Respiratory (Up to Lepto) Flashcards
What is the mode infection of Blastomycosis?
Inhalation of spores from mycelial growth in environ.
What is the most common symptom that is caused by Blasotmycosis?
A dry harsh cough
What are seen in hematology/biochem of a sample of Blastomycosis?
Anemia, leukocytosis with L shift, HYPERglobulinemia, HYPERcalcemia
What are two serology tests used for Blastomycosis? Where are the samples taken from?
AGID test (Agar Gel Immunodiffiusion): serum/urine. ELISA: Urine (cross reacts with histoplasmosis)
What is the tx for Blastomycosis?
Amphotericin B and Itraconazole (oral)
Where is histoplasma capsulatum found?
Soil that is high in bird or bat feces
T/F. Histoplasmosis is the most common systemic fungal disease in cats.
False. second(?)
T/F. Cats that are infected with histoplasma need to be on cough suppressants.
False. COUGHING IN UNCOMMON in histoplasmosis.
Histoplasmosis. What is seen in hematology/biochem? cytology?
Hematology/biochem: Anemia, thrombocytopenia, HYPOalbuminemia.
Cytology: organism in mononuclear-phagocyte system
What are the txs for Histoplasmosis?
Itraconazole (DOC), Fluconazole, Voriconzole, Posaconazole. Amphotericin B.
What is the prognosis for Blastomycosis? Histoplasmosis? Cryptococcosis? Coccidiomycosis?
Blastomycosis: Good
Histoplasmosis: disseminated has a guarded prognosis.
Crytococcosis: Good
Coccidiomycosis: Good for resp. disease; poor for disseminated dz.
Where is Cryptococcus neoformans found? Where is Cryptococcus gattii found?
Neoformans: bird droppigns
Gattii: Eucalyptus trees
What is the distinct sign that is found with Cryptococcosis that is not found with other mycotic pneumonia?
Neurological signs in both dogs and cats
Serology samples for Crypto? Serology samples for Blasto and Histo?
Crypto: Serum/CSF/blood
Blasto and Histo: Urine
T/F. Cryptococcosis shows non-specific signs in hematology/biochem. Cryptococcus organisms have thick capsules.
True
What are txs for Cryptococcosis?
- Surgery.
2. Therapy for antifungal drugs.
How do you monitor Crytopcoccosis?
LAT (Latex Agglutination Test): want a drop in antigen titer.
Where are Coccidia found?
Dry environment, Southwestern US.
What is the other name for Coccidiomycosis?
VALLEY FEVER
What is the most common sign in cats that have Coccidiomycosis?
Cutaneous lesions
T/F. Crypto and Blasto form pyogranulomatous lesions.
False. Coccidiomycosis and Blastomycosis
What are serology tests for Coccidiomyocosis?
Tube precipitin antigens (IgM)
Complement fixation antigens (IgG)
LAT, AGID or ELISA for IgM/IgG
What is the tx for Coccidiomyocosis?
Azoles; Ketoconazole, itraconazole, fluconazole
HALLMARK sign of Idiopathic Pulmonary Fibrosis
Inspiratory Crackles
What is the def. dx for Idiopathic Pulmonary Fibrosis?
Lung biopsies
How do you treat idiopathic Pulmonary Fibrosis?
Lack of tx.
Corticosteroids + bronchodilators; Cyclophosphamide/azathioprine (autoimmune), Colchicine (anti-inflammatory)
T/F. CS of pulmonary neoplasia have a narrow spectrum
False. Wide spectrum (both respiratory and non-respiratory signs)
T/F. Two views of x-rays are enough for pulmonary neoplasia.
False. 3 views.
What are the tx for pulmonary neoplasia?
Primary: surigcal removal (lung lobectomy).
Secondary/multicentric: treat primary; chemotherapy (lymphoma)
Which are primary neoplasms? Which are secondary neoplasms? Which are multicentric neoplasms?
