Respiratory Pathology up to Sp Pneumonias (AH) Flashcards
Stars mean either he said it was important in class, he emphasized it during the review or Muzzy marked it as a previous TQ. Number of starts is not indicative of anything.
1
Q
What makes up the Conductive respiratory system?
A
nostrils, pharynx, larynx, trachea, and bronchi
2
Q
What makes up the Transitional respiratory system?
A
bronchioles
3
Q
What makes up the gas exchange system?
A
Pneumocytes in alveoli
4
Q
What are the two types of pneumocytes and which one can regenerate?
A
Type I-membranous (BM)- no regeneration –> fluid into alveoli from blood vessel.
Type II- granular. Type II regenerates.
5
Q
What makes up the detox system?
A
Goblet cells in the bronchioles are replaced by clara cells (detox similar to hepatocytes)
6
Q
***What are the main routes of entry of etiological agents?
A
Aerogenous (infectious/non-infectious).
Hematogenous (infectious/toxins).
Direct extension (infections through trauma)
7
Q
What are the main defense mech against aerogenous entry?
A
- Sneeze, cough, reflex bronchoconstriction.
- Mucocilliary effect: mycociliary clearance, antibodies, lysosomes, mucus.
- BALT: bronchiole associated lymphatic tissue (immunologic).
- Alveolar macrophages
8
Q
What does mucocilliary defend against?
A
***Particles >10um, about 5% of particles 1-2um in Bronchi
9
Q
**Which bacteria are resistance to alveolar macrophages?
A
Mycobacterium
Rhodococcus
Lysteria spp.
10
Q
**Which spp. defend against blood borne agents with pulmonary intravascular macrophages?
A
Ruminants
Pigs
Cats
Horses
11
Q
**In what spp. are hepatic and splenic macrophages key in fighting blood borne agents?
A
Dog
Rodent
Human
12
Q
How do viruses impair pulmonary defense mechanisms?
A
Destruction of mucocilliary blanket
Impaired alveolar macrophage function
13
Q
How do bacteria impair pulmonary defense mech?
A
Some live and replicate within macrophages.
Produce toxins –> direct destruction of cells
14
Q
What is Rhinitis?
A
Inflammation of the nasal cavity
15
Q
Main causes of rhinitis?
A
Viral Bacterial Fungal Parasites Chemicals Allergens
16
Q
How is rhinitis characterized?
A
Nature of the exudate which varies by causative agent
17
Q
What are the types of exudate associated with Rhinitis?
A
Serous - serum. Catarrhal - Mucous membranes. Purulent - pus. Hemorrhagic - blood. Granulomatous - granulation/ ulcers
18
Q
What is the only dz of the nasal cavity and sinuses is found in bovine?
A
Infectious bovine rhinotracheitis (red nose)
19
Q
What is the etiology of IBR?
A
Bovine herpes virus
20
Q
What type of discharge is associated with IBR?
A
Serous to mucopurulent
21
Q
When is IBR fatal?
A
2* M. hemolytica infection –> pneumonia
22
Q
What are the CS of IBR? (5)
A
Pyrexia, anorexia, coughing. ***Serous to mucopurulent*** nasal discharge. Lacrimation and corneal opacity. Inflamed nares (red nose). Dyspnea of laryngitis develops.
23
Q
Lesions of IBR?
A
. Hyperemia and pustules in the nasal mucosa.
- Lesions develop to ulcers and fibrinonecrotic membranes, extending to pharynx, larynx and trachea.
- Petechial to ecchymotic hemorrhages on the mucous membranes of nasal cavity and paranasal sinuses.
- Serous to serofibrinous exudate, may be blood tinged, in pharynx and trachea.
- Pharyngeal lymph nodes are swollen and hemorrhagic.
- INIBs
24
Q
In addition to nasal infections what else can IBR cause?
A
Genital infections in breeding cattle
25
Nasal Granulomas are found in which animals?
almost all animals
26
Etiology of nasal granulomas?
```
-*Mycotic is the main cause:
R. seeberi in cattle, dog horse, cat.
C. neoformans in cat.
Aspergillus and penicillium in dogs.
Blood fluke - Schistosoma nasalis in cattle.
-Allergic - all spp.
```
27
Gross lesions of nasal granulomas?
Granuloma is seen as polypoid nodules
Cauliflower like
Soft, pink and bleed easily.
