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Oscar G.Illanes,DVM,PhD,DACVP
Department of Pathobiology
Pathology of the Respiratory
System
Disclaimer: Images from this presentation come from
different sources: Mc Gavin ‘s Pathologic Basis of Veterinary
Disease, Dr. King files, Noah’s arkive ,OVC, AVC, author’s
own files etc. This presentation is for teaching purposes only,
please do not distribute.
General objectives
 Overview of the diseases that affect the respiratory system of
domestic animals
 Emphasis on:
 how to recognize the morphologic changes present within
tissues in specific diseases/ conditions
 most common respiratory diseases
 how to arrive to the proper morphologic or etiologic diagnosis
for the lesion
 Disease pathogenesis, if known
 Differential diagnosis, if applicable.
References
 A. Lόpez:“ Respiratory System” in Pathologic Basis ofVeterinary
Disease, McGavin & Zachary, editors, 5th ed., Mosby, p458-,
2012
 J Caswell & K.Williams:“Respiratory System” in JKP
Pathology of Domestic Animals,Vol 2, edited by MG Maxie, 5th
ed., Saunders, p523-653, 2007
Anatomic division of the respiratory
tract
Upper & Lower respiratory
tract. In general the upper respiratory
tract is the portion of the respiratory
system located outside the thoracic
cavity.
Physiologically the respiratory tract
is divided into three independent
but continuous systems:
1.- Conducting system: Includes the
nasal cavity, paranasal sinuses, larynx, trachea
and bronchi.The mucosa of this system
is primarily lined by pseudostratified ciliated
epithelium
and goblet cells.
2.-Transitional system : consists
exclusively of bronchioles which are
lined by Clara cells (detoxification of xenobiotics),
non-ciliated secretory cells and only a few ciliated
cells. Healthy bronchioles do not have
goblet cells.
3. Exchange system: Composed of alveolar
ducts and millions of alveoli; thin-walled
structures enveloped by a rich network of
capillaries, the pulmonary capillaries.
Alveoli are lined by epithelial
type I (membranous) and type II (granular)
pneumocytes (also called pneumonocytes).
Each of these systems has a
characteristic susceptibility to injury
and specific type of host response and
repair.
The lungs have a dual blood supply:
Through the pulmonary arteries which
conduct deoxygenated blood from
the right side of the heart, and the bronchial
arteries, which carry oxygenated blood.
 In addition to gas exchange, the respiratory system is
also involved in phonation, olfaction, temperature
regulation, acid–base balance, blood pressure
regulation etc.
 Several of these functions may be affected by
respiratory disease.
Pictures from Dr. Thomas Caceci’s histology
Web site.
Pictures from Dr. Thomas Caceci’s histology
Web site.
Normal Flora – Restricted only to the most
proximal region of the conductive system: nasal
cavity, nasopharynx, larynx and trachea.
The distal portions of the respiratory tract are
considered to be sterile.
 Even though the majority of
the organisms of the normal
respiratory flora are harmless
others are potentially
pathogenic; e.g.: Mannheimia
haemolytica,Bordetella
bronchiseptica.
“The air that we inhale
every day in a healthy
environment contains
billions of suspended
particles, spores, bacteria,
viruses and noxious gases
that are constantly carried
deep into the
lungs”...Fortunately the
lungs have a very efficient
defence system to deal
with the environmental
hazards present under
normal conditions.
Experimental studies have demonstrated that bacteria
from the nasal flora, including some potentially
important pathogens, are constantly being carried into
the lungs by inspired air. In spite of this constant
bacterial bombardment, the lower respiratory tract remains
essentially sterile due to the presence of
highly effective respiratory defence mechanisms.
Defence mechanisms of the
respiratory system
 Non-specific (non immune-
mediated):
 Mucous trapping
 Mucociliary clearance (mucociliary
escalator)
 Phagocytosis
 Air turbulence (generated by
coughing and sneezing).
 Specific (immune-mediated):
 Antibody production
 Antibody-mediated phagocytosis
 Cell-mediated immunity
Pulmonary Macrophages
 Alveolar Macrophages
(“PAMs”)
 Intravascular
Macrophages (“PIMs”>
ruminants,cats,pigs and horses)
In dogs, humans and laboratory
rodents the cells responsible for removing
circulating bacteria and other particles from
blood are the Kupffer cells (liver) and splenic
macrophages.
..From the web 
 Animals suffering from a respiratory viral infection
have notably suppressed defence mechanisms which make them
susceptible to bacterial colonization within the airways.
 Viruses are not the only factor known to predispose to bacterial
pneumonia, other causes are:
 Stress
 Dehydration
 Pulmonary edema
 Uremia
 Ammonia
 Immunosuppression/ immunodeficiency
Post-mortem examination of the respiratory
tract
Horse-UCVM-09
Thorough systematic examination and appropriate sampling are
very important. Microbiology results should always be interpreted
carefully taken into account clinical and post-mortem findings.
Pig, normal lungs, AVC
Nasal cavity
Ethmoidal hematoma – cause of
epistaxis in horses
Pedunculated tumor-like lesion in
older horses.The exact etiology of
this lesion is unknown.
Dr.King’s show & Tell
Fibrinous rhinitis – mid-sagittal section of the
head – Calf with IBR
Infectious Bovine Rhinotracheitis (formation of
diphtheritic membrane)
Path 1.1 respiratory illanes
Oestrus ovis, nasal bot in sheep
– worldwide distribution
From McGavin, Zachary.
Aberrant migration of Oestrus ovis larva, sheep-TexasA&M.
Atrophic rhinitis in pigs.
Multifactorial disease in growing pigs.
Currently is thought to be the result of a
combined infection of Bordetella
bronchiseptica and Pasteurella multocida
types D andA.
Atrophic Rhinitis – UCVM, OI
Top: Normal
Right: Affected pig
The toxigenic strains of P.multocida produce cytotoxins which inhibit
osteoblastic activity and promote osteoclastic reabsorption of the nasal
turbinates. “The ventral scroll of the ventral nasal turbinate is the area
most commonly and consistently affected”…
Inclusion Body Rhinitis –
Porcine Cytomegalovirus (suid
herpesvirus 2 [SHV-2])
infection, Pig, AVC, OI
Usually in pigs 3-5 weeks of age.
Fatal systemic infection occurs
occasionally in younger suckling pigs
(less than 3 weeks of age).
Nasal submucosal glands
with large basophilic
Intranuclear inclusions
(SHV-2).
Feline herpesvirus 1 (Feline viral rhinotracheitis
[FVR]): rhinitis, conjunctivitis
Cat, vesicles, tongue – Feline calicivirus, Noah’s Arkives
Morphologic Diagnosis?
Cat, feline calicivirus – ulcerative glossitis
Noah’s Arkives
Feline Calicivirus (FCV). Mild oculonasal discharge in
addition to vesicular and ulcerative stomatitis - diffuse
interstitial pneumonia may also occur.
Cat, diffuse interstitial pneumonia, FCV.
