5. Respiratory Diseases Flashcards
What is atelectasis?
Lung collapse
What is hemothorax?
blood in the thorax
What is pleural effusion?
Fluid around the lung; in the pleural space
What is pneumonia?
inflam of the lungs
edema of the alveolar walls = thickening
inflam cells move to the alveoli
What is pneumothorax?
air in the pleural space
What is pulmonary edema?
fluid accumulation in the alveoli
What is collapsing trachea?
A dynamic condition in which the cartilage of the trachea is malformed and the membrane is being sucked in and will block the airway
What are the signs of tracheal collapse?
can be an incidental finding on a wellness exam?
Hx of coughing - often confused with kenal cough, check if went to kennel; occurs during excitement
can have resp distress - emergency
How do we treat collapsed trachea?
depends on the dog, severity of clin signs and loc of collapse (intra vs extrathoracic)
keep patient calm
cough suppressants
stent
emerg tx by sedation, bronchodilators, oxygen support
How do we prevent collapsing trachea?
harness for walks - all sm breeds
dental hygiene
bordetella vx
maintain @ ideal BCS
responsible breeding
avoid overheating
controlled activity/excitement in severe cases
What are some things to watch out for when anesthetizing a patient with tracheal collapse
Careful with ETT size selection - ensure tube size is lg enough
intubation may exacerbate collapse distal to ETT - watch capnograph and oxygenation closely
animals w/ several collapse are at a high to very high anesthetic risk
What is brachycephalic syndrome?
A smooshed faced dog/cat - english bulldogs, pugs, himalayans, persians
clin signs are largely due to facial conformation
elongated soft palate, thickened tongue, hypoplastic trachea, everted laryngeal saccules - dec air flow
What are the clinical signs of brachycephalic syndrome?
noisy breathing, especially on inspiration - stertor
retching or gagging when swallowing
constant open mouth breathing
exercise intolerance
cyanosis, collapse
How can we treat/prevent brachycephalic syndrome?
responsible breeding, weight control, harness instead of a collar, prevent overheating, surgical correction - stenotic nares, elongated soft palate, everted laryngeal saccules
What are the complications of brachycephalic syndrome>
obesity - will make the clinical presentation worse
inc risk of heat store
risk of cardiac dz
high risk of asphyxiation under sedation and GA - watch from sedation until fully recovered
in SOME brachycephalics, ONCE THEY ARE AWAKE, you can deflate cuff, untie tube and leave tube in airway. this will keep airways open but allows them to pull out the tube if it is causing a gag response
What is allergic airway dz?
Upper: allergic rhinotracheitis or hay fever
Lower: Asthma
What issues do we see with allergic rhinotracheitis?
Eyes, nose, coughing, throat, trachea
caused by enviro allergens - often seasonal
How can we treat hay fever?
antihistamines
allergen avoidance - washing, keeping indoors, clean home
sensitization - injections manufactured for the specific pet
What are some changes that can cause narrowing of the airway
Inflammation
1. more mucus; thicker mucus
2. Swelling of the mucosa
3. Bronchoconstriction = narrowing of airways
How is inflammation of the airways decrease air exchange?
- inc inflam cells
- Inc fluid
- dec elasticity over time
What are some clinical signs of feline asthma?
cough/gag (often mistake for a hairball)
wheezing
lethargic
exercise intolerance
What is the pathology of feline asthma?
allergen triggers immune response
major results of inflam during asthma episode
inc mucus secretion, thickening of mucosa, bronchoconstriction, fluid and inc cells in alveoli
Dec air movement; dec air exchange
How can we treat/manage feline asthma?
- drugs - anti-histamines, steroids, bronchodilators
- enviro control - allergen avoidance, dust/particle/smoke avoidance
- Oxygen support
What are our lower respiratory tract defences?
Mucociliary elevator - traps and removWhes Ag’s
Pulmonary macrophages - digest what gets thru
What are 3 things and examples that goes into respiratory dz triad?
