Respiratory Diseases

Alveoli-Capillary Gas Exchange• Alveoli surrounded by capillaries– Incoming RBCs low in O2

– Exiting RBCs rich in O2

– Thin capillary membrane

Respiratory Diseases

Upper respiratory

Upper respiratory

Lower Respiratory Tract includes trachea, bronchi, lungs, ____________________

Upper Respiratory Diseases

• Rhinitis

• Sinusitis

• Tonsilitis

• Laryngitis

Upper Respiratory Diseases

Rhinitis—inflammation/infection of _________ passagesUsually occurs with other resp diseases

– Signs• Nasal discharge; crusty nares

• Pawing at nose

• Coughing/ gagging

• Staphylococcus spp

– Rx• Clean nares

• Antibiotics if necessary

• ____________ drugs: Phenylephrine

drops

Upper Respiratory Diseases

• Sinusitis– Most common cause: ________of 4th premolar (Carnassial tooth)

• Largest tooth; roots extend into frontal/maxillary sinus

– Signs• Swelling under eye on infected side

• _____________ nasal discharge

– Rx• Remove infected tooth

• Antibiotics

• Flush fistula with iodine solution

Upper Respiratory Diseases

• Tonsillitis (Tonsils provide lymphoid protection to lower resp tract)

– Signs• Anorexia• Increased salivation• _______________ on opening mouth• It is more common in small dog breeds

– Dx• Visualized inflamed, swollen tonsils• Tonsils may be coated with __________

– Sx• Antibiotics• Surgical removal of chronic cases

Tonsillitis

Upper Respiratory Diseases

• LaryngitisMost common cause is excessive barking

**________________ can also change vocal quality

• Signs– Loss of voice or alteration of voice

– Increased mucus production in back of throat

• Rx– Restrict barking

– Anti-inflammatory medication (______________ : tapering dose)

• Client info– Most Upper Respiratory Infections are self-limiting

Lower Respiratory Diseases• Infectious Canine Tracheobronchitis (Kennel Cough)

– Causes (a collection of several causative agents including viruses, bacteria, mycoplasmas, fungi, parasites• Canine parainfluenza virus• Canine adenovirus• Canine herpesvirus• Reovirus• _____________________________• mycoplasma

– Signs• Hx of exposure to animals at a kennel, hospital, groomer, show• Dry ______________ cough in an otherwise healthy animal

– Rx—antibiotics, antitussives (hydrocodeine)– Client info

• Self-limiting (2-3 wks); Rx is to make animal/owner more comfortable• Vaccinate 2-3 wk before chance of exposure

COLLAPSING TRACHEA

Lower Respiratory Diseases• Collapsing trachea

Failure of proper ___________ of tracheal rings

– Signs• Cough, esp during excitement or exercise

– Dx• Goose-like ____________ on tracheal palpation

• r/o other causes of coughing

– Rx• Acepromazine to calm excitement

• Antitussives (Hycodan, Butorphanol)

• Glucocorticoids

• Bronchial dilators

• Prosthetics have been surgically implanted, but complications have occurred

– Client info• Wt reduction

• Use shoulder harness rather than neck collar

Lower Respiratory Diseases

• Feline Bordetella InfectionBordetella bronchiseptica grow in ciliated respiratory mucosa; release toxins

– Signs (look like respiratory viral infections)• Fever• Sneezing, nasal discharge, coughing, rales• _____________________ lymphadenopathy

– Rx (usually self-limiting)• Antibiotics (oral tetracycline or doxycycline)

– Prevention• Eliminate stress• Good hygiene, good nutrition• Vaccination

– Client info• Looks like resp infections caused by feline herpes and calicivirus• Usually self-limiting• Vaccination effective

Lower Respiratory Diseases

• Feline asthma (bronchoconstriction, inflamed/hyperreactive airways)

– Signs• Coughing, wheezing• Labored breathing

– Dx• Clinical signs• X-rays show “________________” typical of airway inflammation

– Rx• Long-term corticosteroids (prednisone, DepoMedrol)• Bronchodilators (terbutaline [Brethine], cyproheptadine)

– Client info• Prognosis is variable

– If allergens can be determined and exposure limited, most cats do well– A cure is not usually possible

Feline Asthma• Same cat

– Top—normal

– Bottom—asthmaAirways more prominent because of

inflammation and mucus buildup

Doughnuts (end-on view) and tramways (lateral view) of airways

Feline Viral Resp Infections

• 2 viruses responsible for most feline resp diseases– Feline __________________(FVR; Feline Herpesvirus)

– Feline _________________(FCV) Caliciviridae family• Highly contagious

• High mobidity

• Low mortality

• Most severe in kittens

Feline Viral Rhinotracheitis• Signs

– Acute onset of sneezing– Conjunctivitis, severe rhinitis– Fever, depression, anorexia– Ulcerated______________, excess salivation– Corneal ulcers

• Rx– Supportive Rx

• IV fluids, broad spectrum antibiotics, decongestants• Nursing care: clean nose, eyes; force feed food; decrease stress• Antiviral therapy

• Prevention– Vaccination

• Client info– FVR highly_________________; can transmit via clothing, hands, etc; only cats– Warming food may improve palatability– Vaccinated cats may show mild symptoms– Disinfectants kill herpesvirus type I virus

Feline Calicivirus• Signs

– Fever– Serous ocular/nasal discharge; mild conjunctivitis– _______________, salivation– Pneumonia– Diarrhea

