Resp disease Flashcards
Respiratory disease
URT vs LRT
Mechanical
Collapsing trachea, brachycephalic syndrome
Allergic disease
Hay fever, asthma
Infectious diseases
Canine infectious respiratory disease (CIRD) complex (previously kennel cough), k9 influenza, FURD
Conditions that prevent inflation and air exchange
Recognizing resp emergencies
Atelectasis is
The collapse of part or all of a lung
Hemothorax is
Blood in pleural space
Plural effusion is
Fluid around the lung; in the pleural space
Pneumonia is
Inflammation of the lungs
Edema of the alveolar walls= thickening inflammatory cells move to the alveol
Pneumothorax is
A collection of air outside the lung but within the pleural space
Pulmonary edema is
Fluid accumulation in the alveoli
Tracheal collapse is
Mechanical condition do to makeup of the cartilage
Likely due to a genetic component
Can be anywhere in the trachea, all the way down into the lungs
Presentation of tracheal collapse
Can be incidental finding on a wellness exam
History of coughing
Often confused with kennel cough
Check if went to kennel; occurs during excitement
Can be resp distress- EMERGENCY
Treatment for tracheal collapse
Depends on the dog, severity of clinical signs and location of the tracheal collapse (intra vs extrathoracic)
Keep the patient calm
Cough suppressants
Stent
Emergency treatment
Sedation, bronchodilators, oxygen support
Prevention of tracheal collapse
Harness for walks- small breeds
Dental hygiene
Bordetella vaccination
Maintain at an ideal BCS
Responsible breeding
Avoid overheating
Controlled activity/excitement in severe cases
Anesthesia in an animal with tracheal collapse
Careful with ETT size selection
Ensure tube size is large enough
Intubation may exacerbate collapse distal to the ETT
Watch capnograph and oxygenation closely
Animals with severe tracheal collapse are at a high to very high anesthetic risk
Brachycephalic syndrome is and signalment
These animals have a mechanical resp condition
Signalment
Smooshy faced dogs and cats
English bulldogs, frenchies, pugs, pekingese, bostons
Himalayans, persians
Clinical signs are largely due to facial confirmation
Brachycephalic syndrome animals have what
Elongated soft palate
+ thickened tongue
+ stenotic nares
+ hypoplastic trachea
+/- everted laryngeal saccules
Decreased air flow
Brachycephalic syndrome CS
Noisy breathing, especially on inspiration- stertor
Retching or gagging when swallowing
Constant open mouth breathing
Exercise intolerance
Cyanosis
Collapse
Brachycephalic syndrome treatment and prevention
Responsible breeding
Weight control
Harness instead of collar
Prevent overheating
Surgical correction
Stenotic nares, elongated soft palate, everted laryngeal saccules
Complications of brachycephalics
Obesity- will make the clinical presentation worse
Increased risk of heat stroke
Risk cardiac disease
High risk of asphyxiation under sedation and GA
Watch from sedation until fully recovered
Is some brachycephalic, once they are awake, you can deflate the cuff, untie the tube and leave the tube in the airway. This keeps airway open but allows them to pull out the tube it it is causing a gag response
Allergic airway disease
Upper airway: allergic rhinotracheitis (hay fever)
Lower airway: asthma
Allergens
Antigens don’t cause harm BUT they turn on the immune system
Specific = always the same triggers
Allergic rhinotracheitis can affect
Eyes
Nose
Throat
Trachea
Caused by environmental allergens- often seasonal
Allergic rhinotracheitis treatment
Antihistamines
Allergen avoidance
Washing, keeping indoors, clean home
Sensitization
Injections manufactured for the specific pet
Changes in the airway during inflammation of allergic rhinotracheitis
Changes that cause narrowing of airway
More mucus; thicker mucus
Swelling of the mucosa
Bronchoconstriction = narrowing of airways
Changes that decrease air exchange
Increased inflammatory cells
Increased fluid
Decreased elasticity over time
Feline asthma Clinical signs
cough/gag (often mistaken for a hairball)
Wheezing
Lethargic
Exercise intolerance
Feline asthma pathology
Allergen triggers immune response
Major results of inflammation during an asthma episode
Increased mucus secretion
Thickening of mucosa
Bronchoconstriction
Fluid and increased cells in alveoli
Decreased air movement; decreased air exchange
Treatment/prevention of feline asthma
Drugs
Antihistamines
Steroids
Bronchodilators
Environmental control
Allergen avoidance
dust/particle/smoke avoidance
Oxygen support
Infectious resp disease LRT defenses
Mucociliary elevator- traps and removes antigen
Pulmonary macrophages- digest what gets though
Resp disease triad is
Environmental factors
Cold, dust, smoke
Overcrowding
Mixing
Infectious organisms
Patient factors
Vaccination status
Immune system
Overall health; other diseases
Canine infectious respiratory disease complex is and caused by
Kennel cough
Infectious tracheobronchitis
Infectious organism
Canine adenovirus 2
Parainfluenza
Bordetella bronchiseptica
Can be the primary pathogen
Usually a secondary infection
Where can CIRD be contracted
Doggy daycare
Groomers
Kennel
Hygiene
Crowding
Temp
What is more susceptible to CIRD
Potential health status
Prior vaccination
Upper airway condition
Lower airway condition
Immune suppression
Pathophysiology of CIRD
The virus(es) infect the URT
The virus and the inflammatory response cause damage to the URT
Also results in damage to the mucosa and mucociliary elevator
Secondary infections- Bordetella bronchiseptica
Secondary infectious increase severity of c/s
Increased risk of spread to LRT
Signs of CIRD
Hacking cough
Dry cough
Gag
DDX or CIRD
Esophageal choke
Collapsing trachea
Kennel cough
Oropharyngeal foreign body
Treatment of CIRD
Isolation- extremely infectious!
