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SAM > Upper respiratory diseases in dogs and cats 1+2 > Flashcards

Upper respiratory diseases in dogs and cats 1+2 Flashcards

1
Q

History and clinical signs

A
  • Discharge, sneezing, bleeding, pain, stridor, dyspnea, reverse sneezing
  • virial rhinitis: watery/serous discharge
  • secondary bacterial infection: purulent discharge
  • Foreign body, tumor or fungal rhinitis: bloody discharge
  • systemic diseases
  • discharge (distemper, viral rhinotracheitis)
  • epistaxis (bleeding disorders, e.g DIC)
  • physical examination
  • shape, nasal stridor, closing th mouth, discharge uni- or bilateral, inspection of the mouth (teeth), depigmentation
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2
Q

Special diagnostic prcecure

A
  • Radiography
  • –> you can only see the increased radiodensity, but not differentiate the diagnosis
  • need: sedation, positioning, limited value
  • Rhinoscopy
  • Best choice. but not for frontal sinus or bony dase disroders
  • good to differentiate tumor (benign, malignant) and inflammation
  • need: anesthesia, tracheal intubation, sphinxlike posture, viscualization and biopsy
  • CT/MRI:
  • Good for frontal sinus and body case disorders
  • not good to differentiate tumor or inflammation
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3
Q

Diseases of the nasal cavity and frontal sinus

A
  • Congenital diseases
  • Malformation of the nasal plane
  • oronasal, oropharyngeal clefts
  • primary ciliary dyskinesia/kartagners syndrome
  • Rhinits:
  • viral, bacterial, mycotic, specific, (neurogenic)
  • Tumors
  • nasal plane, nasal cavity, frontal sinus
  • epistaxis
  • trauma
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4
Q

Viral rhinitis in cats

A
  • Usually in unvaxinated outdoor cats.
  • FHV-1, FCV 80-90% (URT)
  • starts with a bilateral problem, paroxysmal sneezing, serous ocular and nasal discharge, in 5 days mucopurulent (due to secondary bacterial infection)
  • immunization (LMV) severe disease but infection!
  • chronic carriers: no sigsn or sneezing, mild nasal discharge, gingival ulceration
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5
Q

Viral rhinitis in dogs

A
  • kennel cough
  • canine distemper
    • profuse mucopurulent nasal discharge
    • PCR
  • CHV in puppies –> sytemic, life threatening disease
    • profuse mucopurulent nasal discharge
    • autopsy
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6
Q

Bacterial rhinitis

A
  • usually secondary due to
  • viral infections, foreign body, tumor, distrutpion of mucosal integrity
  • sometimes it can be primary (rare)
  • Pasteurella, treptococcus, staphylococcus, bordetella, chlamydia
  • treatment:
  • antibitoics, but always find the primary disease first
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7
Q

Mycotic rhinitis

A
  • more common in dogs than cats
  • Aspergillus spp. > Cryptococcus (except crypto. is more common in cats)
  • nasal cavity and frontoal sinus
  • Cause:
  • opportunist, house dust, bird cages
  • large number of spores, foreign bodies
    • e.g foxtail can cause mycotic rhinitis due to allergy in the summer, by aspirating the forign body
  • can be iatrogenic due toglucocorticoid treatment
  • clinical signs: nasal discharge (mucopurulent), depigmentation, pain, epistaxis
  • rhinoscopy: plaques, bone resportion, atrophy of the conchae
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8
Q

Sinosal aspergillosis

  • treatment
A
  • Topical 1% clotrimazole gel (nasal cavity/frontal sinus), 1-3 x endoscopy + oral itraconazole for 8 weeks
  • be carefull not to damage the cribriform plate. if this is damaged the medication can enter the brain and lead to coma
  • topical enilconazole va tubes thorugh trephine holes 10ml 10% BID for 14 days
  • systemic: ketoconazole, itraconazole, or fluconazole for 8 weeks
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9
Q

