Respiratory 2015-2019

Question 1

What is the affect of inhaled helox on peak flow rates in brachycephalic dogs?

Answer 1

Improved peak and expiratory flow rates
Diagnostis exam not performed at any time.

The effect of inhaled heliox on peak flow rates in normal and brachycephalic dogs JVIM 2019

Question 2

What is the affect of liposome toll-like receptor ligand receptor complexs for immunoprotectio from feline herpes virus 1?

Answer 2

Decreased FHV-1 DNA
The treatment caused increased nasal discharge which may or ay not be related to the administration

Evaluation of liposome toll-like receptor ligand complexes for non-specific mucosal immunoprotection from feline herpesvirus-1 infection JVIM 2019

Question 3

What changes occur in the upper respiratory tract mucosa after topical administration of liposomal toll-like receptor ligand complexes?

Answer 3

Rapid activation of leukocytes in vitro
Rapid recruitment of monocytes to nasal and oropharyngeal mucosa

Activation of upper respiratory tract mucosal innate immune responses in cats by liposomal toll-like receptor ligand complexes delivered topically (JVIM 2019)

Question 4

What are some proposed reasons for recurrent pneumonia in some Irish Wolfhounds?

Answer 4

Focal bronchiectasis
unilateral or bilatral laryngeal paralysis
esophageal hypomotility

5 year mean age at presentation. Median 5 bronchopneumonia episodes.

Recurrent bacterial pneumonia in Irish Wolfhounds: Clinical findings and etiological studies JVIM 2019

Question 5

What is the expected outcome of botulinum toxin A injections as a treatment for lower esophageal sphincter acalasia-like syndrome in dogs?

Answer 5

BW increase in 20.4% of dogs
BCS increase from 3 to 5 median
Frequency of regurgitaiton 
Duration of effect - 40 days
Prologned symptom free period in patients that have good response to initial therapy
Megaesophagus persists

Mechanical dilation, botulinum toxin A injection, and surgical myotomy with fundoplication for treatment of lower esophageal sphincter achalasia-like syndrome in dogs JVIM 2019

Question 6

What were the most common videofluoroscopic abnormalities noted in brachycephalic dogs with regurgitation?

Answer 6

prolonged esophageal transit time, decrease propagation of secondary peristaltic waves and GE reflux
8/20 brachycephalic dogs had a hiatal hernia
Compared to all presented dogs, brachycephaly was sig associated with prolonged esophageal transit time, GERD and hernia

Retrospective analysis of esophageal imaging features in brachycephalic versus non-brachycephalic dogs based on videofluoroscopic swallowing studies JVIM 2019

Question 7

Which of the follow mycoplasma species has been shown to be clinically associated with lower respiratory tract disease?
Cyanos
Canis
Spumans
Edwardii?

Answer 7

Cyanos was the only one in a large review study

A systematic review and meta-analyses of the association between 4 mycoplasma species and lower respiratory tract disease in dogs JVIM 2019

Question 8

What is the normal reference interval for inflammatory cell populations in BAL fluid?

Answer 8

Normal reference values used for canine BAL fluid differential cell counts in our laboratory are approximately 80% macrophages, 7% lymphocytes, 5% neutrophils, 6% eosinophils, 1% mast cells, and 1% epithelial cells in dogs.

Bronchoalveolar lavage fluid lymphocytosis in 104 dogs (2006‐2016) jvim 2019

Question 9

What is the most common disease abnormality associated with lymphocytic inflammation in dogs?

Answer 9

Airway collapse
Duration of cough not associated

Bronchoalveolar lavage fluid lymphocytosis in 104 dogs (2006‐2016) jvim 2019

Question 10

What are some correlations between complications with stent placement and tracheal and stent dimensions?

Answer 10

Natural tracheal taper and stent oversizing in the intrathoracic trachea were associated w/ caudodorsal stent fracture
14 mm stents were the only that fracture
Stent fracutre results in decreased survival time (600 d vs 1200 d)

Correlations among tracheal dimensions, tracheal stent dimensions, and major complications after endoluminal stenting of tracheal collapse syndrome in dogs JVIM 2019

Question 11

What are the noted positive affects of phermones on stress-associated reactivation of feline herpesvirus-1 in experimentally innoculated cats?

Answer 11

Decreased sneezing
More sleeping

Effect of a Pheromone on Stress-Associated Reactivation of Feline Herpesvirus-1 in Experimentally Inoculated Kittens JVIM 2018

Question 12

What are the expected immediate and long-term changes in stent diamter, length and location in dogs with tracheal stent placement?

