Administration of porcine surfactant in the treatment of a fatal case of acute respiratory distress syndrome in a cat with calicivirus pneumonia.

CASE SUMMARY: A 1-year-old, male neutered Persian cat presented to the emergency room with acute, severe wheezing and coughing after the introduction of a new kitten to the household. The patient progressed to hypoxemic respiratory failure consistent with acute respiratory distress syndrome (ARDS) and required mechanical ventilation. RT-PCR testing from a conjunctival and deep pharyngeal swab confirmed feline calicivirus infection. Because of refractory hypoxemia and declining lung compliance (2.4 ml/cmH2O), novel therapy with intratracheal porcine surfactant (Curosurf) was attempted. A dose of 1.5 ml/kg was administered over 60 s. After administration, pulmonary compliance improved to 3.1 ml/cmH2O. The patient was weaned from the ventilator on day 10; however, severe laryngeal swelling necessitated a temporary tracheostomy. The patient died on day 15 from tracheal stenosis and obstruction of the stoma site by granulation tissue.

RELEVANCE AND NOVEL INFORMATION: To the authors' knowledge, this is the first report describing the development of ARDS from calicivirus pneumonia and the use of porcine surfactant in the treatment of ARDS in a cat. The administration of surfactant resulted in objective improvements in lung compliance.