What signs are associated with disease in the following areas:
Larynx (voicebox)?
Trachea (windpipe)?
Bronchi?
- Larynx = hoarse bark, gagging, inspiratory difficulty
- Trachea = cough and resp distress
- Bronchi = cough and resp distress
Clinical signs?
- Cough (most common)
- +/- productive
- Retch/gag
- Wheezing
- Inspiratory sounds
- Tachypnea
- Resp distress
- Cyanosis if severe
- +/- productive
Canine etiology
- Brachycephalic airway syndrome and laryngeal paralysis--know hallmarks
- Canine infectious respiratory disease complex: kennel cough
- Canine influenze
- Oslerus osleri
- Collapsing trachea, bronchi
- Canine chronic bronchitis
- Bronchiectasis
Canine infectious respiratory disease complex (CIRD): kennel cough
Pathogens responsible?
- Parainfluenza virus--mild clinical signs
- Canine adenovirus (CAV-2)
-
Mycoplasma spp.--mild to severe clinical signs
-
Bordetella spp.--mild to severe clinical signs
- Attaches to cilia of bronchial epithelium and interferes with motility--resulting in mucous accumulation and inflammation
- Other viruses--canine distemper virus (CDV), canine respiratory coronavirus (CRCoV), canine herpes virus (CHV-1), and canine influenza virus (CIV)
- Secondary bac. invaders are comon
- Attaches to cilia of bronchial epithelium and interferes with motility--resulting in mucous accumulation and inflammation
CIRD: kennel cough
Contagious?
Spread?
Incubation?
Most common clinical sign?
- Very contagious--acquire pathogen from dog shows, kennels, vet clinics, etc.
- Spread through resp secretions and fomites
- Incubation 3-7 days
- Coughing is most common clinical sign
CIRD: kennel cough
Clinical signs
- Usually develop 4-10 days post exposure
- Uncomplicated
- Non-sick animals
- Involves upper airways
- Dry cough is elicited on tracheal palpation
- Serous oculonasal discharge, gagging, and retching can be found
- Complicated
- Sick animals
- Upper and lower airways
- Moist cough
- Oculonasal discharge more mucopurulent
- May develop into bronchopneumonia
- Non-sick animals
- Involves upper airways
- Dry cough is elicited on tracheal palpation
- Serous oculonasal discharge, gagging, and retching can be found
- Sick animals
- Upper and lower airways
- Moist cough
- Oculonasal discharge more mucopurulent
- May develop into bronchopneumonia
CIRD: kennel cough
Diagnosis
- History
- Where has the dog been? Kennels?
- Has the dog received bordetella vaccine recently?
- Clinical signs
- In uncomplicated cases further diagnostics may be included
- Hemogram--left shift neutrophilia
- Thoracic radiographs
- Transtracheal wash, cytology and culture
- PCR panels for upper resp viruses and bac.
- Where has the dog been? Kennels?
- Has the dog received bordetella vaccine recently?
- Hemogram--left shift neutrophilia
- Thoracic radiographs
- Transtracheal wash, cytology and culture
- PCR panels for upper resp viruses and bac.
CIRD: kennel cough
Treatment: uncomplicated
- Uncomplicated
- Restricted exercise
- Use doxycycline if Bordetella spp is suspected
- Usually resolves w/in 2 weeks
- Cough suppressants
- Butorphanol, hydrocodone, codeine derivative, dextromethorphan
- Restricted exercise
- Use doxycycline if Bordetella spp is suspected
- Usually resolves w/in 2 weeks
- Cough suppressants
- Butorphanol, hydrocodone, codeine derivative, dextromethorphan
CIRD: kennel cough
Treatment: complicated
- Restrict exercise
- Systemic antibiotic for 2 wks
- Doxycycline, tetracycline, sulphonamides, enrofloxacin
- Penicillins are not a good choice for Bordetella spp as they reach poor concentrations in the respiratory secretions
- Nebulization w/ or w/o gentamycin (only antibiotic that can actually have an effect when added to nebulizer)
- Cough suppressants (avoid if bac. pneumonia is present)
- Bronchodilators
- Albuterol, theophylline (avoid or reduce dose by 30% if using together w/ fluoroquinolones)
- Doxycycline, tetracycline, sulphonamides, enrofloxacin
- Penicillins are not a good choice for Bordetella spp as they reach poor concentrations in the respiratory secretions
- Albuterol, theophylline (avoid or reduce dose by 30% if using together w/ fluoroquinolones)
CIRD: kennel cough
Prognosis?
Prevention?
