1
|
Lin CH, Johnson LR, Chang WT, Lo PY, Chen HW, Wu HD. Quantifiable features of a tidal breathing phenotype in dogs with severe bronchomalacia diagnosed by bronchoscopy. Vet Q 2023; 43:1-10. [PMID: 37616027 PMCID: PMC10478619 DOI: 10.1080/01652176.2023.2252518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023] Open
Abstract
Dynamic lower airway obstruction is the primary component of canine bronchomalacia, but the ventilatory function remains underinvestigated. This prospective study analyzed tidal breathing characteristics in 28 dogs, comprising 14 with severe bronchomalacia diagnosed by bronchoscopy versus 14 without respiratory disease. Spirometry was conducted in all dogs. Bronchoscopy with bronchoalveolar lavage or brush under anesthesia was performed in 14 dogs with cough and expiratory effort. Severe bronchomalacia was defined by the severity of collapse and total number of bronchi affected. Ventilatory characteristics were compared between groups. Results revealed that dogs with severe bronchomalacia had lower minute volume (218 vs 338 mL/kg, p = .039) and greater expiratory-to-inspiratory time ratio (1.55 vs 1.35, p = .01) compared to control dogs. The tidal breathing pattern of dogs with bronchomalacia was different from that of normal dogs, and the pattern differed from the concave or flat expiratory curves typical of lower airway obstruction. Compared to control dogs, dogs with severe bronchomalacia had a significantly prolonged low-flow expiratory phase (p < .001) on the flow-time plot and a more exponential shape of the expiratory curve (p < .001) on the volume-time plot. Flow-time index ExpLF/Te (>0.14) and volume-time index Vt-AUCexp (≤31%) had a high ROC-AUC (1.00, 95% confidence interval 0.88 to 1.00) in predicting severe bronchomalacia. In conclusion, the tidal breathing pattern identified here indicates abnormal and complicated ventilatory mechanics in dogs with severe bronchomalacia. The role of this pulmonary functional phenotype should be investigated for disease progression and therapeutic monitoring in canine bronchomalacia.
Collapse
Affiliation(s)
- Chung-Hui Lin
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Lynelle R. Johnson
- Department of Medicine and Epidemiology, The University of California School of Veterinary Medicine, Davis, CA, USA
| | - Wei-Tao Chang
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Pei-Ying Lo
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Hui-Wen Chen
- Department of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Huey-Dong Wu
- Section of Respiratory Therapy, Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
2
|
Gareis H, Hörner‐Schmid L, Zablotski Y, Palić J, Hecht S, Schulz B. Correlation of clinical and radiographic variables in cats with lower airway disease. J Vet Intern Med 2023; 37:2443-2452. [PMID: 37728391 PMCID: PMC10658588 DOI: 10.1111/jvim.16874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Feline lower airway disease (FLAD) is frequently associated with radiographic abnormalities. OBJECTIVES To evaluate whether radiographic changes in cats with naturally occurring FLAD improve with treatment and if radiographic changes correlate with clinical signs. ANIMALS Twenty-four client-owned cats newly diagnosed with FLAD, based on medical history, typical clinical signs, radiographic findings, and examination of bronchoalveolar lavage fluid, were included in the prospective study. METHODS At 2 examination time points (days 0 and 60), an owner questionnaire, clinical examination, and thoracic radiography were carried out. Information from the questionnaire and clinical examination were evaluated on the basis of a 12-point clinical score. Radiographs were assessed using a 10-point radiographic score. Individual treatment was given to all cats over the study period, based on severity of the disease and compliance of the cat. Clinical and radiographic scores were compared statistically for both examination time points and evaluated for correlation. RESULTS All cats showed radiographic abnormalities at initial presentation. In addition to significant improvement in clinical variables, the total radiographic score improved significantly (P = .01) during the study period, with significant improvement in the severity of bronchial (P = .01) and interstitial lung pattern (P = .04). Improvement of the clinical and radiographic score was not correlated. CONCLUSION AND CLINICAL IMPORTANCE In addition to clinical signs, repeated radiographic examination can be used as a diagnostic tool to evaluate treatment response in cats with FLAD.