Large growths may obstruct the nasal passage --> resp. distress.
28
What are diseases of the nasal cavity in sheep and goats? (3)
Non-specific Dz.
Nasal Granuloma
Myasis (O. ovis larvae)
Endemic Ethemoidal Carcinoma
29
What diseases of the nasal cavity do horses get? (6)
```
Eq. viral Rhino
Eq. Influenxa
Eq. Viral Arteritis
Strangles****
Glanders
Meliodiosis
```
30
Etiology of equine viral rhinopheumonitis (EVR)?
Herpes 4 (occasionally Herpes 1)
31
Type of exudate associated with EVR?
Serous inflammation
32
CS of EVR?
```
serous inflammation of nasal mucosa
sometimes edematous swelling of pharyngeal lymph nodes
conjunctivitis
cough
fever
congestion.
```
33
Lesions of EVR?
**Ulceration and necrosis of resp. epithelium with INIB in epithelial cells.
34
Ddx of EVR?
| Dx?
equine influenza and equine viral arteritis
| VI, serology
35
Equine influenza etiology?
Type A Orthomyxovirus
36
Type of discharge associated with Eq. flu?
Serous then mucopurulent later.
37
Lesions of Eq. flu?
*Usually not seen in the nasal passages.
| Mild Dz but may lead to *interstitial pneumonia and pulmonary edema.
38
Dx of Eq. flu?
Need lab confirmation to differentiate for other resp. viruses.
VI/serology
39
Etiology of Eq. Viral Arteritis?
Arterivirus
40
Lesions of Eq. viral arteritis?
*serous to mucopurulent rhinitis.
Conjuctivitis and plapebral edema.
Fibrinoid degeneration of muscular arteries ➡️ *hemorrhage in varius tissues*
41
CS of Eq. Viral arteritis?
edema of the limbs and ventral abdomen. Respiratory distress, feer, diarrhea, colic, abortion in 50-80% of mares.
42
Etiology of Strangles?
Strep. equi equi*
43
CS of strangles?
bilateral mucopurulent nasal discharge.
*Lymphadenopathy* and painful swalling of lymph glands.
Fever
44
Lesions of Strangles?
*suppurative rhinitis and lyphadenitis
45
***Sequelae of strangles?
Purpura hemorrhagica (type III hypersens.)
Extension of infection to: paranasal sinuses, Guttural poush, internal organs.
Facial paralysis and horners syndrome.
Laryngeal hemiplagia.
46
Dx of strangles?
isolation of bact from surgically drained abscess of lymph gland
47
What is a nasal polyp?
growth on nasal or septum mucosa made of chronic inflammatory leasions.
Cause is unknown.
Surgery is curative.
48
What are the diseases of nasal cavity in dogs?
Transitory rhinitis
Nasal granuloma
Linguatula serrata
Allergic rhinitis.
49
Etiology of Transitory Rhinitis?
*Generalized bacterial and viral Dz.
-Bact:
B. bronchiseptica, E.coli, P. multocida.
*-Viral:
Canine distemper, Canine adenovirus 1,2, Reovirus, Canine herpes virus, and Parainfluenza virus
50
Nasal granuloma is associated with what type of infection?
Fungal
51
What is Lingualtula serrata ?
| What kind of inflammation does it produce and in which type of animals?
Specialized arthropod.
| Produce catarrhal inflammation in carnivores.
52
*What are the diseases of the nasal cavity in cats?
Feline virus rhinotracheitis (FVR)
Feline Calicivirus
Feline Chlamydiosis
Feline Respiratory Disease complex
53
Etiology of FVR?
Feline herpesvirus 1
54
Besides respiratory infection, what else can FVR cause?
Ulcerative keratitis
hepatic necrosis
abortion and stillbirths
55
Where is FVR found?
Worldwide
56
CS of FVR?
Suppurative rhinitis
| conjunctivitis with oculonasal discharge
57
What other resp. disease is similar to FVR in cats?
Feline calicivirus
58
Which two viruses account for 80% of resp. disease in cats?
FVR and FCV
59
CS of FCV? What is unique?
Conjunctivitis, rhinitis.
| Unique: herpes virus in immunocompromised cats ➡️ ulcers of the tongue and hard palate.
60
FCV Dx?
differentiate from FVR by*** ulcers on tongue and hard palate. ***
61
What is limping kitten syndrome?
