35 Disorders of the Trachea and Bronchi

1. canine infectious tracheobronchitis (kennel cough)

2. canine chronic bronchitis

3. feline bronchitis

4. tracheobronchomalacia (collapsing trachea)

5. allergic bronchitis

6. parasitic oslerus osleri

Name the common diseases of the trachea and bronchi

Young dogs

What age of animal does oslerus osleri parasite occur in?

Kennel cough, Canine Infectious Tracheobronchitis (ITB), CIRDC (canine infectious respiratory disease complex)

all names for the same thing

This disorder of the trachea and bronchi most commonly occurs due to canine parainfluenza virus or adenovirus with Bordetella bronchiseptica. Overall, it is HIGHLY contagious from aerosol or direct contact

Young unvccinated dogs at boarding facilities or parks

Name the signalment of dogs commonly affected with kennel cough

Canine infectious tracheobronchisits (kennel cough)

A young dog presents with a *loud, goosehonk cough* after being boarded at a facility when the owner left for vacation. The cough produces foamy, clear liquid and often gags after coughing. Lung sounds are normal. Thoughts?

FALSE: highly contagious thru DIRECT CONTACT = wait in vehicle

True or false: Canine infectious tracheobronchitis is HIGHLY CONTAGIOUS thru fomites, so affected dogs are okay to come into the lobby and wait with other dogs

Often self limiting in 10-14 days but if you want to treat:

*Doxycycline*, antitussives

Canine infectious tracheobronchitis is classified as uncomplicated if there is tracheal sensitivity but normal lung sounds and a self limiting disease. How do you treat?

Antibiotics (nebulization is most effective), supportive care = bronchodilators, hydration, antiinflammatory corticosteroids

Canine infectious tracheobronchitis is classified as complicated if there is a fever, crackles or wheezing, and anorexia, all of which may progress to bronchopneumonia. How do you treat?

Vaccine is not 100% effective because it has multiple etiologies = oral includes bordetella, intranasal includes parainfluenza and bordetella, parenteral (IV/IM/SQ/IT) includes CAV-2 and bordetella and requires a second dose

What is the problem with trying to prevent kennel cough?

a. oral

Which kennel cough vaccine includes bordetella only, providing immunity in 5 days?

a. oral

b. intranasal

c. parenteral

b. intranasal

Which kennel cough vaccine includes bordetella and parainfluenza, providing immunity in 5 days?

a. oral

b. intranasal

c. parenteral

c. parenteral

Which kennel cough vaccine includes bordetella and CAV-2, providing immunity in 14 days and requires a second dose?

a. oral

b. intranasal

c. parenteral

Parenteral vaccine with CAV2 and bordetella

Two vaccine routes for canine infectious tracheobronchitis give immunity within 5 days. Which route takes the longest, at 14 days?

Canine chronic bronchitis

This is defined as a chronic, persistent cough of 2 or more consecutive months in duration without other disease processes

Canine chronic bronchitis

Which problem commonly occurs in middle aged to older small breeds like *terriers, poodles, and cocker spaniels* as a cough that progresses slowly over months to years?

*radiographs* (bronchial-bronchiointerstitial pattern) and *BAL* (neutrophilic-mixed inflammatory cells and increased mucous)

How do you diagnose canine chronic bronchitis?

Glucocorticoids to decrease inflammation

Treating canine chronic bronchitis is mainly thru symptomatic management. What is the MAINSTAY treatment?

Control weight AGGRESSIVELY, glucocorticoids, bronchodilators, cough suppressants

Name some ways you can symptomatically treat canine chronic bronchitis

Cough suppressant

How does hydrocodone help canine chronic bronchitis?

true

TRUE OR FALSE: cats do not cough with heart disease

PRIMARILY: coughing and intermittent respiratory distress (owners often think they are "vomiting a hairball" but nothing comes up)

Others: wheeze, *expiratory* dyspnea

Name some common signs of bronchitis in cats:

Allergic bronchitis

Heartworm disease

Pulmonary parasites

Bacterial bronchitis

You suspect a cat has idiopathic feline bronchitis. What things did you have to rule out to get here (what are some differentials)?

Cats

Which animal has highly reactive airways prone to bronchoconstriction, *cats or dogs*?

1. bronchial asthma

2. acute bronchitis

3. chronic bronchitis

4. emphysema

Name the ways you classify feline bronchitis

a. bronchial asthma

Which classification of feline bronchitis is reversible, presenting with bronchoconstriction, increased mucous, and airway eosinophilia

a. bronchial asthma

b. acute bronchitis

c. chronic bronchitis

d. emphysema

b. acute bronchitis

Which classification of feline bronchitis is reversible airway inflammation going on for less than 3 months, showing increased neutrophils

a. bronchial asthma

b. acute bronchitis

c. chronic bronchitis

d. emphysema

c. chronic bronchitis

Which classification of feline bronchitis is irreversible, going on for more than 3 months

a. bronchial asthma

b. acute bronchitis

c. chronic bronchitis

d. emphysema

d. emphysema

Which classification of feline bronchitis is irreversible, showing destruction of bronchiolar and alveolar walls and fibrosis

a. bronchial asthma

b. acute bronchitis

c. chronic bronchitis

d. emphysema

DRUGS: #1. terbutaline bronchodilator

#2. dexamethasone (rapid acting glucocorticoid)

Stabilize with *oxygen*. May give albuterol via "aerokat" face mask

Feline bronchitis is *AN EMERGENCY*. What are the MOST IMPORTANT drugs and things you have to do?

Dorsoventral collapse of the trachea on inspiration

When does collapsing trachea occur during respiration and in which direction?

Middle aged to older toy and small breed dogs

What is the common signalment for collpasing trachea?

4 grades:

Grade 1: 25% collapse

Grade 2: 50%

Grade 3: 75%

Grade 4: 100% collapse

What are the grades of trachael collapse?

Collapsing trachea

What is this?

Remember that in collapsing trachea there is dorsoventral collapse of trachea on inspiration

1. there may be increased inspiratory effort with extrathoracic causes

2. there may be increased expiratory effort with intrathoracic causes

What is the difference in respiratory effort with collapsing trachea and its' causes?

You are suspecting collapsing trachea, and tracheobronchoscopy is the best diagnosis

A chihuahua comes to your clinic because the owner has heard him coughing that gets worse after he exercises. When you palpate the trachea, there is a wretching cough that is dry and nonproductive. You tell the owner it may be helpful to do tracheobronchoscopy. Why?

Tracheobronchoscopy

What is the BEST WAY to diagnose collapsing trachea (aka tracheobroncho-malacia)?

STABLE: bronchodilators, weight loss, antiinflammatory steroids

DYSPENIC: oxygen, anxiolytics, nebulize corticosteroids, potential stent placement

What is the difference between the way you treat a stable patient versus a dyspneic collapsing trachea patient?