Eosinophilic Bronchopneumopathy and Asthma

• Respiratory System

  • Parts
  • Nasal cavity
  • Pharynx/larynx
  • Trachea
  • Bronchi
  • Bronchioles
  • Alveolar sacs
• Nasal Cavity to Larynx

  • Nasal cavity
  • Mucus lined airway
  • Bony turbinates to help humidify inhaled air
• Nasal Cavity to Larynx

  • Pharynx
  • Area containing structures at back of throat
• Nasal Cavity to Larynx

  • Larynx
  • Opening to trachea
  • Epiglottis
  • Glottis
  • Arytenoid cartilage
• Trachea

  • 4 layers
  • Mucosa
  • Submucosa
  • Musculocartilaginous
  • Adventitia
• Trachea

  • Mucosa
  • Ciliated cells that move particles out of trachea
  • Goblet cells that produce mucus to trap particles
• Trachea

  • Submucosa
  • Provides structural support
• Trachea

  • Musculocartilaginous
  • Contains muscle and cartilage rings
• Trachea

  • Adventitia
  • External covering and location of nerve fibers and vessels to feed tissues
• Bronchi

  • 1st branching from trachea into each lung lobe
  • Contains less cartilage, muscle, and goblet cells
  • Has clara cells that produce surfactant
• Bronchioles

  • Further branching from bronchi
  • Break down into primary, terminal, and respiratory
  • No cartilage, less muscle, and no goblet cells
  • Smaller bronchioles don’t have ciliated cells
• Alveolar Sacs

  • Terminal ends of respiratory tract
• Alveolar Sacs

  • Made of 3 types of cells
  • Pneumocytes type 1
  • Pneumocytes type 2
  • Alveolar Macrophages/dust cells
• Alveolar sacs

  • Pneumocytes type I- perform gas exchange with pulmonary capillaries
• Alveolar sacs

  • Pneumocytes type II- produce surfactant to reduce surface tension
• Alveolar sacs

  • Alveolar macrophages/dust cells- clear out particles not cleared by upper respiratory tract
• Eosinophilic Bronchopneumopathy

  • Eosinophil infiltration of the lower respiratory tract
• Eosinophilic Bronchopneumopathy

  • Eosinophils related to allergies, hypersensitivities, and parasites
  • Means an overabundance of eosinophils within the respiratory tract, mostly in bronchial mucosa
• Eosinophilic Bronchopneumopathy

  • Believed to be related to a hypersensitivity, but cause is unknown
• Eosinophilic Bronchopneumopathy

  • Theoretical causes also include: parasites, chronic bacterial or fungal infections, viruses, external antigens
• Eosinophilic Bronchopneumopathy- Risk Factors

  • Rare in miniature and giant breeds
  • Age: average 4-6 years old
  • More common in females
• Eosinophilic Bronchopneumopathy- Clinical signs

  • Cough
  • Gagging and retching
  • Dyspnea
  • Nasal discharge
  • Exercise intolerance
  • +/- lethargy
  • +/- anorexia
• Eosinophilic Bronchopneumopathy- Physical exam

  • BAR-QAR
  • Sometimes will have no abnormalities during physical exam
  • Tachypnea +/- dyspnea
• Eosinophilic Bronchopneumopathy- Physical exam

  • Increased lung sounds, crackles, or wheezes
  • +/- serous or mucus discharge
• Eosinophilic Bronchopneumopathy- Diagnostics

  • CBC/chem
  • Marked eosinophilia (50% to 60% of cases), leukocytosis, neutrophilia, basophilia
  • NSF on chemistry
• Eosinophilic Bronchopneumopathy- Diagnostics

  • Radiographs
  • Used more to rule out other causes
  • Can sometimes see diffuse, mixed bronchointerstitial pattern, alveolar infiltrates, and bronchial wall thickening
• Eosinophilic Bronchopneumopathy- Diagnostics

  • Rule out tests
  • Cocci-titer, Heartworm tests, other PCR/ELISA
• Eosinophilic Bronchopneumopathy- Diagnostics

  • Bronchoscopy
  • Putting a camera down trachea and bronchi
  • Can physically see mucosal lining of respiratory tract
  • Can take biopsy samples
• Eosinophilic Bronchopneumopathy- Diagnostics

  • Bronchial lavage
  • Put fluid down respiratory tract and then remove it
  • Use it fluid for cytology and analysis to identify eosinophils
• Eosinophilic Bronchopneumopathy- Diagnostics

  • CT scan
  • Rule out other respiratory diseases
• Eosinophilic Bronchopneumopathy- Treatment

  • Treat co-infections first: antibiotics, anti-fungals, anti-parasitics
  • Antibiotics depend on culture results
• Eosinophilic Bronchopneumopathy- Treatment

  • Prednisone or prednisolone- 1 mg/kg orally BID for 21 28 days
  • Reduce dose by 25% to 50% 2 weeks after improvement seen and every 2-3 weeks after if improvement persists
  • Will be chronic medication
• Asthma

  • Plethora of different names
  • Eosinophilic bronchitis, Allergic bronchitis, Feline bronchitis, Feline bronchial asthma, and Feline chronic obstructive pulmonary disease
• Asthma

  • Caused by an allergic reaction
  • Cats are very sensitive to scents and other allergens
  • Immune cells trigger inflammatory substances → diameter of the airways decrease and mucus accumulate within the passages
• Asthma -Risk factors

  • Breed disposition: Siamese
  • No sex predisposition
  • Age onset: 4-5yrs
• Asthma - Risk Factors

  • Dyspnea
  • Vomiting
  • Open-mouthed breathing
  • Coughing or hacking
  • Tachypnea
  • Wheezing
• Asthma -Physical Exam

  • May appear normal
  • Increased tracheal sensitivity
  • Harsh lung sounds, crackles, or wheezes on expiration
• Asthma -Physical Exam

  • Abdominal push
  • Can present with extreme dyspnea, cyanosis, and open-mouth breathing
  • Will sometimes have hunched posture with extended neck
• Asthma - Diagnostics

  • Radiographs
  • Diffuse bronchial or bronchointerstitial pattern, hyperinflation, and/or collapse of the right middle lung lobe caused by mucus plug obstruction
• Asthma - Diagnostics

  • CBC/chem
  • Can see neutrophilia, eosinophilia, and hyperproteinemia