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Year 4 small animal > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Advantage of BAL over tracheal wash

A

More sensitive

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2
Q

Difference between endotracheal wash and transtracheal wash

A

Transtracheal wash - through trachea done conscious
Endotracheal wash - under GA down ET tube

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3
Q

indications for bronchoscopy

A

Need samples
Airway assessment/treatment
Unexplained clinical signs

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4
Q

BAL types

A

Bronchoscopic - pre-oxygenate, sterile saline via catheter
Non-bronchoscopic - urinary catheter down ET tube, lung of interest positioned downwards

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5
Q

What is BAL useful for

A

Bronchopneumonia
Eosinophilic bronchopneumonia
Parasites
Chronic bronchitis

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6
Q

What is transtracheal wash useful for

A

Bronchopneumonia
Chronic bronchitis
Parasites

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7
Q

What occurs with chronic airway disease

A

Thickening of airways
Distortion
Mucous
Thinning of walls

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8
Q

What does oslerus osleri causr

A

Nodules in the trachea

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9
Q

Areas to look at for sneezing and nasal discharge

A

Facial symmetry
Eyes
Air flow
Lymph nodes
Nasal planum pigmentation
Teeth
Pain

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10
Q

Diagnostics for sneezing/nasal discharge

A

History
CS
Imaging
Rhinoscopy
Cytology
Serology
Nasal flush

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11
Q

How does aspergillosis present in dogs

A

Medium/long nosed breeds
Marked destruction of turbinates
Mucopurulent discharge with intermittent epistaxis
Pain on palpation
Sneezing
Deformity

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12
Q

How does nasal planum neoplasia present

A

Carcinoma - squamous cell, mets rare
White cats
Photodynamic therapy/planectomy to treat

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13
Q

Nasal cavity neoplasia

A

Normally malignant
Carcinomas in dogs

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14
Q

What is a cough

A

Reflex due to airway irritation, glottis closes, intrathoracic pressure increases, glottis opens to expel air quickly

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15
Q

Aetiology canine chronic bronchitis

A

Tracheal collapse
Chronic barking
FB
Previous infection/inhaled toxins
Environmental

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16
Q

Differentials for acute cough

A

Tracheobronchitis
Irritation
Fb
Pulmonary haemorrhage
Acute pneumonia
Acute oedema
Airway trauma

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17
Q

Differentials for chronic cough

A

Chronic bronchitis
Oslerus/aelurostrongylus
Tracheal collapse
Fb
Bronchopneumonia
Pulmonary neoplasia
Extra-luminal mass
Eosinophilic disease

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18
Q

Infectious tracheobronchitis causes

A

Canine parainfluenza
Canine adenovirus
Bordetella bronchiseptica

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19
Q

Anti-tussives

A

Don’t use unless absolutely necessary as normally protective
Butorphanol/codeine

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20
Q

Canine chronic bronchitis

A

Neutrophilic/eosinophilic infiltration of mucosa
Thickening of smooth muscle, fibrosis/scarring of lamina propria
Oxidative injury and inflammatory cells damage
Loss of ciliated epithelium

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21
Q

Signalment for canine chronic bronchitis

A

Small/toy breeds more common
Worse with excitement
Harsh cough
Externally well but often obese

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22
Q

What does bronchi-ectatic mean

A

Dilated airways
Shows as bronchial donuts

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23
Q

What do BAL results for canine chronic bronchitis typically show

A

Increased mucous
Non-regenerative neutrophils, eosinophils, macrophages
Cushman’s spiral - airway mucus casts

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24
Q

Management of chronic bronchitis

A

Weight control
Harness walks
Avoid irritants or smoking
Avoid dry environments
Oral/inhaled Glucocorticoids
Bronchodilators
Courage
Antimicrobials with need

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25
Q

Treatments for lower airway disease

A

Inhaled medications - corticosteroids, bronchodilators, nebulizers delivered by mask, spacing device, metered dose inhaler
Expensive, time consuming, owner compliance, patient compliance

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26
Q

What is salbutamol

A

Beta 2 agonists
Fast onset, lasts 3 hours
Cleared renally
10-20% reaches lower airways
SE - tachycardia, arrhythmias, tremors