- Prognosis = good to excellent
- Prevention
- Avoid places where dog could get infected
- Vaccination
- Sanitation--household bleach dilated 1:32
- Ventilation in kennels
- Avoid places where dog could get infected
- Vaccination
- Sanitation--household bleach dilated 1:32
- Ventilation in kennels
CIRD: kennel cough
Vaccination
- Parenteral vaccination
- CAV-2, CPIV, CDV and Bordetella spp (dogs)
- Blocked by maternal antibodies so repeat every 3-4wks until 16wks of age
- Intranasal vaccination
-
Bordetella spp and CPIV
- Important for high- or at-risk animals
- New vaccinations against CIV
- Need vaccine 2-3 wks BEFORE going to kennels for protection
- CAV-2, CPIV, CDV and Bordetella spp (dogs)
- Blocked by maternal antibodies so repeat every 3-4wks until 16wks of age
- Bordetella spp and CPIV
- Important for high- or at-risk animals
Canine influenza
Influenza type A?
Spread?
- Type A
- H3N8 (related to equine flu)
- H3N2 (related to avian flu)
- Spread through direct contact (resp secretions) and fomites or indirect contact through kennel surfaces, water/food bowls, toys, collars and leashes
- H3N8 (related to equine flu)
- H3N2 (related to avian flu)
Canine influenza
Clinical signs
Diagnosis
- Clinical signs
- 2-5 days post exposure
- Usually results in coughing, sneezing, nasal discharge and fever; may result in hemorrhagic pneumonia
- Disease has high morbidity but low mortality
- 20% don't show clinical signs and just shed virus
- Most animals dev. mild clinical signs, but some can dev. severe (2 forms)
- Diagnosis--PCR, serology (acute and convalescent titres) or viral isolation
- 2-5 days post exposure
- Usually results in coughing, sneezing, nasal discharge and fever; may result in hemorrhagic pneumonia
- Disease has high morbidity but low mortality
- 20% don't show clinical signs and just shed virus
- Most animals dev. mild clinical signs, but some can dev. severe (2 forms)
Canine influenza
2 forms?
- Mild/uncomplicated--typical mild uncomplicated kennel cough
- Severe/complicated
- Pyrexia (104-106F)
- Hemorrhagic pneumonia--dyspnea, tacypnea, hemoptysis
- Rapid onset and animal can die w/in hours
- 5-8% mortality
- Pyrexia (104-106F)
- Hemorrhagic pneumonia--dyspnea, tacypnea, hemoptysis
- Rapid onset and animal can die w/in hours
- 5-8% mortality
Canine influenza
Treatment
Prevention
- Treatment
- Supportive care, NSAIDs to reduce fever, and IV fluids
- Systemic antibiotics in the severe form--may require ICU but extremely contagious and requires isolation
- Prevention
- Vaccination
- Isolate sick and exposed dogs
- Change clothes/wash hands
- Virus does not persist in environment >48hrs--good quality bleach/disinfectant solution
- Supportive care, NSAIDs to reduce fever, and IV fluids
- Systemic antibiotics in the severe form--may require ICU but extremely contagious and requires isolation
- Vaccination
- Isolate sick and exposed dogs
- Change clothes/wash hands
- Virus does not persist in environment >48hrs--good quality bleach/disinfectant solution
Oslerus osleri
What is it?
Generally affects?
Life cycle?
Causes what?
Clinical signs?
- Canine parasite on resp. passages
- Generally affects younger dogs in kennels
- Direct life cycle--larvae ingested, molt in small bowel and migrate to lungs, bronchi, and trachea
- Cause cream-colored nodules in trachea
- Clinical signs: coughing, wheezing, dyspnea
Oslerus osleri
Diagnosis
- Radiographs--may see tracheal mass
- Bronchoscopy--masses are found
- Tracheal/bronchial brushes or biopsies
- Fecal
What parasite is this indicative of (white plaques)?

Oslerus osleri

Oslerus osleri
Treatment
- Fenbendazole
- Ivermectin
Tracheal collapse
Signalment?
Usually acquired reduction in what?
Pathophysiology?
- Signalment
- Middle aged to older dogs (rarely cats--full cartilagenous rings in trachea)
- Toy or small breed dogs--usually obese
- Usually acquired reduction in chondrocytes
- Lack glycosaminoglycans and chondroitin sulfate in tracheal cartilage
- Pathophysiology
- Weak cartilage w/ flattening of tracheal rings, resulting in mechanical irritation, edema, and inflammation
- Tracheal rings lose their firmness and collapse
- Middle aged to older dogs (rarely cats--full cartilagenous rings in trachea)
- Toy or small breed dogs--usually obese
- Lack glycosaminoglycans and chondroitin sulfate in tracheal cartilage
- Weak cartilage w/ flattening of tracheal rings, resulting in mechanical irritation, edema, and inflammation
- Tracheal rings lose their firmness and collapse
Tracheal collapse
Clinical signs
- Goose honking cough
- Exacerbated by exercise, excitement and eating
- Elicited w/ tracheal palpation
- Causes cyanosis and collase/syncope
- Many dogs have hepatomegaly
- Theory: O2 deprivation--> significant liver disease
- Many have cardiac murmur
- Variable breath sounds
- Theory: O2 deprivation--> significant liver disease
Tracheal collapse
Diagnosis
- Signalment, history, clinical signs
- Thoracic/cervical rads
- Inspiratory AND expiratory films
- May/may not be diagnostic
- Often underestimate severity
- Extra-thoracic and intra-thoracic collapse occurs
- Fluoroscopy
- Bronchoscopy
- Best diagnostic tool
- Assess dynamic change
- Grade extent of collapse
- Look for concurrent diseases
- Inspiratory AND expiratory films
- May/may not be diagnostic
- Often underestimate severity
- Extra-thoracic and intra-thoracic collapse occurs
- Best diagnostic tool
- Assess dynamic change
- Grade extent of collapse
- Look for concurrent diseases

Tracheal collapse
Grading scale?

