Changes

==Introduction==

==Introduction==

Respiratory disease is one of the most common problems in veterinary medicine and can be classed in many different ways, including obstructive and restrictive. The respiratory tract is a route of entry for many infectious agents as well as there being anatomical problems, for example ''brachycephalic obstructive airway syndrome'' seen in brachycephalic breeds. Respiratory disease poses many issues for an anaesthestist from intubation issues in cases of upper airway obstructive disease to ventilation perfusion mismatch and respiratory depression caused by some of the agents used.

Respiratory disease is one of the most common problems in veterinary medicine and can be classed in many different ways, including obstructive and restrictive. The respiratory tract is a route of entry for many infectious agents as well as there being anatomical problems, for example ''brachycephalic obstructive airway syndrome'' seen in brachycephalic breeds. Respiratory disease poses many issues for an anaesthestist from intubation issues in cases of upper airway obstructive disease to ventilation perfusion mismatch and respiratory depression caused by some of the agents used.

In dogs, diagnosis of laryngeal paralysis is performed by examination of the larynx under a light plane of anaesthesia. This is often performed at the same time as corrective surgery, if a diagnosis of laryngeal paralysis is highly suspcious. Anaesthetic agents should be selected carefully, to prevent any effects to laryngeal function which may complicate diagnosis, e.g. high doses of opioids should be avoided if possible. If the patient undergoes surgery, swelling may present as a problem post operatively, which can usually be managed with anti inflammatories, e.g. non steroidal anti inflammatories are often sufficient.

In dogs, diagnosis of laryngeal paralysis is performed by examination of the larynx under a light plane of anaesthesia. This is often performed at the same time as corrective surgery, if a diagnosis of laryngeal paralysis is highly suspcious. Anaesthetic agents should be selected carefully, to prevent any effects to laryngeal function which may complicate diagnosis, e.g. high doses of opioids should be avoided if possible. If the patient undergoes surgery, swelling may present as a problem post operatively, which can usually be managed with anti inflammatories, e.g. non steroidal anti inflammatories are often sufficient.

===Brachycephalic Obstructive Airway Disease===

===[[Brachycephalic Obstructive Airway Disease]]===

This syndrome is a combination of conditions including ''stenotic nares'', ''elongated soft palate'', ''everted laryngeal saccules'',  and ''laryngeal collapse''. Care of these patients is similar to that of those with laryngeal paralysis, however, greater care is required in selection of any sedation and anaesthetic agent used as to not exacerbate breathing problems that may already be present. Once any agent has been given to these patients, including premedication, they should not be left without supervision and intubation equipment and oxygen should be readily available in case of an emergency.  

This syndrome is a combination of conditions including ''stenotic nares'', ''elongated soft palate'', ''everted laryngeal saccules'',  and ''laryngeal collapse''. Care of these patients is similar to that of those with laryngeal paralysis, however, greater care is required in selection of any sedation and anaesthetic agent used as to not exacerbate breathing problems that may already be present. Once any agent has been given to these patients, including premedication, they should not be left without supervision and intubation equipment and oxygen should be readily available in case of an emergency.

==Lower Airway Disease==

==Lower Airway Disease==

*Feline Asthma

*Feline Asthma

In many of these cases, agents which ''clear'' the airway should be selected to try and optimise function of the diseased pulmonary tissue. Agents known to cause severe respiratory depression should also be avoided. Severe cases may require preoxygenation before induction and intubation and if possible, local anaesthetic and sedative techniques should be be used, to avoid risks associated with general anaesthesia in these patients.

In many of these cases, agents which ''clear'' the airway should be selected to try and optimise function of the diseased pulmonary tissue. Agents known to cause severe respiratory depression should also be avoided. Severe cases may require preoxygenation before induction and intubation and if possible, local anaesthetic and sedative techniques should be be used, to avoid risks associated with general anaesthesia in these patients.