what is bronchitis and - Issues Regarding the Progression of Chronic Bronchitis
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Issues Regarding the Progression of Chronic Bronchitis

Chronic bronchitis refers to inflammation and infection of the bronchial tubes and mucosal membranes, generating an overproduction of mucus. The excessive production of mucus at the level of the respiratory tract is the body's inflammatory response to irritation and infection of the bronchia. Excess mucus perturbs the process of respiration by reducing the amount of air that is normally received by the lungs. Common symptoms of chronic bronchitis are: mucus-producing cough, difficult breathing, shortness of breath, chest pain and discomfort and wheezing.


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In the incipient stages of the disease, the symptoms of chronic bronchitis are usually perceived in the morning or during the night. In more advanced stages of chronic bronchitis, the entire respiratory tract becomes inflamed and obstructed with mucus, generating intense, persistent cough. This type of recurrent, highly productive cough is commonly referred to as "the smoker's cough". As the disease progresses, chronic bronchitis sufferers also experience pulmonary problems and they are at risk of developing serious lung diseases (pneumonia, emphysema). In time, people with chronic bronchitis may suffer from poor oxygenation of the blood and hypoventilation (shallow, accelerated breathing). Complicated forms of chronic bronchitis may also involve cyanosis as a result of poor oxygenation of the lungs. Cyanosis (bluish aspect of the skin) generally suggests the presence of emphysema or pneumonia.

2. Remove or avoid airway irritants. The most obvious one is ensuring the cat has no contact with cigarette smoke, and purchasing dust free cat litter.

Chronic bronchitis symptoms are usually of moderate intensity, but they are persistent and have a recidivating character. Unlike acute bronchitis, chronic bronchitis is an infectious disease and needs specific, long-term medical treatment. It is very important not to interrupt the treatment prescribed by the doctor even if chronic bronchitis symptoms are considerably ameliorated. If the medical treatment is prematurely stopped, the illness will quickly reoccur and chronic bronchitis symptoms can become even intensify.

The Pathology Little is known about the underlying causes or exacerbating factors in feline asthma. There may be an element of genetic predisposition. While chronic inhalation of airway irritants, such as smoking, has been shown to cause bronchitis in humans, this has not been studied in detail in cats. Likewise, allergens such as pollen, housedust mites, dander, fungal spores, dust and cat litter could all be implicated theoretically.

Bronchitis symptoms that reveal the acute character of the illness are: painful cough, chest sourness and pain, painful throat, wheezing, pain in the region of the upper abdomen, difficulty breathing. Bronchitis symptoms that reveal the chronic character of the illness are: persistent cough, cough that produces mucus, mild or moderate fever, shortness of breath, pronounced difficulty breathing (due to obstruction of the respiratory tract with mucus), recidivating chest pain, nausea and headache.

2. Radiography The next test performed is usually thoracic radiography. This is best performed under general anesthetic so there is lee chance for motion blur, though in acute situations this is not possible. This is where the most meaningful information can be gained.

5. Bronchoalveolar lavage This is similar to the technique described above, but the catheter is inserted all the way into a lower airway before the saline is injected and withdrawn. This is therefore a good test for lower airway disease.

3. Bronchoscopy Bronchoscopy allows visualization of the larger airways, and assessment for increased mucus and inflammation. 4. Tracheal wash This involves injecting a small amount of saline into the trachea and immediately withdrawing it, and then examining the cells and debris harvested under a microscope.

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Cats usually present with one or all the following signs: CoughingWheezingDifficulty breathing A minority of cases will have the classic human status asthmaticus, rapid onset breathing difficulty due to severe narrowing of the bronchi. Cats tend to be middle aged or older, and Siamese cats may be more prone than other breeds.

Bronchitis can be either acute or chronic. Acute bronchitis symptoms can be very intense, but they usually ameliorate in a few days. If acute bronchitis is caused by infection with viruses, the illness usually clears on itself, without medical treatment. However, if acute bronchitis symptoms appear to intensify, it is very important to seek the advice of your doctor.

There is a form of Emphysema influenced by a long period of smoking called "Smoker's Emphysema". It develops usually in older patients. Another type of Emphysema is the one with a hereditary transmission. In this case there is a deficiency of alpha-i-antitrypsin (AAT), but just one to three percent of all cases of Emphysema are due to AAT deficiency. This happens because in the lungs, at cells level there is an imbalance between elastin and AAT. The reaction between this two proteins is mediate by an enzyme called elastase. When there is a genetic deficiency of AAT the elastin degradation occurs unchecked. This phenomenon is worsen if the patients with genetic deficiency of AAT smoke and the symptoms appears early middle age. The deficiency of ATT is detected by blood tests made in specialized laboratories.

To return to the comparison with human asthma, when trying to understand the underlying causes it is important to differentiate between asthma (constriction of the bronchi), chronic bronchitis (oversecretion of mucus with a chronic cough) and COPD (chronic obstructive pulmonary disease). Asthma is reversible bronchial constriction caused by eosinophil cells, whereas COPD is irreversible bronchial constriction involving neutrophil cells.

