CAL: airway inflammation Flashcards
What do these images show?
Cytological Findings Mostly macrophages, occasional neutrophil Giant cell No intracellular bacteria Curshmann’s spiral Diagnosis Non septic lower airway inflammation (RAO)
Treatment - RAO
- Oral clenbutarol - Beclamethasone via MDI - (Oral prednisolone = could be used but inhaled steroids more appropriate)
Define MDI
metered-dose inhaler
Pros and cons of oral clenbutarol
PROS: - Bronchodilator - Increases mucociliary clearance - Stabilises mast cells - Improves airway secretions CONS: - Variable absorption from GIT - Clinical efficacy variable at lower doses - Receptor down-regulation with prolonged use - Dose dependent side effects : tachycardia, sweating
Pros of oral prednisolone
Potent anti-inflammatory; decrease smooth muscle contraction and epithelial damage by inhibiting effects of inflammatory cells and the mediators they produce reduce mucus production.
Cons of oral prednisolonePros of oral prednisolone
Some improvement seen clinically after a few days, but takes a week for maximal clinical response. Side effects: immunosuppression, laminitis Variable absorption from GIT
Pros - beclamethasone via MDI
Use lower dose compared to systemic therapy, therefore lower risk of side effects, but still get high local concentration.
Cons - beclamethasone via MDI
May not provide therapeutic benefit for 24 to 72 hours Horse may not be co-operative to method of administration
What does sodium chromoglycate do?
Stabilises mast cells and reduces need for corticosteroid therapy
Cons - sodium chromoglycate
Only preventative, no role in therapy Need nebuliser to administer which is expensive, time consuming and horse may not cooperate Tend to cause horse to cough
What does this show?
Cytology: Increased amount of mucus Increased numbers of degenerate neutrophils Intracellular bacteria (gram positive chains of cocci) Interpretation: Septic airway inflammation
How should a septic airway inflammation (Step. zooepidemicus) be treated?
ABs that it is sensitive to (e.g. IM penicillin)
T/F: Ceftiofur is only licensed for IM administration in the horse
True
What does this show?
Cytology: Squamous epithelial cells with extracellular Simonsiella (only found in oropharynx) Interpretation: Oropharyngeal contamination –> repeat the sample!
What does this show?
Cytology: Predominantly macrophages, giant cells Interpretation: Resolving inflammation
What does this show?
- Cell types in tracheal wash: macrophages, eosinophils - Organism present in second picture Dictyocaulus arnfieldi larvae - Interpretation: Lungworm infection – parasitic pneumonia