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27
Q

Inhaled Corticosteroids

A

Fluticasone propionate
Slowly absorbed from lungs but dwells
Rapid liver metabolism
Long half life
Bronchodilatory and anti-inflammatories

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28
Q

Benefits of bronchodilators

A

Reduction in lower airway spasm
Decreases tendency for airway collapse improves muco-ciliary clearance
Inhibits mast cell degranulation

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29
Q

Oral therapy for bronchitis

A

Anti-inflammatories
Bronchodilators
Antibiotics, anthelmintics
Mucolytics

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30
Q

Feline bronchial disease

A

Feline asthma
Type 1 hypersensitivity
Suspected breed disposition eg Siamese
Smoke/feathers/inhaled dust
Can lead to chronic bronchitis

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31
Q

Common pathogens causing bacterial bronchopneumonia

A

E.coli
Klebsiella
Pasteurella
Staphs
Streps
Mycoplasma
Bronchiseptica

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32
Q

Is primary bacterial bronchopneumonia common

A

No it’s rare, look for the underlying cause

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33
Q

What does S.equi zooepidemicus cause in dogs

A

Fatal haemorrhagic pneumonia
Highly contagious, sudden onset
CS - pyrexia, dyspnoea, haemorrhagic nasal discharge, haemoptysis

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34
Q

Predisposing factors to bronchopneumonia

A

Debilitation
Prolonged recumbency
Immunosuppression
Immunodeficiency
Defective respiratory defenses
Damaged epithelium
Aspiration
Airway obstruction
Systemic sepsis
Bronchiectasis

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35
Q

Diagnosis of bacterial bronchopneumonia

A

CBC, biochemistry, UA, faecal
Thoracic radiography- early disease can show interstitial pattern only
Airway sampling - culture and cytology on fluid

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36
Q

Treatment of bacterial bronchopneumonia

A

Antibiotics
Supplemental humidified oxygen
IVFT
Anti inflammatories
Bronchodilators
Mucolytics
Physiotherapy
Nebulization
Surgery

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37
Q

What is the first thing you should do with respiratory noise

A

Localise it

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38
Q

What should you approach in the consult

A

Critical assessment of patient - emergency?
Condition
Breathing - rate, pattern, regularity, depth, effort
MM colour - pale, cyanotic, normal
Behaviours worrying the owner

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39
Q

Which breathing phase is longer

A

Inspiratory

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40
Q

What is orthopnoea

A

Dyspnoea in any position other than standing/erect sitting

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41
Q

What is trepopnoea

A

Dyspnoea only on one lateral - unilateral lung/pleural disease

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42
Q

What are the two types of alveolar cell

A

Type 1 - very thin squamous cell lining 95% alveolar surface
Type 2 - cuboidal cell secreting surfactant

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43
Q

What are the 4 areas that cause breathing difficulty

A

URT - inspiratory difficulty, noise, normally surgical, emergency tracheostomy
Pleural space - muffled heart/lung sounds, thoracic ultrasound, remove
fluid
Lung itself - stuff in alveoli of interstitium
Non-crs - metabolic/physiologic, rapid shallow breathing, severe difficulty

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44
Q

Clinical signs of cat flu

A

Wheezing
Coughing
Nasal discharge
Spotty tongue
Ocular discharge/discolouration

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45
Q

What is special about FHV-1 (herpes)

A

Sheds intermittently and without disease for life but exacerbated by stress

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46
Q

What type of virus is calicivirus

A

RNA related to norovirus

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47
Q

Key points about calicivirus

A

Shed by >80% cats in multi cat
Spontaneous outbreaks of severe disease
Tongue ulcers
Floppy kittens with synovitis

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48
Q

How do you treat Chlamydia feliz

A

Doxycycline 10mg/kg daily for 4 weeks
Presents with swollen conjunctiva

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49
Q

Difficulties of chronic rhinitis in cays

A

Have snuffles so don’t re-home well
Antibiotics can have to be prolonged
Long time decongestants
Specific antivirals

