Feline LRT Disease Flashcards
What can be an important clue to diagnosis?
What age range tends to acquire lower airway disease in cats?
Age at presentation.
Lower airway disease tends to affect young adult to middle aged cats but can affect cats of any age.
What diseases do older cats increase suspicion for?
Hyperthyroidism
Neoplasia
Cardiac disease
What diseases do younger cats and kittens increase suspicion for?
Viral Parasitic Mycoplasma Bacterial Toxoplasma
What is the clinical history of feline LRT disease?
Usually a low grade chronic disease. Coughing. Audible wheezing. “Exercise intolerance”. Sometimes a very acute presentation... -brought in as an emergency -respiratory distress -mouth breathing -tachypnoea Episodic respiratory distress... -self limiting? -respiratory effort?
Check for a more chronic history in these cases….have the owners overlooked that the cat is coughing?
What questions should we ask about the patients’ history?
Are there any trigger factors? -change in environment? -new cat litter? -passive smoking? -seasonal? Is the cough productive? Is anything “brought up”? -often confusion with hair balls. Any significant weight loss, anorexia? -consider other differentials.
Acute or chronic disease?
Cats are excellent at masking their clinical signs…
quieter?
staying in bed all day?
less playful?
grooming less?
staying at floor level/reluctant to jump up on furniture?
An emergency presentation doesn’t always mean an acute disease.
Lower airway disease in the cat - graph.
Purple line – sudden deterioration from nowhere, clinical signs, a real sort of spike and continue having problems until effective treatment decided and given,
Other cats – fairly chronic low grade disease, subtle, owners may not be aware of it as very subtle signs,
Other – episodic crisises, sudden onset deterioration.
How to assess the cat and determine how critical the situation is?
Respiratory reserve often minimal. Sympathetic stimulation is counterproductive. -transport -waiting room -is it “cat friendly”? -physical exam Initial assessment should be hands off. Triage emergency patients - are there trained staff empowered to make decisions?
What should you prioritise?
Oxygenation
What should be observed during a physical examination?
Respiratory patterns (watch and listen, try to localise disease)
As an example, how could you use respiratory patterns to diagnose upper respiratory disease in cats?
Laryngeal disease - Laboured inspiration... stridor ↑ effort slow inspiratory phase - +/- change in... purr vocalisation
Fleur - cat that had laryngeal lymphoma (picture).
Here she has a temporary tracheotomy tube in place after her laryngeal biopsy was taken. It’s worth thinking about why a biopsy procedure might make things worse in a cat with severe respiratory distress associated with a laryngeal mass. She did well once she started chemotherapy for her lymphoma. Her tracheotomy tube was removed the day after she started treatment.
In upper airway disease in cats, what should you check the clinical history for signs of?
Dysphagia +/- salivation.
Coughing /gagging.
-might be triggered by eating/drinking
“Head shaking” behaviour.
What can be seen with lower airway disease in cats?
- Laboured expiration... prolonged expiratory phase additional expiratory push audible expiratory wheeze - ↑ airway resistance due to bronchospasm mucous bronchial wall thickening - +/- occasional paroxysmal cough owners may think “fur ball” - does the signalment fit?
Harder to pick up, harder for owners to pick up.
Increased expiratory effort – so lungs fill quite easily but it is hard for the lungs to empty.
Increased airway resistance, increased mucus production as part of an inflammatory response.
Spasm, thickening of the bronchial wall, contributing to narrowing of the airways.
What can be seen on physical examination of a cat with lower airway disease?
Can be deceptively normal - rule out other diseases? Auscultation: quiet room listen for an expiratory wheeze is the heart normal? --no murmur --no gallop rhythm --no tachycardia
