Tracheobronchial Disease

Question 1

What anatomy is included in the conducting airways?

Answer 1

Nasopharynx
Trachea - psuedostratified ciliated, goblet cells, basal cells
Bronchi
Bronchioles

Question 2

What are the defenses of the conducting airwyas?

Answer 2

Epithelial barrier
Mucus
Mucociliary elevator
Oxidant defenses
IgA antibodies
Lysozymes, defensins, mucins, NO

Question 3

How do the conducting airways respond to insult?

Answer 3

Epithelial cell desquamation
Goblet cell hyperplasia
Increased mucus production
Inflammation and bronchoconstriction

Question 4

What clinical signs are associated with conducting airway disease?

Answer 4

Hacking cough
Stridor or stertor
Wheezes
Inspiratory, expiratory effort
Airway obstruction
Dyspnea
Clear bronchovesicular sounds
Normoxemia

Question 5

What are infectious differential diagnoses for a young dog with an acute onset dry cough, partially vaccinated, attends doggy daycare?

Answer 5

Question 6

What makes up the CIRDC?

Answer 6

Question 7

What is the pathophysiology of CIRDC?

Answer 7

Adherence to respiratory epithelium and cilia
Infection of epithelial cells, necrosis, and loss
Destruction and loss of cilia
Increase mucus production
Stimulate immune cell influx

Question 8

How is CIRDC spread, incubated? What are risk factors?

Answer 8

Aerosolized spread
2-10d incubation
Increased risk: crowding, poor ventilation and sanitation, introduction of new animals, stressed animals, lack of vaccination

Question 9

What are the clinical signs of CIRDC?

Answer 9

Acute dry, hacking cough
Sneeze
Serous nasal and ocular discharge

Question 10

What are the clinical signs of CIRDC with secondary infection?

Answer 10

Systemically ill - febrile
Moist, productive cough
Respiratory distress
Hypoxemia

Question 11

How can CIRDC be diagnosed?

Answer 11

Canine respiratory screen panel

Question 12

Compare the different types of airway sampling

Answer 12

Question 13

What is the treatment for CIRDC?

Answer 13

Do nothing
Isolate for 2 weeks after cough stops
Cough suppressants PRN for sleep (hydrocodon, butorphanol, codeine, dextromethorpan)

Question 14

When should antibiotcs be considered for CIRDC?

Answer 14

Evidence of bacterial infection - fever, mucopurulent discharge, wet cough, lethargy, inappetence, pneumonia
Young patients or immunocompromised patients

Question 15

What antibiotics should be used for CIRDC?

Answer 15

Doxycycline 7-10d
Clavamox (secondary bacterial pneumonia!!