The respiratory distress patient Flashcards
Key phrases on the phone regarding respiratory distress.
Heavy breathing
* Cat : panting; breathes mouth open, hyperventilating.
* Dog: does not want to lie down, breathes with whole body, gagging.
Collapse
* Fainting, unconscious, collapse
* Tongue is blue, unwilling to walk
Cough
* Coughing and choking, coughs pink foam, coughs with whole body
Cat: hindleg paralysis/paresis (FATE)
Enlargement of abdomen (ascites etc.)
Minimum preparation for a respiratory distress case. (7)
At least two people: doctor and nurse
Oxygen!
Emergency drugs: sedation, diuretics (butorphanol, furosemide etc.)
Intubation equipment
IV catheter placement
Primary diagnostics (e.g. TFAST)
Specific equipment for procedures (thoracocentesis; tracheostomy)
1 cause of resp. distress in cats
cardiac disease with pleural effusion
infectious diseases that can cause resp. disease in dogs (4)
kennel cough (complex)
angiostrongylus vasorum
crenosoma vulpis
leptospirosis
irish wolf hounds are predisposed to what disease that can result in resp. distress? (2)
DCM
&
immune mediated ciliary deficiency / ciliary dyskinesia
describe immune mediated ciliary deficiency / ciliary dyskinesia / Rhinitis/Bronchopneumonia Syndrome
a rare congenital defect where the ciliary throughout the body do not function properly.
This can cause respiratory issues such as coughing, nasal congestion and exercise intolerance.
westies are predisposed to what disease that can result in resp. distress? (1)
Canine idiopathic pulmonary fibrosis (CIPF)
huskies & malamutes are predisposed to what disease that can result in resp. distress? (1)
spontaneous pneumothorax due to congenital air bullae in the lungs
describe CIPF in westies
Canine idiopathic pulmonary fibrosis (CIPF) affects middle-aged to older dogs of a single breed, mainly the West Highland white terrier (WHWT), which is suggestive of a genetic predisposition.
CIPF causes exercise intolerance, restrictive dyspnea and coughing. Coarse crackles are heard on thoracic auscultation.
Clinical exam of resp. distress patient, first 3 points. (3)
Observe from a distance
Auscultation
Temperature (infectious, heat stress, shock etc.)
Upper airway obstructive diseases in dogs (6)
- Laryngeal paralysis (labradors, malamutes, St. Bernhards etc., onset 1 y/o)
- Tracheal collapse
- Brachiocephalic syndrome
- Polyps
- Foreign bodies
- Neoplasia
Describe laryngeal paralysis in dogs.
Voice change, honking, coughing etc. Commonly onset 1 y/o.
Secondary innervation issues to esophagus resulting in megaesophagus.
But can also be geriatric onset in Labradors (geriatric onset laryngeal paralysis and polyneuropathy (GOLPP)).
Airway polyps more common in
cats (originate from inner ear and infiltrate)
Most common lower airway obstructive diseases in cats. (2)
Asthma from allergic-cause
* Siamese and Burmese especially
* Coughing cat
* Risk for secondary pneumothorax
Chronic bronchitis (diagnosis of exclusion, challenging, more commonly used in dogs)
Aspiration pneumonia most commonly caused by (2)
- Anaesthesia
- Megaoesaphagus
Describe Salbutamol (albuterol sulfate) use
Product Ventonil 100μg/dose
- Bronchodilator
- Cat/dog: one puff q30min up to 4-6h
- Used in acute cases
Animal needs to breathe in and out 5-10 times before removal of mask.
Explain the gator sign in tFAST.
The “gator sign” is a specific sonographic finding observed in the tFAST examination, which is used to evaluate patients for conditions such as pneumothorax or pleural effusion following trauma.
The “gator sign” is seen in a normal lung, where the pleura is intact and smoothly sliding with respiration. The gator sign typically rules out pneumothorax in that region.
This sign contrasts with abnormal findings, such as the barcode or stratosphere sign, which are indicative of conditions like pneumothorax where the lung and pleural layers are separated.
You can’t view it on a still as its a movement to be observed.
Explain: Dry vs wet lung
the terms dry lung (normal air content) and wet lung (excess fluid) refer to different sonographic patterns observed in the lung parenchyma, often related to the presence or absence of fluid in the lungs.
In a dry lung, the ultrasound typically shows a clear pleural line with A-lines, which are horizontal, regularly spaced lines that are reverberation artifacts. These A-lines indicate air-filled lungs.
“wet lung” Ultrasound Appearance, B-lines are observed. These are vertical, laser-like, comet-tail artifacts that arise from the pleural line and extend all the way to the bottom of the ultrasound screen. B-lines move with respiration and represent the presence of fluid in the lung.
An occasional B-line is considered normal; excessive B-lines are indicative of interstitial-alveolar lung abnormality.
identify
pleural effusion
In this case, you could do tFAST first instead of xray. Take fluid off the lungs and only then xray. Removing the fluid could allow other structures to come into view in the xray (e.g. neoplasia).
identify
pneumothorax
cardiac tip and sternum should not have space between
