Respiratory Diseases. Alveoli-Capillary Gas Exchange Alveoli surrounded by capillaries – Incoming...
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Transcript of Respiratory Diseases. Alveoli-Capillary Gas Exchange Alveoli surrounded by capillaries – Incoming...
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—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
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
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
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