Collapse
Affiliation(s)
- Hannah Gareis
- Clinic of Small Animal MedicineLudwig Maximilian University of MunichMunichGermany
| | - Lina Hörner‐Schmid
- Clinic of Small Animal MedicineLudwig Maximilian University of MunichMunichGermany
| | - Yury Zablotski
- Clinic of Small Animal MedicineLudwig Maximilian University of MunichMunichGermany
| | - Jelena Palić
- Division of IDEXX LaboratoriesVet Med Labor GmbHKornwestheimGermany
| | - Silke Hecht
- College of Veterinary MedicineUniversity of TennesseeKnoxvilleTennesseeUSA
| | - Bianka Schulz
- Clinic of Small Animal MedicineLudwig Maximilian University of MunichMunichGermany
| |
Collapse
|
3
|
Hennessey E, DiFazio M, Hennessey R, Cassel N. Artificial intelligence in veterinary diagnostic imaging: A literature review. Vet Radiol Ultrasound 2022; 63 Suppl 1:851-870. [PMID: 36468206 DOI: 10.1111/vru.13163] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 12/09/2022] Open
Abstract
Artificial intelligence in veterinary medicine is an emerging field. Machine learning, a subfield of artificial intelligence, allows computer programs to analyze large imaging datasets and learn to perform tasks relevant to veterinary diagnostic imaging. This review summarizes the small, yet growing body of artificial intelligence literature in veterinary imaging, provides necessary background to understand these papers, and provides author commentary on the state of the field. To date, less than 40 peer-reviewed publications have utilized machine learning to perform imaging-associated tasks across multiple anatomic regions in veterinary clinical and biomedical research. Major challenges in this field include collection and cleaning of sufficient image data, selection of high-quality ground truth labels, formation of relationships between veterinary and machine learning professionals, and closure of the gap between academic uses of artificial intelligence and currently available commercial products. Further development of artificial intelligence has the potential to help meet the growing need for radiological services through applications in workflow, quality control, and image interpretation for both general practitioners and radiologists.
Collapse
Affiliation(s)
- Erin Hennessey
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA.,Army Medical Department, Student Detachment, San Antonio, Texas, USA
| | - Matthew DiFazio
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Ryan Hennessey
- Department of Computer Science, College of Engineering, Kansas State University, Manhattan, Kansas, USA
| | - Nicky Cassel
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| |
Collapse
|
4
|
Young V, Rao S, Shropshire SB, Marolf AJ. Association between feline hyperthyroidism and thoracic radiographic evaluation of cardiomegaly and pulmonary hyperinflation. J Feline Med Surg 2022; 24:e394-e400. [PMID: 36043487 PMCID: PMC10812301 DOI: 10.1177/1098612x221118190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Hyperthyroidism frequently affects middle-to-older-aged cats that can present with cardiorespiratory signs. The effects of hyperthyroidism on cardiac size and function have been previously documented. Anecdotally, pulmonary hyperinflation identified on thoracic radiographs may also be associated with hyperthyroidism; however, there is no literature to support this claim. The goal of this study was to determine any association between hyperthyroidism, pulmonary hyperinflation and cardiomegaly with the following hypotheses: (1) hyperthyroid cats would not have evidence of radiographic pulmonary hyperinflation compared with control cats; and (2) hyperthyroid cats were more likely to have evidence of radiographic cardiomegaly than control cats. METHODS In this retrospective case-control study, the thoracic radiographs of 52 hyperthyroid cats and 46 non-hyperthyroid cats were evaluated for subjective and objective measurements of pulmonary hyperinflation and cardiomegaly. RESULTS There were no statistically significant differences between hyperthyroid and non-hyperthyroid cats for any variable indicative of pulmonary hyperinflation. The mean ± SD vertebral heart score on lateral views for hyperthyroid cats was 7.75 ± 0.53 and for control cats was 7.55 ± 0.54, which was significantly different (P = 0.05). Among all cats, a more severe total elevation in thyroxine (T4) was correlated with a larger vertebral heart score on lateral views (Spearman's correlation coefficient = 0.23, P = 0.02). CONCLUSIONS AND RELEVANCE While the results of this study suggest that hyperthyroid cats are more likely to have a larger vertebral heart score on lateral views than control cats, the clinical relevance of this finding is unclear given the large degree of overlap between hyperthyroid and non-hyperthyroid cats. In addition, among all cats, a greater total T4 elevation was weakly correlated with a larger vertebral heart score. Hyperthyroidism is not associated with radiographic pulmonary hyperinflation and is an unlikely differential for this radiographic finding.
Collapse
Affiliation(s)
- Victoria Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sangeeta Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sarah B Shropshire
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Angela J Marolf
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
5
|
Falerno I, Paolini A, Tamburro R, Aste G, De Bonis A, Terragni R, Vignoli M. Imaging and endoscopic diagnosis of lung diseases in small animals. A review. Top Companion Anim Med 2022; 51:100701. [PMID: 36041659 DOI: 10.1016/j.tcam.2022.100701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022]
Abstract
Diagnostic imaging plays a fundamental role in the diagnosis of pulmonary diseases. Radiography, ultrasound, computed tomography, and endoscopy are important tools for achieving a diagnosis. The choice of diagnostic procedure varies according to the patient, the suspected diagnosis and the risk/benefit ratio. Culture, cytology and histology are nearly always necessary to obtain a definitive diagnosis. Several biopsy sampling techniques are described. Surgical biopsies are the gold standard for the diagnosis of bronchiolitis or interstitial lung diseases but often not performed due to the high risk. In humans, the introduction of transbronchial cryobiopsies has led to excellent results in the study of interstitial lung diseases.
