SA Upper Respiratory Diseases (above oropharynx) Flashcards
1
Q
disease localization to nose/nasopharynx
(cranial to oropharynx)
A
- stertor
- nasal discharge
- sneezing
- open mouth breathing
- …
2
Q
epidemiology of feline URI
A
- common
- several infectious agents involved
- contact transmission
- actively infected cats, carriers, fomites
- signalment
- young, old, immunosuppressed cats more likely to show clinical signs
- latent (FCV and FRV) carriers for weeks to years after resolution
3
Q
causative agent(s) of feline URI
A
- several infectious agents involved:
- Feline Herpes Virus-1 (FHV-1)
- Feline Calicivirus (FCV)
- Chalmydiophila felis
- Bordatella bronchiseptica
- Mycoplasma spp
4
Q
clinical features of feline URI
A
- acute form more common
- common signs: sneezing, serous to mucopurulent nasal discharge, conjunctivitis with ocular d/c
- classic signs vary with infectious agent
- FRV-corneal ulceration; FCV-oral ulceration; Chalmydiophila: conjunctivitis
- chronic: 80-100% persistently infected
- only small % are clinical
- clinical signs occur more often in stressed or immunosuppressed cats
5
Q
diagnosis of feline URI
A
- often presumptive (hx, clinical signs)
- PCR
- outbreak in catteries
- diagnostic and prognostic info
- chronic rhinitis?
6
Q
treatment of acute signs of feline URI
A
- self limiting in most cases: supportive tx
- nutrition, fluids, cleaning/suction
- nebulization?
- pediatric nasal decongestants? (no NSAIDS!)
- abx rarely needed
- corticosteroids contraindicated
7
Q
treatment of chronic signs of feline URI
A
8
Q
prognosis of feline URI
A
- acute:
- GOOD
- chronic
- good for quality of life
- cure is very unlikely
9
Q
prevention of feline URI
A
- for individual
- avoid exposure
- vaccinate
- modified live against FCV and FRV
- for multi-cat households
- herd-health
- minimize exposure
- strengthen immunity
10
Q
nasal tumors
A
- majority are malignant
- carcinomas most common in dogs
- adenocarcinoma and lymphoma most common in cats
- benign tumors occur rarely
- consider TVT in endemic areas
11
Q
clinical features of nasal tumors
A
- more frequent in older animals
- no sex or breed predisposition
- signs usually chronic: reflect slow growing, locally invasive nature of the tumors
- nasal d/c
- sneezing, decreased airflow, deformation of face
- nonspecific signs such as wt loss and anorexia
12
Q
diagnosis of nasal tumors
A
13
Q
treatment of nasal tumors
A
- benign tumors should be surgically excised
- malignant tumors
- radiation is tx of choice for most
- surgical excision unlikely to yield clear margins
- chemo for lymphoma
- analgesics, NSAIDs, abx…
14
Q
prognosis
A
- prognosis w/out treatment is poor
- survival time ~ few months from dx
- survival times with radiation tx ~1 year
15
Q
nasopharyngeal polyps
A
- benign growths
- kittens and young cats
- often attached to base of Eustachian tube
- generally pink, pedunculated
16
Q
clinical features of nasopharyngeal polyps
A
- stertorous breathing: altered vocalization
- nasal discharge
- serous to mucopurulent
- often unilateral
- upper airway obstruction
- otitis externa/media/interna
17
Q
diagnosis of nasopharyngeal polyps
A
- otic exam
- radiographs
- thorough oropharyngeal exam
- nasopharyngoscopy (retroflexed)
- histopathology confirms dx
18
Q
treatment of nasopharyngeal polyps
A
- surgical excision usually curative
- typically performed via oral cavity
19
Q
prognosis of nasopharyngeal polyps
A
- excellent if entire polyp removed
20
Q
fungal rhinitis
A
- aspergillosis: Aspergillus fumigatus
- cryptococcosis: Cryptococcus neoformans
- other: Penicilium, Rhinosporidium, Sporothrix…
21
Q
nasal cryptococcosis and clinical signs
A
- most common systemic fungal disease in cats
- sneezing, nasal discharge
- unilateral or bilateral
- serous to mucopurulent
- may also see:
- granulomatous lesions in nares
- facial deformity
- ulceration of nasal planum
22
Q
nasal cryptococcosis diagnosis
A
-
cytology of nasal discharge
- pyogranulomatous inflammation
- organisms often present
-
serology
- latex agglutination for capsular antigen
- histopathology
23
Q
nasal cryptococcosis treatment
A
- systemic fluconazole, itraconazole
- nasal and cutaneous disease normally respond well to tx, but tx may be prolonged
- can develop resistance to anti-fungals
24
Q
nasal aspergillosis
A
- dogs
- generally dolichocephalic or mesocephalic
- typically younger, middle-aged
- can occur in immunocompetent dogs
- very rare in cats
- opportunistic
- pre-existing nasal disease
- long-term abx
25
clinical signs of nasal aspergillosis
* nasal discharge
* serous, mucopurulent, sanguino-purulent, or epistaxis
* nasal pain
* ulceration of external nares
26
nasal aspergillosis diagnosis
* false + or - from Ab serology, cytology, histopathology, and cultures
* skull radiographs and/or CT
* rhinoscopy may allow direct visualization
* need to combine info from various tests
* important to differentiate from neoplasia
27
nasal aspergillosis treatment
* topical clotrimazole, enilconazole
* good prognosis
28
idiopathic rhinitis
* **Lymphoplasmacytic rhinitis**
* rare (?) disease in dogs and cats
* chronic nasal discharge +/- sneezing
* histopathology
* inhaled irritants/particulate matter, unknown infection, or auto-immune origin?
* tx with corticosteroids
29
bacterial rhinitis
* **uncommon as primary nasal disease**
* *Bordatella bronchisepptica, Mycoplasma spp,* and *Chlamydia felis* can act as primary pathogens
* **very common** secondary complication of other nasal dz
30
allergic rhinitis
* uncommon manifestation of allergy
* sneezing and nasal discharge
* sometimes seasonal or related to specific environmental changes
31
diagnosis of allergic rhinitis
* response to removal of allergen +/- re-exposure challenge
* nasal biopsies generally indicate eosinophilic inflammation
* skin testing helpful?
32
treatment of allergic rhinitis
* removal of offending allergen
* antihistamines indicated if this not possible or sufficient
* corticosteroids (anti-inflammatory doses) in refractory cases
* hyposensitization?
