Feline LRT Disease Flashcards

(45 cards)

1
Q

What would you be most suspicious of in an older cat with LRT signs?

A

Increases suspicion for other disease such as:

  • hyperthyroidism
  • neoplasia
  • cardiac disease
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2
Q

What would you be most suspicious of in a younger cat with LRT signs?

A

Increases suspicion for:

  • infectious disease
    • viral
    • parasitic
    • Mycoplasma
    • bacterial
    • toxoplasma
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3
Q

How common is bacterial pneumonia in cats compared to dogs?

A
  • Bacterial pneumonia is relatively uncommon in cats compared with dogs
  • More likely to be inflammatory disease rather than bacterial cause if they have pulmonary pathology
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4
Q

What is the usual clinical history of a cat with LRT disease? What are the 3 ways it tends to present?

A
  1. Usually a low grade chronic disease
  • Coughing
  • Audible wheezing
  • “exercise intolerance”
  1. Sometimes a very acute presentation
  • Brought in as an emergency
  • Respiratory distress
  • Mouth breathing
  • Tachypnoea
  1. Episodic respiratory distress
  • Sometimes self-limiting
  • Sometimes will come and go
  • Respiratory effort?
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5
Q

What are the main questions that should be asked with a cat with LRT disease?

A
  • Are there any trigger factors?
    • Change in environment?
    • New cat litter?
    • Passive smoking?
    • Seasonal?
  • Is the cough productive?
  • Any significant weight loss, anorexia, signs of other systemic disease?
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6
Q

What behavioural changes might make you suspect a more chronic disease in cats?

A
  • quieter?
  • staying in bed all day?
  • less playful?
  • grooming less?
  • staying at floor level/reluctant to jump up on furniture?
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7
Q

What should be your first priority with a cat presented to you with respiratory signs?

A

Oxygenation and minimal handling

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8
Q

What clinical signs would make you suspect laryngeal disease, such as laryngeal lymphoma?

A
  • Laboured inspiration
    • stridor
    • ↑ effort
    • slow inspiratory phase
  • +/- change in
    • purr
    • vocalisation
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9
Q

What specific clinical signs would make you most suspicious of upper airway disease in cats?

A
  • Dysphagia +/- salivation
  • Coughing /gagging
    • might be triggered by eating/drinking
  • “Head shaking” behaviour
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10
Q

What clinical signs would make you more suspicious of lower airway disease in cats?

A
  • Often more subtle
  • Laboured expiration
    • Prolonged expiratory phase
    • Additional expiratory push
    • Audible expiratory wheeze
  • ↑ airway resistance due to
    • Bronchospasm
    • Mucous
    • Bronchial wall thickening
  • +/- occasional → paroxysmal cough
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11
Q

In a cat with lower respiratory tract disease, what type of condition will be at the top of your differentials list generally?

A

Inflammatory

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12
Q

What are the main two lower airway diseases we tend to see in cats?

A
  • Feline asthma
  • Chronic bronchitis
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13
Q

How is feline asthma caused?

A
  • Reversible
  • Inhaled allergen
  • Airway hyper reactivity
  • Bronchoconstriction
  • Sometimes get eosinophilic airway inflammation
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14
Q

What are the main clinical signs of feline asthma?

A

Episodic respiratory distress and dyspnoea

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15
Q

How is chronic bronchitis caused?

A
  • Response to infection or inhaled irritants
  • Airway damage
  • Excess mucus
  • Neutrophilic airway inflammation?
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16
Q

How is chronic bronchitis similar/different from feline asthma?

A
  • Similar inflammatory problem but doesn’t have the same degree of reactivity
  • More chronic
  • Coughing is a key clinical sign of chronic bronchitis (compared to episodic respiratory distress and dyspnoea in asthma)
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17
Q

What are the main differentials for a coughing cat?

A
  • Upper respiratory tract disease
  • Inflammatory lower airway disease
  • Infectious – bacterial, viral, parasitic
  • Foreign body
  • Neoplasia
  • Heart disease rarely causes coughing in cats
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18
Q

What are the main differentials for hyperpnoea/tachypnoea in a cat?

A
  • Stress/pain/fear response
  • CNS disease
  • Anaemia/hypovolaemia
  • Heatstroke
  • Think about non cardiorespiratory causes: could your patient have been in an RTA?
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19
Q

How useful are haematology and biochemistry when investigating a cat with LRT disease?

A
  • Haematology might be helpful as would indicate systemic inflammation, anaemia of chronic disease, eosinophilia etc. but often normal
  • Biochemistry is often normal
  • Therefore in a budget case haematology and biochemistry probably are not necessary, especially compared to diagnostic imaging
20
Q

What is the problem with attempting bronchoscopy in a cat with LRT disease?

A
  • Useful but we already have narrowed airways so doing this without causing further damage is not ideal in an animal of this size
  • Therefore not usually a first line approach in a coughing cat
21
Q

What are the main diagnostics you would consider using in a cat with LRT disease?

