Difference between revisions of "Canine Infectious Tracheobronchitis"

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Also known as: '''''Kennel Cough — Canine Respiratory Disease Complex — Infectious Canine Tracheobronchitis Infectious Canine Tracheitis'''''
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{| cellpadding="10" cellspacing="0" border="1"
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| Also known as:
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| '''Kennel Cough'''<br>'''Canine respiratory disease complex'''<br>'''Infectious Canine Tracheobronchitis<br>Infectious Canine tracheitis
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|-
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|}
  
 
==Description==
 
==Description==
A highly contagious acute respiratory disease spread by close contact causing laryngitis, tracheitis, bronchitis and in some cases a rhinitis.
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A highly contagious acute respiratory disease spread by close contact causing larngitis, [[Trachea Inflammatory - Pathology#Infectious causes of tracheitis|tracheitis]], [[Bronchi and Bronchioles Inflammatory - Pathology#Infectious causes of bronchitis or bronchiolitis|bronchitis]] and in some cases a [[Nasal Cavity Inflammatory - Pathology#Rhinitis|rhinitis]].
 
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Multiple agents are implicated in the disease including [[Canine Adenovirus 1|Canine Adenovirus 1 ]],[[Canine Adenovirus 2|Canine Adenovirus 2]],[[Canine Herpesvirus 1|Canine Herpes virus]], [[Canine Parainfluenza - 2|Canine Parainfluenza - 2]], [[Canine Distemper Virus|Canine Distemper Virus]], [[Category:Mycoplasmas|Mycoplasma species]] and [[Bordetella bronchiseptica|''Bordetella bronchoseptica'']]. Most cases involve a primry viral infection and sometimes with secondary bacterial involvement. ''B.bronchoseptica'' adheres to ciliated epithelial cells in the trachea where it proliferates and releases toxins causing epithelial necrosis and prevents[[Diseases of the nasal cavity and sinuses#Mucociliary escalator| ciliary clearance]].  Mortality rates are very low and it is a common disease in dogs that are housed in groups.
Multiple agents are implicated in the disease including [[Canine Adenovirus 1|Canine Adenovirus 1]], [[Canine Adenovirus 2|Canine Adenovirus 2]], [[Canine Herpesvirus 1|Canine Herpes virus]], [[Canine Parainfluenza - 2|Canine Parainfluenza - 2]], [[Canine Distemper Virus|Canine Distemper Virus]], [[:Category:Mycoplasmas|Mycoplasma species]] and [[Bordetella bronchiseptica|''Bordetella bronchoseptica'']]. Most cases involve a primary viral infection and sometimes with secondary bacterial involvement. ''B.bronchoseptica'' adheres to ciliated epithelial cells in the trachea where it proliferates and releases toxins causing epithelial necrosis and prevents[[Diseases of the nasal cavity and sinuses#Mucociliary escalator| ciliary clearance]].  Mortality rates are very low and it is a common disease in dogs that are housed in groups.
 
  
 
==Signalment==
 
==Signalment==
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==Diagnosis==
 
==Diagnosis==
===History and Clinical Signs===
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==History and Clinical Signs==
 
Often a history of exposure to other dogs at either rehoming centers, bording kennels, or in a hospital etc. Direct contact or aerosol spread are the most common routes of infection.  
 
Often a history of exposure to other dogs at either rehoming centers, bording kennels, or in a hospital etc. Direct contact or aerosol spread are the most common routes of infection.  
Clinical signs develop 3-5 days after exposure. Signs are often mild and self limiting.  Affected dogs usually have a dry hacking cough which is likely to be exacerbated on exercise or excitement. Sometimes sneezing, [[Diseases of the nasal cavity and sinuses#Nasal discharge|serous nasal discharge]] and lymphadenopathy are present.
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Clinical signs develop 3-5 days after exposure. Signs are often mild and self limiting.  Afected dogs usually have a dry hacking [[Cough - Canine|cough]] which is likely to be exacerbated on exercise or excitement. Sometimes sneezing, [[Diseases of the nasal cavity and sinuses#Nasal discharge|serous nasal discharge]] and lymphadenopathy are present.
The clinical signs typically persist from 2-3 days to 2-3 weeks.
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The clinical signs typically persist for 2-3 days to 2-3 weeks.
  
