Pneumonias Flashcards
Pneumonia classifications
- Pathophysiology
- Clinical signs
How does bronchopneumonia get established?
- Via the pulmonary tree
Clinical signs with bronchopneumonia
- Think systemic signs
- Fever, lethargy
- +/- emphysema
- +/- sepsis
- Anterio-ventral lesions and lung sounds!! (Indicates consolidation)
How does metastatic pneumonia get established?
- Via blood (septic embolization from other foci)
- Classic: liver abscess and CVCT
What characterizes metastatic pneumonia?
- Fever, lethargy
- Sepsis
- Widespread abnormal lung sounds
- Hemoptysis
Interstitial pneumonia causes
- Diverse, but usually non-infectious
- Reaction from inahled or ingested antigens
What characterizes interstitial pneumonia?
- NOT febrile, depressed, or septic
- Diffuse abnormal lung sounds
- Don’t respond to routine therapies
Where do bacteria come from with bronchopneumonia most often?
- Normal flora of the upper respiratory tract
- This is why doing a TTW is not likely helpful
When do you get disease with bronchopneumonia?
- When host defenses are altered
Bronchopneumonia in beef common name
- Shipping fever
Bronchopneumonia in dairy common name
Enzootic pneumonia
What are the three agents that factor into bronchopneumonia of ruminants?
- Host
- Agent
- Environment
Host changes contributing to shipping fever or enzootic pneumonia
- Variations in host
- Immunologically naive
- Immunologically compromised
Environment changes contributing to shipping fever or enzootic pneumonia
- Temperature, humidity, air flow, nitrogen or ammonia content
- Don’t undershoot this importance
Agents for bronchopneumonia?
- Often just normal flora
- They do a respiratory panel that tests for the implicated viruses too
Acute signs of bronchopneumonia
- Rapid, shallow respiration
- Dyspnea, fever, anorexia, lethargy
- Moist cough
- Increased anterio-ventral lung sounds***
- Nasal discharge
- Adventitial sounds
- Reluctant to lay down
Subacute to chronic clinical signs of bronchopneumonia
- Weight loss, rough hair coat
- Moderate fever
- Tachycardia, tachypnea
- Mosit, productive cough
- Mucopurulent nasal discharge
- Ventral consolidation
- Adventitial sounds like crackles and wheezes
- Expiratory grunt, open mouth breathing
When do adventitial sounds occur?
- Later on in the disease
- As they crop up, often those animals are getting over the worst of it
- Wheezes from a narrowing of the airway (intraluminal or extraluminal)
If you hear adventitial sounds, where should you listen?
- Listen over the trachea because there can be referred noise?
- You can squeeze the trachea, make them cough, and get rid of the crackles (I guess this is important to him???**)
Treatment for Bronchopneumonia***
- Based on clinical diagnosis and assessment
Maybe no culture and sensitivity
- Response to therapy
- Frequent re-evaluation
What are the three main aspects of treatment for bronchopneumonia?
- Antimicrobials
- Anti-inflammatories
- Support
Ceftiofur
- Used a lot
- Cephalosporin
- There are different forms (Naxcel, Excenel, Excede)
What must you keep on with if you’re prescribing drugs to food animals?
- ALL federal and state laws
- They change a lot
- You could lose your license if you get this wrong
Florfenicol
- Don’t use in female dairy cows >20 months (AKA lactating dairy cows)
Enrofloxacin** labeled use
- ONLY RESPIRATORY disease, beef cattle, and non-lactating dairy cattle (female dairy cattle <20 months of age)
ELDU of Enrofloxacin
- Don’t do
- you could lose your license
Danofloxacin label
- Same strict label as with enrofloxacin
- Not for cattle intended for dairy production or veal
- Federal law prohibits ELDU of this drug in food -producing animals
Gamithromycin
- Macrolide
- Not used in people
- Don’t use in dairy cattle that are lactating, veal
Tildipirosin
- Prevo?
- Macrolide
- Don’t use in dairy cattle or veal calves
Oxytetracycline
Useful I think
- Don’t use in lactating dairy cattle
Tilmicosin
- Kills people
- Don’t use in dairy cattle >20 months
- Don’t use in horses, sheep, or goats due to toxicity
- FATAL to horses, pigs, and primates
Tylosin
- Antibiotic
Erythromycin
- Macrolide
Tulathromycin
- Very expensive
- Mostly FYI
Sulfadimethoxine
- Can’t use extra-labelly
- Only sulfonamide you can use
- Extra-label use of SDM is prohibited (higher dose, slow release bolus)
Procaine Penicillin G
- Generally used well
- IM
Ampicillin
- They use it
Flunixin meglumine***
- Anti-inflammatory
- Used IV ONLY
- Not for lactating cows
Aspirin
- he doesn’t like
- It’s cheap
Ketoprofen
- Least ulcerogenic of the drugs we have for anti-inflammatory
Phenylbutazone***
- Highly protein bound in cattle
- YOU CANNOT USE IN A FOOD PRODUCING ANIMAL
- Use of any phenylbutazone in an adult dairy cow is a violation of federal law
Drug withdrawals in healthy vs sick animals
- Remember that pharmacokinetics change when they are sick and can alter withdrawal times !
