First off, your regular vet needs to be made aware that AP can often NOT be heard by listening to the lungs–X-rays are needed to definitively diagnose AP. What is the connection between nebulizer treatments and fighting bacterial infection? Or does a nebulized dog just regurg less because…why? or is it just the many mysteries of ME? I think of a nebulizer to help with lungs but maybe it has other benefits? The nebulizer fights the bacterial infection within the respiratory tract. Those infections are set up in the lungs, or somewhere within the respiratory tract. The nebulizer helps the lungs clear themselves of  junk in which bacteria can reproduce. Albuterol should probably not be used on any dog w/ a heart condition, nor, should people w/ heart conditions be exposed to the mist. You should find nebulizer treatments with albuterol and saline very helpful in eliminating the fluid in the lungs. You need to have a nebulizer and Saline solution on hand, in case of an emergency with AP. When you see the dog isn’t breathing right you can act immediately or you may never need to use it.

Dr. Kathy mentions as being good in her nebulizer handout are pulmo-aide Devilbiss and Omron. You want to make sure you don’t get a handheld model so that you will have both hands free.

You can use a vaporizer, but it is not going to be nearly as effective as a nebulizer which breaks up the mist into tiny particles that can be breathed deeply into the lungs. I would highly suggest you invest in a nebulizer (look on Ebay for just a regular table top model for adults–not handheld) and either make or purchase a mask to go along with it. Then you will need to get the saline (available behind the counter at pharmacies) and hopefully your vet will write you a prescription for albuterol, which is on the $4 list at Wal-Mart. Of course, you will need the tubing and medicine cup and accessories that come with it–you can buy these separately on Ebay if you are buying a used nebulizer that doesn’t come with the tubing and accessories.

To administer liquids via the nebulizer they need to be what is called “water soluble,” which Baytril injectable is not. About the only nebulizable antibiotics are amikacin and gentacin, both which can cause kidney problems, but, are safer to give through a nebulizer than by injection. Monitoring of kidney values are needed whenever these 2 drugs are used, in any way.

Saline versus Albuterol:
An owner asked: “My albuterol that my vet has prescribed is premixed with saline. Do I need to still add saline with the albuterol? Should I still nebulize with saline after using the albuterol? How often can I actually use the albuterol/nebulizer?
Answered by a DVM: “Since I cannot evaluate your baby, I can only tell you how I have treated these dogs, and must leave the final advise up to your veterinarian. I have used albuterol up to 3 times daily on dogs and cats, dosage based on the nebulizer link in the folders (empirical doses based on weight).
The albuterol/saline can be used by itself, or, especially with an active pneumonia, nebulizing w/ saline after the albuterol/saline, may actually moisten the lung tissues, allowing stuff to be coughed up more easily.”

Brands of nebulizers used by some ME dog owners:
“Portable ultrasonice OctiveTech that had a rechargeable battery and recharging device (I got the deluxe model); it also has a 3-year warranty on it. Admittedly, I haven’t used it yet, because it’s meant for people, so I went to the vet to have them measure Tasha’s snout so that they could order the appropriate mask for her. They also told me that in order to make sure that it works properly, they’re going to have to adjust the tube, then everything will work perfectly. According to the machine description, very little, if any, of the medicine is wasted, and it takes 1/3 to 1/2 the amount of time to deliver the medicine. Again, I know Tasha, so if I bought anything that made noise or took a lot of time, it was going to be a waste of money, so I made this as easy as possible on myself and her. I went to http://www.clinicalguard.com, and paid $112.00 for this machine — of course, no tax, and there was no shipping & handling. It came with ALL tubing, adult/pediatric masks, medicine cups — everything you would need if you were going to use this on a human being.”

I use a plastic Gatorade bottle and just taped some gauze on the end to make it soft and to fit tight around the muzzle and then just taped the connection for the hose in the other end.

“This is where Allegro’s mask was purchased: “I contacted Cheryl Crozier who is in charge of the mask program down in Florida. The organization is Help Animals, Inc. Go down on the page when you do a google search and you will see the one in Florida and their main original purpose was to provide masks for animals who were in fires or disaster situations. Now, they have expanded so that they will sell the masks to folks like us and we don’t even need a DVM to order one so it’s great. Cheryl wrote that it’s best to call her cell # 386-479-4966 or the home phone 386-775-4966. You may get her sister Nancy if you call home phone and she’s also into this helping animals big time, however Cheryl is the main person in charge of the masks. You can email Cheryl at Bleumoon@fbs.net. This is really her sister’s email, however they live together and work together on this common cause and if you put MASK in the subject line Cheryl will get it sooner. Cheryl’s email address having issues right now so use the Bleumoon@fbs.net one or call her. Cheryl also says the small mask is for feline or short snouted canines. It’s 4 inches across and 2 inches deep (front to back) The medium mask is for small to medium sized canines with longer snout. 4 inches across and 3 inches deep. The large mask is for larger canines such as retrievers, Collies, Rottweilers, etc. It is 5 1/4 inches across and 4 1/2 inches deep.”

