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133 Cards in this Set
- Front
- Back
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When should you decide to investigate potential causes of nasal cavity disease?
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once signs have persisted for weeks as expensive to investigate - most diseases affecting the nasal sinuses include viral and trauma both of which tend to resolve
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list 2 causes of viral rhinitis in dogs and in cats
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dogs: distemper, acnine adenovirus and Pi3
cats. feline calicivirus and rhinotracheitis (herpes) |
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which 3 fungi can cause fungal rhinitis
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aspergillus
penicilliosis cryptococcus |
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list 3 non infectious causes of rhinitis
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allergic
irritant lymphocytic/plasmacytic |
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list the 3 most common neoplasms of the nasal cavity
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adenovirus
fibrosarcoma osteosarcoma |
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what are the acute vs the chronic clinical signs of rhinitis
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acute get sneezing and serous discharge
if chronic get mucopurulent or purulent discharge with or without epistaxis bear in mind dogs can get nasal discharge with lower airway disease |
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when assessing the nasal sinuses, what should you look for/do on your clinical exam?
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symmetry
palpation retropulse eyes examine nares with otoscope assess airflow look at teeth percuss sinuses palpate lymph nodes |
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what should be done prior to rhinoscopy
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test coagulation factors!
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what do you want to include when biopsing nasal cavity?
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bone - often invasion of bone/osteomyelitis ocurs - send to culture
(FNA lymph nodes for mets) |
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why is biopsy one of the main diagnostic procedures when assessing rhinitis vs swabs and cytology?
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swabs and nasal flush cytology provide less info and are rarely of diagnostic value as nasal cavity full of commensals
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how is fungal rhinitis treated? how does it usually present?
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usually purulent and bleeding (usually unilateral destruction) - histopath confirms
enilconazole flush: sometimes keto/itraconazole PO works |
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which breeds do rhinal neoplasms tend to affect? where can they spread to and how are they treated?
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large breed
spread behind eye --> brain radiotherapy palliative if lymphoma: chemo or radiotherapy and tends to respond well |
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how is non infectious inflammatory rhinitis treated
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with steroids
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which 2 respiratory diseases are common in terriers?
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chronic bronchitis
pulmonary interstitial disease |
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what are ronchi?
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low pitched sounds due to high airflow velocity through larger airways
- can be normal if exercise/excitement associated |
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what is the volume capacity of feline pleural space?
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200 ml
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list 11 diseases affecting the airways
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tracheal collapse
trachel neoplasis acute tracheobronchitis trachel stenosis acute bronchitis hypoplastic trachea chronic tracheobronchial syndrome bronchiectesis foreign body ciliary dyskenesia bronchial neoplasia |
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list 11 diseases that affect the lungs
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pneumonia
pulmonary haemorrhage PIE non cardiogenic oedema neoplasia idiopathic pulmonary fibrosis pulmonary cavitary lesion pulmonary thromboembolism emphysema chest wall injury torsion smoke inhalation injury |
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which respiratory conditions can result in coughing (12)?
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tracheal collapse
tracheobronchitis chronic tracheobronchial syndrome chronic bronchitis bronchiectasis bromchial neoplasia oslerus olseri FB bronchopneumonia chronic pulmonary interstitial disease pulmonary neoplasia intrapulmonary haemmorrhage |
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which respiratory conditions can result in tachypnoea and/or dyspnoea (20)?
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brachycephalic syndrome
laryngeal paralysis upper aiwray neoplasia FB tracheal collapse hypoplastic trachea tracheal stenosis extramural compression of trachea chronic bronchitis bronchial tumour pneumonia chronic pulmonary interstitial disease neoplasia intrapulmonary haemorrhage pulmonary thromboembolism pleural effusion neoplasia ruptured diaphragm polyneuropathies CNS disease |
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list 5 feline diseases of the upper airway
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stenotic nares
hrnoic rhinisinusitis cleft palate oronasal fistula nasopharyngeal polyp |
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what conditions affect the pharynx/larynx/trachea in cats (6)?
