Lecture 25 11/18/24 Flashcards

1
Q

What is included in upper airway localization?

A

-nasal passages
-pharynx
-larynx
-trachea
-mainstem bronchi

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2
Q

Where does rhinitis localize to?

A

nasal passages

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3
Q

What is the diagnostic approach for nasal disease?

A

-exam and history
-clinicopathologic data
-radiology/CT scan
-scoping
-cytology/biopsy and culture

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4
Q

What are the potential causes of feline rhinitis?

A

-infectious
-immune mediated and/or inflammatory
-neoplastic
-dental/oral pathology
-foreign body

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5
Q

What are the infectious etiologies of feline rhinitis?

A

-feline rhinotracheitis virus/feline herpes
-feline calicivirus
-Chlamydia felis
-Mycoplasma spp.
-Bordetella spp.
-influenza virus

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6
Q

What are the characteristics of feline rhinotracheitis virus?

A

-unusual to have concurrent lower resp. problems
-generally more severe URT signs
-most cats exposed in their lifetime
-most infected cats develop latent infection in trigeminal ganglia

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7
Q

What are the characteristics of feline calicivirus?

A

-many strains with differing antigenicity and pathogenicity
-associated with oral ulcerations
-carrier state exists in absence of clinical signs

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8
Q

What are the characteristics of Mycoplasma felis?

A

-normal flora
-primary opportunistic pathogen
-typically only causes upper resp. tract disease
-culture and PCR often necessary for diagnosis

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9
Q

Which pathogens are common in coviral upper resp. infections in cats?

A

-FVR
-calicivirus
-FeLV
-FIV

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10
Q

Which bacteria is commonly found in feline upper resp. coinfections?

A

Chlamydia

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11
Q

What are the methods of transmission for feline upper resp. pathogens?

A

-direct
-indirect
-aerosol

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12
Q

Which factors impact the severity of URI clinical signs in cats?

A

-infecting dose and strain
-general health of cat
-pre-existing immunity

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13
Q

What are the clinical signs of an acute viral URI in cats?

A

-sneezing
-nasal discharge
-ocular signs
-pharyngitis/laryngitis
-drooling/gagging
-possible fever

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14
Q

How does FRV differ from feline calicivirus?

A

FRV:
-affinity for conjunctiva, upper airway epithelium, and cornea
-causes ocular problems
Calici:
-affinity for lung and oral mucosa
-causes pneumonia and oral ulcers
-less virulent
-may affect joint and cause limping

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15
Q

What are the characteristics of the course of infection for URI in cats?

A

-high morbidity for all etiologies
-higher mortality if cat is < 6 months old
-secondary bact. infections common
-disease course of 1-4 weeks depending on virus

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16
Q

What are the characteristics of virulent calicivirus?

A

-more common in adult, vaccinated cats
-can persist in environment for 28 days
-outbreaks appear self-limiting
-awareness and isolation required
-killed vaccine may help

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17
Q

What are the clinical signs of virulent calicivirus?

A

-fever
-URI
-oral ulcers
-nasal discharge
-ocular signs
-facial edema
-paw edema
-dermatitis on face, pinnae, and feet

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18
Q

What are the characteristics of chronic viral infections?

A

-predispose animal to opportunistic bacterial infections
-can damage epithelium and cause osteolysis of nasal turbinates without deformity of facial bones/soft palate

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19
Q

What are the characteristics of chronic FRV/herpes infection?

A

-almost all cats infected become chronic carriers
-periods of latency interspersed with episodes of infectious viral shedding
-shedding begins 1 week after stress and continues for another week

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20
Q

What are the characteristics of chronic calicivirus infection?

A

-continuous excretion from carrier cats
-may recover spontaneously
-most shed for 30 days prior to recovery
-carriers have individual amounts of virus shedding

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21
Q

What is the diagnostic approach for acute viral infection?

A

-history/PE
-conjunctival smears and IFA
-viral cultures
-viral PCR panels

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22
Q

What is the diagnostic approach for chronic viral infection?

A

-signs may persist due to mucosal damage and secondary bact. infection; may not find virus
-diagnosed through elimination
-history/clinical signs
-CT/rhinoscopy and biopsy

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23
Q

What are the treatment steps for acute viral URI?

