Pulmonary Parenchymal Disorders Flashcards
What are the clinical signs of pulmonary disease?
- difficulty breathing (expiratory)
- increased rate and effort
- coughing
- exercise intolerance
- crackles on auscultation
- orthopnea
What is pneumonia?
inflammatory disorder of the pulmonary parenchyma
What is the most common cause of pneumonia in the dog?
bacteria
What are the general clinical signs of pneumonia?
- soft, ineffectual cough
- difficulty breathing on expiration
Which pathogens are the most common in primary bacterial pneumonia?
Bordetella
Pasteurella
Which diagnostics are used to detect bacterial pneumonia?
- hematology (neutrophilia)
- thoracic radiograph
- transtracheal wash
- cytology and culture
- bronchoscopy
Describe a thoracic radiograph of a dog with bacterial pneumonia
- alveolar patterns
- right middle lung lobe collapsed
- right cranial lobe also affected
- deviated trachea due to megaesophagus
What are the treatments for bacterial pneumonia?
- antibiotics pending culture results
- nebulization (saline +/- gentamycin)
- supportive care
Which diagnostics are used to detect mycotic pneumonia?
- urine or serum antigen titers
- cytology/histopathology
Describe the pathogenesis of Blastomycosis
- inhalation of spores from environment
- Blastomyces establishes in the lungs, then disseminates throughout the body
What are the clinical signs of Blastomycosis?
- often none
- fever
- emaciation
- dry, harsh cough
- lymphadenopathy
- exercise intolerance
- some will have ocular lesions, skin lesions, or bone lesions
Which diagnostics are used to detect Blastomycosis?
- radiographs, US, MRI, CT
- hematology, biochem
- cytology, histopathology
- serology (AGID, ELISA, PCR, radioimmunoassay)
What are the treatments for Blastomycosis?
- Amphotercin B: slow IV (nephrotoxic), accumulated dose of 8-10 mg/kg
- Itraconozole: oral 5 mg/kg daily (80-90 days)
What are the clinical signs for Histoplasmosis in cats?
- disseminate disease: depression, weight loss, fever, anorexia, pale mm
- dyspnea, tachypnea, abnormal lung sounds
- coughing uncommon
Which is the second most common fungal disease in cats?
Histoplasmosis
What are the clinical signs for Histoplasmosis in dogs?
- inappetance, weight loss, fever
- dyspnea, coughing, abnormal lung sounds
Which diagnostics are used to detect Histoplasmosis?
- hematology
- biochemistry
- radiographs, US
- TTA/BAL
- FNA/biopsy
What are the treatments for Histoplasmosis?
- Itraconazole (tx of choice)
- Fluconazole
- Voriconazole and Posaconazole
- Amphotericin B in severe cases
What are the clinical signs of Cryptococcosis in cats?
- often immunosuppressed
- chronic listlessness, weight loss, poor appetite
- bilateral nasal discharge, snuffly
- firm to flucuant swelling over bridge of nose
- lymphadenopathy (mandibular)
- neurological signs (ocular lesions)
What are the clinical signs of Cryptococcosis in dogs?
- often immunosuppressed
- disseminated disease
- 2/3 have neurological signs
Which diagnostics are used to detect Cyrptococcosis?
- hematology and biochemistry
- cytology
- tissue biopsy
- fungal isolation
- serology (CSF, serum, latex agglutination, PCR)
What are the treatments for Cryptococcosis?
- surgery
- Amphotericin B
- Fluconazole, Itraconazole, Voriconazole, Posaconazole
What are the clinical signs of Coccidiomycosis?
- dry, harsh cough
- fever, anorexia, weight loss, weakness
- cutaneous lesions common in cats
Which diagnostics are used to detect Coccidiomycosis?
- hematology (non-regen anemia)
- US, MRI, radiographs
- cytology, histopathology
- fungal culture
- serology (tube precipitin antigens, complement fixation antigens, latex agg, AGID, ELISA)
What are the treatments for Coccidiomycosis?
- Ketoconazole, Itraconazole, Flucoconazole
- 3-6 months past resolution of clinical signs
What is Aleurostrongylus abstrusus, and what are the clinical signs?
- feline lungworm
- signs similar to asthma
How do you diagnose Aleurostrongylus abstrusus?
- hematology: eosinophilia
- radiograph: diffuse nodular densities, caudal lobes
- TTW/BAL: eosinophilia, larvae
- fecal: larvae
What is the treatment for Aleurostrongylus abstrusus?
Fenbendazole
Ivermectin
What is Paragonimus kellicoti, and what are the clinical signs?
- dog/cat lung fluke
- cough, wheeze, respiratory distress
- cysts formed in lungs, which can rupture and cause pnuemothorax
How do you diagnose Paragonimus species?
- CBC: eosinophilia
- radiographs: air filled cysts
- TTW/BAL
- fecal: operculated egg
What is idiopathic pulmonary fibrosis/progressive interstitial fibrosis?
- chronic fibrosis of the lung interstitium characterized by infiltration of fibroblasts
- collagen deposits in alveolar septa
What are the clinical signs of idiopathic pulmonary fibrosis/progressive interstitial fibrosis?
- respiratory distress, tachypnea
- progressive coughing
- exercise intolerance
- weight loss in cats
- inspiratory crackles on auscultation
How do you diagnose idiopathic pulmonary fibrosis/progressive interstitial fibrosis?
- inspiratory crackles on auscultation
- radiograph: interstitial pattern
- arterial blood gas: hypoxemia
- TTW/BAL
- lung FNA aspirates
- lung biopsy (definitive)
What is the treatment for idiopathic pulmonary fibrosis/progressive interstitial fibrosis?
- no specific
- corticosteroids plus bronchodilators alleviate clinical signs
- Cyclophosphamide or Azathiprine
- Colchicine
