respiratory Flashcards
Treatment for the life threatening Hyperkalaemia?
- Calcium
- Insulin/dextrose
- Terbutaline
What is the progression of CKD clincial signs?
- None
- PU/PD and/or wieght loss –> uraemic syndrome +/- anaemia
What are teh goals of Oxygen therapy?
- SpO2 >95%
- PaO2 >80mmHg
- Less work to breath
- Less distress
- Resolution of cyanosis
What are the indications to when to intubate and ventilate?
- Severe hypoemia despite O2 supplementation
- PaO2 < 60mmHg, SpO2 <90%
- Severe hypercapnea
- PaCO2 = >60mmHg
- Increased work of breathing and sustained respiratory distress
- You think they might die.
What Diagnostics if we have a urethral Obstruction?
- Imaging of the bladder and urethra
- Rads
- US
- Urinalysis and Culture&S
- Often hypersthenuric >1.030Dogs, >1.035Cats
- Struvite = alkaline
- CaOxalate = Acidic
- Often hypersthenuric >1.030Dogs, >1.035Cats
- Treatment Goals
- Address life threating hyperkalaemia (Prior to sedation/anaesthesia)
- Calcium Gluconate (protect mypocardium)
- Insulin + Glucose/dextrose
- Sodium bicarb
- Ternutaline
- Unblock
- IV fluid diuresis
- Address life threating hyperkalaemia (Prior to sedation/anaesthesia)
If a dogs Nasal planum has become depigmentation what could cause this?
Mucopurulent nasal discharge
unilateral
Epistaxix
Aspergillosis fumigatus (Fungal rhinosinusitis ) DOGS
Turbinate loss
Whife fungle plaques
Treatment- Clotrimazole cream & Oral antifungal meds
What causes the noise Stridor in dogs?
Laryngeal paresis
What is Brachycephalic obstructive airway syndrome? (BOAS)
- Stenotic nares
- Hypoplastic trachea
- Elongated soft palate
- Large Tongue
Localise the lesion
- Nasal Discharge
- REverse Sneeezing
- Stridor
- Cough
- Nasal Discharge
- Nasal passage disease
- REverse Sneeezing
- Nasopharyngeal
- Stridor
- Laryngeal or tracheal disease
- Cough
- Airways, lungs
If an animal has Hypercalcaemia what could be causing this ?
Treat as an emergency why?
- Hypercalcaemia
- PTH related peptide associated tumors
- Lymphoma (mainly t cell)
- Anal Sac adenocarcinoma
- Multiple myeloma
- Squamous Cell Carcinoma
- Mammary gland carcinoma
- Thyroid carcinoma
- PTH related peptide associated tumors
- Cause irreversible nephrocalcinosis leading to renal failure
Treatment
- IV fluids diuresis
- Frusemide
- Glucocorticoids
What drugs can you use if a dog is anxious with a urt obstruction?
- Anxiolysis
- Acepromaziine
- Butorphanol
- Trazadone
What are some causes of acute kidney injury?
- Ethylene Glycol
- Lilly Ingestion (Cats only)
- Grapes and Raisins
- NSAIDS
- Iatrogenic
- Aminoglycosides eg gentamicin
- ACE inhibitors (used for cardiac disease)
- Bacterial Pyelonephritis
If we have a dog with suspected urethral Obstruction (Lower urinary tract signs & Large inexpressible urinary bladder) what are teh 3 diagnostic tests we need to do?
- Bloods
- Potassium (High can be bad if anaesthesia)
- BUN/Creatinine
- Acid-Base status
- ECG
- Due to changes to hyperkalaemia
- Access underlying/concurrent disease
- Full Bloods
- Determine the cause of Uurethral Obstruction
How do you treat Prostatitis in intact dogs/
- Treat at least 4 weeks if acute, 4-6 weeks chronic
- Choose antimicrobials that penetrate the prostrate
- Fluoroquinolones eg enrofloxacin, pradofloxacin
- MUST ALSO NEUTER the dog surgically or chemically
- Surgical is faster reolution
- Treat with abx 5-7days
MCV on bloods stands for
MCHC
- Mean Corpuscular volume
- microcytic
- Normocytic
- Macrocytic
- MCHC
- Hypochromic
- Hyperchromic
- Normochromic
What are the most common lower respiratory bacterial pathogens in dogs and cats?
