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SEM 5: SAM 1 > Tracheal Collapse, Laryngeal paralysis, and BAOS > Flashcards

Tracheal Collapse, Laryngeal paralysis, and BAOS Flashcards

1
Q

What is a primary cause of tracheal collapse?

A

Born with weak cartilage rings deficient in glycosaminoglycan, chondroitin, and calcium

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2
Q

What are secondary causes of tracheal collapse?

A
  • Increased pressure on the trachea in association with other chronic resp disease (Ex: Chronic bronchitis, idiopathic pulmonary fibrosis)
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3
Q

True or False: Tracheal collapse is more commonly seen in dogs than cats

A

True

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4
Q

Collapse of the cervical trachea occurs during ______________

A

Inspiration

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5
Q

Collapse of the thoracic trachea occurs during ______________

A

Expiration

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6
Q

What respiratory sounds can be heard on inspiration and expiration from a patient with tracheal collapse?

A
  • “Honking” on expiration (most common CS), can have terminal retch
  • Loud “rattling” or stridor during inspiration
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7
Q

What breeds are more at risk for tracheal collapse?

A

Small breeds

  • Yorkie, pomeranian, poodle, maltese, chichi, pug
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8
Q

Chronic “honking” sound that is precipitated by excitement/activity or drinking water is a good indicator of which of the following?

A. Asthma
B. Chronic bronchitis
C. Tracheal collapse
D. Spirocerci lupi infection

A

C. Tracheal collapse

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9
Q

What physical exam findings can be present in a patient with tracheal collapse?

A
  • Cough elicited on tracheal palpation
  • “Honking” or rattling
  • Stridorous sounds on tracheal auscultation
  • Hyperthermic if in resp distress
  • Signs of PH if severe
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10
Q

What is the first diagnostic performed following a complete PE in a patient suspect of tracheal collapse?

A

3 view thoracic and cervical rads on inspiration and expiration

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11
Q

What test is needed to obtain a definitive diagnosis of tracheal collapse?

A
  • Fluoroscopy or tracheoscopy
  • Bronchoscopy to rule out other causes
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12
Q

What is the drug treatment protocol for a stable patient with tracheal collapse?

A

- Short term tapering dose of Prednisone
- Lifelong cough suppressant (Hydrocodone), only to be used as needed for flare ups
- Sedative to be given for stressful events
- Abx if 2ndary infection
- +/- bronchodilator

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13
Q

Other than drugs, what treatments can reduce clinical signs associated with tracheal collapse

A
  • Weight loss!!!
  • Avoid hot climates
  • Avoid strenuous exercise
  • No collar around neck
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14
Q

What is the treatment protocol for a patient with tracheal collapse who is refractory to drug therapy or has severe dyspnea?

A
  • Intraluminal stenting or surgical prostheses only in patients with severe dyspnea or failure to respond to meds
    Tx of resp distress:
  • Sedation
  • O2
  • Dexamethasone
  • Cooling if hyperthermic
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15
Q

List the main functions of the larynx

A
  • Regulates airflow
  • Protects trachea from aspiration during swallowing
  • Controls phonation (voice)
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16
Q

List the common etiologies associated with acquired laryngeal paralysis

A
  • Polyneuropathy
  • Polymyopathy
  • Trauma
  • Mass (neoplasia, granuloma)
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17
Q

List the breeds associated with early onset laryngeal paralysis-polyneuropathy

A
  • Rottie
  • Dalmations
  • Pyrenese mountain dogs
  • Leonberger dogs
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18
Q

List the breeds associated with geriatric onset laryngeal paralysis-polyneuropathy

A

Lab retrievers

19
Q

List the breeds associated with congenital laryngeal paralysis

A
  • Bouviers des flanders
  • Bull terriers
  • Huskies
  • White coated GSD
20
Q

True or False: Laryngeal paralysis is usually more common in older small breed dogs

A

False - older LARGE BREED dogs

21
Q

What can be found on physical exam from a dog with laryngeal paralysis?

A
  • Stridor on inspiration, localized to the larynx or extrathoracic trachea, heard during activity or panting
  • Can be hyperthermic if in resp distress
  • Voice change, coughing or gagging
22
Q

What abnormal respiratory sound is commonly heard in patients with laryngeal paralysis?

A

Stridor - high pitched, continuous URT sound

23
Q

What is a common complication of laryngeal paralysis?

