Lecture 29 11/19/24 Flashcards
Which viruses can cause viral pneumonia in dogs?
-distemper virus
-canine parainfluenza virus
-canine adenovirus 2
-influenza virus
Which viruses can cause viral pneumonia in cats?
-calicivirus
-herpesvirus
-FIP
-influenza virus
What are the characteristics of toxoplasmosis in cats?
-causes protozoal pneumonia in immunocompromised animals
-lungs are major site of replication
-pneumonia indicates generalized toxoplasmosis
Which protozoa causes protozoal pneumonia in young and immunocompromised dogs?
neospora
Which parasites can cause parasitic pneumonia?
-lungworms; Aelurostrongylus, Filaroides
-lung flukes; Paragonimus
-larval migration; roundworms, hookworms
-heartworms
-Angiostrongylus vasorum
What are the characteristics of heartworms in cats?
-causes heartworm associated resp. disease (HARD)
-due to infection with immature L4s that do not mature into adults
-inflammatory airway and lung parenchymal reaction
-lung changes remain despite death of L4s
-often misdiagnosed as asthma
What are the clinical signs of eosinophilic bronchopneumopathy?
-coughing
-gagging
-retching
-increased lung sounds
-dyspnea possible
What is the signalment for eosinophilic bronchopneumopathy?
-young adults
-medium to large breeds
-nordic breeds
-females > males
How is eosinophilic bronchopneumopathy diagnosed?
-radiographs/CT
-CBC: peripheral eosinophilia
-bronchoscopy
-BAL: >50% eosinophils
-ruling out parasites
What are the characteristics of eosinophilic bronchopneumopathy presentation?
-variety of radiographic signs based on phenotype
–diffuse mixed broncho-interstitial pattern, granulomas, alveolar pattern
-may have hilar lymphadenopathy
-possible bronchiectasis
How is eosinophilic bronchopneumopathy treated?
-allergen avoidance
-treat allergic disease
-systemic corticosteroids +/- inhaled corticosteroids
What is the prognosis of eosinophilic bronchopneumopathy?
-good for control
-can cure if cause is identified and removed
-relapse can occur if therapy is discontinued
-more guarded prognosis if eosinophilic pulmonary granulomatosis occurs
What are the characteristics of idiopathic pulmonary fibrosis in west highland white terriers?
-chronic, progressive, interstitial lung disease
-presents in middle to old age
-animals have prolonged history of resp. signs
-distinct pulmonary crackles on auscultation
What is important to note about the etiology and treatment of idiopathic pulmonary fibrosis in west highland white terriers?
both the etiology and the best treatment are currently unknown
Which dog breeds are most likely to develop pulmonary neoplasia?
-boxer
-doberman pinscher
-australian shepherd
-irish setter
-bernese mountain dog
What are the clinical findings in animals with pulmonary neoplasia?
-cough
-exercise intolerance
-distress
-potentially asymptomatic
-clinical signs vary in paraneoplastic syndromes
How is pulmonary neoplasia diagnosed?
-radiographs
-CT
-TTW/BAL
-fine needle aspirate
-biopsy
What are the treatments for pulmonary neoplasia?
-surgery
-chemotherapy (unlikely to be effective)
-stereotactic radiation therapy
-inhaled IL-15 possible
What are the characteristics of feline lung neoplasia?
-primary lung neoplasia less common in cats than dogs
-average age at diagnosis is 11-12 years
-history includes vague clinical signs and resp. signs
-carcinoma commonly metastasizes to the digits
-lymphoma can have variable radiographic presentation
How is feline pulmonary neoplasia diagnosed?
cytology on pleural effusion
What are the treatments for feline pulmonary neoplasia?
-palliative care
-chemotherapy
-NSAIDs or steroids
What is the prognosis of feline pulmonary neoplasia?