An acute self limiting arthritis caused by infection of vaccination with some FCV strains.
62
What does Feline Chlamydiosis cause?
Conjunctivitis and serous to mucopurulent rhinitis
63
***Feline respiratory disease complex causative agents? (5)
```
FCV
FVR
Chamydia
Mycoplasma
FIP* - usually generalized Dz as well as resp. dz*
```
64
What are the diseases of the nasal cavity in pigs?
Inclusion body rhinitis
| Atrophic rhinitis
65
Etiology of Inclusion body rhinitis?
Porcine cytomegalovirus (herpes virus)
66
CS of Inclusion body rhinitis?
affects pigs up to 10wks of age*
high morbidity, low mortality
sneezing, conjunctivitis, lacrimation--> mucopurulent with bacterial infection.
67
Lesions of Inclusion body rhinitis?
Necrotizing and non-suppurative
68
Dx of Inclusion body rhinitis?
INIC bodies in *nasal gland epithilium
69
***Main difference between Atrophic rhinitis and Iclusion body rhinitis?
INIB Rhinitis - young, no distortion of snout.
| Atrophic - older with distortion of snout.
70
Etiology of Atrophic rhinitis?
not clear.
| Maybe infection of B. bronchiseptica and toxigenic strain of P. multocida.
71
CS of Atrophic rhinitis?
**Slow progressing**
Sneezing/nasal discharge.
Slow progressing Dz over months ➡️ dypsnea and death.
72
Lesions of Atrophic rhinitis?
retarded growth of snout
| atrophy of chonchae or missing conchae
73
What is Bronchiectasis?
Permanent abnormal dilation of the bronchi from chronic bronchial obstruction/inflamation.
74
Types of Bronchiectasis?
Saccular - less common, in all animals, local obstruction by inhaled foreign body or tumor or granuloma cause saccular bronchiectasis.
Cylindrical - sheep/pig/goat, usually seen in parasitic bronchitis.
75
In what animal is Necrotic layringitis most commonly seen?
Calves, but call also occur in sheep.
76
Etiology of Necrotic laryngitis?
F. necrophorum
77
Sequelae of necrotic laryngitis?
Toxemia / bronchoneumonia --> death
78
Dz. Of larnynx, trachea and bronchi of horses?
```
Laryngeal paralysis
Equine pharyngeal lymphoid hyperplasia
Guttural pouch mycosis
Guttural pouch tympany
Chronic obstructive pulmonary Dz
```
79
*What is Laryngeal paralysis due to?
| What is another name for it?
recurrent laryngeal nerve paralysis from compression or damage due to inflammation --> in atrophy of cricoarytenoid muscles. "Roaring"
80
*Common causes of laryngeal paralysis due to inflammation of nerve (5)
```
Mycosis of Guttural pouch
retropharyngeal abscess
neoplasm involving cervical lymph glands
injury and inflammatory lesions in the neck
Empyema of Guttural pouch (strangles)
```
81
What causes mycosis of the Guttural pouch?
Aspergillus spp. (A. fumigatus)
82
What do CS of Mycosis of Guttural pouch arise from?
Damage to cranial nerves (9-12) and arteries w/i the mucosa of Guttural pouch.
83
***What is the most common CS of Mycosis of Guttural pouch?
***Dysphagia with Epistaxis due to fungal erosion of internal carotid or external carotid.
May proceed to fatal hemorrhage if not treated
84
What may develop due to nerve damage with mycosis of guttural pouch?
Dysphagia
horner's syndrome
dorsal displacement of soft palate.
85
Lesion associated with Mycosis of Guttural pouch?
Mucosa of Guttural pouch is covered with fibrinonecrotic exudate, located at the caudodorsal aspect of the medial pouch.
86
Guttural Pouch Tympany is observed in what horses?
Horses neonate to 1yr of age
87
CS of Guttural pouch tympany?
Guttural pouch is distended with air --> non-painful swelling in parotid region.
Stertorous in severely affected animals. Usually unilateral.
88
Sequela of guttural pouch tympany?
Inflammation/ defect of the eustatchean tube.
89
Chronic Obstructive pulmonary Dz is comparable to what in humans?
*Allergic bronchitis
90
What causes COPD?
fungal spores and dust.
91
Lesions of COPD?
