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Canine/Feline Internal Medicine > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is the most important thing to ask when a dog presents nose bleeding?

A

Ask owner - did they have any nasal discharge/sneezing etc. BEFORE bleeding?

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2
Q

What causes epistaxis?

A 
Systemic haemostasis (Coagulopathy or hypertension)
Local disease
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3
Q

Compare stertor & stritor.

A

Stertor - snorting nasopharyngeal noise Nasophayngeal disease.
Stritor - wheezing strained. Larynx disease.

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4
Q

What is facial pain a strong suggestion of?

A

Aspergillosis in dogs

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5
Q

What fungi infections commonly affect cats? What about dogs?

A

Cats - Cryptococcus

Dogs- Aspergillosis

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6
Q

What is reverse sneezing?

A

Reflex from inspiratory effort
Small breed dog mostly
Behavioural? Nasopharyngeal disease.

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7
Q

What are the 3 features of brachycephalic airway syndrome?

A

Stenotic nares
Overlong soft palate
Hypoplastic trachea

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8
Q

What is your approach to disease of the nasal cavity?

A

History
Physical examination - airway obstruction, facial assymetry, lymph nodes, retropulse eyes, traumatic flush.
Clin path, culture, haemostasis, BP, skull radiography/CT
Rhinoscopy (endoscope behind soft palate)

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9
Q

How do you perform rhinoscopy?

A

General anaesthetic & local anaesthetic.

Flexible endoscope behind soft palate.

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10
Q

What is an alternative to biopsy of nasal cavity?

A

Traumatic flush with syringe water or saline.
Pack the pharynx.
Occlude other nostril.
Good for tumours

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11
Q

Describe chronic rhinosinusitis.

A

“Snuffles”
Caused by bacteria/virus infection.
Can lead to osteomyelitis of turbinates.
Treat with supportive care, long term antibiotics, expectorants.

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12
Q

What are the clinical signs of nasal cryptococcus?

A

Rhinitis, facial distortion, turbinate lysis, get cutaneous sores (nose & skin).
Diagnose cyto, cultulre, histo.

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13
Q

How do you treat Cryptococcus?

A

Amphotericin B & Fluconazole

Flucytosine (best CNS penetration)

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14
Q

What causes ulcerated tracts in nostrils?

A

Nasal aspergillosis usually Aspergillus fumigatus.
Medium-large nose breeds.
Unilateral or bilateral nasal discharge.

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15
Q

What is the gold standard diagnosis of nasal aspergillosis?

A

Culture & histopath.

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16
Q

How do we treat nasal aspergillosis?

A

Debride
Topical clotrimazole
Antifungal cream
Referral.

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17
Q

What are the most common nasal neoplasias?

A

Adenocarcinoma, fibroma, squamous cell carcinoma - dogs

Lymphoma - cats

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18
Q

What is meant by the term idiopathic rhinitides?

A

Ongoing issue of sneezing, mucoid discharge.
ALWAYS worm dog - in case you missed mites etc.
Allergic, eosinophilic, lymphocplasmacytic???

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19
Q

What is laryngeal paralysis?

A

Arytenoid cartilages don’t open during inspiration or closing failure during drinking
More in dogs eg. Labradors

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20
Q

Weak bark, coughing after drinking, coughing during hot weather and stridor are clinical signs of what condition?

A

Laryngeal paralysis

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21
Q

How do we diagnose laryngeal paralysis?

A

Laryngoscopy when lightly anaethetised.

Bewarned don’t anaethetise unless prepared for tie back surgery.

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22
Q

Layngoplasty can cure what condition?

A

Laryngeal paralysis

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23
Q

Why do fat dogs have more complications with brachycephalic airway syndrome?

A

Extra thorax fat pushes diaphragm forward and exacerbates clinical signs.

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24
Q

What would your plan be with a bulldog suffering the normal clinical signs of brachycephalic airway syndrome?

A

Restrict exercise & excitement where possible.
Surgery to open stenotic nares
Resect overlong soft palate

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25
Q

What’s a nasopharyngeal polyp?

A

Inflammatory masses in ear or pharynx.

Cause stertor and flu like signs.

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26
Q

How do you diagnose nasopharyngeal stenosis?

A

Endoscope - see mucous membrane with very small opening - have to tear it open.

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27
Q

What is the most common trachea/bronchi condition?

A

Canine infectious tracheobronchitis.

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28
Q

What is your major DDx for mitral valve regurgitation?

