Respiratory Diseases in Dogs, Cats and Rabbits Flashcards
What is the usual clinical presentation of Upper Respiratory Tract Disease?
- Sneezing/ nasal discharge
- Stridor
- Increased respiratory effort
- Facial deformity
- Altered vocalisation/ Loss of voice
What is the usual clinical presentation of Lower Respiratory Tract Disease?
- Coughing
- Dyspnoea
- Exercise Intolerance
- Respiratory Distress
- Other systemic signs
What are the three most common causes of URT in cats?
- Feline Upper Respiratory tract Infection
- Feline Herpes Virus
- Feline Calcivirus
What is feline herpes virus associated with?
Sneezing.
* Ocular discharge, conjunctivitis, keratitis and corneal ulcers.
* Infection at a young age can result in chronic rhinitis.
What is feline calcivirus often associated with?
Oral ulceration.
* Sneezing and nasal discharge.
* Chronic stomatitis and gingivitis.
* Can develop pneumonia in severe cases.
What are the clinical signs of URT Infection in cats?
Depression.
* Difficulty/pain on swallowing and anorexia.
* Pyrexia.
* Ocular and nasal discharge and sneezing.
* Salivation.
* Coughing.
* Voice changes.
How might you diagnose a feline upper respiratory tract infection?
Clinical presentation is often suggestive.
* Polymerase chain reaction (PCR) from oropharyngeal or conjunctival swabs.
* Viral isolation (VI) from oropharyngeal or conjunctival swabs (not as widely available)
How might you treat a feline upper respiratory tract infection?
Supportive care (hydration, nutrition).
* Antiviral therapy for FHV-1 (e.g., famciclovir).
* Broad-spectrum antibiotics for secondary bacterial infections. (Amoxicillinclavulanate is often appropriate.
* Nebulisation (saline)and steam therapy can help ease respiratory congestion.
* Mucolytics.
How might we prevent upper respiratory tract infections?
Regular vaccination (reduce shedding and clinical signs).
* Stress can cause recrudescence so try to avoid.
* Environmental control (good hygiene, solid walls in cattery)
What is chronic rhinosinusitis?
A chronic inflammatory condition, usually post-viral (secondary to FHV-1 or FCV infections). Damage to nasal turbinates reduces mucosal immunity and leads to chronic secondary infection.
What are the clinical signs of chronic rhinosinusitis?
Persistent or recurrent nasal discharge (mucopurulent).
* Sneezing.
* Nasal obstruction
How might you diagnose chronic rhinosinusitis?
History, clinical signs and examination.
* Rule out other causes.
* Radiography.
* Rhinoscopy with biopsy for histopathology (neutrophilic and mixed
inflammatory infiltrate).
* Advanced imaging (CT or MRI) to assess sinus involvement
How might you treat chronic rhinosinusitis?
Aimed at controlling severe clinical signs.
* Broad spectrum antibiotics (often osteomyelitis of turbinates so long courses of
antibiotics (2-6 weeks) may be necessary. Ideally based on culture and sensitivity.
* Nebulised saline and steam treatment.
* NSAIDs (Care with long-term use and only if eating and well hydrated).
* Antivirals e.g., Famciclovir anecdotal reports that can be beneficial.
* Topical nasal decongestant (e.g., phenylephrine, xylometazoline) short term use only.
* Owners need to be aware that long-term management and recurrent courses of
treatment will be required.
What causes allergic rhinitis?
Caused by exposure to allergens including Pollens (from trees, grasses, or weeds), dust
mites, moulds, cigarette smoke or other airborne irritants, household chemicals or
cleaning agents. Less common than post viral chronic rhinosinusitis but can be more
responsive to treatment
What are the main clinical signs of allergic rhinitis?
Sneezing: Often intermittent but may become frequent in response to allergen
exposure.
* Nasal Discharge: Usually serous (clear, watery), though mucopurulent discharge can
occur if secondary bacterial infection develops.
* Cats may paw at their noses or face.
* Conjunctivitis: Often accompanies nasal signs in cases of allergic rhinitis.
* Coughing and Wheezing: In severe cases, allergic rhinitis may be associated with
allergic bronchitis or feline asthma.
How might you diagnose URT disease in cats?
Seasonal pattern of clinical signs.
* An improvement in clinical signs following anti-inflammatory or antihistamine therapy can
support a diagnosis of allergic rhinitis.
* Exclusion of Other Causes (especially infectious causes).
* Eosinophilic or lymphoplasmacytic infiltrate present on biopsy.
How might you treat URT disease in cats?
Reduce exposure to inhaled allergens (eg, cat litter house dust, cigarette smoke, aerosol
sprays).
* Antihistamines (eg, cetirizine), response can be unpredictable.
* Systemic administration of anti-inflammatory doses (e.g., prednisolone 1 mg/kg/day, then
titrated down to the minimum effective dose).
