Download Cough in Cats

diagnostic tree
Janice Dye, DVM, MS, PhD, Diplomate ACVIM (Small Animal Internal Medicine)
Cough in Cats
NO
Perform thoracic examination and auscultation, tracheal palpation, thoracic
radiography, MDB
Adventitial lung sounds
Normal or reduced bronchovesicular
sounds
Tracheobronchial cough
Nonspecific cough
Radiographic evidence of bronchial,
mixed bronchointerstitial, or bronchoalveolar pattern
Serology, fecal examinations, BAL or
fine-needle lung aspiration
(cytology/culture), thoracic CT
Bronchoscopy and/or airway sampling
(cytology/culture), heartworm antigen &
antibody
• Pneumonia/pneumonitis
- Viral (FHV-1, FCV)
- Parasitic (Dirofilaria, other)
- Mycotic
- Bacterial: Primary (Bordetella) or
secondary (dental disease)
- Protozoal (Toxoplasma)
- Atopy-related (?)
• Pleuritis or pleural space disease
(FIP, pleural effusions)
• Interstitial lung disease (IPF, other
subtypes)
• Neoplasia
• Pulmonary edema—if severe,
CHF, fluid overload
• Extrapulmonary chronic inflammatory conditions (rhinitis, otitis,
GERD)
YES
Article Title
Laryngopharyngeal cough
Perform MDB, cranial & oral examination,
skull/neck radiography or CT, rhinoscopy
or laryngoscopy
• Rhinitis/sinusitis
- Infections
- Inflammatory (idiopathic)
- Atopy-related (?)
- Neoplasia
• Laryngitis
- Infectious
- Inflammatory
- Postnasal drip (?)
- Injury (prior intubation)
- Irritant exposure (noxious fumes/gases,
particles or dust, smoke inhalation,
ETS, litter)
• Laryngeal or nasopharyngeal mass,
polyp, stenosis, or foreign material (hair,
food, medication)
• Comorbid conditions
- Megaesophagus
- Laryngeal paralysis
•
•
•
•
•
• Tracheitis/bronchitis (rule-outs similar
to laryngitis)
- Infectious (viral)
- Inflammatory (feline asthma)
- Atopy/allergy-related
- HARD
- Idiopathic
- Irritant exposure
- Foreign material
- Postnasal drip (?)
• Airway obstruction
• Airway mucus, debris
• Airway fluid or hemorrhage
• Airway collapse
• Airway compression
• Comorbid conditions
- Megaesophagus
- Laryngeal paralysis
Article archived on www.cliniciansbrief.com
Cats have a well developed cough reflex. Coughing dispels mucus and inhaled substances from the lower airways.
Coughing is not pathognomonic for a specific diagnosis. It often occurs intermittently, with or without wheezing or respiratory distress. Alternatively, it can occur with sneezing/nasal discharge, noisy or stertorous breathing, retching/gagging, or even vomiting.
Chronic cough is frequently related to development of airway inflammation, airway obstruction, and mucous hypersecretory states.
In cats, cough is commonly observed with bronchial or asthma-like disease; it is variable in parenchymal or pleural space
disorders; and is uncommon in cardiac disease alone. However, concurrent pulmonary and cardiac disease may occur.
Posttussive vomiting may be a result of air-induced distension of the stomach.
Diagnosis
Investigation
Result
BAL = bronchoalveolar lavage; CHF = congestive heart failure; CT = computed tomography; ETS = environmental tobacco smoke; FCV = feline coronavirus; FHV-1 =
feline herpervirus type 1; FIP = feline infectious peritonitis; GERD = gastrointestinal reflux disease; HARD = heartworm-associated respiratory disease; IPF = idiopathic
pulmonary fibrosis; MDB = minimum database; (?) = analogous to human condition
d i a g n o s t i c t re e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N AV C c l i n i c i a n’s b r i e f . j u l y . 2 0 0 8 . . . . . 1 7
R E S P I R ATO RY M E D I C I N E
Author Sneezing/nasal discharge?
Noisy (stertorous) breathing?
Retching or gagging?
Altered vocalization?