Respiratory Diseases Flashcards

1
Q

What are the categorizations of respiratory diseases

A

Infections (bacterial/viral/fungal/parasitic)

Allergic

Mechanical

Traumatic

Aspiration pneumonia

Toxicity (inhaled/ingested)

Neoplasia

Secondary to another disease process

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2
Q

What is pneumonia

A

Inflammation to the lungs, can be infectious or non infectious

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3
Q

What is pneumonitis

A

Inflammation to the lung specifically due to a non infectious cause

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4
Q

What is interstitial pneumonia/viral pneumonia

A

Pneumonia due to a viral infection

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5
Q

Describe viral infections of the respiratory tract

A

Viruses primarily infect the upper respiratory tract (is possible to infect lower respiratory tract)

Will predispose the animal to secondary bacterial infections

Can involve the globe, conjunctiva, lacrimal ducts, eyelids and oral mucus membranes

Diffuse lung damage can occur with lower respiratory tract infections

Won’t hear crackles in the lungs

Ratio and effort is similar

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6
Q

What are the signs of a viral infection of the upper respiratory tract

A
Conjunctivitis 
Ocular discharge (clear to cloudy)
Rhinitis 
Sneezing
Nasal discharge (serous to purulent)
Inappetence (can’t smell food)
Lethargy 
\+/- fever and coughing
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7
Q

What are the signs of a viral infection of the lower respiratory tract

A
Fever
Lethargy 
Anorexia 
Dry cough
Serous to mucopurulent nasal discharge 
Increased lung sounds 
Often accompanied with URT disease
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8
Q

True or false

Upper respiratory tract infections are extremely common in cats

A

True

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9
Q

Describe viral upper respiratory tract infections in cats

A

Often cause chronic flare ups throughout life (especially with stress)

Can affect the cornea, conjunctiva, lacrimal ducts, eyelids, mucous membranes, nasal cavities and sinuses

Often present sneezing, increased tearing and can have dendritic corneal ulcers secondary to herpes virus infections or oral ulcers (painful)

Chronic disease can lead to destruction of the nasal turbinates

Most cases are self resolving

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10
Q

Describe bacterial infections of the respiratory tract

A

Can affect upper or lower tract

Often a sequela to viral infections (from death of lymphocytes which compromise the immune system)

Often self resolving

Ex. Canine kennel cough (has bacterial and viral components)

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11
Q

Signs of bacterial infections of the upper respiratory tract

A
Sneezing
Coughing 
Mucopurulent to purulent nasal discharge
Lethargy 
\+/- Inappetence And Fever
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12
Q

True or false

You can use supportive antibiotics with viral infections

A

FALSE

never use antiBIOTICS on a viral infection or vise versa

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13
Q

What is Atrophic Rhinitis

A

Condition that affects pigs

Infections from pasteurella multocida and bordetella bronchiseptica

Signs: coughing, sneezing, inflammation of the lacrimal ducts, epistaxis, lateral deviation, shortening of upper jaw and atrophy of the nasal turbinates

Prevention: vaccination

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14
Q

Describe bacterial infections of the lower respiratory tract

A

More severe than bacterial infections of the URT

inflammation of the lung which causes increased mucous production, inflammatory cells will move into the alveoli to fight infection and increases secretions, making it purulent

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15
Q

True or false

Bacterial can reach the lung through the airways or the blood stream

A

True

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16
Q

If pneumonia is from a blood borne pathogen, the infection may be more

A

Diffuse

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17
Q

Signs of a bacterial infection of the lower Respiratory tract

A
Fever
Lethargy 
Anorexia 
Coughing (productive: will swallow) 
Purulent nasal discharge 
Abnormal lung sounds (crackles on inspiration)
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18
Q

True or false

Bacterial infections of the lower respiratory tract normally need antibiotics

A

True

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19
Q

What is the most common fungal infection in southern Saskatchewan

A

Blastomycosis

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20
Q

Describe blastomycosis

A

Normally from inhalation

Also causes ocular, skin and nervous system disease (skin lesions and glaucoma)

Radiographs: multi focal, round fuzzy edge lesions throughout the lungs

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21
Q

Give some examples of parasitic lung diseases

A

Visceral larval migrans: round words

Lung worms

Tape worms

Verminous bronchitis

Verminous pneumonia

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22
Q

How do you manage infectious respiratory diseases

A

Infectious diseases (especially viral and bacterial) are extremely contagious

Effective decontamination protocols, management and isolation of cases is essential to prevent spread

