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CRS2 > Feline LRT Disease > Flashcards

Feline LRT Disease Flashcards

1
Q

What would you be most suspicious of in an older cat with LRT signs?

A

Increases suspicion for other disease such as:

  • hyperthyroidism
  • neoplasia
  • cardiac disease
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2
Q

What would you be most suspicious of in a younger cat with LRT signs?

A

Increases suspicion for:

  • infectious disease
    • viral
    • parasitic
    • Mycoplasma
    • bacterial
    • toxoplasma
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3
Q

How common is bacterial pneumonia in cats compared to dogs?

A
  • Bacterial pneumonia is relatively uncommon in cats compared with dogs
  • More likely to be inflammatory disease rather than bacterial cause if they have pulmonary pathology
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4
Q

What is the usual clinical history of a cat with LRT disease? What are the 3 ways it tends to present?

A
  1. Usually a low grade chronic disease
  • Coughing
  • Audible wheezing
  • “exercise intolerance”
  1. Sometimes a very acute presentation
  • Brought in as an emergency
  • Respiratory distress
  • Mouth breathing
  • Tachypnoea
  1. Episodic respiratory distress
  • Sometimes self-limiting
  • Sometimes will come and go
  • Respiratory effort?
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5
Q

What are the main questions that should be asked with a cat with LRT disease?

A
  • Are there any trigger factors?
    • Change in environment?
    • New cat litter?
    • Passive smoking?
    • Seasonal?
  • Is the cough productive?
  • Any significant weight loss, anorexia, signs of other systemic disease?
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6
Q

What behavioural changes might make you suspect a more chronic disease in cats?

A
  • quieter?
  • staying in bed all day?
  • less playful?
  • grooming less?
  • staying at floor level/reluctant to jump up on furniture?
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7
Q

What should be your first priority with a cat presented to you with respiratory signs?

A

Oxygenation and minimal handling

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8
Q

What clinical signs would make you suspect laryngeal disease, such as laryngeal lymphoma?

A
  • Laboured inspiration
    • stridor
    • ↑ effort
    • slow inspiratory phase
  • +/- change in
    • purr
    • vocalisation
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9
Q

What specific clinical signs would make you most suspicious of upper airway disease in cats?

A
  • Dysphagia +/- salivation
  • Coughing /gagging
    • might be triggered by eating/drinking
  • “Head shaking” behaviour
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10
Q

What clinical signs would make you more suspicious of lower airway disease in cats?

A
  • Often more subtle
  • Laboured expiration
    • Prolonged expiratory phase
    • Additional expiratory push
    • Audible expiratory wheeze
  • ↑ airway resistance due to
    • Bronchospasm
    • Mucous
    • Bronchial wall thickening
  • +/- occasional → paroxysmal cough
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11
Q

In a cat with lower respiratory tract disease, what type of condition will be at the top of your differentials list generally?

A

Inflammatory

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12
Q

What are the main two lower airway diseases we tend to see in cats?

A
  • Feline asthma
  • Chronic bronchitis
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13
Q

How is feline asthma caused?

A
  • Reversible
  • Inhaled allergen
  • Airway hyper reactivity
  • Bronchoconstriction
  • Sometimes get eosinophilic airway inflammation
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14
Q

What are the main clinical signs of feline asthma?

A

Episodic respiratory distress and dyspnoea

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15
Q

How is chronic bronchitis caused?

A
  • Response to infection or inhaled irritants
  • Airway damage
  • Excess mucus
  • Neutrophilic airway inflammation?
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16
Q

How is chronic bronchitis similar/different from feline asthma?

A
  • Similar inflammatory problem but doesn’t have the same degree of reactivity
  • More chronic
  • Coughing is a key clinical sign of chronic bronchitis (compared to episodic respiratory distress and dyspnoea in asthma)
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17
Q

What are the main differentials for a coughing cat?

A
  • Upper respiratory tract disease
  • Inflammatory lower airway disease
  • Infectious – bacterial, viral, parasitic
  • Foreign body
  • Neoplasia
  • Heart disease rarely causes coughing in cats
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18
Q

What are the main differentials for hyperpnoea/tachypnoea in a cat?

A
  • Stress/pain/fear response
  • CNS disease
  • Anaemia/hypovolaemia
  • Heatstroke
  • Think about non cardiorespiratory causes: could your patient have been in an RTA?
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19
Q

How useful are haematology and biochemistry when investigating a cat with LRT disease?

A
  • Haematology might be helpful as would indicate systemic inflammation, anaemia of chronic disease, eosinophilia etc. but often normal
  • Biochemistry is often normal
  • Therefore in a budget case haematology and biochemistry probably are not necessary, especially compared to diagnostic imaging
20
Q

What is the problem with attempting bronchoscopy in a cat with LRT disease?

A
  • Useful but we already have narrowed airways so doing this without causing further damage is not ideal in an animal of this size
  • Therefore not usually a first line approach in a coughing cat
21
Q

What are the main diagnostics you would consider using in a cat with LRT disease?

A
  • Diagnostic Imaging, esp. radiography or CT if available
  • Haematology and biochemistry?
  • Bronchoscopy?
  • Endotracheal wash
  • Faecal analysis for parasites
22
Q

Is it safe to go straight ahead with the investigations for a cat brought in as a respiratory emergency?

