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Small Animal Medicine > Unit 3 - Lower Airway Disease and Pneumonia > Flashcards

Unit 3 - Lower Airway Disease and Pneumonia Flashcards

1
Q

Why is inflammatory disease in cats identified as ‘feline lower airway disease’?

A

Because it is difficult to distinguish between bronchitis and asthma in cats so it is all just lumped together

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2
Q

What inflammatory airway disease happens in dogs?

A

chronic bronchitis

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3
Q

What is airflow limitation?

A

Impedance to air movement in the airways caused by inflammation, secretions, and smooth muscle contraction

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4
Q

Characterize spontaneous bronchoconstriction in chronic bronchitis.

A

little to no spontaneous bronchoconstriction

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5
Q

Characterize spontaneous bronchoconstriction in feline asthma.

A

reversible spontaneous bronchoconstriction

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6
Q

What is the signalment for canine chronic bronchitis?

A

middle-aged to older, small breeds over-represented

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7
Q

What is the signalment for feline asthma and bronchitis?

A

young to middle-aged adult, siamese is common

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8
Q

What clinical signs are associated with inflammatory airway disease?

A

chronic cough, expiratory wheezes, and tachypnea at rest

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9
Q

If a patient with one of the inflammatory airway diseases were dyspneic, what kind of dyspnea pattern would you most likely see?

A

restrictive

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10
Q

What contributes to airflow limitation on expiration?

A

Positive thoracic pressures and airway inflammation contribute to airflow limitation

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11
Q

What diagnostics are important for inflammatory airway disease?

A

CBC, parasite testing, rads (bronchial lung pattern), and TTW, ETW, or BAL (

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12
Q

What parasite can cause ‘feline lower airway disease’?

A

Aleurostrongylus abstrusus

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13
Q

How do cats get Aleurostrongylus and where do they live?

A

They ingest L3 larva and adult worms live in terminal bronchioles/alveolar ducts

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14
Q

How is Aleurostrongylus diagnosed?

A

L1 larvae is ID’d in the airway fluid or feces

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15
Q

How is Aleurostrongylus treated?

A

mild cases are self-limiting; fenbendazole

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16
Q

What are the classic signs of feline asthma radiographically?

A

broncho-intersitial lung pattern, pulmonary hyperinflation, and atelectasis of the right middle lung lobe due to mucus plugging

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17
Q

What will you find on bronchoscopy in feline asthma patients?

A

hyperemia, irregularity, increased mucus, and lower airway collapse

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18
Q

How will the respiratory wash cytology look in cats with bronchitis?

A

neutrophilic

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19
Q

How will the respiratory wash cytology look in cats with asthma?

A

eosinophilic

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20
Q

What is the treatment for lower airway disease?

A

corticosteroids (tx of choice), bronchodilators (don’t effect inflammation), and +/- cough suppressants (dogs)

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21
Q

What drugs can be used for inhaled therapy of lower airway disease?

A

fluticasone, albuterol, and others

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22
Q

What are some other treatments for lower airway disease?

A

weight loss, harness versus collar, and environmental trigger avoidance

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23
Q

What are the treatment goals for lower airway disease?

A

minimize clinical signs and slow airway remodeling

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24
Q

What type of lower airway disease is eosinophilic bronchopneumopathy?

A

Interstitial disease

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25
Q

What is eosinophilic bronchopneumopathy?

A

interstitial lung disease characterized by infiltration with eosinophils

26
Q

Most cases of eosinophilic bronchopneumopathy are _______.

A

iodiopathic

27
Q

What is the signalment for eosinophilic bronchopneumopathy?

A

young dogs, arctic breeds and rottweilers predisposed

28
Q

Before diagnosing for eosinophilic bronchopneumopathy, what must you rule out first?

A

parasites and neoplasia

29
Q

What does eosinophilic bronchopneumopathy respond well to?

A

corticosteroids

30
Q

What type of lower airway disease is idiopathic pulmonary fibrosis?

A

interstitial disease

31
Q

What breed typically gets Idiopathic pulmonary fibrosis?

