Cytology of the respiratory tract

Information has been presented to assist veterinary practitioners in obtaining and interpreting cytology specimens from the respiratory tract. The various cytologic techniques are rapid, economical, and relatively noninvasive. Cytologic examination of the respiratory tract may provide a definitive diagnosis or information for improved case management until more complex diagnostic procedures are performed.     

Reptile respiratory medicine.

Respiratory tract disease is commonly diagnosed in captive collections of reptiles and associated with high morbidity and mortality. Improper environmental conditions are often contributing factors for the development of respiratory disease in reptiles. A detailed knowledge of the unique reptilian respiratory morphology and function is essential to successfully diagnose and treat respiratory disease. A variety of noninfectious and infectious causes have been identified in the etiology of reptile respiratory disease. Knowledge of the pathophysiology of reptilian diseases is increasing, and with the availability of new therapeutic agents and advanced diagnostic techniques, the diagnosis and treatment of reptile respiratory tract disease has become more successful.     

Respiratory diseases, diagnostics, and treatment of marsupials.

Primary respiratory disease is uncommon in marsupials, but generalized disease often involves the respiratory tract in these animals. Other disease entities may spread to involve the respiratory system secondarily. Treatment is challenging because most animals are severely compromised on presentation. Bacteria, viruses, parasites, fungi and yeasts, trauma, and neoplasia all can affect the respiratory systems of marsupials. Some of these conditions are only incidental findings, whereas others are pathogenic. Many therapies and diagnostic procedures are extrapolated from those in companion animal medicine and surgery. Despite the problems associated with the diagnosis and treatment of respiratory disease in marsupials, new therapeutic agents and diagnostic techniques are making these tasks easier and ultimately more successful.     

Comparison of results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage fluid, and histologic evaluation of lung specimens in dogs with respiratory tract disease: 16 cases (1996-2000)

OBJECTIVE: To compare results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage (BAL) fluid, and histologic evaluation of biopsy and necropsy specimens in dogs with respiratory tract disease and to determine whether histologic evaluation provides important diagnostic information not attainable by the other methods. DESIGN: Retrospective study. ANIMALS: 16 dogs. PROCEDURE: BAL fluid was classified as normal, neutrophilic, eosinophilic, mononuclear, mixed, neoplastic, or nondiagnostic. Radiographic abnormalities were classified as interstitial, bronchial, bronchointerstitial, or alveolar. Histologic lesions were classified as inflammatory, fibrotic, or neoplastic, and the predominant site of histologic lesions was classified as the alveoli, interstitium, or airway. RESULTS: The predominant radiographic location of lesions correlated with the histologic location in 8 dogs. Of 11 dogs with histologic evidence of inflammatory disease, 8 had inflammatory BAL fluid. Of the 2 dogs with histologic evidence of neoplasia, 1 had BAL fluid suggestive of neoplasia, and the other had BAL fluid consistent with septic purulent inflammation. Two dogs without any histologic abnormalities had mononuclear or nondiagnostic BAL fluid. Two dogs with histologic evidence of fibrosis had mononuclear or mixed inflammatory BAL fluid. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that although thoracic radiography, cytologic evaluation of BAL fluid, and histologic evaluation of lung specimens are complementary, each method has limitations in regard to how well results reflect the underlying disease process in dogs with respiratory tract disease. Lung biopsy should be considered in cases where results of radiography and cytology are nondiagnostic.     

Virus and its relationship to the "poor performance" syndrome

Racehorses perform badly for many different reasons. Trainers often expect clinicians to determine the cause in individual cases and, more especially, where most of the immates of the stable are apparently affected by loss of form. Clinical examinations may reveal signs including fever, serous nasal discharge and the occasional cough. Haematology and blood biochemistry are commonly used aids to diagnosis in the field and may be helpful, but there is a need for facilities for virological investigations to be made readily available for use by clinicans as an adjunct to more commonplace laboratory techniques. This paper presents the background to a serious and widely publicised problem experienced by racing stables in the UK in recent years and, in discussing its epidemiology, lays emphasis on upper respiratory tract (URT) disease caused by viruses. It is suggested that, if the incidence of URT disease could be reduced, there would be a corresponding diminution of the "poor performance" syndrome. The inter-relationship of viral diagnosis, epidemiology and research is discussed in terms of methology, interpreting results and limits of present day knowledge.     

