systolic PAP
> 30mmhg
example of Pulmonary Hypertension due to pulmonary vascular disease
parasitic - heartworm
congenital shunts PDA
DMVD and DCM cause Pulmonary hypertension by what classification
due to left sided heart disease
examples of PH due chronic pulmonary disease and/or hypoxia
pulmonary fibrosis
chronic bronchitis
upper airway obstruction
T/F
in small animals pulmonary hypertension is a primary condition
FALSE – occurs secondary to another condition
non invasive gold standard test to DX pulmonary hypertension in small animals
echocardiogram
Direct treatment of pulmonary arterial hypertension is achieved with ___
pulmonary vasodilator drugs
most common small animal pulmonary vasodilator drug
Sildenafil
thrombus formation needs these things from virchows triangle
- Hypercoaguability
- Endothelial injury
- Blood stasis
definitive diagnosis of PTE requires
CT or angiography
T/F
with PTE thoracic radiographs may appear completely normal
TRUE
antithrombotic drug of choice
Clopidogrel
Defined as an abnormal accumulation of fluid in the pleural space
pleural effusion
what volume of fluid normally exists in the pleural space
1-5ml very small vol
breathing pattern of patient with pleural effusion
restricted - shallow and rapid
T/F
intrathoracic pressure is normally postive
false - negative
most common type of efusion
modified transudate
type of effusion that has very low cells and protein
trasudate
what diseases are transudate effusion seen in
low ALB – protein losing enteropathy
CHF, chyle and neoplasia will see this type of pleural effusion
modified transudate
what type of effusion is in pyothorax
exudate
A malignant neoplasm that originates from cells that line serosal surfaces
mesothelioma
what is tension pneumothorax
volume of air is so significant that it depresses cardiac output – fatal if not treated promptly
most common cause of pneumomediastinum in cats
General anesthesia with endotracheal intubation & positive pressure ventilation
primary function of the parenchyma
gas exhcange
Bacterial infection within the pulmonary parenchyma
bacterial pneumonia
pneumonia that develops in a patient that has not been
recently hospitalized
community acquired
s pneumonia that occurs ≥48 hours after hospital admission & was not incubating at the time of admission
hospital acquired
the result of inhalation of gastric/oropharyngeal contents that are contaminated by pathogenic bacteria
aspiration
classic pattern seen on thoracic radiographs of pneumonia
alveolar & predominantly ventral
PaO2 < 80 mmHg
hypoxemia
T/F
CAP patients are at risk for MDR infections
FALSE – HAP are
mycotic pneumonia radiographic pattern
nodular or miliary, interstitial & perihilar
lymphadenopathy may be present
most common cause of protozoal pneumonia
Toxoplasma gondii
interstitial lung disease (ILD) that is characterized by fibrosis
idiopathic pulmonary fibrosis
these breeds are predisposed to idiopathic pulmonary fibrosis
West Highland white terrier, Stafforshire bull terrier
physical exam often reveals crackles in all lung fields
idiopathic pulmonary fibrosis
radiographic pattern in dogs with idiopathic pulmonary fibrosis
Diffuse bronchointerstitial pattern is most common in dogs.
T/F
NCPE is typically protein rich while cardiogenic PE is low protein
TRUE
a pulmonary inflammatory disorder characterized by non-cardiogenic pulmonary edema, neutrophilic inflammation, and hypoxemia
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)
two potential risk factors for chronic bronchitis
obesity, periodontal disease
what defines bronchitis as being chronic
a cough longer then 1 month
non-productive, harsh,
Expiratory abdominal “push”
seen in chronic bronchitis
how to dx chornic bronchitis
it is a diagnosis of exclusion – do thoracic radiographs and other tests to rule out causes of chronic coughs
cough suppressants used in canine chronic bronchitis
tramadol
hydrocodone
butorphanol
Permanent dilation and distortion of bronchi due to chronic
inflammation
Bronchiectasis
Bronchial collapse due to weakened walls; occurs commonly in dogs with tracheal collapse and/or CB or BM can occur by itself
bronchomalacia
chronic obstructive pulmonary disease
Obstruction of small airways due to thickening/weakness of the bronchial walls & mucus accumulation
predisposed breeds to Eosinophilic bronchopneumopathy (EBP)
husky
malamute
difference between feline chronic bronchitis and asthma
both: inflammation, mucus, wall thickening
asthma also has bronchospasm
the primary effector cells in allergic asthma
eosinophils
feline inflammatory bronchial disease cat breed
SIAMESE
T/F
cats with bronchitis cough every day
TRUE – asthmatic cats are intermittent
what test is imperative to do with coughing cats
Heartworm & fecal testing is imperative
how does the trachea collapse
dorsoventral flattening
primary etiology of tracheal collapse
they are deficient in glycosoaminoglycans, chondoitin, and calcium
T/F
cervical tracheal collapses during expiration and thoracic collapses during inspiration
FALSE - reversed
most common clinical sing in tracheal collapse
honking cough
t/F
patients in respiratory distress may be hypothermic
FASLE - hyperthermic
what mumur may also be present in a tracheal collapse doggo
left apical systomic – due to mitral valve
laryngeal functions
- Regulate airflow
- Protect trachea from aspiration during swallowing
- Control phonation
the ____ muscles of the larynx are responsible for laryngeal function
intrinsic
innervates the cricothyroid m.
