Respiratory Tract Disease in Small Animals Flashcards
What would you expect to see clinically if a animal had lung disease?
•(not as obvious in SA can be seen in horses with COPD)- see the abdomen lift as they force air out of their lungs. Lung disease – EXPIRATORY dyspnoea
What will you see clinically in an animal with URT obstruction?
INSPIRATORY dyspnoea (bulldogs and pugs – will often have a noise too). Inspiratory phase will be longer
Is inspiratory or expiratory phase longer in pleural effusion?
Phases are equal
Should you anaesthetise a patient with pleural effusion?
- Actually can be better off by anaesthetising them – but you HAVE to know what you are going to do next
- When anaesthetised they are breathing 100% Oxygen and you have control of airway
- Use the drugs you are used to e.g. propofol and iso. If you change to something you aren’t used to – you don’t know if something happens whether it is normal for the drugs or if there is an issue with the animal
Is pleural space disease or lung disease easier to manage and why?
•Pleural space disease in an acute situation – easier to manage than a diffuse lung disease. As you can just drain it.
What should you do if you find difuse lung disease on radiograph?
Take samples! Do this at the same time as radiographs/CT if you find lung disease as you will need to then know WHAT is causing the lung disease.
What pre med is good in a cardiac problem?
•Opiod +/- BZD
Why are opioids good to use in a CRS case?
•Opioids – Patients often have high resp rate which can cause further issues but opioids reduce resp rate and can help them relax
What 3 things are useful for nasal disease diagnosis?
- History and clinical signs (helpful)
- Radiography
–CT
•Diagnostic sampling – rhinoscopy or nasal flush
What is a common cause of nasal disease in cats?
Infections
What is important for the diagnosis of a coughing case? (5)
- Acute and chronic
- History and physical exam(!!!!)
–+/- resp difficulty? Suggests airway and lung involvement
•Radiography
–CT?
- Endoscopy
- Diagnostic sampling – Blind BAL or TAL is perfectly viable to help get a definitive diagnosis
What are the major causes of dyspnoea? (4)
1 airway obstruction (URT or lung disease)
2 reduced airway capacity (pleural space disease?)
3 pulmonary parenchymal disease
4 other – metabolic/physiologic causes (tend to be more rapid shallow breathing rather than difficulty)
What are the common causes of Airway obstruction (often +/- cough/cyanosis/noise)? (13)
–Trauma/haemorrhage etc
–Laryngeal paralysis/trauma/granuloma
–Brachycephalic airway obstruction- long soft palate, stenotic nares, larynx collapse etc
–Tracheal or bronchial collapse
–Extra-luminal mass lesions - thyroid, abscess, lymphoma, large heart
–Asthma/bronchospasm (cat)
–Nasopharyngeal polyp (cat)
–Nasal cavity (+/- sneezing, +/- nasal discharge) - rhinitis/F.B./neop/polyp/trauma
–F.B.
–Neoplasia
–Oslerus infestation - “lungworm”
–Brochiectasis
What are the common causes of Loss of thoracic capacity (+/- cyanosis)? (6)
–Pleural effusion – e.g. pyothorax, haemothorax
–Pneumothorax
–Neoplasia - pleural or mediastinal
- Most tumours in the pleural space will result in pleural effusion
- Look at the structures – if there is a change in the positions there has to be a mass
–Ruptured diaphragm
–Abdominal abnormality causing diaphragmatic compression – severe ascites, abdominal mass
–Gross cardiomegaly
•Heart gets so big that it compromises cardiac function
What are the common causes of Pulmonary parenchymal disease (+/- cyanosis/cough)? (10)
–Pulmonary oedema - L. heart failure typically
–Eosinophilic disease - “P.I.E or EBPn“
•Can be quite diffuse and cause respiratory difficulty
–Pulmonary fibrosis
–Pulmonary thromboembolism
•Acute onset, moderate difficulty and the best x ray is unremarkable. Consider this!!!! Clot in aorta preventing blood to lung. V/Q mismatch.
–Non-cardiogenic pulmonary oedema
•Following trauma or near drowning
–Neoplasia - primary or (more likely) secondary
–Pulmonary haemorrhage
–Bronchopneumonia
–Paraquat poisoning
–Angiostrongylus/Aelurostrongylus
What is this and how is it used?
Cats – these new drains (seldinger) (catheter through chest, then guide wire, then pleura catheter)
Much easier to use
Plain lateral thoracic radiograph from a dog, coughing and unwell for 2 or 3 days
Which lung pattern is evident?
Alveolar – must have air bronchgrams. Increase soft tissue density obliterating the cardiac. Too white for interstitial.
Dog probably has bronchopneumonia (maybe aspiration pneumonia). But typical presentation – ventral and cranial. Next: BAL.
Bronchial apttern – walls are thick and we can see then. White lines against the background (see white lines and doughnuts). Alveoli around it due to ST density – Alveolar due to AIR BRONCHOGRAMS