Collapse
Affiliation(s)
- Ilaria Falerno
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Andrea Paolini
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Roberto Tamburro
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Giovanni Aste
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Andrea De Bonis
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | | | - Massimo Vignoli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| |
Collapse
|
6
|
Hsieh PI, Chen HW, Yeh HN, Lam MC, Lo PY, Huang WH, Shih CH, Lin CH. Constrictive bronchiolitis obliterans with a presumptive etiology of preceding feline herpesvirus infection in a cat. BMC Vet Res 2022; 18:258. [PMID: 35790990 PMCID: PMC9254555 DOI: 10.1186/s12917-022-03368-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/30/2022] [Indexed: 11/02/2022] Open
Abstract
Abstract
Background
Bronchiolar disorders are rarely recognized in cats. Constrictive bronchiolitis obliterans is characterized by concentric peribronchiolar fibrosis and inflammation of the bronchioles, but the underlying causes remain poorly understood in current small animal medicine.
Case presentation
A 9-year-old cat presented with paroxysmal tachypnea, infrequent cough and persistent labor breathing. Thoracic radiography showed lung hyperinflation and bronchointerstitial pattern, and pulmonary function assessment revealed flow limitation in the late-expiratory phase and poor response to short-acting bronchodilator. Dorsally distributed subpleural ground glass opacities with distinct margin and tree-in-bud opacities were observed on lung high-resolution computed tomography. The cat underwent bronchoalveolar lavage (BAL) and showed severe neutrophilic inflammation. Feline herpesvirus was the only pathogen detected in the BAL fluid. Multiple therapeutic attempts were unsuccessful and the cat died 8 weeks after the initial presentation. Necropsy revealed the infiltration of inflammatory cells, obstruction of the bronchiolar lumen, and submucosal concentric fibrosis suggesting constrictive bronchiolitis obliterans. Combining the pre- and post-mortem findings, as well as the time from symptom onset or BAL to necropsy, constrictive bronchiolitis obliterans was possibly triggered by a preceding feline herpesvirus infection in this case.
Conclusions
The history of nonvaccinated status, lower airway neutrophilic inflammation, and presence of feline herpesvirus in the BAL fluid without coexistence of other pathogens led to the presumption that constrictive bronchiolitis obliterans was induced by a preceding feline herpesvirus infection in this cat. The pathological changes of bronchiolitis obliterans induced by a preceding feline herpesvirus infection could be different from that of cats with acute herpesvirus pneumonia, such as intranuclear inclusions would disappear over time and were no longer found 7–10 days after inoculation. The presence of patchy distribution of subpleural ground glass opacities on lung high-resolution computed tomography should raise the suspicion of peribronchiolar fibrosis. Clinical awareness of bronchiolar disorders as a differential diagnosis is important in cats with lung hyperinflation and labored breathing who show poor reversibility to bronchodilator.
Collapse
|
7
|
Hung L, Hopper BJ, Lenard Z. Retrospective analysis of radiographic signs in feline pleural effusions to predict disease aetiology. BMC Vet Res 2022; 18:118. [PMID: 35346189 PMCID: PMC8959281 DOI: 10.1186/s12917-022-03218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/15/2022] [Indexed: 11/14/2022] Open
Abstract
Background The objectives of the study were to determine the prevalence of underlying conditions causing pleural effusion in cats and to calculate the positive predictive values, negative predictive values, sensitivity and specificity of radiographic signs to predict aetiology of the pleural fluid. Methods Data from 148 cats with pleural effusion and diagnosed with known aetiologies were retrospectively analysed. Sixty one cats had thoracic radiographs evaluated by consensus through pre-defined radiographic signs by two radiologists blinded to the diagnoses. Results Congestive heart failure (53.4%) was the most common diagnosis, followed by neoplasia (20.3%), pyothorax (10.8%), idiopathic chylous effusion (5.4%), feline infectious peritonitis (1.4%) and "other" or cats with multiple diagnoses (total 8.8%). Cats with an enlarged cardiac silhouette had a high positive predictive value of congestive heart failure (90%). Mediastinal masses (100%)and pulmonary masses (100%) were highly predictive of neoplastic disease. Pulmonary nodules (50%) were poorly predictive of neoplastic disease. The remainder of the radiographic variables were not informative predictors of underlying disease. Conclusions In our sample of cats, congestive heart failure was the most common cause of pleural effusion. Radiographically enlarged cardiac silhouette and presence of a mediastinal mass may be useful predictors of aetiology, however there are limitations to the use of radiography alone as a diagnostic tool. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-022-03218-3.