Specific rhinitis

A
  • Polyps:
  • more common in cat than dog
  • uni/bilateral, nasal cavity/nasopharynx
  • clinical signs: stridor, compensate with open mouth breathing -> can be lethal for cats.
    • cats may extend their neck and pand and being very anxious
  • rhinoscopy, biopsy, surgery
    • Recurrence of the polyp is very unusual if bulla osteotomy
    • prognisis is excellent! Horners syndrome usually resolves within a month
  • Foreign bodies:
  • sudden sneezing (initially), pain
  • rhinoscopy
  • Allergic rhinitis
  • serous discharge, sneezing
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10
Q

Tumors of the nasal cavity

A
  • Any age, but usually older dogs/cats over 5 years
  • clinical signs:
  • similar to rhinitis
  • epistaxsis +/-
  • unilateral bloody nasal discharge
  • radiography, rhinoscopy + biopsy, CT, MRI
  • Cause:
  • cats usually lymphoma
  • dogs: squamous cell carcinoma, adenocarcinoma, sarcoma
  • Treatment:
  • CT, MRI, radiation therpy, chemotherapy, surgery
    euthanasia: bleeding, dyspnea, stop eating
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11
Q

Pharynx

  • history and diagnosis
A

Oro-/naso-/laryngopharynx

  • history:
  • dysphagia, couging, gagging, regurgitation, salivation
  • physical examination: sedation +/-, intubation
  • diagnosis:
  • pharyngoscopy, retrograde rhinoscopy, video fluroscopy, CT (middle ear), UL (masses)
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12
Q

Diseases of the pharynx

A
  • foreign body: common in dogs
  • sudden salivation after eating bones
  • pain, dysphagia, dyspnea
  • retropharyngeal abscess:
  • migrating foreign body,
  • salivation, fever, dysphagia, diagnsis dofficult, painfull neck
  • WBC increases
  • nasopharyngeal polyps: same as above
  • nasopharyngeal stenosis:
  • young cats
  • rare, open-mouth breathing
  • endoscopy, surgery, ballon dilatation
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13
Q

Soft palate abnormalities

A
  • Elongated soft palate:
  • brachycephalic dogs, stertorous breathing, exercise intolerance, collapse, gagging
  • Cleft palate
  • neonate patients
  • milk in the nares, aspiration
  • surgery
  • can lead to nasal discharge and chronic rhinitis
  • soft palate hypoplasia
  • brachycephalic dogs, chronic rhinitis, gagging, reverse sneezing
  • can lead to nasal dicharge and chronic rhinitis
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14
Q

Larynx

  • history and diagnostic procedures
A
  • changes in vocalisation, stridor (air turbulence thorugh the narrowed laryngeal opening)
  • always rule out rabies!
  • coughing, gagging
  • systemic disease?, nauropathy, myopathy, secondary complications like aspiration
  • palpation (pain, fremitus), auscultation (stridor), excersising the patient
  • laryngoscopy
  • x-ray
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15
Q

Diseases of the larynx

A
  • laryngitis/obstructuve inflamatory disease
  • laryngeal paralysis
  • laryngeal collapse /brachycephalic airway syndrome
  • neoplasia
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16
Q

Laryngitis

A
  • rarely a disease alone
  • dommon infectious agents:
  • Dog: CAV-2, CPIV, Bordetella bronchiceptica (kennel cough)
  • Cat: FHV-1, FCV
  • loud cough, fever +/-, pneumonia +/-, lethargy +/-
  • antibiotics: Doxycycline, amoxcicillin+clavulonic acid
  • Antitussives: butorphanol, hydrocodone (but! pneumonia)
  • other causes (non-infectious):
  • local irritation (endotracheal tube, foreign body, hot food, insect bites)
  • Treatment:
  • glucocorticosteroids + NSAIDs
  • tracheostomy
17
Q

Obstructive laryngitis

A
  • rare, dogs and cats
  • histopathology is imperative to distinguish between neoplasia and obstructube inflammatory disaease
  • severe respiratoy distress, dysphonia, stridor, dyspnea
  • glucocorticoids, tracheostomy, tube placement
  • biopsy can kill the animal (bleeding?)
18
Q

