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Respiratory Diseases > Coughing > Flashcards

Coughing Flashcards

1
Q

What other clinical signs can be mistaken for coughing?

A

Comiting
Regurgitation
Reverse sneezing
Retching
Stridor/stertor sounds

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2
Q

What is coughing?

A

Protective mechanism of URT
Forceful expelling of air

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3
Q

Causes of ACUTE coughing

A

CIRD/tracheobronchitis
irritation by smoke/dust
Airway FB
Pulmonary haemorrhage
Acute pneumonia
Acute oedema
Airway trauma

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4
Q

What is CIRD?

A

Canine Infectious Respiratory Disease
Caused by:
* Canine parainfluenza virus
* Canine adenovirus -2
* Bordetella bronchiseptica

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5
Q

What are anti-tussives?

A

Anti cough medication
Shouldn’t use if coughing is productive
Useful if non-productive e.g. neoplasia
Butorphanol/codeine

Want to keep cough response as it protects the airways

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6
Q

Causes of CHRONIC coughing

A

Chronic bronchitis/bronchiectasis
Airway F.B.
Bronchopneumonia
L. heart failure
Oslerus/Aelurostrongylus infestation
Tracheal collapse
Pulmonary neoplasia - primary or secondary
Extra-luminal mass lesions - thyroid, abscess, lymphoma
Eosinophilic disease – EBP/PIE/allergic airway disease
(Pulmonary “fibrosis”)

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7
Q

What will you see on a radiograph with chronic coughing?

A

Bronchial patterns (tramlines and donuts)
Lsided heart failure (cardiomegaly)
Foreign body potentially

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8
Q

Canine Chronic Bronchitis

A

Coughing for >2 months
Characterised by:
* neutrophilic/eosinophilic infiltration of mucose and thickening of smooth muscle
fibrosis of lamina propria
Increased goblet cell size and number
Loss of ciliated epithelial cells

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9
Q

Secondary complications to canine chronic bronchitis

A

Thickening of bronchial tissue
Over production of airway mucus
Narrowing of airways
Airway collapse due to wall weakaness (bronchomalacia)

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10
Q

Clinical signs of canine chronic bronchitis

A

Wheezing
Productive coughing, worse on excitement
Typical in small/toy breeds
Often obese

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11
Q

How to diagnose canine chronic bronchitis

A

History/clinical findings
over exaggerated sinus arrhythmia
coughing
Increased bronchial pattern on radiographs
Red and raw on bronchoscopy
BAL - increased mucus with inflammatory cells

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12
Q

Management of chronic bronchitis

A

Can’t cure unless find underlying cause
General control:
* Weight control
* No collars
* Steam in bathroom
* avoid dry environments
Glucocorticoids - oral or inhaled
Bronchoddilators
Coupage

NOT NSAIDs
NOT ANTITUSSIVES

LONG TERM TREATMENT
DOG WILL ALWAYS HAVE A COUGH

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13
Q

Examples of bronchodilators

A

Terbutaline
Theophylline
Salbutamol

Beta 2 agonists

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14
Q

Benefits of bronchodilators

A
  • Reduce spasm of lower airways
  • Decrease intrathoracic pressures
  • Decrease tendency of larger airways to collapse
  • Improve diaphragmatic function
  • Improves muco-ciliary clearance
  • Inhibit mast cell degranulation (reduced release of mediators of bronchoconstriction)
  • Possible additional ways that signs are improved:
    ○ Improves pulmonary circulation
    ○ Improves cardiac function
    ○ Reducing respiratory effort
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15
Q

Examples of corticosteroids

A

Fluticasone
Beclomethasone

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16
Q

Benefits of corticosteroids

A
  • Broncho-dilatory
  • Anti-inflammatory
    ○ Inhibit both prostaglandin & leukotriene synthesis
  • Reduce leukocyte accumulation
  • Reduce vascular permeability
  • Alter macrophage function
  • Inhibit fibroblast growth
  • Modulate the immune system
  • BUT adverse side effects
    ○ Dose limiting
17
Q

Advantages of inhaled medications

A
  • Management of chronic airway disease
  • Minimal absorption into systemic circulation
    ○ Less systemic effects
  • Faster onset of action
  • Dose of glucocorticoid is lower
  • Effective in acute situations
18
Q

Disadvantages of inhaled medications

A

Expensive
Time consuming
Owner and patient compliance issues

19
Q

What is feline bronchial disease

A

AKA Feline asthma, feline allergic airway disease
* Type I hypersensitivity condition to inhaled allergens

20
Q

Common causes of bacterial bronchopneumonia

A

(Primary infection is rare)
○ E Coli
○ Klebsiella
○ Pasteurella
○ Staphs
○ Streps
○ Mycoplasma

21
Q

Predisposing factors to bacterial bronchopneumonia

A

○ Debilitation
○ Prolonged recumbency
○ Systemic immunosuppression
○ Defective respiratory defences
○ Damaged respiratory epithelium
○ Aspiration
○ Airway obstruction
○ Systemic sepsis

22
Q

Clinical signs of bacterial bronchopneumonia

A

Cough
Respiratory distress
Ex intolerance
○ More severe infections may produce hyperthermia
○ Anorexia and lethargy are common signs
○ Increased or decreased lung sounds may be present, may include crackles
○ Respiratory distress and cyanosis may develop in severe cases

23
Q

Diagnostic approach to bacterial bronchopneumonia

A

CBC
Biochemistry
thoracic radiographs (alveolar pattern)
Airway sampling (culture and cytology)

Respiratory Diseases (15 decks)

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