Respiratory Disease - The Dyspnoeic Cat

Question 1

What are the clinical signs of respirtory distress in cats?

Answer 1

techypnoea, orthopnoea, open mouth breathing, mucous mebrane colour, dyspnoea, heart rate increase of decrease

Question 2

How would you triage a dyspnoeic cat?

Answer 2

• assess most life-threatening concern
• respiratory
• cardiovascular - tachycardia, weak pulses
• neurological - signs of head trauma or abnormal mentation

Question 3

What would you observe when examining a dyspnoeic cat?

Answer 3

rate, effort and pattern of breathing

Question 4

What would you physically examine?

Answer 4

asculation, percussion, cranial rib spring, oxygenation

Question 5

What is percussion?

Answer 5

When you tap the chest while auscultating

Question 6

What would you see with inspiratory dyspnoea?

Answer 6

dynamic extrathoracic upper airway obstruction

Question 7

What would you see with expiratory dyspnoea?

Answer 7

• intrathoracic upper airway obstruction
• lower airway disease e.g feline asthma

Question 8

What might occur if a cat is expericning rapid shallow breathing or slow laboured breathing?

Answer 8

• pleural space disease
• parenchymal disease

Question 9

What is paradoxical breathing

Answer 9

when the chest wall and abdomen are moving abnormally

Question 10

What does adventition lung sounds mean?

Answer 10

abnormal respiratory noises

Question 11

What does steror mean?

Answer 11

snore like low pitched noise

Question 12

What does stridor mean?

Answer 12

high pitched noise associated with laryngeal or tracheal collapse

Question 13

What are we listening for when auscultating?

Answer 13

• normal breath sounds
• adventitious sounds such as wheezes or crackles
• stertor or stridor

Question 14

What are we palpating the thorax for?

Answer 14

compressibility

Question 15

What are the causes of dyspnoea caused by upper respiratory tract obstruction?

Answer 15

-foreign bodies, nasopharyngeal polyps, laryngeal tumours

Question 16

What are the causes of dysponea caused by lower respiratory disease?

Answer 16

• feline asthma/bronchitis

Question 17

What are the causes of dyspnoea caused by pleural space disease?

Answer 17

• pneumothorax, pleural effusion (many causes), haemothorax, diaphragmatic rupture

Question 18

What are the causes of dyspnoea caused by parenchymal disease?

Answer 18

• pulmonary oedema (heart disease), haemorrhage, infection, neoplasia, fibrosis

Question 19

What are some examples of laryngeal disease?

Answer 19

• neoplasia
• oedema
• foreign body
• spasm
• paralysis
• abscess
• granuloma

Question 20

What are some examples of feline lower airway disease?

Answer 20

• asthma
• chronic bronchitis
• bacterial infection
• lungworm - aelurostrongylus abstrusus
• foreign body
• neoplasia

Question 21

What are some examples of feline chronic lower airway disease?

Answer 21

• feline asthma(type 1 sensitivty response to allergen, airway hyper-responsiveness, reversible bronchocontriction, secondary inflammation)
  chronic bronchitis (airway inflammation, excess mucus production, leads to airway arrowing)
• can develop pneumothorax

Question 22

How can you treat feline lower airway disease?

Answer 22

• emergency treatment (stress-free, oxygen, bronchodilators)

Question 23

What are some examples of bronchodilators?

Answer 23

• terbutaline 0.015mg/kg
• salbutamol 1-2 puffs

Question 24

What are some causes of parenchymal disease?

Answer 24

• haemorrhage
• pneumonia
• oedema (cardiogenic, non-cardiogenic)
• neoplasia
• fibrosis

Question 25

Emergency treatment for cardiogenic oedema

Answer 25

• cage rest
• oxygen
• sedation if necessary
• furosemide i/m

Question 26

Causes of pleural space disease

Answer 26

• pleural effusion
• pneumothorax
• neoplasia
• diaphragmatic rupture

Question 27

Examples of exudate in the pleural space

Answer 27

• pyothorax (sepsis)
• neoplasia, FIP (non-septic)
• chyle - congestive heart failure trauma, idiopathic)
• blood (trauma, coagulopathy, neoplasia)

Question 28

What would transudate be?

Answer 28

fluid in the extracellular space, hypoalbuminaemia

Question 29

What equipment would you need for a thoracocentesis?

Answer 29

• procedures book
• hair clippers
• sterile prep kit
• gloves
• butterfly catheter
• three-way tap
• EDTA tube
• plain tube
• 20ml syringe

Question 30

Emergency care for the dyspnoeic cat

Answer 30

• stress free environment
• sedation
• oxygen
• equipment for thoracocentesis/intubation (tracheostomy)
• ultrasound/radiography
• medication

Question 31

What are some examples of glucocorticoids?

Answer 31

• dexamethasone IV or IM
• fluticasone inhalor

Question 32

What is the first thing you would do if you suspect upper respiratory tract disease?

Answer 32

intubate

Question 33

What is the first thing you would do if you suspect lower airway disease?

Answer 33

provide bronchodilators

Question 34

What is the first thing you would do if you suspect congestive heart failure?

Answer 34

provide furosemide

Question 35

What is the first thing you would do if you suspect pleural space disease?

Answer 35

perform a thoracocentesis

Question 36

A cat comes in with 3 week progressive lethargy and respiratory noise, you observe inspiratory dyspnoea, what do you suspect?

Answer 36

upper respiratory disease, stridor (noise over the larynx), suspect laryngeal disease

Question 37

A cat comes in with intermittent coughing for 2 months with sudden onset dyspnoea, you observe tachypnoea, expiratory effort and no upper respiratory noise, what do you suspect?

Answer 37

potentially lower airway disease, hear expiratory wheezes and increase resonance, suspect feline chronic lower airway disease

Question 38

A cat comes in with IBD diagnosed 2 weeks previously with endoscopic biopsies which was treated with prednisolone. They present with progressive tachypnoea/dyspnoea and you observe rapid, shallow breathing with no upper respiratory noise, what do you suspect?

Answer 38

• potentially either parenchymal disease of pleural space disease.
  there is no muffling of the heart or lung sounds so could be parenchymal disease, there are gallop sounds and poor pulse quality and showing signs of congestive heart failure