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What are risk factors for viral and bacterial infections? (6)
boarding kennel, shelter, pet shop, vet hospital stay, dog show, doggie daycare
What pathogens are most commonly associated with canine infectious tracheobronchitis, what signs does each cause? (3)
- [kennel cough]
- Bordatella bronchiseptica: decreased mucociliary clearance
- Parainfluenza virus: short-lived contagious cough, denudes resp epithelium
- Canine Adenovirus type 2: upper airway dz (cleared in 9 days)
What are some minor pathogens that MIGHT be involved with kennel cough, but not usually? (3)
canine coronavirus (epithelial ciliary damage), mycoplasma, canine influenza virus
How is kennel cough transmitted?
spread by oronasal contact, respiratory secretions, fomites
What is the incubation of kennel cough? When does shedding take place?
5-7 day incubation; viral shedding lasts 6-10 days (Bordatella shedding is weeks to months)
What are the clinical signs of kennel cough? (6)
- coughing (high pitched honking), paroxysmal cough, laryngitis, tracheitis w/ episodic gagging and expectoration
- shouldn't have fever/lethargy/inappetance unless secondary pneumonia
How is kennel cough diagnosed?
- clinical signs!
- history of exposure/ boarding
Describe treatment of kennel cough. (3)
- usually self-limiting
- if prolonged (ie. Bordatella), Doxycycline (not for pups), Clavamox, enrofloxacin, azithromycin
- if cough is REALLY bad, low dose steroids (cover w/ antibiotic), +/- antitussives (hydrocodone)
Describe prevention of kennel cough. (3)
- Core vaccines already include parainfluenza and adenovirus
- Optional Bordatella vaccine (IN best, local immunity)- needs boostered every 6 months
- Isolate infected dogs
What dogs are at risk for distemper?
unvaccinated dogs, 3-6month old puppies (maternal Ab waning)
When does viral shedding occur with distemper?
- starts 7 days after infection and continues for 2-3 months
- luckily does not persist in environment
How is distemper transmitted?
via respiratory exudates
Describe the pathogenesis of distemper.
virus multiplies in macrophages--> spreads to respiratory system--> spreads to spleen/ gut--> reaches CNS in 8-9d
What are signs of distemper in adult dogs? (13)
thick mucopurulent nasal d/c, ocular d/c, keratoconjunctivitis, depression, anorexia, vomiting, diarrhea, tenesmus, intussusception, dehydration, emaciation, hyperkeratosis of nose and footpads (hardpad), mild uveitis/ retinal scarring
What are radiographic signs of distemper pneumonia? (2)
interstitial early, alveolar later
Describe the CNS form of distemper.
CNS signs 1-3 weeks after recovery from systemic/ respiratory disease: progressive chronic deterioration, seizures, cerebellar/ vestibular signs, myoclonus
What is a unique sign of distemper in puppies?
damage to enamel, teeth
How is distemper diagnosed clinically? (4)
- usually just based on clinical signs
- CBC: lymphopenia, inclusions in leukocytes
- thoracic rads: interstitial pattern
- CSF: increased protein, cytoplasmic inclusions, + antibody titer
How is distemper definitively diagnosed (not usually done clinically)? (3)
- PCR of blood or tissue
- immunofluorescence of conjunctival scrape, tonsil swab/resp/genitals(must be w/i 1-2 weeks of infection b4 coated with antibody)
- serum antibody neutralization test
Describe the treatment of distemper. (8)
supportive care, isolation, broad spectrum antibiotics, nebulization, IV fluids, anti-emetics, dexamethosone ONCE for severe CNS dz, anticonvulsants if persistent seizures
What are the possible outcomes for distemper? (3)
- if no improvement in 9-14 days, high mortality
- CNS signs, unclear
Describe prevention of distemper.
- vaccination is effective!
- maternal antibody gone by 12-14 weeks then vaccinate every 3-4 weeks from 6-16 weeks
- booster every 3 years
What is the canine influenza virus?
What are the clinical signs of influenza? (4)
cough, fever, tachypnea, mucopurulent nasal d/c (contrast to kennel cough b/c systemically ill)
How is influenza diagnosed? (3)
- exclude kennel cough
- rising titer on paired serum antibody testing at 7 and 14 days
- nasal swabs to ID virus
Desribe treatment of influenza. (3)
- usually self-limiting, supportive care
- treat secondary pneumonia
- should get better in 2-3 weeks
Why do dogs get bacterial pneumonia? (5)
- aspiration, inhalation, direct extension from pleural space, hematogenous spread
- usually secondary pathogens given an opportunity, usually mixed flora, usually anaerobes
What are risk factors for development of bacterial pneumonia? (6)
debilitation, prolonged recumbency, systemic immunosuppression, immunodeficiency, defective respiratory defenses (ciliary dyskinesis), damage to resp epithelium (smoke inhalation, etc)
What are predispositions for aspiration pneumonia? (6)
- impaired conscious protection of airway (general anesthesia)
- laryngeal paralysis
- megaesophagus (impaired swallowing)
- vomiting or regurg
- gastric overdistension (GI obstruction)
- forced feeding
What are the most common pathogens implicated in bronchopneumonia? (6)
enterics (E. coli, Klebsiella), Pasteurella, Staph aureus, Strep, Mycoplasma, Bordatella
What are common clinical findings with bronchopneumonia? (13)
- possibly no signs (if only single lung lobe)
- cough, nasal d/c, exercise intolerance, resp distress, anorexia, lethargy, fever variable, poor BCS, tachypnea, increased bronchoalveolar sounds, inspiratory crackles, +/- cyanosis
How is bronchopneumonia diagnosed? (4)
- CBC: neutrophilia+/- left shift, lymphopenia
- Hypoxemia (blood gas, not usually done)
- Rads: Early interstitial pattern, late alveolar pattern, ventral if aspiration; lag behind clinical signs
- TTW/ endotracheal wash for culture: + possible in health, neg possible with pneumonia...not great
Describe the treatment of bronchopneumonia. (8)
- Severe dz: broad-spectrum- ampicillin and enrofloxacin together
- Mild to moderate: oral clavamox or trimethoprim-sulfa
- Treat for one week past radiographic resolution (usually 3-4 weeks)
- +/- oxygen supplementation
- saline nebulization
- IV fluids- want debris in lungs to stay moist so they can clear it
- bronchodilators if persistent hypoxemia
- mucolytics (N-acetyl-cysteine)
What is the prognosis for bronchopneumonia?
poor if need ventilation, good for mild disease
What should you NOT use when treating bronchopneumonia?
NO COUGH SUPPRESSANTS- we want them to cough up and expectorate mucus
How can we prevent bronchopneumonia?
prevent recurrent aspiration- upright feeding of patients with megaesophagus, metoclopramide, airway lavage after aspiration, ET tube with anesthesia, bronchodilators with aspiration