Respiratory Disease Flashcards
What do you need to perform and endotracheal wash
Sedation
Endoscope
Tracheal wash catheter
Sterile saline
Sample pots
What do you need to perform a bronchoalveolar lavage
Sedation
BAL tube
Local anaesthetic
Sterile saline
Sample pots
What do you need to perform a trans tracheal wash
Sedation
Large gauge IV catheter
Local anesthetic
Sterile gloves
Sterile prep
Canine urinary catheter
Sterile saline
Sample pots
What is the advantage of a trans tracheal aspirate
No contamination from passing through the airways so gets the cleanest culture
Why is butorphanol often doubled for respiratory sampling
It is an antitussive so oppresses the cough reflex
What is a nasal swab used for
Viral isolation
- equine flu
- EHV 1 and 4
(Keep moist in transport)
What is the pathogenesis of influenza A virus
Infection of the respiratory epithelial cells that destroys cilia
Clinical signs of influenza A virus
Fever
Cough
Nasal discharge
Treatment of influenza A virus
Nursing care and anti-inflammatories
- antibiotics for secondary infection
Vaccines are available
Diagnosis of influenza A virus
Nasal swab - use proper ones
- detection of viral antigen via ELISA
- detection of RNA via PCR
Serum
- detection of antibodies - Elisa
- haemagglutination inhibition.
How is herpes virus 1,4 transmitted
Aerosol
Contact with fomites
Latency reactivation
Pathogenesis of EHV1, 4
Infection of respiratory epithelium -shedding
Dissemination to secondary replication sites
- abortion from pregnant uterus
- neurological disease from spinal cord
Latency established
Clinical signs of EHV-1,4
Common - fever, cough / nasal discharge, poor performance
Occasional - abortion, neurological disease
Treatment of EHV-1, 4
Nursing case and anti inflammatories
Rest
Vaccines available
Diagnosis of EHV-1, 4
Nasal swab - PCR
Blood samples - antigen detection
Virus isolation in tissue culture
EVA transmission
Respiratory
Venereal
Congenital
Fomites
EVA pathogenesis
LRT infection, infected monocytes/T lymphocytes replicate in lymph node to create a cell-associated viraemia in the bloodstream
Persistent infection and abortion can occur
Clinical signs of EVA
Often asymptomatic
Fever
Nasal discharge
Loss of appetite
Respiratory distress
Skin rash
Muscle soreness
Conjunctivitis
Depression
Diagnosis of EVA
Virus PCR from body fluids or tissues
Elisa screening
Treatment of EVA
General supportive care in acute infection
Inactivated virus
No treatment for persistent infections
How is lungworm transmitted
Ingestion of L3 larvae
Donkeys main source
Pilobolus fungi possible transmission (as in cows)
Pathogenesis of lungworm
Mucopurulent exudate, hyperplastic epithelium, lymphocytic infiltrate in lamina propria
Clinical signs and treatment of lungworm
Moderate - severe coughing
Treatment moxidectin/ivermectin
What is the DISH outbreak control
Disinfection
Isolation
Submission of samples
Hygienic procedures
Reasons for treating URT noise
Dyspnoea
Cosmetics
Poor performance
Dysphagia
What is the alar fold
Separates the diverticulum from true nostril
Supports dorsal and lateral nostril
Conditions that effect the external nares
Epidermal inclusion cysts (atheromas)
Redundant alar folds
Lacerations
How many pairs of paranasal sinuses are there
7
What sinuses are in the rostral group
Rostral maxillary
Central conchal
Which sinuses are in the caudal group
Caudal maxillary
Dorsal conchal
Ethmoidal
Frontal
Sphenopalatine
What lies in the maxillary sinus
The tooth routes of the 4th/5th/6th maxillary cheek teeth - infection causes sinusitis
What are the indications for sinus surgery
Expansive lesions in the sinus
Primary sinusitis
Severe trauma of facial bones
What are the treatment options for dorsal displacement of the soft palate
Staphylectomy (no longer recommended)
Myectomy
Palatal fibrosis
Tie forward (currently most popular 80% success)
What is dynamic pharyngeal collapse
collapse of pharyngeal wall when negative pressure highest caused by dysfunction of mechanoreceptors and neuromuscular reflexes
What are the treatment options for recurrent laryngeal neuropathy
Laryngoplasty (tie back)
Ventriculectomy (hobday)
Ventriculocordectomy
Arytenoidectomy
Neuromuscular pedicle graft
Complications of recurrent laryngeal hemiplegia surgery
Dysphagia
Aspiration pneumonia
Implant failure
Arytenoid chondropathy
Different size arytenoids
Loss of bumps on mucosa
Rounded muscular process on palpation
Treatment of arytenoid chondropathy
Antimicrobials
Anti-inflammatories
Surgery
- local excision
- arytenoidectomy
Permanent tracheostomy
What is the difference between a tracheostomy and a tracheotomy
A tracheostomy is permanent
Tracheostomy partially resects cartilage rings
Indication for Surgery of the gutteral pouch
Tympany
