Interstitial Disease

Question 1

What is IPF?

Answer 1

Interstitial Pulmonary Fibrosis
Seen in middle aged to older dogs

Question 2

Common history of IPF

Answer 2

Insidious onset (gradual)
Chronic breathlessness which is slowly progressive
Coughing can be a feature
Exercise intolerance
Owner may notice cyanosis
Can cause syncope
Unwormed animal

Question 3

Clinical exam of IPF

Answer 3

Crackles throughout lung fields
Prolonged expiratory phase
Expiratory dyspnoea

Question 4

How to diagnose IPF

Answer 4

Suggestive clinical signs
Thoracic radiographs
CT
Bronchoscopy
Lung biopsy is only method of DEFINITIVE diagnosis but very uncommon

NOT BAL but would rule out inflammatory conditions

Pulmonary hypertension
○ Severe interstitial/some alveolar pattern
○ Generalised cardiomegaly
○ Right sided emphasis
○ Abdominal distension
○ Hepatomegaly

Question 5

What would you see on a thoracic radiograph with IPF?

Answer 5

Generalised interstitial lung pattern
+/- right sided cardiomegaly
+/- pulmonary hypertension

Lace like overlay of lungs

Question 6

Treatment for IPF

Answer 6

Success depends on whether active inflammation is present
Symptomatic
* Avoid collars
* Avoid smoke inhalation
Inhaled or oral
* Bronchodilators
* Corticosteroids
Adjuvant immunosuppressive therapy

PROGNOSIS IS GUARDED - no cure
- Long term treatment

Question 7

What is interstitial pneumonia

Answer 7

Severe subacte to multifocal to coalescing interstitial pneumonia
Fluid in interstitium
Alveoli and airways usually spared

Question 8

What types of interstitial disease are there?

Answer 8

Parasites
Interstitial Pulmonary Fibrosis
Metastatic diseaase
Interstitial pneumonia