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Year 4 Small Animal Studies > Respiratory: Bronchial Diseases > Flashcards

Respiratory: Bronchial Diseases Flashcards

1
Q
  1. Why may it not be appropriate to suppress a cough?
  2. Where are cough receptors?
A
  1. Coughing is a normal protective mechanism
  2. Present in the caudal oropharynx, larynx, trachea, tracheal bifurcation and bronchi- decreasing numbers towards the lungs
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2
Q

What are the three general causes of coughs- physiologically?

A
  • Stimulation of cough receptors- laryngeal, tracheal, bronchial disorders
  • Compression of bronchi- atrial enlargment, mass, lymphadenopathy
  • Excessive fluids/mucus/inflammation
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3
Q

How can respiratory and cardiac causes of cough be distringuished?

A
  • Heart rate and rhythm
  • Increased sympathetic drive
  • Tachycardia
  • Absence of sinus arrhythmia
  • Presence of abnormal heart sounds, time of coughing

Cats rarely cough due to cardiac disease

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3
Q

How can respiratory and cardiac causes of cough be distringuished?

A
  • Heart rate and rhythm
  • Increased sympathetic drive
  • Tachycardia
  • Absence of sinus arrhythmia
  • Presence of abnormal heart sounds, time of coughing

Cats rarely cough due to cardiac disease

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4
Q

What is the single most useful thing to make an initial diagnosis of the cause of a cough and whether it is due to cardiac or resp?

A

Radiographs

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5
Q

What chamber of the heart will have apparent enlargment with cardiac disease?

A

Left Atrial enlargment

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6
Q

If the animal is in left sided heart failure what triad of signs will present on radiographs?

A
  • LA enlargment
  • Pulmonary venous distension
  • Pulmonary infiltrate
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7
Q

What are the cardiac causes of LA enlargment ± left sided heart failure

A
  • Acquired- mitral valve disease, DCM
  • Congenital- VSD, PDA, mitral dysplasia
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8
Q

What is important to ascertain about a cough from clinical exam?

A
  1. Is the cough productive- may not be externally seen
  2. Signs of infection (pyrexia)- evidence of URT (lymph nodes)
  3. Change in respiratory rate/pattern
  4. When is the cough worse- night, day, exitement
  5. What does the cough sound like- goosehonk- tracheal collapse
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9
Q

What disease commonly causes a chronic cough in small and toy breed dogs?

A

Chronic bronchitis

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10
Q
  1. What is the definition of chronic bronchitis?
  2. What are typical radiographic findings?
A
  1. Coughing for over 2 of the last 12 months
  2. Thickened bronchial walls (cuffing)- doughnuts and tramlines
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11
Q
  1. What is the aetiology of chronic bronchitis?
  2. What characterises the syndrome?
  3. How is diagnosis confirmed?
A
  1. Unknown- environment play part
  2. Excessive mucus production, Goblet cell hyperplasia, bronchial mucosa inflammation, compromise to MC escalator, excess mucus- soft crackles, expiratory wheezes- bronchial narrowing
  3. Bronchoscopy and BAL fluid cytology
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12
Q

Why is bronchoscopy required to diagnose chronic bronchitis?

A
  • Exclude tracheal/bronchial collapse
  • See loss of normal glistening mucosal surfaces
  • See thickened mucosa- difficult to see vessels (sometimes cobblestone)
  • Excess of mucus
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13
Q
  1. How is BAL used to diagnose chronic bronchitis?
  2. How much saline is used?
A
  1. Cytology of BALF- typically mixed inflammatory infiltrate- macrophages, neutrophils- bacteria looked for
  2. 0.5ml/kg

Bacterial infection can play part but BALF usually sterile

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14
Q

If the animal is too small for a endoscope or GA is contraindicated what sampling techniques can be used for chronic bronchitis?

A
  • Blind sampling through an endotracheal tube in an anaesthetised animal
  • Trans tracheal wash- sedated, local- 14G between cartilages
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15
Q

What is the general managment of chronic bronchitis?

A
  • Reduce weight if obese
  • Avoid stimulating a cough- harness
  • Avoid irritants
  • Keep airway moist- avoid dry environments
  • Warn owners- life long condition
16
Q

What drugs can be used to treat chronic bronchitis?

A
  • Bronchodilators- theophylline, salbutamol (inhaled)
  • Glucocorticoids- anti-inflamm, reduce leucocyte accum, anti-fibrotic
  • ABs- if positive culture
  • Mucolytics- maybe-
  • Antitussives- risky to supress productive cough- maropitant, diphenoxylate, loperamide
17
Q

What is the definition of bronchomalacia?

A

Regional to diffuse dynamic airway collapse of segmental and/or subsegmental bronchi with associated clinical signs

18
Q

What is the cause of bronchomalacia?

How is it diagnosed?