Granulomatous rhinitis, dog due
to Rhinosporidium seeberi (aquatic
protistan parasite),TexasA&M
University
Mature sporangia filled with endospores
Path 1.1 respiratory illanes
Guttural pouch tympany in a foal
Strangles, Streptococcus equi, lymph node and guttural pouch
involvement
http://www.equinevoices.org/horses/natural-care-corral/strangles/
Inflammation of the guttural pouch,
horse (guttural pouch empyema) due
to “strangles”-TAMU
“Chondroids”
“Inspissated” exudate
Path 1.1 respiratory illanes
Path 1.1 respiratory illanes
 Caused by infection with
Aspergillus fumigatus or
other Aspergillus species.
 Involvement of cranial
nerves (VII, IX, X, XI, XII)
is common and result in a
variety of clinical signs.
 Erosion of the wall of the
internal carotid artery can
lead to epistaxis or fatal
hemorrhage
Guttural Pouch mycosis
Guttural pouch Mycosis- horse. Mdx?
Multifocal, ulcerative and necrotizing eustachitis
Guttural pouch mycosis, horse
Guttural pouch mycosis, horse, AVC, Dr. A. Lopez.
Guttural pouch mycosis – AVC E24094-97, OI
Guttural pouch mycosis, AVC E24094-97
Which special stains are often used to visualize
fungi within tissue sections?
GMS (Gomori’s methenamine silver) stain and
PAS (Periodic Acid Shiff) stain.
Nasal Squamous Cell Carcinoma, Cat
Path 1.1 respiratory illanes
Nasal neoplasia
Nasal carcinoma,
10 year-old dog,AVC
3 year-old German Shepherd dog –Nasal and facial deformity,
UCVM-09.
Nasal FSA, 3 year-old dog, UCVM.
Enzootic nasal carcinoma, sheep
(retrovirus-induced).
Larynx
 Necrotic laryngitis (Calf
diphtheria)
Secondary infection by
Fusobacterium necrophorum
following trauma or viral
infection (IBR). Can also
occurs as part of oral
necrobacillosis in calves and
swine.
Plaques of ulceration covered
by fibrinonecrotic exudate.
Larynx
 Laryngeal hemiplegia
(paralysis) – “roaring”
horses.Atrophy of the left
dorsal cricoarytenoid
muscle.
 Usually the result of an
idiopathic neuropathy
affecting the left recurrent
laryngeal nerve.
*From McGavin „s Pathologic Basis of Veterinary Disease book.
Trachea - bronchi
 Tracheal collapse: Mainly in toy and miniature dog
breeds; occasionally seen in horses, cattle and goats.
Texas A&M
Dorso-ventral flattening of the trachea and
concomitant widening of the dorsal tracheal
membrane, pony
May result in coughing and exercise
intolerance.
UCVM-08, OI, feedlot heifer.
Calf, Cornell files.
IBR,
Cattle
Ulcerative and necrotizing
laryngo-tracheitis
Path 1.1 respiratory illanes
Canine infectious tracheobronchitis
(Kennel cough).
 A variety of infectious
agents are often isolated
from affected dogs but
there is consensus that
Bordetella bronchiseptica
usually plays a primary
role.
 CAV-2, CPIV-2 and to a
lesser extend canine
distemper virus and
Mycoplasma spp., have
predisposing roles.
Horses and ponies– chronic bronchiolitis-emphysema
complex, “heaves”, “broken wind”, Recurrent Airway
Obstruction (RAO). Asthma-like syndrome (used to be
known as Chronic Obstructive Pulmonary Disease (COPD)
From: « Recurrent airway obstruction – heaves ». The
Veterinary Clinics, Equine Practice, 19: 63-86, 2003. Renaud
Léguillette, DMV, MSc, DACVIM. McGill University, UCVM- Canada.
Severe heaves. The head &neck are
extended and the horse shows nasal
flaring with mucoid nasal discharge. „„Heave line.‟‟ The hypertrophy of external abdominal oblique
muscles as a result of expiratory efforts suggests that the horse
has been chronically affected by heaves.
Recurrent Airway Obstruction (RAO), Heaves.
RAO, horse, HE stained histo slide
Other similar disease in veterinary
medicine : Feline asthma,
a.k.a. feline allergic bronchitis.
“Hyperactive airway disease”
Lungs
 Blood-Air Barrier:
Composed of the
vascular endothelium,
basement membrane of
the endothelial cell,
basement membrane of
the type I pneumocyte
and the cytoplasm of the
of the type I
pneumocyte.
Circulatory disturbances: Pulmonary
haemorrhage
 Exercise-induced pulmonary haemorrhage (EIPH):
Relatively common condition in race horses.
 Follows strenuous exercise.
 Epistaxis is present in only 1-10% of affected horses.
 Frequency increases with age and the severity of exertion.
 Probably the result of marked elevations in arterial and capillary
pressures during strenuous exercise.
 Haemorrhage occurs in the dorso-caudal portions of the caudal
lung lobes.
 Massive pulmonary haemorrhage may be the only detectable
lesion in horses that die during exercise .
Epistaxis and pulmonary hemorrhage are relatively
common in cattle with vena cava thrombosis
* From McGavin’s Pathologic Basis
of Veterinary Disease
Pulmonary edema, pig
Pulmonary edema, pig
Pulmonary edema
Main pathogenic
mechanisms:
1. ↑ hydrostatic pressure
(cardiogenic edema).
2. ↑ vascular permeability:
Injury to the blood-air
barrier
3. Obstruction to lymphatic
drainage: Neoplasia
involving thoracic lymph
nodes or vessels.
Horse with CHF, UCVM, OI.
Pulmonary edema,
horse,
UCVM
Path 1.1 respiratory illanes
Path 1.1 respiratory illanes
HE-stain, dark brown pigment within the cytoplasm of alveolar macrophages,
UCVM
Iron (Perl‟s) stain –
Hemosiderin-laden
macrophages (“heart failure
cells”)
within alveoli – UCVM.
From McGavin’s Pathologic Basis of Veterinary Disease
Pigmentary disturbances: Pulmonary anthracosis
From McGavin’s Pathologic Basis of Veterinary Disease
Atelectasis
 Incomplete expansion of the lungs or portions of the
lungs.
 Pulmonary parenchyma appears dark-red and sunken in
comparison to aerated lung. Consistency is fleshy and the
lung tissue does not float.
 Congenital, acquired, compressive (caused by space-
occupying lesions like hydrothorax, hemothorax,
pleuritis), massive (pneumothorax).
Pulmonary atelectasis – bovine fetus; also in
stillborn animals
Aspiration of amniotic fluid
“Meconium is the dark-green
mucilaginous material
in the intestine of a full term
fetus –a mixture of secretions
from intestinal glands and
amniotic fluid”
Patchy pulmonary atelectasis due to aspiration of
meconium and amniotic fluid-calf, 1 day old,AVC.
Pulmonary Emphysema
“Permanent enlargement of
air-spaces distal to the terminal
bronchiole, accompanied by
destruction of alveolar walls”
Pulmonary Emphysema
 Important primary disease in humans where often co-exists with
COPD attributable to cigarette smoking.
 “It is thought to be an imbalance between proteases and anti-
proteases (like α1 antitrypsin) Neutrophil-derived serine
proteases, particularly elastase and matrix metalloproteinases from
a variety of sources are the likely culprits.Their concentrations are
enhanced by neutrophil and macrophage activation induced in
chronic bronchitis” –JKP, 2007 –G Maxie, ed.
