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Cardiorespiratory Diseases

Cardiorespiratory Diseases. Alveoli-Capillary Gas Exchange. Alveoli surrounded by capillaries Incoming RBCs low in O 2 Exiting RBCs rich in O 2 Thin capillary membrane. Respiratory Diseases . Upper respiratory. Lower Respiratory Tract includes trachea, bronchi, lungs,

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Cardiorespiratory Diseases

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  1. Cardiorespiratory Diseases

  2. Alveoli-Capillary Gas Exchange • Alveoli surrounded by capillaries • Incoming RBCs low in O2 • Exiting RBCs rich in O2 • Thin capillary membrane

  3. Respiratory Diseases Upper respiratory Lower Respiratory Tract includes trachea, bronchi, lungs, _pleural cavity Upper respiratory

  4. Upper Respiratory Diseases • Rhinitis • Sinusitis • Tonsilitis • Laryngitis

  5. Upper Respiratory Diseases Upper Respiratory Tract is any resp structure above the trachea • Rhinitis—inflammation/infection of nasal passages Usually occurs with other resp diseases • Signs • Nasal discharge; crusty nares • Pawing at nose • Staphylococcusspp • Rx • Clean nares • Antibiotics if necessary • Vasoconstrictive drugs: Phenylephrine drops

  6. Upper Respiratory Diseases • Sinusitis • Most common cause: tooth root abscess of 4th premolar (Carnassial tooth) • Largest tooth; roots extend into frontal/maxillary sinus • Signs • Swelling under eye on infected side • Unilateral nasal discharge • Rx • Remove infected tooth • Antibiotics • Flush fistula with iodine solution

  7. Upper Respiratory Diseases • Tonsillitis (Tonsils provide lymphoid protection to lower resp tract) • Signs • Anorexia • Increased salivation • Pain on opening mouth • It is more common in small dog breeds • Dx • Visualized inflamed, swollen tonsils • Tonsils may be coated with mucus/pus • Sx • Antibiotics • Surgical removal of chronic cases

  8. Tonsillitis

  9. Upper Respiratory Diseases • Laryngitis Most common cause is excessive barking **Rabies can also change vocal quality • Signs • Loss of voice or alteration of voice • Increased mucus production in back of throat • Rx • Restrict barking • Anti-inflammatory medication (glucocorticoids: tapering dose) • Client info • Most Upper Respiratory Infections are self-limiting

  10. Lower Respiratory Diseases Lower Respiratory Tract includes trachea, bronchi, lungs, pleural cavity • Infectious Canine Tracheobronchitis (Kennel Cough) • Causes (a collection of several causative agents including viruses, bacteria, mycoplasmas, fungi, parasites • Canine parainfluenza virus • Canine adenovirus • Canine herpesvirus • Reovirus • Bordetella bronchiseptica • mycoplasma • Signs • Hx of exposure to animals at a kennel, hospital, groomer, show • Dry hacking cough in an otherwise healthy animal • Rx—antibiotics, glucocorticoids, antitussives • Client info • Self-limiting (2-3 wks); Rx is to make animal/owner more comfortable • Vaccinate 2-3 wk before chance of exposure

  11. COLLAPSING TRACHEA

  12. Lower Respiratory Diseases • Collapsing trachea Failure of proper development of tracheal rings • Signs • Cough, esp during excitement or exercise • Dx • Goose-like honk on tracheal palpation • r/o other causes of coughing • Rx • Acepromazine to calm excitement • Antitussives (Hycodan, Butorphanol) • Glucocorticoids • Bronchial dilators • Prosthetics have been surgically implanted, but complications have occurred • Client info • Wt reduction • Use shoulder harness rather than neck collar

  13. Lower Respiratory Diseases • Feline Bordetella Infection Bordetella bronchiseptica grow in ciliated respiratory mucosa; release toxins • Signs (look like respiratory viral infections) • Fever • Sneezing, nasal discharge, coughing, rales • Submandibular lymphadenopathy • Rx (usually self-limiting) • Antibiotics (oral tetracycline or doxycycline) • Prevention • Eliminate stress • Good hygiene, good nutrition • Vaccination • Client info • Looks like resp infections caused by feline herpes and calicivirus • Usually self-limiting • Vaccination effective

  14. Lower Respiratory Diseases • Feline asthma (bronchoconstriction, inflamed/hyperreactive airways) • Signs • Coughing, wheezing • Labored breathing • Dx • Clinical signs • X-rays show “doughnuts” typical of airway inflammation • Rx • Long-term corticosteroids (prednisone, DepoMedrol) • Bronchodilators (terbutaline [Brethine], cyproheptadine) • Client info • Prognosis is variable • If allergens can be determined and exposure limited, most cats do well • A cure is not usually possible

  15. Feline Asthma • Same cat • Top—normal • Bottom—asthma Airways more prominent because of inflammation and mucus buildup Doughnuts (end-on view) and tramways (lateral view) of airways

  16. Feline Viral Resp Infections • 2 viruses responsible for most feline resp diseases • Feline Viral Rhinotracheitis (FVR; Feline Herpesvirus) • Feline Calicivirus (FCV) Caliciviridae family • Highly contagious • High mobidity • Low mortality • Most severe in kittens

  17. Feline Viral Rhinotracheitis • Signs • Acute onset of sneezing • Conjunctivitis, severe rhinitis • Fever, depression, anorexia • Ulcerated hard palate, excess salivation • Corneal ulcers • Rx • Supportive Rx • IV fluids, broad spectrum antibiotics, decongestants • Nursing care: clean nose, eyes; force feed food; decrease stress • Antiviral therapy • Prevention • Vaccination • Client info • FVR highly contagious; can transmit via clothing, hands, etc; only cats • Warming food may improve palatability • Vaccinated cats may show mild symptoms • Disinfectants kill herpesvirus type I virus

