DM3 Pt2-4 Feline Lower Airway Disease Flashcards
Where are cough receptors located in cats?
Cough receptors are located in the larynx, trachea, and bronchial tree of cats.
What is the most common cause of coughing in cats?
Chronic lower airway disease is the most common cause of coughing in cats.
Is coughing in cats typically associated with heart disease?
No, cats with heart disease rarely cough.
Which respiratory diseases are less likely in cats if coughing is present?
Pleural space diseases, upper respiratory tract diseases, and parenchymal disorders are less likely if a cat is coughing, as coughing suggests airway disease.
List some common causes of lower respiratory tract disease in cats.
Chronic lower airway disease, pneumonia/bronchopneumonia, neoplasia, foreign bodies, pulmonary contusions, pulmonary oedema (rarely causes coughing), pulmonary fibrosis.
What are the bacterial and viral causes of pneumonia/bronchopneumonia in cats?
Bacterial: Various species. Viral: Feline herpesvirus-1 (FHV-1), Feline calicivirus (FCV).
Which parasitic infections can cause pneumonia/bronchopneumonia in cats?
Toxoplasmosis and Aelurostrongylus abstrusus (lungworm) are parasitic causes of pneumonia/bronchopneumonia in cats.
Does pulmonary oedema typically cause coughing in cats?
No, pulmonary oedema does not usually cause coughing in cats.
What clinical signs are helpful in differentiating the causes of coughing in cats?
The clinical history, duration of signs, presence of tachypnoea/dyspnoea, respiratory pattern, and other clinical signs can help narrow down the differential diagnosis.
What is a rare cause of pneumonia/bronchopneumonia in the UK?
Fungal pneumonia is rare in the UK.
What is feline chronic lower airway disease?
It is a group of conditions affecting the lower airways, including feline asthma, chronic bronchitis, and chronic bronchopulmonary disease, characterized by airway obstruction, inflammation, and possible irreversible damage.
What is feline asthma characterized by?
Feline asthma is characterized by hyper-responsiveness of the airways and reversible bronchoconstriction.
What is chronic bronchitis in cats characterized by?
Chronic bronchitis is characterized by airway inflammation and excessive mucus production, leading to irreversible narrowing of the airways.
What breeds are predisposed to feline chronic lower airway disease?
Siamese, Burmese, and Oriental breeds are predisposed to feline chronic lower airway disease.
What are the common clinical signs of feline chronic lower airway disease?
Cough, wheeze, and mild tachypnoea are common signs. In severe cases, dyspnoea, mouth breathing, and cyanosis may be present.
What complications can occur due to chronic lower airway disease?
Complications such as pneumothorax (due to ruptured alveoli) can occur.
What findings may be observed on physical examination of a cat with chronic lower airway disease?
Prolonged expiratory phase, crackles or wheezes, a barrel-chested appearance, and decreased compressibility of the thoracic cavity may be observed.
What radiographic changes are typically seen in feline chronic lower airway disease?
A prominent bronchial pattern (“doughnuts” and “tramlines”), over-inflated lungs, flattening of the diaphragm, and atelectasis of the right middle lung lobe may be seen.
What is bronchoalveolar lavage (BAL) used for in diagnosing feline chronic lower airway disease?
BAL is used to collect samples for cytology and culture to assess the presence of inflammation and infection in the airways.
What might BAL cytology show in a cat with chronic lower airway disease?
Cytology may show increased numbers of macrophages (60-90%) and eosinophils (2-30%, though healthy cats can have up to 85%).
What is the recommended treatment if bronchoconstriction occurs during bronchoalveolar lavage (BAL)?
If bronchoconstriction occurs during BAL, emergency administration of a bronchodilator such as IV terbutaline is recommended.
What are the goals of treating feline lower airway disease?
The treatment aims to control clinical signs, manage bronchoconstriction, and reduce inflammation rather than cure the condition.
What are some rapid-acting drugs used to treat acute decompensation in cats with lower airway disease?