 The emphysematous lung is dysfunctional since the loss of alveolar
septa reduced the alveolar surface area  Reduction in gas
exchange.
Pulmonary Emphysema
 In animals is always secondary to obstruction of outflow of
air or agonal at slaughter.
 Frequent in animals with bronchopneumonia airflow
imbalance  the volume of air entering the lungs exceeds
the volume exiting the lung during expiration.
 Classified also as alveolar of interstitial (the latter mainly in
cattle).
 Bullous emphysema: Large focal
air-filled spaces (bullae) rupture
may lead to fatal pneumothorax.
Cow, pulmonary edema emphysema,
``fog fever``.
Bovine, interstitial emphysema
Pneumonia
 No universal classification in
veterinary medicine –quite
confusing.
 Right: Diagram of common
patterns of pneumonia:
 A: Normal lung
 B: Suppurative
bronchopneumonia
 C: Fibrinous bronchopneumonia
 D: Interstitial pneumonia
 E: Embolic pneumonia
 F: Granulomatous pneumonia A. Lopez, Atlantic Veterinary
College
Aerogenous (airborne) route and
hematogenous route.
Path 1.1 respiratory illanes
Pneumonias in cattle:
Viral pneumonias
 Infectious Bovine Rhinotracheitis (IBR): Caused by BoHV-1.
 Para-influenza-3 virus (PI-3 virus) and Bovine Respiratory
Syncytial virus (BRSV) cause a transient rhino-tracheitis and
broncho-interstitial pneumonia with the formation of eosinophilic
intracytoplasmic inclusions bodies in bronchial, bronchiolar and
alveolar epithelial cells and alveolar macrophages. Formation of
syncytial cells occurs in both, BRSV and PI-3 virus infection.
 BRSV and PI-3 should be considered in calves with necrotizing
bronchiolitis
 Diagnosis is confirmed by virus isolation, PCR or detection of
viral antigens by fluorescence antibody test (FAT) or
immunohistochemistry (IHC).
BRSV-calf,
AVC
BRSV, heifer, Cornell files –
Syncytial cells
BRSV. Right: IHC stains demonstrates
widespread injury to the airway
Epithelium.
Bovine enzootic pneumonia (chronic
suppurative bronchopneumonia.
 Disease caused by a variety of
etiologic agents which include
respiratory viruses, Mycoplasmas,
Chlamydophila, followed by
opportunistic bacteria such as
Pasteurella multocida,Arcanobacterium
pyogenes,Histophilus somni,
Mannheimia haemolytica and E.coli.
Calves with bovine leukocyte
adhesion deficiency (BLAD), which
prevents the migration of
neutrophils from the capillaries, are
highly susceptible to
bronchopneumonia.
Chronic suppurative
bronchopneumonia,
Calf, OVC.
Chronic suppurative bronchopneumonia,
Calf, TS, OVC.
Suppurative bronchopneumonia,
calf,
A. Lόpez, AVC.
Abscessation and bronchiectasis are
Common sequels of chronic suppurative
pneumonia.
Pneumonic mannheimiosis (“shipping
fever”)
 Acute respiratory disease that
occurs in cattle several days or
weeks after shipment.
 Because Mannheimia haemolytica
(formerly Pasteurella haemolytica) is
typically isolated the term
penumonic mannheimiosis or
pneumonic pasteurellosis have
been used.
 Most economically important
respiratory disease of cattle in
NorthAmerica, particularly in
feedlot cattle.
Fibrinous bronchopneumonia,
OVC.
Pneumonic mannheimiosis, steer, from McGavin.
Mannheimia haemolytica biotype A,
serotype 1 is responsible for the
severe pulmonary lesions (areas of
necrosis etc.)
Pneumonic
mannheimiosis:
Marbling appearance
of the
pulmonary
parenchyma.
What type of necrosis?
Respiratory histophilosis
 Part of the Histophilus somni
disease complex (TME,
pneumonia, pleuritis,
myocarditis, arthritis, abortion
etc.,).
 May cause suppurative or
fibrinous bronchopneumonia.
The later may be
undistinguishable from the
fibrinous bronchopneumonia
caused by Mannheimia haemolytica.
Fibrinous pneumonia,
cattle-Cornell files
Mycoplasma bovis pneumonia
 Important cause of chronic
respiratory disease in feedlot
cattle – common inAlberta.
 The organism causes a chronic
necrotizing bronchopneumonia
which is quite characteristic.
 M.bovis also causes severe chronic
fibrinous arthritis.
Chronic necrotizing bronchopneumonia, heifer,
UCVM. Mycoplasma bovis was cultured from
the lesions, OI, 2008.
Mycoplasma bovis
Necrotizing
bronchopneumonia, heifer,
UCVM, O.I., 2008.
What type of necrosis?
Positive immunoperoxidase staining of M. bovis antigens,
from McGavin‟s, 2012
Bovine tuberculosis
Caused by M.bovis. It has been suggested
that the termTB should be limited to
diseases caused by M.tuberculosis (human)
and M.bovis (cattle); other conditions
should be referred as “Mycobacteriosis”.
In NorthAmerica the disease has been
almost eliminated but there still outbreaks
that often originate from wild life (M.bovis
not only affects cattle and humans but also
deer, elk, bison etc. wild ruminants).
Lesions are more common in
retropharyngeal lymph nodes, lungs,
thoracic and mesenteric lymph nodes.
Lesions in cervids often contain prominent
suppurative exudate and may resemble
abscesses...
Multifocal granulomatous pneumonia, M. bovis, cow,
Dr. King-Cornell’s file.
Verminous bronchitis/ pneumonia
In cattle is caused by infection with Dictyocaulus viviparus. Varies from
interstitial pneumonia (larval migration) to chronic bronchitis
(intrabronchial adult parasites) to granulomatous pneumonia (eggs,
dead larvae).
Cornell Files
Heifer, dictyocaulosis, OI, UCVM-2010
Dictyocaulus filaria –sheep, goats
Dictyocaulus arnfieldi –equids (horses,
donkeys)
Terminal bronchi from the right caudal lung lobe, pig. Slaughterhouse specimen,
St. Kitts. Lung worms are admixed within slightly turbid mucoid exudate.
Morphologic dx?.., etiologic dx?...
Lung worms in pigs:
Metastrongylus spp.
Numerous thin and elongated worms within the terminal bronchi of the
caudal (diaphragmatic) lung lobes: Metastrongylus spp. Pig,
slaughterhouse specimen, St. Kitts, 2012.
Same pig as in the previous image. Numerous Metastrongylus spp. are
present within a bronchus, caudal lung lobe. Possible morphologic dx:
catarrhal bronchitis; Etiologic dx: Verminous (or parasitic) bronchitis;
pulmonary metastrongylosis. RUSVM, OI.
Atypical Interstitial Pneumonia (AIP) of cattle
 Pneumonias that did not fit any of the “classical” forms of
pneumonia
 Characterized by the presence of edema, interstitial
emphysema, hyaline membranes, type II pneumocyte
hyperplasia and interstitial fibrosis with cellular infiltrates
 These types of pneumonias have specific etiologies.
