Lecture 16: Disease of the Upper RT 2 (Specht)

Question 1

where are CS localized in disease of upper RT?

Answer 1

at or below oropharynx

Question 2

canine infectious respiratory disease aka:

Answer 2

Kennel Cough

Infectious tracheobronchitis

Question 3

potential infectious agents of K9 infectious resp. dz**

Answer 3

Viruses: parainfluenza, adenovirus, distemper, influenza, pneumovirus
Bacteria: Bordetella, Mycoplasma, Strep

Question 4

CS of K9 infectious resp. dz

Answer 4

• SUDDEN ONSET of severe cough*
• gagging, retching, nasal d/c
• recent history of expsure*
• usually NO signs of systemic illness*

Question 5

Canine Influenza

Answer 5

5-8% mortality

• good prognosis
• supportive care
• prevent with standard sanitation

Question 6

K9 infectious resp. dz prevention

Answer 6

• prevent exposure
• SQ and IN vax against PIV, CAV, CDV
  
  • caution: intranasal vaccine given SC can cause liver necrosis!!

Question 7

K9 infectious resp. dz Dx/Tx/Prognosis

Answer 7

Dx: 
-presumptive based on Hx, CS, PE; CBC
-TTW,TXR may be indicated in progressive/systemic cases
-definitive dx: PCR**, culture
Tx:
-usually no Abx needed, self-limiting
\+/- cough suppressants
-NO steroids
Prog: excellent if uncomplicated

Question 8

collapsing trachea

Answer 8

dynamic narrowing of the tracheal lumen due to flattening of the cartilaginous rings and/or redundancy of dorsal tracheal membrane.

• most common at thoracic inlet, but can also occur at maintstem bronchi, intra or extra-thoracic trachea
• animal usually older, small breed, overweight

Question 9

collapsing trachea CS

Answer 9

-worsening, loud, non-productive cough (“goose honk”)**

Question 10

Dx of collapsing trachea**

Answer 10

TXR:
-intrathoracic collapse visible on expiratory films**
-extrathoracic collapse visible on inspiratory films**
Fluoroscopy (id’s dynamic processes)
Bronchoscopy if rads fail to confirm dx

Question 11

cautions of collapsing trachea

Answer 11

be careful about stress**
anesthesia risk
concurrent dz

Question 12

medical management of collapsing trachea

Answer 12

-reduce weight!!
-use harness
-min. exercise
-reduce inhaled irritants
-lomotil
+/- anti-tussives, glucocorticoids, bronchodilators (onlyif there is a small airway problem too)

Question 13

tx of collapsing trachea

Answer 13

• emergency airway management (O2, anxiolytics, intubation, etc.)
• salvage procedures (internal stents, external prostheses)

Question 14

collapsing trachea prog.

Answer 14

often progressive, depends on severity

Question 15

laryngeal paralysis

Answer 15

failure of arytenoid cartilage to abduct during inspiration. Usually idiopathic but can be assoc. with trauma, tumors, or polyneuropathies/myopathies

Question 16

laryngeal paralysis CS

Answer 16

-resp. distress
-stridor
-bark change
-cyanosis
-syncope (faint)
CS worse with increased resp. effort*
often neuro deficits such as trouble swallowing

Question 17

laryngeal paralysis Dx

Answer 17

• laryngoscopy (sedation required)
• arytenoids stay closed or collapse in during inspiration and open slightly during expiration
• tests to R/O underlying problems

Question 18

laryngeal paralysis Tx

Answer 18

• emergency airway management
• address underlying dz
• address obesity**
• env. factors
• sx intervention: unilateral arytenoid lateralization*

Question 19

disadvantage of unilateral arytenoid lateralization

Answer 19

can’t guard airway –> infection

Question 20

laryngeal paralysis prog.

Answer 20

depends…ok with sx correction

Question 21

brachiocephalic syndrome

Answer 21

complex of anatomic abnormalities including:
-stenotic nares
-elongated soft palate
-everted laryngeal saccules
-hypoplastic trachea
\+/- laryngeal collapse

Question 22

brachioceph. syndrome CS

Answer 22

• upper airway obstruction –> resp. distress, stertor, stridor, cyanosis, syncope
• worse with excitement, inc. temp.

Question 23

brach. syndrome dx/tx/prog.

Answer 23

Dx:
-presumptive based on breed/history/CS
-laryngoscopy, rads
Tx:
-airway management
-sx correction of elongated soft palate, stenotic nares, everted laryngeal saccules
-weight management**
Prognosis:
-depends on severity: severe hypoplastic trachea and laryngeal collapse the worst
-sx corrected defects should cause no further CS

Question 24

most common disease seen with laryngeal paralysis**

Answer 24

stridor (an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the larynx. It is most often heard when taking in a breath - web)