respiratory disease

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vanessasoto
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241486
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respiratory disease
Updated:
2013-10-20 00:43:37
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respiratory disease
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respiratory disease
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  1. inspiration breathing
    • active
    • diaphragm contracts caudally-diaphragm creates negative pressure in the chest when diaphragm drops, air sucked in
    • chest wall muscles pull ribcage out and cranial
    • glottis opens
    • requires muscle movement
    • upper airway disease
  2. expiration breathing
    • passive
    • spring action of the chest wall pushes air out
    • relaxes
    • lower airway disease
  3. what should you do when an animal has trouble breathing
    watch them to see if they have problems breathing in or trouble breathing out that way you know if its an upper or lower airway disease
  4. gas exchange
    at the level of the alveolus
  5. stertor
    snoring noises
  6. cyanosis
    bluish  gums
  7. exercise intolerance
    1st signs of respiratory disease
  8. respiratory tract diagnostics
    • exam under sedation-physical exam always
    • radiograph-distribution of lesions-x-ray for chest always
    • fluoroscopy-real time x-ray, x-ray video camera
    • trans tracheal wash-C/S, cytology aka (BAL) bronchoalveolar lavage-take 18ga needle put saline in take sample out and send to lab
    • endoscopy-brush and biopsy, C/S-bronscopy is a scope that goes to bronchi
    • biopsy-FNA, scope, surgical-for mass of lungs
  9. respiratory therapy
    • antihistamines- Diphenhydramine, chlorpheneramine, Benadryl
    • cough suppressants-narcotics-Butorphanol, hydrocodone bitartrate-we use it centrally
    • antimicrobials-antibiotics, antifungal
    • anti-inflammatories-corticosteroids
    • bronchodilators-Theophylline, aminophylline
    • diuretics-furosemide (lasics)-pull fluids out of lungs
    • oxygen-intranasal, mask, chamber, flow by
    • Thoracocentesis
    • Thoracostomy tube
  10. reverse sneeze syndrome
    • basically unknown
    • nasal, pharyngeal, or sinus irritation-allergic (antihistamine) or physical or anatomical
    • possibly an attempt to remove mucous
    • pharyngeal spasm
    • nothing to be concerned about, tell clients it is not a big deal
  11. clinical signs for reverse sneeze syndrome
    • series of loud forced inspirations
    • head forward and neck extended
    • patient normal before and after
    • cheek puff out
  12. diagnostics for reverse sneeze syndrome
    only needed to rule out more severe possibilities in extreme cases
  13. treatment for reverse sneeze syndrome
    • during episode-rubbing of throat, light blowing into face, try to distract them, get their mind off of it, stimulate swallowing
    • chronic-antihistamines for allergies, steroids
  14. client education about reverse sneeze syndrome
    • looks at lot worse than it is
    • rarely a problem
  15. brachycephalic syndrome occurs in both dogs and cats
    • dogs- English bull dog most severe, Lhasa apso, peke, shar pei, shih Tzu, boxer, pug
    • cats-Persian, Himalayan
  16. one or more of 5 main airway problems in brachycephalic syndrome
    • stenotic nares- small naris opening-need to open it but removing tissue on side of inside of nose
    • elongated soft palate-can get trapped
    • everted laryngneal saccules-voice box, membrane stretch, increase resp. effort
    • laryngeal collapse-negative pressure cause it to  collapse from trying to breath
    • hypoplastic trachea-smaller than normal trachea in diameter
  17. brachycephalic syndrome
    • generally due to the selective breeding for a flat face, round head, and short thick neck
    • closure or narrowing airways cause increased work on the rest of the respiratory tree
    • also increased work on other systems-CV, neuro
  18. clinical signs for brachycephalic syndrome
    • Dx, TX, CE
    • syndrome dependent
  19. stenotic nares
    • narrowing of the other nares
    • clinical signs-increased inspiratory noise and effort, obvious exam finding
    • diagnostics-physical exam
    • treatment-wedge resection-take a chunk out of the nares black tissue to open up the airway
    • client education- surgical post op info, revision?
