DM3 Pt2-4 Feline Lower Airway Disease

Question 1

Where are cough receptors located in cats?

Answer 1

Cough receptors are located in the larynx, trachea, and bronchial tree of cats.

Question 2

What is the most common cause of coughing in cats?

Answer 2

Chronic lower airway disease is the most common cause of coughing in cats.

Question 3

Is coughing in cats typically associated with heart disease?

Answer 3

No, cats with heart disease rarely cough.

Question 4

Which respiratory diseases are less likely in cats if coughing is present?

Answer 4

Pleural space diseases, upper respiratory tract diseases, and parenchymal disorders are less likely if a cat is coughing, as coughing suggests airway disease.

Question 5

List some common causes of lower respiratory tract disease in cats.

Answer 5

Chronic lower airway disease, pneumonia/bronchopneumonia, neoplasia, foreign bodies, pulmonary contusions, pulmonary oedema (rarely causes coughing), pulmonary fibrosis.

Question 6

What are the bacterial and viral causes of pneumonia/bronchopneumonia in cats?

Answer 6

Bacterial: Various species. Viral: Feline herpesvirus-1 (FHV-1), Feline calicivirus (FCV).

Question 7

Which parasitic infections can cause pneumonia/bronchopneumonia in cats?

Answer 7

Toxoplasmosis and Aelurostrongylus abstrusus (lungworm) are parasitic causes of pneumonia/bronchopneumonia in cats.

Question 8

Does pulmonary oedema typically cause coughing in cats?

Answer 8

No, pulmonary oedema does not usually cause coughing in cats.

Question 9

What clinical signs are helpful in differentiating the causes of coughing in cats?

Answer 9

The clinical history, duration of signs, presence of tachypnoea/dyspnoea, respiratory pattern, and other clinical signs can help narrow down the differential diagnosis.

Question 10

What is a rare cause of pneumonia/bronchopneumonia in the UK?

Answer 10

Fungal pneumonia is rare in the UK.

Question 11

What is feline chronic lower airway disease?

Answer 11

It is a group of conditions affecting the lower airways, including feline asthma, chronic bronchitis, and chronic bronchopulmonary disease, characterized by airway obstruction, inflammation, and possible irreversible damage.

Question 12

What is feline asthma characterized by?

Answer 12

Feline asthma is characterized by hyper-responsiveness of the airways and reversible bronchoconstriction.

Question 13

What is chronic bronchitis in cats characterized by?

Answer 13

Chronic bronchitis is characterized by airway inflammation and excessive mucus production, leading to irreversible narrowing of the airways.

Question 14

What breeds are predisposed to feline chronic lower airway disease?

Answer 14

Siamese, Burmese, and Oriental breeds are predisposed to feline chronic lower airway disease.

Question 15

What are the common clinical signs of feline chronic lower airway disease?

Answer 15

Cough, wheeze, and mild tachypnoea are common signs. In severe cases, dyspnoea, mouth breathing, and cyanosis may be present.

Question 16

What complications can occur due to chronic lower airway disease?

Answer 16

Complications such as pneumothorax (due to ruptured alveoli) can occur.

Question 17

What findings may be observed on physical examination of a cat with chronic lower airway disease?

Answer 17

Prolonged expiratory phase, crackles or wheezes, a barrel-chested appearance, and decreased compressibility of the thoracic cavity may be observed.

Question 18

What radiographic changes are typically seen in feline chronic lower airway disease?

Answer 18

A prominent bronchial pattern (“doughnuts” and “tramlines”), over-inflated lungs, flattening of the diaphragm, and atelectasis of the right middle lung lobe may be seen.

Question 19

What is bronchoalveolar lavage (BAL) used for in diagnosing feline chronic lower airway disease?

Answer 19

BAL is used to collect samples for cytology and culture to assess the presence of inflammation and infection in the airways.

Question 20

What might BAL cytology show in a cat with chronic lower airway disease?

Answer 20

Cytology may show increased numbers of macrophages (60-90%) and eosinophils (2-30%, though healthy cats can have up to 85%).

Question 21

What is the recommended treatment if bronchoconstriction occurs during bronchoalveolar lavage (BAL)?

Answer 21

If bronchoconstriction occurs during BAL, emergency administration of a bronchodilator such as IV terbutaline is recommended.

Question 22

What are the goals of treating feline lower airway disease?

Answer 22

The treatment aims to control clinical signs, manage bronchoconstriction, and reduce inflammation rather than cure the condition.

Question 23

What are some rapid-acting drugs used to treat acute decompensation in cats with lower airway disease?