Primary: Adenocarcinoma, SCC.
Secondary: Adenocarcinoma, Osteosarcoma/chondrosarcoma, HAS, oral melanoma.
Multicentric: lymphoma, histiocytosis, mastocytoma.
What does non-cardiogenic pulmonary edema progress to?
ALI and ARDS; respiratory failure
What are txs for non-cardiogenic pulmonary edema?
Control of primary disease.
Cage rest and O2.
Supportive therapy: IV fluids (careul), pressure ventilation.
What is the prognosis for non-cardiogenic pulmonary edema?
Better with no fluid and renal function intact.
Shock and seizures can be treated; vasculitis cannot be treated.
What is the difference between ALI and ARDS?
ALI (Acute Lung Injury): pulmonary inflammation and edema.
ARDS (Acute respiratory distress syndrome): severe ALI.
HYPOXEMIA IS WORSE FOR ARDS.
Cyanosis may be present.
T/F. ALI and ARDS are primary diseases that cause secondary bacterial infection.
False. Secondary to underlying cause (sepsis, systemic inflammatory distress syndrome, shock, bacterial pneumonia).
What is the tx for respiratory distress (ALI and ARDS)?
Aggressive supportive + P ventilation
T/F. Morbidity rate is 100% in respiratory distressed animals.
False. MORTALITY IS 100%!
What is pulmonary contusions? What is this commonly caused by? What are dx? tx?
Various degrees of respiratory distress.
Commonly caused by trauma.
Dx: auscultation and radiographs.
Tx: monitor for 1-2 days, O2, fluids, pain meds.
What is Eosinophilic Bronchopenumopathy? What breed is it commonly seen in?
Pulmonary infiltrates with eosinophils (hypersensitivity to unknown antigens). Siberian huskies (young/middle aged).
T/F. Eosinophilic bronchopneumopathy lacks response to antibiotics.
True
T/F. Ensure fecal and HW are negative in Eosinophilic Bronchopneumopathy.
True.
What are txs for Eosinophilic Bronchopneumopathy?
Treat underlying disease.
Fenbendazole, Pred, cyclosporine, azathiprine.
What is pulmonary thromboembolism associated with?
HW, IMHA, nephrotic syndrome, hyperadrenocorticism (hypercoagulability), pancreatitis, DIC, endocarditis.
What is the tx for pulmonary thromboembolism?
O2, no stress, tx underlying disease.
Pred for IMHA and HW.
Low dose heparin for DIC or hyperadrenocorticism.
What is the prominent respiratory signs in pleural space disorders?
Restrictive pattern (rapid shallow breathing); cyanosis.
What is pleural effusion? Is this usually primary or secondary?
Accumulation of excessive amount of fluid within the pleural space.
Usually secondary to FB, penetrating injury, pneumonia.
What is seen in cytology for pleural effusion? culture?
Cytology: degenerative neutrophils/bacteria.
Culture: anaerobes/aerobes.
What is the general tx for pleural effusion? What is the best tx for dogs? cats?
Thoracocentesis to stabilize the patient (7-8th ICS; enter caudal to cost-chondral junction).
Chest drain.
Lavage: saline into chest > aspirate out.
Dogs: flush out fluids > doesn’t respond > sx.
Cats: chest drain; often need sx.
What are the mechanisms of pleural effusion?
Decreased oncotic pressure, increased hydrostatic pressure, increased capillary permeability, lymphatic malformation.
What the ABX used for pleural effusion for Dogs? Cats?
Dogs: Amoxyclav and metronidazole.
Cats: Amoxyclav, Metronidazole, enro.
What is chylothorax?
Any disease that increases systemic venous pressure (accumulation of chyle in pleural space).
T/F. The most common cause of chylothorax is trauma.
False. IDIOPATHIC.
What is both diagnostic and therapeutic in pleural space disorders?
Thoracocentesis
What is the tx for Idiopathic chylothorax?