Answer 12

Deployed stent length was 26.7% longer than nominal length
There was 10% shortening over the course of initial few months
No significant migration oberved
Care in initial placement likely affects outcome

Immediate, short-, and long-term changes in tracheal stent diameter, length, and positioning after placement in dogs with tracheal collapse syndrome (JVIM 2018)

Question 13

Can a minimally invasive endoscopic procedure be used to treat sino-nasal aspergillosis?

Answer 13

Yes
Study of 12 dogs
2 treatmetns - endoscopy w/ debridement, 1% clotrimazole application
3 dogs had erosion into calvarium on CT

Minimally invasive treatment of sino-nasal aspergillosis in dogs (JVIM 2018)

Question 14

What is the known correlation between reflux aspirtion and pulmonary disease in dogs?

Answer 14

Bile acid levels are used to establish amount severity of aspiration

Significantly higher in pulmonary fibrosis, healthy westies, laryngeal dysfunction and chronic bronchitis compared to healthy beagle dogs

Question 15

What is the possible clinical utility in acute-phase protein assessment for dogs with bacterial pneumonia?

Answer 15

Increased CRP, and SAA sig decreased after administartion of antibiotics
Use of CRP to guide treatment duration resulted in sig shorter (and still successful) duration of therapy. (21 d vs 35 d)
Severity of increase did not correlate w/ severity of disease
Persistent increase in acute-phase proteins correlates with poorer prognosis

The utility of acute-phase proteins in the assessment of treatment response in dogs with bacterial pneumonia (JVIM 2017)

Question 16

What is the most sensitive diagnostic procedure to detect bronchiectasis?

Answer 16

CT > bronchoscopy > thoracic radiographs

Bronchoscopy, imaging, and concurrent diseases in dogs with bronchiectasis: (2003-2014) JVIM 2016

Question 17

What were the most common diagnoses associated with bronchiectasis in dogs?

Answer 17

Pneumonia > inflammatory airway disease > EBP

Bronchoscopy, imaging, and concurrent diseases in dogs with bronchiectasis: (2003-2014) (JVIM 2016)

Question 18

What percentage of dogs with bronchiectasis had concurrent bacterial infection?

Answer 18

28% - most commonly streptococcus, pasteurella, enteric organisms and stentorophonomas - some opportunistic
22/45 w/ pneumonia - 12/25 aspiration, 9/11 unrecognized cause, 1/6 intersttial, 0/3 fb

Bronchoscopy, imaging, and concurrent diseases in dogs with bronchiectasis: (2003-2014) (JVIM 2016)

Question 19

What percentage of cas with upper respiratory tract aspergillosis have serum IgA levels?

Answer 19

91%

Evaluation of serum Aspergillus-specific IgA by indirect ELISA for diagnosis of feline upper respiratory tract aspergillosis JVIM 2016

Question 20

Is serum ELISa of IgG or IgA better for the detection of nasal aspergillosis in cats?

Answer 20

IgG - IgA + IgG is not better than IgG alone.

Evaluation of serum Aspergillus-specific IgA by indirect ELISA for diagnosis of feline upper respiratory tract aspergillosis JVIM 2016

Question 21

What is whole-body barometic plethysmography and how is it used in brachycephalic airway syndrome?

Answer 21

A noninvasive technique used to determine breating effort.

Minute volume is decreased in asymptomatic pugs, Frenchis and bulldogs compared to nonbrachycephalic

established index predicted BOAS status with 94-97% accuracy

Weight and stenotic nares associated w/ BOAS index most significantly

Whole-body barometric plethysmography characterizes upper airway obstruction in 3 brachycephalic breeds of dogs JVIM 2016

Question 22

How is neurokinin-1 receptor antagonism through the use of Cerenia used in airway disease?

Answer 22

No change in inflammation
Reduction in cough

Investigation of neurokinin-1 receptor antagonism as a novel treatment for chronic bronchitis in dogs JVIM 2016

Question 23

What is the level of agreement among radiographs, fluoroscopy and bronchoscopy for diagnosis of airway collapse in dogs?

Answer 23

poor-moderate agreement
Highest sensitivity: Radiography of trachea, left lobar bronchi, and R middle bronchus
Highest spec: Fluoroscopy increased after induction of cough

** Id’ing collapse of airways often requires multiple modaities.

Agreement among radiographs, fluoroscopy and bronchoscopy in documentation of airway collapse in dogs JVIM 2015

Question 24

What the the typical clinical features and surgical outcome of dogs with epiglottic retroversion ?