Systemic signs are likely to indicate the development of [[Bronchopneumonia|bronchopneumonia]], signs include pyrexia, inappetance and depression. Systemic disease is more likely to occur in young or immunocompromised animals. This condition is usually a result of secondary infection with [[:Category:Pasteurella and Mannheimia species| ''Pasturella'' species]] and [[:Category:Streptococcus species|''Streptococci'' bacteria]]. If widespread systemic signs are present infection with canine distemper virus should be suspected.
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Systemic signs are likely to indicate the development of [[Lungs Inflammatory - Pathology#Bronchopneumonia|bronchopneumonia]], signs include pyrexia, inappetance and depression. Systemic disease is more likely to occur in young or immunocompromised animals. This condition is usually a result of secondary infection with [[Category:Pasteurella and Mannheimia species| pasturella species]] pasturella and [[Category:Streptococcus species| streptococci bacteria]] streptococci species. If widespread systemic signs are present infection wth canine distemper virus should be suspected.
  
 
Diagnosis is most often made on history and physical exam ruling out other causes of the cough.
 
Diagnosis is most often made on history and physical exam ruling out other causes of the cough.
  
===Laboratory Tests===
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==Laboratory Tests==
[[Canine Haematology|Haematology]] and [[Canine Biochemistry|Biochemistry]] will help to look for an underlying cause of disease in immunocomprommised animals. Additionally they may show signs of infection including a [[Neutrophilia|Neutrophilia]] sometimes with a left shift.
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[[Canine Haematology - WikiNormals|Haematology]] and [[Canine Biochemistry - WikiNormals|Biochemistry]] will help to look for an underlying cause of disease in immunocomprommised animals. Additionally they may show signs of infection including a [[Changes in Inflammatory Cells Circulating in Blood - Pathology#Neutrophilia|Neutrophilia]] sometimes with a left shift.
  
===Radiography===
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==Radiography==
 
Thoracic radiography and ultrasound are often unremarkable however may help to rule out other causes of the cough.
 
Thoracic radiography and ultrasound are often unremarkable however may help to rule out other causes of the cough.
  
===Endoscopy===
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==Endoscopy==
 
Only considered when it is necessary to rule out a number of alternative diagnoses.  
 
Only considered when it is necessary to rule out a number of alternative diagnoses.  
Will enable collection of samples from the respiratory tract. Often no specific findings however, tracheal cytology may reveal increased numbers of neutrophils and bacteria. Samples for bacteriology from the upper airways may be deceptive as they are likely to harbour commensal organisms. Ideally samples should be collected from the lower airways by a transbronchial wash.
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Will enable collection of samples from the respiratory tract. Often no specific findings however, tracheal cytology may reveal inreased numbers of neutrophils and bacteria. Samples for bacteriology from the upper airways may be deceptive as they are likely to harbour commensal organisms. Ideally samples sholud be collected from the lower airways by a transbronchial wash.
  
 
==Treatment==
 
==Treatment==
Uncomplicated cases are often self limiting and will resolve with a regime of strict rest for 7 days until coughing subsides.
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Uncomplicated cases are often self limiting and will resolve with or without treatment.  
 
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Antibiotic treatment is indicated if the animal is showing signs of systemic illness or if there is bronchopneumonia present. Where culture and sensitivity has been undertaken an appropriate antibiotic should be chosen on these results otherwise [[Tetracyclines| doxycycline]], [[Macrolides and Lincosamides|erythromycin]], [[Chloramphenicol|chloramphenicol]] or a [[Potentiated-Sulphonamides| potentiated sulphonamide]] are good choices.  
Antibiotic treatment is indicated if the animal is showing signs of systemic illness, fever, mucoid or mucopurulent nasal discharge, or if there is bronchopneumonia present. Where culture and sensitivity has been undertaken an appropriate antibiotic should be chosen on these results otherwise [[Tetracyclines| doxycycline]], [[Macrolides and Lincosamides|erythromycin]], [[Chloramphenicol|chloramphenicol]] or a [[Potentiated-Sulphonamides| potentiated sulphonamide]] are good choices.  
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Antitussives and bronchodilators may be used to alleviate severe coughing. Nebulization can also be useful to help loosen bronchial and tracheal secretions.
 