Eviro factors: cold, dust, smoke, overcrowding, mixing
Infectious organisms
Patient factors: vaccinated or not, immune system, overall health; other dz’s
What are some risks of canine infectious respiratory disease compiled (CIRD)
Infectious organisms - canine adenovirus-2 parainfluenzae (bordetella)
Enviro - doggy daycare, groomers, kennel, hygiene, crowding, temp
Patient health status - prior bord vx, prior DA2PP vx, upper/lower airway condition, immune suppression
What pathogens cause CIRD?
canine parainfluenza virus, canine adenovirus2 (CAV2)
bordetella bronchiseptica - can be primary pathogen but usually 2nd infection
What is the pathophysiology of CIRD?
virus(es) infect the URT - virus and inflam response cause damage to URT, also results in damage to mucosa and mucociliary elevator
2nd infections - bordetella bronchiseptica: 2nd infections inx severity of c/s, inc reisk of spread to LRT
What are your ddx for hacking cough, dry cough, gag?
esophageal choke, collapsing trachea, kennel cough, oropharyngeal foreign body
How do we treat a dog with CIRD?
isolate - extremely infectious
nursing care - rest, humidified air, maintain hydration status
antitussives - controversial
antibiotics if patient develops pneumonia
How can we prevent CIRD?
vx!
DA2PP - core vx, adenovirus2 + parainfluenza virus
Bord - non core, bordetella bronchiseptica +/- adenovirus-2, +/- parainfluenza
What are the 3 types of bordetella vx’s
- live intranasal
- Live oral vx
- Killed injectable vx
What is FURD?
Feline upper respiratory dz
Feline herpes virus - effects eyes
Feline calicivirus - can affect mouth
both can cause chronic, latent infections
What is the pathophysiology of FURD?
very contagious - one or more viruses may be involved
Infects and damages URT
What are the clinical signs of FURD?
coughing, sneezing, runny nose (clear or cloudy d/c), runny eyes, fever, depression, anorexia
What are some complications of FURD?
2nd bact pneumonia
severe corneal ulcers, severe stomatitis/oral ulcerations, latent infections
How can we prevent FURD?
vx - FCVRP vx @ 8+12+16wks +1yr, shelter may vx q2w in kittens
Isolate
Disinfect - calicivirus vry hard to destroy
What is pneumonia?
inflammation of the lungs, common with virus, bacteria and fungus
Inflam causes;
Bronchoconstriction, inc bronchiolar secretions, thickening of alveoli, fluid in alveoli, chronic fibrosis
What is aspiration peumonia?
inhalation of a liquid or solid
Often inhalation of contents from mouth or stomach
Risk factors/causes: aspiration while under GA, forced aspiration, chronic regurgitation/vomit, cleft palate, oronasal fistula
What are the consequences of aspiration?
inflam from bacteria or chemical irritation
asphyxiation - if large volume is aspirated
How can we prevent aspiration pneumonia?
anesthesia - by fasting, appripriate ETT sizing, inflation of the cuff, timing of removal of ETT, patient positioning during GA and recovery
tx primary cause of vomiting or regurgitation
stomach tubing and force feeding
How do we use a stomach tube?
pre-measure tube from tip of nose to the last rib
pass tub when animal swallows, rad or add a few drops of mL’s of water, watch for coughing
admin food or meds slowly, flush tube with water, pinch tube to seal it b4 withdrawing from patient
What are some respiratory issues that result in decreased ventilation
Airway obstruction - upper airways problems that prevent air getting to lung
Lungs can’t inflate/deflate - something in pleural space
Fluid accumulates in the airways - prevents air exchange at the alveoli, aspiration, inflammation
Physical damage - punctures, torsions, collapse
What signs correlate with respiratory emergency?
- cyanosis
- Open mouth breathing/choking
- Rapid breathing/breathing w/ abdominal involvement
- Chest appears full and is not moving
- dyspnea w/ hx of HBC, chest wound
- Dyspnea w/ abnormal lung sounds
- dyspnea w/ hx of CHF
- SpO2 <90%
How do we response to respiratory emergency?
CALL THE VET
If conscious - 100% O2 mask or O chamber
Unconscious - intubate and deliver 100% O2
Skip this question
MM quiz answers
- Normal
- Very Pale, gray/purple/blue
- Petechae
- Cyanotic/pale pink
- Pale
- Red, hyperemic
- icteric
- Cyanotic, pale
- Petechiae, ecchymosis