Answer 24

Middle aged to older small breed dogs
Female spayed
BCS >6/9

Stridor and dyspnea
80% had concurrent or previous airways issues

Decreased severity:
Surgery 53%
medical 60%

long-term survival of at least 2 yrs

Clinical features and outcome of dogs with epiglottic retroversion with or without surgical treatment: 24 cases (JVIM 2015)

Question 25

What is the role of viral infection in dogs with bacteria pneumonia?

Answer 25

Resp viruses (CPIV & CRCoV) frequently with bronchopneumonia but not bordetella TB
C/S and disease severity did not differe in dogs w/  BP w/ or w/o virus

Co-infections with respiratory viruses in dogs with bacterial pneumonia (JVIM 2015)

Question 26

Can barometric whole body plethysmography be used as a noninvasive diagnostic technique in cats with lower airway disease?

Answer 26

Cats with PEF/EF50 > 1.51 before treatment had a sig higher granulocyte percentage

Functional phenotype and its correlation with therapeutic response and inflammatory type of BALF in feline lower airway disease JVIM 2015

Question 27

What is the correlation between brush cytology and BAL fluid analysis in dogs and cats with chronic cough?

Answer 27

Brush cytology detected airway inflamation in 85% of dogs w/ inflammatory BALF
Type of inflammation differed in 68%

Tracheobronchial brush cytology and BAL in dogs and cats with chronic cough: 45 cases (2012-2014) JVIM 2015

Question 28

What is the typical signalment and present complaint of a patient with pharyngeal collapse?

Answer 28

M > F (60% vs 40%)
median wt 5.2 kg
obese
Yorkshire terrier, chihuahua, pug, pomeranian
Coughing, stertorous upper air way sound

27 had concurrent disease - mainstem bronchial collapse, tracheal collapse, BAOS, mitral/tricuspid regurgitation

Signalment, Clinical Presentation, Concurrent Diseases, and Diagnostic Findings in 28 Dogs with Dynamic Pharyngeal Collapse (2008–2013) JVIM 2015)

Question 29

Are radiographs a good survey technique for diagnosis of pharyngeal collapse?

Answer 29

No - only 28.5%

Concurrent findings - tracheal collpase in 57%, concurrent bronchointerstitial pattern in 36%

Signalment, Clinical Presentation, Concurrent Diseases, and Diagnostic Findings in 28 Dogs with Dynamic Pharyngeal Collapse (2008–2013) JVIM 2015

Question 30

What are fluoroscopic or endoscopic results in patients with pharyngeal collapse?

Answer 30

Complete collapse in 71% of dogs
out of 14 that had pharyngolaryngoscopy - elongated soft palate in 4, everted laryngeal sacules 1, laryngeal edema 1, epiglottic retroversin 1, 8 normal

Signalment, Clinical Presentation, Concurrent Diseases, and Diagnostic Findings in 28 Dogs with Dynamic Pharyngeal Collapse (2008–2013) JVIM 2015

Question 31

What is the extpect treatment outcome metalic stenting in dogs with nasoparhyngal stenosis?

Answer 31

Improvement in signs with a balloon expandable metallic stent

Patients developed stenosis after either FB trauma or vehicular trauma
Patients were stertrurous prior to presentation

Treatment of canine nasopharyngeal stenosis using balloon-expandable metallic stents JS 2016

Question 32

What are the expected outcomes from placement of endoluminal trachea stenting for tracheal colla[se in dogs?

Answer 32

93% survival to discharge

MST 1005 days
Improvement in cough and breaething in 89%; improvemennt in dyspnea in 84%

Major complication 47% fracture, tissue ingrowth

Male and younger dogs had longer survival

Mainstem bronchial collpase did not impact survival

Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse JAVMA 2019

Question 33

What is the sensitivity and specificity of thoracic ultrasound for cardiogenic pulmonary edema?

Answer 33

92% and 94% w/ total b-line scopre >/= 10 and preence of >/= 2 sites strongly positive for B lines

Lung ultrasonography findings in dogs with various underlying causes of cough JAVMA 2019

Question 34

Is cistena chyli ablation recommended in addition to thoracic duct ligation and pericardectomy for the treattment of idiopathic chylothorax in cats?

Answer 34

No survival benefit

MST non CCA 774 days vs CCA 380 days
SX significantly shorter w/o CCA

Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats JAVMA 2018

Question 35

What is the most common cause of pleural effusion in cats?

Answer 35

CHF (40.8%) of cases from one study > neoplasia > others

CHF had sig lower body temp
Lymphoma sig younger than carcionma (4/13 lymphoma cats FelV positive AND had mediastinal lymphoma)
Trauma and FIP sig younger than CHF or neoplasia

Question 36

What are common considerations for postanesthetic risks?

