Lecture 29 11/19/24

Question 1

Which viruses can cause viral pneumonia in dogs?

Answer 1

-distemper virus
-canine parainfluenza virus
-canine adenovirus 2
-influenza virus

Question 2

Which viruses can cause viral pneumonia in cats?

Answer 2

-calicivirus
-herpesvirus
-FIP
-influenza virus

Question 3

What are the characteristics of toxoplasmosis in cats?

Answer 3

-causes protozoal pneumonia in immunocompromised animals
-lungs are major site of replication
-pneumonia indicates generalized toxoplasmosis

Question 4

Which protozoa causes protozoal pneumonia in young and immunocompromised dogs?

Answer 4

neospora

Question 5

Which parasites can cause parasitic pneumonia?

Answer 5

-lungworms; Aelurostrongylus, Filaroides
-lung flukes; Paragonimus
-larval migration; roundworms, hookworms
-heartworms
-Angiostrongylus vasorum

Question 6

What are the characteristics of heartworms in cats?

Answer 6

-causes heartworm associated resp. disease (HARD)
-due to infection with immature L4s that do not mature into adults
-inflammatory airway and lung parenchymal reaction
-lung changes remain despite death of L4s
-often misdiagnosed as asthma

Question 7

What are the clinical signs of eosinophilic bronchopneumopathy?

Answer 7

-coughing
-gagging
-retching
-increased lung sounds
-dyspnea possible

Question 8

What is the signalment for eosinophilic bronchopneumopathy?

Answer 8

-young adults
-medium to large breeds
-nordic breeds
-females > males

Question 9

How is eosinophilic bronchopneumopathy diagnosed?

Answer 9

-radiographs/CT
-CBC: peripheral eosinophilia
-bronchoscopy
-BAL: >50% eosinophils
-ruling out parasites

Question 10

What are the characteristics of eosinophilic bronchopneumopathy presentation?

Answer 10

-variety of radiographic signs based on phenotype
–diffuse mixed broncho-interstitial pattern, granulomas, alveolar pattern
-may have hilar lymphadenopathy
-possible bronchiectasis

Question 11

How is eosinophilic bronchopneumopathy treated?

Answer 11

-allergen avoidance
-treat allergic disease
-systemic corticosteroids +/- inhaled corticosteroids

Question 12

What is the prognosis of eosinophilic bronchopneumopathy?

Answer 12

-good for control
-can cure if cause is identified and removed
-relapse can occur if therapy is discontinued
-more guarded prognosis if eosinophilic pulmonary granulomatosis occurs

Question 13

What are the characteristics of idiopathic pulmonary fibrosis in west highland white terriers?

Answer 13

-chronic, progressive, interstitial lung disease
-presents in middle to old age
-animals have prolonged history of resp. signs
-distinct pulmonary crackles on auscultation

Question 14

What is important to note about the etiology and treatment of idiopathic pulmonary fibrosis in west highland white terriers?

Answer 14

both the etiology and the best treatment are currently unknown

Question 15

Which dog breeds are most likely to develop pulmonary neoplasia?

Answer 15

-boxer
-doberman pinscher
-australian shepherd
-irish setter
-bernese mountain dog

Question 16

What are the clinical findings in animals with pulmonary neoplasia?

Answer 16

-cough
-exercise intolerance
-distress
-potentially asymptomatic
-clinical signs vary in paraneoplastic syndromes

Question 17

How is pulmonary neoplasia diagnosed?

Answer 17

-radiographs
-CT
-TTW/BAL
-fine needle aspirate
-biopsy

Question 18

What are the treatments for pulmonary neoplasia?

Answer 18

-surgery
-chemotherapy (unlikely to be effective)
-stereotactic radiation therapy
-inhaled IL-15 possible

Question 19

What are the characteristics of feline lung neoplasia?

Answer 19

-primary lung neoplasia less common in cats than dogs
-average age at diagnosis is 11-12 years
-history includes vague clinical signs and resp. signs
-carcinoma commonly metastasizes to the digits
-lymphoma can have variable radiographic presentation

Question 20

How is feline pulmonary neoplasia diagnosed?

Answer 20

cytology on pleural effusion

Question 21

What are the treatments for feline pulmonary neoplasia?

Answer 21

-palliative care
-chemotherapy
-NSAIDs or steroids

Question 22

What is the prognosis of feline pulmonary neoplasia?

