ISSN 2398-2985      

Dyspnea

Jreptile
Contributor(s):

Jemma Hildrew

Sarah Brown


Introduction

  • Distress associated with difficult or labored breathing which leads to a shortness of breath.
  • Cause: respiratory causes including disease of the upper and/or lower respiratory tract; non-respiratory causes include pain, anxiety, fever, heat stroke, obesity, coelomic distension, cardiac disease, metabolic disorders, neuromuscular disease, and anemia.
  • Signs: depends on underlying cause. General: anorexia, lethargy, weight loss, dysecdysis. Increased respiratory effort, pyrexia, nasal discharge, sneezing, coughing, wheezing. Poor buoyancy control in aquatic species.
  • Diagnosis: a complete physical examination with history. Husbandry and diet review. CBC/chemistries, microbiology, ELISA and IFA, PCR tests, nasal swab/wash, transtracheal wash or bronchoalveolar lavage, cytology of any exudate, ultrasound-guided lung aspiration, histopathology, radiography, CT or MRI, ultrasonography, respiratory endoscopy.
  • Treatment: fluid therapy, analgesia.
  • Prognosis: poor if the reptile is open-mouth breathing; poor to grave for underlying disease such as neoplasia, cardiac disease.
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Pathogenesis

Etiology

Respiratory causes

  • Upper respiratory tract:
  • Lower respiratory tract Lower respiratory tract disease:
  • Neoplasia: pulmonary adenoma; metastatic lesions rare.
  • Pulmonary edema (usually cardiogenic).
  • Pulmonary contusion from trauma, eg fall, dropped, chelonians chewed by dog or fox, trauma from lawnmowers and trimmers.
  • Allergy (not well documented).
  • Intrathoracic tracheal disease including neoplasia, abscess, foreign body: uncommon.
  • Extraluminal tracheal compression due to abscess or neoplasia.
  • Traumatic airway rupture: common post trauma from dogs, foxes, lawnmower/strimmer Traumatic injuries.

Non-respiratory causes

  • Any cause of anxiety, pain.
  • Obesity Obesity.
  • Heat stroke Heat stress.
  • Abdominal distension: gravidity, organomegaly, dilation of stomach, cecum, ascites.
  • Cardiac disease Heart disease, including congestive heart failure, shock, severe arrhythmias.
  • Metabolic acidosis or uremia.
  • Severe central nervous system disease such as trauma Traumatic injuries, abscess, neoplasia, inflammation.
  • Spinal disease (trauma) Traumatic injuries.
  • Anemia Anemia.
  • Iatrogenic: following multiple attempts at intubation or recent intubation.

Predisposing factors

General

Specific

Pathophysiology

  • Primary respiratory disease:
  • Non-respiratory disease:
    • Abnormalities in pulmonary vascular tone as seen with central nervous system disease or shock.
    • Abnormalities with pulmonary circulation as seen with congestive heart failure.
    • Problem with oxygenation as seen with anemia.
    • Problems with ventilation: obesity, ascites, abdominal organomegaly, or musculoskeletal disease.

Timecourse

  • Depends on underlying disease.
  • If dyspnea becomes severe such that there is open-mouth breathing; that is an acute development.
  • However, reptiles frequently have an acute presentation of a chronic disease.

Epidemiology

  • With infectious disease, there may be transmission between reptiles directly, airborne orby fomites in a colony or household.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

Other sources of information

  • Chitty J (2019) Respiratory System. In: BSAVA Manual of Reptiles. 3rd edn. Eds: Girling S & Raiti P. BSAVA, UK. pp 309-322.
  • Wendland L, Brown D, Klein P & Brown M (2006). Upper Respiratory Tract Disease (Mycoplasmosis) in Tortoises. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D. Saunders, USA. pp 931-938.

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