Thoracic drainage, low fat diet, rutin, ligation of thoracic duct.
What is the most common cause of pneumothorax?
Trauma (open, close,d, tension)
What is the tx for pneumothorax?
Thoracocentesis: 9-10th ICS, above costal chondral junction; analgesia and O2.
Surgery: large lacerations and if cannot stabilize with thoracostomy tube.
What are bacterial diseases that are infectious to dogs?
Salmonella, Campylobacter, Helicobacter, Brucella, Actinomyces/Nocardia, Lyme, Lepto.
What are gram positive bacteria that affect dogs?
Actinomyces/Nocardia.
How is Salmonellosis transmitted?
Raw chicken fed to animals (most comon).
What are tx for salmonellosis?
If no signs - no tx.
Severe: Chloramphenicol, T/S, amoxi, ampicillin.
What are characteristics of Campylobacter species? Where are they found?
GULL-WING SHAPED.
Slender, motile.
Found in GI of healthy animals.
T/F. Campyolobacter infections are excerbated by stress.
True.
What are txs for Campylobacter infections?
Erythromycin, Chloramphenicol, Cephalosporins, Enro.
Where is Helicobacter usually found? How does it survive in that environment? What is the pathogenesis?
Stomach by producing urease.
Bacteria infiltration crypts of stomach.
How do you dx Helicobacter infections?
Gastric biopsies (Endoscopy); PCR on gastric samples.
What is the tx for Helicobacter infections?
TRIPLE THERAPY: Amoxi, metro + omeprazole or Amoxi, metro + famotidine.
T/F. Dogs are most susceptible to brucellosis.
False. HORSES ARE! (Cats are the most resistant and dogs are quite resistant).
How is Brucelllosis transmitted?
Aborted fetal material, semen, urine, milk; oral and conjuctiva.
T/F. Brucellosis is easily eradicable
False. Difficult to eradicate!
What is seen in hematology/biochem with brucellosis? CSF tap?
Hematology/biochem: Leukocytosis, HYPERglobuinemia with HYPOalbuminemia.
CSF: neutrophilic pleocytosis with increased protein levels.
What is the specific serology test for brucellosis?
Rapid slide agglutination test (RSAT): not specific (cross reacts with other bacteria).
Tube agglutination test (TAT).
Confirm with AGID, ELISA or PCR, culture.
What is the tx for Brucellosis?
MULTI-ANTIBIOTIC REGIMEN: Doxy, aminoglycosides, quinolones.
T/F. Nocardia has draining tracts/wounds with yellow granules.
False. Actinomyces does!
Actinomyces also associated with anaerobic infections.
T/F. Nocardia and Actinomyces are both associated with wounds and pyothorax.
True.
T/F. Need to tell the lab to hold onto the culture of Nocardia/Actinomyces for 10 days.
True.
What are txs for Nocardia/Actiomyces?
Surgical drainage and debridement.
Antibiotics: Penicillins, T/S.
T/F. Leptospirosis are vector borne, which are Deer tick and Western black legged tick.
False. Borrelia Burgdorferi are (Lyme disease).
What is the pathogenesis of Borrelia burgdorferi (Lyme disease)?
Tick engorges (48-50 hours post attachment).
Utero transmission.
Bacteria has OspA and OspC; morph to survive motile and flagella; extracellular.
T/F. Borrelia burgdorferia can be sequestered in joints, fibroblasts, astrocytes for a long time.
True.
What is the prevention for Lyme disease in cats and dogs?
Vector control.
Vaccines (only against OspA).
What is the main CS of lyme disease?
Shifting leg lameness (polyarthritis)
T/F. A small red lesion can be seen with lym disease within the 1st week (where the tick was attached).
True
T/F. Lyme disease does not cause protein losing glomerulopathy.
False. It does cause PLG.
What is dx for Lyme?
No pathognomonic test. EXCLUSION OF OTHER DISEASES.
Lab findings (CSF, joint, urine): inflammation, thorombocytopenia.
