Lecture 25 11/18/24 Flashcards
What is included in upper airway localization?
-nasal passages
-pharynx
-larynx
-trachea
-mainstem bronchi
Where does rhinitis localize to?
nasal passages
What is the diagnostic approach for nasal disease?
-exam and history
-clinicopathologic data
-radiology/CT scan
-scoping
-cytology/biopsy and culture
What are the potential causes of feline rhinitis?
-infectious
-immune mediated and/or inflammatory
-neoplastic
-dental/oral pathology
-foreign body
What are the infectious etiologies of feline rhinitis?
-feline rhinotracheitis virus/feline herpes
-feline calicivirus
-Chlamydia felis
-Mycoplasma spp.
-Bordetella spp.
-influenza virus
What are the characteristics of feline rhinotracheitis virus?
-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
What are the characteristics of feline calicivirus?
-many strains with differing antigenicity and pathogenicity
-associated with oral ulcerations
-carrier state exists in absence of clinical signs
What are the characteristics of Mycoplasma felis?
-normal flora
-primary opportunistic pathogen
-typically only causes upper resp. tract disease
-culture and PCR often necessary for diagnosis
Which pathogens are common in coviral upper resp. infections in cats?
-FVR
-calicivirus
-FeLV
-FIV
Which bacteria is commonly found in feline upper resp. coinfections?
Chlamydia
What are the methods of transmission for feline upper resp. pathogens?
-direct
-indirect
-aerosol
Which factors impact the severity of URI clinical signs in cats?
-infecting dose and strain
-general health of cat
-pre-existing immunity
What are the clinical signs of an acute viral URI in cats?
-sneezing
-nasal discharge
-ocular signs
-pharyngitis/laryngitis
-drooling/gagging
-possible fever
How does FRV differ from feline calicivirus?
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
What are the characteristics of the course of infection for URI in cats?
-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
What are the characteristics of virulent calicivirus?
-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
What are the clinical signs of virulent calicivirus?
-fever
-URI
-oral ulcers
-nasal discharge
-ocular signs
-facial edema
-paw edema
-dermatitis on face, pinnae, and feet
What are the characteristics of chronic viral infections?
-predispose animal to opportunistic bacterial infections
-can damage epithelium and cause osteolysis of nasal turbinates without deformity of facial bones/soft palate
What are the characteristics of chronic FRV/herpes infection?
-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
What are the characteristics of chronic calicivirus infection?
-continuous excretion from carrier cats
-may recover spontaneously
-most shed for 30 days prior to recovery
-carriers have individual amounts of virus shedding
What is the diagnostic approach for acute viral infection?
-history/PE
-conjunctival smears and IFA
-viral cultures
-viral PCR panels
What is the diagnostic approach for chronic viral infection?
-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
What are the treatment steps for acute viral URI?
-oral or nasogastric tube for nutritional support
-humidification of air
-possible decongestants
-fluids
-pain management
-ocular medication
-antibiotics for secondary bact. infections
How is pneumonia secondary to a URI treated?
-supplemental oxygen
-antibiotics
-nutritional support
-hospitalization
Which medications are used for treatment of ocular herpes?
-trifluoridine
-cidofovir
-antibiotics for secondary bact. infection
What is important about famciclovir?
can be used for severe, recurrent, or persistent disease; or if cat displays severe conjunctivitis, facial dermatitis, or keratitis
What is the treatment approach for chronic URI?
-broad spectrum antibiotics for secondary bact. infections
-identifying/ruling out other underlying comorbidities
-supportive care
What are the characteristics of intranasal vaccination and its impact on URI?
-improvement of clinical signs found when intranasal vx used in cats with chronic URI
-potential dampening of pathogenic viral strains
What is the prognosis for acute URI in cats?
-good with supportive care in kittens
-good to excellent in adult cats
-potential for development of chronic infection
What is the prognosis for chronic URI in cats?
-usually not able to resolve
-requires long term support/management in many cases
What are the characteristics of maternal antibodies and URI?
-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
Which vaccines are considered core for cats?
-rabies
-FVRCP
-FeLV in cats < 1 year of age
Which vaccines are available for FVRCP?
-attenuated live
-canarypox-vectored
-inactivated
-intranasal
What are the characteristics of the intranasal FVRCP vx?
-stimulates local immunity
-not blocked by maternal antibodies
-rapid onset of protection
-may cause clinical signs
What are the characteristics of Bordetella bronchiseptica?
-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
What are the characteristics of Chlamydia felis?
