Respiratory

Question 1

What is the most important question to ask when presented with an animal with a nose bleed?

Answer 1

Was the nose bleed preceeded by any other nasal signs? (discharge, sneezing, etc)

Question 2

Explain ‘stertor’ vs ‘stridor’:

Answer 2

Stertor: a low pitched, snorting nasal type noise (like a bulldog)

Stridor: high pitched - more to do with the larynx / trachea

Question 3

Which fungus is likely to infect the nasal passage of cats more and which is likely to affect dogs?

Answer 3

Cats: Nasal cryptococcosis

Dogs: Nasal aspergillosis

Question 4

What are the clinical signs of nasal cryptococcosis?

Answer 4

Rhinitis with haemorrhagic discharge.

Facial distortion is common.

Turbinate lysis.

Concurrent CNS, occular and/or dermatological signs.

Question 5

Why should you always include retropulsion of the eyes in your clinical exam for nasal disease?

Answer 5

Nasal disease (esp. infections) can involve the orbit of the eye

Question 6

What would you use to treat nasal cryptococcosis if CNS signs were present?

Answer 6

Flucytosine (+ Amphotericin B)

Question 7

What would you use to treat a mild - moderate case of nasal cryptococcosis?

Answer 7

Fluconazole

Question 8

If you diagnose nasal cryptococcosis in a cat, what else should you check for?

Answer 8

FIV / FeLV - immunosuppression may be why the cat is infected in the first place

Question 9

What is the primary signalment of animals with nasal aspergillosis?

Answer 9

Young - middle aged doliocephalic dogs. Male > female.

Question 10

What are the typical clinical signs of nasal aspergillosis?

Answer 10

Mucopurulent nasal discharge (often with blood).

Ulceration and depigmentation of the nares.

PAIN on palpation of the maxilla and/or nares.

Question 11

What would you see on radiography of a nasal aspergillosis case?

Answer 11

Destructive rhinitis

Question 12

How would you treat nasal aspergillosis?

Answer 12

Debride visible plaques endoscopically THEN Topical 1% clotrimazole under general anaesthetic.

Oral itraconazole 60-90 days (less successful)

Question 13

What is the most common nasal neoplasia in dogs?

Answer 13

Adenocarcinoma.

Question 14

What 2 systemic diseases may cause epistaxis?

Answer 14

Coagulopathy or systemic hypertension

Question 15

Is all reverse sneezing pathological?

Answer 15

No, the owners fussing over a dog which has reverse sneezed may cause it to become behavioural

Question 16

What clinical signs will you see in an animal with laryngeal paralysis?

Answer 16

Weak/absent bark/meow.

High pitched / altered bark.

Stridor.

Coughing.

Question 17

What is likely to exacerbate the clinical signs associated with laryngeal paralysis?

Answer 17

Hot weather, exercise, excitement or pain.

Question 18

How should you examine the larynx of a suspect animal?

Answer 18

Larygoscopy under sedation.

NEVER anaesthetise unless someone is able to do a tick back surgery - difficult to recover these animals.

Question 19

What is the most common complication of laryngeal tie-back surgery?

Answer 19

Aspiration pneumonia.

Question 20

What is the most effective non-surgical treatment for brachycephalic airway syndrome?

Answer 20

Weight control!

Question 21

What is the most simple and effective treatment for nasopharyngeal polyps?

Answer 21

Traction (pull them out) and put the cat on prednisolone to make recurrence less likely (+/- antibiotics).

Question 22

What is one of the first things you should always treat a coughing animal with, even before you have a diagnosis?

Answer 22

Anti-parasitic drugs! Cheap, easy and can eliminate parasites as a differential.

Question 23

What is a ‘honking’ cough typically associated with?

Answer 23

Tracheal / bronchi collapse

Question 24

What are the major indications for a trans-tracheal wash?

Answer 24

Moist cough. Bronchial pattern on chest films.

Question 25

What is important to remember when doing a trans-tracheal wash on a cat?

