Pneumonia Flashcards
Which breeds are predisposed to aspiration pneumonia?
Brachycephalic breeds
Golden retriever
Cocker spaniel
English springer spaniel
Irish wolfhound
Which conditions are related to aspiration pneumonia?
Any type of vomiting Pancreatitis Intussuscpetion/ FB Ileus Mega-oesophagus Oesophageal motility disorder Hiatal hernia Oesophageal stricture Oesophagitis Prolonged GA Polyneuropathy Seizures Myasthenia Gravis Conditions leading to prolonged recovery Cricopharyngeal dyssynchrony Muscular dystrophy Oropharyngeal dysphagia Laryngeal disease Tracheostomy
How do infection canine pneumonias often begin?
viral colonization and infection of the upper respiratory tract with canine respiratory coronavirus, adenovirus, herpesvirus, pneumovirus, parainfluenza virus, or others
may then be colonised with bacteria such as Streptococcus (specifically Streptococcus equi subsp zooepidemicus and Streptococcus canis), Mycoplasma cynos, and Bordetella bronchiseptica
What are the common feline lower respiratory tract pathogens?
include Pasteurella spp, Escherichia coli, Staphylococcus spp, Streptococcus spp, Pseudomonas spp, B bronchiseptica, and Mycoplasma spp
Mycoplasma spp are considered normal flora in the upper respiratory tract and their role is controversial in lower respiratory tract infection. Because they are rarely identified cytologically and specific culture or polymerase chain reaction is needed to document the presence of these organisms, the role of Mycoplasma in cats (as well as in dogs) remains difficult to define.
What congenital conditions can cause an increased risk of pneumonia?
Innate - Primary ciliary dyskinesia
Complement deficiency
Leukocyte adhesion deficiency
Adaptive - Immunoglobulin deficiency
Severe combined immunodeficiency
What acquired conditions can lead to increased risk of aspiration pneumonia?
Innate - Bronchiectasis
Secondary ciliary dyskinesia
Adaptive - Retrovirus infection (eg, feline immunodeficiency virus, feline leukemia virus)
Endocrine or metabolic disease (eg, diabetes mellitus or hyperadrenocorticism)
Chemotherapy and other immunosuppressive therapy
Splenectomy
How do animals with bacterial pneumonia present?
generally present with mixed inspiratory and expiratory signs, similar to those seen with other diseases of the pulmonary parenchyma. Fever is detected in 16% to 50% of cases, so it is not a reliable indicator
How do you diagnose bacterial pneumonia?
confirmed by the presence of septic suppurative inflammation on airway cytology obtained through bronchoalveolar lavage (BAL) or tracheal wash, along with a positive microbiology culture
Inflammatory leukogram common
Check FIV/ FelV in cats
Arterial blood gas analysis
Radiographic evidence of bacterial pneumonia can appear as a focal, multifocal, or diffuse alveolar pattern, although early in the disease process infiltrates can be primarily interstitial
How may location of radiographic signs help diagnosis?
Ventral lung lobes are most commonly affected in aspiration pneumonia, and a caudodorsal pattern would be expected with inhaled foreign bodies or hematogenous bacterial spread. A lobar sign is often seen in cases of aspiration pneumonia in which the right middle lung lobe is affected
What are the ddx for a diffuse or focal interstitial pattern?
Early bacterial pneumonia Imminent congestive heart failure Pneumocystis canis infection Inhalant toxicity (eg, paraquat) Viral pneumonia
What are the ddx for an alveolar pattern?
Pneumonia Acute respiratory distress syndrome Congestive heart failure (perihilar in dogs) Fluid overload Eosinophilic bronchopneumopathy Coagulopathy Metastatic neoplasia Fungal pneumonia
What are the ddx for lobal alveolar consolitation?
Aspiration pneumonia (cranioventral, right middle)
Lung lobe torsion (cranial)
Atelectasis secondary to mucus plugging (right middle most commonly)
How are BAL samples from mycoplasma infections a bit different?
animals with mycoplasma pneumonia can have positive culture in the absence of cytologic evidence of sepsis.
Can do mycoplasma PCR
What empiracal treatment should be used in severe life threatening pneumonias?
Amox-clav + fluoroquinolone
how do you help to remove secretions?
nebulization with sterile saline can be achieved by directing the hosing from the nebulizer into a cage or animal carrier covered in plastic. Depending on how viscous secretions are, therapy can be provided for 15 to 20 minutes 2 to 4 times daily. In many cases, nebulization coupled with coupage can help the animal expectorate airway secretions,