Also vaccination and environmental protocols

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23
Q

Who are allergic lung disease most common in? Give an example of their disease

A

Horses (>6 yo): heaves or recurrent airway obstruction (RAO)

Cats: feline asthma

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24
Q

True or false

Allergic rhinitis is rare in animals

A

True

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25
Describe the signs of animals with allergic lung disease, include how the animal acts between episodes
Between episodes the animal is relatively normal, BAR etc. When mild or severe episodes occur, signs vary from coughing, increased respiratory rate, expiratory wheezes and severe Dyspnea
26
What are the 3 changes that occur in animals with allergic lung disease that contribute to what signs we see?
Thickening of mucosa of the airways Bronchospasm (causes narrowing of the airways because the lungs are trying to prevent the spread of mucous into the alveoli, causes wheezing) Increased mucous production and thicker mucous in lower airways All 3 reduce airflow and air exchange within the alveoli
27
Describe equine recurrent airway obstruction (heaves)
Common in horses >6yo Due to allergic reactions to airborne particles (mold in hay/straw is common) Signs: Coughing, exercise intolerance, nasal discharge, flared nostrils, wheezing, increased respiratory rate, “heave line” Can lead to emphysema
28
What is a heave line
Due to increased abdominal effort during expiration, causes hypertrophy of the abdominal muscles
29
What is emphysema
Membranes in the alveoli regress and end up with enlarged alveoli and no oxygen uptake
30
How do you diagnose RAO
Bronchoalveolar lavage is a common diagnostic procedure
31
How do you treat RAO
Medications: bronchodilators, steroids, anti inflammatories changes in management and housing to minimize exposure to allergens
32
What is the preferred methods of administering medications to allergic lung disease patients , why is this?
Injectable or inhaled These are faster acting and act directly on the lungs
33
Describe feline asthma
Allergic reaction in response to inhaled allergens Common in cats, and a primary differential diagnosis in cats. Cats are often 4-5 years old when they start to show signs Chronic and progressive (especially if not treated) Clinical signs range from mild to life threatening
34
Why do cats need to be handled in a low stress manner with respiratory disease
Stress it over exertion can cause them to decompensate and die very quickly
35
How do cats with feline asthma normally present
In a crouched position With a history of coughing, expiratory wheezes, increased expiratory rate
36
What do radiographs of a cat with feline asthma look like
Flattened diaphragm due to over inflation of the lungs (very large lung space and compression of the heart)
37
How would you describe treatment of feline asthma
The same as RAO/heaves in horses
38
Mechanical airway diseases are limited to the
Upper respiratory tract
39
What is collapsing trachea
Seen in obese middle aged and older miniature and toy breed dogs Paroxysmal (recurrent) episodes, “goose honking” cough that is exacerbated by exercise/excitement/overheating Caused by abnormal composition of hyaline rings in the trachea; lose shape and don’t hold during respiration and causes narrowing when breathing (stridor) Can see a collapsed trachea on radiographs
40
What is the medical management of collapsed trachea
Weight loss, use of harness instead of collar, prevent over heating and excitement, antitussives, Can place a mesh stent to hold open the trachea
41
What are the four main presenting components of brachycephalic syndrome
Stenotic nares: narrow nostrils that reduce air flow Excessive soft tissue in oral and nasal cavities: wide tongue and elongated soft palate and short snout Hypoplastic trachea: diameter is smaller than normal Everted laryngeal saccules: stenotic nares and long soft palates cause the tissue lining the saccules to be sucked into the airway, impeding air flow (stridor)
42
What are brachycephalic dogs prone to
Over heating | Respiratory disease
43
True or false | Intubation of brachycephalic dogs is challenging
True
44
True or false | Masking a brachycephalic dog instead of intubating is acceptable
FALSE never mask a brachycephalic -can actually prevent air flow further
45
Describe what you should do when intubating a brachycephalic
Remove intubation tube When they are awake and can no longer tolerate it (this often takes a while since they often like the intubation tube and can breath better with it in) Always consider pre-oxygenation Monitor very closely after sedation and during and after surgery
46
What is laryngeal paralysis