Collapse
|
8
|
Chalifoux NV, Drobatz KJ, Reineke EL. Predictors of inflammatory lower airway disease in cats presented to the emergency room in respiratory distress: a case-control study. J Feline Med Surg 2021; 23:1098-1108. [PMID: 33645320 PMCID: PMC10812157 DOI: 10.1177/1098612x21996145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The objective of the study was to identify whether venous blood gas (VBG) variables may serve as a predictor of inflammatory lower airway disease (ILAD) in cats presenting with respiratory distress. A secondary objective of this study was to compare the diagnostic utility of patient signalment, history and physical examination findings, as compared with VBG variables. METHODS The medical records of cats presenting with respiratory distress secondary to ILAD (54 cases) and non-ILAD (121 controls) were retrospectively reviewed. RESULTS No admission VBG variables were predictive of a final diagnosis of ILAD. Comparatively, multivariable analysis identified a history of a cough (P <0.001), increased respiratory rate (P = 0.001), the presence of an abdominal component to respiration (P = 0.007) and the absence of pleural effusion (P <0.01) to be independently associated with a final diagnosis of ILAD. Cats with a history of a cough and an abdominal component to respiration had 7.86 and 5.81 greater odds of being diagnosed with ILAD, respectively. Cats with pleural effusion had 7.43 lower odds of having this final diagnosis. For every 10 breaths/min increase in respiratory rate, cats had 1.48 greater odds of being diagnosed with ILAD. Cats diagnosed with ILAD had a survival rate of 94% (95% CI 84-99%) vs 61% (95% CI 51-70%) for non-ILAD controls (P <0.001). CONCLUSIONS AND RELEVANCE The results of this study found patient history and physical examination findings to be more useful predictors of a final diagnosis of ILAD in comparison with VBG variables at presentation. A history of a cough, an abdominal component to respiration and a lack of pleural effusion were found to be significant predictors of this diagnosis. Further investigation into the role of respiratory rate in ILAD is warranted.
Collapse
Affiliation(s)
- Nolan V Chalifoux
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| | - Kenneth J Drobatz
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| | - Erica L Reineke
- Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA
| |
Collapse
|
9
|
Melco AL, Petrovitch NP, Birkenheuer AJ, Yang TS, Schreeg ME, Savage M. Pathognomonic thoracic radiographic findings are lacking in cats with acute Cytauxzoonosis. Vet Radiol Ultrasound 2021; 62:141-149. [PMID: 33245609 PMCID: PMC10688514 DOI: 10.1111/vru.12935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/26/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022] Open
Abstract
Cytauxzoon felis is a tick-borne haemoprotozoan parasite that often causes fatal disease in domestic cats. Histological studies have described substantial pulmonary pathology due to cytauxzoonosis. Published reports were not found describing the thoracic radiographic signs associated with acute cytauxzoonosis in cats. The purpose of this retrospective descriptive study was to describe thoracic radiographic findings in a group of felines with confirmed acute cytauxzoonosis. A total of 37 cats with confirmed cytauxzoonosis and with available thoracic radiographs were included. A subset of 7 cats in this sample also had histopathologic evaluation of their lung parenchyma. Thoracic radiographs were retrieved and reviewed. A bronchial pulmonary pattern was identified as the most common finding (n = 27/37; 73%). Other radiographic findings included cardiomegaly (n = 19/37; 51%), interstitial pattern (n = 17/37; 46%), pleural effusion (n = 12/37; 32%), arterial vascular distension (n = 10/37; 27%), arterial and venous distension (n = 10/37; 27%), and venous distension (n = 1/37; 3%). The primary histological features present in 7 cats with additional histopathologic evaluation, similar to previously published studies, were vascular occlusion. Our study suggests that, despite severe histologic evidence of disease, there are no pathognomonic thoracic radiographic findings in cats with acute cytauxzoonosis.
