doc. dr. sc. Marin Torti
Veterinarski fakultet Sveučilišta u Zagrebu
marin.torti@vef.hr
Izlaganje sa Znanstveno-stručnog skupa
Izvor: Zbornik, Veterinarski dani, Opatija, 2017.
Prevalencija kroničnih bolesti bronha u mačaka je nepoznata; obolijevaju najčešće mlade i srednje stare mačke, nešto češće sijamske pasmine. Uspoređujući kronične bolesti bronha u mačaka s onima u pasa, glavna je razlika u pojačanoj reaktivnosti dišnih prohoda mačaka – mačke su sklonije bronhokonstrikciji. Uzroci nastanka kroničnog bronhitisa i astme mačaka su nepoznati, i najvjerojatnije su različiti.
Kliničkom slikom kroničnog bronhitisa i astme mačaka dominira epizodna pojava kliničkih znakova, najčešće kašlja i respiratornog distresa. Vlasnici pri napadima kašlja ili respiratornog distresa češće opisuju zviždukanje pri disanju. Epizode respiratornog distresa često se javljaju nakon tjelesnog napora (poput igranja). Progresija bolesti je polagana i nije praćena općim kliničkim znakovima, poput gubitka na tjelesnoj masi, slabijim apetitom i sl.
Na kronični bronhitis i astmu možemo posumnjati na temelju anamnestičkih podataka te kliničkog i rentgenskog nalaza. Nažalost, nema patognomoničnih kliničkih znakova ili nalaza laboratorijskih pretraga. Do dijagnoze idiopatskog kroničnog bronhitisa i astme dolazi se isključivanjem drugi mogućih uzroka kašlja i respiratornog distresa. Važno je pritom naglasiti da mačke u epizodama akutne egzarcerbacije praćene respiratornim distresom ne pregledavamo, već prvo pristupamo stabilizaciji.
Rentgenski kronični bronhitis i astmu prati bronhalni uzorak s hiperinflacijom pluća (naglašeno perifernih režnjeva). U ranijim fazama bolesti, kada promjene nisu uznapredovale, rentgenski je nalaz često normalan. Kao i kod pasa, i kod mačaka je kod sumnje na kronični bronhitis/astmu dobro učiniti endoskopsku pretragu dišnog sustava s uzorkovanjem, ponajprije kako bi se isključiti drugi uzroci kašlja i respiratornog distresa. Citološkom pretragom endoskopski dobivenih ispiraka dišnih prohoda često nalazimo mješovitu populaciju upalnih stanica – u slučajevima kroničnog bronhitisa dominiraju neutrofilni leukociti, dok astmu često prati dominacija eozinofilnih leukocita (iako povećan udio eozinofilnih leukocita može u mačaka biti i normalan nalaz).
Mačke oboljele od kroničnog bronhitisa/astme su često hitni pacijenti, jer prilikom prijema očituju znakove izrazitog respiratornog distresa, praćenog disanjem otvorenim ustima i cijanozom. U tim slučajevima često je potrebno provesti hitnu stabilizaciju primjenom bronhodilatatora (aminofilin ili salbutamol) i oksigenoterapije.
Kao što je to slučaj kod kroničnog bronhitisa pasa, okosnicu liječenja idiopatskog kroničnog bronhitisa i astme mačaka čine kortikosteroidi, primjenjeni sistemski i lokalno.
Prognoza je dobra, iako se kronični bronhitis i astma mačaka ne mogu izliječiti.
Reference
Dostupne na zahtjev kod autora.
Marin Torti
C hronic bronchitis and asthma are chronic inflammatory diseases of the lower respiratory tract; chronic bronchitis is accompanied by persistent, daily cough, while asthma is accompanied by acute and reversible bronchoconstriction. In practical terms, chronic bronchitis and asthma are often difficult to distinguish clinically, especially in cases of cough-variant asthma. Accordingly, cats that cough can suffer from chronic bronchitis or asthma, while cats who do not cough and manifest clinical signs of exercise intolerance and respiratory distress may suffer from asthma, but not from chronic bronchitis.The prevalence of chronic bronchial diseases in cats is unknown; they are most commonly seen in young and middle-aged cats are, most often in Siam breed. When compared to the canine dogs, the main difference in cats is the increased reactivity of the respiratory tract – cats are more prone to bronchoconstriction. Causes of chronic bronchitis and asthma in cats are unknown, and are most likely different.
Clinical picture of chronic bronchitis and asthma cats is dominated by episodic clinical signs, most often coughing and respiratory distress. Cough or respiratory distress episodes are commonly accompanied by wheezing. Episodes of respiratory distress often occur after physical exertion (such as playing). Progression of the disease is slow and is not accompanied by signs such as loss of body weight, decreased appetite, etc.
On the basis of history, clinical sings and radiography findings we make a presumptive diagnosis of chronic bronchitis/asthma. Unfortunately, there are no pathognomonic clinical signs or laboratory test findings. The diagnosis of idiopathic chronic bronchitis and asthma is made with the exclusion of other possible causes of cough and respiratory distress. It is important to emphasize that in cases of acute worsening of the disease with signs of respiratory distress, cats should not be examined but first stabilized.
Radiographically, chronic bronchitis and asthma are accompanied by a bronchial pattern with hyperinflation of the lungs (more pronounced in peripheral lobes).
In earlier phases of the diseases, X-ray findings are often normal. As is the case with dogs, endoscopy of the respiratory tract with sampling is often indicated primarily to exclude other possible causes of cough and respiratory distress. In the bronchoalveolar lavage fluid mixed population of inflammatory cells is found – in cases of chronic bronchitis with the predominance of neutrophilic leukocytes, and in asthma by dominance of eosinophilic leukocytes (although the increased number of eosinophilic leukocytes can be a normal finding in cats).Cats suffering from chronic bronchitis/asthma often present themselves as emergency patients, with signs of severe respiratory distress (open mouth breathing andcyanosis). In these cases, it is often necessary to undergo an emergency stabilization by using a bronchodilator (aminophylline or salbutamol) and oxygen therapy. As is the case with canine chronic bronchitis, the backbone of feline idiopathic chronic bronchitis treatment and feline asthma are corticosteroids, administered systemically and locally.
The prognosis is good, although chronic bronchitis and asthma cannot be cured.