Answer 36

Brachycephalic status, increased ASA statups, ketamine + benzodiazepine premdication and invasive procedures

For each 30-minute increase in duration of anesthesia, the odds of an intra-anesthetic complication increased by 0.6% (OR = 1.01

Risk of anesthesia-related complications in brachycephalic dogs (JAVMA 2018)

Question 37

What is the overall accuracy of and interobserver agreement regarding thoraic CT for dx of chronic bronchitis in dogs?

Answer 37

57%, sens 46%, spec 90%
Moderate interobserver agreement
Bronchial wall tickness to PA artery ratio did not help w/ chronic bronchitis vs normal dog diagnosis
Accuracy of and interobserver agreement regarding thoracic computed tomography for the diagnosis of chronic bronchitis in dogs JAVMA 2018

Question 38

What is the relative risk for aspiration pneumonia for brachycephalic dogs vs nonbrachy dogs?

Answer 38

3.77X

Retrospective analysis of incidence, clinical features, potential risk factors, and prognostic indicators for aspiration pneumonia in three brachycephalic dog breeds JAVMA 2018

Question 39

What are some differences between pug dogs, French bulldogs and English bull dogs in regards to aspiration pneumonia?

Answer 39

pugs older than French or English bull dogs
GI signs common - 66% cases
Neuro dz more common in Pugs than French and English bull dogs

Retrospective analysis of incidence, clinical features, potential risk factors, and prognostic indicators for aspiration pneumonia in three brachycephalic dog breeds JAVMA 2018

Question 40

What are key features regarding risk for laryngeal paralysis in Alaskan Huskies?

Answer 40

Mean age 6.4 months
Blue eyes, white facial markings and oral mucosal tags or tissue bands most common
Mononeuropathy > polyneuropathy of the recurrent laryngeal nerve

32% underwent tie back and had sig improvement
16% w/o tie back died of asphyixiation, 40% had spontaneous improvement, 12% remained affected

Congenital laryngeal paralysis in Alaskan Huskies: 25 cases (2009–2014) JAVMA 2018

Question 41

What is the sens and spec of Vet BLUE to ID cardiogenic pulmonary edema?

Answer 41

84% sens 74% spec - similar to thoracic radiographs
False pos w/ diffuse interstitial or alveolar dz

Accuracy of point-of-care lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs and cats with acute dyspnea JAVMA 2017

Question 42

What is the noted prevalence of Alaria in Oklahoma?

Answer 42

9.0% higher feral cats
26% of Wild pigs
overall increase
mild zoonotic potential

Question 43

Is there benefit in the use of felie facial pheromone and URI incidence?

Answer 43

No.
Owner-relinquished vs stray, days in shelter, feral vs adult cat significant variables

Effect of a synthetic feline facial pheromone product on stress scores and incidence of upper respiratory tract infection in shelter cats
JAVMA 2017

Question 44

What was the signalment and outcome of 7 juvenile dogs with lung lobe torsion?

Answer 44

All male, < 12 months
5 pugs, 1 shar-pei, 1 bullmastiff
dyspnea and lethargy most common
5 had suspicions on radiographs - confirmed with CT and ultrasound
Left cranial most common (4), right middle (2), right cranial (1)

Lung lobe torsion in seven juvenile dogs JAVMA 2017

Question 45

What percentage of dogs presenting for cough alone have evidence of laryngeal dysfunfunction?

Answer 45

19% - dysphonia and strider were not commonly noted

Laryngeal structure and function in dogs with cough JAVMA 2016

Question 46

What is the ideal isolation period for dogs diagnosed with H3N2?

Answer 46

At least 21 days

Prolonged intermittent virus shedding during an outbreak of canine influenza H3N2 virus infection in dogs in three Chicago area shelters: 16 cases (2015)
JAVMA 2016

Question 47

What are general risk factors for development of aspiration pneumonia after unilateral arytenoid lateralization in dogs w/ lar par?

Answer 47

Lack of aspiration before was a good thing - none noted after
Post op megaesophagus (HR 2.6) and postop opioids (HR 1.7) were sig risk factors for long term asp pnuemonia
Post op metoclopramide did not help.

Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987-2012) JAVMA 2016

Question 48

What is the best processing technique for ET tube cleaning to eliminate Strep zoo and Bordetella bronchiseptica?

Answer 48

Chlorhexidine gluconate and accelerated hydrogen peroxide soaks for 5 minutes is best
No disinfection completely cleared