A

West Highland White Terriers

32
Q

What do you find on auscultation with patients that have idiopathic pulmonary fibrosis?

A

diffuse inspiratory crackles

33
Q

What does idiopathic pulmonary fibrosis look like on rads?

A

diffuse broncho-interstitial lung pattern

34
Q

How is idiopathic pulmonary fibrosis diagnosed?

A

biopsy, rule out cases of secondary fibrosis

35
Q

What is the prognosis of idiopathic pulmonary fibrosis?

A

poor long-term

36
Q

What type of lower airway disease is bacterial pneumonia?

A

alveolar disease

37
Q

What can cause bacterial pneumonia?

A

Immunocompromise, recumbency, and impaired host defenses

38
Q

What is the route of infection of bacterial pneumonia?

A

aspiration (inhaled), hematogenous, and traumatic/penetrating

39
Q

What is the most common bacterial isolate of bacterial pnuemonia?

A

E. coli

40
Q

What other bacterial isolates are found in bacterial pneumonia?

A

(from most to least common) Pasteurella, Bordatella, Anaerobes, Streptococcus, and Staphylococcus
Mycoplasma species are also common

41
Q

Are aerobes are anaerobes more commonly isolated in bacterial pneumonia cases?

A

aerobes

42
Q

What is the number 1 cause of community-acquired infectious pneumonia in dogs less than a year of age?

A

Bordatella bronchiseptica

43
Q

What are the clinical signs of bacterial pneumonia?

A

lethargy, reduced appetite, exercise intolerance, increased respiratory rate/effort, fever, nasal discharge, +/-cough

44
Q

How is bacterial pneumonia diagnosed?

A

CBC, radiographs, pulse ox/arterial blood gase, and airway wash with culture

45
Q

What is the distribution of an interstitial to alveolar pattern of aspiration pneumonia?

A

cranial-ventral

46
Q

What is the distribution of an intersitital to alveolar pattern due to humatogenous pneumonia rads?

A

dorsal-diffuse

47
Q

Aspiration pneumonia is the most common cause of bacterial pneumonia in _____ dogs.

A

adult

48
Q

What is the initial problem to cause aspiration pneumonia in dogs?

A

airway irritation/injury

49
Q

What is aspiration pneumonia commonly associated with?

A

regurgitation, megaesophagus, laryngeal paralysis, myasthenia gravis

50
Q

Do you want a cidal or static antibiotic to treat bacterial pneumonia?

A

cidal

51
Q

When selecting an appropriate antibiotic, what factors should you keep in mind?

A

spectrum, good lung penetration, low risk of side effects, cost, and mode/frequency of administration

52
Q

What is the empiric treatment for uncomplicated bacterial pneumonia?

A

Narrow spectrum, single therapy - amoxicillin/amoxicillin clavulanate, cephalexin, doxycycline (Bordatella), TMS, and Azithromycin

53
Q

What is the duration for treatment in uncomplicated bacterial pneumonia?

A

1-2 weeks post-radiographic resolution

54
Q

What is the empiric treatment for complicated/severe bacterial pneumonia?

A

Broad spectrum, combination therapy (aerobic and anaerobic coverage, gram negative and positive coverage), parenteral administration initially, adjust based on C/S results

55
Q

How long is treatment for complicated/severe bacterial pneumonia?

A

1-2 weeks post-radiographic resolution

56
Q

What is the empiric treatment for hospitilized patients with complicated/severe bacterial pneumonia?

A

IV administration of antibiotics initially, and hospitilization with supportive care (IV fluids, nebilization, nutritional support, O2 if needed)

57
Q

What is the benefit of nebulization?

A

loosens/moistens airway secretions and improves expectoration

58
Q

What can cause fungal pneumonia?

A

Blastomyces dermatidis, Histoplasma capsulatum, Coccidiodes immitis, and Cryptococcus neoformans in cats

59
Q

How is fungal pneumonia diagnosed?

A

cytology (most important) and urine antigen (for histo/blasto)

60
Q

What is the treatment for fungal pneumonia?

A

long-term antifungals (itraconazole/fluconazole) +/- anti-inflammatory steroids

Small Animal Medicine (100 decks)

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