Pulmonary 2, and Pleural Space Disorders Flashcards
What are the primary types of pulmonary neoplasia?
adenocarcinoma
squamous cell carcinoma
What are the clinical signs of pulmonary neoplasia?
- crackles, wheezes, or muffled sounds
- cough, dyspnea, tachypnea, hemoptysis
- weight loss, inappetance, lameness
- dysphagia/regurg (megesophagus)
- edema of head/neck (venous obstruction)
How do you diagnose pulmonary neoplasia?
- radiographs, 3 views
- cytology: FNA of mass, bronchoscopy, biopsy
What is the treatment for pulmonary neoplasia?
if primary: surgery removal
if metastatic: treat primary mass, chemotherapy
What is pulmonary edema?
accumulation of fluid in alveoli or pulmonary interstitium
What are the four mechanisms of non-cardiogenic pulmonary edema?
- vascular overload/increased hydrostatic pressure
- decreased plasma oncotic pressure
- increased alveolar-capillary membrane permeability
- lymphatic obstruction
What is seen on thoracic radiographs with pulmonary edema?
alveolar pattern on caudo-dorsal lung fields
What is the treatment for pulmonary edema?
- control of primary disease
- cage rest and oxygen therapy
- supportive care (sedation, IV fluids, positive pressure ventilation)
What is ALI?
- acute lung injury
- pulmonary inflammation and edema resulting in acute respiratory failure
What is ARDS?
- acute respiratory distress syndrome
- severe manifestation of acute lung injury
- severe hypoxemia
What is a pulmonary contusion?
leakage of blood into the lungs as a result of trauma
What is the treatment for pulmonary contusions?
- oxygen therapy
- IV fluids
- pain medication for trauma
What is eosinophilic bronchopneumopathy?
- inflammation of the lungs
- due to hypersensitivity to unknown antigen
Who is predisposed to eosinophilic bronchopneumopathy?
siberian huskies
young to middle-aged animals
What are the clinical signs of eosinophilic bronchopneumopathy?
- harsh cough
- progressive respiratory difficulty
- exercise intolerance
- nasal discharge
- anorexia/lethargy
How do you diagnose eosinophilic bronchopneumopathy?
- auscultation: crackles, exp wheezes
- hematology: eosinophilia
- pulse ox and blood gas: hypoxemia
- radiographs: diffuse bronchointerstitial patterns, alveolar infiltrates
- cytology, TTW, BAL
What is the treatment for eosinophilic bronchopneumopathy?
- Treat underlying disease
- if parasitic: Fenbendazole
- prednisone
- other immunosuppressives
What is pulmonary thromboembolism?
- obstruction of pulmonary arteries and arterioles
- ventilation/perfusion abnormalities
What diseases predispose to pulmonary thromboembolism?
- heartworm
- immune-mediated hemolytic anemia
- nephrotic syndrome
- hyperadrenocorticism
- pancreatitis
- DIC
- endocarditis
How do you treat pulmonary thromboembolism?
- oxygen supplementation
- treat underlying disease
- bronchodilators
- prednisolone in IMHA and heartworm
- low dose heparin if DIC
What are the general clinical signs of pleural space disorders?
- rapid shallow breathing
- dyspnea
- possible open mouth breathing
- cyanosis
- exercise intolerance
Describe the auscultation of an animal with pleural effusion and pneumothorax
both: muffled heart sounds and muffled lung sounds ventrally
effusion: increased lung sounds dorsally
pneumothorax: decreased lung sounds dorsally
What is pleural effusion?
accumulation of excessive amounts of fluid within the pleural space
Do cats get pulmonary edema due to CHF?
Why or why not?
Do dogs?
- cats do not often get pulmonary edema because pleural veins drain into the left atrium
- dogs often get pulmonary edema because pleural veins drain into the right atrium
How do you diagnose pleural effusion?
- pulmonary sounds auscultated dorsally
- severe, shallow breaths due to inability to expand lungs
- radiographs
When do dog get pyothorax?
Cats?
Dogs: secondary to inhaled foreign bodies or penetrating injury, pneumonia
Cats: secondary to penetrating bite wounds, oropharyngeal aspiration, or URTI
How is pyothorax diagnosed?
- signs: tachypnea, shallow breathing
- cytology: degenerative neutrophils/bacteria
- radiographs, CT
How do you treat pyothorax?
- drainage and lavage through thoracotomy tube (bilateral in cats)
- lavage of warm saline
- long term antibiotics based on culture/cytology (amoxyclav, metronidazole)
- surgery if not improvement
What causes chylothorax?
- any disease that increases systemic venous pressure
- rupture of thoracic duct
How do you diagnose chylothorax?
thoracocentesis: white to pink opaque fluid
- triglycerides in fluid > in serum
What is the treatment for chylothorax?
- treat underlying cardiomyopathy if present
- thoracic drainage
- Rutin (stimulates macrophages to carry away fat)
- ligation of thoracic duct
What is the sequel to chylothorax?
restrictive pleuritis
What is pneumothorax, and what is the most common cause?
- air in the pleural space
- blunt force trauma
Describe the radiograph of an animal with pneumothorax
- absence of pulmonary vasculature to chest wall
- dorsal displacement of heart and trachea
- retraction of lung from chest wall
- increased density in collapsed lobe
What is the treatment for pneumothorax?
- emergency thoracocentesis
- analgesia
- oxygen therapy
- surgery
Explain the procedure of a thoracocentesis
- sternal or lateral recumbency
- surgical prep at 7-8th ICS
- insert needle at cranial border of rib
- advance needle in ventral direction
- open stopcock and use suction
