Allergic bronchitis

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Subsequent management, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Elizabeth Rozanski DVM DACVIM DACVECC
Dr Philip K Nicholls BVSc BSc PhD MRCVS FRCPath
Ms Penny Watson MA VetMB CertVR DSAM DipECVIM MRCVS
Synonyms Feline asthma, Bronchial asthma, Eosinophilic bronchitis

Introduction

  • Chronic bronchial inflammation associated with mucus hypersecretion and bronchial smooth muscle hypertrophy and constriction.
  • Signs : coughing and/or dyspnea.
  • Treatment : oxygen, corticosteroids and bronchodilators - long- or short-term.
  • Prognosis : variable - many cats suffer recurrences but some are well controlled.

Diagnosis

Clinical signs

  • Cough - harsh to soft (elicited on tracheal palpation).
  • Mucus swallowed after cough.
  • Frothy saliva produced after gagging/retching.
  • Increased airway sounds - crackles and wheezes or quiet lung fields if little airflow.
  • Expiratory dyspnea.
  • Cachexia and debility.
  • Recurrent bouts of bronchopneumonia or bacterial bronchitis.
  • Tachypnea, dyspnea.
  • Cyanosis in acute attack.

Diagnosis

Differential diagnosis

  • Pulmonary infection, eg bronchopneumonia  Pneumonia  , FIP  Feline infectious peritonitis  , toxoplasmosis  Toxoplasmosis  .
  • Pulmonary edema  Lung: pulmonary edema  .
  • Pneumothorax  Pneumothorax  .
  • Ruptured diaphragm  Diaphragm: hernia  .
  • Pleural effusion  Pleural effusion  , eg chylothorax  Chylothorax  , pyothorax  Pyothorax  .
  • Neoplasia, eg thymic lymphosarcoma  Lymphoma  .
  • Anemia  Anemia: overview  .
  • Pulmonary thromboembolism  Thromboembolism: aorta  .
  • Cardiac failure, eg hypertrophic cardiomyopathy  Heart: hypertrophic cardiomyopathy  .
  • Airway obstruction, eg  Trachea: foreign body  .
  • Parasitic infection:
    • Aelurostrongylus abstrusus  Aelurostrongylus abstrusus  .
    • Filaroidiasis.
    • Lung fluke ( Paragonimus kellicotti ).
    • Ascarid migration ( Toxocara cati  Toxocara cati  ).
    • Heartworm ( Dirofilaria immitis ).

Sequelae

Prognosis

  • Depends on initial response to treatment.
  • Good: short- and medium-term if signs controlled by treatment; later may become unresponsive. Many respond well to treatment, others have good quality and quantity of life although may be on long-term treatment.
  • Hopeless: fatal or require euthanasia on humane grounds if poor response to treatment.
  • Can die during acute episode of bronchoconstriction.

Expected response to treatment

  • Control of signs, but airway changes may be irreversible and may be progressive   →   signs worsen   →   more severe and difficult to control bouts of bronchoconstriction and bacterial infections   →   deteriorating quality of life.

Reasons for treatment failure

  • Severe, acute bronchoconstriction resistant to therapy.
  • Occasionally - inability to control secondary infections.
  • Standard reasons  Standard reasons for failure in a treatment  .

Sources

Publications

Refereed papers

  • Dye J A, McKiernan B C, Rozanski E A, Hoffmann W E, Losonsky J M, Homco L D, Weisiger R M & Kakoma I (1996)Bronchopulmonary Disease in the cat - Historical, Physical, Radiographic, Clinicopathologic, and Pulmonary Functional Evaluation of 24 Affected and 15 Healthy Cats.JVIM10, (6), 385-400.

Other sources of information

  • Johnson L (1997)Bronchial Disease.In:August Consultations, Feline Internal Medicine 3.

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