Nursing care- rest, humidified air, maintain hydration status
Antitussives- controversial
Antibiotics if the patient develops pneumonia
Prevention of CIRD
DA2PP
Core vaccine
Adenovirus-2 + parainfleunza
Bordetella (aka kennel cough)
Non core vaccine
Bordatella bronchiseptica
+ or - Adenovirus-2
+ or - Parainfluenza
3 types of bordatella vaccines
Live intranasal vaccine
Live oral vaccine
Killed injectable vaccine
K9 influenza
New disease as of 2004
Most common in race dogs
Started in california
FURD is
Feline herpes virus
Can also affect the eyes
Feline calicivirus
Can also affect the mouth
Both can cause chronic, latent infections
Pathophysiology of FURD
Very contagious
One or more viruses may be involved
Infects and causes damage to the URT
CS of FURD
Coughing
Sneezing
Runny nose (clear or cloudy d/c)
Runny eyes
Fever
Depression
Anorexia
Complications with FURD
Secondary bacterial pneumonia
Severe corneal ulcers
Severe stomatitis/oral ulcerations
Latent infections
Pathology of FURD
Nasal turbinate destruction with chronic infection
Stomatitis and oral ulcers due to calicivirus
Herpes virus keratoconjunctivitis
Prevention of FURD
Vaccinate
FVRCP vaccine at 8+12+16 weeks +1 year and so forth
Shelter may vaccinate q2w in kittens
Isolate
Disinfection
Calicivirus is very hard to destroy
Pneumonia is
Inflammation
Most common cause is infection
Virus, bacteria, fungus
inflammation causes of pneumonia
Bronchoconstriction
Increased bronchiolar secretions
Thickening of alveoli
Fluid in alveoli
Chronic fibrosis
Aspiration Pneumonia
Inhalation pneumonia
Liquid or solid
Often inhalation of contents from mouth or stomach
Risk factors of aspiration pneumonia
Aspiration while under GA
Forced aspiration
Chronic regurgitation/vomit
Cleft palate, oronasal fistula
Consequences of aspiration pneumonia
inflammation= aspiration pneumonia
Bacterial
Chemical irritation
Asphyxiation
If large volume is aspirated
Prevention of aspiration pneumonia
Anesthesia
Fasting
Appropriate ETT sizing, inflation of the cuff
Timing of ETT removal
Patient positioning during GA and recovery
Treat primary cause of vomiting or regurgitation
Stomach tubing and force feeding
Use of a stomach tube
Premeasure tube from the tip of the nose to the last rib
Pass tube when the animal swallows
Watch for coughing
Administer food or medication slowly
Flush tube with water
Pinch the tube to seal it before withdrawing it from the patient
Resp issues resulting in decreased ventilation
Airway obstruction
Upper airway problems that prevent air getting to lungs
Lungs won’t inflate/deflate
Something in the pleural space
Fluid accumulates in the airways
Prevents air exchange at the alveoli
Aspiration, inflammation
Physical damage
Puncture, torsions, collapse
How to recognize a resp emergency
Cyanosis
Open mouth breathing/choking
Rapid breathing/breathing with abdominal involvement
Chest appears full and is not moving
Dyspnea with history of HBC, chest wound
Dyspnea with abnormal lung sounds
Dyspnea with history of CHF
SpO2 <90%
Response to resp emergency
Call the vet
Conscious -100% O2 by mask or oxygen chamber
Unconscious- intubate and deliver 100% O2