Inherited or acquired condition Occurs in dogs and cats but more common in large breed dogs Affects the abductor muscles of the larynx Clinical signs: voice change, exercise intolerance, respiratory distress, coughing, Inspiratory stridor,
47
What is the diagnosis and treatment of laryngeal paralysis
Suspected based on exam, diagnosed with a sedated exam of the larynx Treatment: restrict activity, avoid over heating and excitement, anti anxiety meds, and surgically; a laryngeal arytenoid tie back (affected cartilage is sutured laterally) these animals also cannot swim
48
With the clinical signs associated with laryngeal paralysis, what should you always consider as well?
Rabies
49
What is equine left laryngeal hemiplegia (Roaring)
Similar to laryngeal paralysis, likely inherited, common in thoroughbreds and draft breeds, normally first noted when 2-3yo It is the loss of control of the abductor muscles in the larynx, collapse of arytenoid cartilage and vocal folds, causing reduced airflow. increased inspiration effort (exercise) Causes increased collapse of structures Signs: exercise intolerance, increased inspiratory noise Treatment: laryngoplasty Diagnosed: endoscopic exam of the larynx
50
What are pulmonary contusions
Blunt trauma causes damage to the blood vessels, causing edema and blood accumulation in the pulmonary tissue Clinical and radiographic signs may not be fully apparent until 12-24 hours after trauma Signs: tachypnea, Dyspnea, increased respiratory effort, crackles Treatment: supportive, there is no fix (oxygen therapy, exercise restriction, sedation)
51
What is a hemothorax
When blood accumulated in the thoracic cavity between the lungs and body wall Indistinguishable from pleural effusion on radiographs Two important signs: Blood loss and fluid accumulate by in the thoracic cavity Treatment: supportive care, blood transfusion, therapeutic thoracocentesis, theracotomy or euthanasia if severe enough
52
What is a pneumothorax
Accumulation of air in the thoracic cavity May be from a penetrating wound from the outside to the thoracic cavity (can be iatrogenic caused by a laceration, aggressive intubation or during theracocentesis) Diagnosis: radiographs (heart is floating on air in the chest) Signs: absence of lung sounds, shallow rapid breathing, external wounds, increased heart rate Treatment: depends on severity: supportive care, repair of wounds, therapeutic thoracocentesis, thoracotomy, euthanasia
53
What is a diaphragmatic hernia
When the diaphragm is not intact and the abdominal organs can move Into the thoracic cavity
54
What is aspiration pneumonia
Inhalation of food/meds/contrast media/fluids Most commonly occurs when normal protective swallowing mechanisms are impaired such as during: sedation, laryngeal paralysis, megaesophagus, cleft palates, neurological issues, when being force fed, regurgitation, or incorrect tube placement
55
Why are megaesophagus prone to aspiration pneumonia
Prone to regurgitation (from not having a closed glottis)
56
What do radiographs looking like with aspiration pneumonia
See fluid in the lungs in the cranioventral field of the thorax
57
What can aspiration pneumonia lead to? What are the signs?
Signs: crackles in the lungs Can lead to: toxemia (fever, increased HR, depression) Bacterial and chemical contamination and infection
58
How can you prevent aspiration pneumonia? How do you treat it?
With anesthesia: fasting, proper removal of tube, notify DVM with any signs of vomiting/regurgitation Proper tube placement with stomach tubing prior to food or med administration Megaesophagus: feed in upright position and meatballs of food Laryngeal paralysis: no swimming Treatment: there is no fix, supportive care, may need antibiotics with infections
59
Describe what inhaled toxins are and how the affect the lungs
Smoke inhalation is a common inhaled toxin Fine particles cause inflammation of the lungs leading to diffuse lung disease Signs: coughing, wheezing, depression, lethargy, secondary infections with a fever
60
Describe a common ingested toxin in cows and how the affect the lungs
Ex: fog fever or acute bovine pulmonary edema and emphysema Cattle will develop severe lung disease with a sudden transition to a diet high in tryptophan (lush pasture) The rumen bacteria convert tryptophan to 3-methylindole which is toxic to cells in the lungs Signs: abnormal lung sounds, respiratory difficulty, coughing, collapse, death
61
Describe neoplasia of the lungs
The lungs are a common metastatic site for most types of neoplasia in small animals (Metastasis is much more Common than primary Timor development) Must have 3 views on radiographs of the lungs in order to diagnose or eliminate neoplasia -often see many ping pong ball sized tumours
62
What are some common causes of secondary respiratory disease
``` Congestive heart failure Electrocution Strangulation Near drowning Fluid overload ```