Feline Upper Respiratory Tract Disorders PDF

AHT 1210 Module F Module F1 Upper Respiratory Tract Disorders Feline Upper Respiratory Disease Complex 1. Feline herpes virus - FHV 2. Feline calicivirus - FCV 3. Chlamydophila felis 4. Bordetella bronchiseptica Epidemiology...

AHT 1210 Module F Module F1 Upper Respiratory Tract Disorders Feline Upper Respiratory Disease Complex 1. Feline herpes virus - FHV 2. Feline calicivirus - FCV 3. Chlamydophila felis 4. Bordetella bronchiseptica Epidemiology Pathogenesis FHV and FCV Higher prevalence in multi cat households FHV Infection can occur via nasal, oral or conjunctiva Shed in ocular, nasal and oral secretions Virus replicates in NASAL turbinates, Spread by direct contact between cats nasopharynx and tonsils Infection can spread from infected animals or from Can cause necrosis of nasal turbinates with chronic carrier chronic rhinitis Infection can be indirect and by fomites (hands, Asymptomatic carriers food/water dishes, kennels) FCV Routes of infection are nasal, oral and FHV Carriers Shedding in carriers often occurs after stress conjunctiva A lag time for shedding exists at which the cat can Virus replicates in ORAL and RESP tissues shed from 1-2 weeks On rare occasions can progress to viral Carrier state is life long pneumonia Carriers FCV carriers Shed virus continuously - FCV carriers will always infect other cats Chlamydophila OCULAR discharge, fever and sneezing Carrier state can be lifelong but many cats will felis Inflammation of conjunctiva or nictitating spontaneously recover and eliminate the virus membrane Chronic carriers Chlamydophila felis Seen in young cats (unlikely for cats 5+ to be infected) Transmission from queen during parturition Bordetella Infection via ORONASAL cavity Transmission from direct contact and from aerosol bronchiseptica Pathogenesis in cats not well understood contact Can develop into bronchopneumonia Bordetella Transmission can occur between cats and dogs bronchiseptica Can have carrier states Can occasionally be zoonotic to humans Clinical Signs and Diagnosis - Incubation period 2-8 days - Can be fatal in young kittens - Acute disease can lsat 21 days Four distinct forms: 1. Acute Disease - Mild to severe upper resp signs - Fever - Anorexia - Coughing (rare), sneezing - Serous to mucopurulent nasal discharge - Ulceration of tongue and upper palate - Salivation - Conjunctivitis - Can result in dehydration, malnutrition and death - Malnutrition is secondary to fever, loss of olfaction and oral lesions 2. Chronic Carriers - Asymptomatic - 80% of herpes recovered cats - Chronically infected but may appear asymptomatic for years - Stress (GA, trauma, steroids and pregnancy) can induce reactivation and onset of acute clinical signs 3. Chronic Snuffers (Rhinosinusitis) - Residual damage = low grade chronic rhinitis and sinusitis - Usually after severe infection with necrosis of turbinates - Can get secondary bacterial infection periodically - May require intermittent/chronic treatments, decongestants 4. Chronic Calici - Chronic periodontal disease - Persistent conjunctivitis and rhinitis Diagnosis - History and Clinical signs - Oral ulcers suggest FCV - Sneezing, severe resp signs and conjunctival signs suggest FHV - CBC/Chem/UA - May have mild to moderate increase in WBC - Imaging - Other tests - PCR - Virus isolation - Difficult and usually unnecessary to distinguish between agents - In acute disease using oropharyngeal mucosal swabs - Chlamydia - conjunctival scrapings may show intracytoplasmic inclusions - For carriers - rarely successful Treatment - Supportive - Keep eyes and nose clean - Maintain hydration - IV or SQ fluids - Maintain caloric intake - Soft, smelly foods - High caloric density - Broad spectrum antibiotics - Nasal decongestants - Eyes - tetracycline ointment - Alpha interferon oral for FCV and FHV = SQ for severe infections - Alpha interferon with saline as a topical treatment for conjunctivitis - Topical cidofovir BID for FHV conjunctivitis Prevention - Maternal antibodies - Vaccines - FVRCP - does not include chlamydia vaccine would be FVRCPC - MLV - FVR and Calici require boosters to get seroconversion, chlamydophila requires only one vaccine Module F2 Lower Respiratory Tract Disorders Disorder