Respiratory emergencies (Conner) Flashcards
Muscles of inspiration
- Diaphragm most imp
- contraction:
- abdominal contents move caudally and ventrally
- chest cavity increases in volume in craniocaudal direction
- ribs lifted
- contraction:
- External intercostals
- contraction
- pulled cranially and ventrally
- contraction
- Scalene: accessory moscle of inspiration
- Sternomastoids: pull sternum cranially
- Alae nasi: nasal flare
During normal breathing abdomen
- DOES move
- abdominal muscles not involved in normal breathing
Muscles of expiration
- Not emplyed during normal tidal breathing
- Elastic properties of lung & chest wall
- recoil to equilibrium
- When needed
- adbominal wall contraction
- inc intraabdominal pressure
- pushes diaphragm cranially
Labored breathing
Def
- Outward signs of breathing difficulty
- often includes engagement of accessory muscles of inspiration and/or expiration
Dyspnea
def
- Sensation of breathlessness
- patient in trouble and panicking
Tachypnea
def
Increased respiratory rate
Orthopnea
Def
- Positional increases in difficulty
- vet patients often extend head, and neck, abduct elbows
Rapid localization of problem
- Upper respiratory
- problems on inspiration
- Lower airway
- problems on expiration
- Parenchymal
- increased effort during all phases
- Pleural space
- short, shallow breathing
*combinations are common
Minimize stress in cats
- don’t scruff
- hands off is better
- minimize stress
Approach to respiratory distress
Oxygen
- Doesn’t always help
- doesn’t hurt
- method of delivery may induce stress
- Oxygen cage
- Mask/flow by
- Hood
- Nasal cannula
Approach to respiratory distress
Sedation
- Dyspnea is stressful
- Ideal sedative
- rapid onset
- multiple routes admin
- minimal cardiac/resp effects
- reversible
- Butorphanol
- 0.1-0.3 mg/kg IV or IM
- repeat if needed
Three keys to approaching resp distress
TQ
- Minimize stress
- Oxygen
- Sedation
Contraindications for oxygen
- If your patient is on fire
If all else fails
- Sedate and intubate
- reduces stress and work of breathing
- Short-term solution to facilitate diagnostics
- May need to continue with mechanical ventilation
*Better to intubate a living patient than a dead patient that just suffered resp distress
Diagnostics
Initially
- Brief physical exam
- visual inspect
- brief auscultation
- (T)PR
- mm
- Take step-by-step approach
- Give patient lots of breaks
Diagnostics
When patient more calm and stable
- Full physical exam
- Blood sample
- Imaging
- thoracic rads
- Fluoroscopy
- echocardiography
- bronchoscopy
- comuted tomography
Rule #1 of diagnostics in respiratory cases
Don’t kill your patient to get diagnostics
-that’s a necropsy!
Common upper airway dz
- Lar par
- Tracheal collapse
- foreign bodies
- polyps
- brachycephalic airway syndrome
Lower airway disease
- Feline bronchial disease (asthma)
- Chronic bronchitis
Parenchymal disease
Primary Cardiac Disease
- Very young and very old
- small breed dogs
- Maine coon cats
- Presence of murmur or arrhythmia
- history of cough (dog)
*TX WITH LASIX (FUROSEMIDE)
Parenchymal Disease
Non-cardiac dz
- any age or breed
- history of vomiting or recent anesthesia
- coughing
- cats or dogs
- severe concurrent dz
*TX with Bronchodilators: these can exacerbate heart failure
Cats with heart dz don’t
cough
Radiographs
Get good at differentiating heart failure from parenchymal dz

Big left atrium