A

-oral or nasogastric tube for nutritional support
-humidification of air
-possible decongestants
-fluids
-pain management
-ocular medication
-antibiotics for secondary bact. infections

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24
Q

How is pneumonia secondary to a URI treated?

A

-supplemental oxygen
-antibiotics
-nutritional support
-hospitalization

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25
Q

Which medications are used for treatment of ocular herpes?

A

-trifluoridine
-cidofovir
-antibiotics for secondary bact. infection

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26
Q

What is important about famciclovir?

A

can be used for severe, recurrent, or persistent disease; or if cat displays severe conjunctivitis, facial dermatitis, or keratitis

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27
Q

What is the treatment approach for chronic URI?

A

-broad spectrum antibiotics for secondary bact. infections
-identifying/ruling out other underlying comorbidities
-supportive care

28
Q

What are the characteristics of intranasal vaccination and its impact on URI?

A

-improvement of clinical signs found when intranasal vx used in cats with chronic URI
-potential dampening of pathogenic viral strains

29
Q

What is the prognosis for acute URI in cats?

A

-good with supportive care in kittens
-good to excellent in adult cats
-potential for development of chronic infection

30
Q

What is the prognosis for chronic URI in cats?

A

-usually not able to resolve
-requires long term support/management in many cases

31
Q

What are the characteristics of maternal antibodies and URI?

A

-interfere with vx responses
-variable duration; 2-10 weeks for FRV, 10-14 weeks for calicivirus
-kittens may be susceptible to disease beginning at 1 month of age

32
Q

Which vaccines are considered core for cats?

A

-rabies
-FVRCP
-FeLV in cats < 1 year of age

33
Q

Which vaccines are available for FVRCP?

A

-attenuated live
-canarypox-vectored
-inactivated
-intranasal

34
Q

What are the characteristics of the intranasal FVRCP vx?

A

-stimulates local immunity
-not blocked by maternal antibodies
-rapid onset of protection
-may cause clinical signs

35
Q

What are the characteristics of Bordetella bronchiseptica?

A

-can be isolated in healthy cats
-shed in oral and nasal secretions of infected cats
-risk factors involve stress, overcrowding, and coinfections
-signs include sneezing, mild upper resp. signs, pneumonia, dyspnea, cyanosis, and death

36
Q

What are the characteristics of Chlamydia felis?

A

-chronic, mucopurulent conjunctivitis
-hyperemia of nictitating membrane
-blepharospasm
-no corneal involvement
-can infect epithelial cells of ocular, resp, GI and repro. systems

37
Q

Which fungal species can cause fungal rhinitis in cats?

A

-Cryptococcus neoformans
-Cryptococcus gatti
-histo
-blasto
-aspergillis

38
Q

What are the characteristics of Cryptococcus?

A

-more common in cats than dogs
-yeast-like fungus with large capsule
-associated with bird droppings

39
Q

What is the pathogenesis of Cryptococcus?

A

-most likely acquired through inhalation
-may disseminate
-capsule contributes to virulence

40
Q

What is the clinical presentation of Cryptococcus?

A

-animal is bright and alert
-copious mucopurulent nasal discharge
-sneezing
-noisy or open-mouth breathing
-can have nasal, CNS, cutaneous, or systemic presentation

41
Q

What are the nasal clinical signs of Cryptococcus?

A

-granulomatous tissue that fills nasal cavity
-lesion may break through bone and form swellings on bridge of nose or palate

42
Q

What are the ocular clinical signs of Cryptococcus?

A

-epiphora due to compression of nasolacrimal duct
-granulomatous chorioretinitis
-retinal detachment
-blindness

43
Q

How is Cryptococcus diagnosed?

A

-antigen test (preferred)
-antibody test
-histopath/cytology
-PCR
-fungal isolation

44
Q

What is the treatment for Cryptococcus?

A

fluconazole or itraconazole for many months; monitoring therapy success with antigen test

45
Q

How do gingivitis and dental disease relate to rhinitis?

A

-periodontal disease and profound gingival proliferation may be associated with Calicivirus carrier states
-virus causes persisting line of gingival reddening

46
Q

What are the characteristics of lymphoplasmacytic rhinitis?