 Investigators have proposed that these syndromes previously
clustered underAIP be named according to their specific
cause or pathogenesis.
Diffuse alveolar damage –formation of hyaline
membranes – AIP, cow. From McGavin’s
Atypical Interstitial Pneumonias -
common syndromes:
 Bovine pulmonary edema & emphysema (“fog fever”)
 Extrinsic allergic alveolitis (hypersensitivity pneumonitis)
 Reinfection syndrome (hypersensitivity to Dictyocaulus sp.
or BRSV).
 Milk allergy: type I hypersensitivity in cows sensitized to
their own milk casein and lactalbumin.
 Ingestion of moldy potatoes  contain 4-ipomeanol which
is metabolized by mixed function oxydases in the lung
(Clara cells) to a potent pneumotoxicant.
“Fog Fever”
Bovine pulmonary edema &
emphysema (“fog fever”)  occurs
in cattle grazing “fog” pastures (re-
growth pasture after a hay or silage
has been cut or lush green grass). L-
tryptophan present in the pasture is
metabolized in the rumen to 3-
methylindole → absorbed into the
blood and carried to the lungs →
metabolized by the mixed function
oxidases of non-ciliated bronchiolar
epithelial cells (“Clara” cells) into a
highly pneumotoxic compound that
causes extensive necrosis of
bronchiolar epithelial cells and type I
pneumocytes (diffuse alveolar
damage).
“Extrinsic Allergic Alveolitis”
(hypersensitivity pneumonitis)
 Common; mainly seen in adult dairy cows in the winter.The human
counterpart is referred to as “farmer’s lungs”.
 Type III hypersensitivity reaction to inhaled organic antigens, most
commonly fungal spores present in moldy hay (local deposition of Ag-
Ab complexes in the lungs).
 Gross lesions vary from subtle gray subpleural foci of granulomatous
inflammation to severe lesions in which the lungs acquire a “meaty
appearance” due to alveolar epithelial hyperplasia, interstitial
inflammation and fibrosis.
Pathogenesis of toxic and allergic pneumonias
(“AIP”) in cattlle.
* From McGavin’s pathology book
Pneumonias of Sheep
Viral pneumonias: Like in cattle PI-3 virus and RSV can produce
pneumonitis in sheep.
Maedi (maedi-visna): Lifelong, persistent disease of sheep that
occurs in most countries with the exception of Australia and New
Zealand. It is also known as Ovine Progressive Pneumonia (OPP).
The disease is caused by a retrovirus of the lentivirus subfamily
(ovine lentivirus) similar to the agent of CAE. Infection results in a
lymphocytic interstitial pneumonia (LIP).
The virus may also cause a non-suppurative encephalitis (Visna),
lymphocytic arthritis, lymphofollicular mastitis and vasculitis.
Maedi is characterized by dyspnea and an insidious slowly
progressive emaciation despite good appetite.
In goats, CAE virus can cause a lymphocytic interstitial pneumonia
similar to OPP in sheep.
Bacterial Pneumonias - Sheep
Chronic enzootic
pneumonia:
Multifactorial disease –rarely
fatal. In general it affects animals
younger than 1-year-old.
Etiologic agents include
Mannheimia haemolytica,
Pasteurella multocida,PI-3,
adenovirus, reovirus, RSV,
Chlamydophila, and Mycoplasmas
(mycoplasma ovipneumoniae).
Suppurative bronchopneumonia, sheep –
Pasteurella multocida – from McGavin’s.
 Ovine pneumonic Mannheimosis: Similar to
shipping fever in cattle.
 Septicemic pasteurellosis: Caused by
 Mannheimia haemolytica (biotypeA) usually in lambs under 3
months.
 Bibersteinia (Pasteurella) trehalosi (biotypeT) usually in lambs 5 to
12 months-old.
Lesions:necrotizing pharyngitis and tonsilitis, septicemia with
disseminated intravascular thrombosis and bacteremia.
u
Multifocal subpleural pneumonitis – Muellerius capillaris sheep, Cornell files
Verminous bronchitis also occurs in sheep and goats. The etiologic agent
Is Dictyocaulus filaria.
Pneumonias of horses
Viral pneumonias: Equine viral rhinopneumonitis (EHV-1, EHV-
4) and equine influenza are important diseases in horses
worldwide. In addition, equine viral arteritis (EVA) virus and
equine adenovirus can also cause pneumonia in horses.
These viruses often cause only a transient broncho-interstitial
pneumonia but impair the pulmonary defences and make horses
susceptible to secondary bacterial pneumonias (P.Multocida,
Streptococcus spp.,E.coli,Klebsiella pneumoniae,Rhodococcus equi etc.).
It has also been suggested that viral respiratory infections may
predispose horses to “airway hyper-responsiveness” and “chronic
obstructive respiratory disease” (COPD).
EquineViral Arteritis (EVA) virus – Arterivirus.
Sporadic pansystemic disease of foals and horses:
May result in interstitial pneumonia with
vasculitis, pulmonary edema, hydrothorax and
hydroperitoneum.
 Equine Morbillivirus (Hendra virus disease): Fatal
respiratory disease in horses and humans (high mortality rates
were seen in both horses and humans) which appeared in
1994 in Australia. Classified as a Morbillivirus, subfamily
Paramyxoviridae.Affected horses have severely edematous
lungs. Histologically there is vasculitis and the presence of
multinucleated syncytial cells, typical of morbillivirus
infections, in the endothelium of small pulmonary blood
vessels and alveolar capillaries. No inclusion bodies are seen.
Clinical signs are non-specific and include fever, anorexia,
respiratory distress and nasal discharge
Interstitial pneumonia-foal, Equine Viral Rhinopneumonitis,
Texas A&M, JE.
Interstitial pneumonia due to adenovirus or
Pneumocystis carinii Infection are common complication
in Arabian foals with SCID (Inherited disorder-
autosomal recessive trait- characterized by lack of B and
T lymphocytes  die before 5 months of age)
Right: Pneumocystosis, Pig, AVC. Foamy eosinophilic
proteinaceous material within alveoli. Fungal organisms are
detected with Gomori’s methenamine silver stain (GMS).
“Pneumocystosis is one of
the most common and often
fatal complications in AIDS patients”.
Jack Russell Terrier
Adenovirus infection, foal, HE.
Interstitial pneumonia due to Pneumocystis carinii infection with
concomitant Rhodococcus equi infection in a foal (Arabian CID foal).
Rhodococcus equi
Important cause of morbidity and
mortality in foals worldwide.
Facultative intracellular gram positive
bacterium that causes two major
clinical syndromes.
The organism may become enzootic in
farms where the organisms has been
shed earlier by affected foals.
Virulence factors encoded by plasmids
(virulence-associated proteins) appear
to be responsible for the survival of
the organism within macrophages
(avoid phagocytosis by inducing
defective phagosome-lysosome
fusion).
6-week-old foal, Chronic pyogranulomatous
pneumonia –Rhodococcus equi, Texas A&M
University.
6-week-old foal, Chronic
pneumonia –Rhodococcus equi,
Texas A&M University.
