Medical Management With Mechanical Ventilation of a Dog With Severe Barium Sulfate Aspiration.

Mechanical ventilation enables successful recovery from severe barium aspiration in dogs.

This case report documents the successful medical management of a 26-month-old Golden Retriever with severe barium sulfate aspiration following accidental administration of approximately 300 mL of contrast material into the lower airways via an improperly placed orogastric tube. The dog presented in respiratory distress with marked bilateral aspiration evident on thoracic radiographs. Despite initial oxygen supplementation via nasal cannulas, concerns regarding respiratory muscle fatigue necessitated mechanical ventilation for 4 days. Initial blood gas analysis revealed significantly impaired oxygenation (PaO2 135.9 mm Hg, FiO2 85%, P/F ratio 159). Concurrently, the patient developed acute eosinophilic dermatitis with edema, confirmed via histopathology. Successful weaning occurred on Day 4 with improved gas exchange (PaO2 86.2 mm Hg, FiO2 45%, P/F ratio 216). At discharge on Day 13, the A-a gradient normalized to 25 mm Hg on room air. Four weeks post-discharge, the patient achieved complete recovery with normal A-a gradient (6 mm Hg) and resolved dermatologic lesions. This represents the first documented case of successful mechanical ventilation management for severe barium aspiration in dogs.

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