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34 Cards in this Set
- Front
- Back
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with nasal disease
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Reverse Sneezing
~~~ Paroxysm Noisy Laboured Inspiration ~~~ Through Nose ~~~ Also Indicates Pharyngeal Dz Sneezing Nasal Discharge Stertor ~~~ also Indicates Pharyngeal Obstruction Pawing or Rubbing Face Facial Deformity |
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with pharyngeal disease
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Stertor
~~~ Coarse Snoring or Snorting on Inspiration ~~~ Pharyngeal Obstruction Reverse Sneezing ~~~ Paroxysm Noisy Laboured Inspiration ~~~ Through Nose ~~~ Also Indicates Nasal Dz Noisy Inspiratory Dyspnea ~~~ Also Indicates Laryngeal Dz |
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with laryngeal disease
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Stridor
~~~ High Pitched Sound on Inspiration ~~~ Also Indicates Extrathoracic Tracheal Dz Noisy Inspiratory Dyspnea ~~~ Also Indicates Pharyngeal Dz Respiratory Distress Exacerbated By ~~~ Exercise ~~~ Excitement ~~~ High Ambient Temp |
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with tracheal disease
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Cough
~~~ Especially Elicited upon Tracheal Palpation ~~~ Also Indicates Airway Dz Stridor ~~~ High Pitched Sound on Inspiration ~~~ Extrathoracic Dz ~~~ Also Indicates Laryngeal Dz End Expiratory SNAP ~~~ Intrathoracic Collapse |
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with lung disease
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Dyspnea
~~~ Laboured Shallow Rapid Inspiration and Expiration Cough ~~~ Parenchymal Dz with Exudates that Impinge Trachea ~~~ Also Indicates Primary Airway or Tracheal Dz Exercise Intolerance Cyanosis Crackles ~~~ Airway Dz Wheezes ~~~ Airway Dz Hemoptysis Systemic Illness |
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What are the 2 or 3 most prominent clinical findings you expect to find in a dog with pleural disease
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Rapid Shallow Breathing with Silent Inspiratory Effort
~~~ Often Prolonged Inspiration ~~~ ~~~ Mainly Abdominal Effort ~~~ Often Short Effortless Expiration Dramatic Reduction of Lung Sounds ~~~ Ventrally ~~~ ~~~ Pleural Effusion ~~~ ~~~ Diaphragmatic Hernia ~~~ Dorsally ~~~ ~~~ Pneumothorax Systemic Signs ~~~ Pyothorax ~~~ ~~~ Febrile ~~~ ~~~ Ill ~~~ Hemothorax ~~~ ~~~ Pale ~~~ ~~~ Weak |
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When you are presented with a dyspneic dog or cat that is actually having trouble breathing at rest, describe how you will attempt to localize the disease based upon clinical findings.
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Observation of Respiratory Pattern
~~~ Inspiration vs Expiration ~~~ Depth and Rate ~~~ Characteristics Ascultation ~~~ Heart Lungs Trachea |
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What are the most common signs associated with acute viral upper respiratory tract disease in cats?
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Fever
Sneezing Serous to Mucopurulent Discharge ~~~ Nasal ~~~ Ocular Conjunctivitis Hypersalivation Anorexia Dehydration |
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What viruses are involved with acute viral upper respiratory tract disease in cats – do they look different clinically?
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Feline Viral Rhinotracheitis (FVR - Herpes)
~~~ May Also Cause ~~~ ~~~ Corneal Ulceration ~~~ ~~~ Abortion ~~~ ~~~ Neonatal Death ~~~ ~~~ Damage to Nasal Turbinates and Mucosa ~~~ ~~~ ~~~ Predisposes Chronic Bacterial Rhinosinusitis Feline Calicivirus (FCV) ~~~ May Also Cause ~~~ ~~~ Oral Ulcers ~~~ ~~~ Mild Interstitial Pneumonia ~~~ ~~~ Transient Polyarthritis |
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How will you cats affected treat acute viral upper respiratory tract disease?
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Fluids
~~~ IV ~~~ SC Nutrition ~~~ Warm Smelly Foods ~~~ Force Feeding Discharge ~~~ Wipe Exudates from Nares Several x Day ~~~ Coat with Vaseline to Prevent Dermatits Nasal Congestion ~~~ Hot Showers with Your Kitty ~~~ Decongestants if Severe Antimicrobials for Secondary Infections ~~~ Mucopurulent Discharge ~~~ Pneumonia Corneal Ulcers ~~~ Topical Ophthalmic Ointments ~~~ Suspect Chalmydia or Mycoplasma ~~~ ~~~ Chloramphenicol ~~~ ~~~ Erythromycin ~~~ Otherwise ~~~ ~~~ Gentamicin ~~~ ~~~ Triple Antibiotics ie BNP ~~~ Stay Away From ~~~ ~~~ Tetracycline ~~~ ~~~ ~~~ Burns Kitties Lysine ~~~ Decrease Viral Replication |
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How can you try to minimize infection wit acute viral upper respiratory tract disease in a problem cattery?