Mdx: Pyogranulomatous
pneumonia
Cytokines, lysosomal enzymes and bacterial toxins are responsible for extensive caseous
necrosis of the lungs and recruitment of large numbers of neutrophils, macrophages and
giant cells containing numerous intracytoplasmic organisms. Affected foals develop chronic
coughing and weight loss.
“Any foal with bronchopneumonia unresponsive to routine broad-spectrum antibiotic
therapy should be suspected of having R. equi bronchopneumonia” Equine practice, vol 14
(1): 15-18, 1992.
R.equi can infect people undergoing
immunosuppression (AIDS, chemotherapy,
therapeutically-induced immunosuppression
because of organ transplantation).
Foal, Rhodococcus equi– Texas A&M
pyogranulomatous enterocolitis/ lymphadenitis
Horse, idiopathic broncho-interstitial pneumonia. Note prominent
Type II pneumocyte hyperplasia., HE
Horse, embolic Aspergillus infection (Mycotic
pneumonia), Texas A&M, Dr. John Edwards.
Multifocal, necrotizing and hemorrhagic (or necro-hemorrhagic)
pneumonia
Pneumonias of pigs
• Viral Pneumonias:
Porcine reproductive and respiratory syndrome (PRRS): First recognized in Europe in
1987. PRRS is characterized by late-term abortions, stillbirths and respiratory disease in
young pigs (interstitial pneumonia).
Swine Influenza: Resulted from adaptation of the typeA influenza virus that caused the
pandemic of human influenza duringWorldWar I. Low mortality unless complicated
with secondary bacterial infections. H1N1 influenza pandemic in 2009.
Postweaning multisystemic wasting syndrome (PMWS):
Causes progressive emaciation in weaned pigs.The causative agent is PCV-2. May result
in interstitial pneumonia.
Porcine Respiratory Coronavirus (PRCV): Sporadic cause of mild bronchointerstitial
pneumonia with necrotizing bronchiolitis.
Interstitial pneumonia, feeder
pig – highly suggestive of viral pneumonia
Right: Pneumocystosis, Pig, AVC. Foamy eosinophilic
proteinaceous material within alveoli. Fungal
organisms are detected with Gomori’s methenamine
silver stain (GMS). Infections with Pneumocystis
carinii are common in pigs with PRRS and PMWS.
Pig, enzootic pneumonia-Cornell. Multifactorial disease,
Mycoplasma hyopneumoniae is the main pathogen involved. The organism induces
a suppurative or cattarrhal bronchopneumonia with BALT hyperplasia that is quite
characteristic. This highly contagious disease of pigs is influenced by immune status
and management factors such as crowding, poor ventilation, humidity and
temperature fluctuation in the barns. The disease is characterized by low mortality
unless complicated with secondary pathogens.
Porcine Enzootic Pneumonia : Mycoplasma pneumonia
(Mycoplasma hyopneumoniae, young piglet, UCVM, O.Illanes.
Multifactorial disease.
Mycoplasma pneumonia, young piglet, UCVM, OI. The bronchopneumonia is
mild to moderate (low mortality) unless complicated with Pasteurella multocida,
Arcanobacterium pyogenes, Bordetella bronchyseptica, Haemophilus spp.,
Mycoplasma hyorhinis etc.).
Path 1.1 respiratory illanes
3-month-old pig, fibrinous pleuritis and pneumonia,
may be a component of Glasser’s disease (Haemophilus parasuis)
CVM, Western University of Health Sciences, O.Illanes
Porcine Contagious Pleuropneumonia,
Actinobacillus pleuropneumoniae
Highly contagious often fatal
fibrinous bronchopneumonia
of pigs 2-5 months of age.
Dorsal area of the caudal lung
lobes are often affected.
Lesions are severe and
characterized by hemorrhage,
necrosis and thrombosis.
Except for the distribution
lesions are similar to those of
pneumonic mannheimiosis of
cattle.
Cornell files
Porcine Contagious Pleuropneumonia,
Actinobacillus pleuropneumoniae,
CVM, Western University of Health Sciences, O.Illanes.
Top: Cut surface, contagious
pleuropneumonia, pig. Nebraska Diagnostic
Laboratory – From
McGavin‟s 2012.
Pneumonias of Dogs
Pneumonias are not as common in dogs as in food-
producing animals.
 Infectious pneumonias: Infectious tracheobronchitis
(Kennel cough) and canine distemper are the most
common.
 Non-infectious: Uremia and paraquat (widely used
herbicide) toxicity are most common
• In addition to distemper, canine adenovirus type 2 (CAV-2),
canine herpesvirus 1 (CHV-1) and canine influenza virus can
produce pneumonias in dogs.
• Bacterial pneumonias are often secondary to distemper virus
infection or aspiration of gastric contents (when pulmonary
defence mechanisms have been impaired). Pasteurella
multocida,Streptococcus spp.,E.Coli,Klebsiella pneumoniae and
Bordetella bronchiseptica can be involved.
Broncho-interstitial pneumonia, canine distemper
From McGavin’s Path. Basis of Vet. Disease
Aspiration pneumonia, dog.
Granulomatous pneumonia, Blastomyces dermatitidis, dog -OVC
Dog, mycotic pneumonia
(granulomatous pneumonia).
Left: Blastomycosis,
Bottom: Histoplasmosis
McGavin’s –Path Basis of Disease
Uremic pneumonitis, dog.
Pneumonias of cats
 Upper respiratory infections: Common
 Pneumonias: Rare
The viruses that produce upper respiratory disease may
also induce pneumonia, but unless complicated with
secondary bacterial infections they usually do not pose a
significant clinical problem.
Cat, Dr. King, Cornell
Aelurostrongylus abstrusus
Snails and slugs are the
intermediate hosts. Subpleural
nodules contain larvae and eggs,
HE.
Pulmonary neoplasia
 In comparison to humans primary pulmonary
tumors are rare in animals
 Most are malignant an appear as solitary masses
of variable size
 In domestic animals they are most common in
dogs and cats.
Cat, pulmonary adenocarcinoma, HE.
Ovine pulmonary carcinoma (pulmonary
adenomatosis).
3-year-old sheep, University of Zaragoza, Spain – in McGavin’s
Caused by a transmissible retrovirus. Found around the world but not in New
Zealand or Australia. Mainly seen in mature sheep. Slowly progressive signs of
respiratory disease  death after several months from the initial onset of
respiratory signs.
Metastatic neoplasms are relatively
common. Primary pulmonary neoplasms,
largely carcinomas are relatively rare but
more common in aged dogs and cats.
Dog, Morphologic diagnosis? Cornell Files
Hydrothorax, 8-y-old dog, AVC
From McGavin’s Path. Basis
Of Vet. Disease
Chronic liver disease (end-stage liver, cirrhosis).
Pleura & pleural cavity
Hemothorax, dog with ruptured aortic aneurism.
Chylothorax, mink,
WCVM
From McGavin’s Path. Basis
Of Vet. Disease
Fibrnous pleuritis,
horse.
Pyothorax, Pasteurella
Multocida, cat
Chronic pleuritis with “sulfur granules”, nocardiosis (Nocardia asteroides),
Cat.