• Rx– Supportive care– Antibiotics– Force feed disinfect using____________

• Prevention– Vaccination

• Client info– Highly________________– Signs last 5-7 d– Force-feeding may be necessary (if cats can’t smell, they won’t eat)

Pleural Effusion

Fluid in thorax• Types of fluid Causes

– Transudate R-sided CHF, FIPplasma-like fluid; straw colored

– Blood trauma, neoplasia– Chyle neoplasia, pancreatitis, traumalymphatic fluid from intestine; high fat content infection, parasites --Empyema Infection, foreign body, traumapus in thorax

All types of fluid cause same signs– dyspnea– may show cough, fever, pleural pain

Dx—x-ray

Pleural Effusion

• Thoracentesis– Clip hair, scrub skin, block with local anesthetic

• Most dependent space (______________ intercostal space)

– Aspirate using 3 way valve– Remove as much fluid as possible

• Do not create________________

– Analyze aspirate

• Rx—depends on pathology causing effusion• Client info– Owner may need to continue pleural drainage– Unless 1° is treated, effusion will return– Rx can be long and expensive

Fungi

Fungal DiseasesUsually result from inhalation of fungal spores or wound contamination

Fungi release enzymes/toxins that damage host’s cells

Endemic along east coast, Great Lakes, river valleys of the Miss, Ohio, St Lawrence

• Commonly seen fungal diseases of animals– Blastomycosis

– Coccidioidomycosis

– Histoplasmosis

– Aspergillosis

Blastomycosis (Blastomyces dermatitides)• Signs (non specific)

– Anorexia, depression, wt loss– Fever, cough, dyspnea– Enlarged LN

• Dx– X-rays—diffuse, ___________interstitial lung pattern (x-ray)– Serology testing is available– Most cases are diagnosed in the______________.

• Rx– Amphotericin B

• Client info– Blastomycosis usually not zoonotic disease, however, use caution with

animals with draining wounds– Owners share same environment and are likely to be exposed– Relapses are common– Rx is expensive

Coccidioidomycosis (Coccidioides immitis)• Signs

– Mild, non-productive cough– Low-grade fever, anorexia, wt loss– Weakness, depression– ____________ , pain is bone involvement– LN enlargement

• Dx– Parenchymal changes

on x-ray– Serology

• Rx– ______________– Itraconazole

• Client info– Usually not zoonotic disease, however, use caution with animals with draining

wounds (during necropsy)– Response to Rx is good, but recurrence is common– Rx is expensive

radius-ulna

Histoplasmosis (Histoplasma capsulatum)• Organism which grows in ___________, _________or organically

enriched soil. • Signs

– Feline (pulmonary signs)• Wt loss, anorexia• Fever, pale mm, swollen LN

– Canine (GI signs)• Wt loss, diarrhea, low-grade fever• Dyspnea, cough, pale mm

• Dz– CBC: anemia– X-ray: diffuse pulmonary interstitial pattern

• Rx– Ketoconazole– Itraconazole

• Client info– Px fair to good for pulmonary form; ____________ for systemic form

Cryptococcosis (Cryptococcus neoformans)A yeast-like fungus found in soil contaminated with pigeon and other bird droppings.Inhalation major route of infection. ________________ animal more susceptiblethan normal animal• Signs

– Feline (_______________ systemic fungal disease)• Lesions in nasal and sinus cavities; chronic nasal discharge• enlarged LN, wt loss, anorexia, low-grade fever

– Canine• Usually CNS lesions (__________________)

• Dx– Cytology of aspirates, impression smears– Antigen test available

• Rx– ______________________– Ketoconozole– Itraconazole

• Px– Fair to good unless ________involvement– No known health hazard to humans

Aspergillosis (Aspergillus fumigatus)Inhalation major route of infection; nasal cavity is main location of lesions. Sewage, compost

• Signs– Feline (uncommon)

• May be immunocompromised (FeLV)• Lethargy, fever, wt loss, anorexia

– Canine (localized)• Young to middle age• Chronic nasal discharge, sneezing, loud breathing

(like snoring)

– Canine (generalized infection)• Primarily seen in G Shep• Wt loss, anorexia• fever, lameness, paresis/paralysis

• Dx– X-ray—loss of _________________– endoscopy:--yellow-green to black fungal plaques on nasal mucosa

• Rx—topical ______________

• Client info– Localized dis—poor Px; Generalized dis—grave Px; not zoonotic

Pulmonary NeoplasmsTumors in lungs are usually metastatic, although primary lung tumors do

occur. Dogs 9-12 yrs.

• Signs– Primary neoplasia

• Cough, exercise intolerance

• Wt loss, poor condition

• _______________, vomiting, anorexia

– Metastatic neoplasia• Evidence of primary tumor at other location

• Same signs as above for Primary neoplasia

Pulmonary Neoplasms

• Dx– Chest X-rays—mass occupying lesions; can be mistaken

for_________, parasitic dis, fungal infect, bact infect

– Biopsy—provides

________________

Pulmonary Neoplasms

• Rx—surgical removal is TOC– _________________for solitary tumor

• Chemotherapy (may reduce tumor size, may not increases survival time

• Client Info– Px is guarded to grave– By the time these tumors are diagnosed, they are usually

in_____________________– Chemotherapy may reduce clinical symptoms

Same dog as x-ray