Respiratory 1 Flashcards
what are common signs of nasal disease?
nasal discharge, sneezing, stertor sometimes
others less common: pawing at muzzle, facial deformity, CNS signs
true or false, reverse sneezing is pathologic
false!
you see a dog named Nick who has some nasal discharge. you are a smart doctor so youre thinking about all the places the discharge could be coming from which are…
the nasal cavity, the frontal sinuses, the nasopharynx, the oral cavity (fistula), vomiting or regurg, systemic disease like hemostatic defects
tumors most commonly have a history of ____ discharge that may progress to ______ with chronicity
unilateral, bilateral
a thorough oral examination requires
anesthesia
you are doing a detailed oral examination of a dog and you notice the ocular retropulsion on the left eye is decreased. what does this mean?
could be indicative of neoplasia, an abscess, or fungal disease
there are a lot of diagnostics you can do for nasal disease, but what are the 3 gold standard ones needed, especially for chronic cases?
CT, rhinoscopy, and biopsy
true or false: primary bacterial rhinitis is uncommon in cats and dogs
true! there are likely other diseases happening if you see mucopurulent nasal discharge. if it is a bacterial pathogen, this is more common in cats compared to dogs
a german shepherd named Terry presents to you with unilateral muco-hemorrhagic nasal discharge and has also been sneezing lately. this is what the inside of the nose looks like. what is this? what diagnostics should you perform for this dog?
canine sinonasal aspergillosis caused by aspergillus fumigatus
CT or rads to check for bony destruction or possible invasion of the cribiform plate, could do serology but its not good as screening test. diagnosis is made via rhinoscopy, and then a biopsy of the fungal plaques: cytology and histopath
why do dogs with canine sinonasal aspergillosis sometimes present with nasal depigmentation in chronic cases?
the fungal toxin causes depigmentation
How will you treat terry with the canine sinonasal aspergillosis?
debridement, topical antifungals in the nasal cavity and sinuses (flush or cream), often need multiple treatments
what are the two classifications of canine inflammatory rhinitis?
eosinophilic and lymphoplasmacytic
a dog named Rufus comes to you because he has been sneezing, and has bilateral mucoid nasal discharge with no other signs of systemic illness. differential? what diagnostics would you like to perform?
canine inflammatory rhinitis
CT, rhinoscopy, biopsy
what is one important thing to remember about canine inflammatory rhinitis
you need to rule out other treatable diseases such as neoplasia, fungal disease, FBs, or dental disease
for Rufus, you have ruled out all other diseases that could cause inflammation and you decide he has canine inflammatory rhinitis. While you wait for the biopsy to come back, you start thinking of treatment for him. what treatments are available (for both lymphoplasmacytic and eosinophilic/allergic)?
lymphoplasmacytic: air humidification, steroids or immunosuppressions, address any dental disease, allergy testing, NO NSAIDs
eosinophilic: air humidifcation, steroids, ahtihistamines, allergy testing, and JUST IN CASE give them anti parasitics
what is the species of mite that infects nasal passages of dogs? what are clinical signs of this?
pneumonyssoides caninum
sneezing, mild serous nasal discharge
how do you treat canine nasal mites?
milbemycin oxime
ivermectin
selamectin
you see a mastiff dog with an ACUTE onset of sneezing and pawing at the face, with a little bit of unilateral epitstaxis. differential?
a nasal foreign body
true or false, FURD is not a diagnosis
true, it is an umbrella term: feline upper respiratory disease, which can have many causes such as infectious, neoplastic, inflammatory
clinical signs of FURD
ocular or nasal discharge, epistaxis, sneezing, conjunctivitis
what are the primary agents involved in URI in cats
upper respiratory infection
calicivirus, herpesvirus 1, mycoplasma, bordetella bronchoiseptica, chlamydophila felis, strep sp, usually multiple pathogens involved at one time
what factor increases the incidence of URI in cats the most?
the number of cats! more cats/multiple cat environments=more disease
a cat comes to see you with acute depression, a fever, oral ulceration, hypersalivation, and some mild sneezing. top differential?
feline calicivirus
a cat comes to see you with sneezing, seros ocular and nasal discharge, anorexia, fever, and has conjunctivitis as well. top differential?
feline herpesvirus 1
briefly describe the clinical signs associated with:
chlamydophila
mycoplasma
bordetella bronchiseptica
in cats with nasal disease
chalmydophila: usually just conjunctivitis
mycoplasma: conjunctivitis and other upper resp infections
bordetella: if primary, nasal discharge and pneumonia. if secondary it is mostly a predisposing factor to other infections
with nasal disease in small animals, further diagnostics are not often done and culture and PCR are not that useful due to the nose having lots of other contaminants. when would you consider obtaining a definitive diagnosis?
cases with unusual or severe clinical signs
monitoring hospital changes
legal issues
detecting carriers of disease
cats with FURD or URI, what is the appropriate treatment?
usually self limiting and just need supportive care. can do nebulization, probiotics, stress relief management, antivirals, lysine, appetite stimulants, clean the nasal secretions, fluids, etc.
are antibiotics often used for FURD or URI?
most of the time they are not indicated, but can use them if C/S last more than 10 days, or if there is fever, lethargy, mucopurulent discharge that is severe
what antibiotic is a good first choice for nasal disease in cats (if indicated)?
doxycyline
what is the cause of feline chronic rhinosinusitis?
chronic means more than 1 month
viral most commonly: FHV1, epithelial/tubinate damage
bacterial infections: can happen due to viral dz
immune is posible
what are some expected clinical signs of feline chronic rhinosinusitis?
sneezing, stertor (super congested), nasal discharge, otherwise healthy
canine inflammatory rhinitis is a diagnosis of exclusion. what is the nasal disease in cats that is also a diagnosis of exclusion?
feline chronic rhino sinusitis
list some possible treatments for feline chronic rhinosinusitis
antibiotics, humidifcation of air, lysine, antivirals, probiotics, nasal flushing, dental disease treatments, could consider nasal vaccine or steroids. you cannot cure this, only control it.
what feline nasal disease is spread by pigeons? what are some clinical signs?
feline nasal cryptococcus (neoformans and gatti)
upper resp tract signs, granulomatous lesions on nasal bones or extending from nasal cavity, can be neurological, can also cause systemic and ocular disease
if you suspect a cat has nasal cryptococcus, how do you diagnose this?
LCAT: latex capsular agglutination test, run it on serum or CSF, the result is a titre
can also do cytology if you want
treatment of a cat with nasal cryptococcus?
oral or injectable antifungals like fluconazole or itraconazole
theraputic monitoring of titres using LCAT test
prognosis good if no neurologic involvement
a 10 yo white haired cat named Snowy comes to you because the owner says theyve noticed a “weird” change in Snowy’s nose. It looks like the nasal phalanum if affected, and it looks red. differential? what diagnostics would you like to do and what will you tell the owner?
squamous cell carcinoma.
these are usually slow to metastasize
could do a biopsy but it might just cause inflammation. Snowy needs surgery and/or a referral to an oncologist (radiation commonly used)
which diseases fall under the “unilateral discharge” column and which fall under “bilateral”?
unilateral: FB, tooth root abscess, neoplasia, inflammatory, fungal
bilateral: inflammatory, infectious, fungal, systemic, progressive neoplasia