A
  • Bronchial cartilage degeneration (chondromalacia)
  • Results in dynamic bronchial collapse
  • Typically small breed dogs- can be any

Diagnosis is based on bronchoscopy- recognition of the dynamic airway collapse of bronchial lumen

19
Q

How is bronchomalacia managed?

A
  • Control of the cough- supressents- codine phosphate
  • Bronchodilators
  • Weight managment
  • Avoiding collar
20
Q

What is chronic trachoebronchial syndrome?
How is it resolved?

A
  • Term reserved for coughing dog where the pathological changes are minimal
  • Typically- chronic coughing dogs with initial diagnosis of kennel cough

Most cases respond to anti-inflammatory doses of prednisolone

21
Q
  1. What is bronchiectasis?
  2. How is it managed?
A
  1. Dilated bronchi with bronchoscopy confirming being full of mucopurulent material
  2. Chronic ABs, if one lobe involved, lobectomy

May be complication of bronchial diseases

21
Q
  1. What is bronchiectasis?
  2. How is it managed?
A
  1. Dilated bronchi with bronchoscopy confirming being full of mucopurulent material
  2. Chronic ABs, if one lobe involved, lobectomy

May be complication of bronchial diseases

22
Q
  1. What is primary ciliary dyskinesia?
  2. What is required for diagnosis?
  3. What does it therefore lead to?
  4. What breeds can be affected?
  5. What else can patients be asccoated with?
A
  1. Cilia of the airways may be abnormal resulting in abnormal microtubule arrangment or gross ciliary disarray
  2. Diagnosis relies on electron-microcopic identification of microtubule abnormalities or semen sample (repro cilia affected)
  3. Lack of mucus clearance- high risk of bacterial infection- bronchopneumonia
  4. English springers, pointer, old english sheepdog, sharpei, bichon frise, newfoundland
  5. Situs inversus- left right reversal of thoracic/abdominal organs (spleen on right)
23
Q

What antibiotics should be used for life-threatening infections if culture and sensitivity not available?

A

Broad spectrum bacteriocidal
‘four quadrant’ AB selection
* Potentiated amoxicillin
* Fluoroquinolone
* Metronidazole

Parenterally

24
Q

What antibiotics are likely to be appropriate for respiratory tract infections?

A
  • Clavulonate potentiated amoxycillin- broad spec
  • Cephalexin- G-ve
  • TMP sulphonamides- broad spec
  • Fluoroquinolones- broad spec
  • Doxycycline- mycoplasma, bordatella
  • Clinamycin- G+ve
  • Metronidazole
25
Q

What are the different names for Eosinophilic Lung Disease?

A

AKA
* Eosinophilic bronchopneumopathy
* Pulmonary infiltrate with Eosinophils

26
Q
  1. How do dogs with ELD present?
  2. What can the disease vary from and to?
  3. What needs to be ruled out?
  4. What does bronchoscopy/BALF show?
A
  1. Coughing is the major presenting sign
  2. Mild to severe airway disease to granulomatous lung disease
  3. Parasitic causes- primary resp parasites or migrating ascarids
  4. Bronchoscopy- copious amounts of yellow-green mucus, BALF >25% cells eosinophils
27
Q

What is lung parasitic involvement of EBP suspected to be associated with hypersensitivity to migrating ascarids treated with?

How is EBP generally treated?

A

Fenbendazole for 7 days

  • General managment
  • Immunosuppressive doses of prednidolone
28
Q

What are the two main manifestations of feline asthma?

A
  • Chronic cough- feline chronic bronchial disease (respond to treatment with glucocorticoids)
  • Dynamic reversible) bronchoconstriction- true asthma
29
Q

What can be identified with feline asthma on radiograph, bronchoscopy and BALF cytology?

A

Radiography- increased bronchial markings, sometimes air-trapping resulting in a barrel chest, right middle lung lobe collapse
Bronchoscopy- difficult and risky
BALF- preponderance of eosinophils, neg bacteriological culture

30
Q

How should feline astma be treated in an emergency (dyspnoeic cat)

A
  • Humidified oxygen
  • Inhaled bronchodilators- salbutamol
  • If reluctant for face mask- parenteral steroid- dexameth
  • Bronchodilator- beta 2 agonits, terbualine
31
Q

How is chronic feline asthma managed?

A
  • Oral prednisolone
  • ± bronchodilator
  • General management- removal of likely allergens
  • Serological allergy testing considered
32
Q

Where is the most common site for a foreign body to lodge?

A

Right caudal lobe bronchus

33
Q

How do bronchial foreign bodies present and how are they treated?

A
  • Usually present with sudden onset of cough
  • Partial response to ABs

Treatment involved retrival of FB- bronchoscopy
Radiographs may only show subtle evidence

Year 4 Small Animal Studies (97 decks)

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