Respiratory

Question 1

What is the effect of body condition score on vital parameters (eg respiratory parameters and vitals)

Answer 1

JAVMA 2017: BCS positively associated with body temperature, independent of breed and environmental conditions. And negatively associated with tidal volume

Question 2

What factors were associated with an increased odds of temporary tracheostomy tube placement in BOAS dogs having surgery?

Answer 2

Increasing age; for every 1 year increase, increased by 30%. Corticosteroid administration post operatively and pneumonia were also associated

Question 3

What is a non invasive way to diagnose pharyngeal collapse? What other conditions has it been associated with?

Answer 3

JVIM 2015: Fluoroscopy. Associated with bronchial, tracheal collapse and BOAS

Question 4

What dynamic respiratory function test can be used to diagnose BOAS? What characteristics do they show?

Answer 4

JVIM 2016: Whole body barometric plethysmography. Decreased minute volume and increase in trace variation

Question 5

What % of dogs, presenting for cough and no other URT signs, have laryngeal dysfunction?

Answer 5

JAVMA 2016: 19%

Question 6

How does tracheobronchial brush cytology compare to BAL fluid?

Answer 6

JVIM 2015Good agreement for the presence of inflammation (80-85%) but type of inflammation described was different

Question 7

What cytological feature is reliable for the diagnosis of bordetella brochiseptica?

Answer 7

JVIM 2016: PCR more sensitive than culture. Seeing cocobacizlla adherent to the epithelial cells in 20/21 of BAL where epithelial cells were present makes it a reliable and rapid diagnostic tool

Question 8

What has increased lymphocytes on BAL fluid (20%+) been associated with?

Answer 8

JVIM 2019: eosinophilic airway disease, airway neutrophilia of various causes and airway collapse

Question 9

How should BAL samples be stored for 24 hours for culture purposes?

Answer 9

JVIM 2019: at 4 degrees

Question 10

What is a reliable diagnostic method for bronchiectasis? What conditions is it associated with?

Answer 10

JVIM 2016: CT (100%) and bronchoscopy (92%) - bacteria isolated in 28% of cases, inflammatory airway disease (including eosinophilic and pneumonia). Concurrent airway collapse was also seen in 58%

Question 11

What is the impact of maropitant on airway disease?

Answer 11

JVIM 2016: NK 1 receptor pathways can induce cough and maropitant in this study was found to reduce cough frequency and VAS scores (not placebo controlled). No change in inflammation

Question 12

What is the deposition of fluticasone, as reported by scintigraphy, for nebulisation and MDI in dogs?:

Answer 12

JVIM 2017: Nebulisation 4.2% and MDI 2.3%

Question 13

The following are novel drugs for the treatment of pulmonary hypertension, what is their MOA? Imatinib, Beraprost, Bosentan

Answer 13

Imatinib: PDGF antagonist
Beraprost: Prostacyclin agonist
Bosentan: Endothelin 1 antagonist

Question 14

What class of drug is Milrinone?

Answer 14

PDE 3 inhibitor (same class as Pimobendan). IV drug. Mentioned in PH consensus; may improve RV function and act as a positive inotrope.

Question 15

What respiratory functional parameters can be monitored for improvement in cats with bronchial disease? How does their improvement correlate with BAL?

Answer 15

JVIM 2015: Pseudo-tidal breathing flow-volume loop. Specifically PEF/EF50 (peak expiratory / end expiratory flow) and PEF/EF25 decreased after treatment and this was associated with a reduction in the granulocyte (neutrophil + eosinophil) %. EF25 was more strongly associated

Question 16

What marker of air quality was found to be increased in households with cats with respiratory disease?

Answer 16

JVIM 2018: Household PM2.5 level (particulate matter 2.5um or less). >35ug/m3 is considered unacceptable

Question 17

What is the reported MST and major complication rate (requiring stent replacement) in dogs with tracheal collapse?

Answer 17

JAVMA 2019: MST 1005 days, with 93% surviving to discharge. Major complications in 43%, with stent fracture and tissue ingrowth being most common. 84% of dogs experienced an improvement in dyspnoea

Question 18

Where are radiographs most sensitive for the diagnosis of airway collapse?

