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SA Respiratory > Coughing and dyspnoea > Flashcards

Coughing and dyspnoea Flashcards

1
Q
A
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2
Q

Causes of a reduction of thoracic capacity

A

Pyothorax

Chylothorax

Diaphragmatic hernia/rupture

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3
Q

Causes of a loss of pulmonary exchange capacity

A

Bronchopneumonia

Pulmonary oedema

Pulmonary haemorrhage

Pulmonary thromboembolism

Idiopathic pulmonary fibrosis

Pulmonary emphysema

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4
Q

Normal respiratory sounds

A

Bronchial (blowing) sounds

Vesicular sounds

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5
Q

Adventitious sounds

A

Crackles (rales)

Wheezes (bronchi)

Pleural friction rub

Silent lung

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6
Q

Causes of acute coughing

A
  • Infectious tracheobronchitis -
    ○ kennel cough
    ○ feline respiratory complex
    • Airway irritation -
      ○ smoke/dust
      ○ bleeding
      ○ foreign body
    • Bronchopneumonia -
      ○ infectious
      ○ aspiration
      ○ (sterile)
    • Allergic lung disease
    • Inhaled tracheal/bronchial foreign body
    • Pulmonary oedema/haemorrhage
    • Airway trauma
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7
Q

Causes of chronic coughing

A
  • Laryngeal diseases
    • Tracheal collapse
    • Chronic bronchial disease
    • Bronchopneumonia
    • Allergic lung disease
      ○ Bronchial asthma
      ○ Allergic bronchitis
      ○ Eosinophilic bronchopneumopathy
    • Bronchiectasis – usually a consequence of chronic bronchial disease
    • Left-sided heart failure
      ○ Pulmonary congestion/oedema
      ○ Compression of mainstem bronchi
    • Parasitic lung disease
      ○ Oslerus (filaroides) osleri
      ○ Angiostrongylus vasorum
      ○ Aelurostrongylus abstrusis
    • Inhaled tracheal/bronchial foreign body
    • Primary or secondary neoplasia
    • Pulmonary abscess/granuloma
    • Pressure on airway
      ○ Enlarged left atrium
      Pulmonary neoplasia
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8
Q

Kennel cough aetiology

A

Viral
- canine distemper virus
- canine adenovirus CAV-1, CAV-2
- canine reovirus
- canine parainfluenza
- canine herpesvirus

Mycoplasmas

Bacterial
- Bordatella bronchiseptica

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9
Q

Clinical signs of kennel cough

A

Harsh dry cough
Sometimes paroxysmal
Stimulated by excitement, exercise or on tracheal palpation
Usually with minimal other findings
Slight to moderate pyrexia

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10
Q

Feline respiratory complex

A

viral
- feline herpesvirus
- feline calicivirus
- (feline reovirus) mild

Chlamydia
- Chlamydia psittaci

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11
Q

Aetiology of bronchopneumonia

A

various bacteria in single or mixed infections
Pasteurella
Staphylococci
Bordetella
Streptococci
Pseudomonas
Klebsiella
E. coli

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12
Q

Clinical signs of bronchopneumonia

A

cough generally productive, soft and moist

often mucopurulent nasal discharge

exercise intolerance, tachypnoea, dyspnoea, and sometimes cyanosis

depression, anorexia, weight loss

dehydration

fever - not a constant feature, but may be 40-41°C

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13
Q

Auscultation of bronchopneumonia

A

crackles - due to exudate in the lumen or inflammatory infiltrate in the airway walls

wheezes - due to exudates or bronchoconstriction causing narrowing of the airways

bronchial sounds

rarely pleural friction rubs - if pleura involved

may detect areas of consolidation where no respiratory sounds are audible (silent lung)

Percussion: areas of dullness due to consolidation

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14
Q

Radiology of bronchopneumonia

A

fluffy, ill-defined areas of density

areas of consolidation

air bronchograms due to alveolar flooding

peribronchial infiltrate in less affected areas

bronchial lymph node enlargement

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15
Q

Normal arterial blood gas values

A

pH 7.35-7.46

pO2 90-110

pCO2 26-42

HCO3 18-24

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16
Q

Haematology of bronchopneumonia

A

neutrophilia with or without left shift may be toxic degeneration chronically there may be a mild, non-regenerative anaemia

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17
Q

Treatment of bronchopenumonia

A

Ensure patent airway

Oxygen therapy if severe resp distress

Keep environment warm and moist

fluid therapy

antibiotics

bronchodilators if bronchospasm

expectorants

physiotherapy

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18
Q

Chronic bronchitis

A

excessive mucus production, hyperplasia and infiltration of the bronchial mucosa, loss of ciliated epithelial cells and failure of the mucociliary carpet

Affects adult dogs particularly of the smaller breeds

Persistent cough of at least 2 months duration. Cough is usually unproductive and dry

Pronounced sinus arrhythmia is common and helps differentiate cardiac failure.