Cause Epidemiology/Patho Clinical Signs Diagnosis Treatment genesis Feline Hypersensitivity Any age, breed or sex Normal between “attacks” History and C/S Mild - steroids or Asthma (allergic) reaction depo-medrol, to inhaled 1-3 years is common May be seasonal CBC - eosinophilia bronchodilators allergens Irritants cause Coughing, wheezing and gagging Chem and UA Severe - emergency, narrowing of the don not stress, 100% airway and a Tachypnea and wheezing Imaging - thoracic O2, epinephrine, subsequent expiratory radiographs - overinflated bronchodilators, dysfunction Handling and exercise may lungs steroids induce attack Transtracheal wash and Long term management Attacks vary in severity: dyspnea, bronchial lavage - - owner education, barrel chest, sits in sternal with eosinophils inhalation therapy, elbow abducted, cyanotic bronchodilators given 5 min prior to other Can progress to gasping for each inhalants, steroids breath, frantic, hypoxic, hypercapnia, death Canine Multiple agents Canine parainfluenza Develop 3-4 days after infection History and C/S Uncomplicated cases Infectious both bacterial and virus and bordetella are self limiting Respiratory viral bronchiseptica, canine Usually last 10-14 days and can CBC - stress leukogram, Disease herpes, distemper take 6-14 weeks to clear bacteria non diagnostic Antimicrobials Complex Kennel cough virus, mycoplasma completely (CIRDC) and streptococcus Imaging - Antitussives - Uncomplicated: most common, bronchopneumonia with hydrocodone, Spread through dry hacking cough followed by complicated infections butorphanol aerosol exposure but retching, often bright and alert, also direct and indirect serous nasal/ocular discharge, Nasal swabs - culture and Supportive care contact mild fever, resolves in 10-14 sensitivity days, cough can be production, Nebulization Viral components most are self limiting TTW replicate in upper resp Vaccinate epithelial cells Complicated: due to secondary Bronchial lavage allowing colonization bacterial infection, mucoid by Bordetella nasal/ocular discharge, cough, dyspnea, can develop into bronchopneumonia, febrile, lethargic and anorexic Canine Genus Spread through Respiratory tract, GIT and History and CS Supportive care Distemper morbillivirus aerosol exposure - nervous system Virus (CDV) highly contagious CBC - absolute Maintain hydration and Closely related to Mild infection: can be subclinical, lymphopenia electrolyte imbalance human measles Virus can shed 60-90 listlessness, inappetance, fever, virus days after infection upper resp tract infection, Buffy coat smear to look for Nursing care bilateral serous oculonasal distemper inclusions in Most common in discharge , coughing, dyspnea, lymphocytes, monocytes Treat secondary unvaccinated puppies most dogs will recover if treated and neutrophils infections - antibiotics Severe (systemic) infection: Imaging - thoracic Treatment for CNS fever, serous to mucopurulent radiographs disease: anticonvulsant conjunctivitis, moist, productive therapy and steroid cough, anorexia, vomiting and Immunofluorescence therapy diarrhea, dehydration, smears hyperkeratosis of nose and foot Antiemetics pads (hard pad), animals may die Ophthalmologic exam - without treatment ocular involvement Nebulization Neurologic: irreversible, begin 1-3 Serum antibody test Vaccination - prevention weeks after recovery from systemic infection, hyperesthesia Virus isolation and cervical rigidity, cerebellar, vestibular signs, seizures, chewing gum fits, involuntary twitching, blindness, KCS Infectious Canine Spread by direct Severe: moribund within horse History and CS Supportive therapy - iv Canine adenovirus -1 contact and fomites fluids Hepatitis (CAV-1) Vomiting, abdominal pain and CBC/Chem/UA: leukopenia, (ICH) Not aerosol distension lymphopenia, neutropenia, Treat clotting Affects dogs thrombocytopenia, elevated dysfunction Dogs less than one Petechiae, ecchymosis, fever, liver enzymes, year old and diarrhea, tonsillar enlargement, hypoglycemia, bilirubinemia, Treat hypoglycemia unvaccinated coughing proteinuria CNS - depression, disorientation, Imaging - radiographs and Vaccination - prevention seizures US - hepatomegaly, ascites Ocular signs “blue eye” - corneal Bile acid tests and Viral