A

Canine chronic bronchitis

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29
Q

What should you always do when presented with a coughing animal?

A

Broad spectrum wormer

Rule out parasites like oslerus osleri

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30
Q

What predisposes dog to collapsed trachea?

A

Young/middle age small overweight breeds.

31
Q

What are indications for a transtracheal wash?

A

Diagnostic method for moist cough or bronchial pattern on chest xray.

32
Q

How do you perform a transtracheal wash?

A

Small dogs/cats - catheter through ET tube
Large dogs - cricothyroid notch
1mL/kg saline warm temp. clap on chest to encourage coughing and suck back on syringe to get fluid.

33
Q

When do you use a bronchoalveolar lavage or bronchoscopy?

A 
Examine airway
Foreign bodies
Cough diagnosis
Samples 
Better method than transtracheal wash but harder.
34
Q

What are advantages & disadvantages of bronchoalveolar lavage?

A

Adv - area selection, quantitative info, cells/bacteria

Disadv- expensive, invasive, cytology

35
Q

Why does collapsing trachea occur?

A

Weakened rings or ligament elongation.

36
Q

What are the clinical signs and how do you diagnose collapsing trachea?

A

Honking goose sounding cough

Do radiographs at peak expiration/inspiration or see narrowing endoscope.

37
Q

What is your management of a collapsing trachea? Explain each choice.

A

Weight control - avoid abdominal fat pushing diaphragm forward.
Cough suppressant - Butorphanol
Anabolic steroid - Stanozolol increases cartilage strength
Harnesses not collars
Can put in a stent along trachea but expensive and collapses beyond the stent.

38
Q

An older breed dog has 2 months of loud harsh coughing that sounds dry. What are you thinking?

A

Canine chronic bronchitis.
Common caused by chronic inflammation in bronchi with cough.
Rule out other diseases like pneumonia.

39
Q

How do you diagnose canine chronic bronchitis?

A

Loud dry annoying cough.
Crackles loud respiratory sounds
Bronchial pattern & ring shadows
Do transtracheal wash or bronchoalveolar flush.

40
Q

What is the best way to treat canine chronic bronchitis?

A 
Remove irritants 
Weight control?
Nebulisation 
Glucocorticoids
Expectorants
41
Q

Describe idiopathic feline bronchitis.

A

Common. From asthma, acute bronchitis, chronic bronchitis, emphysema.

42
Q

You have an acute presentation of a dyspnoiec cat. What are the common causes of this?

A

Heart disease (hypertrophic cardiomyopathy)
Pleural effusion
Asthma

43
Q

How do you treat feline bronchitis?

A 
Stabilisation 
Environment
Glucocorticoids
Bronchoilators 
Terbutaline
44
Q

What is a metered dose inhaler used for?

A

Spacer to ensure breathing in and out.

Inhaled drugs like Terbutaline. for treatment of asthma or chronic bronchitis.

45
Q

What is the most common type of pneumonia?

A

Aspiration pneumonia. Mostly right middle lobe.

46
Q

Describe bacterial pneumonia.

A

Common in dogs.
Usually E. Coli, Pasteurella, Mycoplasma.
Always look for underlying cause.
Hear muffling (pus) do lateral chest radiographs.

47
Q

What’s your preferred treatment for a dog with bacterial pneumonia?

A 
Antibiotics
Humidifcation
Coupage 
Bronchodilators/Expectorants
Good hydration
48
Q

Radiographically what do you see when you have a case of pulmonary neoplasia?

A

Miliary lung pattern indicates neoplasia, abscesses or cysts.
Usually osteosarcoma

49
Q

What is the biggest reason dogs with haemolytic anaemia die?

A

Pulmonary thromboembolism

50
Q

What are some causes of pulmonary thromboembolism?

A

Heartworm
Cardiac disease
Haemolytic anaemia
Neoplasia

51
Q

How would you diagnose pulmonary thromboembolism?

A

Respiratory distress
Normal radiographs*
Air hungry posture
Split heart sounds

52
Q

Vigorous support, heparin and thrombolytic agents are used for treatment of what condition?

A

Pulmonary thromboembolism

53
Q

Why can’t we use cisplatin in cats?

A

Causes increased vascular permeability.

54
Q

What does paraquat poisoning cause?

A

Pulmonary interstitium & lung decreased oxygen exchange.

55
Q

A WHWT comes into your clinic with a HCT of 75. What does this indicate and what are you thinking?