-often diagnosed in an advanced stage
-prognosis generally poor in advanced stages
-primary neoplasia without metastasis has better prognosis with surgical removal
-variable survival times
What is pulmonary thromboembolism?
obstruction of vessel via a clot from another area in the body
What is the consequence of a thromboembolism entering pulmonary circulation?
it obstructs blood flow and causes V/Q mismatch
What is Virchow’s triad for thrombosis?
-changes in vessel endothelium
-impairment of blood flow
-development of pro-thrombotic tendencies in the blood
How do arterial thrombi differ from venous thrombi?
-arterial thrombi consist of platelets and fibrin
-venous thrombi form under low shear conditions and consist of fibrin and entrapped erythrocytes
-thrombus that forms depends on underlying cause
-arterial vs venous impacts treatment choice
Which specific diseases are risk factors for pulmonary thromboembolism?
-cardiomyopathy
-heartworms
-glomerulonephritis/protein-losing nephropathy
-hyperadrenocorticism
-IMHA
-neoplasia
-nephrotic syndrome
-pancreatitis
-systemic lupus erythematous
-vasculitis
Which general conditions are risk factors for pulmonary thromboembolism?
-DIC
-immobility
-orthopedic surgery
-sepsis
-severe inflammation/inflammatory response syndrome
-severe systemic illness
-trauma
-vascular access
What are the functions of the pulmonary vasculature?
-filtration
-protect other vital structures
What is the prognosis of pulmonary thromboembolism?
-small ones are often subclinical
-large ones can cause sudden death
-degree of occlusion determines outcome
-response to thrombus produces additional pathology
What are the clinical signs of pulmonary thromboembolism?
-acute onset dyspnea
-restlessness
-cough
-normal auscultation
-cyanosis
Which clinical signs can occur when pulmonary thromboembolism causes hypoxia?
-tachypnea
-hemoptysis
-sudden collapse
-altered mentation
What are the determinants of severity for pulmonary thromboembolism?
-extent/size of embolism
-reflex humoral factors
-patient’s prior condition
What are the differentials for pulmonary thromboembolism?
-asthma
-pulmonary hemorrhage
-pleural space disease
-CHF
-ARDS
-airway obstruction
-pneumonia
What is the difficulty in diagnosing pulmonary thromboembolism in dogs?
there is no evidence-based, confirmed diagnostic approach
Which diagnostics are used for pulmonary thromboembolism?
-blood gases
-thoracic rads
-CT with angiography
-nuclear medicine scan
-echo
-thromboelastography
-D-dimers
What are the characteristics of radiology as a diagnostic tool for pulmonary thromboembolism?
-used to rule out other pulmonary disease
-non-specific
-may appear normal initially
-pulmonary vessels affected
-pulmonary infiltrates and pleural effusion possible
-focal/lobar hyperlucency, focal effusions, and/or focal alveolar patterns possible
What are the characteristics of A-a gradient as a diagnostic tool for pulmonary thromboembolism?
-Alveolar and arterial gradient measurement
-valid for patients on room air only
-take PAO2 minus PaO2
-normal is 10 to 15 mmHg; increased gradient may indicate PTE
What are the characteristics of P:F ratio as a diagnostic tool for pulmonary thromboembolism?
-P:F ratio is PaO2/FiO2
-normal is approximately 500
-decreased ratio may indicate PTE
What are the characteristics of D-dimers as a diagnostic tool for pulmonary thromboembolism?
-used to determine if thrombus has formed and is being broken down
-concentrations less than 250 ng/mL have a high sensitivity for the absence of PTE
-sensitive but non-specific
What are the therapies used for pulmonary thromboembolism?
-O2
-fluid therapy
-prevention of further PTE growth: heparin/warfarin/direct factor Xa anticoagulant
-possible thrombolytic therapy
What are the characteristics of feline pulmonary thromboembolism?
-rarely diagnosed
-most commonly associated with neoplasia, anemia, and pancreatitis
-demonstrate with dyspnea and resp. distress
