Infectious Tracheobronchitis Caused by: Canine Parainfluenxa virus Canine Adenovirus-2 Bordetella bronchiseptica Mycoplasma spp Others Any combination of the above Very contagious!

Respiratory - Tracheal Disease Flashcards by Alyssa Sorum

What is the cough reflex?

Elicited by irritation of mucous membranes int he pharynx, larynx, trachea, or bronchi
- mechanical, chemical, mucus
CNS cough center in medulla

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What is Kennel Cough

Infectious Tracheobronchitis
Caused by:
- Canine Parainfluenxa virus
- Canine Adenovirus-2
- Bordetella bronchiseptica
- Mycoplasma spp
- Others
- Any combination of the above
Very contagious!

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Which kennel cough virus has a vaccine that is considered “core”

Adenovirus-2 = “core”
Parainfluenza = “non-core”

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What is Bordetella bronchiseptica?

Aerobic Gram-negative bacteria
one of the causative agents of Kennel Cough
Common in dogs, less common in cats

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What is the pathogenesis of Bordetella bronchiseptica infection?

Colonize respiratory mucosa
Adhere to and destroy cilia, causes ciliostasis
Mucociliary clearance fails
Release toxins and inflammatory mediators
Other bacteria can then adhere and cause disease

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What are the clinical signs of Kennel Cough?

3-10 day incubation period after exposure
Dogs get classic loud honking cough
“healthy” other than the cough
Anorexia, fever, lethargy, nasal-ocular discharge possible
- Not typically seen
- Consider if it has progressed to pneumonia

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How does a typical Kennel Cough dog present?

BAR
Energetic and happy
Loud honking cough

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How is Kennel Cough Diagnosed?

Uncomplicated case:
- “healthy” kennel cough
- Exposure, cough, exam
- no further tests needd
Complicated cases:
- “sick” kennel cough
  - Anorexia, fever, lethargy
- Thoracic radiographs
  - If show pneumonia, then consider tracheal was

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What is the treatment for Kennel Cough

Viral component is self-limiting
Healthy Kennel Cough:
- Hydrocodone or butorphanol for cough suppression
  - Mechanism: opioids inhibit cough center in medulla
  - side effects: sedation, decreased clearance of bacteria
Sick Kennel Cough:
- Antibiotic based on culture and susceptibility when available
  - Doxycycline, amoxicillin, or Clavamox (empirically)
- Cough suppressants are contraindicated in pneumonia cases

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What is the Vaccine for Bordetella bronchiseptica?

Not core
Minimizes risk of infection
- develop fewer clinical signs if infected
2 Types:
- IN: (MLV) quick onset, can develop cough
- SQ: (killed) initial dose requires booster in 2-4 weeks
- Booster annually or 1+ week prior to exposure

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When should kennel cough dogs be isolated?

During clinical signs and therapy
*

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Who are the hosts of Distemper Virus?

Dogs (especially puppies 3-6mo)
Large cats (tigers), seals, minks, ferrets, raccoons

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How is Distemper virus spread?

Mostly respiratory secretions
Can be spread in all bodily fluids
- feces, urine, transplacental
Can spread for up to 90 days after infection

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What is the pathophysiology of Distemper Virus?

Aerosol drops of fluids reach tonsils
Infect macrophages, travel by lymphatics and bloodstream to many organs
- lymph nodes, lungs, spleen, liver, GI tract, eyes, marrow, skin and CNS
If vaccinated/maternal antibodies - puppies can clear the infection with no/mild signs

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What are the signs of Distemper Virus?

Subclinical
Acute Disease:
- Respiratory
  - Nasalocular discharge
  - Kennel cough/pneumonia
- Gastrointestinal Disease
  - Decreased appetite
  - Vomiting/diarrhea
- CNS
  - Myoclonus, blindness
  - seizures, ataxia, hypermetria, paralysis
Enamel hypoplasia
Hard-Pads or pustular skin lesions
KSC/uveitis/optic neuritis/blindness

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How is Distemper Virus diagnosed

CBC:
- may have lymphopenia, thrombocytopenia, regenerative anemia
- May see inclusions in blood cells from CBC or bone marrow
Thoracic Radiographs: unstructured interstitial pattern that is diffuse or dorsocaudal in distribution
- Can have alveolar pattern if 2^o bacterial penumonia
PCR, IFA, Necropsy
- On respiratory secretions, conjunctiva, blood, CSF, feces, tissues

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What is the treatment for Distemper Virus?

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For coughing/pneumonia
- +/- antibiotics, nebulization
For GI:
- Antiemetics, nutrition, fluids
For seizures:
- Anti-epileptics
- Poor Prognosis if neurologic
Isolate suspect/confirmed dogs

How can Distemper be prevented?

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Vaccination

What are the Influnza viruses in Dogs?

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Canine Influenza (H3N8 and H3N2)

How is Canine Influenza (H3N8/H3N2) transmitted?