Diagnosis 1. Clinical examination The first step in the diagnostic protocol is a thorough clinical examination by a veterinarian. This should localize the origin of the disease to the upper airways, lower airways or pleural space. If the cat is found to have pleural disease, a needle may be inserted straight away to remove either air or a sample of the effusion for both diagnosis and short term treatment of the respiratory distress.

A simple cough mustn't be ignored. If this cough transforms into a persistent productive cough with an excessive airway mucus secretion we can think that it is bronchitis. if the process becomes chronic and the cough and sputum persists for minimum three or six months during one or two years with very short periods in which the cough disappears, the diagnosis is sure. All this symptoms leads to the diagnosis of Bronchitis, a disease of the lungs from the COPD category. In Bronchitis the large and small airways can be obstructed and it becomes very difficult to move air in and out of the lungs.

Glucocorticoid drugs (steroids) used in inhalers include Beclometasone, Fluticasone and Budesonide. Beclometasone is cheap, but is rapidly absorbed into the bloodstream when you want it to hang around in the area where it applied. Fluticasone is more expensive, but tends to stay where you want it to. Budesonide is relatively inexpensive and though it is easily absorbed into the bloodstream, it tends to be removed the first time it goes through the liver.

Unlike patients who suffer from acute bronchitis, patients with chronic forms of the disease don't respond well to treatments with antibiotics. The excessive production of mucus at the level of the bronchial tubes facilitates the proliferation of bacteria and other infectious organisms, thus contributing to the progression of the disease. On the premises of repeated infections and compromised natural defenses of the respiratory system (cilia barriers), antibiotics are often ineffective in completely overcoming chronic bronchitis. Thus, the treatment of chronic bronchitis is focused towards relieving the already existent symptoms and preventing the development of further complications.

Regarding Smoker's Emphysema and the hereditary one studies showed that in the lungs cells the mechanism is the same. One of the tobacco smoking effects is the elastese-AAT imbalance. The explanation is that smoking stimulates excessively release of elastase. There was also confirmed the theory that the inhaled smoke stimulates the migration in the lungs of the elastase producing cells. Another aspect of smoking is the effect of the oxidants from the cigarette smoke. The antioxidants inactivate a significant portion of the elastase inhibitors and as a consequence it is upsetted the elastase-antielastase balance. But there are also other factors in addition to smoking effects that influences the development of Emphysema. Nowadays the effect of these other factors is not very clear. There was estimated that only twenty percent of smokers develop Emphysema.

It is very important to pay attention to bronchitis symptoms. Left untreated, both chronic bronchitis and acute bronchitis (when caused by bacteria) can lead to serious complications. However, any form of self-medication is not advised. By taking random left-over medicines you can only cause yourself harm. If bronchitis symptoms ease up in a few days, it is a sign that the illness is caused by airborne irritants or by viruses, in which case no medical treatment is required. However, if you experience an aggravation of bronchitis symptoms, you should see a doctor right away.

 
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Bronchitis is a very common respiratory condition and it can be occur in anyone, regardless of sex and age. However, the people who are exposed the most to developing forms of bronchitis are smokers, people with other respiratory illnesses or people with weak immunes system. Smokers usually develop chronic bronchitis, a form of disease that needs ongoing treatment. The main factors that are considered to contribute to the occurrence of bronchitis are: smoking, prolonged exposure to irritants (dust, pollen, chemicals, pollutants), immunologic deficiencies, genetic predisposition to developing respiratory conditions (in the case of chronic bronchitis) and infection with viruses and bacteria.

More informations about asthmatic bronchitis or bronchitis symptoms can be found by visiting http://www.bronchitis-guide.com/

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More informations about asthmatic bronchitis or bronchitis symptoms can be found by visiting http://www.bronchitis-guide.com/

General bronchitis symptoms are: cough, wheezing, throat pain, difficulty breathing, chest discomfort and soreness when breathing, fatigue and headache. If these bronchitis symptoms are accompanied by sweating, high fever and nausea, it means that the illness is caused by infection with bacteria. Bronchitis symptoms that might indicate an aggravation of the illness are: severe cough that contains yellowish mucus, spitting blood.

Spacer devices A spacer device consists of a chamber into which the aerosol drug is released at one end, with a mask at the other end which fits snugly over the cats mouth and nose. Human baby spacer devices (e.g. Babyhaler) can be easily adapted for cats. Alternatively, veterinary spacers specifically designed for cats are now on the market (e.g. Aerokat). The spacer should be held over the cats nose and mouth for about 30 seconds to ensure complete delivery of the drugs. It should be remembered that aerosol steroid therapy can take up to 2 weeks to reach full effect, and if the cat has been on oral steroids previously, these should be phased out slowly during these initial 2 weeks.