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trauma
FB paralysism spasm stenosis neoplasia |
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list 5 causes of feline upper respiratory tract infection
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herpes (rhinotracheitis)
calicivirus reovirus chlamydia secondary bacterial - mycoplasma |
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list 10 conditions resulting in lower respiratory tract infections in cats
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acute bronchitis
chronic bronchitis asthma FB bronchopneumonia interstitial pneumonia aspiration pneumonia smoke pneumonia pulmonary neoplasia pulmonary thromboembolism |
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list 4 conditions causing pleural and mediastinal disease in cats
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effusion
FIP mediastinal lymphoma (thymic) pneumothorax |
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what are some of the clinical signs of tracheal collapse?
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usually obese dog
chronic cough - seal bark: associated with excitement, exercise or lead pull will be dyspnea - inspiratory if extrathoracic trachea collapses, and expiratory if intrathoracic trachea collapses |
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what is seen radiographically in tracheal collapse cases?
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usually compressed at thoracic inlet or cranial mediastinum: best seen on end expiration. will be dorsoventral flattening and redundancy of dorsal membrane on tracheoscopy which is diagnostic
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what are some of the consequences of tracheal collapse if allowed to progress?
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secondary bronchial or pulmonary problems
- bronchodilators/steroids may help |
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what is acute tracheobronchitis caused by?
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= kennel cough
- B. bronchiseptica, Pi virus III, distemper, adenovirus II, canine herpes, secondary mycoplasma infection |
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what are the clinical signs of acute tracheobronchitis?
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harsh cough exacerbated by exercise
may be mildly pyrexic lethargic nasoocular discharge |
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how long may clinical signs of kennel cough persist?
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up to 3 weeks - in small proportion get residual coughing which may result in chronic tracheobronchial syndrome
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how is kennel cough treated?
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only if needed
- antitussive - avoid dust - restrict exercise - TMPS/tetracycline |
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what is chronic tracheobronchial syndrome?
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usually appears weeks after complete resolution of kennel cough and is due to residual B. bronchiseptica infection
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what are the clinical signs of chronic tracheobronchial syndrome?
what is seen radiographically and what is found on bronchoscopy? how is it treated? |
heightened cough reflex with harsh cough often associated with lead pull
increas bronchial marking radiographically - NAD usually detected on bronchoscopy treated with antitussive and harness |
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what may some cases of chronic tracheobronchial syndrome progress to?
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some may result in chronic bronchitis
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what is chronic bronchitis?
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a mucus hypersecretory disorder
- reaction to airway inflammation --> loss of cilitated epithelium resulting in decreased clearance and thereby accummulation of mucus which in turn compromises airway hygiene |
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what are the clinical signs of chronic bronchitis and which breed is over represented?
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coughing for at least 2 months
will be cachexic if terminal Jack Russell overrepresented |
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what may be a sequela of chronic bronchitis?
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recurrent bout of bacterial bronchitis and bronchopneumonia result in alveolar fibrosis and respiratory failure
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what may be seen radiographically on chronic bronchitis? what may you see on bronchoscopy?
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bronchial pattern with secondar interstitial or alveolar changes and R sided cardiomegaly may be present
bronchoscopy will reveal excess mucus in airways and roughened mucosal surface: definitive diagnosis |
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how is chronic bronchitis treated?
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bronchodilator
steroids antibacterials if bronchopneumonia bromhexine (mucolytic) |
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what is the prognosis of chronic bronchitis?
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long term prognosis poor as progressive disease
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what type of hypersensitivity is feline asthma?
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type I
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what are the clinical signs of feline asthma?
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coughin
dyspnoea wheezing cyanosis head extension with open mouth breathing |
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how is feline asthma diagnosed (3)?
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haematology: eosinophilia
rads: bronchial marking and interstitial disease with R middle lobe collapsed/consolidated - bronchi small bronchial cytology: eosinophilia and neutrophils |
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what is the main differential of feline asthma with regards to bronchial cytology results?
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aleurostrongylus abstrusus
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which lung lobe is usually collapsed in feline asthma?
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R middle lung lobe
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how is a severe attack of feline asthma treated?
