Respiratory Flashcards
What is the first step when encountering a patient in respiratory distress?
Localise the area of distress e.g. upper or lower airway
What are some causes of acute coughing?
Tracheobronchitis (Kennel cough)
Irritation by smoke-dust/chemicals/medicines
Airway FB
Pulmonary haemorrhage
Acute pneumonia e.g inhalation
Acute oedema
Airway trauma
What is canine chronic bronchitis?
Daily coughing for over 2 months characterised by WBC infiltration of mucosa and thickening of smooth muscle
What are some common complications of chronic canine bronchitis?
Airway dilation and airway collapse due to wall weakness (bronchomalacia)
How do you manage chronic canine bronchitis?
Weight control, harness and avoid irritants
Maintain hydration status and steam the bathroom
Drug therapy: Glucocorticoids, bronchodilators accompanied by coupage.
What are the pros of inhaled medications?
Reduced systemic exposure of glucocorticoids
Dose required is lower
Reduces systemic side effects
Effective in acute situations
What are the cons of inhaled medications?
Time consuming
Expensive
Owner compliance
Patient compliance
What hypersensitivity reaction is feline bronchial disease (feline asthma)?
Type 1
What are the common pathogens involved in bacterial bronchopneumonia?
E.coli
Klebsiella
Pasteurella
Staphs
Streps
Mycoplasma
B bronchoseptica
What is the most common type of primary neoplasia found in the lungs?
Carcinomas
What is the pre-patent period of O.osleri?
10-18 weeks
What age of cat does lower airway disease normally affect?
Young adults to middle aged
What are the clinical signs of low grade, chronic lower airway disease in cats?
Coughing
Audible wheezing
Exercise intolerance
What are potential trigger factors of lower airway disease in cats?
Change in environment
New cat litter
Passive smoking
Seasonal
What are clinical signs of laryngeal disease in cats?
Laboured inspiration, stridor, increased effort, slow inspiratory phase +/- change in purr and vocalisation.
What is aelurostrongylus abstrusus?
Feline lungworm
How do you treat feline lungworm?
Fenbendazole
What are the clinical signs of mycoplasma pneumonia in the cat?
Fever, cough, tachypnoea, lethargy
How do you diagnose mycoplasma pneumonia in the cat?
PCR on tracheal wash
How do you treat mycoplasma pneumonia in the cat?
Doxycycline
What are the early cutaneous signs of mycobacterial pneumonia in the cat?
After an infected vole/rodent bite or non-healing sores/nodules +/- large LNs.
What are the early GI signs of mycobacterial pneumonia in the cat?
After ingestion of contaminated product. V+, D+, weight loss, poor appetite, inflammatory granulomas
How do you diagnose mycobacterial pneumonia in cats?
Histopathology and PCR. Seek advice for zoonotic risk.
What is pleural space disease?
Loss of thoracic capacity +/- cyanosis. Accumulation of fluid, air or soft tissue mass.
What are causes of pleural space disease?
Pleural effusion
Pneumothorax
Neoplasia
Ruptured diaphragm
Gross cardiomegaly
Abdominal abnormality
What are the general clinical signs of pleural space disease?
Short, shallow breaths
Tachypnoea
Open mouth breathing
Dyspnoea, distress
Orthopnoea
Cyanosis
What is an accumulation of fluid in the pleural cavity called?
Pleural effusion
What causes transudate accumulation in the pleural space?
Hypoalbuminemia
What causes an accumulation of modified transudate in the pleural space?
RCHF
Diaphragmatic hernia
Lung lobe torsion
Neoplasia
Causes of non-septic effusion
FIP
Neoplasia
Chronic chylothorax
Chronic lung lobe torsion
Fungal infection
Causes of septic effusion (pyothorax)
Penetrating chest wound
Foreign body inhalation
Ruptured oesophagus/abscess
Haematogenous bacterial spread
Causes of chylothorax
Disruption to thoracic duct including lymphangiectasia
Cranial vena cava obstruction
Neoplasia
Heart disease
Fungal infection
Hernia
Torsion or trauma
Causes of haemothorax
Trauma
Coagulopathy
Neoplasia
Lung lobe torsion
What is a pneumothorax?