A

HCT of 75 indicates hypoxia - no oxygen carrying capacity or absorption occurring.
Idiopathic pulmonary fibrosis is common in Westies.

56
Q

What radiographically indicates pleural effusion?

A

Wide mediastinum.

See lung retracting from rib cage (and lung lobe seperation).

57
Q

Compare pleural effusion and pulmonary oedema.

A

Pulmonary oedema is fluid in lungs.

Pleural effussion is fluid around the outside of the lungs.

58
Q

What sound on percussion would you hear for a fluid filled pleural cavity compared to gas filled?

A

Fluid - dull sounds

Gas- hollow sounds

59
Q

What would you find on physical exam indicating pleural disease?

A 
Space occupying disease - rapid shallow breathing. 
Barrel chest
Cyanosis
Cough
Fever
Fluid line
60
Q

How do you differentiate pleural effussion causes?

A

Colour of the fluid * EXAM*

Transudate, modified transudate, exudate, pus, blood, chyle, bile.

61
Q

You diagnose a pleural effusion what is your immediate plan?

A

AVOID STRESS
Thoracocentesis immediately
Oxygen supplementation (cage)
Radiography no VD.

62
Q

What is a strawberry milk colour and texture pleural fluid most likely to be?

A

Chyle & blood

63
Q

Explain the different fluid types you might analyse with pleural effusion.

A

Transudate - low protein fluid, hypoalbuminaemia, heart failure
Modified transudate - long term, neoplasia, diaphragmatic hernia
Chyle - RS heart failure (lymph weeps from liver), milk.
Pus - exudate
Exudate - from viruses like FIP, yellow colour

64
Q

Pyothorax. Describe it thoroughly.

A

More cats. From spreading infection of trauma.
Treat like abscess (chest tube w/ intermittent suction)
Systemic antibiotics.

65
Q

What’s the difference between spontaneous, traumatic and tension pneumothorax?

A

Spontaneous - tends to resolve
Traumatic - easily stopped with tapping chest
Tension - positive pressure builds up with breathing where leak is occurring

66
Q

What do you see radiographically for pneumothorax?

A

Elevated heart off the sternum

Collapsed lung

67
Q

4yo Siamese cat paroxysmal coughing & dyspnoea episodes. Radiography bronchial pattern. Bronchoalveolar lavage reveals mucous fluid. What are you thinking?

A

Allergic bronchitis
Hypersensitivity
Heartworm
Parasites

68
Q

3yo DSH cat lethargy, pyrexia & depression for 5 days. Revealed inspiratory dyspnoea, bilateral ventral dullness on percussion. Thoracocentesis yields foul bloody fluid. What do you think?

A

Pyothorax.
WBC, neutrophils bacteria present in fluid.
Caused by systemic disease, penetrating trauma wound, bites, abscesses, cat fights.
Dogs more wounds/inhaled material.

69
Q

What’s the difference between transtracheal wash and bronchoalveolar lavage?

A

Bronchoalveolar lavage using an endoscope so you can see where you’re going.

70
Q

6yo DSH cat in respiratory disease mouth breating. How do you stabilise the cat and how do you take thoracic radiographs?

A

Stabilise with oxygen tank and keep quiet - minimise stress.
Don’t take VD view. Only take radiograph is absolutely necessary dorsoventral view. Laterals also aren’t suitable (pressure on lungs).

71
Q

5yo Cornish Rex cat 3 months of sneezing and inspiratory dysnpoea. There is some lesions on the face and nose appears to be slightly blood filled. What are your DDx? If due to infection what caused it and how do you diagnose it?

A

DDx: Cryptococcus infection, FIV, Chlamydia, Calicivirus
Most likely Cryptococcus caused by scratches/cat fight introducing the bacteria.
Diagnose with a rub of skin nostril and cytology/histo.

72
Q

4yo DSH cat 2 weeks worsening sneezing and epistaxis. First was left nostril now both nostrils. What are your DDx? What is your approach?

A

DDx: Coagulopathy, Local disease, Cryptococcus, Trauma, Systemic hypertension.
History & clinical exam.
Blood test, urinalysis, coagulation time.

73
Q

7yo neutered male Siamese with unilateral purulent nasal discharge for 3-4 months. Sneezing and worsening signs. There is some sunkening of eye and hair colour change.

A

When hair in Siamese is lost/shaved grows back a dark brown.
DDx: Crypto, Tooth root abscess, Chronic rhinosinusitis.

Canine/Feline Internal Medicine (9 decks)

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