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Airway Dz (Infectious Tracheobronchitis (Canine infectious respiratory dz…
Airway Dz
Infectious Tracheobronchitis
Canine infectious respiratory dz complex(CIRD) → Kennel cough
Parainfluenza, Adenovirus-2, Bordetella bronchiseptica, Canine influenza, Distemper(systemic dz), Mycoplasma, others(respiratory Corona, Strep zoo, Herpes, etc.)
usually self-limiting, 어린 강아지에서 주로 발생, 대증처치, 대부분 증상 mild
진해제? ← only for harsh cough
dextromethorphan, hydrocodone bitartrate, butorphanol
Feline Asthma
eosinophilic airway inflammation → 평활근 수축, 기도 좁아짐.
young adults(F>M, young to middle age)
C/S : cough, wheeze, exercise intolerance, respiratory distress, "hair balls"(헤어볼을 토하려는 듯한 모습을 보임.)
Dx : 다른 질병 r/o, 방사선 촬영, airway eosinophilia, 치료 반응, 기능 검사(seldom)
Tx
Steroids(항염증)
Bronchodilators
β-agonists eg. albuterol, terbutaline
Methylxanthine eg. theophylline, aminophylline
Ciliary Dyskinesia
immotile cilia syndrome (rare)
Kartagener's syndrome w/ situs inversus(50%)
기도 내 섬모가 제대로 작용하지 못함.
발생학적 문제와 관련된 듯
Brachycephalic Airway Syndrome
stenotic nares, elongated soft palate, hypoplastic trachea → surgical condition
Secondary : everted laryngeal saccules, laryngeal collapse
Complications : hyperthermia, noncardiogenic pulmonary edema/ARDS, aspiration pneumonia
Laryngeal Paralysis
common in big old dogs, but occurs in cats too
mild problem or fatal condition, stridor
수술적 교정 필요
Collapsing Trachea
나이 많은 소형견에서 잘 발생
Paroxysms or bouts of cough
worse w/ activity or excitement
honking or harsh cough w/ terminal retch ← 거위 울음소리
Tx : cough suppressants, corticosteroids(+/-), bronchodilators(+/-), 심하면 tracheal stents
Feline Bronchial Dz
Asthma : allergic; IgE, eosinophilic airways
Bronchitis : neutrophilic inflammation
Heartworms : HARD
Chronic Bronchitis
neutrophilic airway inflammation
radiographic peribronchial infiltrates
chronic cough(daily cough>2 months)
C/S : cough, retch/gag, stridor(upper), wheeze(lower), dyspnea, voice change, SQ emphysema, asymmetry, mass effects, hypercapnea, hemoptysis
Laryngitis
: uncommonly diagnosed in dogs & cats
Fixed Tracheal Obstruction
Neoplasia
: not very common
Traumatic Airway Dz
: BDLD(big dog-little dog; dogfight injury)
Bronchiectasis
: big, dilated bronchi(비가역적)
Parasitic Airway Dz
- 기침이 주증상
Pulmonary Dz
PTE
Predisposing factors(Virchow's triad) - IMHA, GN, Cushing's, PLE, etc.
Causes V/Q mismatch : A-a gradient increased
pulmonary hypertension common
Dx : x-ray, blood gas, scintigraphy, D-dimer, angiography, etc.
Tx : 예방이 중요, 보조요법
빈도수는 높지 않으나 한번 생기면 critical(낮은 생존율)
Pulmonary Edema
Cardiogenic : CHF 촉발
Non-cardiogenic
간혹 발생. 어려움.
electric shock, neurologic dz(post epilepsy), oxygen toxicity, near drowning, choking, pancreatitis, ALI/ARDS, uremia(uremic pneumonitis), smoke inhalation, toxins
Dx : exercise intolerance, cough(moist), orthopnea, loud BV sounds, crackles(soft)
Tx : oxygen, diuretics, mechanical ventilation
Lung Lobe Torsion
often accompanied by effusion(often chylous)
cough, respiratory distress, lethargy, vomiting, hemoptysis
아프간 하운드 퍼그에서 호발
수술적 교정
Pulmonary Fibrosis
Terrier and Poodle dogs, old cats
생검으로 확진
crackles가 들림.
보조요법만 가능(예후 나쁨.)
Pneumonia
Infectious
Bacterial
dogs more than cats
bronchopneumonia, lobar pneumonia
subclinical~fatal
Dx : 임상증상, inflammatory leukogram(+/-), radiographic changes, tracheal or bronchoalveolar lavage, predisposing causes를 찾을 것
개와 고양이에서 주로 동정되는 균이 다름.
Tx : antibiotics(broad spectrum), nebulization/humidification, coupage, not cough suppressants
Viral : Canine Influenza, Distemper virus, Herpes virus, Feline Calicivirus
Fungal
Blastomycosis : lungs, eyes, skin, bones, LN
Histoplasmosis : lungs, GI, spleen/liver, eyes, marrow, LN
Coccidioidomycosis(Valley fever) : lungs, bones, eyes, skin, CNS, pericardium, LN
visual identification, culture(long), Ag vs Ab test
Tx : conazoles, amphotericin B(nephrotoxic)
Aspiration
inhale "stuff" you shouldn't
damage often due to the "stuff" - acid, oil, particulates, bacteria
Predisposing factors : anesthesia, vomiting, regurgitation, swallowing disorders, laryngeal paralysis, forced feeding, recumbency, etc.
세균성 폐렴과 치료 유사
Heartworms
Canine : asymptomatic, exercise intolerance, cough, 우심부전, caudal caval syndrome
Feline
asymptomatic, sudden death, cough, dyspnea, vomiting
HARD(heartworm associated respiratory dz)
Cats may be clinical w/o ever having adult worms.
no good diagnostic test for cats ← false negative Ag, false negative Ab, false positive Ab
no good tx for infected cats ← 예방
비특이적 호흡 증상, anaphylaxis, thromboembolism, rarely RS-CHF
C/S : cough(soft), exercise intolerance, hemoptysis, collapse, cyanosis, orthopnea, dyspnea, crackle, wheeze, increased/decreased BV sounds
Lung Cancer
: metastatic vs primary
Eosinophilic Lung Dz
- 천식과 비슷
Parasitic Lung Dz
*ARDS=acute/acquired respiratory distress syndrome
*ALI=acute lung injury
*대기 중 흡입 산소 농도(FiO2)는 21%, 동맥혈 내 PaO2는 대략 5배인 100mmHg
*Alveolar-arterial(A-a) oxygen gradients - hypoxemia의 source를 진단에 사용. PTE가 생기면 alveoli에서 blood로의 산소 이동이 줄어드니까 A-a gradient가 증가
*그외 폐 질환 : Contusions, Abscess, Cysts, Bullae