Empyema
Chondroids
Where is unilateral nasal discharge from
rostral to nasal septum
Clinical signs of URT disease
Unilateral/bilateral nasal discharge
Swelling/pain/lymph node enlargement
URT noise
Cough
Exercise intolerance
Increased respiratory rate and effort
Appetite and demeanor changes
Possible causes of epistaxis t
Trauma, FB
Vascular damage
Erosive conditions
Possible causes of mucoid/serious discharge
Viral infection
Non infectious inflammatory disease
Causes of purulent non odorous discharge
Bacterial +/- viral infection
Causes of purulent discharge with foul odour
Usually mixed bacteria with anaerobes (often with underlying causes)
Causes of food material nasal discharge
Choke
Grass sickness
Breakdown or pharyngeal anatomy
Differentials for nasal passages disease
Cleft palate
Cysts
Polyps
Ethmoid haematoma
Trauma
Fb
Fungal rhinitis
Neoplasia
Differentials for sinus disease
Primary/secondary bacterial sinusitis
Cysts
Neoplasia
Ethmoid haematoma
Trauma
Fungal sinusitis
FB
Differentials for gutteral pouch disease
Empyema
Mycosis
Tympany
Trauma
Neoplasia
Differentials for pharynx/larynx disease
Pharyngitis
URT bacterial/ viral disease
Arytenoid chondropathy
Fb
Differentials for lung disease
Inflammatory conditions
Infectious conditions
Neoplasia
EIPH
What pathogen causes strangles
Streptococcus equi
Clinical signs of strangles
Nasal discharge - mucopurulent
Dysphagia
Cough
Laryngeal pain
Extended head
Pyrexia
Lymph node abcessation
Diagnostics for strangles
History
Clinical signs
Endoscopy, ultrasound, radiology
Culture
qPCR from lavage
Serology - identify exposed for PCR
Treatment for strangles
Nsaids
Soft palatable high calorie diet
Abscess management
Isolation
Nursing care
What is haemoptysis
Coughing up of blood
Nasal cavity causes of epistaxis
Foreign bodies
Fungal granulomas
Neoplasms
Profuse
Iatrogenic
Ethmoid haematoma
Trauma
Paranasal sinus causes of epistaxis
Trauma
Neoplasia
Ethmoid haematoma
Coagulation disorders
Gutteral pouch causes of epistaxis
Mycosis
FB
Neoplasia
Purpura
DIC
Clotting defects
Rectus capitis muscle rupture
Oral cavity, pharynx and larynx causes of epistaxis
FB
Neoplasia
Purpura
DIC
Clotting defects
Trauma
Iatrot
Tracheal/lung causes of epistaxis
Pulmonary haemorrhage - epih
Trauma
Pneumonia
Neoplasia
FB
Iatrogenic - lung biopsy/ng tube
Diagnostics for epistaxis
History
PE, oral and nares exam
Complete CBC
Clotting profile
Biochemistry
Endoscopy
Radiography and ultrasonography
TTW and BAL
Diagnostics for unilateral nasal discharge
History and signalment
Physical exam
Radiography
Endoscopy
Oral/dental exam
CT/MRI
History and signalment for unilateral nasal discharge
Young - primary infection and congenital problems common
Older - neoplasia, ethmoid haematoma and dental disease
Onset, duration, clinical progression and incontacts important
Physical exam for unilateral nasal discharge
Type and smell of discharge
Lymph nodes
Pyrexia
Lumps and bumps
Sinus percussion
Radiography for unilateral nasal discharge
Good for bony lesions, locating fluid
Not good for soft tissue and fluid types
Endoscopy for unilateral nasal discharge
Good for visualizing internal structures, differentiating soft tissue and fluid
Not good for bony lesions and severe epistaxis
Oral/dental exam for unilateral nasal discharge
Last 3-4 teeth in contact with sinus
Dental disease can cause secondary sinusitis
Pleuro Pneumonia
Infection of lower respiratory tract extended into pleural space
Exudative - sterol transudate into pleural space
Fibrinopurulent - bacterial invasion and fibrin deposition
Organisation - fibroblasts grow into exudate
Risk factors for Pleuro Pneumonia
Viral infection.
Strenuous exercise
Transportation/head elevation
GA
Overcrowding
Dysphagia
Caudal agents of Pleuro Pneumonia
Streptococcus equi .zooepidemicus
Staphylococcus aureus
Actinobacillus
E coli
Bacteroides
Fusobacterium
Clinical signs of pleuropneumonia
Tachycardia/tachypnoea
Respiratory distress
Fever
Anorexia
Depression
Nasal discharge
Exercise intolerance
Crackles and dull areas on auscultation
Clinical pathology of pleuropneumonia
Neutrophilic leukocytosis
Leukopenia
Anaemia
Increased fibrinogen andcSAA
Decreased iron
Antibiotic treatment for Pleuro Pneumonia
1st line - penacillin and gentamycin
Adjustments on C and S
Can use antimicrobials via nebulizers
Nebulizer types
Jet - cheap, easy, inefficient, need compressed gas and tubing
Ultrasonic - easy and more efficient, large residual volume, degradation with heating
Mesh - fast, quiet and portable, easy, efficient, expensive an needs cleaning
Thoracocentesis
7/8th ics above costochondral junction
Aseptic prep
Diagnosis - c and s and cytology
Therapeutic - drain, remove bacteria, decrease adhesion formation, improve respiratory function
