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Management of respiratory disorders
/content/chapter/10.22233/9781910443149.chap10
Management of respiratory disorders
- Author: Angie Hibbert
- From: BSAVA Manual of Feline Practice
- Item: Chapter 10, pp 350 - 361
- DOI: 10.22233/9781910443149.10
- Copyright: © 2013 British Small Animal Veterinary Association
- Publication Date: January 2013
Abstract
This chapter will focus on the management of the most important respiratory disorders encountered in feline practice, considered in order of anatomical regions of the respiratory tract: upper respiratory tract disorders, lower respiratory tract disorders and pleural space disorders. Quick reference guide: Inhalant asthma treatment.
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Figures
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10.1
MRI (T1 scan dorsal plane) of a cat’s skull, showing a nasal mass in the right nasal chamber (arrowed). The mass appears predominately hyperintense compared to the remainder of the tissue within the nasal chambers. © 2013 British Small Animal Veterinary Association
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10.1
MRI (T1 scan dorsal plane) of a cat’s skull, showing a nasal mass in the right nasal chamber (arrowed). The mass appears predominately hyperintense compared to the remainder of the tissue within the nasal chambers.
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10.2
(a) A lateral skull radiograph showing a soft tissue opacity within the nasopharynx of a young DSH cat. The mass (arrowed) is seen dorsal to the soft palate. The mass was removed via traction and sectioning through the ‘stalk’-like attachment and histopathology confirmed it to be a nasopharyngeal polyp. (b) Gross appearance of a nasopharyngeal polyp removed via traction from a young cat presented with stertor and sneezing. © 2013 British Small Animal Veterinary Association
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10.2
(a) A lateral skull radiograph showing a soft tissue opacity within the nasopharynx of a young DSH cat. The mass (arrowed) is seen dorsal to the soft palate. The mass was removed via traction and sectioning through the ‘stalk’-like attachment and histopathology confirmed it to be a nasopharyngeal polyp. (b) Gross appearance of a nasopharyngeal polyp removed via traction from a young cat presented with stertor and sneezing.
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10.3
Cytology of a BAL sample demonstrating eosinophilic inflammation in a cat diagnosed with feline asthma. Eosinophils (E) are characterized by their red cytoplasmic granules; alveolar macrophages (AM) and neutrophils (N) are also present. Feline asthma is characterized by an increased percentage of eosinophils within the airways (>25% of the total cell count), as seen here. Modified Wright’s stain; original magnifications: (a) X500, (b) X1000. (Courtesy of Kathleen Tennant) © 2013 British Small Animal Veterinary Association
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10.3
Cytology of a BAL sample demonstrating eosinophilic inflammation in a cat diagnosed with feline asthma. Eosinophils (E) are characterized by their red cytoplasmic granules; alveolar macrophages (AM) and neutrophils (N) are also present. Feline asthma is characterized by an increased percentage of eosinophils within the airways (>25% of the total cell count), as seen here. Modified Wright’s stain; original magnifications: (a) X500, (b) X1000. (Courtesy of Kathleen Tennant)
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10.4
Lateral thoracic radiograph of a cat diagnosed with feline asthma. In this case there is a diffuse bronchial pulmonary pattern, which appears as bronchointerstitial in the cranial lobes. Note the proximal rib fracture lesions (T10–12) and barrel shape of the thorax, which are consistent with pulmonary hyperinflation. Other signs of hyperinflation to look for but not shown here include flattening of the diaphragm and extension of the tips of the caudodorsal lung fields to the 12–13th thoracic vertebrae during expiration (i.e. assessed on a non-inflated view). © 2013 British Small Animal Veterinary Association
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10.4
Lateral thoracic radiograph of a cat diagnosed with feline asthma. In this case there is a diffuse bronchial pulmonary pattern, which appears as bronchointerstitial in the cranial lobes. Note the proximal rib fracture lesions (T10–12) and barrel shape of the thorax, which are consistent with pulmonary hyperinflation. Other signs of hyperinflation to look for but not shown here include flattening of the diaphragm and extension of the tips of the caudodorsal lung fields to the 12–13th thoracic vertebrae during expiration (i.e. assessed on a non-inflated view).
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10.5
(a) Dorsoventral thoracic radiograph of a cat diagnosed with aspiration pneumonia secondary to vomiting and inhalation of gastric material. There is a marked alveolar pulmonary pattern in the right middle and caudal lung lobes; the other lobes appear to have a bronchointerstitial pattern on this view. The classic pulmonary change following aspiration is a cranioventral interstitial/alveolar pattern, with the right middle lung lobe frequently involved; however, radiographic changes may lag behind aspiration and development of clinical signs. (b) In this left lateral thoracic radiograph of the same cat air bronchograms are now evident in the right cranial and caudal lung lobes (highlighted by the arrows), showing an area of lung with a focal alveolar pattern. © 2013 British Small Animal Veterinary Association
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10.5
(a) Dorsoventral thoracic radiograph of a cat diagnosed with aspiration pneumonia secondary to vomiting and inhalation of gastric material. There is a marked alveolar pulmonary pattern in the right middle and caudal lung lobes; the other lobes appear to have a bronchointerstitial pattern on this view. The classic pulmonary change following aspiration is a cranioventral interstitial/alveolar pattern, with the right middle lung lobe frequently involved; however, radiographic changes may lag behind aspiration and development of clinical signs. (b) In this left lateral thoracic radiograph of the same cat air bronchograms are now evident in the right cranial and caudal lung lobes (highlighted by the arrows), showing an area of lung with a focal alveolar pattern.
