L98: Small Animal Upper Respiratory Conditions and Lower Airway pt. 1

What diagnostic test is considered the most valuable in assessing laryngeal disease in all species? What diagnostic test is considered the most valuable in assessing laryngeal disease in all species?

laryngoscopy

what are signs of pharyngeal disease?

1. stertor

2. reverse sneezing

3. gagging

4. retching

5. dysphagia

6. airway obstruction

what are signs of laryngeal disease?

1. respiratory distress

2. stridor

3. change in vocalization

4. dysphagia or gagging

5. if coughing indicates aspiration pneumonia

what exacerbates distress on respiratory system?

1. exercise

2. excitement

3. temperature

what is the common laryngeal disease in dogs and cats?

laryngeal paralysis

what are the common pharyngeal diseases in dogs and cats?

1. brachycephalic airway syndrome

2. elongated soft palate

3. nasopharyngeal polyp

4. lymphoma in cats

what diagnostic test is a real time radiograph?

fluroscopy

what can fluroscopy be used to diagnose/

1. dynamic tracheal collapse

2. placement of stents

what do the aryntenoid cartilage do when on inspiration?

arytenoid cartilage move outward

what is laryngeal paralysis (Lar Par)?

failure of arytenoid cartilage to abduct during inspiration

what animals do we see larygneal paralysis in?

• older large breed dogs

• goldens and labs

what are the clinical signs of laryngeal paralysis?

1. stridor

2. change in bark

3. coughing after eating or drinking

larygneal paralysis is an…

emergency

how do we diagnose laryngeal paralysis?

laryngoscopy

what do you always need to have ready when doing an exam on an animal with suspected laryngeal paralysis?

IV catheter and ET tube (this is potential emergency!)

A 3 year old golden comes into the clinic after the owner noticed a change in the dog’s bark. You also notice the dog has a stridor. You decide to grab your laryngoscope to examine the dog and see the following. What is your diagnosis?

laryngeal paralysis

why do you need to do thoracic radiographs in an animal with laryngeal paralysis?

right middle lung lobe most commonly affected by aspiration pneumonia

what is the treatment for laryngeal paralysis?

1. weight loss

2. avoid heat

3. avoid collars

4. short and tapering glucocorticoids

5. rest

what is the treatment for laryngeal paralysis that is idiopathic and the animal is in respiratory distress?

arytenoid laterizations (“tie back”) surgery

what are the potential complications with tie back surgery for laryngeal paralysis?

1. perioperative mortality

2. aspiration pneumonia

3. polyneuropathies will progress

what is the MST for animals that had tie back surgery for laryngeal paralysis?

5 years

what is the prognosis for laryngeal paralysis?

fair to good

what can animals with laryngeal paralysis NOT do whether they have had surgery or not?

NO SWIMMING

what contributes to brachycephalic airway syndrome?

1. stenotic nares

2. elongated soft palate

3. everted laryngeal saccules

what breed with brachycephalic airway syndrome may also have hypoplastic trachea?

english bulldogs

what are the clinical signs of brachycephalic airway syndrome?

1. loud breathing

2. stertor or stridor

3. increased inspiratory effort

4. gagging

5. cyanosis or syncope

what are the secondary effects of brachycephalic airway syndrome?

1. laryngeal edema

2. everted saccules

3. laryngeal collapse

4. acid reflux

5. hiatal hernia

what is used to diagnose brachycephalic airway syndrome?

1. breed

2. clinical signs

3. physical and laryngeal exams

4. thoracic radiographs

what is the treatment for brachycephalic airway syndrome?

1. increase air flow (surgical repair)

2. weight management

what salvage procedure might you do for a laryngeal collapse?

tracheostomy

what tumor type is more common for the larynx?

local tumors more common

what local tumors can be present in the larynx?

thyroid carcinoma

what structures are part of the lower airway?

1. trachea

2. bronchi

3. bronchioles

4. alveoli

5. interstitium

6. vasculature

what are you considering if you hear quiet bronchovesicular sounds on your auscultation?

1. shallow inspiration

2. obesity

3. atelectasis

4. pleural effusion

5. pneumothorax

6. thoracic mass

what are you considering if you hear harsh bronchovesicular sounds on your auscultation?

1. hyperpnea

2. pneumonia

3. pulmonary edema

4. turbulence of airflow

5. referred upper airway sounds

what are you considering if you hear wheezes on your auscultation?

1. asthma

2. airway secretions

3. airway obstruction

4. severe bronchitis

what are you considering if you hear crackles on your auscultation with a cranioventral alveolar pattern?

1. bacterial pneumonia

2. aspiration pneumonia

3. hemorrhage

what are you considering if you hear crackles on your auscultation with a caudodorsal alveolar pattern?

1. noncardiogenic edema

2. mycotic pneumonia

3. protozoal pneumonia

4. hemorrhage

what is the most common clinical sign associated with a lower airway issue?

cough

what are you thinking if you hear a goose honk cough?

tracheal collapse

what are you thinking if you hear a hoarking cough?

kennel cough

what are you thinking if you hear a harsh and paroxysmal cough?

bronchitis

what are you thinking if you hear a soft cough?

1. pneumonia

2. pulmonary edema

what causes cranioventral alveolar patterns?

1. pneumonia

2. hemorrhage

3. neoplasia

4. lung lobe torsion

what causes caudodorsal to diffuse alveolar patterns?

1. cardiogenic pulmonary edema

2. non-cardiogenic edema

what causes peri-hilar alveolar patterns?

CHF

what causes unilateral/mediastinal shift alveolar patterns?

1. atectasis

2. airway obstruction

what causes patchy, focal, or mutlifocal alveolar patterns?

1. contusions

2. hemorrhage

3. neoplasia

4. heartworm disease

5. thromboembolisms

what parasite can infect the trachea and bronchi?

Oslerus osleri

what agents are involved with canine infectious tracheobronchitis/kennel cough?

1. canine adenovirus

2. parainfluenza virus

3. canine respiratory coronavirus

4. bordatella bronchiseptica

how long does kennel cough last?

2 weeks

what are the signs of kennel cough?

1. non-productive cough

2. cough exacerbated by exercise, excitement

3. sudden onset

what is important to understand about kennel cough?

not a systemic illness animal just coughing

An owner calls you about their dog with kennel cough. The dog started to develop signs of systemic illness. What is the more likely pathogen causing this?

canine influenza

what is the treatment for kennel cough?

1. rest

2. ± cough suppressants (not if productive cough and only at night)

what can lead to collapsing trachea?

1. progressive weakening of cartilage

2. redundant tracheal membrane

what type of cough will an animal with a collapsed trachea have?

inducible goose honk cough

what animal do we usually see collapsing trachea in?

middle aged toy and miniature breed dogs

what are the progressive diagnostics we do for a dog with think has tracheal collapse?

1. thoracic and cervical neck radiographs

2. fluroscopy

3. endoscopy

what is shown in the image?

tracheal collapse

what is the treatment for laryngeal collapse?

1. cough suppressants

2. weight loss

3. harnesss

4. avoid overheating

5. surgical stents if not managed medically

what airway diseases have a bronchial pattern?

1. canine chronic bronchitis

2. feline asthma

3. allergic bronchitis

4. kennel cough

5. bacterial and mycoplasma infection

6. parasites