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50
Q

What is FCGS

A

Feline chronic gingivitis stomatitis
Associated with FCV
Full mouth extraction
Antibacterials

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51
Q

Diagnosing feline respiratory tract disease

A

Only when management will change
Oral/ocular swabs
Viral transport medium
PCR

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52
Q

Treatment for feline respiratory disease

A

Supportive care - nutritional, fluids, anti-inflammatories, nebulizers, eye drops,
Specific - antivirals

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53
Q

Prevention/control of feline respiratory disease

A

Hygiene, ventilation
Disinfection
Low stress
Vaccination

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54
Q

What is CIRD

A

Canine infectious respiratory disease

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55
Q

Clinical signs of kennel cough

A

Hacking cough
Submandibular lymphadenopathy
Ocular/nasal discharge
Lethargy
Pyrexia

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56
Q

What is canine adenovirus-2

A

Non enveloped DNA
Closely related to CAV-1
Vaccine based on CAV-2 for core

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57
Q

What is canine parainfluenza virus

A

Enveloped RNA virus
Upper URT only
Subcutaneous and intranasal vaccines

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58
Q

Pathogenesis of CIRD

A

Disrupts muco-ciliary escalator allowing bacterial invasion

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59
Q

What is canine coronavirus

A

Enveloped RNA
Not the same as enteric coronavirus

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60
Q

What is bordetella bronchiseptica

A

Primary/secondary disease
Mild - severe
Shedding 12 weeks post infection

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61
Q

What is canine distemper virus

A

Enveloped RNA, she’d in all body fluids
CS - bronchopneumonia, purulent ocular and nasal discharge, haemorrhagic vomiting and diarrhoea, neurological signs

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62
Q

Can strep equi effect dogs

A

Yes
Causes pyrexia, bloody nasal discharge and haematemesis

63
Q

Prevention of canine respiratory disease

A

Hygiene
limit dog to dog contact
Ventilation
Vaccination

64
Q

Clinical signs of infectious respiratory disease

A

Nasal dist
Ocular swelling/discharge
Coughing
Dyspnoea/tachypnoea
Stertor/stridor
Pyrexia
Depression
Lethargy
Inappetence

65
Q

Treatment for canine respiratory disease

A

Symptomatic
- avoid choke chains
- clean eyes/nose
-nsaids
- anti-tussives (butorphanol/codeine/
Antibiotics - rarely necessary as viral - if used for secondary pathogens - tetracyclines, potentiated sulphonamides

66
Q

Canine influenza

A

Cough/ purulent discharge
10-30 day duration
20% very unwell with pyrexia/pneumonia
~8% die
Vaccines in US
Serological evidence in foxhounds

67
Q

How do bronchial foreign bodies present

A

Sudden onset coughing/gagging

68
Q

Diagnostics for bronchial foreign bodies

A

Thoracic radiographs -can see pleural involvement but often difficult
Bronchoscopy - visualisation and retrieval look in all lobes

69
Q

Primary pulmonary tumours

A

> 50% are solitary and often caudal right love - lobectomy
Present with non productive cough and exercise intolerance

70
Q

What family are most lungworms from

A

Metastrongyloides
(Inc. oslerus osleri, filaroides, crenosoma vulpis, aelurostrongylus abstrusus, angiostongylus vasorum)

71
Q

Oslerus osleri

A

10-18week PPP
Immune response to adult in trachea and bronchus
Dry rasping cough, exercise associated
6-12 month dogs most common
Bronchoscopy best diagnosis, L1 in faeces possible but variable
Fenbendazole treatment

72
Q

Filaroides hirthi

A

Treat as oslerus osleri
Diffuse broncho-interstitial pattern

73
Q

Crenosoma vulpis

A

Fox lung parasite can affect dogs
PPP 3 days
Indirect life cycles with slugs/snails
Adults in bronchi/bronchioles
Investigate and treat as oslerus osleri

74
Q

Thoracic FNA

A

Ultrasound guidance
Lesions >1cm
Contraindicated by coagulopathy, pneumothorax, infectious process, pulmonary hypertension
Complications - pneumothorax, empyema, bleeding, implantation, seeding neoplasia