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In patients with severe disease further supportive care including [[Fluid Therapy |fluids]] and enteral feeding wil be required.
Antitussives (Hydrocodone, Codeine....without acetaminophen) may be used to alleviate severe coughing. Do not use cough suppressants in patients with pulmonary infiltrates, rather encourage coughing and use expectorant such as bromhexine along with nebulization and coupage.  Nebulization with saline, bronchodilators, and/or antibiotics can also be useful to help loosen bronchial and tracheal secretions.  
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[[Anti-Inflammatory Drugs|Anti-inflammatories]] may help relieve some of the clinical signs however there use is contra-indicated in immunocompromised animals.
 
 
In patients with severe disease further supportive care including [[Principles of Fluid Therapy |fluids]] and enteral feeding will be required.
 
 
 
Prednisone at an anti-inflammatory dose (0.5mg/kg BID, tapering) can be used to decrease tracheal inflammation and stop the cough-inflammation-infection cycle.  Be careful to not use in animals that are ill or showing signs of pneumonia or systemic illness.
 
  
 
==Control==
 
==Control==
[[Vaccines|Vaccines]] can prevent or reduce the severity of disease caused by ''B. bronchiseptica'', parainfluenza virus and adenovirus. Vaccinated animals can still contract the disease as multiple agents are implicated. Vaccines are available to be given systemically or intranasally. Intranasal vaccination provides mucosal [[Immunoglobulin A|IgA]] immunity and the presence of maternal antibodies do not affect actions of the vaccine..  
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[[Vaccines - WikiBlood|Vaccines]] can prevent or reduce the severity of disease caused by ''B. bronchiseptica'', parainfluenza virus and adenovirus. Vaccinated animals can still contract the disease as multiple agents are implicated. Vaccines are available to be given systemically or intranasally. Intranasal vaccination provides mucosal [[Immunoglobulin A|IgA]] immunity and the presence of maternal antibodies are not a problem.  
 
It is important to practice good husbandry in areas where groups of dogs mix e.g boarding kennels . Ideally all animals should be vaccinated, any infected animals should be isolated to minimise the spread to unaffected animals and all fomites that have come into contact with an affected animal must be disinfected. Areas should be kept well ventilated and ideally animals should be kept in low population densities.
 
It is important to practice good husbandry in areas where groups of dogs mix e.g boarding kennels . Ideally all animals should be vaccinated, any infected animals should be isolated to minimise the spread to unaffected animals and all fomites that have come into contact with an affected animal must be disinfected. Areas should be kept well ventilated and ideally animals should be kept in low population densities.
  
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Good, generally self limiting.
 
Good, generally self limiting.
  
{{Learning
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==References==
|flashcards = [[Trachea_Flashcards_-_Pathology|Trachea Pathology Flashcards]]
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|literature search =[http://www.cabdirect.org/search.html?q=title%3A%28%22Canine+Infectious+Tracheobronchitis%22%29+OR+title%3A%28%22Kennel+Cough%22+%29+OR+title%3A%28%22Canine+respiratory+disease+complex%22+%29+OR+title%3A%28%22Infectious+Canine+Tracheobronchitis%22%29+OR+title%3A%28%22Infectious+Canine+tracheitis%22%29+ Canine Infectious Tracheobronchitis]
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Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)
}}
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Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
  
==References==
 
  
Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2) ''W.B. Saunders Company''
 
  
Merck & Co (2008) '''The Merck Veterinary Manual''' (Eighth Edition) Merial
 
  
  
{{review}}
 
  
{{OpenPages}}
 
  
[[Category:Respiratory Diseases - Dog]]
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[[Category:Dog]]
  
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[[Category:To_Do_-_Caz]]
 
[[Category:Respiratory_Viral_Infections]]
 
[[Category:Respiratory_Viral_Infections]]
 