- Dogs
- Bordertella bronchiseptica, mycoplasma spp
- Cats
- Bordetella bronchisptica, pasteurella spp, Mycoplasma spp
DDX for Sneezing/nasal discharge
- Infectious
- Fungal (aspergillus (dog) , Cryptococcus (Cat)
- Bacterial rhinitis
- Cat flu
- Nasal mites
- Immune mediated
- allergic
- Lymphoplasmacytic (chronic) rhinitids
- Neoplasia
- Foreign body
- tooth abscess
- Polyp
- Stricture
FCov and FIP
- FIP
- Diagnosis
- Acheive a high degree of clinical suspicion (<2yrs multicat envrion with stress and jaunce)
- Rule out more readily diagnosable disease
- Mutation PCR
- immunocytochemistry of organ biopsies
- Management
- Pred
- Diagnosis
What are teh therapeutic interventions in CKD chronic care?
- Provision of adequare and appropriate nutrition
- Maintenance of water/electrolyte and acid balance
- Amelioration of clinical signs (Cats Amlodipine; Dogs Benazepril)
- Slowing the rate of pregression of renal disease through renoprotective therapies
What are teh 3 mechanisms that cause polyuria?
- Reduced medullary hypertonicity
- Absence of or interference with ADH function
- Osmotic diuresis (eg. glucose in urine)
- What is this?
- Signament
- Cx
- Diagnosis
- Therapy
- What is this? - Cryptococcsis
- Signament -
- Cat - young adult
- Dog - Young large breed
- CS
- Cat - URT signs, Skin lesions
- Dog - Sneezing, nasal discharge, CNS signs, GI involvement
- Diagnosis
- Cytology
- Cryptococcal antigen titres (LCAT)(serum)
- Histo
- Fungal Culture
- Therapy
- Long term systemic antifungal
- Fluconazole
- Amphotericin B
- Treat till antigen = Zero
- Long term systemic antifungal
What level of water intake for cats and dogs = Polydipsia
WHat is the output that is classed Polyuria?
- Polydipsia
- Dog
- 100mL/kg/day
- Cat
- 50mL/kg/day
- Dog
- Polyuria
- Dog and Cat
- 50mL/kg/day
- Dog and Cat
What is the differences in presentation and treatment of canine and feline lymphoma.
- Dogs
- p53 mutations
- 80-85% Stage 3 or 4 - 80 Medium-High grade; 70-80% B-Cell immunophenotype
- Treatment Multiagent Chemo responce rate 80%
- Cats
- Most common neoplasia of cats
- FeLV, FIV, Genetic predisposition, Chronic inflammation eg IBD
- 75% cases are ill (dogs only 10-20%)
- Leukaemia and stage 5 rare
- Phenotype 70%B; 66% Medium grade
- Cytology of LN may be insufficient
WHat initial treatment would you give an animal with LRT problems? (Narrowed bronchail lumen from bronchospasm, diffuse bronchomalacia
Oedema of the bronchial wall(anaphalaxis)
- O2
- Bronchodilator trial (injectable or enhaled)
- albuterol
- terbutaline
- Adrenaline IM for anaphylaxis
- When Stable
- BAL or TTW
- Thoracic rads
- Heartworm test (Cats)
- Tx
- Bronchiodilators
- Corticosteroids
- Deworming with Fenbendazole (cats)
What are the applications of chemotherapy?
- Primary Chemotherapy
- Adjuvant Chemotherapy
- Neo-adjuvant Chemotherapy
- Palliative Chemotherapy
- Radiation sensitiser
If an animal has expiratory distress with wheezes (louder on expiration where is the lesion?
Lower Respiratory tract obstruction
FeLV
Transmission ANy contact
- Testing
- POC test detect p27 antigen
- Detection of provirus DNA by pcr
- Vaccination 80% effective
What are teh IRIS stages of CKD?
- Stage 1
- Diminished renal reserve but no clincial signs
- Stage 2
- Mild Azotaemia and few clinicl signs
- Stage 3 & 4
- Moderate to severe azotaemia with progressive uraemic signs
What is Kennel cough now called?
Canine Infectious Respiratory disease Complex (CIRDC)
- Highly contagious respiratory infection
- High morbidity, low mortality
- Young dogs -
- In contact with coughing dogs
- Paroxysmal cough/retching active healthy dog
- Fever, anorexia, lethargy possible
- CS 3-10 days after exposure
- Can progress to pneumonia..