A
  • Diagnostic Imaging, esp. radiography or CT if available
  • Haematology and biochemistry?
  • Bronchoscopy?
  • Endotracheal wash
  • Faecal analysis for parasites
22
Q

Is it safe to go straight ahead with the investigations for a cat brought in as a respiratory emergency?

A
  • The crisis point in cats with episodic symptoms, it is not the ideal time to investigate
  • A dyspnoeic cat is often best left alone for a while and stabilised
23
Q

Why is general anaesthetic often safer for cats with suspected airway disease than sedation?

A
  • Better for these cats generally than sedation as you can control the airways and oxygenation
  • Also often shorter acting
  • And sedation may reduce the inspiratory effort and therefore oxygenation of the animal
24
Q

What would you expect to find on thoracic radiographs of a cat with LRT disease?

A
  • Might be normal
  • Bronchial pattern
  • +/- interstitial pattern
  • Hyperinflation
  • Air trapping
  • Collapse of R middle lung lobe? (sometimes)
  • Patchy alveolar pattern?
  • Aerophagia → air in stomach
25
What would you expect to find on bronchoscopy in a cat with LRT disease?
* hyperaemia * oedema * excess mucus * ↓ airway diameter
26
What samples can be collected by carrying out a BAL/blind tracheal wash?
* Cytology * bacterial culture * Mycoplasma PCR
27
The cytology result of a BAL/blind tracheal wash comes back showing eosinophilic inflammation. What are the differentials for this?
* viral pneumonia * parasitic * HES (hypereosinophilic syndrome)
28
29
What is Terbutaline and what is its effect?
* Selective β2 receptor agonist * **Smooth muscle relaxant** * **Bronchodilation** * For use in critical cases in cats * Can give IV, IM or SC
30
Why should you ideally rule out heart disease before using Terbutaline in an acute respiratory crisis?
* Will cause tachycardia and therefore worsening oxygen demands for a failing heart * Not one to use if you are still unsure that heart failure is a problem or not, but if certain of airway disease then very useful
31
What is inhaled salbutamol and how is it used?
* Selective β2 receptor agonist * Smooth muscle relaxant * Bronchodilation * Can give every 30 mins for 2-4 hrs * Stop if stresses the patient
32
How would you manage LRT disease once you get past the crisis stage?
* Reduce allergens? * Prednisolone PO 2-3 weeks * Consider inhaled fluticasone if improved
33
If a LRT case is not responding to prednisolone therapy, what would you do next?
* Review case - It is probably not an inflammatory disease if not resolving * Repeat test for mycoplasma/or treat? * Was a Mycoplasma PCR carried out from an endotracheal wash previously? * If this wasn’t carried out initially then consider carrying it out here * Have we ruled out lungworm? * Consider ciclosporin
34
What is the main risk with prednisolone therapy in cats?
Steroids are diabetogenic in cats. If side effects include polydipsia and polyuria treatment must stop!
35
What is the name of the feline lungworm?
*Aeleurostrongylus abstrusus*
36
How common is *Aeleurostrongylus abstrusus*?
* Feline lungworm * The most common respiratory parasite in cats, but not overly common in cats generally due to worming regime * More so in young animals than older * Worming a cat that is coughing is never a bad thing
37
What is the clinical presentation of feline lungworm?
* Most infected cats are asymptomatic * Clinical presentation * Usually young cats * Mild coughing but might progress to → dyspnoea * Radiography: similar to inflammatory airway disease
38
How is feline lungworm diagnosed?
* Consider faecal flotation * Airway wash analysis * Often will just do a treatment trial instead
39
How is feline lungworm (*Aeleurostrongylus abstrusus*) treated?
Fenbendazole
40
Mycoplasma pneumonia (*M.felis*) might be a contributing factor in feline inflammatory airway disease, what are the clinical signs?
* fever, cough, tachypnoea, lethargy * If you have a pyrexic cat with coughing, this should be higher on your list of differentials
41
How would you diagnose and treat Mycoplasma pneumonia?
* Diagnosis: PCR on tracheal wash * Treatment: doxycycline
42
What consideration should you have when using doxycycline as a treatment in cats?
Can cause oesophageal stricture in cats so minimise risk of damage to the oesophagus
43
What organisms are associated with mycobacterial pneumonia in cats?
* *M. bovis, M. microti* * Rare in cats but remember it as a possibility
44
What are the clinical signs of Mycobacterial Pneumonia?
* Pneumonia represents late stage systemic spread of infection * Early cutaneous signs: * After bite from an infected vole or rodent * Non-healing sores or nodules +/- large LNs * Early GI signs: * After ingestion eg contaminated milk * Vomiting, diarrhoea, weight loss, poor appetite * Lesion = inflammatory granulomas
45
How is Mycobacterial Pneumonia diagnosed and what major consideration is there with it?
* Diagnosis: histopath and PCR * Seek advice because we need to consider **zoonotic aspects**