Lower respiratory tract disease in Thoroughbred racehorses: analysis of endoscopic data from a UK training yard

REASON FOR PERFORMING STUDY: There has been much research directed at potential causative agents and the epidemiology of lower respiratory tract disease (LRTD), but few reports of the clinical progression and outcome. OBJECTIVES: To define clinical features of LRTD in racehorses, including association with age and average duration of disease, through the analysis of endoscopic data. METHODS: A retrospective analysis of records from a single training yard of endoscopic examinations undertaken over a 2-year period was performed. Horses were subjected to regular endoscopic examination for a variety of reasons, and all horses placed on antibiotic therapy for lower respiratory tract disease were rescoped following treatment. Data analysed included a 0-8 tracheal mucus score based on visible endoscopic mucus and gross tracheal lavage turbidity, as well as age and treatment duration and type. RESULTS: A total of 522 endoscopic examinations undertaken on 123 horses and tracking 169 episodes of lower respiratory tract disease were recorded. Mean duration of disease episode was 15.5 days (median = 11 days, range = 4-61 days). Horses age 2 years were significantly more likely than those age > or=3 years to have at least one episode of respiratory disease (P<0.001). There was a direct association between initial tracheal mucus score and rescope score after treatment. CONCLUSIONS: Lower respiratory tract disease was more common in 2-year-olds than in older horses. Affected horses had endoscopic evidence of increased tracheal mucus accumulation for an average of 15.5 days per episode, a considerably shorter period than that suggested by previous studies. POTENTIAL RELEVANCE: Endoscopic examinations permit longitudinal tracking of lower respiratory tract disease in Thoroughbred racehorses. A prolonged duration of disease, sometimes extending for months, can be expected in a small proportion of cases, some of which appear to be refractory to treatment. There is a clear need for evidence-based analysis of treatment regimes to assist clinicians in decision making when managing disease in both individual and group situations.     

Cytological findings in bronchoalveolar lavage fluid from feedlot calves: associations with pulmonary microbial flora.

Samples obtained by bronchoalveolar lavage (BAL) were used to evaluate pulmonary cytology in 59 feedlot calves with clinical signs of respiratory disease (cases) and 60 clinically normal comparison calves (controls). Many calves in both case and control groups had inflammatory changes in the lower respiratory tract, as determined by changes in proportions in the BAL differential cell count. Approximately 35% of cases and 40% of controls showed a normal differential cell count. It therefore appeared that the criteria used to select cases for treatment, which were similar to those often used in the field, were poor predictors of lower respiratory tract disease. A positive association was found between an increased proportion of neutrophils in BAL fluid and isolations of Pasteurella multocida and Mycoplasma bovis from BAL fluid.     

Antibiotic prophylaxis of lower respiratory tract contamination in horses confined with head elevation for 24 or 48 hours

