Canine and Feline Bronchial diseases Flashcards
What is the most common bronchial disease?
Chronic bronchitis
True or False: Chronic bronchitis is usually due to an underlying infectious cause
False - chronic bronchitis with no identifiable underlying cause
What risk factors in dogs can predispose the animal to possibly developing chronic bronchitis?
- Obesity
- Periodontal disease
What is the signalment for chronic bronchitis in dogs? (sex, breed, etc)
- Small breed
- Overweight
- Middle to older age
What is the most common presenting complaint and history in a dog with chronic bronchitis?
- chronic (1+ month) cough
- Cough described as “harsh, hacking, or deep”
- Terminal retch (gagging/choking)
- May produce mucus/white foam
What potential abnormal exam findings can be found in a dog with chronic bronchitis?
- Increased breath sounds, crackles or wheezes
- Expiratory dyspnea (abdominal push)
- Sinus arrhythmia is common
- Right apical systolic murmur if PH is present
- Obesity, periodontal disease, panting, cyanosis, tachypnea
- ** OR pulmonary auscultation + RR/RE may be normal**
True or False: A normal pulmonary auscultation and RR generally rules out bronchial disease in cats
False - pulmonary auscultation + RR/RE may be normal
What clinical exam finding in dogs can help differentiate if a chronic cough is due to a cardiac cause or chronic bronchitis?
Absence of a murmur helps rule out cardiac cause
What arrhythmia is commonly found in dogs with chronic bronchitis?
Sinus arrhythmia
What can be seen on thoracic rads from a dog with chronic bronchitis?
- Diffuse bronchointerstitial pattern, or rads may be normal
- Bronchiectasis and/or bronchomalacia with severe CB
What diagnostics would you run in a dog with suspect chronic bronchitis?
- MDB
- HW Ag test
- Fecal (centrifug + Baermann)
- Thoracic and cervical rads
Advanced diagnostics:
- Bronchoscopy/fluoroscopy
- Bronchoalveolar lavage (non degen neuts)
- CT
What cell type predominates in a patients (dogs + cats) with chronic bronchitis?
A. Non-degenerate neutrophils
B. Degenerate neutrophils
C. Eosinophils
D. Lymphocytes
A. Non-degenerate neutrophils
What cell type predominates in cat with asthma?
A. Non-degenerate neutrophils
B. Degenerate neutrophils
C. Eosinophils
D. Lymphocytes
C. Eosinophils
What is the drug and treatment protocol for a dog with chronic bronchitis?
- Tapering dose of corticosteroids (Prednisolone)
- Fluticasone inhaler
- +/- cough suppressant
- +/- bronchodilator
- Reduce potential allergens
- Weight loss
- Reduce periodontal disease
- Eliminate 2ndary resp infection if needed with Abx
List complications of chronic bronchitis in dogs
- Bronchiectasis (permanent dilation)
- Bronchomalacia (collapse)
- Chronic obstructive pulmonary disease (COPD) / obstruction of small airways
- Pulmonary hypertension
What is the prognosis for a dog with chronic bronchitis?
- Usually good if symptoms can be controlled
- Earlier diagnosis leads to better prognosis
What dog breeds are predisposed to eosinophilic bronchopneumopathy?
- Siberian husky
- Malamute
What radiographic pattern is shown in dogs with eosinophilic bronchopneumopathy?
Diffuse bronchointerstitial pattern
What is false about dogs with eosinophilic bronchopneumopathy?
A. Females > males
B. Usually young adult dogs
C. Can present with thick yellow-green discharge
D. All of the above are true
D. All of the above are true
What is the drug protocol for a dog with eosinophilic bronchopneumopathy?
- Tapering dose of corticosteroids (Prednisone)
- Fluticasone inhaler
Describe the findings you would expect to see on a BAL from a patient with eosinophilic bronchopneumopathy
- Thickened, irregular mucosa with yellow green mucus and eosinophilic inflammation
Explain what primary ciliary dyskinesia (PCD) is
- Defective ciliary motility resulting in mucus accumulation, inflammation, and recurrent bacterial infections
- Upper and lower airways affected
What important history is given in a patient with primary ciliary dyskinesia (PCD)?
Recurrent bilateral nasal discharge and repeated episodes of bronchitis or bronchopneumonia since birth
What is the treatment protocol for a dog with primary ciliary dyskinesia (PCD)?
- Antibiotics
- Hydration
- Coupage
- Close monitoring for infections
Define asthma
Inflammation, mucus, wall thickening, PLUS bronchospasm (constriction)
PLUS bronchospasm (constriction) is what makes asthma different from chronic bronchitis
True or False: Definitive diagnosis of asthma or chronic bronchitis in cats is important, as the treatment differs between the two causes
False
- Asthma and chronic bronchitis in cats are treated similarly
___________ are the primary effector cells in allergic asthma
Eosinophils
(eosinophils release proteins that cause smooth muscle to be hyper-reactive)
What cat breed has increased risk or developing chronic bronchitis or asthma?
Siamese cats
Describe the frequency of the cough in cats with chronic bronchitis vs cats with asthma
- Cats with CB cough every day
- Asthmatic cats cough intermittently/ in episodes
- Wheezing can be common in both
What abnormal respiratory sound is most commonly heard in cats with both chronic bronchitis and asthma?
Wheezing (LRT sound, mostly heard on expiration)
- Possible to hear crackles or auscultation might be normal
Describe the following in a cat with chronic bronchitis or asthma
HR-
RR-
Temp-
HR- usually normal
RR- Normal or expiratory dyspnea (with or without tachypnea)
Temp- normal or increased
What cell type predominates in a patients with asthma?
A. Non-degenerate neutrophils
B. Degenerate neutrophils
C. Eosinophils
D. Lymphocytes
C. Eosinophils
What can be seen on thoracic rads from a cat with chronic bronchitis?
- Diffuse bronchial or bronchointerstitial pattern
- Right middle lung lobe atelectasis (due to mucus plug)
- Or rads can be normal
What can be seen on thoracic rads from a cat with asthma?
- Diffuse bronchial or bronchointerstitial pattern
- Hyperinflation (air trapping) = increased size of lung fields, flattening of diaphragm
- Right middle lung lobe atelectasis (due to mucus plug)
- Or rads can be normal
(All the same as what you’d see with chronic bronchitis except for the hyperinflation)
What diagnostic is best for detecting disease and determining severity of chronic bronchitis or asthma in cats?
CT !! Rads can’t determine severity or differentiate between the 2
What diagnostics should be ran in a cat presenting with a chronic cough?
- HWT and fecal (R/O HARD vs bronchitis/asthma)
- Bronchoscopy and BAL (eosinophils predominate in asthma, neuts predominate in bronchitis)
What is the treatment protocol for a cat with either chronic bronchitis or asthma?
Acute (emergency) Tx:
- Rapid corticosteroid (Dexamethasone)
- Bronchodilator (terbutaline)
- Supplemental O2
Chronic Tx:
- Tapering dose of corticosteroids PO (prednisolone)
- Can transition to Fluticasone inhaler once stabilized
- Bronchodilator reserved for flare ups (terbutaline, albuterol)
Weight loss!!!!
Remove allergens!
How can chronic bronchitis/asthma be differentiated from a dyspneic cat in CHF?
Asthma/Bronchitis
- Usually young adult-middle age
- Normothermic or hyperthermic
- Breeds: Siamese
- History of a cough
CHF
- Usually old
- Mildly hypothermic
- Arrhythmia, murmur, or gallop will be present
- Breeds: DSH, Maine coon, ragdoll
- Cough is rare in cats with CHF
