Respiratory 2 Flashcards
tracheal collapse is caused by
dorsoventral flattening of the tracheal rings and the dorsal tracheal membrane prolpasing into the lumen
why this happens if not exactly clear, could be defective cartilage development or degeneration of hyaline cartilage
what factors make tracheal collapse worse?
obesity, chronic coughing from cardiac disease, lower airway disease, BOAS
the cervical trachea tends to collapse during______ compared to the thoracic trachea which tends to collapse during _____
inspiration
expiration
which breeds are prone to tracheal collapse?
chihuahuas, poms, toy poodles, yorkies
a 6 yo yorkie named Sadie comes to you because she has a goose honk cough that worsens with exercise. top differential? what diagnostics would you like to do?
tracheal collapse
rads (both inspiratory and expiratory), tracheosbronchoscopy, fluoroscopy
remember, it may not show up on rads as this is a dynamic disease
for diagnosing tracheal collapse on tracheobronchoscopy, what is the grading?
grade 1: 25% collapsed, rings still circular
grade 2: 50% collapsed, dorsal membrane stretched
grade 3: 75% collapsed, dorsal membrane pendulous
grade 4: 95% collapsed
how will you treat Sadie with tracheal collapse?
Medical: environmental, pharmacologic, manage concurrent conditions
surgical: only used if medical fails
what are some environmental changes you can make to help medically manage tracheal collapse for Sadie?
weight loss, use a harness instead of a collar, avoid excitement or stress, treat any concurrent disease
what medications can you use for tracheal collapse?
cough suppressants: hydrocodan, butorphanol, loperamide
possibly bronchodilators
anti inflammatory steroids, not as much due to side effects
what are the surgical treatment options for tracheal collapse?
intraluminal stents, supportive rings
Sadie the yorkie with tracheal collapse is NOT responding to medical management and the owner wants to try surgery. what are important things you need the owner to know about before doing so?
surgery is only used for severe cases that are not managed by medical treatment alone! surgical treatment does NOT stop coughing and Sadie will still need medications! a stent is a FB and can cause inflammation as well! and if the problem extends into the bronchi, you can’t stent that!
what is hypoplastic treachea, who is it common in, and how is it treated?
congenital disease in bulldogs and bostons, essentialy their trachea is too small
treat BOAS! these cannot be stented
classically, CIRDC is referring to:
parainfluenza, adenovirus-2, bordetella
can also involve: distemper, influenza, pasturella, strep zoo
a dog named Barney that recently went to doggy daycare presents to you with a hacking cough and some sneezing. top differential?
canine infectious respiratory disease complex
does vaccination prevent CIRDC?
no (except for distemper)
how do you diagnose CIRDC?
usually based on history and exam findings
sampling often not necessary, but you could IF: disease is complicated, if there is an outbreak in kennels or shelters, or in cases with unusual/severe clinical signs
how will you treat CIRDC in Barney?
supportive care
could use abs if: complicated infection (fever, lethargy, inappetence + mucupurulent discharge), doxycycline good first choice
when does a dog with CIRDC need a diagnostic workup?
if there’s no improvement in 7 days, signs of penumonia (crackles, wheezes, productive coughing, hypoxemia, dysnpea, etc), or if there’s other concerns
Barney’s owner asks how they can prevent CIRDC “kennel cough”, and you say…
vaccination=less shedding and less severe clinical signs
decrease exposure: isolate infected animals and avoiding places like kennels, shelters, dog parks
tracheal rupture is most commonly seen…….and results in…
after ET intubation in cats
pneumomediastinum, sub Q emphysema
how is tracheal rupture treated?
most heal without doing anything, just monitor the patient. on rads might see sub Q gas
tracheal parasites are caused by _____ and treated with _____
oslerus osleri
fenbendazole or ivermectin
a 6 yo chihuahua named Nacho comes to you for a 3 month history or harsh coughing and exercise intolerance and increased resp effort. when listening to lungs you hear crackles and wheezes. differential?
chronic bronchitis
how do you diagnose chronic bronchitis?
exclude other causes of cough: heartworm testing, fecal testing for parasites, bloodwork
rads: may be normal
BAL: more cells, lots of non degenerate neutrophils
how will you treat Nacho with chronic bronchitis?
glucocorticoids: oral prednisone 1mg/kg/day and then taper to lowest effective dose
inhaled steroids: fluticasone
could consider bronchodilators like theophylline or albuterol
maintain ideal BCS and avoid environmental stressors, get a humidifier
what is the pred rule for dosaging?
0.1 mg/kg/day is replacement
0.5-1 is anti inflammatory
1-2 is immune supressive
chronic bronchitis cannot be cured, only controlled, so why bother treat at all?
it will get worse and predispose to penumonia, bronchiectasis, bronchomalacia due to the ongoing inflammation
what are the 2 big feline bronchial diseases?
asthma and chronic bronchitis
with feline asthma, clinical signs are a result of
airway narrowing: smooth muscle conrtaction, airway edema, mucus, cellular infiltrates and inflammation
feline asthma starts with airway inflammation and progresses to…
excessive mucus–>bronchial wall edema and remodelling–>bronchoconstriction
a 4 yo siamese named Nelly presents with coughing, wheezing, expiratory dyspnea and tachypnea. top differential? what diagnostics do you wanna do?
asthma
use history and C/S and exclude other diseases like chronic bronchitis and heartworm, cardiac disease and pleural effusion,
rads–>bronchial pattern, collapse of R middle lobe if severe, hyperinflation, hyperlucent lungs
cytology/airway sampling: eosinophils
what do hyperlucent lungs look like on rads, as with feline asthma?
diaphragm is flattened, lungs poke out past ribs, and you can’t see the vessels as much as usual
eosinohpils are most consistent with____ and neutrophils are most consistent with ____
asthma
bronchitis
how will you treat Nelly with asthma?
steroids: injectable, oral, inhaled
bronchodilators (doesn’t help inflammation)
dont use albuterol chronically, only during a crisis!!
emergency treatment of feline asthma (acute crisis) includes:
oxygen and sedation (butorphanol)
bronchodilator (albuterol or terbutaline)
steroid injection (dex IV)
possibly abs if secodnary infections
chronic treatment of feline asthma includes:
oral pred 1-2mg/kg/day and taper
inhaled fluticasone (not immediately effective)
bronchodilators for acute flareups only
environmental modifications