edema, anterior uveitis, ocular isolation pain, squinting, discharge Serologic testing Module F3 Selected Surgical Thoracic Procedures in Dogs and Cats Thoracic Procedures - Anesthetic risk may increase due to underlying pulmonary or cardiac disease - Pneumothorax - provide PPV during the procedure - Re-expand lungs prior to the thorax being close - Remove free air from the thorax - thoracocentesis - Possible chest tube placement - Cysts, diaphragmatic hernia repair, foreign bodies tumors Surgical Approaches 1. Intercostal thoracotomy 2. Median sternotomy 3. Thoracoscopy Cardiovascular procedures 1. Pericardiocentesis 2. Patent ductus arteriosus Patient preparation and position 1. Clip - Dorsal recumbency - clip from the umbilicus to maxilla and half way up the rib and mid humerus - Sternal recumbency - clip from C2 to T13 and to the middle of the ribs laterally and mid humerus on the lateral portion of the forearm 2. VAcuum 3. Scrub as per scrub protocols 4. V trough Complications - Poor ventilation - Low O2 - Hypothermia  - Electrolyte imbalances - Low BP - Infection - Slow respiration - Hemorrhage After Care - Position animal for optimal breathing - sternal recumbency - Supplemental oxygen - Periodic repositioning - Warm animal up slowly - Frequent BP and blood gas testing - Monitor urination amounts and frequency Module F4 Infectious Disorders of Respiratory Tract of Ruminants Disorder Cause Etiology Clinical Signs Diagnosis Treatment Prevention Bovine Infectious Viruses: Parainfluenza, Young calves, Dairy Clinical signs Individual animal: Make sure calves Respiratory microorganisms bovine respiratory syncytial cattle housed indoors, antibiotics, sick receive colostrum DIsease (BRD) virus, bovine herpes virus, feedlot aged calves Swabs for C & S pens, careful for Lowered host bovine viral diarrhea virus due to stressors, withdrawal times Vaccinate when immune status uncommon in mature Necropsy young Environmental stressors: cattle Mass meds: Favorable poor air quality, dusty PCR (viruses) parenteral Vaccinate cows environmental barns, weather conditions Rapid shallow antibiotics with respiratory conditions breathing, dyspnea, antigens Other stressors: cough, depression, Inflammation endogenous cortisol and fever, off feed, Try to wean ands within terminal reduced immune response, hyperemic MM and hip beef calves bronchioles and long periods without feed injected scleral vessels when the weather alveoli and water, poor hygiene, is good commingling with new Histophilus cattle Dehord and somni castrate calves early Manheimia  hemolytica Good barn ventilation Pasteruella multocida Ovine Viral disease Long incubation period Progressive AGID/ELISA No treatment Working to Progressive (months to years) more pneumonia eradicate Pneumonia Retrovirus commonly in mature Serological testing (OPP) animals Gradual weight loss Cull positive Infects a sheep PCR sheep for life Aerosol transmission, cross Udder changes contamination from infected No vaccine equipment, vertical Lambda nursing these transmission and colostrum udders may starve Verminous Dictyocaulus Nematodes, affects calves Usually seen in the fall Fecal analysis Deworming Fall deworming pneumonia viviparous but can affect adults using Baermann products (Lungworm) Dyspnea Technique Harrow pastures Larva are Direct lifecylce Ivermectin, to expose the ingested on Persistent coughing Necropsy doramectin larvae to sunlight summer pasture and nasal discharge Pasture Worms are found management in terminal (avoid airways overcrowding) Nasal Blot Oestrus ovis fly Irritates the mucosal lining Sheep will sneeze and Based on clinical Parasiticide in No prevention (nasal myiasis) and may cause purulent have purulent signs early fall when Female deposits discharge discharge and mature larva are small larva directly in larva will be sneezed or near sheeps out Killing larva in nostrils and the winter when they larva migrate up are bigger can the nostrils into cause severe the front sinuses inflammation in the sinuses Vaccinations for BRD: - Can be given to young suckling calves going out onto summer pastures - Can be given to dairy cattle - Give around weaning time to beef calves about to start the feeding period  1. Infectious bovine rhinotracheitis and parainfluenza 