Tracheal Diseases

What can elicit a cough?

irritation of mucous membranes in the pharynx, larynx, trachea, or bronchi

Where is the CNS cough center?

Medulla

What is CIRDC?

Canine infectious respiratory disease complex (kennel cough)

T/F CIRDC is just one pathogen?

No it is an umbrella term to include lots of pathogens

What two viruses cause kennel cough?

Canine Parainfluenza Virus and Adenovirus-2

T/F both canine parainfluenza and adenovirus-2 are self-limiting when by themseleves?

True

T/F parainfluenza is a core vaccine?

False

T/F adenovirus-2 is a core vaccine?

True

How is Bordetella bronchiseptica transmitted?

Aerosol

What species can get Bordetella bronchiseptica?

Dogs and less common in cats

What are the risk factors for bordetella bronchiseptica?

Exposure to dogs with kennel cough

Concurrent respiratory infections

Multi-pet households

What is the pathogenesis of Bordetella bronchiseptica?

Colonize respiratory mucosa

Adhere to and destroy cilia

Mucociliary clearance fails

Release toxins and inflammatory mediators

Secondary bacterial infections

Why is Bordetella so bad?

By destroying the cilia, it makes the animal more prone to other bacterial infections

What are the C/S of “healthy” kennel cough?

Loud honking cough but healthy otherwise

Can have nasal-ocular discharge

How long is the incubation period for kennel cough?

3-10 days

What are the C/S of kennel cough that is not healthy?

Anorexia, fever, lethargy with loud honking cough

The non-healthy version of kennel cough is often accompanied with what?

Pneumonia

How do you diagnose uncomplicated kennel cough?

Exposure to other dogs with a cough but healthy NO OTHER DIAGNOSTICS NEEDED

How do you diagnose complicated kennel cough?

Thoracic radiographs to look for pneumonia. Can consider a tracheal wash

What is a dangerous bacterial cause of kennel cough?

Strep equis zooepidemicus

What are the C/S of Strep zoo kennel cough?

Same as normal with the addition of hemorrhagic pneumonia

How do you treat a Strep zoo kennel cough?

Ampicillin or Unasyn

How should you treat healthy kennel cough?

Only if dog is high risk (shelter) with antibiotics

Hydrocodone or butorphanol for cough suppression

How do you treat sick kennel cough?

Antibiotics based on culture with doxy empirically

NO COUGH SUPPRESSANTS if pneumonia

T/F you should use neck leads on dogs with kennel cough?

False

When do you use cough suppressants during kennel cough?

If cough is interfering with quality of life

What is a non core vaccine that has triple coverage against kennel cough?

Bordetella/parainfluenza/adeno

What is the efficacy of the Bordetella/parainfluenza/adeno vaccine?

Minimized risk of infection and reduces clinical signs if they become infected

What are the 2 types of vaccines for the bordetella/parainfluenza/adeno vaccine?

IN (MLV): quick onset, can develop cough

SQ (killed): must be boosted in 2-4 weeks and then annually

What type of bordetella/parainfluenza/adeno vaccine can cause a cough?

IN

How can you control kennel cough?

Try to avoid bringing them into the lobby of the clinic

What are the hosts of distemper virus?

Mostly puppies 3-6 months old

Large cats, seals, minks, ferrets, raccoons too

How is distemper spread?

Respiratory secretions

Any bodily fluid

How long can distemper virus be spread?

90 days after infection

How can you destroy distemper virus?

Heat, drying, most disinfectants

What is the pathophysiology of distemper virus?

Aerosol drops or fluds reach tonisls

Infect macrophages, travel to lymphatics, and bloodstream to many organs

What are some places in the body distemper can spread to?

Lymph nodes, lungs, spleen, liver, GI tract, eyes, marrow, skin, CNS

What helps puppies clear distemper virus?

Vaccination or maternal antibodies

T/F distemper can be subclinical?

True

What are the types of acute distemper disease?

Respiratory disease

GI disease

CNS disease

What are the signs of respiratory acute distemper virus?

Nasalocular discharge

Kennel cough/pneumonia

What are the GI signs of acute distemper?

Decreased appetite

Vomiting/diarrhea

What are the CNS signs of acute distemper?

Myoclonus, seizures, blindness, ataxia, hypermetria, paralysis

What are 3 additional C/S of distemper outside of respiratory, GI, CNS?

Enamel hypoplasia

Hard pads or pustular skin lesions

KCS/uveitis/optic neuritis/blindness

How do you diagnose distemper?

CBC

Thoracic radiographs

PCR, IFA, necropsy

How do you diagnose distemper virus with a CBC?