Chronic Bronchitis
92
In severe cases of COPD what happens?
*accumulation of mucus -->
incomplete obstruction of bronchioles and alveoli -->
ALVEOLAR EMPHYSEMA
93
K9 Dz of larynx, trachea, bronchi?
K9 Infectious Tracheobronchitis and Laryngeal Paralysis
94
Etiology of CIT?
complex.
| Flu viruses, adenoviruses and bacterium have been suggested
95
CS of CIT?
```
Highly contagious.
Coughing rhinitis
conjunctivitis
pharyngitis
Between bouts of coughing animals tend to appear normal.
```
96
Lesions of CIT?
Necrosis and suppuration in trachiobronchi
97
Laryngeal paralysis is most common in what dogs?
Older
large breed
male
98
CS of Laryngeal paralysis?
abnormal barking
exercise intolerance
May predispose to aspiration pneumonia
99
What Dz of larynx, trachea, and bronchi does type I hypersensitivity cause in cats?
Feline Asthma (feline allergic bronchitis)
100
How would you treat Feline Asthma?
Responds well to steroids
101
Lesions of Feline Asthma?
chronic bronchitis
| in severe cases obstruction of small bronchioles
102
List pathologies of the lung?
```
Atelectosis
Emphysema
ARDS
Pulmonary hypertension
Inflammation of the lungs (bronchopneumonia, interstitial pneumonia, embolic pneumonia, granulomatous pneumonia)
```
103
**What is the main difference between Atelectosis and Emphysema?
```
Atelectosis = no air in alveoli.
Emphysema = air
```
104
**What are the two types of Atelectosis?
Congenital or Aquired
105
Congential Atelectasis can be caused by what?
Obstructions: muconeum, aspriate, amniotic fuild.
| Hyaline membrane disease (piglets/ foals)
106
Aquired Atelectasis can be caused by what?
Compressive - pneumothorax, hydrothorax, bloat, neoplasm.
| Obstructive - exudate, parasites, neoplasms, foreign material.
107
Describe the lung tissue associated with atelectasis?
dark red, flabby and depressed below the surface of surrounding lung. Micro: alveolar walls are gongested and in close opposition.
108
Two types of Emphysema?
Alveolar
| Interstitial
109
What causes alveolar emphysema?
1. Pressure of inhaled air
| 2. Incompletely closed bronchioles,
110
Lesions of alveolar emphysema?
excessive air in the alveoli --> abnormal, permanent enlargement of albeoli with destruction of alveolar walls.
Emphysematous areas are raised, pale or white, dry, and can be easily compressed.
Usually alternates with areas of atelectasis.
111
What causes interstitial emphysema?
Forced respiratory efforts.
1. when death is followed by violent efforts in anoxia.
2. during quick loss of blood in trauma, slaughter or fully conscious animal.
3. death after protracted illness.
112
Where is air found with interstitial emphysema?
Air collects in connective tissue of lungs (interalveolar septa, interlobular septa, below pleura, around bronchi and blood vessels.)
113
In what animal is Interstitial emphysema mostly commonly found? Why?
In cattle.
Developed interlobular septa
lack of collateral ventilation in adjacent lobules --> thick, shiny septa filled with bubbles.
114
what is the most commonly encountered pulmonary abnormality?
Plumonary edema = very important**
115
Two categories of causes for pulmonary edema?
Non-Inflammatory = increase in capillary hydrostatic pressure. *Inflammatory* = increasing *permeability* of the air-blood barrier
116
Examples of non-inflammatory causes of pulmonary edema? (3)
1. increased left atrial pressure in left sided or bilateral CF (cardiogenic edema).
2. Excessvie fluid transfusion.
3. Pulmonary venous occlusion.
117
Examples of inflammatory causes of pulmonary edema? (4)
1. inhalation of corosive gases (SO2, Cyanides, Smoke).
2. Infectious agents (mycoplasma, viruses)
3. Systemic toxins.
4. Anaphylaxis in certain spp. (horse and cow)
118
Pulmonary edema is almost always?
Fatal
119
What causes Acute respiratory distress syndrome (ARDS)?
Diffuse alveolar damage due to…
1. systemic diseases
2. direct injury to lungs.
3. leasions in other organ systems.
120
Pathogenesis of ARDS?
