Pulmonary diseases Flashcards
What are Ddx for inspiratory dyspnoea?
- Laryngeal paralysis
- Laryngeal neoplasia
- Tracheal mass / stenosis
What are Ddx for expiratory dyspnoea?
- Dynamic airway collapse
- Feline asthma
What are Ddx for inspiratory + expiratory dyspnoea?
- Pulmonary parenchymal disease (Pneumonia; pulmonary oedema; Idiopathic pulmonary fibrosis IPF)
- Pleural effusions
- Pneumothorax
- Pulmonary thromboembolism
When doing a clinical exam what should be done?
- Mucus membrane colour (cyanosis?)
- Auscultate heart and lung field
- Assess thoracic compressibility (cats)
- Percussion
- Effect of body position on dyspnoea?
- Watch ribs from above (no movement in tension pneumothorax, any flail segments?)
- Normal respiration or paradoxical?
When is aspiration pneumonia seen in SA?
- Megaoesophagus
- Laryngeal paralysis after tie-back surgery
What does ventral / caudodorsal distribution suggest with pneumonia?
- Ventral = suggest airway disease / aspiration
- Caudodorsal = suggest haematogenous spread
What is Pnneumocystis carinii? Tx?
- Yeast like fungus
- Cavalier King Charles puppies have immunoglobulin deficiency and may present with dyspnoea due to PC pneumonia
- Tx = Only responds to TMP sulphonamides
What is Angiostrongylus vasorum? What does it cause?
- “French heart worm” infestation.
- In pulmonary vessels
- Causes respiratory signs: cough, shortness of breath, hypoxaemia, exercise intolerance.
- Can also cause coagulopathies, neurological signs etc
How is angiostrongylosis diagnosed?
- Faecal baermann
- Rectal swab, smeared onto slide
- SNAP test
What are other pulmonary conditions resulting in dyspnoea?
- Cardiac disease
- Pulmonary neoplasia / metastatic neoplasia - need 3 x-ray views (R-lat, L-lat + DV)
When would you do FNA of lung mass?
- Only if next to chest wall - ultrasound guided
- otherwise = risk of pneumothorax
Where can bronchogenic carcinoma metastasize to?
- Extremities = digits
What pulmonary condition is common in westies?
- Idiopathic pulmonary fibrosis
What is seen with idiopathic pulmonary fibrosis?
- Slow, insidious progression
- Dogs have inspiratory and expiratory dyspnoea, rapid, shallow breathing, can develop rectus abdominus hypertrophy and become cyanotic on minimal exertion.
- Characteristic “crackles” like cellophane on lung field auscultation
- Become severely disabled
- May be similar to diffuse fibrosing alveolitis in humans
What is treatment of idiopathic pulmonary fibrosis?
- Symptomatic support
- Restrict exercise + excitement
- Give o2 (expensive)
- Bronchodilators
- Mycophenolate
What is Paraquat poisoning?
- Herbicide
- Severe pneumotoxin
- Results in severe dyspnoea (initially with minimal radiographic findings).
- Initial alveolitis progresses to severe pulmonary fibrosis
- Very poor / hopeless prognosis
Pulmonary thromboembolism is usually due to an underlying systemic disease, what can these be?
- IMHA
- Protein losing conditions (especially nephropathy)
- Hyperadrenocorticism (Cushing’s disease)
- Pancreatitis
- Sepsis
*D.I.C
How is suspected pulmonary thromboembolism treated?
- Oxygen supplementation
- Sedation / anxiolytic
- Treat underlying disease
- Antiplatelet medication (clopridogrel)
- Anticoagulation tx to prevent further episodes
What is ARDS (Acute Respiratory Distress Syndrome)?
- In life, a form of non-cardiogenic pulmonary oedema. Respiratory distress with alveolar infiltrates on radiographs.
- Various initiating factors, especially pneumonia,
electrocution, smoke inhalation, near drowning,
trauma, sepsis, DIC.