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Record Keeping
Aggressive Vaccination ~~~ Intranasal New Arrivals ~~~ Kittens ~~~ ~~~ Start as Early as 8 - 10 Days with Intranasal if Outbreak ~~~ ~~~ Follow at 9 and 12 Weeks Separation of Queens and Kittens ~~~ Until 2 Weeks after End of Vaccination Protocol Cull or Isolation of Clinical or Carriers Quarantine New Arrivals Biosecurity Handle in Order of Susceptibility ~~~ Kittens > Healthy Adults > Quarantined > Clinical |
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What is “reverse sneezing”?
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Paroxysm of Noisy Laboured Inspiration
Through Nose Triggered by Nasopharyngeal Irritation Animal Assumes Rigid Posture with Extended Neck |
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How do you figure out that reverse sneezing is what an owner is describing?
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Posture
Inspiratory Dyspnea Through Nose |
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What is the significance of reverse sneezing?
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Nasopharyngeal Irritation
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What are the typical signs seen with nasal mite infection (Pneumonysus caninum)?
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Asymtomatic
~~~ Most Dogs Nasal Irritation ~~~ Sneeze ~~~ Snort ~~~ Reverse Sneeze Chronic Nasal Discharge ~~~ Rarely ~~~ via Severe Allergic and Irritant Response Epistaxis ~~~ Unlikely Nasal Erosions ~~~ Unlikely |
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How do you treat nasal mite infection (Pneumonysus caninum)?
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Ivermectin
~~~ 0.2 mg/kg SC Every 3 Weeks X 3 Tx ~~~ White Feet ~~~ ~~~ Genetic Test All In Contact Dogs ~~~ Kitties are Excempt |
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What are the most common differential diagnoses considered for chronic mucopurulent nasal discharge in the dog?
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Nasal Aspergillus
Bacterial Infection Foreign Body Neoplasia ~~~ Dogs Adenocarcinoma Squamous Cell Carcinoma ~~~ Cats Lymphosarcoma Adenocarcinoma Polyps Allergies Extension of Oral Dz |
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What tests (clinical examinations and lab tests) can you use to try to “figure out” a case of chronic nasal discharge in the dog?
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Physical Examination
~~~ Respiratory Pattern ~~~ ~~~ Nasal Airflow ~~~ Auscultation Trachia, Airway and Lung ~~~ Oral Exam Systemic ~~~ Thoracic Rads ~~~ Abdominal Rads and US ~~~ CBC ~~~ ~~~ Inflammation Aspergillus Titer Nasal / Maxillary / Dental Arcade Rads or CT Aspirates ~~~ Lymphnodes ~~~ Lumps Bumps Nasal Deformities Rhinoscopy Nasal Flush and Cytology Nasal Biopsy and Histology ~~~ Culture Fungal and Bacterial |
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What do you do if all your tests to determine the cause of a case of chronic nasal discharge in the dog are negative?
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Nasal CT
Surgical Exploration ~~~ Rhinotomy ~~~ Turbinectomy Suspect Allergic Rhinitis |
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Suppose you are presented with a case chronic mucopurulent bilateral nasal discharge in a cat. What tests will you do in the cat in addition to those that you might do in a dog?
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Nasal Swab
~~~ Cytologic Evaluation - Cryptococcus Cryptococcal Antigen Titer Viral Testing ~~~ FeLV ~~~ FIV ~~~ FRV (Herpes Virus) ~~~ FCV |
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In addition to the severe intranasal diseases like neoplasia and fungal disease, what extra-nasal disorders should be considered in a dog or cat presenting for epistaxis but no other nasal signs?
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Thrombocytopenia
Decreased Platelet Function ~~~ Myeloma Coagulopathy Hypertension |
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What are the common clinical features of nasal Aspergillosis in dogs?
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Nasal Discharge
~~~ +/- Mucopurulent ~~~ +/- Hemorrhagic ~~~ Uni or Bi Lateral Ulceration of External Nares Nasal Deformity ~~~ Rare Systemic Signs ~~~ Rare |
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How can the diagnosis of nasal Aspergillosis in dogs be made?