C6 Snap.
T/F. Dogs and Cats are the sources of infection for Lyme Disease in humans.
False. They are not!
Humans cause erythematous rash, musculoskeletal/neurologic or CV disease.
T/F. Lyme Disease should not be treated if not showing CS.
True.
T/F. Even if UPC is elevated, you do not need to treat the animal until he/she shows CS.
False. NEED TO TREAT!
What are the drugs used for Lyme disease?
Amoxi, Azithromycin, Ceftriazone, Doxy.
Relpase is common.
What are the most common infectious Leptospira spcies in dogs?
Canicola, Icterohemorrhagiae, grippotyphosa; Serovars Autumnalis, Bratislava and Pomona.
T/F. Leptospirosis is highly infectious in cats.
False. Rare in cats.
What is the transmission of Lepto?
Direct (urine, placenta, bite wounds, ingestions).
Indirect (COMMON): contaminated environ.
T/F. Lepto remain viable for several months in warm tmep (slow moving water, high pH).
True.
What is the pathogenesis of Lepto?
Enters blood > multiple rapidly > kidney, spleen, CNS, eyes, genital area > endothelial cell attachment and renal tubular epithelial cells for months.
T/F. Lepto is commonly seen in older dogs.
False. Younger dogs.
T/F. Contaminated urine is very infectious in people and dogs. Do not contact MM with it.
True.
What are CS of Lepto?
Vascular CS.
What is the serology test for Lepto?
MAT (microscopic agglutination test).
Used together with PCR.
* Culture takes a long time (rarely done).
What is tx for Lepto?
Supportive care with urinary catheter.
Drugs: antiemetics (metoclopramide, maropitant), gastric protectants (H2 blockers, H+ pump inhibitors), diruesis (renal failure), Antibiotics (doxy or Penicillin G).
What does Lepto vaccine cover?
Pomona, grippotyphosa, canicola, icterohemorrhagiae oNLY!
T/F. A dog that develops CS has a high host Ab titer.
False. Low host Ab titer > young dogs.
T/F. Stertor and Stridor are both due to inspiratory problems. Stridor more commonly with upper resp. disease and Stertor more commonly with Brachycephalic breeds (soft palate is obstructing larynx in the back).
True
T/F. Ciliary dyskinesia occurs in older animals.
False. Younger animals.
T/F. crackles and wheezes are heard with upper resp. diseases.
False. Lower resp. diseases.
T/F. Upper resp. disease leads to increased inspiratory efforts and lower resp. disease leads to increased expiratory efforts.
True.
What are the two physical exams performed to determine nasal disease?
Glass slide technique and facial palpation.
T/F. Sneezing locates a lower resp. disease and coughing locates a upper resp. disease.
False. Sneezing is from upper resp. disease and coughing is from lower resp. disease.
T/F. Normal sneezing is due to a powerful of inspiration of air. Reversal sneezing is due to expiration of air.
False. Normal sneezing is from expiration of air. Reversal sneezing is from inspiration of air.
What are general mechanisms that trigger a cough?
Irritant receptors in the airways, inflammatory mediators, excessive secretion, airway compression/collapse.
Where is bronchial sound the loudest?
Hilus during EXPIRATION.
Where is vesicular sound the loudest?
on the periphery of the lungs during INSPIRATION
What is the normal pulmonary sounds?
Bronchovesicular
T/F. With disease, vesicular sound is increased.
False. Bronchovesicular.
Which sound produces “rice krispies” sound?
Crackles
What is pulmonary percussion?
To distinguish between fluid/air.
Use finger to strike the chest cavity and listen to the sound.
What is the minimum data base?
CBC, chem, fecal, HW, imaging
What is rhinoscopy? What is it used for?
Scope nasal cavity of a dog.
Anesthesia needed; block off the oropharnx with swabs.
Enter each nare (dorsal, middle, ventral, common meatus).
May be able to take biopsies.
