Lecture 15 - Respiratory diseases (specht) Flashcards
arytenoid cartilage fails to abduct during inspiration creating upper airway obstruction
laryngeal paralysis
what causes laryngeal paralysis
idiopathic most common
trauma
tumor
myopathies
primary signalment and CS of laryngeal paralysis
old fat lab
resp distress stridor bark change cyanosis synocope
dx laryngeal paralyssi
sedated laryngoscopic exam
explain the movement of the arytenoid cartilage with laryngeal paralysis
arytenoids CLOSE during inspiration (should be open)
only open slightly during expiration
a lot of dogs with laryngeal paralysis have concurrent issues with
esophageal motility
acute/emergency tx for laryngeal paralysis
O2
sedative
steroids
intubation/tracheostomy
prognosis for laryngeal paralysis tx with surgical correction
fair to good depending on underlying cause
patients that have laryngeal tie back surgery are predisposed to
aspiration pneumonia
components of brachycephalic airway syndrome
stenotic nares elongated soft palate everted laryngeal saccules hypoplastic trachea \+/- laryngeal collapse or paralysis
upper airway obstruction conditions can be exacerbated by
excitement
exercise
high temperature
secondary edema/inflammation further worsens
which conditions of brachycephalic syndrome cannot be sx corrected
hypoplastic trachea
laryngeal collapse
peri-operative complication when sx correcting components of brachycephalic syndrome
morbidity/mortality from inflammation
disease characterized by wheezing, coughing, and dyspnea due to spontaneous bronchoconstriction
feline bronchitis (asthma)
factors that contribute to feline asthma
bronchospasm SM hypertrophy increased mucous, decreased clearance inflammation fibrosis emphysema
cat w/ sudden onset of dyspnea, cough or wheezing or crackles, increased expiratory effort/time
feline asthma/bronchitis
asthma is normally slowly progressive, but can be exacerbated by
environmental changes (smoking, cat litter, cleaner, pollen, etc)
CXR of feline asthma
Bronchial pattern
hyperinflation of lungs
+/- aerophagia
airway wash of feline asthma p
eosinophilic, neutrophilic or mixed inflammation
basic tests that should be done before dx cat with asthma
HW ab and ag test
fecal analysis
emergency tx for feline asthma
O2
short-acting steroids (for inflammation)
short acting bronchodilators
mainstay therapy for feline asthma
long-term corticosteroids (prednisolone PO)
sympathomimetic beta agonist bronchodilators that can be used for feline asthma
terbutaline
albuterol
these can be used if patient is not maintaining on steroids or as emergency
only use bronchodilator with an antiinflamm/steroid on board do not only use bronchodilators (may increase mortality)!
prognosis of feline asthma
poor for cure
good for control of CS
common cause of sudden death in cats
obstruction of pulmonary arterial blood flow resulting in altered respiratory and hemodynamic function
PTE
dz that have been associated with PTE
Cushing's hypothyroidism PLN IMHA cardiac dz HW dz spesis DIC pancreatitis neoplasia
__ prevents the deposition of fibrin and platelets on the thrombus surface and is a controversial tx for PTE
Heparin
controversial bc must have enough antithrombin 3 in plasma and this may vary between patients
abrupt cessation of heparin therapy should be avoided bc
may induce prothrombic state
primary concern when using anticoagulant therapy to resolve PTE is
bleeding
prognosis for PTE
Poor
may be due to underlying dz
PTE may reoccur
most feline asthma patients require __ for the rest of their life
some steroids
pathophys of PTE
Clot blocks blood flow of pulmonary artery = VQ mismatch = neurogenic reflex = decreased CO and increased pulmonary vascular resistance, bronchoconstriction, more clots/prothrombic state
bad situation :(
SUDDEN onset of respiratory distress, tachypnea, dyspnea, depression, tachycardia, shock or sudden death
PTE
definitive dx for PTE
CT/MRI with angiogram
tx for PTE
No tx, just support
O2
+/- diuretic
reverse prothrombic state to dissolve thrombi (heparin, warfarin, clopidogrel)
fibrinolytics (streptokinase, TPA) - little data
anticoagulants used to prevent growth and formation of thrombi but do not directly dissolve already present clots
heparin, warfarin, clopidogrel
primary SE/concern: bleeding
common causes of non-cardiogenic pulmonary edema
neurogenic causes electrocution upper airway obstruction vasculitis ARDS allergic rxn toxins
tx w/ O2 and +/- furosemide, support
__ results in severe pulmonary damage due to aspiration pneumonia and water dilution of pulm surfactant leading to alveolar collapse and reduced compliance
near drowning
CS associated with smoke inhalation are due to
carboxyhemoglobinemia tissue hypoxia thermal injury = inflamm and edema direct toxic effect/chm burn suppression of mucociliary escalator and macs = increased risk of infection DIC
other common causes of respiratory dz not to forget about/not discussed
CHF neoplasia hypertension fibrosis hemorrhage ... more