Although smoking alone can't be considered to be the cause of chronic bronchitis, the disease has the highest incidence in regular smokers. Smoking greatly contributes to the proliferation of bacteria and slows down the healing of the respiratory tissues and organs. Chronic bronchitis is often associated with asthma as well. Patients with chronic bronchitis who also suffer from asthma are even less responsive to specific treatments and they commonly experience symptomatic relapse. Sometimes, chronic bronchitis can be the consequence of untreated or mistreated acute bronchitis or other respiratory diseases. Chronic forms of bronchitis can also be developed by people who regularly expose themselves to airborne irritants such as dust, chemicals and pollutants.

Treatment The aims of treatment are as follows. 1. Eliminate any suspected infectious agents. This may be a sufficiently long course of antibiotics if bacterial infection is suspected, or a wormer such as fenbendazole if lungworm is suspected.

Another aspect is the deficiency of alpha-1-antitrypsin. This deficiency is caused by the loss of elastin which is a structural protein. All this leads to Emphysema. Because elastin is involved in the maintenance of the strength of the alveolar walls, in Emphysema there will be a permanent destruction of the alveoli.

6. Lung biopsy This is an invasive procedure that carries a significant risk to the patient. It is only indicated where diffuse cancer or extensive fibrosis is suspected, or in severe disease that responds poorly to treatment.

Bronchodilator drugs used in inhalers include Salbutamol and Salmeterol. Salbutamol is very fast acting and therefore useful in a crisis caused by spasm of the bronchi. However, it only lasts for about 30 minutes and is therefore unsuitable for chronic therapy as frequent dosing is required. Salmeterol on the other hand is longer acting, and lasts for about 12 hours so twice daily dosing is possible. Salmeterol is better for long term control of mild to moderate asthma while Salbutamol is better for relief of acute bronchospasm.

The Seretide Evohaler is useful for cats requiring both steroid and bronchodilator therapy. It contains salbutamol and fluticasone, a combination allowing minimal dosing frequency.

Pulmonary edema. Often due to severe heart disease.Infectious bronchitis. This can be due to bacteria, viruses or parasites.Pleural disease. Filling of the space between the lung and the chest wall with air or an effusion.Cancer. This can be a primary lung tumor or metastatic spread.Potassium bromide induced respiratory disease. A side effect from an anti-epileptic drug.Idiopathic pulmonary fibrosis. Responds poorly to treatment.Pulmonary thromboembolus. Lodging of a clot in a respiratory blood vessel causing sudden onset breathing difficulty.Pulmonary hypertension. Usually secondary to other heart or respiratory disease.

If you have bronchitis, the best things you can do before receiving medical assistance are: drink plenty of fluids (especially if you have fever), rest, stay away from irritants (smoke, alcohol vapors, chemicals, astringent substances), maintain a warm temperature in your bedroom and use air humidifiers to keep the air moist.

Chronic bronchitis generates recurrent, time-persistent symptoms that intensify as the disease progresses. The main characteristics of chronic bronchitis are productive cough, increased susceptibility to bacterial and viral infections of the respiratory tract and low responsiveness to medical treatments. Chronic bronchitis usually lasts for up to three months and regularly reoccurs over the period of two years or more. In present, there is no specific cure for chronic bronchitis.

The Differentials There are a large number of possible diagnoses when a cat first presents with coughing or breathing difficulty. Here are some of the more important ones:

It is quite common for cats to present to veterinary clinics with a chronic cough or wheeze. The problem may be constant or just recur from time to time, and can range from mild to severe. Clinically the disease may resemble human asthma, but the term feline asthma can be misleading as there are a number of different possible causes. Here we look at what those underlying causes can be, and the different forms of treatment available to affected cats.

Is treatment lifelong? Generally yes. Doses can often be reduced gradually once clinical remission has been achieved. As with many chronic conditions, complete control might not always be possible and an acceptable quality of life is the main aim of the treatment.

3. Removal or avoidance of potential allergens. House dust mite allergy must be excluded by spraying the house with an acaricidal product. 4. Chronic therapy for the underlying condition. For long term treatment of cats with feline asthma, a combination of steroids and bronchodilators are a popular choice. Steroids reduce the inflammation and lower mucus production, and can limit long term consequences such as fibrosis. Bronchodilators are most useful when there is airway spasm. Traditionally, medication has been given orally via tablets, but over the last few years, metered dose inhalers such as the ones used for human asthma have come on the market.

Aerosol therapy has the advantage that the maximum concentration of drug is delivered to the target site. This means that lower overall doses can be used, and the cat is less likely to suffer the negative side effects of steroids. Various inhalers can be used in both cats and dogs, but they tend to be designed for humans. As a result, higher doses are given compared with human medicine, as humans can be instructed to breathe deeply whereas cats will breathe normally at best.

For more resources on bronchitis or especially about acute bronchitis please click this link http://www.bronchitis-guide.com/acute-bronchitis.htm



Dr Matthew Homfray is one of the veterinary pet experts at http://www.WhyDoesMyPet.com. Our dedicated community of caring pet experts are waiting to offer you advice, second opinions and support.


 
 
     
 
 





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