From McGavin’s Path. Basis
Of Vet. Disease
Mesothelioma – In domestic animals seen mainly in cattle – can be
congenital. In humans has been associated with inhalation of asbestos
(mining, construction, ship building).
Additional Information…
Fibrinosuppurative pleuropneumonia, rabbit –P. Multocida,
Atlantic Veterinary College.
Pasteurellosis is a common disease in domestic rabbits. P.multocida can
result in rhinitis (“snuffles”), pneumonia, abscesses, reproductive tract
infections, ear infections and septicemia.
Emu, AVC
Mycotic airsacculitis – Aspergillus spp. infection
Emu, granulomatous pneumonia – Aspergillus, spp., AVC-1996
The End...

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Path 1.1 respiratory illanes

  • 1. Oscar G.Illanes,DVM,PhD,DACVP Department of Pathobiology Pathology of the Respiratory System Disclaimer: Images from this presentation come from different sources: Mc Gavin ‘s Pathologic Basis of Veterinary Disease, Dr. King files, Noah’s arkive ,OVC, AVC, author’s own files etc. This presentation is for teaching purposes only, please do not distribute.
  • 2. General objectives  Overview of the diseases that affect the respiratory system of domestic animals  Emphasis on:  how to recognize the morphologic changes present within tissues in specific diseases/ conditions  most common respiratory diseases  how to arrive to the proper morphologic or etiologic diagnosis for the lesion  Disease pathogenesis, if known  Differential diagnosis, if applicable.
  • 3. References  A. Lόpez:“ Respiratory System” in Pathologic Basis ofVeterinary Disease, McGavin & Zachary, editors, 5th ed., Mosby, p458-, 2012  J Caswell & K.Williams:“Respiratory System” in JKP Pathology of Domestic Animals,Vol 2, edited by MG Maxie, 5th ed., Saunders, p523-653, 2007
  • 4. Anatomic division of the respiratory tract Upper & Lower respiratory tract. In general the upper respiratory tract is the portion of the respiratory system located outside the thoracic cavity.
  • 5. Physiologically the respiratory tract is divided into three independent but continuous systems: 1.- Conducting system: Includes the nasal cavity, paranasal sinuses, larynx, trachea and bronchi.The mucosa of this system is primarily lined by pseudostratified ciliated epithelium and goblet cells. 2.-Transitional system : consists exclusively of bronchioles which are lined by Clara cells (detoxification of xenobiotics), non-ciliated secretory cells and only a few ciliated cells. Healthy bronchioles do not have goblet cells.
  • 6. 3. Exchange system: Composed of alveolar ducts and millions of alveoli; thin-walled structures enveloped by a rich network of capillaries, the pulmonary capillaries. Alveoli are lined by epithelial type I (membranous) and type II (granular) pneumocytes (also called pneumonocytes). Each of these systems has a characteristic susceptibility to injury and specific type of host response and repair.
  • 7. The lungs have a dual blood supply: Through the pulmonary arteries which conduct deoxygenated blood from the right side of the heart, and the bronchial arteries, which carry oxygenated blood.
  • 8.  In addition to gas exchange, the respiratory system is also involved in phonation, olfaction, temperature regulation, acid–base balance, blood pressure regulation etc.  Several of these functions may be affected by respiratory disease.
  • 9. Pictures from Dr. Thomas Caceci’s histology Web site.
  • 10. Pictures from Dr. Thomas Caceci’s histology Web site.
  • 11. Normal Flora – Restricted only to the most proximal region of the conductive system: nasal cavity, nasopharynx, larynx and trachea. The distal portions of the respiratory tract are considered to be sterile.
  • 12.  Even though the majority of the organisms of the normal respiratory flora are harmless others are potentially pathogenic; e.g.: Mannheimia haemolytica,Bordetella bronchiseptica.
  • 13. “The air that we inhale every day in a healthy environment contains billions of suspended particles, spores, bacteria, viruses and noxious gases that are constantly carried deep into the lungs”...Fortunately the lungs have a very efficient defence system to deal with the environmental hazards present under normal conditions.
  • 14. Experimental studies have demonstrated that bacteria from the nasal flora, including some potentially important pathogens, are constantly being carried into the lungs by inspired air. In spite of this constant bacterial bombardment, the lower respiratory tract remains essentially sterile due to the presence of highly effective respiratory defence mechanisms.
  • 15. Defence mechanisms of the respiratory system  Non-specific (non immune- mediated):  Mucous trapping  Mucociliary clearance (mucociliary escalator)  Phagocytosis  Air turbulence (generated by coughing and sneezing).  Specific (immune-mediated):  Antibody production  Antibody-mediated phagocytosis  Cell-mediated immunity
  • 16. Pulmonary Macrophages  Alveolar Macrophages (“PAMs”)  Intravascular Macrophages (“PIMs”> ruminants,cats,pigs and horses) In dogs, humans and laboratory rodents the cells responsible for removing circulating bacteria and other particles from blood are the Kupffer cells (liver) and splenic macrophages.
  • 18.  Animals suffering from a respiratory viral infection have notably suppressed defence mechanisms which make them susceptible to bacterial colonization within the airways.  Viruses are not the only factor known to predispose to bacterial pneumonia, other causes are:  Stress  Dehydration  Pulmonary edema  Uremia  Ammonia  Immunosuppression/ immunodeficiency
  • 19. Post-mortem examination of the respiratory tract Horse-UCVM-09 Thorough systematic examination and appropriate sampling are very important. Microbiology results should always be interpreted carefully taken into account clinical and post-mortem findings.
  • 22. Ethmoidal hematoma – cause of epistaxis in horses Pedunculated tumor-like lesion in older horses.The exact etiology of this lesion is unknown. Dr.King’s show & Tell
  • 23. Fibrinous rhinitis – mid-sagittal section of the head – Calf with IBR Infectious Bovine Rhinotracheitis (formation of diphtheritic membrane)
  • 25. Oestrus ovis, nasal bot in sheep – worldwide distribution From McGavin, Zachary.
  • 26. Aberrant migration of Oestrus ovis larva, sheep-TexasA&M.
  • 27. Atrophic rhinitis in pigs. Multifactorial disease in growing pigs. Currently is thought to be the result of a combined infection of Bordetella bronchiseptica and Pasteurella multocida types D andA.
  • 28. Atrophic Rhinitis – UCVM, OI Top: Normal Right: Affected pig
  • 29. The toxigenic strains of P.multocida produce cytotoxins which inhibit osteoblastic activity and promote osteoclastic reabsorption of the nasal turbinates. “The ventral scroll of the ventral nasal turbinate is the area most commonly and consistently affected”…
  • 30. Inclusion Body Rhinitis – Porcine Cytomegalovirus (suid herpesvirus 2 [SHV-2]) infection, Pig, AVC, OI Usually in pigs 3-5 weeks of age. Fatal systemic infection occurs occasionally in younger suckling pigs (less than 3 weeks of age). Nasal submucosal glands with large basophilic Intranuclear inclusions (SHV-2).
  • 31. Feline herpesvirus 1 (Feline viral rhinotracheitis [FVR]): rhinitis, conjunctivitis
  • 32. Cat, vesicles, tongue – Feline calicivirus, Noah’s Arkives Morphologic Diagnosis?
