Trachea and Lung diseases

Question 1

Non-infectious tracheal diseases (4)

Answer 1

Collapsed trachea
Chronic cardiac disease
Allergic lower airway disease
Prolonged barking

Question 2

Non-infectious tracheal diseases treatment

Answer 2

Antitussives (Codeine, butorphanol, dextromethorphan)
Broncho-dilating drugs (Theophylline, Aminophylline, terbutaline)
Prednisolone
Nebulization

Question 3

Infectious tracheobronchitis (5)

Answer 3

Kennel cough complex
Distemper
Reovirus
CHV
Mycoplasma

Question 4

Kennel cough comples (3)

Answer 4

Canine adenovirus 2
Canine parainfluenza virus
Bordetella bronchiseptica

Question 5

Tracheobronchitis

Answer 5

Proximal cough, gagging,
Can create cough by pinching the trachea
Antitussive (codeine, tramadol), NOT if suspecting bronchopneumonia!
AB: Cephalosporins, amox+clav, doxycycline
(In norway it is not recommended to use AB unless general condition is bad, and if so, trimethoprim is the first choice)
Bronchodilators

Question 6

Collapsed trachea

Answer 6

Middle aged toy breeds
DV collapse, Aquired, cervical more commen
Extra-thoracic= inspiratory obstructive dyspnoea
Intra-thoracic= expiratory obstructive dyspnoea
Due to failure of chondrogenesis?
I-IV
Goose honk cough
Diagnosis: Fluoroscopy, radiography, bronchoscopy
Treatment: Sedation (butorphanol) Anxiolytics (Acepromazine), O2, GC (Dexamethasone, prednisolone), Antitussive (Butorphanol, hydrocodone), Surgery as last resort.

Question 7

Tracheal hypoplasia

Answer 7

Congenital

Bulldogs, Boston Terrier

Question 8

Tracheal parasites

Answer 8

Oslerus osleri (Lungworm)
Inspiratory wheezing sound

Question 9

Diseases of the small airways (5)

Answer 9

Canine chronic bronchitis
Bronchiectasis
Feline bronchial disease/asthma
Airway foreign bodies
Bronchial neoplasia

Question 10

Canine chronic bronchitis

Answer 10

Middle-aged-older dogs, small breeds
Inflammation -> fibrosis & mucous -> inflammation
Airborne allergens ?
Daily cough for more than 2 months, exercise intolerance.
Inspiratory crackles, expiratory wheezing
Bronchial/interstitial pattern, right-sided cardiomegaly
Hyperaemic mm
Treatment: controlled but never cured. Prednisolone, bronchodilators (theophyllin, terbutaline), antitussives (only if inflammation is treated).

Question 11

Bronchiectasia

Answer 11

Irreversible dilatation of bronchi w/ secretion.
Cocker spaniels.
Response to long-standing inflammation
Loud bronchial sounds, nasal discharge, haemoptysis (cough up blood)
Treatment: If local (lobectomy), bronchodilators. Do not give cough suppressants!

Question 12

Feline bronchial disease/Feline asthma

Answer 12

Asthma:
Acute reversible narrowing of the airways due to bronchoconstriction. Typically Eosinophilic. Can cause acute distress in the cat. Hacking cough, loud breathing.
Siamese cats!
Ascultation: Harsh lung sounds, crackles, wheezing
Percussion: increased resonance.
Bronchial pattern
Treatment: Sedation (Butorphanol), Anxiolytics (Acepromazine), Brochodilators (Terbutaline), GC

Question 13

Pulmonary parenchymal diseases (11)

Answer 13

Aspiration pneumonia
Acute respiratory distress syndrome
Bacterial pneumonia
Eosinophilic bronchopneumopathy
Lung lobe torsion
Pulmonary oedema
Pulmonary fibrosis
Pulmonary thromboembolism
Pulmonary neoplasia
Smoke inhalation
Viral bronchopneumonia

Question 14

Bacterial pneumonia (6)

Answer 14

Bordetella
E. coli
Klebsiella
Mycoplasma
Pasteurella
Pseudomonas

Question 15

Bacterial pneumonia

Answer 15

Usually secondary

Increased lung sounds crackles or wheezes (+ basic clinical signs)

Question 16

Viral bronchopneumonia (2)

Answer 16

Distemper

Morbillivirus

Question 17

Viral bronchopneumonia

Answer 17

Bronchopneumonia, enteritis, encephalitis
Mucopurulent oculo-nasal discharge, fever, lethargy, neurological symptoms (50%)
Seizure control: Diazepam, KBr, phenobarbital

Question 18

Eosinophilic bronchopneumopathy

Answer 18

Inflammatory disease, aetiology unknown.
Huskies, but all breeds
Nasal discharge, crackling sounds. Green-yellowish mucous
Treatment: GC

Question 19

Pulmonary oedema

Answer 19

Vascular hydrostatic pressure increased due to left sided congestive heart failure, excessive fluid administration or anuric renal failure.
Plasma oncotic pressure decrease: hypoalbuminaemia
Increased vascular permeability.
Dyspnoea –> cyanosis

Question 20

Acute Respiratory Distress Syndrome

Answer 20

Caused by lung injury or pulmonary capillary permeability increase due to sepsis, pancreatitis, aspiration, shock or microbial pneumonia
Early phase: proteinaceous fluid (can treat with Furosemide)
Late phase: pulmonary hypertension due to increased inflammatory cells