respiratory disease

• 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

• passive
• spring action of the chest wall pushes air out
• relaxes
• lower airway disease

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

at the level of the alveolus

snoring noises

bluish  gums

1st signs of respiratory disease

• 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

• 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

• 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

• series of loud forced inspirations
• head forward and neck extended
• patient normal before and after
• cheek puff out

only needed to rule out more severe possibilities in extreme cases

• 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

• looks at lot worse than it is
• rarely a problem

• dogs- English bull dog most severe, Lhasa apso, peke, shar pei, shih Tzu, boxer, pug
• cats-Persian, Himalayan

• 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

• 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

• Dx, TX, CE
• syndrome dependent

• 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?

• soft palate interferes with epiglottis
• inflammation over time worsens signs
• upper airway

• stertor-snore sound
• intermittent gagging and choking
• coughing after eating and drinking
• dysphagia (fluid in the lungs)-difficulty swallowing
• increase resp. noise

• exam under sedation to look in there
• sometimes trouble waking up

• surgical shortening of the soft palate
• laser does great here-usually goes well, usually no issues

• post op-food, meds
• usually very pleasing outcome

• congenital lack of tracheal development
• under developed tracheal
• smaller than usual

• none
• possibly cough and increased noise
• exercise intolerance
• respiratory distress
• progression of symptoms
• trouble breathing
• cant keep up with oxygen needs

• 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

• 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

• bouvier des flanders, huskies, huskie mix
• symptomatic by 4-8 months old
• 3:1 male predilection

• giant (SB, Newfs), large breeds (IS, GR, Labs)
• mean presentation is 9-12 years old
• slight male predisposition

• hypothyroidism
• vagal nerve disease
• cervical trauma
• recurrent laryngeal nerve disease
• cranial thoracic disease
• peripheral neuropathy
• generalized myopathy
• immune mediated disease
• tumor

• 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

• 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

• exam under sedation-glottis doesn't open on inspiration, often bilateral
• additional tests for complications-Rads, CBC, TTW, C/S, U/S

• 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

• good surgical Px
• avoid exercise in humidity and heat

• 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  

• 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

• 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  

• 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