A. Hypothermia
B. Aspiration pneumonia
C. Stricture formation
D. Tracheal collapse

A

B. Aspiration pneumonia

24
Q

What drug is given to stimulate respiration during a sedated laryngeal exam?

A

Doxapram

(Helps reduce drug related lack of motility)

25
Q

Why is a complete neuro exam important in dogs with laryngeal paralysis?

A

Common cause of laryngeal paralysis is polyneuropathy - can see pelvic limb deficits + esophageal dysfunction

26
Q

What diagnostics would you perform in a dog with suspect laryngeal paralysis?

A
  • MDB, thyroid testing
  • Thoracic rads (evaluate for aspiration pneumonia + megaesophagus, severe LP can cause NCPE)
  • Sedated laryngeal exam for definitive diagnosis
27
Q

What can be seen on a sedated laryngeal exam from a patient with laryngeal paralysis

A
  • Lack of abduction of arytenoids during inspiration (can’t open and let air into trachea)
28
Q

When is surgical intervention indicated for patients with laryngeal paralysis?

A
  • Reserved for bilateral LP and moderate or severe clinical signs

(unilateral arytenoid lateralization-permanent opening of the larynx. Con: more at risk for aspiration pneumonia)

29
Q

What is the name of the surgical procedure performed on patients with severe bilateral laryngeal paralysis?

A

unilateral arytenoid lateralization (permanent opening of the larynx)

Con: more at risk for aspiration pneumonia

30
Q

List 3 upper respiratory tract conditions in DOGS where you would recommend the following conservative treatments: Avoid heat/humidity, strenuous exercise, over-excitement, and stress

A
  1. Laryngeal paralysis
  2. Tracheal collapse
  3. BAOS

(true for cats with laryngeal paralysis too)

31
Q

Weight loss is strongly recommended in patients with which of the following upper respiratory tract diseases?

A. Laryngeal paralysis
B. Tracheal collapse
C. Chronic bronchitis
D. All of the above

A

D. All of the above

32
Q

What is the treatment protocol for a patient in respiratory distress due to severe laryngeal paralysis?

A
  • Oxygen
  • Corticosteroid (Dexamethasone)
  • Sedation (acepromazine, butorphanol)
  • Cooling if hyperthermic
33
Q

True or False: Laryngeal paralysis is uncommon in cats, but when laryngeal disease is present, its usually due to laryngeal paralysis

A

True

34
Q

True or False: Dogs with laryngeal paralysis usually present with worse clinical signs than cats

A

False

CS can be more severe in cats, even with unilateral paralysis (smaller orifice than dogs)

35
Q

List the causes of laryngeal paralysis in cats

A
  1. Neoplastic
  2. Trauma
  3. Iatrogenic (post-thyroidectomy)
36
Q

List the primary defects of BAOS

A

1. Stenotic nares
2. Elongated soft palate
3. Tracheal hypoplasia
4. Distorted turbinates

37
Q

List the secondary defects from BAOS

A

Everted laryngeal sacs, laryngeal collapse, bronchial collapse

Concurrent GI disorders are common: esophageal deviation, gastroesophageal reflux, GI stasis, pyloric hypertrophy, inflammation

38
Q

What is the function of nasal conchae?

A

Cleans and thermoregulates air

(brachycephalics have messed up nasal conchae - can’t cool air - prone to overheating)

39
Q

Why are patients with BAOS instructed to avoid heat, stress, and strenuous exercise?

A

Heat/stress/exercise → Increased velocity of airflow → increased turbulence in airways → worsens inflammation, swelling, and edema

40
Q

What abnormal respiratory sound is most commonly heard in patients with BAOS?

A. Stertor
B. Stridor
C. Wheezing
D. Crackles

A

A. Stertor “snoring”

  • discontinuous, low pitch URT sound localized to nasal cavity/pharynx

+/- can hear stridor

41
Q
A
42
Q

What GI signs are common in patients with BAOS?

A

Regurg, vomiting

42
Q

What is the treatment protocol for a patient in respiratory distress due to BAOS?

A
  • Oxygen
  • Corticosteroid (Dexamethasone)
  • Sedation (acepromazine, butorphanol)
  • Cooling if hyperthermic

(same tx for resp distress due to laryngeal paralysis)

43
Q

What is the definitive treatment to fix a patient with BAOS and further prevent life-threatening respiratory distress?

A

Requires surgery:
- Rhinoplasty
- Soft palate resection (palatoplasty)

SEM 5: SAM 1 (26 decks)

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