kennel cough

Question 1

etiologic agents

Answer 1

Bordetella bronchiseptica

canine parainfluenza virus

Canine adenovirus 1 & 2

Mycoplasma

secondary bacterial inf

Question 2

Bordetella bronchiseptica

Answer 2

primary bacterial pathogen

gram negative found in respiratory tract of normal dogs, affects multiple spp

can vary in genetic diversity and dz-causing potential

Question 3

Bordetella bronchiseptica: pathophysiology

Answer 3

transmitted through aerolization of organism in respiratory secretion and fomites

colonizes ciliated respiratory tract epithelium by utilizing severeal exotoxins and endotoxins which causes ciliary stasis and disables phagocytic cells

secondary bacterial infections common

can cause pneumonia and acute rhinitis

Question 4

parainfluenza virus

Answer 4

highly contagious

infections leads to damage of tracheal epithelium

infection by itself leads to only mild disease

often associated with secondary bacterial infections

no carrier state

Question 5

Canine adenovirus 1 & 2

Answer 5

CAV-1-not significant cause of kennel cough

CAV-2 infects respiratory and GI systems, infect by itself is mild, can infect type 2 alveolar cells and lead to pneumonia if secondary infection occurring

Question 6

Mycoplasma

Answer 6

can be primary respiratory pathogen

normal inhabitant

role not clear

can be associated with pneumonia

also isolated from cat noses

Question 7

secondary bacterial infections

Answer 7

often associated withe kennel cough

opportunistic gram + and - infections: Strep, Pasteurella, Pseudomonas, etc

may lead to severe pneumonia

Question 8

transmission

Answer 8

highly contagious

most common in summer and fall

direct oronasal contact with other dogs (CAV-2-urine)

fomites

Question 9

typical history

Answer 9

recent exposure to other dogs

incubation: 3-10 days

Question 10

clinical signs

Answer 10

hacking, paroxysmal nonproductive cough

otherwise healthy

cough elicited by tracheal palpation

cough often terminates with gagging and production of phlegm

symptoms are usually self-limiting

+/- acute rhinitis

snezzing

nasal and ocular d/c-serous

Question 11

DDx

Answer 11

canine influenza virus

tracheal FB

tracheal collapse

chronic bronchitis

chronic mitral valve disease

parasitis infection

tracheal tumor or polyp

Question 12

Diagnostic work up

Answer 12

often none is required

CBC-leukocytosis and left shift with severe cases

rads normal

transtracheal wash-do if pyrexic, PMN’s intracellular bacteria

PCR

Question 13

PCR

Answer 13

Canine respiratory disease panel

conjunctival swab and pharyngeal swab, nasal swab, TTW fluid

vax may interfere

best way to identify pathogens

Question 14

treatment

Answer 14

often none is required

Abx-if pyrexic (Clavamox, Tetracyclines, Baytril, Chloramphenicol, aminoglycosides-nebulized, azithromycin)

Antitussive therapy-hycodan, butorphanol

corticosteriods-do not use if pyrexic

severe cases: hospitalization, fluid therapy, nebulization, parenteral abx

Question 15

Clinical course

Answer 15

mild, usually self-limiting

may get severe bronchopneumonia

Question 16

Prevention

Answer 16

minimize exposure to infection-isolation of infected dogs, proper hygiene and disinfection

effective disinfectants: blead, nolvasan, Roccal-D

Question 17

vaccination

Answer 17

routine vax for parainfluenza, CAV2 and distemper

Bordetella parenteral (2 doses, 3-4 weeks apart, immunity within 1-2 weeks of 2nd dose) and intranasal vax (immunity within 4-14 days)

booster every 6 months

oral vaccine

Question 18

Feline Bordetella

Answer 18

many cats are seropositive for Bordetella

clinical illness rare-dry nonproductive cough, sneezing, ocular and nasal d/c, submandibular lymphadenopathy

self-limiting

tx: doxycycline, clavamox, tetracycline
vax: MLV intranasal vaccine-short lived immunity

Question 19

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: the cough in this dog is cardiogenic or noncardiogenic

Answer 19

noncardiogenic

Question 20

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: localize the cough to?

Answer 20

tracheal

Question 21

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: top DDx?

Answer 21

kennel cough

Question 22

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: what dx tests are recommended?

Answer 22

none

or Canine infectious respiratory disease PCR panel

let owner decide

Question 23

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: What tx would be most helpful for this dog?

Answer 23

none or cough suppressant

Question 24

3 yr FS mixed breed dog, 21 kg

presenting complaint: coughing for 2 days, otherwise healthy

hx: boarded at kennel ~1 weeks ago, started coughing the day after getting home. cough: hacking with terminal retch

PE: normal other than cough elicited with tracheal palpation.

Question: What is the likely clinical scenario?

Answer 24

The cough will resolve within 10 days

Question 25

transtracheal wash

Answer 25

Cytology: infectious agents-bacterial and fungal

inflammatory cells

neoplastic cells

foreign debris

hemorrhage

culture

landmark is cricohyoid cartilage

clip and prep area

local anesthetic block