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Cardiopulmonary test 1 > Feline bronchial disease > Flashcards

Feline bronchial disease Flashcards

1
Q

sympathetic innervation

A

stimulation of Beta2 receptors leads to smooth relaxation

Bronchodilation

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2
Q

parasympathetic innervation

A

responsible for baseline tone

ACh–>increased intracellular calcium

stimulation leads to bronchoconstriction, mucus, cough

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3
Q

serotonin

A

released from feline mast cells

leads to bronchoconstriction

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4
Q

alpha adrenergic stimluation

A

decrease in cAMP

contraction of smooth muscles

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5
Q

inhibition of phosphodiesterase

A

increase in cAMP, cGMP

relaxation of smooth muscle

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6
Q

nitric oxide

A

endothelium-derived vasodilator

promotes bronchodilation

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7
Q

Which class of drugs is used to relax bronchial smooth muscle?

A

phosphodiesterase inhibitor

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8
Q

airway obstruction of asthma

A

hyperreactivity of bronchial smooth muscle

airway inflammation (bronchitis)

luminal bronchial secretions-goblet cell hyperplasia, musuc accumulation

extraluminal obstruction-emphysema, contributes to airway collapse

intramural changes-hypertrophy, fibrosis, edema, hyperplasia

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9
Q

Feline asthma

A

spontaneous bronchoconstriction associated with airway inflammation

reversible constriction

young adults, females>males, Siamese

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10
Q

etiology of feline asthma

A

type 1 hypersensitivity reaction

inhaled allergens, infectious agents, eosinophilia

idiopathic

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11
Q

hx and clincial signs of feline asthma

A

historical cough, normal between episodes

wheezing

sneezing

vomiting

acute respiratory distress

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12
Q

PE findings for feline asthma

A

tachypnea

dyspnea

wheezes

crackles

cough

normal PE

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13
Q

DDx for feline asthma

A

feline bronchial disease

layngeal disease

tracheal disease

heart disease-dyspnea, no cough

heartworm infection

pleural effusion

neoplasia

parasitic disease

pneumonia

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14
Q

Heartworm associated respiratory disease (HARD)

A

cough and dyspnea

due to arrival of immature heartworms in pulmonary vasculature and death of adult heartworms

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15
Q

Dx of feline asthma

A

administration of beta agonist if wheezing

chest rads

CBC-eosinophilia

Chem-increased TP

heartworm testing

fecal float

Airway wash

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16
Q

Chest rad findings for feline asthma

A

bronchial pattern

interstitial to patchy alveolar poss

collapse of right middle lung lobe-10%

overinflation of lung-increased lucency, flat, caudally displaced diaphragm, ventral bowing of caudal vena cava, extension of lung past L1

17
Q

Airway wash for feline asthma

A

endotracheal washe

BAL

reasons: to characterize the inflammatory response, ID infectious agents, ID neoplastic cells, atypical rads, don’t respond to tx

Increase total cell count, eos, neutrophils, macs, mixed, excessive mucus, culture + in 10-25%

18
Q

airway wash cytology normal

A

alveolar macs and lymphocytes

<10% are neutrophils

total cell count<400/ul

eos present

epithelial cells, goblet cells, mast cells

+/- positive culture

19
Q

Feline chronic bronchitis

A

airway inflammation

narrowing of airways is minimally reversible with bronchodilators

middle to old age

siamese

fibrosis, emphysema

BAL cytology variable

bacterial culture usually positive

rad changes severe

20
Q

hx and clinical signs for feline bronchitis

A

Chronic (>2 months) daily cough

episodes of wheezing and dyspnea

vomiting, coughing spells

PE findings similar to asthma

21
Q

dx of feline chronic bronchitis

A

Chem-increased TP

CBC-eosinophilia

Chest rads-bronchial patter, interstitial to patchy alveolar poss, emphysema, collapse of right middle lung lobe

airway wash-neutrophils, mucus, positive culture

22
Q

tx of feline bronchial disease

A

remove any underlying etiology

provide anti-inflammatory therapy

provide bronchodilator therapy

23
Q

tx of feline bronchial disease: environmental changes

A

unscented, dust free cat litter

remove hood for litterbox

change air filters

minimize exposure to smoke, aerosols, powder

24
Q

Tx of feline bronchial disease: methylxanthines

A

PO, injection

aminophylline, theophylline

phosphodiesterase inhibitors

inhibits calcium influx into cells

blocks adenosine receptors

increase contractility of fatigued muscle

inhibit mast cell degranulation

increase mucociliary clearance

prevent microvascular leakage

improve strength of respiratory muscles

side effects: GI upset, neurologic signs

25
Tx of feline bronchial disease: Beta2 agonist
PO, inhalant, injection terbutaline, albuterol relax bronchial smooth muscle, decrease mucus viscosity, enhance mucociliary clearance
26
tx of feline bronchial disease: glucocorticoids
anti-inflammatory PO, injection, inhalant high dose initially recommended often combined with bronchodilator fluticasone-inhalant
27
tx of feline bronchial disease: other tx
leukotriene inhibitors abx cyprohepatadene-serotonin inhibitor omega-3 fatty acids cyclosporine laser therapy hyposensitization
28
How should you treat a mildly affect asthmatic
environmental changes oral pred, slowly tapered bronchodilator-oral BID, inhalation PRN
29
how should you treat a moderate to severely affected asthmatic?
environmental changes oral pred for 2 weeks fluticasone BID bronchodilator
30
How should you treat a emergency case/dyspnic cat?
minimize handling oxygen cage SQ terbutaline IV dexamethasone Lasix if concurrent heart disease
31
Px for feline bronchial disease
early dx and proper therapy can be effective environmental changes make a difference some become refractory to therapy chronic cases very challenging to manage euthanasia for severe refractory cases
32
5 yo MC Siamese, indoor only Presenting complaint: chronic coughing, intermittent, no episodes of dyspnea but owner sometimes hears wheezing, getting worse over past 6 months PE: normal RR,Wheezes ausculted bilaterally, no cardiac abn, rest-normal What diagnostic test do you recommend?
CBC Chem Response to terbutaline chest rads
33
5 yo MC Siamese, indoor only Presenting complaint: chronic coughing, intermittent, no episodes of dyspnea but owner sometimes hears wheezing, getting worse over past 6 months PE: normal RR,Wheezes ausculted bilaterally, no cardiac abn, rest-normal Lab: CBC-eosinophilia, Chem-normal, Wheezing improves after terbutaline Chest rads: moderate bronchial pattern, early right middle lung lobe collapse What is your next diagnostic step?
no additional testing is needed
34
5 yo MC Siamese, indoor only Presenting complaint: chronic coughing, intermittent, no episodes of dyspnea but owner sometimes hears wheezing, getting worse over past 6 months PE: normal RR,Wheezes ausculted bilaterally, no cardiac abn, rest-normal Lab: CBC-eosinophilia, Chem-normal, Wheezing improves after terbutaline Chest rads: moderate bronchial pattern, early right middle lung lobe collapse What tx protocol do you recommend?
tapering oral steroids, oral bronchodilator BID

Cardiopulmonary test 1 (9 decks)

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