Lymphopenia, thrombocytopenia, regenerative anemia

Inclusions in blood cells from CBC or bone marrow

How do you diagnose distemper with a thoracic radiograph?

Unstructured interstitial pattern that is diffuse or dorsocaudal

can be alveolar if secondary bacterial pneumonia

What tissues can be used to diagnose distemper with PCR or IFA?

Respiratory secretions, conjunctiva, blood, CSF, feces, tissues

How do you generally treat distemper virus?

Supportive care

How do you treat coughing distemper?

Antibiotics, but only if secondary bacterial infection is present

How do you treat GI signs of distemper?

Antiemetics, nutrition, fluids

How do you treat seizures from distemper?

Anti-epileptics

What happens to the prognosis of distemper if neurologic signs occur?

Much worse

Why do we rarely see distemper?

It is preventable with vaccines

What are the canine influenzas?

H3N8 and H3N2

How is canine influenza spread?

Respiratory secretions and fomites

T/F canine influenza is endemic in Kansas?

False

How can canine influenza be presented?

Subclinical, mild cough, nasal discharge, decreased appetite, fever, lethargy

How do you diagnose canine influenza?

PCR and sequencing

Describe the vaccine for canine influenza

Killed vaccine that must be boosted every 4 weeks, then yearly

Only recommended for at risk patients

T/F cats can get canine influenza?

True

T/F avian influenza is zoonotic?

True

How are cats getting infected with HPAI H5N1?

Drinking contaminated milk

What are the C/S of HPAI H5N1 in cats?

Upper respiratory signs, sometimes neurological signs

What is your top differential when you suspect HPAI H5N1 in cats?

Rabies due to neurologic and respiratory signs

How do you diagnose HPAI H5N1 in cats?

PCR or necropsy

T/F you should have PPE when examining potential HPAI H5N1 outbreak cats?

True

T/F dogs and cats can get covid?

True

What is the pathophysiology of tracheal collapse?

Primary cartilage abnormality

Secondary initiating factors

What is the cartilage abnormality with tracheal collapse?

Decrease in glycoproteins and GAGs in tracheal rings preventing water retention and loss of rigidity

What are some secondary initiating factors of tracheal collapse?

Obesity

Smoke

Concurrent respiratory disease

Cardiomegaly

Cushings

What is the signalment for tracheal collapse?

Toys and miniature breeds that are middle aged or older

T/F males and females get tracheal collapse evenly?

True

What are the C/S of tracheal collapse?

Paroxysmal cough that is triggered by stress, excitement, exercise, can collapse

What do you find on the exam of a tracheal collapse?

Induce cough on palpation

Overweight or obese

Otherwise healthy

What do radiographs tell you with tracheal collapse?

Can sometimes show collapse, but better for ruling out other diseases

How can you diagnose tracheal collapse?

Radiographs

Fluoroscopy

Endoscopy

What is the gold standard for tracheal collapse diagnostics?

Endoscopy, but it is risky so it is not used

What will a radiograph that tells you tracheal collapse look like?

No trachea in inspiration

Trachea is fine in expiration

What is the most common way to diagnose tracheal collapse?

Fluoroscopy because it is easy and there is no anesthesia

What are some other diagnostics for tracheal collapse?

CBC and tracheal wash is secondary pneumonia is present

Chemistry panel to look for hepatic dysfunction

How do you manage acute tracheal collapse?

Oxygen

Sedation with acepromazine or butorphanol

Steroids

What is wrong with the labeled dose of acepromazine?

It is too high

How do you manage chronic tracheal collapse?

Avoid stress, it cannot be cured only managed

Weight loss

Harnesses and not collars

Antitussives

When should you use bronchodilators with tracheal collpase?

Only if concurrent lower airway disease

When would you use a tent for tracheal collapse?

If medical management is not effective

What are some complications for a tracheal stent?

Stent can break or move

Granulation tissue develops

T/F tracheal stents are a perfect cure?

False

T/F tracheal hypoplasia is congenital

True

What should you not do with dogs that have tracheal hypoplasia?

Breed them

What is tracheal hypoplasia a part of?

Brachycephalic airway syndrome

What are the signs of tracheal hypoplasia?

Cough, dyspnea, stridor

How do you diagnose tracheal hyoplasia?

Radiographs

How do you treat tracheal hypoplasia?

No medical or surgical treatment

Manage weight

Protect from infeciton

What is the prognosis for tracheal hypoplasia?

Incidental in some dogs

Poor in severe cases

Some dogs can grow out of it