75
Q

What causes stertor

A

Reverberation of the nasopharynx

76
Q

Stages of laryngeal collapse

A

Stage 1 - laryngeal saccule eversion
Stage 2 - medial deviation of the cuneiform cartilage and aryepiglottic fold/aryepiglottic collapse
Stage 3 - medial deviation of corniculate process of arytenoid cartilage/corniculate collapse

77
Q

aetiology of laryngeal collapse

A

neurogenic atrophy of laryngeal muscles
dysfunction of recurrent laryngeal nerves
generalised neuropathy
CNS origin
hypothyroidism

78
Q

clinical signs of laryngeal dysfunction

A

stridor
cough
dyspnoea
change in phonation
exercise intolerance
collapse
signs related to severity of disease
CS worse when hot or exercised

79
Q

diagnosis of laryngeal collapse

A

characteristic signs - auscultation of larynx/thorax
laryngoscopy - swallowing level
laryngoscope
inflated radiographs
haematology/biochemistry

80
Q

emergency management for laryngeal collapse

A

rest
supplemental oxygen
sedation
iv access
corticosteroid
anaesthesia

81
Q

tracheal collapse signs

A

goose honk cough
pulling on collar/lead
exercise
things that make the dog cough
latero-lateral flattened trachea

82
Q

medical management of tracheal collapse

A

antitussives
bronchodilators
antibiotics
nsaids
inhaled corticosteroids/bronchodilaters

83
Q

surgery for tracheal collapse

A

open ring procedure
stenting (must contact whole tracheal wall)

84
Q

fungal rhinitis cause

A

Aspergillus fumigatus

85
Q

CS of aspergillus

A

mucopurulent nasal discharge progressing to bilateral
intermitted epistaxis
ulceration/depigmentation of nasal planum
pain on palpation
sneezing

86
Q

diagnosis of aspergillosis

A

history
clinical signs
blood tests - coagulopathy
diagnostic imaging - radiography of nose/sinuses, CT/MRI
rhinoscopy
cytology
serology

87
Q

treatment for aspergillosis

A

challenging
prolonged oral anti-fungal ‘azoles’
topical therapy - enilconazole, clotrimazole best delivery by catheter into frontal sinuses

88
Q

feline chronic rhinitis

A

common cause of nasal discharge
inflammation of the chonchae
increased mucous production
can be mild or severe
endoscopically similar to dogs

89
Q

surgery for stenotic nares

A

wedge resection
alar fold resection

90
Q

surgeries of the soft palate

A

partial staphylectomy
folded flap palatoplasty - thins and pulls forward to shorten palate
tonsilectomy - often included in soft palate surgery

91
Q

arytenoid lateralisation surgery

A

tie back
prevent dynamic collapse of arytenoid cartilages - normally unilateral

92
Q

post op care for laryngeal tie back

A

observe feeding/drinking
rest 2-3 weeks
antibiotics
analgesia
harness not collar

93
Q

complications of laryngeal tie back

A

seroma formation
aspiration pneumonia
inadequate lateralisation
failure
change in bark

94
Q

Signalment for lower airway disease in cats

A

Older - hyperthyroidism, neoplasia, cardiac disease
Younger - infectious causes

95
Q

History for lower airway disease in cats

A

Age at presentation
Presentation - acute, episodic, chronic

96
Q

Feline asthma

A

Reversible
Inhaled allergen
Airway hyper reactivity
Bronchoconstriction
Eosinophilic airway inflammation
Signs - episodic respiratory distress, dyspnoea, coughing

97
Q

Chronic bronchitis

A

Response to infection/inhaled irritants
Airway damage
Excess mucous
Neutrophilic airway inflammation
Coughing

98
Q

Pathogenesis of lower airway disease in cats

A

Hyperreactivity of bronchial smooth muscle - type 1 hypersensitivity, autonomic imbalance, muco-ciliary imbalance
Acute bronchoconstriction in response to triggers
Inflammation of bronchial mucosal lining
Can develop pneumothorax or spontaneous rib fracture if bad

99
Q

Differentials for coughing

A

Upper respiratory tract disease
Inflammatory lower airway disease
Infectious - bacterial, viral and parasitic
FB
Neoplasia

100
Q

Feline lungworm

A

Aelurostrongylus abstrusus
Paratenic hosts required
PPP 1-2 months
Most cats are asymptomatic
Presentation - young, mild coughing but can progress to dyspnoea.