  • 33. Cat, feline calicivirus – ulcerative glossitis Noah’s Arkives
  • 34. Feline Calicivirus (FCV). Mild oculonasal discharge in addition to vesicular and ulcerative stomatitis - diffuse interstitial pneumonia may also occur.
  • 35. Cat, diffuse interstitial pneumonia, FCV.
  • 36. Granulomatous rhinitis, dog due to Rhinosporidium seeberi (aquatic protistan parasite),TexasA&M University Mature sporangia filled with endospores
  • 39. Strangles, Streptococcus equi, lymph node and guttural pouch involvement
  • 41. Inflammation of the guttural pouch, horse (guttural pouch empyema) due to “strangles”-TAMU “Chondroids” “Inspissated” exudate
  • 44.  Caused by infection with Aspergillus fumigatus or other Aspergillus species.  Involvement of cranial nerves (VII, IX, X, XI, XII) is common and result in a variety of clinical signs.  Erosion of the wall of the internal carotid artery can lead to epistaxis or fatal hemorrhage Guttural Pouch mycosis
  • 45. Guttural pouch Mycosis- horse. Mdx? Multifocal, ulcerative and necrotizing eustachitis
  • 47. Guttural pouch mycosis, horse, AVC, Dr. A. Lopez.
  • 48. Guttural pouch mycosis – AVC E24094-97, OI
  • 49. Guttural pouch mycosis, AVC E24094-97 Which special stains are often used to visualize fungi within tissue sections? GMS (Gomori’s methenamine silver) stain and PAS (Periodic Acid Shiff) stain.
  • 50. Nasal Squamous Cell Carcinoma, Cat
  • 53. 3 year-old German Shepherd dog –Nasal and facial deformity, UCVM-09.
  • 54. Nasal FSA, 3 year-old dog, UCVM.
  • 55. Enzootic nasal carcinoma, sheep (retrovirus-induced).
  • 56. Larynx  Necrotic laryngitis (Calf diphtheria) Secondary infection by Fusobacterium necrophorum following trauma or viral infection (IBR). Can also occurs as part of oral necrobacillosis in calves and swine. Plaques of ulceration covered by fibrinonecrotic exudate.
  • 57. Larynx  Laryngeal hemiplegia (paralysis) – “roaring” horses.Atrophy of the left dorsal cricoarytenoid muscle.  Usually the result of an idiopathic neuropathy affecting the left recurrent laryngeal nerve. *From McGavin „s Pathologic Basis of Veterinary Disease book.
  • 58. Trachea - bronchi  Tracheal collapse: Mainly in toy and miniature dog breeds; occasionally seen in horses, cattle and goats. Texas A&M
  • 59. Dorso-ventral flattening of the trachea and concomitant widening of the dorsal tracheal membrane, pony May result in coughing and exercise intolerance.
  • 60. UCVM-08, OI, feedlot heifer. Calf, Cornell files. IBR, Cattle Ulcerative and necrotizing laryngo-tracheitis
  • 62. Canine infectious tracheobronchitis (Kennel cough).  A variety of infectious agents are often isolated from affected dogs but there is consensus that Bordetella bronchiseptica usually plays a primary role.  CAV-2, CPIV-2 and to a lesser extend canine distemper virus and Mycoplasma spp., have predisposing roles.
  • 63. Horses and ponies– chronic bronchiolitis-emphysema complex, “heaves”, “broken wind”, Recurrent Airway Obstruction (RAO). Asthma-like syndrome (used to be known as Chronic Obstructive Pulmonary Disease (COPD) From: « Recurrent airway obstruction – heaves ». The Veterinary Clinics, Equine Practice, 19: 63-86, 2003. Renaud Léguillette, DMV, MSc, DACVIM. McGill University, UCVM- Canada. Severe heaves. The head &neck are extended and the horse shows nasal flaring with mucoid nasal discharge. „„Heave line.‟‟ The hypertrophy of external abdominal oblique muscles as a result of expiratory efforts suggests that the horse has been chronically affected by heaves.
  • 65. RAO, horse, HE stained histo slide
  • 66. Other similar disease in veterinary medicine : Feline asthma, a.k.a. feline allergic bronchitis. “Hyperactive airway disease”
  • 67. Lungs  Blood-Air Barrier: Composed of the vascular endothelium, basement membrane of the endothelial cell, basement membrane of the type I pneumocyte and the cytoplasm of the of the type I pneumocyte.
  • 68. Circulatory disturbances: Pulmonary haemorrhage  Exercise-induced pulmonary haemorrhage (EIPH): Relatively common condition in race horses.  Follows strenuous exercise.  Epistaxis is present in only 1-10% of affected horses.  Frequency increases with age and the severity of exertion.  Probably the result of marked elevations in arterial and capillary pressures during strenuous exercise.  Haemorrhage occurs in the dorso-caudal portions of the caudal lung lobes.  Massive pulmonary haemorrhage may be the only detectable lesion in horses that die during exercise .
  • 69. Epistaxis and pulmonary hemorrhage are relatively common in cattle with vena cava thrombosis
  • 70. * From McGavin’s Pathologic Basis of Veterinary Disease
  • 73. Pulmonary edema Main pathogenic mechanisms: 1. ↑ hydrostatic pressure (cardiogenic edema). 2. ↑ vascular permeability: Injury to the blood-air barrier 3. Obstruction to lymphatic drainage: Neoplasia involving thoracic lymph nodes or vessels. Horse with CHF, UCVM, OI.
  • 77. HE-stain, dark brown pigment within the cytoplasm of alveolar macrophages, UCVM
  • 78. Iron (Perl‟s) stain – Hemosiderin-laden macrophages (“heart failure cells”) within alveoli – UCVM.
  • 79. From McGavin’s Pathologic Basis of Veterinary Disease Pigmentary disturbances: Pulmonary anthracosis
  • 80. From McGavin’s Pathologic Basis of Veterinary Disease
  • 81. Atelectasis  Incomplete expansion of the lungs or portions of the lungs.  Pulmonary parenchyma appears dark-red and sunken in comparison to aerated lung. Consistency is fleshy and the lung tissue does not float.  Congenital, acquired, compressive (caused by space- occupying lesions like hydrothorax, hemothorax, pleuritis), massive (pneumothorax).
  • 82. Pulmonary atelectasis – bovine fetus; also in stillborn animals
  • 83. Aspiration of amniotic fluid “Meconium is the dark-green mucilaginous material in the intestine of a full term fetus –a mixture of secretions from intestinal glands and amniotic fluid”
  • 84. Patchy pulmonary atelectasis due to aspiration of meconium and amniotic fluid-calf, 1 day old,AVC.
  • 85. Pulmonary Emphysema “Permanent enlargement of air-spaces distal to the terminal bronchiole, accompanied by destruction of alveolar walls”
  • 86. Pulmonary Emphysema  Important primary disease in humans where often co-exists with COPD attributable to cigarette smoking.  “It is thought to be an imbalance between proteases and anti- proteases (like α1 antitrypsin) Neutrophil-derived serine proteases, particularly elastase and matrix metalloproteinases from a variety of sources are the likely culprits.Their concentrations are enhanced by neutrophil and macrophage activation induced in chronic bronchitis” –JKP, 2007 –G Maxie, ed.  The emphysematous lung is dysfunctional since the loss of alveolar septa reduced the alveolar surface area  Reduction in gas exchange.