Collapse
Affiliation(s)
- Ashley L Melco
- Department of Clinical Sciences, North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - Nicholas P Petrovitch
- Molecular Biomedical Sciences, North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - Adam J Birkenheuer
- Department of Clinical Sciences, North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - Tzushan S Yang
- Department of Clinical Sciences, North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - Megan E Schreeg
- Population Health and Pathobiology, North Carolina State College of Veterinary Medicine, Raleigh, North Carolina
| | - Mason Savage
- Department of Clinical Sciences, Georgia College of Veterinary Medicine, Athens, Georgia
| |
Collapse
|
10
|
Ward JL, Lisciandro GR, Ware WA, Miles KG, Viall AK, DeFrancesco TC. Lung ultrasonography findings in dogs with various underlying causes of cough. J Am Vet Med Assoc 2020; 255:574-583. [PMID: 31429645 DOI: 10.2460/javma.255.5.574] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize lung ultrasonography (LUS) findings in dogs with a primary clinical complaint of cough. ANIMALS 100 client-owned coughing dogs. PROCEDURES A standardized LUS examination was performed for all dogs to quantify the number of B lines and identify subpleural abnormalities at 4 sites on each hemithorax. The final clinical diagnosis (reference standard) was determined by medical record review, and sensitivity and specificity of LUS for the diagnosis of selected causes of cough was determined. RESULTS Common underlying causes of cough included dynamic airway collapse (n = 37), cardiogenic pulmonary edema (CPE; 12), and bronchitis (10). Compared with dogs with other causes of cough, dogs with bacterial pneumonia (n = 7) were more likely to have subpleural shred signs, whereas dogs with pulmonary neoplasia (4) were more likely to have subpleural nodule signs. Dogs with CPE had higher total B-line scores and higher numbers of LUS sites strongly positive for B lines (> 3 B lines/site) than other dogs. The LUS criteria of total B-line score ≥ 10 and presence of ≥ 2 sites strongly positive for B lines were each 92% sensitive and 94% specific for CPE diagnosis. Notably, 18% (16/88) of dogs with noncardiac causes of cough had been treated previously with diuretics because of prior CPE misdiagnosis. CONCLUSIONS AND CLINICAL RELEVANCE LUS profiles in dogs with cough differed by the underlying cause. In dogs with a clinical history of cough, this imaging modality could be diagnostically useful, particularly to help exclude the possibility of underlying CPE.
Collapse
|
11
|
Grotheer M, Hirschberger J, Hartmann K, Castelletti N, Schulz B. Comparison of signalment, clinical, laboratory and radiographic parameters in cats with feline asthma and chronic bronchitis. J Feline Med Surg 2020; 22:649-655. [PMID: 31483195 PMCID: PMC10814432 DOI: 10.1177/1098612x19872428] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Feline asthma (FA) and feline chronic bronchitis (CB) are common respiratory conditions in cats, frequently referred to as 'feline lower airway disease'. However, the aetiologies of both inflammatory airway diseases are probably different. Little is known about the differences in signalment, clinical signs, laboratory abnormalities and radiographic features between cats with these two airway diseases. The aim of the study was to investigate whether certain parameters can help in differentiating between both diseases, as distinguished by airway cytology. METHODS Seventy-three cats with FA and 24 cats with CB were included in the retrospective study. Inclusion criteria were compatible clinical signs and a cytological evaluation of bronchoalveolar lavage fluid indicating either FA (eosinophilic inflammation) or CB (neutrophilic inflammation) without cytological or microbiological evidence of bacterial infection. Parameters of signalment, physical examination, haematology and thoracic radiographs of both disease groups were compared statistically (P <0.05). RESULTS The median age of cats with FA was 6 years, and was 7.5 years in cats with CB (P = 0.640). The most commonly reported clinical signs in both groups were a cough (95% FA/96% CB; P = 1.000), pathological pulmonary auscultatory sounds (82% FA/79% CB; P = 0.766) and dyspnoea (73% FA/79% CB; P = 0.601). Abnormal radiographic lung patterns were detected in 94% of cats with FA and 91% with CB (P = 0.629), respectively. Blood eosinophilia was significantly more common in cats with FA (40%) compared with CB (27%) (P = 0.026). CONCLUSIONS AND RELEVANCE The study indicates that a differentiation of FA and CB by means of signalment, a single clinical sign, and haematological and radiographic findings is not possible.
Collapse
Affiliation(s)
- Maike Grotheer
- Clinic of Small Animal Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Johannes Hirschberger
- Clinic of Small Animal Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Noemi Castelletti
- Department of Statistics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bianka Schulz
- Clinic of Small Animal Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| |
Collapse
|
12
|
Lee EA, Johnson LR, Johnson EG, Vernau W. Clinical features and radiographic findings in cats with eosinophilic, neutrophilic, and mixed airway inflammation (2011-2018). J Vet Intern Med 2020; 34:1291-1299. [PMID: 32338397 PMCID: PMC7255660 DOI: 10.1111/jvim.15772] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/16/2020] [Indexed: 01/01/2023] Open
Abstract
Background Idiopathic inflammatory airway disease (IAD) in cats often is described as asthmatic (eosinophilic) or bronchitic (neutrophilic), but this designation requires collection of airway fluid and it fails to consider cats with mixed airway inflammation. Objective To identify clinical features that would differentiate inflammatory disease types. Animals Forty‐nine cats with nonspecific airway inflammation identified by bronchoscopic bronchoalveolar lavage (BAL) between 2011 and 2018 were evaluated. Methods This is a retrospective study. Cats were categorized by BAL differential cytology as having eosinophilic (eosinophils >20% with neutrophils <14%, or eosinophils >50%), mixed (eosinophils 20%‐50% and neutrophils >14% or discordant inflammation from 2 BAL sites), or neutrophilic (neutrophils >14% and eosinophils <20%) inflammation. Type and duration of presenting complaints, signalment, body condition score, respiratory rate, CBC results, bronchoscopy, BAL results (% recovery, total nucleated cell count, differential cell count), and radiographic findings were compared among groups. Results Idiopathic IAD was diagnosed in 49 cats, with BAL eosinophilic inflammation in 23, mixed inflammation in 14, and neutrophilic inflammation in 12. Cough was the predominant presenting complaint with no difference in duration of signs among groups (median, 5.5 months). Respiratory rate and effort also did not differ. Cats with eosinophilic inflammation were significantly younger (4.4 ± 3.3 years) than those with neutrophilic (8.0 ±5.6 years) or mixed inflammation (7.5 ± 4.0 years; P = .03). Results of CBC and interpretation of radiographic findings did not differ among groups. Conclusions and Clinical Importance Substantial overlap exists in clinical and radiographic findings in cats with various forms of idiopathic airway inflammation.
