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Most of these tests will be commented on in the context of the various diseases. Haematology, biochemistry, serology and cardiac biomarkers They can have limited benefit in diagnosis, but haematology is worth undertaking as it can identify leucocytosis with neutrophilia, suggestive of broncho-pneumonia or circulating eosinophilia suggestive of hypersensitivity disorders and parasitic disease.
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Biochemistry analysis has minimal value in diagnosis of respiratory diseases, but can give information on general health and involvement of other systems. There are a wide range of antibody and PCR testing platforms available for the viral infectious diseases of dogs and cats.
Cardiac biomarkers have variable utility in definitively identifying respiratory disease and are probably best reserved for assessing the degree of myocardial damage in cardiac cases troponins or supporting identification confluent and reticulated papillomatosis doxycycline occult cardiac disease NT-pro BNP in cats.
They might improve ability to distinguish cardiac from respiratory causes of the clinical complaint, but are not substitutes for standard clinical practice, thoracic radiography and informed clinical deduction. Other respiratory disease-specific biomarkers IPF being a good example are being evaluated and may prove clinically useful in the future.
The acute phase C-reactive protein CRP appears to have significant discriminatory utility when comparing bacterial bronchopneumonia with most other respiratory diseases in dogs. Blood gas analysis Use in practice is limited by the preferred need to obtain an arterial sample, but increasingly feasible in general practice due to availability of affordable analysers e.
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Sampling of venous blood gases has limited value except to confluent and reticulated papillomatosis doxycycline an impression of how bad the situation is.
SpO2 through pulse oximetry can be of value if the patient will co-operate and tolerate the probe and correlates with PaO2. Well worth doing under GA when occluding the airway with an endoscope.
Ultrasound Has limited use confluent and reticulated papillomatosis doxycycline making a specific respiratory diagnosis but can allow rapid identification of pleural effusions. Lung pathology is difficult to image due to the presence of air, but mediastinal structures can be examined and with experience, can be sampled. Ultrasound is not an alternative to thoracic radiography or computed tomography. Other sampling techniques n Faecal analysis for parasites Worth considering in suspect cases, but can result in false negatives.
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Best reserved for well-defined lesions whose position can be confidently localised on radiography or can be sampled using ultrasound guidance. Less valuable in diffuse lung disease, where there is also an increased risk of iatrogenic pneumothorax.
Obviously this is the technique of choice for sampling and treating pleural effusion. Thoracic radiography Thoracic radiography is an essential diagnostic aid in cardiac and respiratory medicine, however interpretation is dependent on the quality of the images obtained. Attention has to be paid to obtaining the best quality radiographs and this has greatly improved with the availability of digital radiography. Computed tomography is an emerging modality of immense value, but MRI has no role in investigation of respiratory disease.
Assessment of the Respiratory System Radiography The lung pattern changes in response to both respiratory and cardiac diseases. The normal lung pattern consists primarily of the pulmonary vasculature.
Veins are ventral and medial to the bronchi respectively. The vascular pattern is more prominent in the cat.
The rest of the normal lung pattern is presumed to represent the lung parenchyma. This pattern is linear, but whereas the pulmonary vasculature, particularly in the cat, spreads out towards the lung periphery, the interstitial pattern is more haphazard giving a reticulated appearance to the lung field.
In chronic airway disease the bronchi often become dilated tubular or saccular bronchiectasis. When the alveoli fill with fluid e.
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There is an associated loss of the vascular walls and bronchial walls. When disease affects the interstitium it becomes thickened and therefore more visible as a fine linear or reticular mesh-like pattern. It differs from the vascular pattern in not following any particular direction.
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An interstitial pattern sometime obscures the vessels towards their periphery, and is often identified by excluding all other explanation so of increased density. They include cysts, bullae, blebs congenital or acquiredabscess, trauma, granulomas, neoplasia primarybronchial obstruction and pneumatocoele n Pleural mediastinal changes: the pleural space can contain fluid pleural effusion or free air pneumothorax, pneumomediastinum. With mild effusions the radiographs should be inspected for subtle lobefissure lines, particularly on the ventro-dorsal views.
With severe effusions the cardiac silhouette is obscured and the confluent and reticulated papillomatosis doxycycline lobe edges are pushed away from the thoracic cage and visible.