What is bronchoscopy? What is it used for? Contraindicated in which animals?
Evaluates larynx, trachea, bronchi.
Anesthesia needed.
Samples collected for cytology, culture and sensitivity, FNA.
Contraindication: severe resp. distressed patients.
What is the difference between transtracheal aspirate and endotarcheal wash?
TTW: larger dogs, sedation, cricothyroid lig.
ETW: cats and small dogs, GA, catheter down ET tube.
What are the methods used to collect cytology samples?
Cytobrush with local anesthesia, nasal flush/biopsies, Transtracheal aspirate, bronchoalveolar lavage.
Describe Nasal flush/biopsies.
FB, cleanse airways, obtain sample for cytology.
GA, ET tube required.
Block off one nostril and oropharynx with swab.
Cats: use dorsal recumbency; Dogs: sternal recumbency.
What is the indication of BAL?
Lung disease (small airways, alveoli, interstitum). Drop fluids when can't go anymore > aspirate.
What is the indication of Transthoracic lung aspiration? What are the contraindications?
Intra-thoracic mass lesions in contact with thoracic wall; diffuse disease.
Putting needle through the lungs from the side.
Contraindications: hemothorax, pneumothorax > pyothorax.
What is the most common CS seen in Kennel Cough?
Coughing
Which Dx are used for complicated Kennel Cough?
Hemogram, thoracic x-ray, transtracheal wash/cytology/culture, PCR.
What is the tx for Uncomplicated Kennel Cough?
Restrict exercise, DOXY for BORDETELLA, cough suppressants.
What is the tx for Complicated Kennel Cough?
Restrict exercise, systemic antibiotics (Doxy, tetra, sulphonamides, enro), nebulization (genta), cough suppressants (if pneumonia not present), bronchodilators (albuterol, theophylline).
How to prevent Kennel Cough.
Vaccines: Parenteral and Intranasal (local and quicker)
What are the two agents for Canine Influenza Virus?
H3N8: horse flu
H3N2: avian flu
T/F. Canine Influenza virus has a high morbidity and low mortality. 20% are asymptomatic.
True
What is seen in Complicated Canine Influenza that is not seen in Kennel Cough?
Pyrexia, hemorrhagic pneumonia.
RAPID ONSET AND QUICK DEATH!
What are dx for Canine Influenza?
PCR, serology, viral isolations.
What is the tx for Canine influenza?
NSAIDs, IV, systemic antibiotics.
T/F. Kennel cough and Canine influenza are highly contagious.
True.
What is found during Oslerus Osleri infection?
Cream colored nodule in the trachea.
T/F. Oslerus osleri are commonly found in older animals due to decreased immunity.
False. Younger dogs in kennels.
What are seen in radiographs and bronchoscopy in Oslerus osleri infection?
Masses.
What is the tx for Oslerus Osleri
Fenbendazole, Ivermectin
What is the cause of collapsing trachea?
ACQUIRED reduction in chondrocytes > weak cartilage with flattening of tracheal rings > irritation, edema, inflammation.
Which animals are usually affected by collapsing trachea and chronic bronchitis?
Small, middle/older, obese dogs
Which resp. condition produces GOOSE HONKING COUGH?
collapsing trachea.
T/F. Abnormal liver function tests are seen in Canine Chronic Bronchitis.
False. Collapsing Trachea
What is the best dx for collapsing trachea?
Bronchoscopy
What is the first tx for collapsing trachea?
Calm patient, sedation (acepromazine, butorphanol, diazepam), O2, intubation, dexmethasone.
What tx is used to break cycle in collapsing trachea?
Avoid dust, avoid neck collars, weight loss, cough suppressants, corticosteroids, antibiotics.
What is performed if medical tx is not working in collapsing trachea?
Surgery (Endoluminal stents)
T/F. Collapsing trachea has 4 grades (4 being the worst).
True.
What is the pathogenesis of Canine Chronic Bronchitis?
