Dyspnoea Dogs and Cats Flashcards
Where does obstructive disease affeect URT v LRT?
Either! But single URT or diffuse/multiple LRT
Classes of disease that cause dyspnoeic
- obstructive disease
- loss of thoracic capacity
- pulmonary parenchymal disease -> VQ mismatch
- pulmonary vascular disease
- metabolic/physiological causes
Obstructive causes of dyspnoea
- nasal obstruction
- trauma
- FB
- laryngeal paralysis
- tracheal collapse
- brachycephalic obstructive airway disease
- filaroides
- extra lumenal mass lesions
- asthma
> NOISE!
Causes of loss of thoracic capacity? Ddx?
- fluid/air in pleural space (plerual effusion, pneumothorax)
- organs displaced from abdo (diaphragmatic rupture or cranial abdo organ enlargement, PPDH pericardio-peritoneo-diaphragmatic hernia congenital)
- less comonly neoplasia or marked cardiomegaly
Causes of pulmonary parenchymal disease? DdX?
> diffusion abnormalities due t o disease of the alveolar wall and interstitium
- alveolar flooding with oedema, blood or exudate (bronchopneumonia, pulmonary oedema - cardiogenic or noncardiogenic, haemmorrhage)
- abnormal pulmonary vascular supply (thromboembolism, VQ mismatch)
- neoplasia
- pulmonary fibrosis, idiopathic or toxic
- LRT parasites
Ddx of pulmonary vascular causes of dyspnoea
- pulmonary hypertension (perfusion compromised due to ^ RV afterload)
- pulmonary thromboembolic disease
Non-respiratory causes of dyspnoea?
- hyperthermia
- obesity
- excitement/excercise
- anaemia
- acidosis
- CNS disease
- endocrine disease
- neuromuscular disease
- thoracic wall abnormalities
How does approach to dyspnoeic patient differ to other conditions?
- May need stabilisation first
- Do not stress! WIll ^ oxygen demand
What is the 1st course of action for any dyspnoeic patient?
- oxygen!
How does obstructive URT disease present? Ddx?
- dyspnoea associated with noise and increased inspiratory effort
> laryngeal paralysis
> tracheal collapse
How does pleural disease present?
- decreased resp noise on auscultation
- fluid line on percussion
- expanded chest
How does pulmonary disease present?
- ^ respiratorynoise on auscultation esp. wheezes and crackles
EMergency tx of URT obstruction?
- establish airway (intubate)
- tracheostomy (bypass airway completely)
Emergency tx of ppleural effusion?
thoracocentesis
WHat diagnostic test is best first course of action?
Radiography
- differentiate pulmonary disease, pleural disease, abscence of either of these indicating obstructive/non-respiratory causes
Tx if URT obstruction?
Surgical (laryngeal tieback etc.)
MOst common infectious respiratory disease of cats?
Cat flu
- AKA feline infectious upper respiratory disease complex
Where are outbreaks of cat flu commonly seen?
- boarding catteries/breeding colonies/rescue
- usually young
Pathogens involved in cat flu?
> Feline herpesvirus ( Feline viral rhinotracheitis) > Feline calicivirus > Chlamydophila felis > BOrdatella - mycoplasma, reovirus, cowpox virus
CLinical signs of cat flu
- RHinitis (+2* bacterial)
- Occulitis
- Ulcerative disease seen with calicivirus
> URTI signs generally
WHen is diagnosing type of pathogen helpful?
In an outbreak
- in single cases not particularly useful
What pathogen is most likely to cause occular discharge?
Chlamydophila
What pathogen is more likely to cause lingunal ulcers?
Calicivirus (can also cause systemic problems)
Which pathogen and associated condition causes most severe signs in unvaccinated animals?
- feline viral rhinotracheitis caused by feline herpes virus (FHV)
What is one of the first signs of FHV? Pften missed?
Dendritic corneal ulcers
How may FHV be spread other than via contact?
Vertical transmission - may be born infected
What signsmay FJV have other than respiratory tract infection?
- abortion
- encephalitis and hepatitis in neonatal kittens
Why is calicivirus especially pathogenic?
- high mutation rate so difficult to make vax and highly pathogenic strains can suddenly outbreak and kill things
- FCV-associated virulent systemic disease complex seen
> resp disease with pyrexia, cutaneous oedema, ulcerative dermatitis, anorexia, jaundice
> 50% mortality
How can cat flu be diagnosed?
- Hx and clinical signs
Tx cat flu?
- Symptomatically for individual
- further diagnositcs may be indicated in an outbreak or if vax has failed etc.
Look at ABCD (european board of cat diseases) online
diagnostic tests available for cat flu pathogens?
- PCR (FHV, FCV, Chamydophila)
- Viral isolation
- Serology (not useful for viral as likely vax so + anyway, need paried serology)
- Bacteriology
Which concurrent infections should be checked for in debilitated patients or outbreak animals?
- FIV
- FeLV
> Immunosupressive
Tx of cat flu?
> Acute viral disease, will go away eventually!
- assist respiration (bromohexine, oxygen)
- hydration
- nutritional support
- BS ABx for 2* infections
- 1* bordatella or chlamydophila - ABx (Tetracyclines: oxytet, doxycycline) BUT avoid these in young cats and pregnant queens - risk of enamel staining
- Ideally treat at home otherwie pain to keep in hospital (barrier nursing etc!)
Are antiviral drugs advocated?
- limited proof of efficacy!
> interferon
> aciclovir
> trifluorothymidine
How can herpesvirus and calicivirus spread?
- contact (direct or indirect)
- aerosol recrudescence due to stress
What are cats commonly vax against?
Flu (Calicivirus and FHV (viral rhinotracheitis))
Eneteritis
- Bordatella (less evidence for this)
Is vax effective in cats?
Good at v clinical signs but not good at eradicating disease! No change in prevalence despite widepread vaccinating (cf. smallpox humans where vax could eradicate disease)
Why may vaccine not be effective?
- vaccinated against specific pathogens or strains of pathogens
- disease causing agent may be different!
Standard vax schedule?
- 9 weeks 1st vac
- 2nd vax 3 weeks later
- booster annually or low risk cats every 3 years
- ideally prior to anticipated challenge eg. cattery
How can potential infection be controlled in groups of cats?
- screen new cats for viral shedding and vaccinate
- isolate infected individuals
- disinfect fomites