Answer 23

1. Terbutaline (0.01 mg/kg SQ, IM, or IV every 4 hours)
2. Salbutamol (100 mcg MDI, 2 doses initially, then every 30 mins for 2-4 hours)
3. Dexamethasone (0.2-2.2 mg/kg SQ, IM, or IV)

Question 24

What is the primary aim of long-term treatment in feline lower airway disease?

Answer 24

The primary aim is to reduce airway inflammation and control clinical signs, often using environmental control and medications such as corticosteroids and bronchodilators.

Question 25

What environmental factors should be reduced to help manage feline lower airway disease?

Answer 25

Allergen/irritant exposure should be minimized, including smoke, dust, aerosols, cat litter, and temperature changes. Additionally, obesity should be managed, and bronchoconstricting drugs like beta-blockers and aspirin should be avoided.

Question 26

What corticosteroids are commonly used for chronic management of feline lower airway disease?

Answer 26

Oral prednisolone (1-2 mg/kg PO BID for 7-10 days, then tapered) and inhaled corticosteroids like fluticasone (Flixotide) (125-250 mcg MDI, 1-2 puffs BID) are commonly used to control airway inflammation.

Question 27

Why are inhaled corticosteroids preferred for long-term treatment of feline lower airway disease?

Answer 27

Inhaled corticosteroids avoid the systemic side effects of oral steroids while delivering a high dose of the drug directly to the lungs, reducing inflammation effectively.

Question 28

What is the role of fluticasone in treating feline asthma?

Answer 28

Fluticasone (Flixotide) is the inhaled corticosteroid of choice, given at 125-250 mcg MDI, 1-2 puffs twice daily. It is as effective as 1 mg/kg BID of oral prednisolone and does not get absorbed via the gastrointestinal tract, reducing systemic side effects.

Question 29

How should the inhaler and spacer device be used in cats?

Answer 29

The medication is administered through a spacer chamber attached to a facemask. The mask is placed snugly over the cat’s nose and mouth for 10-15 breaths. The MDI is pressed to release the drug into the spacer, and the cat inhales the medication.

Question 30

What is the first step in introducing an inhaler to a cat?

Answer 30

Introduce the spacer chamber without any drug in it, allowing the cat to become accustomed to the mask over time. Once the cat is used to the chamber, medication can be administered.

Question 31

What medications should be avoided in cats with lower airway disease?

Answer 31

Bronchoconstricting drugs such as beta-blockers, non-specific beta-blockers, and aspirin should be avoided as they can exacerbate respiratory problems.

Question 32

What is important when introducing a facemask and spacer device to a cat?

Answer 32

Introduce the facemask gradually, allowing the cat to become accustomed to it. Offer treats or playtime after applying the mask for short periods and slowly increase the duration.

Question 33

What should owners do if their cat is alarmed by the inhaler's noise?

Answer 33

Owners can press the inhaler in the same room as the cat without using the facemask initially. This helps the cat get used to the noise. Reward the cat with treats or play to reduce anxiety.

Question 34

What is the main aim of corticosteroids in treating chronic lower airway disease?

Answer 34

Corticosteroids, like oral prednisolone or inhaled fluticasone, aim to reduce airway inflammation and control chronic symptoms in lower airway disease.

Question 35

Why are inhaled corticosteroids preferred over oral corticosteroids?

Answer 35

Inhaled corticosteroids, such as fluticasone, reduce systemic side effects while delivering high doses of medication directly to the lungs where they are needed.

Question 36

How should bronchodilators be used in cats with chronic lower airway disease?

Answer 36

Bronchodilators, such as salbutamol, should be used during acute exacerbations or as daily treatment in combination with corticosteroids for cats with persistent symptoms.

Question 37

Why should bronchodilators not be used long-term without corticosteroids?

Answer 37

Long-term use of bronchodilators without corticosteroids can mask ongoing inflammation in the airways, which may worsen until severe damage occurs.

Question 38

What additional treatments may be used if infection is suspected in cats with chronic lower airway disease?

Answer 38

If infection is suspected, antibiotics like doxycycline are often used, especially to treat potential mycoplasma infections.

Question 39

What is the function of mucolytics like bromohexine in treating feline lower airway disease?

Answer 39

Mucolytics, such as bromohexine (Bisolvon), may help cats with excessive mucus production, breaking down mucus to ease airway obstruction.

Question 40

What is the prognosis for cats with asthma or chronic lower airway disease?

Answer 40

The prognosis varies. Many cats respond well to treatment, but acute severe attacks can be fatal. Delayed treatment may lead to irreversible airway damage.

Question 41

What are the signs of bronchodilator toxicity?

Answer 41

Signs of bronchodilator toxicity, especially from drugs like salmeterol, include muscle twitching, tachycardia, and GI upset.