A
  • The crisis point in cats with episodic symptoms, it is not the ideal time to investigate
  • A dyspnoeic cat is often best left alone for a while and stabilised
23
Q

Why is general anaesthetic often safer for cats with suspected airway disease than sedation?

A
  • Better for these cats generally than sedation as you can control the airways and oxygenation
  • Also often shorter acting
  • And sedation may reduce the inspiratory effort and therefore oxygenation of the animal
24
Q

What would you expect to find on thoracic radiographs of a cat with LRT disease?

A
  • Might be normal
  • Bronchial pattern
  • +/- interstitial pattern
  • Hyperinflation
  • Air trapping
  • Collapse of R middle lung lobe? (sometimes)
  • Patchy alveolar pattern?
  • Aerophagia → air in stomach
25
Q

What would you expect to find on bronchoscopy in a cat with LRT disease?

A
  • hyperaemia
  • oedema
  • excess mucus
  • ↓ airway diameter
26
Q

What samples can be collected by carrying out a BAL/blind tracheal wash?

A
  • Cytology
  • bacterial culture
  • Mycoplasma PCR
27
Q

The cytology result of a BAL/blind tracheal wash comes back showing eosinophilic inflammation. What are the differentials for this?

A
  • viral pneumonia
  • parasitic
  • HES (hypereosinophilic syndrome)
28
Q
A
29
Q

What is Terbutaline and what is its effect?

A
  • Selective β2 receptor agonist
  • Smooth muscle relaxant
  • Bronchodilation
  • For use in critical cases in cats
  • Can give IV, IM or SC
30
Q

Why should you ideally rule out heart disease before using Terbutaline in an acute respiratory crisis?

A
  • Will cause tachycardia and therefore worsening oxygen demands for a failing heart
  • Not one to use if you are still unsure that heart failure is a problem or not, but if certain of airway disease then very useful
31
Q

What is inhaled salbutamol and how is it used?

A
  • Selective β2 receptor agonist
  • Smooth muscle relaxant
  • Bronchodilation
  • Can give every 30 mins for 2-4 hrs
  • Stop if stresses the patient
32
Q

How would you manage LRT disease once you get past the crisis stage?

A
  • Reduce allergens?
  • Prednisolone PO 2-3 weeks
  • Consider inhaled fluticasone if improved
33
Q

If a LRT case is not responding to prednisolone therapy, what would you do next?

A
  • Review case - It is probably not an inflammatory disease if not resolving
  • Repeat test for mycoplasma/or treat?
    • Was a Mycoplasma PCR carried out from an endotracheal wash previously?
    • If this wasn’t carried out initially then consider carrying it out here
  • Have we ruled out lungworm?
  • Consider ciclosporin
34
Q

What is the main risk with prednisolone therapy in cats?

A

Steroids are diabetogenic in cats. If side effects include polydipsia and polyuria treatment must stop!

35
Q

What is the name of the feline lungworm?

A

Aeleurostrongylus abstrusus

36
Q

How common is Aeleurostrongylus abstrusus?

A
  • Feline lungworm
  • The most common respiratory parasite in cats, but not overly common in cats generally due to worming regime
  • More so in young animals than older
  • Worming a cat that is coughing is never a bad thing
37
Q

What is the clinical presentation of feline lungworm?

A
  • Most infected cats are asymptomatic
  • Clinical presentation
  • Usually young cats
  • Mild coughing but might progress to → dyspnoea
  • Radiography: similar to inflammatory airway disease
38
Q

How is feline lungworm diagnosed?

A
  • Consider faecal flotation
  • Airway wash analysis
  • Often will just do a treatment trial instead
39
Q

How is feline lungworm (Aeleurostrongylus abstrusus) treated?

A

Fenbendazole

40
Q

Mycoplasma pneumonia (M.felis) might be a contributing factor in feline inflammatory airway disease, what are the clinical signs?

A
  • fever, cough, tachypnoea, lethargy
  • If you have a pyrexic cat with coughing, this should be higher on your list of differentials
41
Q

How would you diagnose and treat Mycoplasma pneumonia?

A
  • Diagnosis: PCR on tracheal wash
  • Treatment: doxycycline
42
Q

What consideration should you have when using doxycycline as a treatment in cats?

A

Can cause oesophageal stricture in cats so minimise risk of damage to the oesophagus

43
Q

What organisms are associated with mycobacterial pneumonia in cats?

A
  • M. bovis, M. microti
  • Rare in cats but remember it as a possibility
44
Q

What are the clinical signs of Mycobacterial Pneumonia?

A
  • Pneumonia represents late stage systemic spread of infection
  • Early cutaneous signs:
    • After bite from an infected vole or rodent
    • Non-healing sores or nodules +/- large LNs
  • Early GI signs:
    • After ingestion eg contaminated milk
    • Vomiting, diarrhoea, weight loss, poor appetite
    • Lesion = inflammatory granulomas
45
Q

How is Mycobacterial Pneumonia diagnosed and what major consideration is there with it?

A
  • Diagnosis: histopath and PCR
  • Seek advice because we need to consider zoonotic aspects

CRS2 (64 decks)

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