-
Viral
- Canine Parainfluenza virus
-
Bacterial
- Bordetella bronchisptica, Mycoplasma spp
- Can be primary or secondary
- Treatment
- Persistant cough >7 days
- Doxycycline 7-10days
- If fail to respone 3 view chest rads
- Endo tracheal wash
- Persistant cough >7 days
Pulmonary ausculaton
Describe
Bronchial
Vesicular
and
Bronchovesicular
sounds
- Bronchial - trachea and large airways
- “Wind Blowing (High pitch)
- Expiration louder and longer than inspiration
- Vesicular - peripheral airways
- Rustling of leaves (Low Pitch)
- inspiration slightly louder and longer than expiration
- Bronchovesicular - intermediate lung regions
- Mostly expiratory - louder as move towards large airways
- Freq termed harsh sounds
- Can indicate early lung disease or congestive heart failure if exaggerated
Where do you do a thoracocentesis?
Betweent the 7th and 9th intercostal space
- Air
- Dorsal 1/3 of the thorax
- Fluid
- Ventral 1/3
- Analysis
- Specigic Gravity
- Cell count & Morph
- Protien quantification
- Gram stain
- C&S
If you hear crackles what DDX?
If you hear Wheeze what DDX?
- Crackles
- Pneumonia, bronchitis, fibrosis and severe pulmonary oedema
- Wheeze
- Airway Disease
FIV
Rota virus transmitted in bite and fight wounds
High risk Male intact roaming cat
- Low BCS
- Patchy alopecia
- Lymphopenia on bloods
- Demodex (opportunisitc)
- Testing
- POC Inhouse FIV test if positive do a second with a different brand test.
- Detection of provirus DNA by PCR
- Vaccination felovax 56% effective
What is the difference between
Hypoxia
Hypoxaemia
Hypoventilation
- Hypoxia
- Decrease cellular oxygen
- Hypoxaemia
- Decreased Pa02
- Hypoventilation
- Increase PaCO2
If an animal has epistaxis what are the DDx’s for
Systemic Causes
Local Disorders
- Systemic Causes
- Bleeding disorer
- Platelet number or function
- defect in coag cascade
- Hypertension
- Polycythemia
- Hyperviscosity
- Systemic vasculitis
- Bleeding disorer
- Local Disorders
- Inflammatory disease
- Fungal infection
- Immune-mediated/allergi rhinitis
- Local vasculitis
- Neoplasie
- Foreign bodies
- dental disease
- Inflammatory disease
DDX for Poly dipsia
- Polydipsia (usually compensaion for increased water loss due to polyuria)
- Psychogenic poly dipsia
- Endocrine disorders
- Hyperadrenocorticism in dogs
- Hyperthryoidsim in cats
- Hepatic encephalopathy
- Rare hypothalamic lesion
- Drug therapy
WHat are teh major Dysuria DDx’s for dogs?
- Bacterial cyctitis
- Prostatic disease
- Urolithiasis
- Bladder or urethral neoplasia
- Urinary tract Obstruction
What are teh 6 hallmarks of cancer cells?
- Self-sufficency in growth signals
- Insensitiivity to anti-growth signals
- the ability to evade apoptosis
- Limitless replicative potential
- Susteaind angiogenisis
- The capacity to evade tissues and metastasise
What do the following Breathing Patterns indicate?
- Inspiratory distress
- Expiratory distress
- Mixed Inspiratory and expiratory distress
- Paradoxical breathing
- Inspiratory distress
- With Stridor (Noisy) - Upper airway obstruction
- Quiet - Pleural space disease vs adbominal enlargement
- Expiratory distress
- Lower Airway obstruction
- Mixed Inspiratory and expiratory distress
- Pulmonary parenchymal disease
- Pleural cavity disease
- Paradoxical breathing
- Focal - flail chest
- Generalise - Pleural cavity disease
If an animal has Inspiratory distress and has an externallu audible noise where is the lesion?
Upper Respiratory Tract Obstruction
What are some DDx’s for space occupying disorders of the pleural cavity?
- Pneumothorax
- Pyothorax
- Chylothorax
- Hydrothorax
- Haemothorax
- Neoplastic effusion
- Feline Infectious peritonitis
- Diaphragmatic hernia
- Cranial mediastinal mass
- CM lymphoma, thymoma, abscess, cyst, foreign body
- Thoracic wall eg haemangiosarcoma