Objective To evaluate the administration of procaine penicillin prior to or during confinement with head elevation as a means of reducing the associated accumulation of inflammatory lower respiratory tract secretions and increased numbers of bacteria within the lower respiratory tract of confined horses. Design and Procedure Two experiments were conducted to evaluate the efficacy of different dose rates and dosing frequencies. In experiment A a single low dose (15,000 IU/kg) of procaine penicillin was administered to four horses immediately prior to confinement with head elevation for 48 hours. The systemic leucocyte response, gross and cytologic characteristics of transtracheal aspirate and bacterial numbers in lower respiratory tract samples were compared with corresponding samples from two horses confined with heads elevated but not given penicillin. The efficacy of higher dose rates (20,000 IU/kg and 40,000 IU/kg) given before and during confinement with heads elevated for 24 hours was evaluated in experiment B. Results Treatment with procaine penicillin had no effect on the systemic leucocyte response or on the accumulation of inflammatory lower respiratory tract secretions at any of the dosing schedules evaluated. The number of bacteria isolated from trans-tracheal samples was reduced at 12 hours for treated horses in experiment A and at 24 hours for experiment B. β-haemolytic Streptococcus spp were not isolated from treated horses in either experiment. Bacterial species isolated from treated horses were predominantly Pasteurella and/or Actinobacillus spp, however, members of the family Enterobacteriaceaé and a Staphylococcus sp were isolated from treated horses. One treated horse in experiment A developed clinically apparent pulmonary disease. Conclusions The prophylactic administration of penicillin before or during confinement did not reliably reduce bacterial numbers or prevent the accumulation of purulent lower respiratory tract secretions in horses confined with their heads elevated. Numbers of β-haemolytic Streptococcus spp were reduced following treatment, suggesting that the repeated administration of procaine penicillin may have some merit as part of a strategy to prevent transport-associated respiratory disease. However, methods directed at minimising the duration of confinement with head elevation, augmentation of the clearance of accumulated secretions and prompt identification of animals in which airway inflammation has extended to the pulmonary parenchyma remain the best ways of minimising transport-associated respiratory disease.     

Risk factors for lower respiratory tract disease in a cohort of feedlot cattle

Using data collected from company lot records, potential risk factors related to feedlot management, the cattle, and climate were determined. The risk factors were analyzed by use of weighted multiple regression techniques to determine their effects on the incidence of lower respiratory tract disease in a cohort of 95 lots containing 17,696 cattle. The gender of the cattle, the number of days that groups of cattle filled a lot, pregnancy checking of heifers, and the average temperature change in the first 14 days in which the cattle were on feed significantly influenced the incidence of lower respiratory disease. The incidence of lower respiratory tract disease was most influenced by risk factors in the first 30 days on feed.     

爬行动物呼吸系统疾病临床诊断和防治研究进展

呼吸系统疾病是圈养和野生爬行动物群体中非常常见的疾病,有高患病率和死亡率。多种传染性和非传染性因素与爬行动物的呼吸系统疾病有关系。常用的诊断技术包括放射摄影、血清学检验、下呼吸道灌洗物培养和鉴定、内窥镜检查等。关于爬行动物的药代动力学理论很少,大多数抗菌药物的有效治疗水平尚未确定。推荐用广谱抗生素和多种药物组合来治疗呼吸系统疾病,推荐的药品有阿米卡星、头孢他定、哌拉西林,应当根据培养观察结果和药物敏感性试验结果适当调整。喷雾疗法是一种抗生素治疗的有效辅助疗法。目前,爬行动物呼吸系统疾病相关研究有非常大的发展空间,要根据爬行动物的进化和生理特点研究适用的技术和手段,以指导疾病的预防、诊断和治疗。     

Rational antibiotic therapy for respiratory disorders in dogs and cats.

Therapy of respiratory tract infections presents some unique challenges to the veterinary practitioner. These infections often involve underlying disease processes that have predisposed the patient to secondary bacterial infection and may complicate the response to therapy. Because of the diversity of microbial organisms that may colonize and invade the respiratory tract, treatment targeted at the infecting pathogens is best accomplished with bacterial culture and susceptibility testing. When these data are unavailable, rational antibiotic treatment should be based on familiarity with historical data and clinical experience. Optimal drug selection is based on predicted microbial susceptibility, drug distribution in the respiratory tract, and safety of the patient. Instituting the appropriate dosage regimen and duration of therapy maximizes the opportunity for a successful resolution of bacterial infections.     

Diagnosis of upper respiratory tract diseases in the performance horse.

Wastage of performance horses because of respiratory dysfunction is common. Appropriate identification of the disease is paramount for treatment recommendations. Diagnostic modalities for upper respiratory tract dysfunction include a thorough physical examination, radiographic evaluation when appropriate, and upper respiratory tract endoscopy. Anatomical deviations or structural are easily identified during resting evaluation, while exercise testing is often necessary to assess thedynamic properties of the upper airway. Utilizing the many diagnostic tools available allows the clinician to make an accurate diagnosis and recommend appropriate treatment.     

