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1039.e2 Viral Respiratory Disease

Viral Respiratory Disease Client Education
Sheet
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HISTORY, CHIEF COMPLAINT
BASIC INFORMATION
Varies with specific virus, health and vaccination respiratory infections involving the upper
airways are self-limited, but pneumonia
Definition status, and other variables. (primary or secondary) can be life-threatening.
Upper and/or lower respiratory disease caused • Dog (typically acute onset shortly after
by viral infection exposure to other dogs) DIAGNOSIS
○ Cough (often dry and hacking, occasion-
Synonyms ally soft and moist) Diagnostic Overview
• Dogs: canine infectious respiratory disease ○ Retch after cough Definitive demonstration of a particular patho-
complex (CIRDC), kennel cough ○ Hyporexia gen is not necessary for a pet with acute, stable
• Cats: feline upper respiratory disease ○ Respiratory distress if pneumonia present respiratory infection. Pets that do not improve
complex, feline upper respiratory infection (especially influenza, CDV, herpes) in several days or have evidence of pneumonia
○ Other systemic signs (e.g., vomiting/ require further investigation. Specific patho-
Epidemiology diarrhea, seizures with CDV) gen confirmation can inform preventative
SPECIES, AGE, SEX • Cat (often acute onset after exposure to other strategies in outbreaks in shelters, kennels, or
• Dogs and cats of either sex cats, but FHV and FCV can recrudesce or hospitals.
• Clinical signs often worse in poorly vac- produce chronic signs; FIP causes slowly
cinated (typically young) pets worsening signs over weeks) Differential Diagnosis
○ Hyporexia • Dogs
RISK FACTORS ○ Nasal/ocular discharge ○ Other CIRDC pathogens, including
• Group housing, especially in stressful ○ Sneezing bacterial pathogens (e.g., Bordetella bron-
environments such as shelters or boarding ○ Teary, reddened, swollen eyes chiseptica, Mycoplasma cynos, Streptococcus
facilities ○ Hypersalivation equi subsp zooepidemicus)
• Incomplete or overdue vaccinations ○ Respiratory distress: occasional ○ Heart disease (e.g., congestive heart failure,
○ Other systemic signs (e.g., neurologic signs heartworms)
CONTAGION AND ZOONOSIS with FIP) ○ Aspiration pneumonia
Most viral respiratory infections are highly ○ Foreign body
contagious, especially by aerosol exposure. Only PHYSICAL EXAM FINDINGS ○ Pulmonary thromboembolism
a few (i.e., avian and seasonal influenza) are Dog: • Cats
zoonotic. • Cough easily elicited on tracheal palpation ○ Other feline upper respiratory pathogens,
(very common but nonspecific) including bacterial pathogens (e.g.,
ASSOCIATED DISORDERS • Fever (common) Chlamydophila felis, B. bronchiseptica,
• Secondary bacterial infection (especially • Tachypnea (if pneumonia) Mycoplasma)
pneumonia) • Inspiratory/expiratory effort (if pneumonia) ○ Acute nasal signs: nasal foreign body,
• Corneal ulcers/keratitis (feline herpesvirus) • Auscultable crackles ± wheezes (if pneumonia) cryptococcosis, polyps
• Chronic stomatitis (feline calicivirus) • Systemic signs of CDV ○ Acute ocular signs: corneal injury/uveitis/
Cat: glaucoma
Clinical Presentation • Fever (very common) ○ Acute respiratory distress: lower airway
DISEASE FORMS/SUBTYPES • Nasal/ocular discharge (very common) disease (e.g., asthma), congestive heart
• Dogs: most viral respiratory infections • Oral ulcers/ptyalism (common; especially failure, pleural effusion, feline heartworm
manifest as tracheobronchitis, but primary FCV) disease
pneumonia can occur (p. 987). • Epiphora/blepharospasm/conjunctivitis/
• Canine viral respiratory pathogens: canine chemosis (common [pp. 199, 208, and 464]) Initial Database
adenovirus type 2 (CAV-2), canine para- • Corneal ulcers (FHV) • Depends on clinical presentation; minimal
influenza virus (cPIV), canine distemper • Tachypnea (if pneumonia) initial diagnostics indicated if animal main-
virus (CDV [p. 271]), canine influenza virus • Cough (if pneumonia) tains an appetite, has signs limited to upper
(H3N8, H3N2 [p. 545]), canine respiratory • Inspiratory/expiratory effort (if pneumonia) airways, and appears stable
coronavirus (CRCoV), canine herpesvirus • Auscultable crackles ± wheezes (if pneumonia) • If tachypnea, respiratory distress, or adven-
(CHV [p. 466]), canine bocavirus, canine • Systemic signs of FIP virus, virulent systemic titial lung sounds are appreciated, thoracic
hepacivirus, canine pneumovirus calicivirus radiographs indicated
• Cats: most viral respiratory infections • Other diagnostics vary by clinical presentation
manifest with upper airway and ocular signs, Etiology and Pathophysiology
with or without oral ulcers (p. 1006). Viral Depends on specific viral pathogen. Most are Advanced or Confirmatory Testing
pneumonia may also occur; dry form FIP contagious by contact with aerosol or aerosol • Thoracic radiographs
can cause primary viral pneumonia without droplets in the environment. Many factors other ○ Unstructured interstitial pattern common
upper respiratory signs. than the virus impact disease manifestation, with viral pneumonia
• Feline viral respiratory pathogens: feline including factors related to the inoculum, host ○ Alveolar pattern should prompt airway
herpesvirus (FHV, or rhinotracheitis virus (e.g., vaccination status, comorbid conditions), lavage with culture for secondary bacterial
[p. 464]), feline calicivirus (FCV [p. 141]), and environment (e.g., air quality, crowded/ pathogens.
influenza (H7N2, others), feline infectious stressful conditions). Infections caused by • Nasopharyngeal swab for polymerase chain
peritonitis (FIP [p. 327]), feline reovirus, multiple pathogens are common, including reaction (PCR) pathogen identification
cowpox virus secondary bacterial infections. Most viral (typically as diagnostic respiratory panel)

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