Collapse
Affiliation(s)
- Elizabeth A Lee
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California School of Veterinary Medicine, Davis, California, USA
| | - Lynelle R Johnson
- Department of Medicine and Epidemiology, University of California School of Veterinary Medicine, Davis, California, USA
| | - Eric G Johnson
- Department of Surgical and Radiological Sciences, University of California School of Veterinary Medicine, Davis, California, USA
| | - William Vernau
- Department of Pathology, Microbiology and Immunology, University of California School of Veterinary Medicine, Davis, California, USA
| |
Collapse
|
13
|
Garrity S, Lee-Fowler T, Reinero C. Feline asthma and heartworm disease: Clinical features, diagnostics and therapeutics. J Feline Med Surg 2019; 21:825-834. [PMID: 31446863 PMCID: PMC10814146 DOI: 10.1177/1098612x18823348] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE For feline practitioners, the cat with a cough or respiratory distress and thoracic radiographs with a bronchial or bronchointerstitial pattern suggests lower airway disease. Two important differentials, allergic asthma and heartworm disease (HWD), have many overlapping clinicopathologic features, but also clear and important differences in terms of cause and disease progression, treatment and prognosis. Notably, asthma is readily treatable and HWD is preventable. CLINICAL SIGNIFICANCE Feline HWD comprises two clinical syndromes: the comparatively recently described heartworm-associated respiratory disease (HARD) and adult HWD. The former is much more common; very few cats with HARD develop adult HWD. In HARD, following death of immature worms, pulmonary lesions may improve over time ('self-cure'). Lesions of adult HWD also improve over time as long as reinfection does not occur; however, with death of adult heartworms, mortality is high, and the prognosis is guarded. In asthma, morbidity is relatively high, but mortality is low, with an overall good to excellent prognosis. DISEASE RECOGNITION Feline asthma is encountered worldwide. In the authors' impression, feline HWD is often under-recognized. AIMS The aim of this review is to assist clinicians in differentiating feline asthma from feline HWD; as such, the emphasis is on distinguishing clinical features, as well as on diagnostics, therapy and prognosis. In differentiating these conditions, clinicians can attempt the goal of properly managing these diseases and can best educate owners on prognosis. EVIDENCE BASE For both feline asthma and feline HWD, the authors have drawn on the available peer-reviewed literature studies involving experimental models as well as spontaneous disease.
Collapse
Affiliation(s)
- Sarah Garrity
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA
| | - Tekla Lee-Fowler
- Department of Clinical Sciences, Auburn University, Auburn, AL, USA
| | - Carol Reinero
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA
| |
Collapse
|
14
|
Foo TS, Pilton JL, Hall EJ, Martinez-Taboada F, Makara M. Effect of body position and time on quantitative computed tomographic measurements of lung volume and attenuation in healthy anesthetized cats. Am J Vet Res 2018; 79:874-883. [PMID: 30058848 DOI: 10.2460/ajvr.79.8.874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To quantify the effect of time and recumbency on CT measurements of lung volume and attenuation in healthy cats under general anesthesia. ANIMALS 8 healthy research cats. PROCEDURES Anesthetized cats were positioned in sternal recumbency for 20 minutes and then in left, right, and left lateral recumbency (40 minutes/position). Expiratory helical CT scan of the thorax was performed at 0 and 20 minutes in sternal recumbency and at 0, 5, 10, 20, 30, and 40 minutes in each lateral recumbent position. For each lung, CT measurements of lung volume and attenuation and the extent of lung areas that were hyperaerated (-1,000 to -901 Hounsfield units [HU]), normoaerated (-900 to -501 HU), poorly aerated (-500 to -101 HU), or nonaerated (-100 to +100 HU [indicative of atelectasis]) were determined with a semiautomatic threshold-based technique. A restricted maximum likelihood analysis was performed. RESULTS In lateral recumbency, the dependent lung had significantly greater attenuation and a lower volume than the nondependent lung. Within the dependent lung, there was a significantly higher percentage of poorly aerated lung tissue, compared with that in the nondependent lung. These changes were detected immediately after positioning the cats in lateral recumbency and remained static with no further significant time-related change. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that once anesthetized healthy cats were positioned in lateral recumbency, the dependent lung lobes underwent a rapid reduction in lung volume and increase in lung attenuation that did not progress over time, predominantly attributable to an increase in poorly aerated lung tissue.