* Inhaled corticosteroid delivered via a feline aerosol chamber once initial signs controlled.
What are the clinical signs of URT disease in cats?
- Sneezing- Sudden and Severe
- Nasal Discharge- usually unilateral, can be serous mucopurulent or haemorrhagic
- Gagging, Coughing or Reverse Sneezing
- Pawing at the nose or face
- Halitosis- secondary infection develops due to retained foreign material
- Open-Mouth Breathing or Stridor- In severe cases where there is significant obstruction or inflammation causing respiratory distress
How might you diagnose Nasopharyngeal Foreign Bodies?
Examination of nasopharynx under general anaesthesia. May be immediately visible
or require nasopharyngoscopy.
* Nasal flushing may be necessary if located very rostrally.
How might you treat nasopharyngeal foreign bodies?
Removal of foreign material
* May require NSAIDs and or antibiotics if more long standing.
What is a nasopharyngeal polyp?
Cause is not fully understood (possibly chronic inflammation of middle ear). These are benign pedunculated growths commonly found in young cats, arising from the middle ear or nasopharynx.
What are the clinical signs of nasopharyngeal polyps?
Chronic nasal discharge (usually unilateral).
* Stertor, difficulty breathing, possible dysphagia (obstruction of nasopharynx).
* Otitis externa or media, possible vestibular signs or Horner’s syndrome if extending into middle ear
How might you diagnose Nasopharyngeal polyps?
Visual examination (otoscopy or rhinoscopy) and imaging (radiography).
* Histopathological examination after excision.
How might you treat nasopharyngeal polyps in cats?
Surgical removal of the polyp.
* Recurrence is possible, especially if the stalk is not fully excised.
* Temporary Horner’s syndrome is common but usually resolves.
* NSAID or corticosteroid can be used post-operatively to reduce secondary
inflammation.
* Antibiotics indicated if more chronic and evidence of secondary infection on
removal
What is fungal rhinitis?
Emerging disease of cats worldwide. Can be caused by Cryptococcus species (rare in UK), Aspergillus
species and Penicillium species
What are the clinical signs of fungal rhinitis?
Chronic nasal discharge +/- epistaxis.
* Stertor.
* Facial swelling
* Sometimes neurological signs if extension into the CNS
How might you diagnose fungal rhinitis?
Serology (Cryptococcus spp)
* Imaging (Radiography, endoscopy, turbinate lysis frequently seen on CT
* Cytology and Culture of fungal plaques
How might you treat fungal rhinitis?
Long-term antifungal therapy (intranasal clotrimazole or oral itraconazole or posaconazole).
* Surgical debridement may be required in severe cases.
* Guarded prognosis, recurrence likely
What is feline asthma?
Asthma is a common lower-airway inflammatory disease in cats thought to be allergic in origin
What are the clinical signs of feline asthma?
- Cough
- Increased expiratory effort
- Open Mouth breathing
- Tachypnoea
- Vomiting
How might you diagnose feline asthma?
Rule out other diseases that can mimic clinicopathologic features of
asthma
* Radiographs: bronchial or bronchointerstitial lung pattern common.
* Bronchoscopy mucus, mucosal hyperemia, airway collapse, and
stenosis.
* Eosinophilic inflammation on BAL cytology (>20% eosinophils).
* Thoracic CT can identify subtle lesions that may not be appreciated
on radiograph
How would you manage feline asthma orally?
Glucocorticoids (Prednisolone 0.25-1 mg/kg PO BID. Taper to
minimal effective dose for maintenance therapy).
* Bronchodilators (Terbutaline 0.625 mg PO BID, Theophylline
25 mg/kg PO SID)
How would you manage feline asthma (inhaling agents) ?
Glucocorticoids (Fluticasone (110 ug q 12h, may increase up
to 220 ug twice a day).
* Bronchodilators (Salbutamol or albuterol 1 puff/ 10 kg up to
a maximum of 3 puffs
What is the definition of common bronchitis?
Likely secondary to a previous airway insult, such as respiratory infections or inhaled irritants leading to permanent damage to the airways. Shares many historical, clinical and radiographic features of feline asthma
what are the clinical signs of chronic bronchitis
Chronic coughing (paroxysmal, productive, retching, gagging).
* Recurrent bouts of bronchopneumonia.
* Tachypnoea and dyspnoea.
* Exercise intolerance.
* Cachexia, debility
how might you diagnose chronic bronchitis
Radiographs showing thickened bronchial walls,
* Bronchoscopy showing excessive mucus
roughened hyperaemic mucosa.
* Nondegenerate neutrophilic inflammation on BAL
cytology
how might you manage chronic bronchitis
Glucocorticoids and bronchodilators (oral and/or
inhaled).
* Airway humidification (steam therapy)
