![]() Three-view radiography (ie, left lateral, right lateral, ventrodorsal) is recommended, particularly when neoplasia is suspected. Radiographs can help determine disease location and extent, as well as concurrent abnormalities however, sensitivity is reduced with small or subtle lesions. Thoracic radiography can help investigate respiratory disease and is widely available. Disease affecting more than one location in the airway should be considered when mixed effort is noted. Pulmonary parenchymal disease can be associated with increased inspiratory, expiratory, or mixed effort. Upper airway disease and pleural disease are often associated with increased inspiratory effort, and lower airway disease typically results in increased expiratory effort. Phase of maximal respiratory effort can be inspiratory, expiratory, or mixed. Diminished bronchovesicular sounds are associated with disease of the pleural space. Wheezes are typically appreciated on exhalation and likely indicate lower airway narrowing. Crackles are an inspiratory sound mainly associated with disease in the pulmonary parenchyma and can also be associated with terminal bronchiole collapse and mucus accumulation. ![]() Stertor and stridor are inspiratory sounds associated with the upper airway stertor indicates nasopharyngeal disease (eg, nasopharyngeal polyp in a cat), and stridor indicates disease of the larynx and upper trachea (eg, laryngeal paralysis). In patients presented for cough and/or respiratory distress, respiratory sounds apparent with a stethoscope (eg, crackles, wheezes, increased or decreased bronchovesicular sounds) and without (eg, stertor, stridor) should be noted along with increased effort during a particular respiratory phase. For example, in a patient with nasal discharge, character of discharge, whether discharge is unilateral or bilateral, airflow, ocular retropulsion, dental disease, respiratory sounds (eg, stertor, stridor), and depigmentation, symmetry, and pain on palpation of the nasal planum, surrounding facial structure, or bridge of the nose should be determined. Questions regarding systemic signs, including GI (eg, vomiting, regurgitation) and gastroesophageal reflux (eg, lip licking, repetitive swallowing, neck extension) signs, should be based on the presenting complaint.įocused examination for stabilization, initial treatment, and diagnostics may be needed before complete physical examination in patients with respiratory distress and can provide specific information about the area of concern. General patient history should be supplemented by a respiratory-focused history that includes onset, duration, and character of respiratory signs, as well as changes in these parameters and other respiratory or systemic signs. ![]() Patient history and physical examination should be followed by appropriate advanced diagnostics.įollowing are the 5 most common methods for diagnosing respiratory disease, according to the author. ![]() Evaluating respiratory disease can be challenging, and multiple diagnostics may be required for diagnosis.
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