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Nasal Rads
~~~ Increased Soft Tissue Density if Granuloma ~~~ Lucent Areas of Turbinate Erosion Rhinoscopy ~~~ Nasal Turbinate Erosion ~~~ Fungal Plaques Cytologic Examination ~~~ Fungal Plaques ~~~ ~~~ Ideal ~~~ Biopsy ~~~ Flush Fungal Cultures ~~~ Difficult unless from Visualized Plaques Serology ~~~ Unreliable |
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What treatment is currently recommended for nasal Aspergillosis in dogs?
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1% Clotrimazole
~~~ Non Invasive Nasal Instillation During Dorsal Recumbancy ~~~ Watch the Fatal Cribiform Plate Leakage ~~~ Not to Mention Aspiration Pneumonia ~~~ 85 - 90% |
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What alternative treatments for nasal Aspergillosis in dogs are available?
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Oral Itraconazole for 60 - 90 Days
~~~ ~~~ 60 - 70% Topical Enilconazole via Sinus and Nasal Catheters ~~~ ~~~ 85 - 90% |
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What fungal organism more commonly affects the nose of cats?
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Cryptococcus Neoformans
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How is a diagnosis of Mycotic Rhinitis in Cats made?
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Pinch Biopsy of Granulomas
~~~ Impression Smears ~~~ ~~~ NEARLY ALWAYS DIAGNOSTIC ~~~ India Ink or New Methylene Blue Nasal Rads ~~~ Increased Soft Tissue Density if Granuloma ~~~ Loss of Turbinate Detail ~~~ ~~~ via Fluid and Mucus Accumulation ~~~ Occasionally ~~~ ~~~ Bone Lysis ~~~ ~~~ Nasal Bone Deformity Cytology ~~~ Nasal Exudate ~~~ Lymph Node Aspirates Fungal Isolation |
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What other organs are sometimes affected in Cats with Cryptococcus?
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Lungs
~~~ Some Affected Cats ~~~ Rarely Symptomatic CNS ~~~ Seizures ~~~ Paresis ~~~ Blindness Eyes ~~~ Uveitis ~~~ Blindness Skin Subcutaneous Tissues |
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What are some available treatments for Cats with Cryptococcus?
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Fluconazole
~~~ Oral ~~~ Best Response ~~~ ~~~ 90% ~~~ ~~~ Especially CNS ~~~ Expensive Itraconazole ~~~ Oral Treatment Duration ~~~ 1 - 2 Month Past Resolution ~~~ Until Negative Serum Titre Amphotericin B Added Tx if ~~~ Life Threatening ~~~ Non Responsive ~~~ Watch Those Little Kitty Kidneys |
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Chronic bacterial rhinosinusitis does NOT occur as a primary problem in the dog. What are some of the underlying causes we must consider if we have a dog that we believe has a chronic bacterial infection in the nose?
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Dental Dz
Oronasal Fistula Foreign Body Nasal Neoplasia Cats ~~~ More Commonly Viral (FVR) ~~~ ~~~ Nasal Turbinate and Mucosa Damage |
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Nasopharyngeal polyps in cats commonly cause signs of nasal obstruction. What other signs are common?
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Obstruction of Oropharynx
~~~ Primary Source of Clinical Signs Laboured Breathing Progressive Stertorous Respiration Coughing Retching Voice Change Halting and Open Mouth Breathing During Excercise ~~~ Some Cats Nasal Discharge ~~~ Few Cats Outer and Middle Ear Impingement ~~~ Secondary Source of Clinical Signs ~~~ Horner’s Syndrome ~~~ Otitis ~~~ Head Tilt |
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Why do we often do bulla radiographs for Cats with Nasopharyngeal Polyps?
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Identify Presence of Otitis Media
~~~ Additional Polyps within Middle Ear Common Bulla Involvement Indicates ~~~ Bulla Osteotomy ~~~ ~~~ Recommended in All Cases ~~~ ~~~ ~~~ Lower Rate of Recurrence |
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What is the best treatment for Cats with Nasopharyngeal Polyps?
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Surgical Removal
~~~ Oral Approach ~~~ Bulla Osteotomy if Bulla Involved ~~~ ~~~ ”Recommended” in All Cases ~~~ ~~~ ~~~ Lower Rate of Recurrence Prognosis ~~~ Excellent ~~~ ~~~ If you are Good ~~~ ~~~ ~~~ ie Remove All Abnormal Tissue |
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What is the typical signalment of cats with nasopharyngeal polyps?
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Kittens
Young Cats |
