respiratory disease Flashcards
Clinical signs of nasal disease
nasal dc, sneezing, facial deformity
causes of nasal discharge (location)
what factors to consider?
nasal cavity, sinuses, nasopharynx
unilateral/bilateral?
acute vs chronic
causes of unilateral or bilateral nasal dc
unilateral: FB, neoplasia, inflammatory, fungal
bilateral: systemic, infectious, neoplasia (progressed)
diagnostics for nasal disease
oral exam, aural exam, check nares for lesions, patency
culture, retroviral testing, coag tests
diagnostics for chronic nasal disease
CT, rhinoscopy, biopsy
types of nasal disorders
inflammatory, infectious, neoplastic, FB structural
primary bacterial rhinitis
mucopurulent nasal dc-> uncommon
dx- culture nasal lavage/brushing
canine nasal aspergillosis
C/S, dx, tx
caused by A. fumigatus, lg dose or immune dysfunction
common in young male GSD-> mucoid nasal dc, facial pain, nasal depigmentation
dx- CT, rads, serology, rhino w biopsy/cytology
tx- debridement, topical antifungal
canine inflammatory rhinitis
types, C/S, dx, tx
lymphoplasmacytic or eosinophilic
C/S: sneezing, bilateral nasal dc, no systemic illness
dx- CT, rhino, biopsy-> need to r/o other diseases
tx- humidification, identify allergens, trial antihistamines, steroids
canine nasal mites
C/S. tx
sneezing, reverse sneezing
milbemycin oxime q7d for 3wks
ivermectin 200mcg/kg 3wks twice
selamectin q2wks X3
nasal foreign body
signalment, C/S
lg breed dogs
acute onset sneesing, pawing at face, epistaxis
feline upper resp disease
syndrome- upper resp in cats (infectious, neoplastic, inflammatory, structural), URI
feline upper resp infection agents, transmission, C/S
viral- calici/herpes
mycoplasma sp, bordatella, chlamydophila, strep
resp ocular oral transmission:
FCV- contaminated environment, carrier cats
FHV- latent infection
C/S: depression, fever, oral ulceration, sneezing, conjunctivitis
acute FHV
sneezing, ocular/nasal dc, inappetence, fever, conjunctivitis, ulcerative keratitis
upper resp bacterial infection
chlamydophila- conjunctivitis
mycoplasma- conjunctivitis URI
bordetella- primary nasal dc and pneumonia
acute resp infection approach?
history and C/S diagnostic, further tests not pursued
when to obtain further testing for acute resp infection?
unusual or severe signs
legal issues
detect carriers
acute resp infection treatment
self limiting
- restore fluids, nebulize
- clean nasal dc
- appetite stimulants
- lysine
- famcyclovir
- probiotics, stress management
when to use abx for acute resp infection? which one?
signs >10d, fever, anorexia w nasal dc
doxycycline first choice-> further tests if failure
control strategies for acute resp disease
increase immunity (vx), decreasing exposure
feline chronic rhinosinusitis causes, C/S, dx, tx
secondary to FHV infection. hx nasal disease, recurrent dc, increases w stress
C/S- sneezing, steror, nasal dc, healthy
dx- EXCLUSION
complete oral exam, imaging, rhino, biopsy
tx- abx, air humidification, lysine, antiviral, nasal flushing if significant
feline nasal cryptococcus
etiology? dx, tx
cryptococcus neoformans/gattii-> inhalation of spores-> granulomatous lesions on nasal bones, nasal cavity
dx- LCAT (serum, CSF)
cytology w india ink
tx- oral/inj antifungal 6m
check titres- prognosis good w/o neuro
nasal planum SCC
signalment, dx, tx
locally invasive, white cats
dx- biopsy
tx- sx, radiation +/- chemo
common tracheal condition types
functional/structural. infectious
tracheal collapse causes and factors
dorsoventral flattening of tracheal rings
intra/extrathoracic trachea
worsened by obesity, chronic coughing, increased resp
tracheal collapse signalment, C/S, dx, tx
sm breed dogs
goose honk cough, resp distress (cyanosis, dyspnea)
dx- rads, tracheobronchoscopy, fluoroscopy
tx- weight loss, harness, tx concurrent dz, cough suppressant (hydrocodan, torb)
sx (referral)- stent
tracheal collapse grading
1- 25% collapse, circular rings
2- 50% collapse, dorsal membrane stretched
3- 75% collapse, pendulous membrane
4- 95% collapse
tracheal collapse look alkies on rads
visible (redundant) tracheal membrane
superimposed esophagus
hypoplastic trachea
congenital in bulldogs.