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oxygen
IV steroids methylxanthine B2 agonist atropine |
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how is feline asthma managed?
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with low does pred every other day or nebulised steroids
avoid allergence |
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what may poor owner compliance (treating feline asthma) result in?
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irreperable lung changes
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list 3 airway and lung parasites?
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oslerus osleri
crenosoma vulpis aleurostrongylus abstrusus |
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how is oslerus osleri spread?
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from dam to offspring
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how are airway parasites diagnosed?
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circulating eosinophilia
osleri nodules at carina on radiography bronchoscopy may reveal nodules at carina with mucosal reaction or free worms in bronchi bronchial cytology will show worms, eggs, larvae, eosinophil FAECALS OFTEN GIVE FALSE NEGATIVES |
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where do most airway foreign bodies lodge and why?
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in R mainstem bronchus as straight continuation of trachea
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what may be noted by owner in chronic airway foreign body?
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pronounced halitosis - over weeks to motnhs: signs of acute bronchopneumonia/pleural effusino
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what may be seen radiographically in airway foreign body case?
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localised bronchial or interstitial reaction with alveolar pattern if localised bronchopneumonia
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what secondary bacterial agents result in pneunonia?
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pasteurella
blebsiella proteus E. coli actinomyces nocardia |
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what diseases may pneumonia be secondary to?
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chronic bronchitis, systemic illness, oesophageal disease, etc
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what are some of the clinical signs of pneumonia?
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coughing
nasal discharge tachy/dyspnoea exercise intolerance pyrexia lethargy anorexia cachexia cyanosis |
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what is seen on bronchoscopy in pneumonia?
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mucopurulent airways WITH OUT chronic airway mucosal changes
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what antimicrobials are empirically chosen to treat pneumonia?
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TMPS
flouroquinolones cephalosporins clindamycin and steam vapour - mycolytics |
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what is pulmonary infiltration with eosinophilia caused by?
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hypersensitivity to inhaled allergens/migrating parasites
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what are the clinical signs of PIE?
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coughing, tachy/dyspnoea
exercise intolerance (if severe) |
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what is seen on haematology of PIE case? what is seen radiographically? how is it treated?
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1.5-50 x10^9/l eosinophils
if circulating basophilia more significant interstitial pattern on radiography treated with pred anti-inflammatory dose |
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which breeds are associated with idiopathic pulmonary fibrosis?
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westies
carins terriers |
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what are the causes of idiopathic pulmonary fibrosis
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viral
secondary to underlying chornic respiratory disease (bronchitis, brachycephalic airway syndrome, bronchopneumonia, toxins, ageing, endocrinopathy |
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what are the clinical signs of idiopathic pulmonary fibrosis?
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gradual onset and progressive over months to years
- cough - tachypnoea - dyspnoea - exercise intolerance - cyanosis - CRACKLES on auscultation |
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what may be seen radiographically in idiopathic pulmonary fibrosis. may be seen on CT and bronchoscopy?
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Rads: increased interstitial density
CT. traction bronchiectasis due to fibrosis bronschoscopy: collapse of lobar bronchi during expiration: absence of mucosal changes |
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what are differentials when hearing crackles on auscultation?
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idiopathic pulmonary fibrosis
pulmonary oedema |
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how is idiopathic pulmonary fibrosis treated?
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pred
bronchodilator |
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what is the prognosis of idiopathic pulmonary fibrosis
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guarded as lung change permanent and disease progressive
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what may pulmonary adenocarcinomas do?
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cause vessel erosion and thereby bleeding into airway and lungs
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what may be seen on bronchoscopy in pulmonary neoplasia?
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blood tinged mucus and collapse of airways on expiration
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how is primary pulmonary neoplasia treated palliatively?
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with glucocorticoids
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what infectious agents should you check for when faced with pleural effusion?
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nocardia
actinomyces bacteroids |
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what do you check for on biochem in pleural effusion?
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hypoalbuminaemia
liver disease serum triglycerides |
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when may chylothorax be seen?
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trauma
neoplasia infection congenital congestive heart failure |
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what is protein level in exudate?