Drugs prohibited for ELDU
- Chloramphenicol
- Clenbuterol
- Diethylstilbestrol
- Dipyrione
- Fluoroquinolonges
- Glycopeptides
- Nitrofurans
- Nitroimidazoles
- Phenylbutazone (in adult dairy cattle)
- Sulfonamides (in adult dairy cattle)
What are the three R’s of support?
- Rest (dry, comfortable, ventilated, protected)
- Rumen (fresh palatable feeds, don’t force concentrates)
- Rehydration (oral, IV) - helpful for the mucociliary elevator
Why is rehydration so important?
- Helping the mucociliary elevator
Purpose of clinical scoring systems
- Evaluate efficacy of treatment to facilitate decisions - duration, changes, etc.
- Trying to evaluate efficacy of treatment
- Good for consultations
Bovine herpesvirus 1overview
- Alpha-herpesvirus
- Fragile, don’t survive outside the host
- Transmission requires contact**
Which BHVs are associated with respiratory infection?
1.1 and 1.2 subtype
Where is BHV-1 or IBR?
- Ubiquitous!
What phases of production does BHV-1 or IBR impact?
- ALL PHASES
- Feedlot, range, dairy, etc.
- Feedlot has highest M&M
Reservoir for BHV-1 or IBR
- Adults
- Latent infections**
- reactivated with stress
- MLV vaccines?
- ALSO in goats and wildlife
Transmission of BHV-1/IBR
- respiratory
- GIT
- Reproductive
If you get the respiratory version of BHV-1 or IBR, does that immunity protect against reproductive disease?
- No
Other signs associated with BHV-1
- Conjunctivitis
- Abortion
- Encephalitis
- Septicemia
Respiratory signs of Bovine Herpesvirus 1 or IBR
- Sudden fever (104°-106°)
- Anorexia
- nasal hyperemia
- nasal mucosa may have pustules, grey necrotic membranes
- Serous nasal/ocular discharge
- Salivation/panting
lung sounds in IBR/BHV-1
Normal to increased lung sounds
What type of fever do you expect with IBR/BHV-1?
- VERY high
- 104-106°
Recovery for IBR/BHV-1
10-14 days
Complications from IBR/BHV-1
- bacterial bronchopneumonia
- Tracheitis
- Bronchitis
Conjunctivitis signs of IBR/BHV-1
- Red, swollen, purulent discharge
- Corneal edema
Encephalitis signs of IBR/BHV-1
- ataxia, excitement/depression, blind, salivate, bellow, convulse
- Usually fatal
Who gets encephalitis from IBR/BHV-1?
- <6 months old
Septicemia/viremia form of IBR/BHV-1 - who gets?
- Calves in first week of life
- Naive herds
Septicemia/viremia form of IBR/BHV-1 - Clinical Signs
- Fever, anorexia, salivation, rhinitis, conjunctivitis, oral hyperemia, oral erosions
- Acute pharyngitis, laryngitis, esophagitis
- Often fatal
Diagnosis of BHV-1
- Clinical signs
- Viral isolation
- Seroconversion
- Antigen identification with fluorescent antibody
What can complicate identification of BHV-1?
- Virus may be isolated from stressed animals who are latently infected AND they may still have something else
Treatment for BHV-1
- No specific
- Support (3 R’s)
- Prevention and treatment of secondary infections (bacterial!)
Prevention of BHV-1
VACCINATION
- Hallmark of control
When to vaccinate for BHV-1
4-6 weeks
Management of BHV-1
- Minimize stress
- Avoid mixing animals with different immunity
Parainfluenza virus 3 (PI3) family and stability
- RNA, paramyxovirus family
- Very stable for an RNA virus
Who gets PI3?
- Cattle, sheep, and goats
Clinical disease of PI3?
- URT mucosa
- Interstitial pneumonia
- IMMUNOSUPPRESSION***
Where is PI3?
- Ubiquitous
Clinical signs of PI3
- Fever
- Nasal discharge
- Cough, dyspnea
- Auscultation shows increased sounds in the anterioventral region
Recovery of PI3 - how long does it take?
- 4-7 d if uncomplicated
What is the biggest worry with PI3?
- Secondary bacterial pneumonia
Diagnosis of PI3
- VI (nasal swab) in acute phase
- Serology
- Lungs will be present for extended period after infection
Treatment of PI3
- No specific treatment, just support
- Antibiotics for 2° bacterial
Prevention of PI3
- vaccinate
Bovine Respiratory Syncytial virus - what type?
- RNA
- Paramyxovirus
who gets BRSV?
- All ages but young prevalence