[[Category:Respiratory_Bacterial_Infections]]
 
[[Category:Respiratory_Bacterial_Infections]]
[[Category:Expert_Review]]
 

Revision as of 15:50, 26 July 2010




Also known as: Kennel Cough
Canine respiratory disease complex
Infectious Canine Tracheobronchitis
Infectious Canine tracheitis

Description

A highly contagious acute respiratory disease spread by close contact causing larngitis, tracheitis, bronchitis and in some cases a rhinitis. Multiple agents are implicated in the disease including Canine Adenovirus 1 ,Canine Adenovirus 2,Canine Herpes virus, Canine Parainfluenza - 2, Canine Distemper Virus, and Bordetella bronchoseptica. Most cases involve a primry viral infection and sometimes with secondary bacterial involvement. B.bronchoseptica adheres to ciliated epithelial cells in the trachea where it proliferates and releases toxins causing epithelial necrosis and prevents ciliary clearance. Mortality rates are very low and it is a common disease in dogs that are housed in groups.

Signalment

Affects dogs of all ages. Puppies and immunocompromised dogs are often worst affected.

Diagnosis

History and Clinical Signs

Often a history of exposure to other dogs at either rehoming centers, bording kennels, or in a hospital etc. Direct contact or aerosol spread are the most common routes of infection. Clinical signs develop 3-5 days after exposure. Signs are often mild and self limiting. Afected dogs usually have a dry hacking cough which is likely to be exacerbated on exercise or excitement. Sometimes sneezing, serous nasal discharge and lymphadenopathy are present. The clinical signs typically persist for 2-3 days to 2-3 weeks.

Systemic signs are likely to indicate the development of bronchopneumonia, signs include pyrexia, inappetance and depression. Systemic disease is more likely to occur in young or immunocompromised animals. This condition is usually a result of secondary infection with pasturella and streptococci species. If widespread systemic signs are present infection wth canine distemper virus should be suspected.

Diagnosis is most often made on history and physical exam ruling out other causes of the cough.

Laboratory Tests

Haematology and Biochemistry will help to look for an underlying cause of disease in immunocomprommised animals. Additionally they may show signs of infection including a Neutrophilia sometimes with a left shift.

Radiography

Thoracic radiography and ultrasound are often unremarkable however may help to rule out other causes of the cough.

Endoscopy

Only considered when it is necessary to rule out a number of alternative diagnoses. Will enable collection of samples from the respiratory tract. Often no specific findings however, tracheal cytology may reveal inreased numbers of neutrophils and bacteria. Samples for bacteriology from the upper airways may be deceptive as they are likely to harbour commensal organisms. Ideally samples sholud be collected from the lower airways by a transbronchial wash.

Treatment

Uncomplicated cases are often self limiting and will resolve with or without treatment. Antibiotic treatment is indicated if the animal is showing signs of systemic illness or if there is bronchopneumonia present. Where culture and sensitivity has been undertaken an appropriate antibiotic should be chosen on these results otherwise doxycycline, erythromycin, chloramphenicol or a potentiated sulphonamide are good choices. Antitussives and bronchodilators may be used to alleviate severe coughing. Nebulization can also be useful to help loosen bronchial and tracheal secretions. In patients with severe disease further supportive care including fluids and enteral feeding wil be required. Anti-inflammatories may help relieve some of the clinical signs however there use is contra-indicated in immunocompromised animals.

Control

Vaccines can prevent or reduce the severity of disease caused by B. bronchiseptica, parainfluenza virus and adenovirus. Vaccinated animals can still contract the disease as multiple agents are implicated. Vaccines are available to be given systemically or intranasally. Intranasal vaccination provides mucosal IgA immunity and the presence of maternal antibodies are not a problem. It is important to practice good husbandry in areas where groups of dogs mix e.g boarding kennels . Ideally all animals should be vaccinated, any infected animals should be isolated to minimise the spread to unaffected animals and all fomites that have come into contact with an affected animal must be disinfected. Areas should be kept well ventilated and ideally animals should be kept in low population densities.

Prognosis

Good, generally self limiting.

References

Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)

Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial