genetic selection and testing do not apply to drenching pneumonia in the traditional sense, as the condition is not heritable. However, selection for temperament traits that result in calmer animals during handling may indirectly reduce drenching pneumonia risk by decreasing struggling and facilitating proper technique. Animals from genetic lines known for respiratory robustness may recover more successfully if aspiration does occur. Operations focused on health trait selection may see general benefits in disease resilience that extend to complications of iatrogenic conditions. Some producers cull animals that have experienced drenching pneumonia from breeding programs, not because of genetic transmission risk, but because chronic lung damage may affect lifetime productivity and ability to withstand future health challenges.

Commonly co-occurring conditions with drenching pneumonia include other iatrogenic injuries that may result from the same handling event. Pharyngeal trauma from drenching equipment can cause local tissue damage, swelling, and secondary infection separate from lung involvement. Esophageal injury, though less common, may occur with aggressive drenching technique. Stress-related conditions such as capture myopathy in susceptible species can result from the restraint and handling associated with drenching procedures. In animals that were ill prior to treatment, the underlying condition may complicate or mask drenching pneumonia presentation and recovery.

Conditions with similar symptoms that must be differentiated from drenching pneumonia include various causes of acute respiratory disease. Infectious pneumonia from bacterial, viral, or mycoplasmal pathogens presents with similar respiratory signs but typically lacks temporal association with drenching and may affect multiple animals. Acute bovine pulmonary edema and emphysema causes severe respiratory distress but has distinct predisposing factors related to pasture changes. Foreign body pneumonia from inhaled plant material or other debris may present identically and requires careful history evaluation. Anaphylactic reactions to injected products can cause acute respiratory signs that might initially be confused with aspiration. Pulmonary thromboembolism in cattle with thrombotic conditions can mimic acute respiratory disease.

Complications and sequelae of drenching pneumonia extend beyond the acute illness in surviving animals. Chronic lung scarring with reduced pulmonary function may permanently limit exercise tolerance and production capacity. Lung abscess formation represents a serious complication that may require prolonged treatment or prove refractory to medical management. Pleuritis and pleural adhesions can develop secondary to pneumonia, causing ongoing respiratory compromise. Bronchiectasis, or permanent airway dilation, may develop in damaged lung regions and predispose to recurrent infections. Chronic poor-doing animals that fail to thrive despite apparent recovery may be experiencing ongoing effects of lung damage that warrant culling consideration.