cranial laryngeal nerve
laryngeal paralysis results when
When 1 (unilateral) or both (bilateral) of the arytenoid cartilages do not abduct
damage to this nerve causes Acquired laryngeal paralysis (LP) in dogs
recurrent laryngeal nerve
Geriatric-onset laryngeal paralysis-polyneuropathy (GOLPP) is most common in
labs
definitive diaganosis of larygeal paralyis
laryngeal exam
primary defects of brachycephalic airway obstruction
- Stenotic nares
* Elongated soft palate
polyps
Fibromuscular connective tissue arising from mucosal lining of nasopharynx, auditory tube
which species gets polyps more
cats – often younger
causes of polyps in cats
congenital defect(s), chronic inflammation, viral infection
sneezing associated with nasopharyngeal, caudal nasal, or sinus disease
reverse – inspiratory sneezing
causes of nasopharyngeal stenosis
regurgitation (esp. under anesthesia), chronic inflammation, post- surgical scarring, trauma, congenital anomaly, mass
nasopharyngeal stenosis treatment
Balloon dilation most effective
most common cause of rhinitis in cats
cryptococcus
Cat with clinical signs of sneezing & nasal discharge (mucoid or purulent, often unilateral) and polypoid masses in the nose
fungal rhinitis – crypto
T/F
a positive crypto culture means there is infection
false
oral tx for crypto rhinitis
Oral fluconazole
CHRONIC RHINOSINUSITIS (CRS) in cats has unilateral or bilateral nasal discharge
bilateral
- *FHV-1 seems to be involved
- *dx of exclusion
antiviral med that Reduces FHV-1 replication in vitro
lysine
what is a concern when using doxycycline in cats
esophageal stricture – need to be given with food
caution of use of NSAIDS (meloxicam) in cats
renal dz
geriatrics
gi disease
most common cause of FUNGAL RHINOSINUSITIS in dogs
aspergillosus
type of dogs predisposed to fungal rhinosinusitis
Usually young to middle-aged & dolichocephalic – gsd
may see epistaxis with sneezing
what is seen on CT with nasal aspergillosis
Significant destruction of turbinates & cavitations
how do you collect samples for blood culture in infectious endocarditis cases
3-4 samples collected aseptically from different venous tissue sites at least 30 min - 1 hour apart
source of infection of staph intermedius infective endocarditis
pyoderma
source of infection of staph aureus infective endocarditis
nosocomial
source of infection of strep canis infective endocarditis
urogenital tract, skin, respiratory tract
source of infection of E. coli infective endocarditis
gastrointestinal tract, peritonitis, urinary tract
source of infection of pseudomonas infective endocarditis
chronic wounds, burns
source of infection of bartonella infective endocarditis
ticks and fleas
treatment of acute infective endocarditis caused by staph intermedius
Tiracillin/clavulanate – timentin
treatment of chronic infective endocarditis caused by staph intermedius
clavamox
treatment of acute infective endocarditis caused by staph aureus
vancomycin, amikacin oxacillin
treatment of chronic infective endocarditis caused by staph aerues
if not methicillin resistant, high dose first generation cephalosporin
treatment of acute infective endocarditis caused by strep canis
ampicillin IV
treatment of chronic infective endocarditis caused by strep canis
amoxicillin or clavamox
treatment of acute infective endocarditis caused by e coli
amikacin or imipenem
treatment of chronic infective endocarditis caused by e coli
imipenem
treatment of acute infective endocarditis caused by pseudomonas
amikacin, timentin, ot imipenen IV
treatment of chronic infective endocarditis caused by pseudomonas
imipenem sc or possibly clavamox PO
treatment of acute infective endocarditis caused by bartonella
amikacin and beta lactam
treatment of chronic infective endocarditis caused by bartonella
bta lactam
doxy
azithromycin