Respiratory biology and diseases of captive lizards (Sauria).

This article reviews respiratory diseases of lizards in clinics practice. A review of anatomy and physiology of the saurian respiratory tract sets the foundation for knowledge of normal function. The causes of noninfectious and infectious diseases are discussed. Diagnostic and treatment techniques to combat clinical disease are covered.     

Diagnostic approach to hematuria in dogs and cats.

Hematuria indicates the presence of urogenital disease in dogs and cats. Persistent hematuria (macroscopic or microscopic) should be evaluated to determine the source of bleeding and the underlying cause so that appropriate treatment can be recommended. Results of the history and physical examination often help to localize disease to the urinary tract (either upper or lower) or genital tract.Additional diagnostic evaluation, including laboratory testing(eg, urinalysis, urine culture), diagnostic imaging (eg, abdominal radiographs, ultrasound), and collection of tissues for cytologic or histopathologic evaluation, may be needed to identify the underlying cause. If a thorough evaluation fails to reveal the source or cause of hematuria, exploratory celiotomy should be considered,especially if idiopathic renal hematuria is possible.     

Lower respiratory tract infections in cats: reaching beyond empirical therapy

PRACTICAL RELEVANCE: Lower respiratory tract infections (LRTIs) in cats can be due to bacteria, parasites, fungi and viruses. This review details the practical investigation of these infections and highlights specific therapy where possible. The aim is to avoid the all-too-frequent temptation in practice to treat cats with lower respiratory tract signs empirically for feline bronchial disease (FBD)/asthma. This is potentially hazardous as immunosuppressive therapy for FBD/asthma could exacerbate disease due to a LRTI. Empirical treatment of suspected LRTI is also difficult to recommend given the wide range of potential pathogens. CLINICAL CHALLENGES: Making a clinical ante-mortem diagnosis of LRTI in a cat can be challenging. Consistent historical, clinical, haematological and radiographic abnormalities are often lacking and findings may be non-specific. Astute clinical acumen, thorough investigation and high quality laboratory analysis are usually required for a diagnosis. Bronchoalveolar lavage, if feasible, and tests for lungworm should be routine in cats with lower respiratory tract signs. Lung fine needle aspiration may be useful in cases of diffuse or nodular pulmonary disease. Histopathology is rarely employed in ante-mortem investigations. EVIDENCE BASE: The authors have reviewed a substantial body of literature to provide information on many of the reported bacterial, parasitic, fungal and viral pathogens, including some that occur in Asia. Attention has been given to specific therapy for each pathogen, with evidence-based comments when there is a deviation from routine recommendations.     

Cytologic examination of specimens obtained by means of tracheal washes performed before and after high-speed treadmill exercise in horses with a history of poor performance

OBJECTIVE: To evaluate results of cytologic examination of specimens obtained by means of tracheal washes (TW) in 42 horses with a history of poor performance. DESIGN: Cross-sectional case series. ANIMALS: 42 horses with a history of poor performance. PROCEDURE: A TW was performed via endoscopy before and after horses exercised on a high-speed treadmill, and specimens were evaluated microscopically and graded. RESULTS: Ten (24%) horses were considered to be clinically normal before and after exercise. Pulmonary hemorrhage was diagnosed in 8 (19%) horses. One horse had evidence of exercise-induced pulmonary hemorrhage (EIPH) before exercise and pulmonary hemorrhage and allergic or inflammatory airway disease (IAD) after exercise. Five (12%) horses had IAD, and 1 had IAD and pulmonary hemorrhage after exercise. Seven (17%) horses had evidence of EIPH and IAD in both specimens. Four (10%) horses with EIPH had an increase in the proportion of hemosiderophages in the specimen obtained after exercise. Specimens obtained before exercise in 6 (14%) horses were not representative of the respiratory tract and could not be compared with specimens obtained after exercise. CLINICAL IMPLICATIONS: Interpretation of TW specimens obtained before and after exercise differed for only 5 of 36 (14%) horses. Specimens obtained after exercise were more likely to reveal airway disease. All specimens obtained after exercise adequately represented the respiratory tract, whereas 6 specimens obtained before exercise did not. Specimens obtained after exercise contained more airway secretions and had less cytologic evidence of pharyngeal contamination. Therefore, we recommend that TW samples be obtained after exercise in horses.     