“Many of us have ordered ours off of Ebay. You will need the compressor and a medicine cup and tubing which usually comes with some accessories some of which you may or may not need. It’s better to get a table top nebulizer than a hand held one. I think the table top models tend to last longer, and they free up both hands for you. My Allegro’s mask is from www.helpanimalsinc.org. They are wonderful oxygen masks that have ventilation holes that you won’t find in a lot of other masks. You might also be able to get your veterinarian to order a mask for you. The saline can be purchased at any pharmacy without a prescription (bronchosaline, not saline for contact lenses), and you would need to get your vet to prescribe albuterol for you. You can get the albuterol prescription filled for $4 at Walmart. The albuterol opens up the bronchioles, and the saline moistens the lungs so the gunk in there can more easily be coughed up.”

Where to buy nebulizers:
Local pharmacies
Walmart
Walgreens
Local medical supply stores

ADW Your Diabetes Store
https://www.adwdiabetes.com/

Craigslist here and found a Pulmomate compressor nebulizer model 4650D

Devilbiss
http://www.devilbisshealthcare.com/

Graham Field John Bunn Neb-u-Lite EV Nebulizer
https://www.shopnebulizer.com/p-graham-field-john-bunn-neb-u-lite-ev-nebulizer.html

Respironics 626 Inspiration Nebulizer
https://justnebulizers.com/nebulizer-systems.html

Help Animals, Inc
http://www.helpanimalsinc.org/

CompMist Compressor Nebulizer
https://www.mountainside-medical.com/products/CompMist-Compressor-Nebulizer-Machine.html

Making a nebulizer mask:
Supplies:
anesthesia cone/mask or funnel sufficient to cover the end of the muzzle and snout
piece of craft foam(from Michaels, JoAnn’s, etc)
narrow ribbon or string

Step 1.   Place the cone over the muzzle and secure with ribbon.
Step 2.   Tie ribbon around the circumference of the cone close to largest end.
Step 3.   Since the connecting tip of the cone/mask is smaller than the  nebulizer tubing, cut a strip of craft foam (width = length of tip,  length = sufficient to make tight fit), wrap it around the mask tip and then push the neb tubing onto it.
NOTE: The foam keeps a good connection for only about 5 treatments – but it is easily replaced (not glued, just the pressure of the fit holds it for that amount of time).

Owner stories using a mask on their dog:
“If Lucy won’t allow you to get the mask close enough to her while the nebulizer is running, you might have to use a small crate (smallest that she will fit in would be best) and cover it with a blanket then direct the mist from the nebulizer into the crate by putting the tubing through an opening in the crate. The nebulizer can really be a huge help in overcoming AP, so I hope you can figure something out. A mask would be best, but it sounds like she is just going to freak out. You might keep turning on the nebulizer several times throughout the day just to try to get her used to the sound of it, so it won’t sound so scary–hopefully this might desensitize her and you would be able to use the mask with a little peanut butter or baby food smeared in it. Some on the list have tried using the mask inside of a basket muzzle–that way she can’t get away from the mist, but it probably won’t keep her from freaking out.”

“When we nebulized our Kristi for the first time, we wondered how we were going to direct the mist into Kristi’s breathing passages. We cut the bottom off of a one- gallon plastic water jug and taped the mouth end to the T-tube at the end of the hose of the nebulizer. It made a perfect mask, with its own handle, which made it easy for me to hold still. (The end of a plastic 2-liter pop bottle might work better for a smaller dog) Kristi is a nervous dog and particularly head-shy. We had a difficult time getting her to sit still and submit. I fashioned a cloth blindfold for her. It worked like a charm! She wasn’t afraid of what she couldn’t see, and was at ease with the whole ten minute process.”

“I was able to make a mask for my coonhound using a flexible soft plastic cup cooler. I fringed the edges so that it will slide over his face and use various pvc fittings in the bottom to fit the cup holder and then screw onto the fittings on the tube that goes to the nebulizer.”

Just wondering where you get sterile water for the nebulizer? Sterile water can be bought at any Pharmacy. It’s like 3.89 for 500 ml.

Saline information:
As for the saline for your ordered nebulizer, there is prepackaged nebulizer saline. I’m not in my kitchen to read the box. It’s 100 “capsules” of 3cc’s of saline. Each capsule is one treatment. I got the box of 100 from Walmart pharmacy for something between $12-20. I just don’t remember for sure, but I was shocked at how affordable it was. And you DON’T need a prescription for it. The Albuterol one -yes, the saline one – no.

As for the saline for your ordered nebulizer, there is prepackaged nebulizer saline. I’m not in my kitchen to read the box. It’s 100 “capsules” of 3cc’s of saline. Each capsule is one treatment. I got the box of 100 from Walmart pharmacy for something between $12-20. I just don’t remember for sure, but I was shocked at how affordable it was. And you DON’T need a prescription for it. The Albuterol one -yes, the saline one – no..

How to make saline:
Step 1 – Wash your hands and the pot thoroughly. Use warm water and soap on both your hands and the pot and rinse thoroughly.
Step 2 – Measure four cups of water. Pour this into the pan.
Step 3 – Add two teaspoons of salt to the water.
Step 4 – Cover the pan and boil for 15 minutes.
Step 5 – Remove the pan from the heat. Keep the lid on the pan while you let the solution cool to room temperature.
Step 6 – Store the saline in a sterile jar.

Prescription meds that can be used in nebulizer:
–   Baytril can be administered by injection or by tablets.
–   Medicine used in nebulizer: Xopenex
–   A prescription is needed for either albuterol, or xopenex (which, by the way is supposed to have fewer long term side effects than albuterol, at least in humans).
–   Ventolin is the same thing as albuterol, which is what many of us use in the nebulizer along with saline for our dogs. Check with your dvm to find out proper dosage