A

-chronic rhinosinusitis
-unknown etiology
-often refractory to treatment
-can only be diagnosed via biopsy

47
Q

What are the characteristics of rhinitis caused by neoplasia?

A

-lymphoma most common, followed by adenocarcinoma and squamous cell carcinoma
-lymphoma treated with chemo and radiation
-other tumors treated with radiation only
-NSAIDs may help treat adenocarcinoma

48
Q

What are the characteristics of nasopharyngeal polyps?

A

-non-neoplastic inflammatory nodules that are most common in young cats
-originate in middle ear or auditory canal and grow out through nasopharynx
-disrupt normal flow of secretions

49
Q

What are the potential causes of canine rhinitis/sinusitis?

A

-fungal
-bacterial
-parasitic
-viral
-allergic
-ciliary dyskinesia
-foreign body
-oral disease
-neoplasia
-epistaxis

50
Q

Which fungi can cause canine rhinitis/sinusitis?

A

-blasto
-histo
-aspergillosis
-cryptococcus

51
Q

What are the characteristics of Aspergillosis?

A

-causes chronic nasal discharge, sneezing, and changes in nasal planum color
-local nasal immune dysfunction suspected
-turbinate/bone destruction can extend through cribriform plate and into brain

52
Q

What is the signalment of nasal aspergillosis cases?

A

-mesaticephalic and dolichocephalic breeds
-young to middle aged
-males > females
-immunocompetent and healthy

53
Q

How is nasal aspergillosis diagnosed?

A

-CT with rhinoscopy
-cytology/biopsy
-culture of plaques
-serology; low sensitivity

54
Q

What is the treatment for fungal rhinitis/sinusitis?

A

-trephination and local debridement
-topical infusion of antifungal

55
Q

What are the characteristics of bacterial rhinitis in dogs?

A

-primary chronic bacterial rhinitis is not common
-rule out underlying diseases and predisposing factors
-Bordetella bronchiseptica and Mycoplasma cynos can be isolated from both sick and healthy dogs
-Strep. equi zooepidemicus can cause chronic rhinitis and/or severe bronchopneumonia

56
Q

Which species can cause parasitic canine rhinitis?

A

-Pneumonyssus caninum
-Eucoleus bohemia

57
Q

Which viruses are implicated in viral canine rhinitis?

A

-canine distemper virus
-herpesvirus

58
Q

What are the characteristics of lymphoplasmacytic rhinitis in dogs?

A

-unknown cause
-seen in young to middle age dogs
-causes nasal discharge, stertor, and dyspnea
-diagnosed via biopsy
-ideal treatment is unknown

59
Q

What are the characteristics of rhinitis caused by primary ciliary dyskinesia?

A

-inherited disease of defective ciliary function and poor mucus clearance
-recurrent infections of the airways leads to rhinitis, bronchopneumonia, bronchitis, and bronchiectasis

60
Q

What are the characteristics of rhinitis caused by foreign body?

A

-FB can be inhaled or coughed up
-can be acute or chronic
-inflammatory/infectious causation
-removed with scope, flush, or surgery

61
Q

What are the characteristics of rhinitis caused by oral disease in dogs?

A

-want to do complete oral and dental exam
-may require anesthesia and dental rads to diagnose
-want to look in back of mouth for foreign bodies

62
Q

What are the characteristics of rhinitis caused by cancer in dogs?

A

-major cause of chronic nasal discharge in older dogs
-carcinomas occur more often than sarcomas
-need biopsy to diagnose
-surgery and radiation to treat

63
Q

What are the local etiologies of epistaxis?

A

-trauma
-foreign body
-tumor
-infections

64
Q

What are the systemic etiologies of epistaxis?

A

-coagulopathy
-thrombocytopenia/platelet function disorder
-hyperviscosity syndrome
-vasculitis
-systemic hypertension

65
Q

What is the diagnostic plan for epistaxis?

A

-history
-PE with blood pressure readings
-platelets/coag. profile
-total protein
-buccal mucosal bleeding time
-general nasal workup

66
Q

What is the treatment for epistaxis?

A

-sedatives
-cage rest
-epinephrine or phenylephrine
-packing of internal and external nares
-ice pack on nasal planum