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10.7
(a) Right lateral thoracic radiograph of a cat diagnosed with pyothorax, following a bite injury across the thoracic wall. A soft tissue opacity is present in the cranioventral thorax due to the presence of fluid and inspissated exudate. An indwelling small-bore thoracostomy tube is in place; a single drain was adequate to evacuate pleural fluid from both sides of the thorax in this case, indicating that the mediastinum was no longer intact. (b) Dorsoventral thoracic radiograph following five days of antibiosis, thoracic lavage and drainage. There is significantly increased inflation of the cranial lung lobes, with residual opacity in the region of the right middle lung lobe. The thoracostomy drain was removed 7 days later, when the effusion volume had reduced to <2 ml/kg/day and there were reduced numbers of degenerate neutrophils and no intracellular bacteria present. © 2013 British Small Animal Veterinary Association
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10.7
(a) Right lateral thoracic radiograph of a cat diagnosed with pyothorax, following a bite injury across the thoracic wall. A soft tissue opacity is present in the cranioventral thorax due to the presence of fluid and inspissated exudate. An indwelling small-bore thoracostomy tube is in place; a single drain was adequate to evacuate pleural fluid from both sides of the thorax in this case, indicating that the mediastinum was no longer intact. (b) Dorsoventral thoracic radiograph following five days of antibiosis, thoracic lavage and drainage. There is significantly increased inflation of the cranial lung lobes, with residual opacity in the region of the right middle lung lobe. The thoracostomy drain was removed 7 days later, when the effusion volume had reduced to <2 ml/kg/day and there were reduced numbers of degenerate neutrophils and no intracellular bacteria present.
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10.8
A cat with pyothorax undergoing thoracic lavage via a unilateral thoracostomy tube. Drainage was performed every 4 hours for 5 days, until the volume of effusion reduced, and lavage was performed twice daily. Further details on performing lavage are given in the text. Black arrow: Lavage solution – 10–20% ml/kg of warmed 0.9% sterile saline instilled over 5–10 minutes. White arrow: Indwelling drain – Mila 14 G. © 2013 British Small Animal Veterinary Association
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10.8
A cat with pyothorax undergoing thoracic lavage via a unilateral thoracostomy tube. Drainage was performed every 4 hours for 5 days, until the volume of effusion reduced, and lavage was performed twice daily. Further details on performing lavage are given in the text. Black arrow: Lavage solution – 10–20% ml/kg of warmed 0.9% sterile saline instilled over 5–10 minutes. White arrow: Indwelling drain – Mila 14 G.
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10.9
A cat with a chylothorax undergoing thoracocentesis. The aspirated fluid has a typical opalescent appearance. The chylothorax had developed secondary to congestive heart failure associated with severe thyrotoxicosis. Note the facemask providing supplemental oxygen and also the minimal restraint. © 2013 British Small Animal Veterinary Association
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10.9
A cat with a chylothorax undergoing thoracocentesis. The aspirated fluid has a typical opalescent appearance. The chylothorax had developed secondary to congestive heart failure associated with severe thyrotoxicosis. Note the facemask providing supplemental oxygen and also the minimal restraint.
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The Aerokat spacer (www.breatheazy.co.uk) comes with two different sizes of facemask to accommodate various sizes of patient.
The Aerokat spacer (www.breatheazy.co.uk) comes with two different sizes of facemask to accommodate various sizes of patient. © 2013 British Small Animal Veterinary Association
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The Aerokat spacer (www.breatheazy.co.uk) comes with two different sizes of facemask to accommodate various sizes of patient.
The Aerokat spacer (www.breatheazy.co.uk) comes with two different sizes of facemask to accommodate various sizes of patient.
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A veterinary nurse administering inhalant treatment via an Aerokat spacer. The ‘Flow-Vu’ valve allows the cat’s breaths to be counted whilst the spacer is applied to the face.
A veterinary nurse administering inhalant treatment via an Aerokat spacer. The ‘Flow-Vu’ valve allows the cat’s breaths to be counted whilst the spacer is applied to the face. © 2013 British Small Animal Veterinary Association
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A veterinary nurse administering inhalant treatment via an Aerokat spacer. The ‘Flow-Vu’ valve allows the cat’s breaths to be counted whilst the spacer is applied to the face.
A veterinary nurse administering inhalant treatment via an Aerokat spacer. The ‘Flow-Vu’ valve allows the cat’s breaths to be counted whilst the spacer is applied to the face.