101
Q

Diagnosis and treatment of feline lungworm

A

Radiography similar to inflammatory disease
Airway wash
Consider faecal floatation
Treatment - fenbendazole

102
Q

Mycoplasma pneumonia

A

Mycoplasma felis
Lower airway disease but may cause URT signs
CS - fever, cough, tachypnoea, lethargy
Treatment - doxycycline

103
Q

Mycobacterial pneumonia

A

M.bovis/M.microti
Pneumonia= late stage systemic infections
Early cutaneous signs - bite from vole/rodent, non-healing sores/nodules
Early GI signs - contaminated milk ingestion, vomiting, diarrhoea, weight loss, poor appetite
Diagnosis - histopathology/PCR
Treatment - 6months rifampicin, pradofloxacin, azithromycin

104
Q

Diagnostic plan for feline lower airway disease

A

Haematology/biochemistry
Diagnostic imaging
Faecal analysis
Bronchoscopy
Endotracheal wash

105
Q

Treatment in an airway crisis

A

Management inflammation - dexamethasone IV
Manage bronchospasm
- tetrabutaline - smooth muscle relaxant, bronchodilation
- inhaled salbutamol
Oxygenate

106
Q

Thoracic radiographs for feline LRT

A

Can be normal
Bronchial +/- interstitial pattern
Hyperinflation
Air trapping
Collapse of right middle lung lobe
Can have patchy alveolar pattern
Can have aerophagia

107
Q

Thoracic radiographs for feline LRT

A

Can be normal
Bronchial +/- interstitial pattern
Can look hyperinflated
Air trapping
Collapse of right middle lung lobe
Can have patchy alveolar pattern
Can have aerophagia

108
Q

Bronchoscopy

A

See - hyperaemia, oedema, excess mucous, decreased airway diameter
Complications - irritation, movement of mucous, bronchospasm

109
Q

BAL cat

A

Cytology - eosinophilic inflammation suggests feline inflammatory disease, viral pneumonia, parasites hypereosinophilic syndrome
Culture
Mycoplasma PCR

110
Q

Causes for breathing difficulties

A

Loss of thoracic capacity - pleural effusion, pneumothorax, neoplasia, ruptured diaphragm, abdominal abnormality, gross cardiomegaly

111
Q

Clinical signs of pleural space disease

A

Restrictive breathing pattern - short shallow breaths
Tachypnoea
Open mouth breathing
Dyspnoea
Orthopnoea - elbow abduction, sternal recumbency
Cyanosis

112
Q

Clinical exam for pleural space disease

A

Observe respiratory pattern
Percussion
Palpate apex beat

113
Q

Pleural effusion

A

Muffled heart/lung sounds ventral when standing
Percussion - fluid line
Different fluids can be present
- transudate
- modified transudate
- exudates - non septic, septic, blood, chyle

114
Q

Transudate pleural effusion

A

Pure transudate due to increased oncotic pressure due to hypoalbuminemia
Commonly caused by increased hydrostatic pressure secondary to right sided heart failure. Can be diaphragmatic hernias, lung lobe torsion, neoplasia

115
Q

Septic Exudative pleural effusion causes

A

Non septic - fip, neoplasia, chronic chylothorax, chronic lung lobe torsion, fungal infection

116
Q

Non septic exudative pleural effusion

A

Septic - penetrating chest wound, FB, ruptured oesophagus, ruptured pulmonary abscess/tumour, haematogenous bacterial spread
Can be hard to aspirate

117
Q

Chylothorax causes

A

Disruption of thoracic duct
Lymphangiectasia, cranial vena cava obstruction, neoplasia, heart disease, fungal infection, lung lobe torsion, diaphragmatic hernia