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over 30g/l
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how is pleural effusion managed?
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supplement ocygen - postpone x ray if cyanotic/severe and perform thoracocentesis
- place pleural catheter if recurrent under GA |
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how are true and modified transudate pleural effusions treated?
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by treateing underlying causes e.g. hypoproteinaemia, CHF
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how is pyothorax treated?
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chest drain and lavage with warm saline
- C&S: B lactams, clindamycin, TMPS |
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how is chylothorax treated?
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ligation of thoracic duct and low fat food
benzopyrones? |
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how is pneumothorax treated?
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thoracocentesis
- water seal drainage for 3-4 days sx correction if recurrent and cause identified |
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what are some of the possible clinical signs of mediastinal disease and why?
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- pain and HL paresis (extends to thoracic vertebra and spinal cord)
cough, dyspnoea, dysphagia and regurgitation (if interfering with trachea, oesophagus, bronchi), caval syndrome, ascites, HL oedema, chylothorax (if compressing major vessels), Horners and laryngeal dysfunction (if damage to vagosympathetic trunk, recurrent laryngeal nerves or sympathetic ganglia) |
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list 4 causes of pneumomediastinum
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tracheal/oesophageal rupture
iatrogenic puncture of tracheal bronchi idiopathic deep neck wounds |
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what may be seen clinically in pneumomediastinum?
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may look puffed if air goes to subcutaneous tissues of head
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how is pneumomediastinum treated?
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usually self limiting in 7 - 10 days: but if ruptures can get pneumothorax and if pressure really high it compromises venous return to heart
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list 12 causes of mediastinal widening
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obesity
big thymus (normal in oung) or thymoma lymphoma heart base tumour lipoma ectopic thyroid tumour abscess/granuloma mediastinitis oesophageal dilation/impaction/FB oedema (pleural effusion often associated) haemorrhage |
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what are the defense mechanisms of the URT?
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mucociliary apparatus
goblet cells ciliated cells sensory: cause sneezing and laryngospasm mucus - viscoelastic properties change during respiratory disorders |
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what control do goblet cells and ciliated cells come under?q
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B adrenergic stimulation
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what are the defense mechanisms of the LRT?
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smooth muscles in bronchioles
goblet cells of bronchi (loads in cats) bronchiols sensor: cough and spasm alveoli macrophages, eosinophils and neutrophils at insult |
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what regulates bronchial smooth muscle tone?
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increase in cAMP relaxes it
increase in cGMP constricts it |
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what results in increase in cAMP and thereby bronchial relaxation?
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B2 stimulation
H2 stimulation and decrease in PDE |
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what causes a decrease in cAMP and thereby bronchoconstriction?
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a-adrenergic stimulation
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what causes an increase in cGMP and thereby bronchoconstriction?
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M3 and H1 stimulation
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when is bronchospasm seen?
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in asthma, respiratory infection and chronic lung disease
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which are the most effective drugs against bronchospasm?
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B2 agonists - some also modulate mediatore relase from mast cells and TNFa from monocytes and stimulate mucus secretion
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which B2 agonist used for bronchospasm? name the short acting and long acting ones
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short acting:
salbutamol, terbutaline, clembuterol (used for acute feline asthma: last 4-6 hours) long acting: salmeterol - lasts 12 hours: adults in via inhalation |
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what are unwanted side effects of B2 agonists?
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down regulation of B2 receptors and more viscous mucus
- interferes with cilia movement |
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how do methylxanthines work?
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decrease cAMP breakkdown by inhibiting PDE
also increase strength of respiratory muscles --> less effort to breath |
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when should you take care in using methylxanthines?
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in liver disease as require demethylation in liver
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name 2 methylxanthines used in small animals
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aminophlline
etamphylline |
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what are the high risk side effects with methylxanthine use?
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tachycardia
agitation arrhythmias hypotension seizure death |
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what condition are methylxanthines used in?
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bronchitis
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mention the 3 classes of drugs used to treat bronchospasm
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B2 agonist
methylxanthines anticholingergis (atroping and ipratropium) |
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why is adrenal unsuitable for treating bronchospasm?