An accumulation of air in the pleural space
What does a pneumothorax cause?
Restrictive breathing, dull lung sounds dorsally with increased sounds ventrally. Increased drum like resonance on percussion.
Results in lung collapse.
What is a tension pneumothorax?
The lesion acts as a one way valve, constantly increasing pressure around the lungs.
What is the most common cause of a spontaneous pneumothorax?
Ruptured pulmonary bulla or a sub-pleural bleb
What is aspiration pneumonia?
The inhalation of material into the lower airway.
What are the clinical signs with aspiration pneumonia?
Coughing, harsh/reduced sounds, tachypnoea, pyrexia
What conditions result in pulmonary oedema?
Increased hydrostatic pressure
Reduced oncotic pressure
Increased vascular permeability
Impaired lymphatic drainage
What is the main cause of non-cardiogenic pulmonary oedema?
Pulmonary epithelial injury (head injury, electric shock, chocking, SIRS, smoke inhalation, near drowning)
What is angiostrongylus vasorum?
Canine heartworm
What are the clinical signs of heartworm?
Breathlessness, bleeding, neurological, productive cough, pulmonary hypertension, coagulopathies
What is the breed pre-disposition of interstitial pulmonary fibrosis?
Middle aged to older WHWT and other terries
What is the typical history for interstitial pulmonary fibrosis?
Insidious onset, chronic breathlessness, coughing, exercise intolerance, cyanosis, syncope
What presents on clinical exam with interstitial pulmonary fibrosis?
Crackles throughout lung fields
Prolonged expiratory phase with expiratory effort
What causes stertor?
Soft palate, everted laryngeal saccules, with BOAS
What is the stertor noise?
Like snoring, low pitched soft tissue vibration
What can cause stridor?
Tracheal or laryngeal pathology. Laryngeal paralysis, tracheal collapse
What type of noise is stridor?
High pitched wheezing, vibration of rigid tissues.
What systemic signs can present with upper respiratory disease?
Pyrexia, depression, lethargy, inappetence
What are the clinical signs of kennel cough?
Hacking cough, submandibular lymphadenopathy, ocular/nasal discharge, lethargy, pyrexia
What are common secondary infections of kennel cough?
Canine parainfluenza virus
Canine adenovirus-2
Coronavirus
Bordetella bronchiseptica
What are the options for kennel cough diagnosis?
Paired serology
Nasal/oropharyngeal swab for PCR
Conjunctival swab for distemper (IFA)
What symptomatic treatment can be used for kennel cough?
Avoid pulling on collar
Clean eyes and nose
NSAIDS
Butorphanol, codeine
Glycerine
What antibiotics can be used to treat Bordetella?
Gram negative cover - tetracyclines, potentiated sulphonamides and amoxycillin
What are some methods to try and prevent pneumonia?
Environmental hygiene
Dog-to-dog contact
Fomite transmission
Ventilation
Vaccination
What vaccinations can help reduce the risk of pneumonia in dogs?
Parainfluenza
Distemper
What pathogens can cause cat flu?
Feline herpesvirus
Feline calicivirus
Chlamydia felis
Bordetella bronchiseptica
Mycoplasma felis
Clinical signs of feline herpesvirus
Flu signs
Damage to nasal bones (chronic snufflers)
Ocular ulcers
Herpetic dermatitis
Clinical signs of feline calicivirus
Tongue ulcers
Floppy kittens (synovitis)
What are the clinical signs of aspergillosis?
Nasal discharge
Ulceration or depigmentation of nasal planum
Pain on palpation
Sneezing
Facial deformity/neuro signs
What is the treatment for aspegillosis?
Oral antifungal agents
Topical therapy