Collapse
|
15
|
Hahn H, Specchi S, Masseau I, Reinero C, Benchekroun G, Rechy J, Seiler G, Pey P. The computed tomographic “tree-in-bud” pattern: Characterization and comparison with radiographic and clinical findings in 36 cats. Vet Radiol Ultrasound 2017; 59:32-42. [DOI: 10.1111/vru.12564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 07/17/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Harriet Hahn
- Department of Diagnostic Imaging, Université Paris-Est; Ecole Nationale Vétérinaire d'Alfort; Maisons-Alfort France
| | - Swan Specchi
- Department of Clinical Sciences; Veterinary Institute of Novara; Strada Provinciale 9, 28060, Granozzo con Monticello (NO) Italy
| | - Isabelle Masseau
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire; Université de Montréal; Saint-Hyacinthe QC Canada
| | - Carol Reinero
- Department of Veterinary Medicine and Surgery and Comparative Internal Medicine Laboratory, College of Veterinary Medicine; University of Missouri; Columbia MO
| | - Ghita Benchekroun
- Department of Internal Medicine, Université Paris-Est; Ecole Nationale Vétérinaire d'Alfort; Maisons-Alfort France
| | - Jaime Rechy
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC
| | - Gabriela Seiler
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC
| | - Pascaline Pey
- Department of Diagnostic Imaging, Université Paris-Est; Ecole Nationale Vétérinaire d'Alfort; Maisons-Alfort France
| |
Collapse
|
16
|
Bernhard C, Masseau I, Dodam J, Outi H, Krumme S, Bishop K, Graham A, Reinero C. Effects of positive end-expiratory pressure and 30% inspired oxygen on pulmonary mechanics and atelectasis in cats undergoing non-bronchoscopic bronchoalveolar lavage. J Feline Med Surg 2017; 19:665-671. [PMID: 27250742 PMCID: PMC11128820 DOI: 10.1177/1098612x16651471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The objective of this study was to determine if modification of inspired oxygen concentration or positive end-expiratory pressure (PEEP) would alter bronchoalveolar lavage (BAL)-induced changes in pulmonary mechanics or atelectasis, as measured using ventilator-acquired pulmonary mechanics and thoracic CT. Methods Six experimentally asthmatic cats underwent anesthesia and non-bronchoscopic BAL, each under four randomized treatment conditions: 100% oxygen, zero PEEP; 30% oxygen, zero PEEP; 100% oxygen, PEEP 2 cmH2O; and 30% oxygen, PEEP 2 cmH2O. Pulse oximetry was used to estimate oxygen saturation (SpO2). Ventilator-acquired pulmonary mechanics and thoracic CT scans were collected prior to BAL and at 1, 5 and 15 mins post-BAL. Results While receiving 100% oxygen, no cat had SpO2 <91%. Some cats receiving 30% oxygen had decreased saturation immediately post-BAL (mean ± SD 70.8 ± 31%), but 6/8 of these had SpO2 >90% by 1 min later. There was a significant increase in airway resistance and a decrease in lung compliance following BAL, but there was no significant difference between treatment groups. Cats receiving no PEEP and 30% oxygen conserved better aeration of the lung parenchyma in BAL-sampled areas than those receiving no PEEP and 100% oxygen. Conclusions and relevance Alterations in pulmonary mechanics or atelectasis may not be reflected by SpO2 following BAL. The use of 30% inspired oxygen concentration failed to show any significant improvement in pulmonary mechanics but did diminish atelectasis. In some cats, it was also associated with desaturation of hemoglobin. The use of PEEP in this study did not show any effect on our outcome parameters. Further studies using higher PEEP (5-10 cmH2O) and intermediate inspired oxygen concentration (40-60%) are warranted to determine if they would confer clinical benefit in cats undergoing diagnostic BAL.
