Respiratory Flashcards
What is the most important question to ask when presented with an animal with a nose bleed?
Was the nose bleed preceeded by any other nasal signs? (discharge, sneezing, etc)
Explain ‘stertor’ vs ‘stridor’:
Stertor: a low pitched, snorting nasal type noise (like a bulldog)
Stridor: high pitched - more to do with the larynx / trachea
Which fungus is likely to infect the nasal passage of cats more and which is likely to affect dogs?
Cats: Nasal cryptococcosis
Dogs: Nasal aspergillosis
What are the clinical signs of nasal cryptococcosis?
Rhinitis with haemorrhagic discharge.
Facial distortion is common.
Turbinate lysis.
Concurrent CNS, occular and/or dermatological signs.
Why should you always include retropulsion of the eyes in your clinical exam for nasal disease?
Nasal disease (esp. infections) can involve the orbit of the eye
What would you use to treat nasal cryptococcosis if CNS signs were present?
Flucytosine (+ Amphotericin B)
What would you use to treat a mild - moderate case of nasal cryptococcosis?
Fluconazole
If you diagnose nasal cryptococcosis in a cat, what else should you check for?
FIV / FeLV - immunosuppression may be why the cat is infected in the first place
What is the primary signalment of animals with nasal aspergillosis?
Young - middle aged doliocephalic dogs. Male > female.
What are the typical clinical signs of nasal aspergillosis?
Mucopurulent nasal discharge (often with blood).
Ulceration and depigmentation of the nares.
PAIN on palpation of the maxilla and/or nares.
What would you see on radiography of a nasal aspergillosis case?
Destructive rhinitis
How would you treat nasal aspergillosis?
Debride visible plaques endoscopically THEN Topical 1% clotrimazole under general anaesthetic.
Oral itraconazole 60-90 days (less successful)
What is the most common nasal neoplasia in dogs?
Adenocarcinoma.
What 2 systemic diseases may cause epistaxis?
Coagulopathy or systemic hypertension
Is all reverse sneezing pathological?
No, the owners fussing over a dog which has reverse sneezed may cause it to become behavioural
What clinical signs will you see in an animal with laryngeal paralysis?
Weak/absent bark/meow.
High pitched / altered bark.
Stridor.
Coughing.
What is likely to exacerbate the clinical signs associated with laryngeal paralysis?
Hot weather, exercise, excitement or pain.
How should you examine the larynx of a suspect animal?
Larygoscopy under sedation.
NEVER anaesthetise unless someone is able to do a tick back surgery - difficult to recover these animals.
What is the most common complication of laryngeal tie-back surgery?
Aspiration pneumonia.
What is the most effective non-surgical treatment for brachycephalic airway syndrome?
Weight control!
What is the most simple and effective treatment for nasopharyngeal polyps?
Traction (pull them out) and put the cat on prednisolone to make recurrence less likely (+/- antibiotics).
What is one of the first things you should always treat a coughing animal with, even before you have a diagnosis?
Anti-parasitic drugs! Cheap, easy and can eliminate parasites as a differential.
What is a ‘honking’ cough typically associated with?
Tracheal / bronchi collapse
What are the major indications for a trans-tracheal wash?
Moist cough. Bronchial pattern on chest films.
What is important to remember when doing a trans-tracheal wash on a cat?
They are especially prone to bronchospasms - warm up the fluid first
What are the different methods for trans-tracheal wash?
Vie endotracheal tube (in small dogs and cats). Percutaneous - between the tracheal rings.
What is a contraindication for broncheolar lavage?
Non-responsive hypoxia, hypercapnia, haemostatic disorders, highly responsive airways (asthmatic)
What are indications for a bronchoscopy / broncheolar lavage?
To examine the airways, to remove foreign bodies, diagnose chronic cough, obtain cytological/histological/microbiological samples
What are the advantages of broncheolar lavage?
Allows area selection, provides quantitative information on small airways (cell counts, bacterial cultures)
What are the disadvantages of broncheolar lavage?
Expensive, invasive and limitations to cytology
What causes collapsing trachea?
Weakening of the cartilaginous rings or elongation of the dorsal tracheal ligament (or both)
What is the typical signalment for canine chronic bronchitis?
Middle-age or older small breed dogs
How can you treat canine chronic bronchitis?
Bronchodilators (theophylline), glucocorticcoids, +/- cough suppressants).
Try to eliminate environmental irritants/allergens.
Weight control.
Keep airways hydrated (+nebulisation, -diuretics).
What are the most common causes of acute dyspnoea in cats?
Cardiomyopathy, pleural effusions and asthma.
What is a viral cause of pnuemonia in cats?
Feline calicivirus (very occasionally)
What are viral causes of pneumonia in dogs?
Canine distemper, canine influenza virus, canine adenovirus-2
What is the main cause of non-cardiogenic pulmonary oedema in the clinic?
Fluid overload
Space occupying lesions in the chest (air, fluid, a mass) usually result in what type of breathing pattern?
Rapid, shallow breathing without excessive noise
What are your differential diagnoses for fluid on the chest?
Transudate (low protein conc. and low cell counts)
Modified transudate
Exudate (non-purulent)
Pus
Blood
Chyle
Bile
Outline an immediate plan in a case of pleural effusion:
Oxygen supplementation, cage rest and monitoring to stabilise.
(+/-) immediate thoracocentesis.
Quick and careful radiography
Further thoracocentesis
Re-radiograph after thoracocentesis
What are some causes of trannsudate pleural effusion?
Hypoalbuminaemia
Right sided / bi-ventricular heart failure
What are some causes of modified transudate pleural effusion?
Long-standing transudate
Neoplasia
Diaphragmatic hernia
What are some causes of exudative pleural effusion?
Infection
Neoplasia
Autoimmune disorders
Pancreatitis
What are some causes of chylous pleural effusion?
Neoplasia
Diaphragmatic hernia
Cardiomyopathy
Idiopathic
What are some causes of pyothorax?
Local spread of infection
Penetrating trauma (Inhaled grass seed foreign bodies)
Systemic spread
How should you treat pyothorax?
Flush and drain! Antibiotics
Are traumatic or spontaneous pneumothorax cases more likely to continue leaking after drainage?
Spontaneous pneumothorax is more likely to keep leaking
What is this device and whta is it used for?
This is a metered dose inhaler. It is used to deliver inhaled drugs (like albuterol) to animals.
This dog has mucopurulent nasal discharge with ulceration of the nares. What is a possible diagnosis?
Nasal aspergillosis
What is this instrument?
A rigid rhinoscope
What procedure is being performed on this dog?
A trans-tracheal wash