- Terbutaline (0.01 mg/kg SQ, IM, or IV every 4 hours)
- Salbutamol (100 mcg MDI, 2 doses initially, then every 30 mins for 2-4 hours)
- Dexamethasone (0.2-2.2 mg/kg SQ, IM, or IV)
What is the primary aim of long-term treatment in feline lower airway disease?
The primary aim is to reduce airway inflammation and control clinical signs, often using environmental control and medications such as corticosteroids and bronchodilators.
What environmental factors should be reduced to help manage feline lower airway disease?
Allergen/irritant exposure should be minimized, including smoke, dust, aerosols, cat litter, and temperature changes. Additionally, obesity should be managed, and bronchoconstricting drugs like beta-blockers and aspirin should be avoided.
What corticosteroids are commonly used for chronic management of feline lower airway disease?
Oral prednisolone (1-2 mg/kg PO BID for 7-10 days, then tapered) and inhaled corticosteroids like fluticasone (Flixotide) (125-250 mcg MDI, 1-2 puffs BID) are commonly used to control airway inflammation.
Why are inhaled corticosteroids preferred for long-term treatment of feline lower airway disease?
Inhaled corticosteroids avoid the systemic side effects of oral steroids while delivering a high dose of the drug directly to the lungs, reducing inflammation effectively.
What is the role of fluticasone in treating feline asthma?
Fluticasone (Flixotide) is the inhaled corticosteroid of choice, given at 125-250 mcg MDI, 1-2 puffs twice daily. It is as effective as 1 mg/kg BID of oral prednisolone and does not get absorbed via the gastrointestinal tract, reducing systemic side effects.
How should the inhaler and spacer device be used in cats?
The medication is administered through a spacer chamber attached to a facemask. The mask is placed snugly over the cat’s nose and mouth for 10-15 breaths. The MDI is pressed to release the drug into the spacer, and the cat inhales the medication.
What is the first step in introducing an inhaler to a cat?
Introduce the spacer chamber without any drug in it, allowing the cat to become accustomed to the mask over time. Once the cat is used to the chamber, medication can be administered.
What medications should be avoided in cats with lower airway disease?
Bronchoconstricting drugs such as beta-blockers, non-specific beta-blockers, and aspirin should be avoided as they can exacerbate respiratory problems.
What is important when introducing a facemask and spacer device to a cat?
Introduce the facemask gradually, allowing the cat to become accustomed to it. Offer treats or playtime after applying the mask for short periods and slowly increase the duration.
What should owners do if their cat is alarmed by the inhaler’s noise?
Owners can press the inhaler in the same room as the cat without using the facemask initially. This helps the cat get used to the noise. Reward the cat with treats or play to reduce anxiety.
What is the main aim of corticosteroids in treating chronic lower airway disease?
Corticosteroids, like oral prednisolone or inhaled fluticasone, aim to reduce airway inflammation and control chronic symptoms in lower airway disease.
Why are inhaled corticosteroids preferred over oral corticosteroids?
Inhaled corticosteroids, such as fluticasone, reduce systemic side effects while delivering high doses of medication directly to the lungs where they are needed.
How should bronchodilators be used in cats with chronic lower airway disease?
Bronchodilators, such as salbutamol, should be used during acute exacerbations or as daily treatment in combination with corticosteroids for cats with persistent symptoms.
Why should bronchodilators not be used long-term without corticosteroids?
Long-term use of bronchodilators without corticosteroids can mask ongoing inflammation in the airways, which may worsen until severe damage occurs.
What additional treatments may be used if infection is suspected in cats with chronic lower airway disease?
If infection is suspected, antibiotics like doxycycline are often used, especially to treat potential mycoplasma infections.
What is the function of mucolytics like bromohexine in treating feline lower airway disease?
Mucolytics, such as bromohexine (Bisolvon), may help cats with excessive mucus production, breaking down mucus to ease airway obstruction.
What is the prognosis for cats with asthma or chronic lower airway disease?
The prognosis varies. Many cats respond well to treatment, but acute severe attacks can be fatal. Delayed treatment may lead to irreversible airway damage.
What are the signs of bronchodilator toxicity?
Signs of bronchodilator toxicity, especially from drugs like salmeterol, include muscle twitching, tachycardia, and GI upset.