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19
Q

Radiological signs of chronic bronchitis

A

May be minimal radiological signs.

Bronchial pattern due to peribronchial infiltration (doughnuts and tramlines). Must distinguish from bronchial wall calcification.

May be increased interstitial pattern or patchy alveolar infiltrates in some cases.

Collapse may be apparent in the intrathoracic trachea or mainstem bronchi.

Bronchography may reveal a loss of parallelism of the bronchial walls (early bronchiectasis) and bronchial obstruction.

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20
Q

Treatment of chronic bronchitis

A

Avoid irritant factors e.g. smoke

Control obesity to improve respiratory function

Vaccinate to prevent infectious tracheobronchitis

Control secondary bacterial infection

Reduce airway inflammation with glucocorticoids, but be careful of weight gain

Bronchodilators

Antitussives e.g. butorphanol (Torbutrol), codeine phosphate

Mucolytics e.g. Bromhexine

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21
Q

Indicators of chronic bronchitis

A

obese

variable exercise tolerance

harsh, dry cough

often sinus arrhythmia

may have systolic murmur

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22
Q

Indicators of chronic valvular disease

A

Weight loss

Exercise intolerance

soft moist cough

tachycardia

left systolic murmur

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23
Q

Feline bronchial disease (feline asthma)

A

Thought to be allergic, but allergens not known

Sudden onset of paroxysmal dry coughing, dyspnoea, and wheezing

May show peripheral eosinophilia, but this is not diagnostic in itself.

May have eosinophils in bronchial wash, although neutrophils are often predominant.

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24
Q

Radiological signs of feline asthma

A

May be unremarkable.

Increased bronchial and interstitial patterns.

Increased radiolucency resulting from air trapping.

Increased thoracic volume and a flattened diaphragm with visible insertions (tenting).

Possibly old fractured ribs and/or pectus excavatum.

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25
Q

Treatment of feline asthma

A

Control obesity

Control secondary bacterial infection

Glucocorticoid therapy often dramatic. May need to be given IV.

Bronchodilators: theophylline 4 mg/kg PO tid
terbutaline 0.6 - 1.25 mg/cat PO bid - tid

Nebulized bronchodilators and steroids have been helpful and can help avoid the side effects of using chronic steroids or tableting/giving oral medication

Supplemental oxygen in a severe attack

Inhalational therapy

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26
Q

Canine allergic bronchitis

A

Poorly defined clinical entity as offending allergens rarely identified.

Characterised by eosinophilic inflammation.

Clinical signs and diagnosis similar to chronic bronchitis

Responds well to anti-inflammatory doses of glucocorticoids

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27
Q

Eosinophilic bronchopneumopathy

A

characterised by interstitial or alveolar infiltration and the presence of eosinophilic inflammation

Coughing is the usually the primary complaint, although tachypnoea and dyspnoea may be seen. Weight loss, depression and anorexia may also occur.

increased breath sounds or crackles. Wheezes and decreased lung sounds may occur

Circulating eosinophilia supports a diagnosis

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28
Q

Radiological signs of eosinophilic bronchopneumopathy

A

Usually include an interstitial pattern and patchy alveolar opacities.

A bronchial component may also be present.

Occasionally even large pulmonary nodules indistinguishable from neoplasia, which represent eosinophilic pulmonary granulomatosis.

Hilar lymphadenopathy is common.

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29
Q

Treatment of eosinophilic bronchopneumopathy

A

Prednisolone 1 mg/kg BID initially. Repeat radiographs to assess response. Reduce to lowest effective dose over several months. May require continual alternate day dosing.

Prognosis for control is good except in the more severe granulomatous form of the disease

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30
Q

Bronchiectasis

A

Chronic irreversible, saccular, cylindrical, cystic or varicose dilatations and constrictions of bronchi and bronchioles which may contain large quantities of bronchial secretions.

Usually occurs secondary to destructive inflammatory disease (acute bronchitis/bronchopneumonia).

