Respiratory Medicine

Why two serious respiratory disorders may sneak up on you.

The authors wish to acknowledge that the photos featured in the article "Diagnosing and managing canine eosinophilic bronchopneumopathy" (June 2010) were not appropriately credited.

In the article "Diagnosing and managing canine eosinophilic bronchopneumopathy" (June 2010), credit for the photos was not provided.

Basic lung function is designed to exchange oxygen and carbon dioxide. In order to transfer oxygen from atmospheric air to the blood stream three functions must be in place: ventilation, diffusion, and perfusion. Ventilation is the process of air moving into and out of the lungs.

Pleural space disease is a common cause of respiratory distress in emergent and critical patients. Air, fluid, exudates, chyle, blood, and herniated abdominal organs may be present in the thoracic cavity.

Evaluation of the pet with respiratory disease may be challenging. The best approach to problem solving usually reflects first an assessment for immediate intervention, and then careful evaluation to localize the problem, and then finally determination of the specific problem and the available options for controlling or curing it. Immediate intervention is warranted in any pet that is having difficulty breathing.

Traumatic thoracic injuries are prevalent in small animals, particularly in dogs. The most common causes of thoracic trauma are motor vehicular accidents and bite wounds. Other possible, although less common mechanisms include gunshot, knife wounds or being kicked by a larger animal (horse/cow). Injuries may range from mild to life threatening.

Blood gas, electrolyte and lactate analysis are very useful in management of the ill or injured dog or cat. Knowledge of normal values and what they indicate can help improve patient care and understanding of the pathophysiological changes accompanying critical illness.

Definitive diagnosis of pulmonary disease remains elusive at times. Cytological or histopathological samples are useful to help better classify the underlying cause as well as determine both prognosis and treatment course. Thus, it is prudent for the criticalist to have a strong grasp of the various techniques and options available for sampling.

Feline upper respiratory infection (URI) is a disease complex born in large parts from stress and crowding. I would dare say that URI is perhaps the most frustrating illness facing shelter veterinarians, managers and staff in that many cats are chronically infected, vaccines are partially effective at best, and specific treatments are limited.

It is common to use the terms "kennel cough" or"infectious tracheobronchitis" when talking about canine infectious respiratory disease complex (CIRDC), this is in many cases not approproiate. The disease complex is not limited to the trachea,and often presents with signs other than coughing. In ma

Pulmonary vascular disease or pulmonary vascular obstructive disease (PVOD). is a catch-all term for conditions that affect the pulmonary circulation. These conditions are of particular importance to as they may result in severe respiratory dysfunction. As a review, the pulmonary and systemic circulation are in series, with the cardiac output of the left and right heart (in the absence of cardiac shunt) being equal.

The pleural space is defined as the area between the lungs and the chest wall. Normally there is no soft tissue or free air present in this space. A very small amount of fluid (undetectable on radiographs or ultrasound) may be present within the thoracic cavity. Clinical signs of pleural space disease include tachypnea or difficulty breathing.

Pulmonary edema is defined as the accumulation of abnormal amount of extravascular lung water. Pulmonary edema may range from clinically insignificant to life-threatening. Pulmonary edema forms when there is an alternation in the balance of Starling forces (hydrostatic and colloid osmotic) between the interstitium and pulmonary capillary beds that favors increasing filtration to the interstitium. Increased capillary hydrostatic forces will result in a low protein edema fluid while lowered colloid osmotic forces will promote a high protein edema fluid.

Cough is a common presenting complaint for dogs and, to a lesser extent, cats. Cough is a sign of an underlying disorder, not a primary disease. Therefore, the cause of the cough should be identified and the underlying disease, not just the cough, should be treated.

Treating animals with respiratory distress may be very challenging. It is essential for the practitioner to have a strong knowledge base of available therapeutic and diagnostic techniques. It is also prudent to be prepared for any potential complications that may develop during diagnostic or therapeutic interventions.

Lower respiratory tract disease produces typical clinical signs in cats, including chronic cough and wheeze as well as dyspnea that may have a sudden onset.1 Owners may report an increase in respiratory rate (>30-40 breaths per minute), increased expiratory effort and lethargy. Clinical signs may be mild to severe and may be chronic or intermittent.

Mycoplasma species have been isolated in our laboratory from cats with URTD (Veir et al 2004) and have been detected at a higher rate in cats with URTD than normal cats by other authors (Bannasch and Foley 2005). However, they are readily detected in the oropharynx and nasal cavity of normal cats as well (Randolph et al 1993, Tan et al 1977).

Consequences of chronic kidney disease are many and managing them is the hallmark of improving patient quality and quantity of life. Aside from continuous renal replacement therapy and renal transplants, management of azotemia, acid-base disorders, electrolytes, secondary hyperparathyroidism, nutrition, and hypertension are key.

Eosinophilic bronchopneumopathy is thought to be a pulmonary hypersensitivity disorder that may be triggered by certain drugs, inhaled environmental allergens, or a parasitic, fungal, or bacterial respiratory tract infection.

Canine eosinophilic bronchopneumopathy (EBP) is an important differential diagnosis for cough and dyspnea that practitioners frequently overlook because it is relatively uncommon.

Inhalant delivery of Aerosolized medication offers a number of theoretical benefits including an enormous absorptive surface area across a permeable membrane, a low enzyme environment that results in little drug degradation, avoidance of hepatic first-pass metabolism, and reproducible absorption kinetics.

Delivery of adequate oxygen to tissues and cells is the overall goal of the cardiovascular system. Oxygenation is dependant on cardiac output (heart rate and stroke volume), arterial blood pressure, circulating blood volume, and pulmonary function. Critically ill patients often have impairments to one or several of these processes resulting in hypoxemia, ischemia and cell death. Restoring these functions to normal insures oxygenation.

Feline asthma is one of the most common bronchopulmonary diseases in cats and is responsible for substantial morbidity and occasional mortality. It is an IgE mediated hypersensitivity response against what otherwise would be harmless environmental Aeroallergens.

Pleural effusion is a relatively common cause of respiratory distress in the dog and cat. Both species are affected by several types of effusion, with numerous causes and variable prognosis.