tx- treat concurrent disease (BOAS), can have good QOL
CIRDC
contagious acute onset infection, URT
PI, adenovirus-2, bordetella
CIRDC C/S, dx
dry hacking cough, sneezing, nasal dc, +/- fever
dx- hx, PE sample w complicated disease
tx- abx
tracheal rupture
after ET intubation in cats
dx- rads, outline of esophagus
tx- monitor resp status, most heal w/o intervention
canine chronic bronchitis
signalment, C/S
middle aged-older sm breed dogs
C/S- harsh cough daily >2m, +/- exercise intolerance, increased effort
canine chronic bronchitis dx?
exclude other causes (heartworm testing, fecal, TXR, airway cytology/culture)
canine chronic bronchitis tx?
oral pred 1mg/kg/d, taper down
fluticasone inhaler
bronchodilators, weight loss, avoid irritants, humidification
prognosis-inflammation/inflammatory mediators
feline asthma pathogenesis
airway inflammation-> excessive mucous-> bronchial wall edema-> bronchoconstriction
= airway narrowing
feline asthma dx
hx, C/S, exclude other dz (bronchitis, heartworm, parasitic, pneumonia)
rads- bronchial pattern, collapse of R middle, hyperinflation
definitive dx-> airway sampling (eosinophils) +culture
feline asthma tx
emergency and chronic
emergency:
oxygen, sedation (torb 0.2-0.4mg/kg IV)
bronchodilator (terbutaline), albuterol
0.1mg/kg dexamethasone IV
chronic: pred 1-2mg/kg/d
fluticasone +salbutamol for flare ups
eosinophilic lung disease
eosinophilic infiltration of bronchi and lungs, expected hypersensitivity response
need to r/o other eosinophilic diseases
signalment for eosinophilic lung disease, C/S
young/middle aged dogs
C/S- cough, gagging, retching, nasal dc, tachypnea, exercise intolerance
eosinophilic lung disease dx, tx
cbc- eosinophilia
rads- bronchial/interstitial pattern
CT- bronchial wall thickening, mucous plugs
bronchoscopy- thick mucous, granulomas increased eosinophils on airway sampling
tx- pred 1-2mg/kg/d, taper
prognosis good
deworm, remove allergens
pneumonia types/causes
bacterial- bordetella, mycoplasma, pasteurella, e.coli, strep
viral- CAV-2, distemper, influenza, PI
aspiration
fungal- blastomycosis, big 4
bacterial pneumonia presentation, C/S, dx, tx
unusual in healthy young pets- underlying disease (megaesophagus, FB, etc)
C/S- cough, fever, dyspnea, may be systemically ill
dx- rads (interstitial to alveolar), pleural effusion. cbc- leukocytosis, airway cytology/culture (bacteria, degenerate neutrophils)
tx- abx based on c+s 1-2 wks, IVF, oxygen, nebulize
C/S of pleural space disease
tachypnea, muffled heart/lung sounds
chylothorax
trauma, idiopathic, cardiac disease
predisposed in shibas, persians, older patients
dx- rads, fluid analysis w lymph, high triglycerides
tx- find underlying cause, tap, low fat diet. sx thoracic duct ligation w failed medical intervention
complication of 3rd space disease
hypoprotenemia (repeated taps), infection
fibrosing pleuritis (scalloped outline, persistant dyspnea)-> lung parenchyma doesnt expand
mediastinal mass types
neoplasia (lymphoma, thymoma)
abscess, cyst
mediastinal mass C/S
resp compromise (pushing on lungs), decreased lung sounds, dysphagia, cough, horners, edema of head and neck
mediastinal mass dx, tx
rads- widening, tracheal elevation
U/S- biopsy
CT if sx
tx- radiation, chemo, sx (neoplasia) cysts/abscess sx