Bronchiectasis is an irreversible change which usually predisposes to recurrent infection, due to a failure of the mucociliary escalator. May occur in cases of ciliary dyskinesia.

Cough may be productive.

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31
Q

Radiological signs of bronchiectasis

A

Bronchial pattern with widened and irregular lumen of affected bronchi.

May be localised or generalised.

Ill-defined amorphous area of increased density due to pneumonia or atelectasis, particularly peripherally.

Increased interstitial pattern.

Bronchography for confirmation.

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32
Q

Left sided heart failure

A

Mitral regurgitation can be associated with coughing either as a result of pulmonary congestion and oedema or due to compression of the left mainstem bronchus by massive left atrial enlargement.

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33
Q

Radiological signs of left sided heart failure

A

Left atrial enlargement

Bronchial collapse may be identified.

34
Q

Oslerus (Filaroides) osleri

A

Infection usually acquired by pups from the bitch.

Clinical signs usually apparent in dogs less than 1 year of age. May be asymptomatic in older dogs.

Cough paroxysmal, unproductive and distressing often ending in retching and vomiting. Occasionally nodules may cause respiratory obstruction and dyspnoea.

Little improvement with antibiotics or corticosteroids

35
Q

Radiological signs of Oslerus osleri

A

Nodules present in terminal trachea and bronchi. Can be difficult to identify.

36
Q

Treatment of Oslerus (Filaroides) osleri

A

Fenbendazole (Panacur) 20 mg/kg daily for five consecutive days. Five days off treatment. Repeat treatment four times.

Imidocloprid and moxidectin (Advocate) spot-on, two applications one month apart.

37
Q

Angiostrongylus vasorum

A

Dogs become infected from ingesting snails and slugs which contain infective third stage larvae. Enzootic in Europe and the UK, particularly Cornwall, Wales and the south-east.

Clinical signs include coughing, dyspnoea, exercise intolerance, haemoptysis, anaemia, bleeding, haematoma formation and death.

Coagulopathy may be associated with chronic disseminated intravascular coagulation or immune-mediated thrombocytopenia.

38
Q

Radiological signs of Angiostrongylus vasorum

A

Bronchial thickening

Diffuse interstitial lung disease

Focal areas of alveolar pattern, especially in the caudal lobes

Right heart and pulmonary artery enlargement

Tortuous pulmonary arteries which may appear truncated

39
Q

Treatment of Angiostrongylus vasorum

A

Fenbendazole (Panacur) 20 mg/kg daily for five consecutive days. Five days off treatment. Repeat treatment four times.

Imidocloprid and moxidectin (Advocate) spot-on, two applications one month apart.

40
Q

Aelurostrongylus abstrusus

A

Bronchiolar parasite of cats.

Intermediate host (slugs and snails) may be eaten by birds and small mammals.

Infection usually asymptomatic and self-limiting. Occasionally causes coughing, wheezing and respiratory distress.

Auscultation may reveal wheezes or crackles

41
Q

Radiological signs of aulurostrongylus abstrusus

A

Small nodular densities throughout lung parenchyma, especially associated with bronchi.

Nodules may be well-defined or poorly-defined and irregular.

An accentuated bronchial pattern and a confluent alveolar pattern may be seen in severely affected cats.

42
Q

Treatment of Aulurostrongylus abstrusus

A

Fenbendazole

43
Q

Inhaled tracheal/bronchial foreign bodies

A

Usually whole head of wheat or barley with awns favouring deeper penetration into bronchus. Incidence highest in the summer.

Coughing is the most common clinical sign. Halitosis is often a feature.

Some response to antibiotics, but relapse on withdrawal.

44
Q

Radiological changes of inhaled foreign bodies

A

Often minimal change.

Localised increase in density around bronchus, most commonly of the caudal or accessory lobes.

Expiratory radiographs may be helpful.

Lobar pneumonia.

Large soft tissue mass due to abscess.

Bronchography may be helpful.

45
Q

Radiological signs of pulmonary neoplasia

A

Primary neoplasia - usually well-defined solitary mass with consolidation of entire lung lobe. May be able to biopsy mass at bronchoscopy.

Secondary neoplasia - usually well defined multiple nodules of dissimilar size. Occasionally ill-defined and multiple. Cavitation may occur in rapidly growing tumours.

Lymphosarcoma - always ill-defined, multiple, small nodules particularly associated with bronchi and bronchioles.

May be associated with hypertrophic pulmonary osteoarthropathy.