2 - May be killed or MLV - check if MLV is safe for pregnant animals 2. Histophilus somni - Killed or subunit - Sold alone or in combinations 3. BRSV - Killed or subunit - Sold alone or in combination 4. Bovine diarrhea virus - BVD virus type 1 and type 2 - Killed or MLV 5. Pasteruella multocida - subunit/toxoid - Available in combination 6. Manheeimia haemolytica - Subunit or toxoid - Sold alone or in combination Module F5 Non infectious Disorders of the Respiratory Tracts of Ruminants Disorder Cause Etiology Clinical Signs Diagnosis Treatment Prevention Pulmonary Cardiogenic causes: Severe dyspnea Clinical signs Cardiogenic: treat Edema valvular disease and underlying problem myocardial disease Soft, moist cough Non cardiogenic: Non cardiogenic causes: remove underlying Inhalation of smoke, fog cause, supportive fever, anaphylactic therapy, epinephrine, reactions, secondary to steroid,s antibiotics, severe bloat, blockage of careful handling and upper resp, electrocution moving Pulmonary Not common in cattle Potential for embolic Profuse bleeding Clinical signs Hemorrhage pneumonia to cause an Grain overload → liver erosion of a pulmonary  abscess → fragment vessel breaks off and travels to heart or lungs Aspiration Inhalation pneumonia Usually caused by Lethargic Necropsy Antibiotics Vigilant when Pneumonia careless drenching or treating with Accidental aspiration of stomach tubing coughing Observe Supportive therapy esophageal foreign material into the regurgitates tubing lungs May occur when when stomach animal is recumbent tubing/bottle feeding Secondary to regurgitation during severe bloat or choke Module F6 Infectious Disorders of the Respiratory Tract of Horses Viral agents causing equine upper respiratory disease Disease Etiology Clinical Signs Diagnosis Treatment Prevention Equine Influenza Very common, highly Short incubation (1-3 Clinical signs Isolate Isolate new horses for contagious days) 2 weeks Viral isolation Rest animal High morbidity especially in High fever, dry hacking Practice good hygiene younger horses and large cough Antigen detection NSAIDs to control high animal groups (race tracks, fever Vaccinate: killed IM horse shoes, rodeos) Off feed, depression, Paired serum samples vaccine, MLV weakness Antibiotics intranasal, high risk Influenza type A - RNA Directigen Flu A assay - animals should have a virus Clear nasal discharge rapid test booster every 6 initially which can become months Spread easily via aerosol thick and yellowish Ensure vaccination Can travel 20-30 m from Enlarged submandibular program is completed cough LN two weeks prior to introducing new Not hardy in the Recovery period is 2 animal to her environment (may survive weeks to 6 months up to 48 hrs) Equine Herpes virus Respiratory form: Serological tests looking Rest Killed vaccine Rhinopneumonitis Common in weanlings for antibodies (Equine herpes Young horses more and yearlings, incubation May need softened, Appropriately timed virus) susceptible 2-10 days, fever, watery Viral isolation from feed protocol nasal discharge, nasopharyngeal swabs or 4 Types: 2 and 3 Lives in the horses coughing, depression, off buffy coat of blood A killed parapox ovis not considered lymphocytes, upper resp feed, submandibular LN virus important in tract LN or trigeminal enlarged, may cause PCR immunomodulator Canada at this ganglia pneumonia in foals time (weakness, jaundice, resp Supportive therapy Latent virus persists for life distress) Type 1: abortion or NSAIDs or steroids neonatal death, Aerosol, mare in late Neurological form: neurological gestation will infect foal in peracute onset of paresis Iv fluids disease and utero, contact with aborted and ataxia of the trunk respiratory fetuses or placental fluid, and limbs, dog sitting or Urinary catheter disease fomites recumbent, urinary incontinence and bladder Can take weeks to Type 2: respiratory distention months for neurologic disease signs to subside Equine Viral Mimic equine influenza but Incubation 2-15 days Hematology: lymphopenia Rest One MLV vaccine Arteritis (EVA) more severe and hypoproteinemia Causes abortion, limb Respiratory signs Antibiotics Vaccinate at least 3 edema or conjunctivitis Paired serum samples weeks before Vasculitis Stable bandages