Inflammation of the bronchial wall > thickened walls, increased mucous > obstruction of small airways > inflammation.
Which resp. condition is responsible for “wax and wane”?
Canine Chronic Bronchitis
T/F. Canine chronic bronchitis may have concurrent tracheal collapse or aortic valve insufficiency.
False. Mitral valve insufficiency.
T/F. Want to exclude other causes of a cough in Canine Chronic Bronchitis.
True (progressive daily cough for 2 months in Canine Chronic Bronchitis)
What is the tx for Canine Chronic Bronchitis?
Eliminate trigger, keep hydrated, reduce weight.
Which drugs are given for Canine Chronic Bronchitis?
Pred, bronchodilators, antibiotics, MDI.
How is Canine chronic bronchitis different from asthma?
This is due to inflammation whereas asthma has contraction of muscles in bronchi
What is the condition called when its secondary to canine chronic bronchitis where mucous cannot be cleared > secondary infection > recurrent bronchopneumonia > damage the airway.
Bronchiectasis
What is dx and tx for bronchiectasis?
X-ray (diltation of bronchi) and beta blockers (albuterol)
Which breed of cats is predisposed to Feline Asthma?
Siamese
What is the first tx that you need to do with feline asthma (acute life threatening)?
No stress, O2, Dex, bronchodilators (albuterol or terbutaline).
What are dx performed for feline asthma?
X-ray (if cat is stable), CBC, fecal FIRST.
SECOND: TTW, BAL, cytology, culture, bronchoscopy, culture.
What is the long term tx for feline asthma?
Improve environment, glucocorticoids, oral bronchodilator (theophylline, terbutaline, albuterol), antibiotics (water after doxy).
What happens if feline asthma is left untreated?
Irreversible damage (fibrosis) and emphysema.
What are the two resp. conditions regarding feline tracheobronchial disease?
Feline asthma and Feline Chronic Bronchitis
What are SIX resp. conditions regarding canine tracheobronchial disease?
Kennel cough, Canine Influenza, Oslerus osleri, Canine chronic bronchitis, bronchostectasis, Collapsing trachea
What is the tx for feline chronic bronchitis?
Glucocorticoids.
What are CS of pulmonary parenchymal disease?
Difficulty breathing, increased rate and effort, coughing (VERY COMMON), exercise intolerance, abnormal pulmonary sounds, orthopnea.
What is the most common etiology of pneumonia in dogs? cats?
Dogs: bacterial
Cats: viral
T/F. Primary bacterial pneumonia occurs in older dogs whereas secondary bacterial pneumonia occurs in younger dogs.
False. Primary in younger dogs and secondary in older dogs.
T/F. If there is a history of recent sedation or anesthesia, bacterial organism is most likely to be more resistant.
True
What can bacterial pneumonia result in?
ALI and ARDS (death)
T/F. Mycotic pneumonia is an acute infection that affects joints, eyes, and brain.
False. It’s a chronic infection that affects joints, eyes, and brain.
What is the main dx for mycotic pneumonia?
Urine/serum antigen titers, cytology/histopath (biopsy).
Which three infectious organisms show HYPERglobinemia and HYPOalbuminemia?
Blastomycosis, Histoplasmosis, Brucellosis
Which sound produces “rustling of leaves”?
Vesicular
Which agent is most commonly associated with Kennel Cough?
Canine Adenovirus-2 (CAV2)
Which of the Canine tracheobronchial disease is closely associated with cyanosis, hepatomegaly, murmur?
Collapsing trachea
Which one is most common CS in idiopathic feline asthma? Coughing or acute respiratory distress?
acute respiratory distress
T/F. You can hear audible wheezing in feline asthma.
True
Which resp. condition is more commonly seen in West Highland White Terrier?
Idiopathic pulmonary fibrosis
Which infectious bacterial agent causes discospondylitis, chorioretinitis, optic neuritis, anterior uveitis?
Brucellosis