118
Q

Hemothorax causes

A

Trauma
Coagulopathy
Neoplasia
Lung lobe torsion

119
Q

Diagnosis of pleural effusion

A

Clinical findings
Diagnostic imaging - ultrasound easy, xray also shows
Thoracocentesis - dorsal ribs space 7, asepsis, ultrasound for fluid pocket

120
Q

Chest drain use

A

Animals that require multiple thoracocentesis over a short time period

121
Q

Treatment for pneumothorax

A

Treat primary cause
Heart failure
Pericardial effusion - drainage
Pyothorax - antibiotics, systemic/local, lavage, long course
Chylothorax - diet/surgery

122
Q

Pneumothorax

A

Rupture of major airway/lung parenchyma. Bullous, necrotizing or neoplastic lung disease
Clinical findings
- restrictive breathing
- auscultation, dull sounds dorsally, increased ventrally
- percussion - increased resonance

123
Q

Diagnosis of pneumothorax

A

Physical exam
Respiratory assessment
Thoracic radiographs
Blood gases
Thoracic ultrasound

124
Q

Pathophysiology of pneumothorax

A

Loss of negative pressure means lungs don’t inflate as ribcage is raised
Severity depends on degree of pneumothorax

125
Q

Tension pneumothorax pathophysiology

A

Lesion in lung parenchyma acts as one way valve
Pleural pressure rises causing lung compression
Pressure can exceed venous pressure reducing venous return to heart
Rapidly life threatening

126
Q

Treatment of pneumothorax

A

Oxygen
Drain but avoid over drainage
Some will require chest drains and heimlich valve
Can require surgery

127
Q

What is spontaneous pneumothorax

A

Caused by ruptured pulmonary bulla or sub pleural bleb. Can occur with chronic asthma
CS - dyspnoea, anorexia, vomiting
Can require surgery
Prognosis depends on cause

128
Q

Mediastinal disease

A

Benign/malignant tumours, cystic lesions, enlarged lymph nodes/haematomas
CT very useful, diagnosis challenging

129
Q

Mediastinal lymphoma

A

Common in young cats
CS - tachypnea, inspiratory hyperpnoea, full heart sounds, pleural effusion
Treatment - chemo +/- radiotherapy

130
Q

Thymoma

A

Rare - most common in older dogs
From thymic epithelium
Present with respiratory distress, cranial cabal syndrome, myasthenia gravis
Diagnosis - thoracic radiographs, cytology
Surgical resection best
Poor prognosis is old

131
Q

Thyroid tumours

A

Sink into the thorax
Confirmation on scintigraphy
Treat with radioactive iodine or surgery

132
Q

Pleural tumours

A

Rare
Causes large volume effusions and pain
Multifocal small masses, hard to image
Can do thoracoscopy histopathology best diagnosis
Treatment via intra-cavitady carboplatin/cisplatin

133
Q

Rib tumours

A

Osteosarcoma/chondrosarcoma
Can be aggressive
Treatment = rib resection

134
Q

Differentials for alveolar disease

A

Aspiration pneumonia
Pulmonary oedema
Pulmonary haemorrhage
Eosinophilic lung disease
Pulmonary parasites
Pulmonary neoplasia
Interstitial disease

135
Q

Clinical signs of pulmonary parenchymal disease

A

Increased inspiratory and expiratory effort
Cough can be present
Can see haemoptysis, collapse/syncope, cyanosis
Lung crackles
Change in bronchovesicular sounds

136
Q

Aspiration pneumonia

A

Signs - cough, harsh/reduced lung sounds, tachypnea, pyrexia
Radiographs for infiltrate - alveolar pattern with border obliteration and air bronchograms
BAL to confirm
Treat with supportive care, antibiotics, and underlying cause

137
Q

Anti-biotics for alveolar disease

A

Select on C and S
Lipophilic best to penetrate the blood bronchus barrier
Bactericidal best
May need combination and long treatment period
Azithromycin has good distribution. Metronidazole accumulates well
Tetracyclines reasonable concentration
Penicillins variable