Tracheal collapse
Treatment: calm patient (/owner)
- Sedation often required
- Acepromazine, butorphanol, diazepam
- O2-rich environment
- O2 cage, nasal catheterization
- Use cough suppressant (antitussive)
- Butorphanol injectable/oral
- Oral hydrocodone
- Corticosteroid
- Single dose for anti-inflammatory effects
- 0.1mg/kg IV dexamethasone
- Intubation may be required
- Acepromazine, butorphanol, diazepam
- O2 cage, nasal catheterization
- Butorphanol injectable/oral
- Oral hydrocodone
- Single dose for anti-inflammatory effects
- 0.1mg/kg IV dexamethasone
Tracheal collapse
Treatment: break the cycle
- Weight loss
- Avoid neck collars
- Avoid excitement
- Use sedative if required
- Behavioral--reward quiet behavior
- Avoid dust, smoke, pollens, carpet powders, etc.
- Use cough suuppressants--butorphanol, codeine, hydrocodone
- Use corticosteroids--very short course if required
- Too long--> suppress immune system--> secondary bac. pneumonia
- Antibiotics for secondary infection if suspected
- Use sedative if required
- Behavioral--reward quiet behavior
- Too long--> suppress immune system--> secondary bac. pneumonia
Tracheal collapse
Response to medical management?
Surgery?
- 30% of dogs do not respond to medical management
- Surgical intervention--referral
- Extraluminal stents
- For extrathoracic or cervical collapse
- Endoluminal stents
- For intrathoracic or entire tracheal collapse
- Nitinol stents are used
- Extraluminal stents
- For extrathoracic or cervical collapse
- Endoluminal stents
- For intrathoracic or entire tracheal collapse
- Nitinol stents are used
Canine chronic bronchitis
What is it?
Clinical signs?
Cause?
Long-term sequelae?
Not similar to what?
- Inflammation of bronchial walls--> thickened walls, increased mucous --> obstruction of small airways
- Chronic obstructive pulmonary disease
- Clinical signs--daily cough > 2mo
- By the time it is diagnosed there is rarely a cause found for the underlying inflammation
- Etiology is rarely determined
- Long term sequelae--emphysema, bronchiectasis, pneumonia
- Not similar to asthma in cats or people
- Chronic obstructive pulmonary disease
- Etiology is rarely determined
Canine chronic bronchitis
Signalment
Client complaint
Clinical signs
Diagnostics
- Signalment: small breeds, usually >6yrs
- Often obese
- Client compliant: chronic cough, audible wheezes, exercise intolerance
- Usually BAR, signs wax and wane
- Clinical signs--expiratory wheezes, crackles audible on inspiration and expiration
- Dog can also have concurrent tracheal collapse or mitral valve insufficiency
- Diagnostics--exclude other causes of a cough
- Rads, bronchoscopy, bronchial cytology and culture
- Often obese
- Usually BAR, signs wax and wane
- Dog can also have concurrent tracheal collapse or mitral valve insufficiency
- Rads, bronchoscopy, bronchial cytology and culture
Canine chronic bronchitis
Treatment
- Eliminate triggers--smoke, excitement, allergens
- Keep hydrated--to aid mucociliary clearance
- Reduce weight if obese
- Prednisolone--reduce inflammation
- Bronchodilators--only in reversible stages, use only w/ corticosteroids
- Antibiotics--if secondary bac. infection found
-
Avoid cough suppressants--unless a tracheal collapse is present or the cough is inconsistent and dry
- Metered dose inhalers (MDI)--inhalation steroids
-
Bronchiectasis
Secondary to?
Pathophysiology?
- Secondary to chronic conditions like chronic bronchitis
- Pathophysiology
- Damage to bronchial structure--> thickened wall, dilation of structure
- Mucous cannot be cleared--> builds up
- Secondary infection --> recurrent bronchopneumonia --> more damage to airways
- Dilation of bronchial tree is irreversible caused by the destruction of the muscle and elastic tissue
- Damage to bronchial structure--> thickened wall, dilation of structure
- Mucous cannot be cleared--> builds up
- Secondary infection --> recurrent bronchopneumonia --> more damage to airways
- Dilation of bronchial tree is irreversible caused by the destruction of the muscle and elastic tissue