Correlation of clinical score, intrapleural pressure, cytologic findings of bronchoalveolar fluid, and histopathologic lesions of pulmonary tissue in horses with summer pasture-associated obstructive pulmonary disease

OBJECTIVE: To correlate clinical score, intrapleural pressure, cytologic findings of bronchoalveolar lavage fluid (BALF), and histologic lesions of pulmonary tissue in horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD). ANIMALS: 8 adult horses affected with SPAOPD and 6 adult horses without evidence of respiratory tract disease. PROCEDURE: Clinical score, change in intrapleural pressure (deltaPpl) during tidal breathing, results of cytologic examination and bacteriologic culture of BALF, and results of histologic examination of pulmonary parenchyma were evaluated. RESULTS: Clinical scores for SPAOPD-affected horses (median, 5.75; range, 4.0 to 7.5) were significantly greater, compared with clinically normal horses (median, 2.0; range, 2.0 to 3.0). Cytologic examination of BALF from SPAOPD-affected horses revealed predominantly nondegenerate neutrophils. Histologic lesions were identified throughout pulmonary tissue and included severe accumulation of mucus and neutrophils within the small airways, metaplasia of bronchiolar goblet cells, and mild peribronchial infiltrate. Histologic examination of specimens collected via percutaneous biopsy was predictive of disease and corresponded to findings at postmortem examination. Clinical score and deltaPpl were highly correlated with mucus accumulation in the airways of affected horses. Peribronchial inflammatory infiltrate correlated with percentage of neutrophils in BALF of affected horses. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical scoring and deltaPpl provided valid estimates of disease severity. Findings from cytologic examination of BALF of SPAOPD-affected horses varied, although, in most instances, it was diagnostically useful. Severe mucus accumulation in the airways was the most remarkable histopathologic finding in SPAOPD-affected horses. Examination of biopsy specimens collected from pulmonary parenchyma was consistently useful in diagnosing SPAOPD.     

Prevalence of vesivirus in a laboratory-based set of serum samples obtained from dairy and beef cattle

OBJECTIVE: To examine sera obtained from dairy and beef cattle to detect antibodies against vesivirus and compare seroprevalence among cattle within the sample population. SAMPLE POPULATION: Cattle sera from 8 western states and Maryland submitted to the Washington Animal Disease Diagnostic Laboratory during 1999 and 2000. PROCEDURE: Sera were analyzed for vesivirus-specific antibodies by use of a recombinant vesivirus-San Miguel sea lion virus serotype 5-capsid peptide antigen in an indirect ELISA. RESULTS: Overall, 693 sera were tested and 105 (15.2%) had positive results. Seropositive cattle were from 7 states (all cattle from Montana and Maryland 10 and 4, respectively were seronegative). Overall seroprevalence for antivesivirus antibody in herds ranged between 0% and 80% (median, 14%). Higher antibody prevalence was significantly associated with older age, dairy rather than beef cattle, and reasons for submission. Logistic regression of factors (abortion, respiratory tract disease, and all other reasons for sample submission) revealed that older age and other reasons were independently associated with higher seroprevalence. Higher seropositive optical density values for the ELISA were observed among older cattle and cattle that aborted, compared with values for cattle with respiratory tract disease or other reasons for submission. CONCLUSIONS AND CLINICAL RELEVANCE: This laboratory-based surveillance sample provided a point estimate of seroprevalence against vesivirus among cattle in 9 US states. This suggests that vesivirus infection is widespread with high prevalence in some herds. Risk factors associated with vesivirus seroprevalence in beef and dairy cattle should be confirmed in population-based studies.