138
Q

Mucolytic use in alveolar disease

A

Reduce mucous accumulation and helps with impaired muco-ciliary clearance
Bisolvon licensed

139
Q

Pulmonary oedema causes

A

Increased hydrostatic pressure
Reduced oncotic pressure
Increased vascular permeability
Impaired lymphatic drainage
Leads to fluid accumulation in the interstitium

140
Q

Differentiation between cardiogenic and non cardiogenic pulmonary oedema

A

Cardiogenic - low protein due to increased hydrostatic pressure without increased vascular permeability
Non-cardiogenic - lung damage leads to protein leaking through increased vascular permeability
Cardiogenic much more common

141
Q

Non cardiogenic - alveolar disease

A

Damaged epithelium Increased vascular permeability leads to higher protein fluid in alveoli. Removal requires active transport so if epithelium damaged it wont occur. More refractory than cardiogenic
Causes
- hypoalbuminemia causes pulmonary oedema
- lymphatic drainage more likely to cause cylous effusion
- pulmonary epithelial injury most common due to things like choking, drowning, electric shock, head trauma, smoke inhalation and sirs

142
Q

Physical lung injury

A

Pulmonary contusion - ventilation perfusion mismatch, chest wall damage/pain
Will have a lag phase before visible on radiographs
Supportive care

143
Q

Eosinophilic lung disease

A

More common in dogs, young adults. Can be acute or chronic
Coughing and weightloss common
Diffuse bronchial interstitial pattern (doughnut pattern)
Circulating eosinophilia
BAL to diagnose
Oral Prednisolone for treatment

144
Q

Angiostongylus vasorum

A

Nematode that lives in pulmonary arteries
Indirect lifestyle through slugs/snails
L1 penetrates capillaries into alveoli to be coughed up and swallowwd

145
Q

Clinical signs of angiostongylus vasorum

A

Cardiorespiratory - chronic cough, dyspnoea, exercise intolerance, syncope, tachypnoea - relate to burden
Coagulopathies - anaemia, subcutaneous haematoma, internal haemorrhage, prolonged bleeding. Causes clotting failure (always test is unexplained clotting issue)
Neurological dysfunction - paresis, depression, seizures, spinal pain, behavioral changes, ataxia, vision loss

146
Q

Diagnosis of angiostongylus vasorum

A

L1 in faeces - faecal floatation/smears
L1 in BAL
Radiography for alveolar infiltrates
Cage side snap
PCR on BAL/pharynx swabs

147
Q

Management of angiostongylus vasorum

A

Licensed -
- imidacloprid and moxidectin
Or
- milbemycin oxime and praziquantal
Fenbendazole - effective but unlicensed

148
Q

Treatment of angiostongylus vasorum

A

Supportive care in addition to anthelmintics
Bronchodilators
Corticosteroids
Phosphodiesterase inhibitor
Cage rest and oxygen therapy
Prevention

149
Q

Interstitial pulmonary fibrosis

A

Middle age/older dogs
Chronic breathlessness, coughing, exercise intolerance, cyanosis, syncope, can faint
Clinical exam - crackles in lungs field. Prolonged expiratory phase with expiratory effort

150
Q

Diagnosis of interstitial pulmonary fibrosis

A

Clinical signs
- pulmonary hypertension, interstitial/alveolar pattern, general cardiomegaly, abdo distension, hepatomegaly
Thoracic radiographs
CT
Bronchoscopy
Lung biopsy

151
Q

Treatment of interstitial pulmonary fibrosis

A

Symptomatic treatment
Inhaled therapy - bronchodilator, corticosteroids
Oral therapy - bronchodilator and corticosteroids
Viagra effective for pulmonary hypertension
Normally live 1 year but up to 4

152
Q

Interstitial pneumonias

A

Not common. Disease affects the interstitium
Associated with herpes virus

153
Q

Metastatic disease

A

Often incidental finding
Most common = osteosarcoma, hemangiosarcoma, thyroid carcinoma, melanoma of mucocutaneous junction
Find Mets
Need CT to find how many/where. Care in seeding with thoracoscopy
Local chemo - penetration issues

Year 4 small animal (18 decks)

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