Drowning in the dog: management after submersion
3-year-old Maltese rescued from a swimming pool after a submersion of unknown duration. On arrival it is conscious, mildly tachypnoeic, with an SpO2 of 96% on room air and near-normal thoracic radiographs.
What is the most appropriate approach?
chevron_right Show answer and explanation
A. Immediate discharge, as it is stable and the radiographs are almost normal
After submersion, non-cardiogenic pulmonary oedema and lung injury can appear or worsen over the following hours; a normal initial assessment does not guarantee the outcome.
B. Prophylactic antibiotics and corticosteroids to prevent pneumonia
They are not routinely indicated: corticosteroids do not improve the outcome and antibiotics are reserved for heavily contaminated water or signs of pneumonia.
C. Hospitalise and monitor respiratory rate, SpO2 and temperature for at least 24 hours, giving oxygen if hypoxaemia develops
Correct. Respiratory deterioration can be delayed because of surfactant damage and alveolar inflammation. Hypothermia is also common and must be corrected.
D. Furosemide to remove the aspirated water
Post-submersion oedema is not cardiogenic and does not respond to diuretics; moreover, the distinction between fresh and salt water has little clinical relevance.
lightbulb Key takeaway
Drowning can progress to ARDS. Poor prognostic factors are coma on arrival, the need for CPR and hypoxaemia unresponsive to oxygen. If the patient deteriorates, oxygen and positive-pressure ventilation are the effective treatment.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.