High-velocity nasal insufflation in dogs with left-sided congestive heart failure unresponsive to traditional oxygen therapy: a retrospective case series

Bailey Lane^1,2Rebecca Walton^1,3April Blong¹Meredith 't Hoen^1*Melissa Tropf¹Jessica Ward¹Allison Masters^1,4

• ¹Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States
• ²College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
• ³VCA West Los Angeles Animal Hospital, Los Angeles, California, United States
• ⁴Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, United States

Objective -To describe high-velocity nasal insufflation (HVNI) for managing dogs with leftsided congestive heart failure (L-CHF) failing traditional oxygen therapy (TOT). To secondarily evaluate complications based on retrospective evaluation of the record of HVNI and survival to discharge.Design -Retrospective case series from a university teaching hospital between August 2019 and October 2021.Animals -12 dogs diagnosed with L-CHF and managed with HVNI.Measurements and main results -Medical records were retrospectively reviewed for signalment, point-of-care diagnostics, and HVNI information. Nine dogs were diagnosed with myxomatous mitral valve disease, and three dogs were diagnosed with dilated cardiomyopathy.All dogs in this study required HVNI after failing TOT. Dogs were treated with HVNI for a median of 14 hours (range 2-22 hours). HVNI was successfully discontinued in 10 dogs (83%), all of which survived to discharge. Two dogs on HVNI were humanely euthanized, both of which were diagnosed with Stage D refractory CHF. No major complications of HVNI were noted in any dogs.Conclusions -HVNI is a potential method of escalating oxygen support for dogs in L-CHF who fail TOT. In this case series, all dogs in which HVNI was successfully discontinued survived to discharge.