Laryngeal paralysis

A
  • arythenoid cartilage fails to abduct during inspiration! Recurrent laryngeal nerve
  • Usually happens in old, large breed dogs, idiopathic:
  • congenital: Bouvier des flandres, siberian husky, bull terrier
  • acquired: idiopathic, trauma, systemic neuromuscular disease
    • labrador retrivers, saint bernards, irish setters
  • stridor, excersive intolerance, voice change, couching, respiratory distress, hyperthermia
  • inspection, paradoxic movement (laryngoscopy), complete neurologic examination, X-ray(aspiration, metastatic dis.)
19
Q

Management of laryngeal paralysis

A
  • obstruction –> marked negative pressure
  • –> mucosal and pulmonary edema
  • –> hyperthermia, inflammation
  • Supplemental oxygen:
  • enodtracheal tube, mask, tracheal catheter/tube
  • propofol 4-7 mg/kg IV
  • sedation:
  • anxiolytic tranquillizer; Acepromazine (0.02-0.05 mg/kg IV, IM, SC)
  • hyperthermia: cool IV fluid, wet towels
  • edema and inflammation: glucocorticoids, furosemide
  • examnation and treatment of the underlying disorder
  • srugical repair of the are to open airway
  • partial laryngectomy, arytenoid alteralisation, removal of the vocal folds)
  • aspiration pneumonitis is a common consequence
20
Q

Laryngeal collapse/brachycephalic airway syndrome

A
  • secondary to congenital airway malformations in brachycephalic dogs
    • stenotic nares, elongated soft palate, hypoplastic trachea, laryngeal saccular edema and eversion
  • chronic increased negative pressure during inspiration (as compensatory mechanism) –> laryngeal cartilages will weaken and collapse (stage I-III)
  • medially displaced cuneiform and corniculate processes
  • sedation, oxygen, cooling, glucocoticoids, furosemide
  • surgical treatment of congenital malformations before laryngeal surgery
21
Q

Laryngeal neoplasia

A
  • subacute or chronic. similar symptoms as laryngeal paralysis
  • rare:
    • cts: squamous cell carcinoma, lymphoma but polyps and obstructive laryngitis
    • dogs: malignant epithelial tumours and rhabdomyoma
  • dysphagia, stridor, respiratory distress, gagging, coughing
  • laryngoscopy and biopsy, metastasis=
  • surgery (partial laryngectomy, permanent tracheostomy)
  • Chondrolipoma: biopsy is possible but never do it! serious consequences.
22
Q

Trachea

  • stenotic disease
A
  • Collapse (acquired), Hypoplasia (congenital) –> increased airway resistance –> hypoventilation –> respiratory acidosis; chronic obstruction –> pulmonary hypertension, cor pulmonale
23
Q

Trachea

  • hisotry and physical examination
A
  • Couging:
    • noisy inspiratory sounds, wheezing expiratory sounds /goose honk” cough
  • Palpation of the neck:
    • emphysema, collapse, mass (thyroid gland, haematoma, abscess)
    • cough can be elicited (laryngeal, tracheal irritation)
  • Auscultation:
    • over larynx, trachea, lungs (sounds are usually most intesne near their site of origin)
24
Q

Trachea

  • diagnostic tests
A
  • Radiography: LL and VD/DV
    • collapse: dynamic disease. X-ray not good, endoscopy best choice.
    • Hypoplasia: X-ray good. No trachea/thoracic inlet > 0.2, 0.16, 0.12
    • mediastinal mass, PTX, pneumomediastinum
  • Tracheobronchoscopy: mucosa, culture, cytology, biopsy, foreign body removal
  • blood tests: rarely sefull, systemic or allergic disease
  • Coproscopy: lungworm infection
25
Q

Diseases of the trachea

A
  • tracheitis
  • tracheal collapse
  • tracheal hypoplasia
  • parasites
  • trauma, obstructive masses
  • foreign body
26
Q

Non-infectious tracheitis

A
  • causes:
  • prolonged barking, collapsing trachea, chornic cardiac disease, allergic lower airway disease
  • tests:
  • firm palpation of the thoracic inlet –> typical tracheal cough; tonsilitis, cardiac murmor +/-, lung sounds +/-,
  • treatment:
  • antitussives (codeine, butorphanol, dextromethorphan)
  • bronchodilating drigs: thophyline/aminophyline, terbutaline
  • prednisolone, nebulization (6 times daily)
  • underlying disease
27
Q