Triggering of macrophages to release large amounts of cytokines -->
prime neutrophils in lung and capillairies -->
release enzymes and free radicals -->
diffuse endothelial/epithelial changes -->
permeability edema -->
accumulation of inflammatory cells
121
Lesions of ARDS?
Diffuse damage to alveolar wall epi and or endothelium -->
Congestion and edema.
Hyaline membrane formation.
Alveolar epithelial hyperplasia (pneumocyte II).
Interstitial emphysema.
122
Pulmonary Hypertension is caused by what?
Increase in pulmonary vascular resistance.
1. vasoconstriction
2. vascular obstruction.
3. vascular volume overload.
123
***What is pulmonary hypertension secondary to?
* **Almost always secondary.
1. Cardiac Dz. (septal defects, left to rt shunts.)
2. Lung Dz. ( interstitial pneumonia with fibrosis, occlusion of pulmonary vessels.
124
What does sustained pulmonary hypertension result in?
Increased pressure load to rt ventricle with compensatory rt ventricular hypertrophy --> rt hear failure.
125
What is inflammation of the lungs called?
Pneumonia
| Pnemonitis
126
What are the classification of inflammation of the lungs based on site and pattern of spread?
Aka: list types of pneumonia…
Bronchopneumonia
Interstitial pneumonia
Embolic pneumonia
Granulomatous pneumonia.
127
Which classification of pneumonia is most common in domestic animals?
Bronchopneumonia, of major ecomonic improtance.
128
When does Bronchopneumonia occur?
```
when risk factors tip the balance.
STRESS.
Exposure
Crowding
Dehydration
Other infections and chronic Dz.
```
129
What causes bronchopneumonia?
Bacteria
Mycoplasma
Apriration of feed/gastric content
130
Why are bronchopneumonia lesions only found in the cranio-ventral part of the lung?
1. Shortness and abrupt branching of broncus.
2. Gravitational sedimentation of exudate.
3. Deposition of infectious agent in the 1st broncus.
4. Regional differences in ventilation
131
Exceptions to cranio-ventral restriction of bronchopneumonia lesions?
1. Actinobacillus pleuropneumonia and Actinobacillus suis --> middle and caudal lobes. 2.
dogs/cats also have a patchy distribution throughout the lung.
3. bovine respiratory syncytial virus can also look like bronchopneumonia as it is cranio-ventrally
132
Two subtypes of bronchopneumonia?
Suppurative
| Fibrinous
133
Lesions of Suppurative Bronchopeumonia?
```
*** Supporutive, cranioventral lobular pattern= bronchopnuemonia***
Always cranio-ventral.
Mosaic apperance (red/gray).
```
134
Sequelae of Suppurative Brochopneumonia?
Usually resolves within a few weeks.
Complications:1. Death by toxemia and hypoxia.
2. May cause metastatic abscesses in other organs.
3. May become chronic.
4. Plugging of bronchi and resultant atelectasis.
135
Lesions of Fibrinous bronchopneumonia?
Starts lobular --> involves part or complete lobe.
Fibrinous rather than neutrophilic exudate found on pleural surfaces, septa, alveoli and thoracic cavity.
Marbled pattern.
136
***Etiology of fibrinous bronchopneumonia by spp.?
Strong pathogens are involved.
Cattle: M. hemolytica, Mycoplasma mycoides, Hemophilus somnus. Swine: P. multocida, Actinobacillus pleuropneumonia.
Sheep/Goats: M. hemolytica, mycoplasma mycoides (mainly in goats)
137
Complications of Fibrinous Pneumonia?
Inflmmatory responses are more severe than suppurative pneumonia --> rarely resolves.
1. Death is more frequesnt due to pleuritis and pericarditis.
2. Necrosis with formation of pulmonary sequestra (Foci of coagulative necrosis encapsulated by connecti
138
Predisposing causes of Aspriation Pneumonia?
Any cause of dysphagia or regurgitation.
| Pharyngeal paralysis and megaesophagus.
139
Lesions of aspiration pneumonia?
Liquid gruel or inhaled milk - widespread distribution.
Plant material, dry dusty particulate food - localized lesions = descrete foreign body granulomas, lobar pneumonia or gangrene.
Aspriration of vomitus --> edema development. Long standing cases --
140
Interstitial Pneumonia is what?