46
Q

Pulmonary abscess/granuloma

A

May be secondary to bronchopneumonia, bronchiectasis or bronchial foreign body, nocardiosis, tuberculosis, fungal infection.

Lymphomatoid granulomatosis is an inflammatory condition which may progress to lymphoma. It has been reported in young to middle-aged dogs.

Coughing, choking, gagging, dyspnoea, anorexia and vomiting are the main presenting signs.

Radiographic abnormalities included lung lobe consolidation or pulmonary mass lesions, as well as abnormally large tracheobronchial lymph nodes.

Some dogs respond well to combination chemotherapy.

47
Q

Tracheal collapse

A

Most frequently seen in toy and miniature breeds.

Multifactorial aetiology involving a primary cartilage abnormality resulting in weakness of the tracheal rings together with secondary factors such as obesity, recent endotracheal intubation, respiratory infection, obstructive airway disease, which exacerbate the clinical signs.

Characterised by a chronic, persistent paroxysmal cough precipitated by excitement, anxiety or pulling on a lead.

A chronic expiratory ‘honking’ cough is a frequent, but not consistent finding.

48
Q

Types of respiratory distress

A

Tachypnoea: increased rate of breathing

Orthopnoea: difficulty in breathing when lying down

Dyspnoea: difficult, laboured, or painful breathing

49
Q

Causes of a reduction of thoracic capacity

A

Pleural effusions -
○ Hydrothorax
§ Transudate
§ Modified transudate
○ haemothorax
○ chylothorax
○ pyothorax
○ neoplastic
○ inflammatory

Pneumothorax

Diaphragmatic rupture/hernia

Cardiac enlargement

Intrathoracic masses

Abdominal masses/fluid

50
Q

Aetiology of pleural transudate

A

hypoproteinaemia (gut or urine loss, severe liver disease)

51
Q

Aetiology of pleural modified transudate

A

congestive cardiac failure, particularly cats

neoplasia (particularly cranial mediastinum, thoracic wall)

lung lobe torsion

diaphragmatic rupture and incarceration of liver

52
Q

Aetiology of haemothorax

A

trauma

coagulopathies

53
Q

Aetiology of chylothorax

A

trauma

neoplasia

idiopathic

54
Q

Aetiologies of pyothorax

A

nocardia

bacteroides

tuberculosis

55
Q

Aetiologies of inflammatory pleural effusion

A

FIP

56
Q

Clinical signs of pleural effusions

A

Dyspnoea, hyperpnoea and tachypnoea especially on exertion.

Reluctance to settle or lie down due to orthopnoea.

Increased density on percussion, reduced heart sounds.

57
Q

Radiological signs of pleural effusions

A

Interlobar pleural fissures.

Retraction of lung lobes from chest wall producing scalloped appearance in lateral and rounding of the costophrenic angle in DV.

Cardiac and diaphragmatic lines obscured.

Unilateral effusion suggests pyothorax or chylothorax.

58
Q

Pyothorax

A

may result from haematogenous spread of bacteria or fungal organisms or from extension of underlying infective processes

most commonly diagnosed in young to middle-aged, medium to large breeds of dog

may be found in association with FIV or FIP infections

59
Q

Where do you insert a simple thoracocentesis?

A

1/3 way down the 7th intercostal space

60
Q

Where do you insert a chest drain

A

Over the 9th intercostal space

61
Q

Aetiology of chylothorax

A

Neoplasia

Traumatic

Congestive heart failure, especially in cats

Infectious

Congenital

Lung lobe torsion, although lung lobe torsions can occur as a complication of chylothorax also

Spontaneous

62
Q

How do you distinguish between chyle and pseudochyle?

A

Chyle is sudan III positive and has high triglycerides

63
Q

Treatment of chylothorax

A

Thoracocentesis

Feed a high carbohydrate, low fat diet

Add medium-chain triglycerides, e.g. coconut oil, as these are taken up directly into the portal circulation

Rutin, a benzopyrone, non-anticoagulant coumarin, has been used. Dose 20 - 50 mg/kg TID. Rutin reduces high protein oedema fluid by increasing proteolysis by macrophages and increasing the number of macrophages at the site of oedema.

Surgery?

64
Q

Aetiology of pneumothorax

A

Traumatic rupture of lung or airway.

Penetrating wounds of the thorax wall.

Ruptured lung bulla, pulmonary cyst, emphysema

Ruptured pulmonary abscess or necrotic tumour.