Answer 22

-often diagnosed in an advanced stage
-prognosis generally poor in advanced stages
-primary neoplasia without metastasis has better prognosis with surgical removal
-variable survival times

Question 23

What is pulmonary thromboembolism?

Answer 23

obstruction of vessel via a clot from another area in the body

Question 24

What is the consequence of a thromboembolism entering pulmonary circulation?

Answer 24

it obstructs blood flow and causes V/Q mismatch

Question 25

What is Virchow's triad for thrombosis?

Answer 25

-changes in vessel endothelium -impairment of blood flow -development of pro-thrombotic tendencies in the blood

Question 26

How do arterial thrombi differ from venous thrombi?

Answer 26

-arterial thrombi consist of platelets and fibrin -venous thrombi form under low shear conditions and consist of fibrin and entrapped erythrocytes -thrombus that forms depends on underlying cause -arterial vs venous impacts treatment choice

Question 27

Which specific diseases are risk factors for pulmonary thromboembolism?

Answer 27

-cardiomyopathy -heartworms -glomerulonephritis/protein-losing nephropathy -hyperadrenocorticism -IMHA -neoplasia -nephrotic syndrome -pancreatitis -systemic lupus erythematous -vasculitis

Question 28

Which general conditions are risk factors for pulmonary thromboembolism?

Answer 28

-DIC -immobility -orthopedic surgery -sepsis -severe inflammation/inflammatory response syndrome -severe systemic illness -trauma -vascular access

Question 29

What are the functions of the pulmonary vasculature?

Answer 29

-filtration -protect other vital structures

Question 30

What is the prognosis of pulmonary thromboembolism?

Answer 30

-small ones are often subclinical -large ones can cause sudden death -degree of occlusion determines outcome -response to thrombus produces additional pathology

Question 31

What are the clinical signs of pulmonary thromboembolism?

Answer 31

-acute onset dyspnea -restlessness -cough -normal auscultation -cyanosis

Question 32

Which clinical signs can occur when pulmonary thromboembolism causes hypoxia?

Answer 32

-tachypnea -hemoptysis -sudden collapse -altered mentation

Question 33

What are the determinants of severity for pulmonary thromboembolism?

Answer 33

-extent/size of embolism -reflex humoral factors -patient's prior condition

Question 34

What are the differentials for pulmonary thromboembolism?

Answer 34

-asthma -pulmonary hemorrhage -pleural space disease -CHF -ARDS -airway obstruction -pneumonia

Question 35

What is the difficulty in diagnosing pulmonary thromboembolism in dogs?

Answer 35

there is no evidence-based, confirmed diagnostic approach

Question 36

Which diagnostics are used for pulmonary thromboembolism?

Answer 36

-blood gases -thoracic rads -CT with angiography -nuclear medicine scan -echo -thromboelastography -D-dimers

Question 37

What are the characteristics of radiology as a diagnostic tool for pulmonary thromboembolism?

Answer 37

-used to rule out other pulmonary disease -non-specific -may appear normal initially -pulmonary vessels affected -pulmonary infiltrates and pleural effusion possible -focal/lobar hyperlucency, focal effusions, and/or focal alveolar patterns possible

Question 38

What are the characteristics of A-a gradient as a diagnostic tool for pulmonary thromboembolism?

Answer 38

-Alveolar and arterial gradient measurement -valid for patients on room air only -take PAO2 minus PaO2 -normal is 10 to 15 mmHg; increased gradient may indicate PTE

Question 39

What are the characteristics of P:F ratio as a diagnostic tool for pulmonary thromboembolism?

Answer 39

-P:F ratio is PaO2/FiO2 -normal is approximately 500 -decreased ratio may indicate PTE

Question 40

What are the characteristics of D-dimers as a diagnostic tool for pulmonary thromboembolism?

Answer 40

-used to determine if thrombus has formed and is being broken down -concentrations less than 250 ng/mL have a high sensitivity for the absence of PTE -sensitive but non-specific

Question 41

What are the therapies used for pulmonary thromboembolism?

Answer 41

-O2 -fluid therapy -prevention of further PTE growth: heparin/warfarin/direct factor Xa anticoagulant -possible thrombolytic therapy

Question 42

What are the characteristics of feline pulmonary thromboembolism?

Answer 42

-rarely diagnosed -most commonly associated with neoplasia, anemia, and pancreatitis -demonstrate with dyspnea and resp. distress