  18. Feline Calicivirus • Signs • Fever • Serous ocular/nasal discharge; mild conjunctivitis • Oral ulcers, salivation • Pneumonia • Diarrhea • Rx • Supportive care • Antibiotics • Force feed disinfect using bleach • Prevention • Vaccination • Client info • Highly contagious • Signs last 5-7 d • Force-feeding may be necessary (if cats can’t smell, they won’t eat)

  19. What do you see? or What do you not see?

  20. Pleural Effusion Fluid in thorax • Types of fluid Causes • Transudate R-sided CHF, FIP plasma-like fluid; straw colored • Blood trauma, neoplasia • Chyle neoplasia, pancreatitis, trauma lymphatic fluid from intestine; high fat content infection, parasites --Empyema Infection, foreign body, trauma pus in thorax All types of fluid cause same signs • dyspnea • may show cough, fever, pleural pain Dx—x-ray

  21. Pleural Effusion • Thoracentesis • Clip hair, scrub skin, block with local anesthetic • Most dependent space (7th-8th intercostal space) • Aspirate using 3 way valve • Remove as much fluid as possible • Do not create pheumothorax • Analyze aspirate • Rx—depends on pathology causing effusion • Client info • Owner may need to continue pleural drainage • Unless 1° is treated, effusion will return • Rx can be long and expensive

  22. Fungi

  23. Fungal Diseases Usually result from inhalation of fungal spores or wound contamination Fungi release enzymes/toxins that damage host’s cells Endemic along east coast, Great Lakes, river valleys of the Miss, Ohio, St Lawrence • Commonly seen fungal diseases of animals • Blastomycosis • Coccidioidomycosis • Histoplasmosis • Aspergillosis

  24. Blastomycosis (Blastomyces dermatitides) • Signs (non specific) • Anorexia, depression, wt loss • Fever, cough, dyspnea • Enlarged LN • Dx • X-rays—diffuse, nodular interstitial lung pattern (x-ray) • Serology testing is available • Most cases are diagnosed in the fall. • Rx • Amphotericin B • Client info • Blastomycosis usually not zoonotic disease, however, use caution with animals with draining wounds • Owners share same environment and are likely to be exposed • Relapses are common • Rx is expensive

  25. Coccidioidomycosis (Coccidioides immitis) • Signs • Mild, non-productive cough • Low-grade fever, anorexia, wt loss • Weakness, depression • Lameness, pain is bone involvement • LN enlargement • CNS involvement • Dx • Parenchymal changes on x-ray • Serology • Rx • Ketoconozole • Itraconazole • Client info • Usually not zoonotic disease, however, use caution with animals with draining wounds • Response to Rx is good, but recurrence is common • Rx is expensive radius-ulna

  26. Histoplasmosis (Histoplasma capsulatum) • Organism which grows in bird manure, bat dropings or organically enriched soil. • Signs • Feline (pulmonary signs) • Wt loss, anorexia • Fever, pale mm, swollen LN • Canine (GI signs) • Wt loss, diarrhea, low-grade fever • Dyspnea, cough, pale mm • Dz • CBC: anemia • X-ray: diffuse pulmonary interstitial pattern • Rx • Ketoconazole • Itraconazole • Client info • Px fair to good for pulmonary form; guarded to grave for systemic form

  27. Cryptococcosis (Cryptococcus neoformans) A yeast-like fungus found in soil contaminated with pigeon and other bird droppings. Inhalation major route of infection. Immunocompromised animal more susceptible than normal animal • Signs • Feline • Lesions in nasal and sinus cavities; chronic nasal discharge • enlarged LN, wt loss, anorexia, lwo-grade fever • Canine • Usually CNS lesions (vestibular dysfunction) • Dx • Cytology of aspirates, impression smears • Antigen test available • Rx • Amphotericin B • Ketoconozole • Itraconazole • Px • Fair to good unless CNS involvement • No known health hazard to humans

  28. Aspergillosis (Aspergillus fumigatus) Inhalation major route of infection; nasal cavity is main location of lesions • Signs • Feline (uncommon) • May be immunocompromised (FeLV) • Lethargy, fever, wt loss, anorexia • Canine (localized) • Young to middle age • Chronic nasal discharge, sneezing, loud breathing (like snoring) • Canine (generalized infection) • Primarily seen in G Shep • Wt loss, anorexia • fever, lameness, paresis/paralysis • Dx • X-ray—loss of nasal turbinates • endoscopy:--yellow-green to black fungal plaques on nasal mucosa • Rx—topical clotrimazole • Client info • Localized dis—poor Px; Generalized dis—grave Px; not zoonotic

  29. Pulmonary Neoplasms Tumors in lungs are usually metastatic, although primary lung tumors do occur • Signs • Primary neoplasia • Cough, exercise intolerance • Wt loss, poor condition • Dysphagia, vomiting, anorexia • Metastatic neoplasia • Evidence of primary tumor at other location • Same signs as above for Primary neoplasia

  30. Pulmonary Neoplasms • Dx • Chest X-rays—mass occupying lesions; can be mistaken for abscess, parasitic dis, fungal infect, bact infect • Biopsy—provides definitive diagnosis

  31. Pulmonary Neoplasms • Rx—surgical removal is TOC • Lobectomy for solitary tumor • Chemotherapy (may reduce tumor size, may not increasse survival time • Client Info • Px is guarded to grave • By the time these tumors are diagnosed, they are usually in advanced stages • Chemotherapy may reduce clinical symptoms Same dog as x-ray

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