Spontaneous pneumothorax.

Extension of pneumomediastinum (rare)

65
Q

Clinical signs of pneumothorax

A

Reduced lung sounds.

Increased resonance on percussion.

66
Q

Radiology of pneumothorax

A

Retraction of lung lobes with increased density due to collapse.

Visualisation of the visceral pleura.

Collapsed lobes surrounded by radiolucent area containing no lung markings (beware of skin folds in deep-chested dogs)

Cardiac silhouette elevated from sternum in recumbent lateral view.

With tension pneumothorax, there is over distension of the thoracic cavity (barrel chest) with flattening of the diaphragm and visualisation of the diaphragmatic attachments.
The ribs and costal cartilages become perpendicular to the spine. Tension pneumothorax requires immediate thoracocentesis to relieve the intra-pleural pressure.

67
Q

Diaphragmatic rupture/hernia

A

Usually the result of trauma. Rarely congenital herniation.

Clinical signs include increased density on percussion and displacement of the apex beat of the heart.

68
Q

Radiology of diaphragmatic hernia/rupture

A

Loss of diaphragmatic line.

Loss of normal intrathoracic anatomy with displacement of lung lobes, heart and mediastinum.

Presence of abdominal viscera within the thorax.

Absence or displacement of viscera within the abdomen.

Possibly the presence of free pleural fluid especially if liver or spleen is incarcerated in defect.

Ultrasonography is very useful in the diagnosis of diaphragmatic rupture and is particularly helpful for incarcerated organs.

Barium study may help if plain films are equivocal.

In congenital diaphragmatic hernia, the viscera may be contained in a peritoneal sac appearing as a discrete thoracic mass continuous with the diaphragm

69
Q

Causes of a loss of pulmonary exchange capacity

A

Bronchopneumonia
Pulmonary oedema
Pulmonary haemorrhage/contusion
Metastatic neoplasia
Pulmonary thrombosis
Paraquat poisoning
Pulmonary emphysema
Idiopathic pulmonary fibrosis

70
Q

Bronchopneumonia

A

not uncommon.

i) Infection secondary to kennel cough, cat flu, damage caused by smoke, chronic bronchitis, bronchiectasis, foreign body inhalation, pulmonary neoplasia, granulomata.

ii) Aspiration secondary to megaoesophagus, swallowing disorders, broncho-oesophageal fistulae, chronic rhinitis.

iii) Pulmonary infiltration with eosinophilia (PIE) is believed to be an allergic pneumonia. Solitary, well-defined granulomas can also occur.

iv) Pneumocystis carinii infection, a ubiquitous parasite that can cause severe respiratory disease particularly in immuno-compromised patients.
Trimethoprim-sulphamethoxazole is the treatment of choice.

71
Q

Radiological signs of bronchopneumonia

A

Fluffy, ill-defined areas of density with air bronchograms due to alveolar flooding.

Areas of consolidation.

Peribronchial infiltration in less affected areas.

Bronchial lymph node enlargement.

72
Q

Pulmonary oedema (external signs and radiographic signs)

A

Blood-tinged frothy oedema fluid can appear from the nostrils or mouth.

Abnormal accumulation of fluid in the interstitial tissues, alveoli and bronchi of the lungs.

Radiological signs include increased interstitial and/or alveolar opacity. Cardiomegaly in left-sided cardiac failure.

Cause usually cardiogenic. In acute failure, oedema is widespread with a patchy distribution. When chronic it tends to affect mainly the perihilar and dependent portions of the lung lobes. Heart usually but not always enlarged.

Non-cardiogenic causes include altered capillary permeability (infection, toxic inhalants, systemic toxins, allergy, anaphylaxis, uraemia); increased capillary pressure or obstruction (fluid overload, lymphatic or venous obstruction); decreased oncotic pressure (hypoproteinaemia); neurogenic (head trauma, seizures, electric shock).

73
Q

Pulmonary haemorrhage

A

Coughing ± haemoptysis.

Traumatic - pulmonary contusion is most common. Develops within 6 hours of trauma.
Improves within 24 to 48 hours and is usually completely resolved within 3 to 10 days.
May be associated with other signs of thoracic trauma, e.g. fractured ribs.

Coagulopathies e.g. Warfarin, von Willebrand’s disease, D.I.C.
May be associated with mediastinal and/or pleural haemorrhage.

