This should not be confused with paradoxical abdominal movement, which is a manifestation of severe dyspnea. It should therefore be intuitive that contraction of the abdominal muscles (abdominal effort) can only assist with expiration. During normal inspiration, diaphragmatic contraction displaces abdominal viscera caudally and the abdominal wall moves out passively (i.e., the chest and abdomen move out together). A normal animal should have a respiratory rate of 15–30 breaths per minute and, because the majority of a resting inspiration is due to diaphragmatic contraction, there should be very little apparent chest movement. Initial evaluation of the respiratory system comprises respiratory rate, effort and respiratory auscultation. Once an animal has suffered a respiratory arrest, the odds are hugely stacked against you-prevention is inordinately better than cure! Apart from the most severe upper airway obstructions, most animals will benefit from a period in 100% oxygen in an oxygen cage prior to a complete major body system evaluation. Dyspneic animals are often as their most fragile immediately following presentation and gentle restraint can prove life threatening. The stress of life-threatening disease coupled with transport and the unfamiliar surroundings of a noisy emergency clinic should never be underestimated. Consequently, the risks of any manipulation must be carefully weighed against the potential benefits. In a critically dyspneic animal, even a brief major body system evaluation can prove fatal, especially in cats. Successful emergency management of the animal with difficulty breathing demands that the clinician remain acutely aware of the fragility of the dyspneic patient.
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