An inflammator condition confined to the alveolar walls and alveolar intersitium
141
Interstitial pneumonia etiology? (2)
1. Aerogenous injury --> alveolar epithelium
| 2. Hematogenous Injury --> Alveolar capillaries
142
What can cause hematogenous injury to the alveolar capillaries resulting in intersitial pneumonia? (5)
1. intermitent bacteriemia (E.coli, lepto, salmonela, lung worms, toxoplasma and migrating parasites).
2. DIC.
3. Ingested toxins like moldy sweet potatoes.
4. Allergic condition type III.
5. endotoxins (paraquate).
143
What are the 4 phases of Intersitial pneumonia?
1. Acute - injury to type I pneumocytes.
2. Exudative phase - inflammatory edema accumulates in the alveolar interstitium --> thickening of alveolar walls.
3. Proliferative phase: often follows acute. Hyperplasia of type II pneumocytes.
4. Chronic: ac
144
Where are lesions of intersititial pneumonia founds?
throughout the whole lung.
| May be more pronounced in dorso-caudal region.
145
****Important features of Interstitial Pneumonia (5)
Due to proliverative phase, alveolar walls thicken -->
1. Lung does not collapse on opening thoracic cavity.
2. Rib impressions on lungs.
3. Lack of visible exudate in lungs and meaty appearance.
4. Heavy, elastic, rubbery lungs.
5. Red to pale grey c
146
Sequelae of interstitial pneumonia?
- Complete resolution (recovery).
- 10% death due to pulmonary edema (cattle)
- Healing by fibrosis and epithelization of alveoli --> glandular appearance.
147
Halmarks of Chronic intersitial pneumoina?
1. Accumulation of mononuclear inflammatory cells in intersitium and alvioli and bronchi.
2. persistence of hyperplasitic type II pneumocytes.
3. Alveolar fibrosis
4. Formation of microscopic granulomas.
5. Hyperplasia of sm. Mm in airways or pulmonary
148
What are two causes of Embolic pneumonia and the resulting lesions?
1. Bronchopneumonia -> large abscesses, isolated, confined to anterioventral part of lung.
Are seen extending from bronchial tree.
2. Metatstatic from septic emboli arrested in pumonary vessel. --> small abscesses, multiple and widely distributed in wh
149
Etiology of infectious/ non-infectious granulomatous pneumonia?
Infectious - bact, fungi, parasites, type III sensitivity, FIP.
Non-infectious - Inhaled forgein intert material
150
Lesions of granulomatous pneumonia?
Soft yellow to gray caseous.
| Encapsulated = hard gritty & white-gray
151
Pneumonia of Cattle
Enzootic Pneumonia of Calves
Shipping Fever
Bovine Pasteurellosis Hemorragic Septicemia
Respiratory hemophilosis
Contagious Bovine Pleuropneumonia
Tuberculosis
Acute Bovine Pulmonary Edema "Fog Fever"
Acute Bovine Pulmonary Edema and emphysema
Hyp...(card was cut off here) guessing hypertension?
152
Pneumonia of Pigs
```
Porcine Enzootic Pneumoina
Porcine Pasteurellosis
Porcine Pleuropneumoniae**
Hemophilus Pneumonia
Strep pneumonia
Tuberculosis
Swine Influenza
Porcine Repro&Resp Syndrome (PRRS)
Post weaning Multi-systemic wasting syndrom
Parasitic Pneumonia.
```
153
Pneumonia of Sheep and Goats?
```
Pasteurellosis: Ovine Pneumonic Pasteurellosis
Chronic Enzootic pneumonia
Septicemic Pasteurellosis
Contagious Caprine Pleuropneumonia
Maedi Visna Ovine Progressive Pneumonia
Lymphoid Interstitial pneumonia
Caprine arthritis encephalitis
parasites
```
154
Horse Pneumonias?
```
Rodococcosis
Eq. Viral Rhinopneumoniti
Equine flu
Chamydial infection
Tuberculosis
Diffuse proliferative intersititial pneumonia
Parasitic
```
155
Dog Pneumonia?
```
Canine Distemper
Canine adenovirus Type 2 Infection
Cainine Herpesvirus 1 "fading puppy syndrome"
Canine flu
bact. Pneumonias
tuberculosis
mycotic
Toxic (paraquat and uremic)
Parasitic
```
156
Cat Pneumonias?
```
Bacterial
tuberculosis
mycotic,
lipid pneumoina,
parasitic,
```