74
Q

Pulmonary thromboembolism

A

Most commonly associated with cardiac disease, autoimmune haemolytic anaemia, neoplasia, disseminated intravascular coagulation, hyperadrenocorticism, sepsis, heartworm disease, nephrotic syndrome.

Clinical signs of acute dyspnoea, collapse and shock.

Echocardiography may reveal a thrombus occluding the lumen of the pulmonary artery.

75
Q

Idiopathic pulmonary fibrosis

A

A response to chronic inflammation, paraquat poisoning, Cushing’s disease, other systemic inflammatory diseases and also as an idiopathic syndrome particularly in the WHWT and other terrier breeds

In WHWT, the disease affects older dogs and the onset is slow and insidious.
Deterioration happens slowly but inevitably and dogs are often euthanased when their QoL is poor due to respiratory distress and dyspnoea leading to exercise intolerance (median survival 15 months in one study). The disease often happens concurrently with chronic bronchitis and mitral valve disease and it can be difficult to know which is causing the major problem.

The classical clinical exam findings are of diffuse pulmonary crackles and wheezes. These can be so loud that the heart is difficult to hear.

Treatment with steroids or steroids and azathioprine may be beneficial and cause disease stability. Using another immunosuppressive may allow the dose of glucocorticoid to be reduced and avoid too many steroid side effects.

76
Q

Paraquat poisoning

A

Ingestion of the bipyridilium contact herbicide, paraquat, causes multisytemic signs.

In dogs, respiratory signs are most prominent due to diffuse alveolitis and subsequent fulminant, obliterating pulmonary fibrosis.

Radiological findings are notably unspectacular in relation to the severity of the dyspnoea. Major differential diagnosis is interstitial pneumonia usually of viral origin.

Pneumomediastinum - highlights structures not normally identified such as the oesophagus, azygos vein and cranial blood vessels. Both luminal and extraluminal outline of the trachea can be identified.

Increased interstitial pattern - linear/curvilinear and faint nodular patterns.

Patchy alveolar pattern in late stages due to pulmonary haemorrhage and oedema.

77
Q

Pulmonary emphysema

A

Congenital lobar emphysema.

Acquired pulmonary emphysema complicating chronic bronchitis or bronchiectasis, particularly West Highland white terriers.

Expiratory dyspnoea is the usual clinical sign. Inspiratory crackles and/or wheezing are usually heard on auscultation.

78
Q

Radiological signs of pulmonary emphysema

A

Increased radiolucency with loss of normal lung pattern.

Pruned and attenuated pulmonary vessels.

Bronchial pattern lost.

Thoracic volume increased - flattened diaphragm, visualisation of diaphragmatic muscle attachments, ribs at right angles to spine.

May see emphysematous bullae, blebs and cysts.

79
Q

Causes of airway obstruction

A

Nasal cavity
stenotic nares
foreign body
chronic rhinitis
aspergillosis
intra-nasal neoplasia

Pharynx/larynx
soft palate obstruction
laryngeal paralysis
laryngeal oedema/collapse

Trachea
tracheal collapse
hypoplastic trachea
tracheal haemorrhage
Oslerus (Filaroides) osleri
foreign body

Brachycephalic obstructive airway syndrome (BOAS

80
Q

Mediastinal masses - diffuse enlargement

A

Diffuse enlargement
mediastinitis
mediastinal haemorrhage
mediastinal oedema
mediastinal abscess

N.B. Brachycephalic dogs normally have a more prominent and wider cranial mediastinum. Obese dogs frequently accumulate excessive fat in this area.

Radiological signs
Widening of cranial and/or caudal mediastinum
Reverse fissures
Ultrasound is useful and allows accurate fine needle aspiration biopsy

81
Q

Mediastinal masses- focal enlargement

A

Diffuse enlargement
mediastinitis
mediastinal haemorrhage
mediastinal oedema
mediastinal abscess

N.B.  Brachycephalic dogs normally have a more prominent and wider cranial mediastinum.  Obese dogs frequently accumulate excessive fat in this area.

Radiological signs
Widening of cranial and/or caudal mediastinum
Reverse fissures
Ultrasound is useful and allows accurate fine needle aspiration biopsy

Focal enlargement
tumours
lymphadenopathy
granuloma/abscess

Radiological signs
Cranial mediastinal mass - increased width of the cranial mediastinum, caudal displacement of heart, elevation and deviation of trachea, caudal and lateral displacement of cranial lobes.
Ultrasound is useful and allows accurate fine needle aspiration biopsy

SA Respiratory (6 decks)

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