Cough

Question 1

What is a cough?

Answer 1

Voluntary or involuntary act that clears the throat and breathing passage of foreign particles, microbes, irritants, fluids, and mucus; it is a rapid expulsion of air from the lungs.

Question 2

Where are the receptors for cough?

Answer 2

Oropharynx, trachea, and airways

Question 3

What type of cough is produced from the large airways?

Answer 3

stronger cough

Question 4

What type of cough is produced from the small airways?

Answer 4

soft or quiet cough

Question 5

What are 4 considerations for the coughing dog or cat?

Answer 5

1. This can be an acute or chronic problem, progressive, seasonal
2. Nature of the cough can be helpful (dry and/or honking, productive, gagging)
3. Age of animal is often helpful for discriminating the different types of cough
4. Breed may be helpful for certain diseases

Question 6

Where do upper respiratory coughs come from?

Answer 6

larynx, trachea

Question 7

Where do lower respiratory coughs come from?

Answer 7

lung

Question 8

Where do extrapulmonary coughs come from?

Answer 8

external compression on airways

Question 9

What causes infectious coughs?

Answer 9

viral, bacteria, fungal organisms

Question 10

What causes non-infectious cough?

Answer 10

allergies

Question 11

What is an example of an inflammatory cough?

Answer 11

aspiration pneumonia

Question 12

What is an example of a non-inflammatory cough?

Answer 12

pulmonary edema

Question 13

What is an example of a congenital cough?

Answer 13

mucociliary dyskinesis

Question 14

What is an example of a cough associated with toxins/environment?

Answer 14

One caused by smoke

Question 15

What is an example of a cough associated with neoplasm?

Answer 15

One caused by metastatic disease

Question 16

What are 2 initial diagnostic approaches that should be taken for a coughing dog?

Answer 16

1. Good history

2. Good PE including examining upper airway and auscultation of chest

Question 17

What are some additional diagnostics that can be done to further evaluate a cough?

Answer 17

CBC, fecal, heartworm test, chest rads, trans tracheal wash and cytology, laryngoscopy, thoracocentesis, CT or MRI

Question 18

Why should a chemistry and urinalysis be ordered for a coughing dog?

Answer 18

To have as a general data base

Question 19

What are the 9 initial differentials we should have for coughing dogs?

Answer 19

1. Collapsing trachea
2. Airway foreign body
3. Infectious causes
4. Aspiration pneumonia
5. Chronic bronchitis
6. Heart disease
7. Heartworm disease
8. Neoplasia
9. Laryngeal paralysis

Question 20

What are 2 examples of upper airway disease?

Answer 20

1. Tracheal collapse

2. Foreign body

Question 21

What are 2 examples of extrapulmonary disease?

Answer 21

1. CHF

2. Impingement on trachea or bronchi - lymphadenopathy

Question 22

What are 5 examples of lower airway disease?

Answer 22

1. Infectious causes (distemper, kennel cough influenza)
2. Parasitic (HWD or Filaroides)
3. Primary or metastatic neoplasm
4. Chronic bronchitis
5. Pulmonary edema

Question 23

What are potential causes of pulmonary edema?

Answer 23

CHF, increased capillary permeability, decreased oncotic pressure (hypoalbuminemia)

Question 24

How does left heart disease lead to cough?

Answer 24

Pulmonary edema, left atrial enlargement (compression on main stem bronchus)

Question 25

What are possible causes of left sided heart failure?

Answer 25

1. Mitral valve insufficiency 2. Myocardial hypertrophy (eccentric/concentric) 3. Aortic stenosis 4. Systemic hypertension 5. Congenital shunts (PDA) 6. Neoplastic diseases (hemangiosarcoma)

Question 26

What are differentials for mitral valve insufficiency in a dog?

Answer 26

1. Endocardiosis | 2. Endocarditis

Question 27

What are some additional questions you may ask of an owner with a coughing dog?

Answer 27

``` Are vaccines current? What does the cough sound like? How often does it happen? Is you other dog ok? Is your dog still eating? Any V/D? Has your dog been in contact with other dogs? ```

Question 28

What is a left shift neutrophilia?

Answer 28

Increased banded neutrophils

Question 29

What is vomiting?

Answer 29

Active/forceful expulsion of ingesta from the stomach.

Question 30

What is regurgitation?

Answer 30

Backflow (passive) movement of ingesta out of the esophagus or oropharynx

Question 31

What are 3 differentials for esophageal dilation in dogs?

Answer 31

1. Dilation due to obstruction 2. Congenital megaesophagus 3. Acquired megaesophagus

Question 32

What happens when there is esophageal dilation due to obstruction (external and internal)?

Answer 32

External compression - vascular ring anomalies | Internal obstruction - esophageal strictures, foreign body

Question 33

What breeds most commonly have congenital megaesophagus?

Answer 33

Irish Setters, German Shepherds

Question 34

What causes idiopathic (neuromuscular) megaesophagus?

Answer 34

Congenital myasthenia gravis (lack of ACh receptor)

Question 35

In aspiration pneumonia, the degree of _____ is related to the nature of the _____.

Answer 35

lung damage, aspirated material

Question 36

Foreign material is often not _____.

Answer 36

sterile