  20. elongated soft palate
    • soft palate interferes with epiglottis
    • inflammation over time worsens signs
    • upper airway
  21. clinical signs for elongated soft palate
    • stertor-snore sound
    • intermittent gagging and choking
    • coughing after eating and drinking
    • dysphagia (fluid in the lungs)-difficulty swallowing
    • increase resp. noise
  22. diagnostics for elongated soft palate
    • exam under sedation to look in there
    • sometimes trouble waking up
  23. treatment for elongated soft palate
    • surgical shortening of the soft palate
    • laser does great here-usually goes well, usually no issues
  24. client education for elongated soft palate
    • post op-food, meds
    • usually very pleasing outcome
  25. hypoplastic trachea
    • congenital lack of tracheal development
    • under developed tracheal
    • smaller than usual
  26. clinical signs for hypoplastic trachea
    • none
    • possibly cough and increased noise
    • exercise intolerance
    • respiratory distress
    • progression of symptoms
    • trouble breathing
    • cant keep up with oxygen needs
  27. diagnostics, treatment and client education on hypoplastic trachea
    • diagnostics- radiographs
    • treatment-none, decreased activity, watch weight, can't really do anything about it its a lifestyle
    • client education-grave prognosis if severe enough to cause distress
  28. everted laryngeal saccules
    • protrusion of the saccules in lumen
    • can occur due to change in airway pressure, increase pressure and effort so membrane stretch and bone collapse  
    • clinical signs-change in bark, cough, gag, stridor
    • diagnostics-exam under sedation, laryngoscope
    • treatment-surgical removal of saccules, specialist do this
    • client education-good prognosis post op, occasional revision
  29. laryngeal paralysis inherited form
    • bouvier des flanders, huskies, huskie mix
    • symptomatic by 4-8 months old
    • 3:1 male predilection
  30. laryngeal paralysis acquired form
    • giant (SB, Newfs), large breeds (IS, GR, Labs)
    • mean presentation is 9-12 years old
    • slight male predisposition
  31. suspected causes of laryngeal paralysis
    • hypothyroidism
    • vagal nerve disease
    • cervical trauma
    • recurrent laryngeal nerve disease
    • cranial thoracic disease
    • peripheral neuropathy
    • generalized myopathy
    • immune mediated disease
    • tumor
  32. laryngeal paralysis
    • increased retching and vomiting-increase aspiration pneumonia
    • pulmonary edema-increase airway pressure changes and effort, don't think about this often
    • prone to heat stroke/heat prostration -decrease air movement and heat removal
    • can't exchange the volume of air they need to cool down so the overheat
    • think about large breeds
    • larynx collapse into airway space, happens in older dogs, can be fatal if not addressed
  33. clinical signs for laryngeal paralysis
    • change in voice gets worse over time
    • exercise intolerance
    • inspiratory stridor-history of noise with activity, wheezing, upper airway disease
    • referred upper airway sounds-listening to chest hear noises hear the trachea and notice that is where its coming from that's how you know its upper airway
    • have trouble breathing, gets worse by stressing them out
  34. diagnostics for laryngeal paralysis
    • exam under sedation-glottis doesn't open on inspiration, often bilateral
    • additional tests for complications-Rads, CBC, TTW, C/S, U/S
  35. treatment for laryngeal paralysis
    • laryngeal tie back-usually unilateral surgery
    • in horses its roarers- breathing is louder
    • medical-maybe-steroids to reduce inflammation, sedatives- ace, valium, reduce activity
    • usually surgery
    • often time doesn't progress, it doesn't get worse
    • its progressive no simple treatment
  36. client education in laryngeal paralysis
    • good surgical Px
    • avoid exercise in humidity and heat
  37. collapsing trachea
    • small and toy breed dogs-yorkie, poodle, pom., chih, ages 4-14
    • collapse of the cartilage rings-can involve the bronchi, hypocellularity, lack of chondroitin, defects in chondrogenesis, genetics, tracheal membrane changes
    • fluoroscopy is beneficial
    • trachea is weakened with exchange of airway pressure, the negative pressure happens quickly so it collapses because trachea is weak
    • dynamic collapse secondary to pressure gradients
    • can affect clearance of airway secretions
    • pulmonary hypertension
    • syncope-collapse from lack of oxygenation  
  38. clinical signs of collapsing trachea
    • dry hacking cough-goose honk
    • tracheal sensitivity
    • dyspnea-inspiratory or expiratory, association with complication
    • variable auscultation
    • worsens with heat or stress
    • complications-heart disease, small airway disease
  39. diagnostics for collapsing trachea
    • radiographs- diagnoses 60% of cases, cycle dependent, note other diseases
    • fluoroscopy-movement
    • bronchoscopy-classification of disease-scope down trachea
    • TTW with C/S for complication- for secondary stuff, rule out complications
    • hard to make diagnostics its a dynamic thing so can't see it when doing x-ray, don't know where its going to collapse that's why fluoroscopy and bronchoscopy is better for this  
  40. treatment for collapsing trachea
    • medical- cough suppressants, sedation, bronchodilators, steroids, weight loss, excerise alteration, treatment of complications
    • surgical
    • c-stents-prosthetics for normal ring, plastic, mixed results, trying to hold trachea up

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