Answer 18

Sensitivity for the detection of bronchoscopically identified collapse was highest for radiography at the trachea, left lobar bronchi, and the right middle bronchus, although specificity was relatively low

Question 19

What factors increase the risk of caudal tracheal stent fracture?
What factor was associated with obstructed tissue ingrowth and thoracic inlet fracture?

Answer 19

JVIM 2019: 1. Tracheal taper and stent oversizing. 2. tracheal malformations

Question 20

In what circumstances are BAL bile acids significantly higher than healthy beagles?

Answer 20

JVIM 2018: Idiopathic pulmonary fibrosis, healthy WHWT, laryngeal dysfunction and chronic bronchitis

Question 21

What viruses were detected in dogs with bacterial pneumonia? Did they affect clinical variables? Were any detected in dogs with Bordetella?

Answer 21

JVIM 2015: Parainfluenza and canine respiratory coronavirus. No detected in bordetella affected dogs. No clinical differences in virus co-infected dogs

Question 22

How was CRP used to guide treatment of bacterial pneumonia in one paper?

Answer 22

JVIM 2017: Antibiotics continued 5-7 days beyond normalisation, was not associated with an increased number of relapses

Question 23

What two respiratory syndromes are described in Irish Wolf hounds? what may be associated with their pathogenesis?

Answer 23

JVIM 2019: This paper looked at recurrent bacterial pneumonia; 10/11 dogs had bronchiectasis. A couple had LarPar or oesophageal dysmotility but didn’t appear to be as prevalent. Median age; 5 yo
Also mention rhinitis/bronchopneumonia syndrome seen in young dogs; possibly an IgA deficiency

Question 24

What POC US findings were consistent with pulmonary oedema in dogs?

Answer 24

JAVMA 2019: B line score 10+ and presence of 2+ sites positive for B lines. Sn 92 and Sp 94

Question 25

Median % change in thoracic dimension is affected by what in healthy dogs?

Answer 25

JVIM 2017: body weight

Question 26

What is Heliox and how may it affect breathing in brachycephalic dogs?

Answer 26

JVIM 2019: Heliox is an O2/Helium mixture. It has less density than normal air so promotes laminar air flow. In normal and brachycephalic dogs it increased peak inspiratory flow, peak expiratory flow and normalisation of loop shapes

Question 27

What clinical parameter was lower in a retrospective study in cats with pleural effusion associated with CHF?

Answer 27

JAVMA 2018: rectal temperature, (36.9 vs 37.9)

Question 28

What does Lights criteria use for the characterisation of pleural effusion?

Answer 28

JFMS 2016: Fluid to serum lactate and protein ratios
Lactate ratio 0.6+ and Protein ratio 0.5+ consistent with exudate
The albumin gradient can be added to better distinguish cats with exudates as some CHF cats will be “exudative” on lights criteria but the gradient will help differentiate them

Note: Classic exudate cut of: 30+g/L and >7K cells/uL. Transudate <25, < 1500

Question 29

The SECOND generation NT-proBNP test was evaluated in cats with pleural effusions. What test was Sn/Sp for CHF and which wasn’t?

Answer 29

JVIM 2016: ELISA was Sn and Sp for both plasma and pleural effusion, with different cut-offs. Notably slightly more sensitive for effusion and slightly less specific, but between the two Sn 95-100 and Sp 76-82).
The POC test was useful for plasma samples (Sn 95 and Sp 87) but in pleural fluid the specificity was poor, 64%

Question 30

Is cisterna chyli ablation helpful in addition to thoracic duct ligation + subphrenic pericardectomy in cats with idiopathic chylothorax?

Answer 30

JAVMA 2018: Addition increased surgical time without better outcomes.

Question 31

What echo variable may be useful to predict PH if TVR is unable to be measured?

Answer 31

JVIM 2016: Right pulmonary artery distensibility

Question 32

What are the clinical features of pulmonary vino-occlusive disease and haemangiomatosis?

Answer 32

JVIM 2019: acute presentation in an older dog of respiratory distress. RHS cardiomegaly with PH, CT showed perivascular ground glass opacities and pulmonary artery enlargement

Question 33

What was the prognosis of dogs with respiratory associated PH treated with sildenafil?

Answer 33

JVIM 2019: 32% died within 1 month and 50% mortality by 6 months. In dogs surviving 1 month there was clinical improvement and improvement in tricuspid pressure gradients