Answer 25

They are especially prone to bronchospasms - warm up the fluid first

Question 26

What are the different methods for trans-tracheal wash?

Answer 26

Vie endotracheal tube (in small dogs and cats). Percutaneous - between the tracheal rings.

Question 27

What is a contraindication for broncheolar lavage?

Answer 27

Non-responsive hypoxia, hypercapnia, haemostatic disorders, highly responsive airways (asthmatic)

Question 28

What are indications for a bronchoscopy / broncheolar lavage?

Answer 28

To examine the airways, to remove foreign bodies, diagnose chronic cough, obtain cytological/histological/microbiological samples

Question 29

What are the advantages of broncheolar lavage?

Answer 29

Allows area selection, provides quantitative information on small airways (cell counts, bacterial cultures)

Question 30

What are the disadvantages of broncheolar lavage?

Answer 30

Expensive, invasive and limitations to cytology

Question 31

What causes collapsing trachea?

Answer 31

Weakening of the cartilaginous rings or elongation of the dorsal tracheal ligament (or both)

Question 32

What is the typical signalment for canine chronic bronchitis?

Answer 32

Middle-age or older small breed dogs

Question 33

How can you treat canine chronic bronchitis?

Answer 33

Bronchodilators (theophylline), glucocorticcoids, +/- cough suppressants). Try to eliminate environmental irritants/allergens. Weight control. Keep airways hydrated (+nebulisation, -diuretics).

Question 34

What are the most common causes of acute dyspnoea in cats?

Answer 34

Cardiomyopathy, pleural effusions and asthma.

Question 35

What is a viral cause of pnuemonia in cats?

Answer 35

Feline calicivirus (very occasionally)

Question 36

What are viral causes of pneumonia in dogs?

Answer 36

Canine distemper, canine influenza virus, canine adenovirus-2

Question 37

What is the main cause of non-cardiogenic pulmonary oedema in the clinic?

Answer 37

Fluid overload

Question 38

Space occupying lesions in the chest (air, fluid, a mass) usually result in what type of breathing pattern?

Answer 38

Rapid, shallow breathing without excessive noise

Question 39

What are your differential diagnoses for fluid on the chest?

Answer 39

Transudate (low protein conc. and low cell counts) Modified transudate Exudate (non-purulent) Pus Blood Chyle Bile

Question 40

Outline an immediate plan in a case of pleural effusion:

Answer 40

Oxygen supplementation, cage rest and monitoring to stabilise. (+/-) immediate thoracocentesis. Quick and careful radiography Further thoracocentesis Re-radiograph after thoracocentesis

Question 41

What are some causes of trannsudate pleural effusion?

Answer 41

Hypoalbuminaemia Right sided / bi-ventricular heart failure

Question 42

What are some causes of modified transudate pleural effusion?

Answer 42

Long-standing transudate Neoplasia Diaphragmatic hernia

Question 43

What are some causes of exudative pleural effusion?

Answer 43

Infection Neoplasia Autoimmune disorders Pancreatitis

Question 44

What are some causes of chylous pleural effusion?

Answer 44

Neoplasia Diaphragmatic hernia Cardiomyopathy Idiopathic

Question 45

What are some causes of pyothorax?

Answer 45

Local spread of infection Penetrating trauma (Inhaled grass seed foreign bodies) Systemic spread

Question 46

How should you treat pyothorax?

Answer 46

Flush and drain! Antibiotics

Question 47

Are traumatic or spontaneous pneumothorax cases more likely to continue leaking after drainage?

Answer 47

Spontaneous pneumothorax is more likely to keep leaking

Question 48

What is this device and whta is it used for?

Answer 48

This is a metered dose inhaler. It is used to deliver inhaled drugs (like albuterol) to animals.

Question 49

This dog has mucopurulent nasal discharge with ulceration of the nares. What is a possible diagnosis?

Answer 49

Nasal aspergillosis

Question 50

What is this instrument?

Answer 50

A rigid rhinoscope

Question 51

What procedure is being performed on this dog?

Answer 51

A trans-tracheal wash