Infectious tracheobronchitis / canine infectious respiratory disease complex (CIRDC) / Kennel cough

A
  • causes:
  • CAcV-2, CPIV, CaHV-1, CRCoV, Bordetella bronchiseptica
  • others: reov., mycoplasma spp., distemper
  • History:
  • highly contagious!
  • pensions for dogs, hospital, kennel
  • clinical signs:
  • dry, hacking, paroxusmal cough in generally healthy dogs
  • treatment:
  • antitussives
  • antibiotics (BAL?, systemic illness; cephalosporins, amox-clav., doxycycline)
  • bronchodilators
28
Q

Collapsing trachea/tracheal collpase

  • predisposition, etiology,
A
  • middle-aged to aged toy and miniature breeds
  • chiahuahua, yorshire terrier, toy poodles, shih tzu, lhasa apso, pomeranian
  • Acquired > congenital
  • DV > LL
  • Cervical > intrathoracic
    • inhalation: thoracic dilation. No cervical opening (collapse)
    • Exhalation: thoracic part collapses. Normal cervical part.
    • –> X-rays can not diagnose. endoscopy is best
  • Etiology:
  • deficiency in the organic matrix (failure of chondrogenesis, degeneration) –> tracheal and bronchomalatia –> stretching of the dorsal membrane, collapsing trachea (stage I-IV)
  • associated problems: chronic couching (chronic airway or pulmonary parenchyma disease, chronic cardiac disease, obesity, mediastinal fat, mass.)
29
Q

Collapsing trachea/tracheal collpase

  • history and clinical signs
A
  • long history of coughing, from mild, intermittent to paroxysmal “goose-honk” cough, elicited by palpation, eting, drinking, excitement, cyanosis +/-, auscultation (inspiratory noises)
  • chronic, progressive, irreversible
  • diagnosis: Radiography (respiratory phase), Bronchoscopy (stage I-IV)
30
Q

Collapsing trachea/tracheal collpase

  • treatment
A
  • Respiratory emergency patient
  • sedation, oxygen therapy, glucocorticoids, furosemide, intubation?, cooling
  • NEVER performe tracheostomy
  • Medical managment:
  • Antitussives: butorphanol, hydrocodone
  • prednisolone (in trachea edema, tracheitis)
  • bronchodilators?
  • nebulization, weight reduction, underlying disease!
  • Surgical managment:
  • Intraluminal stents: failure to function well, migration.
  • Extraluminal prostheses: laryngeal paralysis!
  • Plication: not usefull
31
Q

Tracheal hypoplasia

  • predisposition, symptoms
A
  • congenital problem diagnosed in young dogs (2 days to 12 years)
  • Bulldogs, boston terrier
  • Dyspnea, productive coughing, fever if bronchopneumonia + brachycephalic airway syndrome
  • Auscultation, sensitive trachea, radiography (Øtrachea/thoracic inlet < 0,2 doliocephalic; <0.16 brachycephalic, 0.12 bulldogs), leukocytosis
32
Q

Tracheal hypoplasia

  • prognosis, treatment
A
  • Prognosis:
  • degree of hypoplasia, concurrent upper respiratory disease, congenital cardiac disorder
  • Hypoplasia alone is not a life threatening problem, no surgery can fix it. you can only do something with upper airway stenosis.
  • Treatment:
  • brachycephalic airway syndrome (nose, elongated soft palate, laryngeal collapse)
  • bronchopneumonia
  • prevention:
  • advisable to discourage the breeding og these animals
33
Q

Tracheal parasites

A
  • rare, but worldwide disease, kennel-related problem
  • Oslerus osleri (filaroides osleri) = lungworm
  • chronic dyspnea, coughing (dry), inspiratory wheezing sounds
  • worms at the carina (bronchoscopy, feces) 1-5mm nodules
  • fenbendazole 50mg/kg/day for 7-14 days
34
Q

Other diseases of the trachea

A
  • trauma (emphysema, PTX, pneumomediastinum)
  • obstructive tracheal masses:
  • intraluminal lesion: neoplasia, foreign body
  • extraluminal compression
  • segmental trachea stenosis: congenital/aquired
35
Q
A

SAM (6 decks)

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