Collapse
Affiliation(s)
| | - Isabelle Masseau
- Current address: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montréal, Québec, Canada
| | | | | | | | | | | | - Carol Reinero
- Carol Reinero DVM, PhD, DACVIM (Small Animal Internal Medicine), Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA
| |
Collapse
|
17
|
Lidbury JA, Rodrigues Hoffmann A, Ivanek R, Cullen JM, Porter BF, Oliveira F, Van Winkle TJ, Grinwis GC, Sucholdolski JS, Steiner JM. Interobserver Agreement Using Histological Scoring of the Canine Liver. J Vet Intern Med 2017; 31:778-783. [PMID: 28295598 PMCID: PMC5435077 DOI: 10.1111/jvim.14684] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/16/2017] [Accepted: 01/30/2017] [Indexed: 11/29/2022] Open
Abstract
Background Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme. Hypothesis/Objectives To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red. Animals Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives. Methods Six board‐certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed‐rank test. Results Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E‐stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248). Conclusions and Clinical Importance There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.
Collapse
Affiliation(s)
- J A Lidbury
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - A Rodrigues Hoffmann
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - R Ivanek
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Cullen
- North Carolina College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - B F Porter
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | | | - T J Van Winkle
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - G C Grinwis
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Utrecht, Utrecht, The Netherlands
| | - J S Sucholdolski
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| |
Collapse
|
18
|
Affiliation(s)
- Samantha Taylor
- European Veterinary Specialist in Internal Medicine RCVS Recognised Specialist in Feline Medicine International Cat Care Nurse and Technician Distance Education Coordinator
| |
Collapse
|
19
|
Lamb CR, Jones ID. Associations between respiratory signs and abnormalities reported in thoracic CT scans of cats. J Small Anim Pract 2016; 57:561-567. [DOI: 10.1111/jsap.12530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/15/2016] [Accepted: 05/13/2016] [Indexed: 01/12/2023]
Affiliation(s)
- C. R. Lamb
- Department of Clinical Science and Service; The Royal Veterinary College; Hawkshead Lane North Mymms Hertfordshire AL9 7TA
| | - I. D. Jones
- Department of Clinical Science and Service; The Royal Veterinary College; Hawkshead Lane North Mymms Hertfordshire AL9 7TA
| |
Collapse
|
20
|
Respiratory and Thoracic Medicine. THE CAT 2012. [PMCID: PMC7158197 DOI: 10.1016/b978-1-4377-0660-4.00030-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Reinero CR. Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. Vet J 2010; 190:28-33. [PMID: 21036078 DOI: 10.1016/j.tvjl.2010.09.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 09/23/2010] [Accepted: 09/23/2010] [Indexed: 11/18/2022]
Abstract
Asthma is a common inflammatory disease of the lower airways and is believed to be of allergic etiology in cats. As little progress has been made in establishing rigorous criteria to differentiate it from other inflammatory lower airway diseases such as chronic bronchitis, descriptions of 'asthma' in the literature have often been inaccurate, grouping this syndrome with other feline airway diseases. With the development of more sensitive and specific diagnostics, it will become easier to distinguish asthma as a disease entity. Pulmonary function testing with bronchoprovocation/bronchodilator responsiveness trials and biomarkers hold particular promise. Discrimination is of critical importance as targeted therapies for the allergic inflammatory cascade are developed and become available for therapeutic trials in pet cats.
Collapse
Affiliation(s)
- Carol R Reinero
- Department of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
| |
Collapse
|
22
|
Venema CM, Patterson CC. Feline asthma: what's new and where might clinical practice be heading? J Feline Med Surg 2010; 12:681-92. [PMID: 20800209 DOI: 10.1016/j.jfms.2010.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRACTICAL RELEVANCE Feline bronchial asthma is one of the most commonly diagnosed respiratory conditions of cats. Clinical signs range from intermittent wheezing and coughing, which can compromise quality of life, to episodes of severe dyspnea that can be life-threatening. CLINICAL CHALLENGES Feline asthma can be easily disregarded as a simplistic condition. However, much about its pathophysiology remains obscure. There is no gold standard method of diagnosis, and current approaches are associated with various limitations. Also, feline asthma is typically treated with long-term glucocorticoid therapy, which can have significant consequences. AUDIENCE Because of its prevalence, general practitioners encounter asthma regularly. Refractory cases are often managed by veterinary internists and pulmonologists. PATIENT GROUP Asthma can be diagnosed in cats of any age but is usually seen in young to middle-aged adults (mean 4 years, range 1-15 years). There is no sex predilection, but the Siamese breed appears to be overrepresented. EVIDENCE BASE While the standard clinical approach to feline asthma has changed little in recent years, new research has provided greater insight into many aspects of this complex disease and new strategies are being studied. This article reviews the current literature in order to raise awareness of how advances in the understanding of the pathophysiology, diagnosis and treatment of feline asthma may be determining the future direction of clinical practice.
Collapse
Affiliation(s)
- Christine M Venema
- Department of Small Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, D211 Veterinary Medical Center, East Lansing, MI 48824, USA.
| | | |
Collapse
|