-chronic, mucopurulent conjunctivitis
-hyperemia of nictitating membrane
-blepharospasm
-no corneal involvement
-can infect epithelial cells of ocular, resp, GI and repro. systems
Which fungal species can cause fungal rhinitis in cats?
-Cryptococcus neoformans
-Cryptococcus gatti
-histo
-blasto
-aspergillis
What are the characteristics of Cryptococcus?
-more common in cats than dogs
-yeast-like fungus with large capsule
-associated with bird droppings
What is the pathogenesis of Cryptococcus?
-most likely acquired through inhalation
-may disseminate
-capsule contributes to virulence
What is the clinical presentation of Cryptococcus?
-animal is bright and alert
-copious mucopurulent nasal discharge
-sneezing
-noisy or open-mouth breathing
-can have nasal, CNS, cutaneous, or systemic presentation
What are the nasal clinical signs of Cryptococcus?
-granulomatous tissue that fills nasal cavity
-lesion may break through bone and form swellings on bridge of nose or palate
What are the ocular clinical signs of Cryptococcus?
-epiphora due to compression of nasolacrimal duct
-granulomatous chorioretinitis
-retinal detachment
-blindness
How is Cryptococcus diagnosed?
-antigen test (preferred)
-antibody test
-histopath/cytology
-PCR
-fungal isolation
What is the treatment for Cryptococcus?
fluconazole or itraconazole for many months; monitoring therapy success with antigen test
How do gingivitis and dental disease relate to rhinitis?
-periodontal disease and profound gingival proliferation may be associated with Calicivirus carrier states
-virus causes persisting line of gingival reddening
What are the characteristics of lymphoplasmacytic rhinitis?
-chronic rhinosinusitis
-unknown etiology
-often refractory to treatment
-can only be diagnosed via biopsy
What are the characteristics of rhinitis caused by neoplasia?
-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
What are the characteristics of nasopharyngeal polyps?
-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
What are the potential causes of canine rhinitis/sinusitis?
-fungal
-bacterial
-parasitic
-viral
-allergic
-ciliary dyskinesia
-foreign body
-oral disease
-neoplasia
-epistaxis
Which fungi can cause canine rhinitis/sinusitis?
-blasto
-histo
-aspergillosis
-cryptococcus
What are the characteristics of Aspergillosis?
-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
What is the signalment of nasal aspergillosis cases?
-mesaticephalic and dolichocephalic breeds
-young to middle aged
-males > females
-immunocompetent and healthy
How is nasal aspergillosis diagnosed?
-CT with rhinoscopy
-cytology/biopsy
-culture of plaques
-serology; low sensitivity
What is the treatment for fungal rhinitis/sinusitis?
-trephination and local debridement
-topical infusion of antifungal
What are the characteristics of bacterial rhinitis in dogs?
-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
Which species can cause parasitic canine rhinitis?
-Pneumonyssus caninum
-Eucoleus bohemia
Which viruses are implicated in viral canine rhinitis?
-canine distemper virus
-herpesvirus
What are the characteristics of lymphoplasmacytic rhinitis in dogs?
-unknown cause
-seen in young to middle age dogs
-causes nasal discharge, stertor, and dyspnea
-diagnosed via biopsy
-ideal treatment is unknown
What are the characteristics of rhinitis caused by primary ciliary dyskinesia?
-inherited disease of defective ciliary function and poor mucus clearance
-recurrent infections of the airways leads to rhinitis, bronchopneumonia, bronchitis, and bronchiectasis
What are the characteristics of rhinitis caused by foreign body?
-FB can be inhaled or coughed up
-can be acute or chronic
-inflammatory/infectious causation
-removed with scope, flush, or surgery
What are the characteristics of rhinitis caused by oral disease in dogs?
-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
What are the characteristics of rhinitis caused by cancer in dogs?
-major cause of chronic nasal discharge in older dogs
-carcinomas occur more often than sarcomas
-need biopsy to diagnose
-surgery and radiation to treat
What are the local etiologies of epistaxis?
-trauma
-foreign body
-tumor
-infections
What are the systemic etiologies of epistaxis?
-coagulopathy
-thrombocytopenia/platelet function disorder
-hyperviscosity syndrome
-vasculitis
-systemic hypertension
What is the diagnostic plan for epistaxis?
-history
-PE with blood pressure readings
-platelets/coag. profile
-total protein
-buccal mucosal bleeding time
-general nasal workup
What is the treatment for epistaxis?
-sedatives
-cage rest
-epinephrine or phenylephrine
-packing of internal and external nares
-ice pack on nasal planum
