Test 3: 43 non infectious pulmonary disease Flashcards
5 common small animal lung diseases that are not pneumonia
- Pulmonary contusions
- Allergic airway diseas
- Non-cardiogenic pulmonary edema
- Pulmonary thromboembolism
- Pulmonary interstitial fibrosis
common causes of pulmonary contusions
Compression-decompression injury → HBC, High rise syndrome, kicks, abuse, shock waves
clinical signs of pulmonary contusion
- Acute/severe respiratory distress/tachypnea OR may develop progressively over 24-48 hours
- Other signs of trauma- thoracic limb fractures, abrasions, pneumothorax, rib fractures, pleural effusion, diaphragm rupture, arrhythmias, pericardial effusion
- Auscultation: normal or increased breath sounds; crackles and/or wheezes: May worsen over a 24-hour period, Can be asymmetric/unilateral or generalized, Can be difficult to interpret around other thoracic pathology
- Hemoptysis is uncommon in small animals (compared to humans)
diagnosis of pulmonary contusion
B lines on ultrasound
Thoracic radiographs: patchy/diffuse interstitial or alveolar lung infiltrates; localized or generalized
CT
treatment of pulmonary contusion
O2
intubation if severe
pain meds
antibiotics not used unless pneumonia devleops
prognosis: usually resolves in 10-14 days
DDX for allergic airway disease
Parasitic allergic airway disease
Eosinophilic bronchopneumopathy
Feline asthma
clinical signs of allergic airway disease
Range from asymptomatic, chronic disease (>2 months) or acute crisis
* Cough, crackles, wheeze, respiratory distress
* Expect lung hyperinflation thickened bronchi/bronchioles
* Lower airway inflammation– mucosal edema, airway smooth muscle hypertrophy, airway constriction, excessive production of airway secretions
what are some parasites that can cause allergic airway disease
Migrating parasites:
§ Toxocara canis (roundworms)
§ Ancylostoma caninum (hookworms)
§ Strongyloides stercoralis (pinworms)
Primary lung parasites:
§ Paragonimus kellicotti (lung fluke)
§ Aelurosrongylus abstrus (cat lungworm)
§ Capillaria aerophile
§ Filaroides hirthi (dog lungworm)
Dirofilaria immitis: antimicrofilarial antibodies trap microfilaria in pulmonary
capillaries
diagnosis of parasitic allergic airway disease
Fecal testing + Baermann
heartworm testing
CBC (↑eosin)
Xray: interstitial infiltrates, bronchial thickening, alveolar consolidation
treatment of parasitic allergic airway disease
Anthelminthic medications +/- corticosteroids
EBP allergic airway disease is more common in
younger well conditioned Siberian Huskies, Alaskan Malamutes with yellow green nasal discharge
Hypersensitivity with eosinophilic infiltration of lung/mucosa
diagnosis of EBP allergic airway disease
CBC- peripheral eosinophils seen in 60% of cases
Thoracic radiographs: diffuse bronchointerstitial pattern
Often alveolar infiltrates from secondary pneumonia
Bronchoscopy: yellow-green mucous, thick airways
Cytology- >50% eosinophils in 87% of cases
treatment of EBP allergic airway disease
Glucocorticoids – often lifelong
Perform culture and sensitivity – treat for infectious pneumonia if present!!
“Eosinophilic pneumonia of undetermined origin”
Hypersensitivity with eosinophilic infiltration of lung/mucosa in younger well conditioned dogs with yellow- green nasal discharge
feline asthma is a type — hypersensitivity reaction to aeroallergens
1
leads to reversible bronchoconstriction →inflammation/bronchitis with thick airways and mucous production
feline asthma usually occurs in —
young adult/middle aged, well conditioned cat with a chronic cough
clinical signs of feline asthma
Episodic bronchoconstriction leads to increased end-expiratory volume/air trapping, increased work of breathing, and respiratory fatigue
Leads to inflammation/bronchitis with thick airways and mucous production
Crackles/wheeze on auscultation
diagnosis of feline asthma
- CBC: rarely see a circulating eosinophilia
- Thoracic radiographs: diffuse bronchial or bronchointerstitial pattern; lung lobe collapse can be seen secondary to mucous plugging
- Cytology- eosinophilia, may be neutrophilia
treatment of feline asthma
Remove allergens- air fresheners, cigarette smoke, dust exposure
Steroids and bronchodilators →oral or inhaled
young- middle age cat with crackles/wheezing
Feline asthma
diffuse bronchial or bronchointerstitial pattern (donuts); lung lobe collapse can be seen secondary to mucous plugging
bronchoconstriction →Leads to inflammation/bronchitis with thick airways and mucous production
Accumulation of extravascular fluid within pulmonary parenchyma or alveoli with a normal pulmonary capillary wedge
pressure
non cardiogenic pulmonary edema
Increased permeability from damaged microvascular barrier and alveolar epithelium
DDX for Non-Cardiogenic Pulmonary Edema
Neurogenic pulmonary edema
Negative pressure pulmonary edema
ALI/ARDS
explain neurogenic pulmonary edema
Following acute neurologic event (trauma, seizures), increase in intracranial pressure causes surge in catecholamines, increasing vascular resistance and causes alveolar capillary leakage
Mechanisms are poorly understood but are often acute in onset and resolve within 48 hours.
explain Negative pressure pulmonary edema
Choking, strangulation, near-drowning causes acute intra-thoracic negative pressure, increasing cardiac afterload and similar catecholamine surge and alveolar capillary leakage
Mechanisms are poorly understood but are often acute in onset and resolve within 48 hours.
ALI →ARDS
Inflammation leads to vasculitis, increased permeability, and inflammatory cell infiltration/protein rich fluid leakage into lungs
secondary to severe systemic disease such as sepsis or pancreatitis
