RESPIRATORY
Article reprinted with permission of DVM360 – January 04 , 2018 DVM360 MAGAZINE is a copyrighted publication of Advanstar . Communications inc . All rights reserved
Cough ! Gasp !
' Is it My Heart or My Lungs , Doc ?'
By Sarah J . Wooten , DVM
When a veterinary patient presents with coughing , you know you must distinguish between a cardiac or respiratory cause . Which is it ? This veterinary cardiologist helps you sort through your differentials .
If you ’ ve spent any time in small animal private practice , then you ’ ve dealt with coughing , geriatric small-breed dogs and understand that these cases can be diagnostic conundrums . There ’ s a murmur . There are crackles , but the dog is also wheezing . Is it cardiac ? Is it respiratory ? Is it both ? If both , which do you treat ? Fetch dvm360 speaker Nicole Culwell , DVM , MS , DACVIM , a veterinary cardiologist at MedVet Dallas , is on hand with practical tips to help you sort out heart versus lung problems in both cats and dogs .
Be a breedist and an ageist Even before you enter the room , the patient ’ s chart will give you clues , Dr . Culwell says . Don ’ t pigeonhole yourself , but know which heart and lung diseases are common in the breed or species you are treating . Age can also give you a hint as to whether the condition is congenital or acquired .
Has history repeated itself ? That all-important patient history . You need to know if the problem is acute or chronic , what therapies have been tried , and the patient ’ s response to that therapy . In dogs , Dr . Culwell says , respiratory disease is usually chronic and episodic , and cardiac disease is usually associated with an acute onset of coughing unless there ’ s chronic compression of the left mainstem bronchus . Intermittent and transient cyanosis is associated with respiratory disease , while cyanosis in congestive heart failure is present only with severe pulmonary oedema .
In cats , cardiac and respiratory disease are almost always of acute onset because our feline friends don ’ t follow any textbook rules . Cats confound pet owners because they hide disease , and coughing can look like retching or be followed by vomiting . The most common causes of coughing in cats are asthma , bronchitis , and parasitic disease ( not in SA ), says Dr . Culwell . Cats almost never cough with cardiac disease unless they have a chylous pleural effusion .
Examine all the things A physical examination will give you clues or it may give you the answer . Even if you can ’ t touch the pet ( e . g . the cat that ’ s close to death anytime you take it out of the oxygen cage ) and can only get a visual examination , that can still help you . vet360
Issue 01 | MARCH 2018 | 10