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as acts on alpha receptors as well (which results in bronchoconstriction)
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what are the side effects of atroping and ipratropium?
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drying of airways: rarely increase wheezing
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what 3 drugs are used to treat inflammatory comproment of respiratory infection?
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pred/dex
cromogliate NSAIDS: only given when pyrexia results in problems |
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what are pred and dex used to treat?
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asthma
chronic bronchitis chronic pulmonary disease |
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how do glucocorticoids enhance bronchodilation?
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by B2 upregulation
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what is cromoglicate and how does it act?
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drug usedt to prefent inflammatory symptoms: often as aerolisation (poor absorption from gut and insoluble in water)
inhibits calcium influx into mast cells and may also decrease C fibre axonal reflexes safest drug to treat human asthma |
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which 4 drugs may be used to treat allergic inflammation of lungs?
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steroids
B2 agonist - lack long lasting effects anti-histamines sodium cromoglicate |
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how long does it take for corticosteroid use to result in adrenal suppression
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over 6 days of treatment
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list 6 mucolytics
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ipecacuanha
inorganic iodides bromhexine dembrexine guaifenesin acetylcysteine |
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how do ipecacuanha and inorganic iodides work?
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make mucus easier to transport and are considered expectorant mucolytics
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how do bromhexine and dembrexin work?
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decrease viscosity of mucus and increase lysosomal breakdown of metalloproteases
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how does acetylcysteine work?
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SH group donor: decreases viscosity by breaking or blocking formation of disulphide bridges = true mucolytic
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name 4 anti-tussives used in veterinary medicine
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codeine
butorphanol hydrocodone dextromethorphan |
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what is hydrocodone used for
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non productive cough - antitussive
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what is dextromethorphan? what is it used for?
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non narcotic and similar to codeine but no analgesic/addictive properties. no respiratory depression but can cause sedation: used as anti-tussive
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what 2 drugs are used to treat pulmonary hypertension?
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sildenafil
pimobendan |
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what is the mechanism of sildenafil?
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SDE5 inhibitor
- SDE5 maintains pulmonary artery tension |
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what is the most common nasosinal tumour in the dog? what do you need to bear in mind when nasosinal tumour may be involved?
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ALMOST ALWAYS MALIGNANT
adenocarcinoma most common lymphoma MCT olfactory neuroblastoma |
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where do nasosinal tumours met to? what are the PNS?
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met to lung and lymph nodes
erythrocytosis and hypercalcaemia are PNS - but this is rare |
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what are the differentials of nasosinal tumours?
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fungal rhinitis
bacterial rhinitis immune mediated lymphoplasmacytic rhinitis coagulpathy hyperthyroidism foreign body trauma rathke's cleft cyst |
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what do you have to bear in mind with nasosinal tumours?
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can improve temporarily with antimicrobials, NSAIDS and steroids
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what non invasive biopsy techniques can be used for nasosinal tumours?
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nasal flush
blind transnostril biopsy endoscopy guided fiberoptic bopsy FNA facial deformity |
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how far should you put rhinoscope?
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no further than medial canthus as risk of perforating cribiform plate
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how are nasosinal tumours treated?
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with radiotherapy and NSAIDS
SURGERY RESULTS IN RAPID REGROWTH |
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what are the most common nasosinal tumours in cats?
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lymphoma!
carcinoma adenocarcinoma always test for FeLV and FIV - can use adjuvant chemo if lymphoma |
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how to pulmonary tumours usually present ind ogs?
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usually present for weeks or motnhs or acute if secondary to tumour related pneumothorax, haemothorax or pleural effusion
- can present with lameness if hypertrophic osteopathy or as warm swelling of distal limbs |
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what chemotherapeutics can be used for treating pumonary tumours that are non resectable?
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cisplatin
carboplatin CHOP if lymphoma CCNU if sarcoma |
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what can be seen in cats with pulmonary tumours?
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lung digit syndrome: pulmonary epithelial tumour mets to multiple digits
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what is predictive of outome in feline pulmonary tumours?
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histiological grade
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