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Through respiratory secretions
Via fomites

What are the signs of Canine Influenza (H3N8/H3N2)?

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Decreased appetite
Fever
cough
lethargy
nasal discharge
can be subclinical

How is Canine Influenza (H3N8/H3N2) diagnosed?

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signs
PCR

What is the treatment for Canine Influenza (H3N8/H3N2)

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supportive care

Is there a vaccination for Canine Influenza (H3N8/H3N2)

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Killed vaccine, requires booster in 3-4 weeks, then yearly
only for at risk patients

What is the pathophysiology of tracheal collapse?

* 1^o cartilage abnormality * ⇣ glycoproteins and GAGs in tracheal rings, can't retain water, lose rigidity * 2^o Initiating Factors * Obesity * inhaled irritants (smoke) * Concurrent Resp Disease * Infection, trauma, even just intubation * Cardiomegaly * Cushing's Disease

What breeds commonly suffer from tracheal collapse?

* Toy/Miniature breeds * Yorkies, Pomeranians, Chihuahuas, Mini Poodles

What are the signs of Tracheal Collapse? PE findings?

* Paroxysmal Cough * Easily elicited, dry, nonproductive, goose honk * Triggered by stress, excitement, exercise * May have hypoxic collapse episodes * Exam: * Can induce cough on palpation * Can hear turbulence when auscult trachea * Otherwise can have unremarkable exam

How is Tracheal Collapse diagnosed?

* Radiographs * during different phases of respiration * Often radiographs don't show collapse but make other differentials less likely * Fluoroscopy * Dynamic, real time * Endoscopy * Gold standard for visualization, not done routinely due to safety * CBC and Tracheal wash * if evidence of pneumonia * high anesthetic risk! * Chemistry Panel * Hepatic dysfunction has bee reported * true etiology unknown * not typically clinically relevant * Hepatomegaly is common - consider concurrent disease

What is the medical management for an acute crisis with Tracheal Collapse?

* Oxygen * Sedation * Acepromazine - 0.01 - 0.02 mg/kg, IV, IM, SQ * Butorphanol - 0.2 - 0.4 mg/kg IV * +/- Anti-inflammatory dose of steroids * Dexamethasone 0.05-0.1mg/kg IV, IM, Sq

What is the chronic management for Tracheal Collapse?

* No stress, Avoid triggers * Weight loss * harness, no collar * Antitussives: hydrocodone, butorphanol, maropitant * Treat underlying disease * Brochodialators w/ concurrent lower airway disease * Glucocorticoids (not standard)

Can a stent be placed for Tracheal Collapse?

* Try medical management first * Possible complications * stent breaks or moves * granulation tissue forms * Not a perfect cure * many show great improvement * Major complications requiring additional stent ~47% * still cough (hopefully less0 * Still need daily meds

What is Tracheal Hypoplasia?

* Congenital defect * may be hereditary * do not breed * Part of Brachycephalic Airway Syndrome * stenotic nares * everted saccules * elongated soft palate

What are the signs of tracheal hypoplasia?

* Cough * Dyspnea * Stridor

What is the treatment for tracheal hypoplasia?

* no specific medical/surgical therapy * Weight management * protect from infections

What is the prognosis of tracheal hypoplasia cases

* incidental in some * Poor in severe cases * some improve with maturity

What is Ciliary Dyskinesia?

* Congenital defect of cilia * Autosomal recessive (most likely) * English springers, pointers, setters * erratic beating, poor mucociliary clearance * Typically present age 6-12 months

What are the clinical signs of Ciliary Diskinesia?

* Chronic rhinitis * mucopurulent nasal discharge, sneezing * Moist productive cough, can be dyspneic * Hydrocephalus * Otitis media * Infertile * May have chronic recurrent pneumonia

How is Ciliary Dyskinesia diagnosed?

* Radiographs: * 50% can have situs inversus * Bronchitis, pneumonia * Bronchiectasis * Can have rhinoliths * Tracheal Wash: * culture and susceptibility * Mucociliary Clearance * ^99mTc albumin * 1 drop at the tracheal bifurcation * Watch for clearance (40min) * Normal: 7-20mm/minute * Dyskinesia: severely impaired or absence * Not a perfect test, other resp. disease can slow clearance * best used to rule out diskinesia * Biopsy nasal or tracheal epithelium * *In vitro* functional analysis * Electron microscopy for structural defects

Why can checking sperm help diagnose Ciliary Dyskinesia?

* Sperm are poorly motile or nonmotile, dogs may be infertile * An easy in-house test

What is the Treatment for Ciliary Dyskinesia?

* Manage recurrent infections * Encourage coughing (pulmonary therapy) * use coupage, nebulization to loosen mucus * Provide oxygen when needed

What is the prognosis for Ciliary Dyskinesia?

variable, but not great for most dogs

Respiratory - Tracheal Disease Flashcards

(41 cards)