High-flow nasal cannula oxygen therapy improves respiratory parameters compared to conventional oxygen therapy in dogs with presumed noncardiogenic pulmonary edema

Objective To compare the clinical efficacy of high-flow nasal cannula (HFNC) oxygen therapy and conventional oxygen therapy (COT) in dogs with noncardiogenic pulmonary edema (NCPE), focusing on respiratory parameters and survival outcomes. Methods This retrospective observational cohort study reviewed cases from a veterinary teaching hospital between September 2022 and September 2024. Dogs were identified through electronic medical records and included if they met clinical criteria for NCPE, excluding those with cardiac or aspiration-related causes. Patients were assigned to the COT or HFNC group on the basis of the treatment received. High-flow nasal cannula oxygen therapy was initiated in dogs with insufficient response to COT. Respiratory rate (RR), peripheral oxygen saturation of hemoglobin as measured by pulse oximetry (SpO 2 ), and dyspnea scores were evaluated at baseline and 24 hours after treatment. The primary outcome was the change in respiratory parameters; secondary outcomes included survival to discharge and adverse events. Nonparametric statistical tests (Wilcoxon signed rank and Mann-Whitney U tests) were used ( P < .05). Results 26 dogs met the inclusion criteria (COT, n = 13; HFNC, 13). High-flow nasal cannula oxygen therapy resulted in greater improvements in RR (median, 66 to 35 breaths/min) and SpO 2 (median, 83% to 97%) compared to COT. Dyspnea scores significantly improved only in the HFNC group. Two HFNC dogs survived to discharge, while none survived in the COT group. Minor aerophagia occurred in 2 HFNC dogs and was medically managed. Conclusions HFNC was associated with improved clinical signs including RR, SpO 2 , dyspnea scores, and survival in dogs with NCPE. Clinical Relevance HFNC may serve not only as an alternative but also as a more effective and well-tolerated option than COT for the management of dogs with presumed NCPE.