for breeding season Aerosol or venereal route Viral isolation limb edema Edema in limbs, scrotum, Do not breed the Invades small arteries prepuce or udder Most horses seem to “shedder” stallions to throughout the body recover and do not non infected mares causing increased Abortion continue to shed the permeability of the virus vasculature leading to edema, hemorrhage and necrosis Stallion shed virus in semen for long periods of time Bacterial agents Causing Equine Respiratory Disease Disease Etiology Clinical Signs Diagnosis Treatment Prevention Strangles Highly contagious, Incubation period 2-20 Clinical signs Supportive care Isolate infection bacterial infection days animals for 1-2 months Can culture purulent NSAIDs Streptococcus equi equi Febrile, off feed, thick discharge Isolate newly acquired and yellow nasal Antibiotics horses for 1 month Transmission between discharge animals from nasal Hot packing and MLV intranasal give 2 discharge or pus, Difficulty swallowing poulticing may hasten doses 1 to 2 weeks fomites abscess to rupture apart followed by Lymph nodes are hot annual dose Bacteria can live in the and painful environment for up to two months Enlarged enough to possibly rupture with Initially bacteria invades pus the nasal passage and pharynx and settles in Inflammation of the the LN guttural pouch may lead to empyema Rhodococcus equi in Soil borne bacterium Fevers, variable cough, Clinical signs Supportive care No vaccine foals nasal discharge, weight Acute phase causes loss, depression, colic Antibiotics - Commercial plasma pneumonia and chronic or loose watery manure erythromycin and product with high IgG can develop lung rifampin levels abscesses Colic and diarrhea Affects slightly older foals (2-6 mths) Overcrowding and dry, dusty environments Possible Consequences of Strangles infections Bastard Strangles - Streptococcus equi equi bacteria disseminated to other areas of the body - Abscesses have been reported in the thorax, abdomen, brain and joints - Aggressive antibiotic therapy is needed to treat Purpura - Uncommon Hemorrhagica - Type 3 hypersensitivity reaction in which antigen-antibody complexes to streptococcus equi equi lodge in small blood vessels and incite an inflammatory response which damages the vessel wall - Clinical signs: uticaria, swelling of the limbs, head, neck and petechial hemorrhage of MM - Typically penicillin and steroids or NSAIDs are given Guttural Pouch - Pathogens can migrate from the pharynx into the guttural pouch, causing chronic infection Involvement - Clinical signs: persistent nasal discharge, coughing, dyspnea and dysphagia - Diagnosed via endoscopic exam - Pus can form a pebble like mass called a chondroid - horse may actively shed bacteria - Parenteral antibiotics - Local lavage of the pouches with sterile saline and antibiotics - Surgical drainage for difficult cases Module F7 Non Infectious Disorders of the Respiratory Tracts of Horses Disease Etiology Clinical Signs Diagnosis Treatment Prevention Equine Pulmonary Performance horses following Some blood from nostrils Clinical signs Rest Potential Hemorrhage high intensity exercise furosemide before Blood in Endoscopy Blood will absorb races When the heart is beating tracheobronchial trees over time maximally during exercise, the Bronchial alveolar lavage heart cannot pump out enough Reduced performance blood and it builds up and leaks into the alveoli Increased swallowing Migrates upward to the bronchi and can travel up and trickle out the nostrils Equine Pulmonary Common, seen primarily in Chronic and progressive Clinical signs Move horse to dust House horses in Emphysema mature horses free, clean clean environments Subtle hyperpnea at rest Broncho Tracheal lavage environment with clean bedding Housed indoors: bedded with and progress to: and feed dusty straw, fed dusty hay, poor Severe dyspnea, asthma Endoscopy Feed best quality hay ventilation like episodes, coughing, Feed at ground wheezing, presence of a Use shavings rather level House outdoors: eating dusty heave line along ventral than straw hay out of round bale feeder, abdomen, nasal Wet down the feed housed along dusty roads discharge Bronchodilators and corticosteroids Good ventilation if indoors Good hygiene Vaccinate horses