  • 87. Pulmonary Emphysema  In animals is always secondary to obstruction of outflow of air or agonal at slaughter.  Frequent in animals with bronchopneumonia airflow imbalance  the volume of air entering the lungs exceeds the volume exiting the lung during expiration.  Classified also as alveolar of interstitial (the latter mainly in cattle).
  • 88.  Bullous emphysema: Large focal air-filled spaces (bullae) rupture may lead to fatal pneumothorax. Cow, pulmonary edema emphysema, ``fog fever``.
  • 90. Pneumonia  No universal classification in veterinary medicine –quite confusing.  Right: Diagram of common patterns of pneumonia:  A: Normal lung  B: Suppurative bronchopneumonia  C: Fibrinous bronchopneumonia  D: Interstitial pneumonia  E: Embolic pneumonia  F: Granulomatous pneumonia A. Lopez, Atlantic Veterinary College Aerogenous (airborne) route and hematogenous route.
  • 92. Pneumonias in cattle: Viral pneumonias  Infectious Bovine Rhinotracheitis (IBR): Caused by BoHV-1.  Para-influenza-3 virus (PI-3 virus) and Bovine Respiratory Syncytial virus (BRSV) cause a transient rhino-tracheitis and broncho-interstitial pneumonia with the formation of eosinophilic intracytoplasmic inclusions bodies in bronchial, bronchiolar and alveolar epithelial cells and alveolar macrophages. Formation of syncytial cells occurs in both, BRSV and PI-3 virus infection.  BRSV and PI-3 should be considered in calves with necrotizing bronchiolitis  Diagnosis is confirmed by virus isolation, PCR or detection of viral antigens by fluorescence antibody test (FAT) or immunohistochemistry (IHC).
  • 93. BRSV-calf, AVC BRSV, heifer, Cornell files – Syncytial cells
  • 94. BRSV. Right: IHC stains demonstrates widespread injury to the airway Epithelium.
  • 95. Bovine enzootic pneumonia (chronic suppurative bronchopneumonia.  Disease caused by a variety of etiologic agents which include respiratory viruses, Mycoplasmas, Chlamydophila, followed by opportunistic bacteria such as Pasteurella multocida,Arcanobacterium pyogenes,Histophilus somni, Mannheimia haemolytica and E.coli. Calves with bovine leukocyte adhesion deficiency (BLAD), which prevents the migration of neutrophils from the capillaries, are highly susceptible to bronchopneumonia. Chronic suppurative bronchopneumonia, Calf, OVC.
  • 96. Chronic suppurative bronchopneumonia, Calf, TS, OVC. Suppurative bronchopneumonia, calf, A. Lόpez, AVC.
  • 97. Abscessation and bronchiectasis are Common sequels of chronic suppurative pneumonia.
  • 98. Pneumonic mannheimiosis (“shipping fever”)  Acute respiratory disease that occurs in cattle several days or weeks after shipment.  Because Mannheimia haemolytica (formerly Pasteurella haemolytica) is typically isolated the term penumonic mannheimiosis or pneumonic pasteurellosis have been used.  Most economically important respiratory disease of cattle in NorthAmerica, particularly in feedlot cattle. Fibrinous bronchopneumonia, OVC.
  • 100. Mannheimia haemolytica biotype A, serotype 1 is responsible for the severe pulmonary lesions (areas of necrosis etc.) Pneumonic mannheimiosis: Marbling appearance of the pulmonary parenchyma. What type of necrosis?
  • 101. Respiratory histophilosis  Part of the Histophilus somni disease complex (TME, pneumonia, pleuritis, myocarditis, arthritis, abortion etc.,).  May cause suppurative or fibrinous bronchopneumonia. The later may be undistinguishable from the fibrinous bronchopneumonia caused by Mannheimia haemolytica. Fibrinous pneumonia, cattle-Cornell files
  • 102. Mycoplasma bovis pneumonia  Important cause of chronic respiratory disease in feedlot cattle – common inAlberta.  The organism causes a chronic necrotizing bronchopneumonia which is quite characteristic.  M.bovis also causes severe chronic fibrinous arthritis. Chronic necrotizing bronchopneumonia, heifer, UCVM. Mycoplasma bovis was cultured from the lesions, OI, 2008.
  • 104. Necrotizing bronchopneumonia, heifer, UCVM, O.I., 2008. What type of necrosis?
  • 105. Positive immunoperoxidase staining of M. bovis antigens, from McGavin‟s, 2012
  • 106. Bovine tuberculosis Caused by M.bovis. It has been suggested that the termTB should be limited to diseases caused by M.tuberculosis (human) and M.bovis (cattle); other conditions should be referred as “Mycobacteriosis”. In NorthAmerica the disease has been almost eliminated but there still outbreaks that often originate from wild life (M.bovis not only affects cattle and humans but also deer, elk, bison etc. wild ruminants). Lesions are more common in retropharyngeal lymph nodes, lungs, thoracic and mesenteric lymph nodes. Lesions in cervids often contain prominent suppurative exudate and may resemble abscesses... Multifocal granulomatous pneumonia, M. bovis, cow, Dr. King-Cornell’s file.
  • 107. Verminous bronchitis/ pneumonia In cattle is caused by infection with Dictyocaulus viviparus. Varies from interstitial pneumonia (larval migration) to chronic bronchitis (intrabronchial adult parasites) to granulomatous pneumonia (eggs, dead larvae). Cornell Files
  • 108. Heifer, dictyocaulosis, OI, UCVM-2010 Dictyocaulus filaria –sheep, goats Dictyocaulus arnfieldi –equids (horses, donkeys)
  • 109. Terminal bronchi from the right caudal lung lobe, pig. Slaughterhouse specimen, St. Kitts. Lung worms are admixed within slightly turbid mucoid exudate. Morphologic dx?.., etiologic dx?... Lung worms in pigs: Metastrongylus spp.
  • 110. Numerous thin and elongated worms within the terminal bronchi of the caudal (diaphragmatic) lung lobes: Metastrongylus spp. Pig, slaughterhouse specimen, St. Kitts, 2012.
  • 111. Same pig as in the previous image. Numerous Metastrongylus spp. are present within a bronchus, caudal lung lobe. Possible morphologic dx: catarrhal bronchitis; Etiologic dx: Verminous (or parasitic) bronchitis; pulmonary metastrongylosis. RUSVM, OI.
  • 112. Atypical Interstitial Pneumonia (AIP) of cattle  Pneumonias that did not fit any of the “classical” forms of pneumonia  Characterized by the presence of edema, interstitial emphysema, hyaline membranes, type II pneumocyte hyperplasia and interstitial fibrosis with cellular infiltrates  These types of pneumonias have specific etiologies.  Investigators have proposed that these syndromes previously clustered underAIP be named according to their specific cause or pathogenesis.
  • 113. Diffuse alveolar damage –formation of hyaline membranes – AIP, cow. From McGavin’s
  • 114. Atypical Interstitial Pneumonias - common syndromes:  Bovine pulmonary edema & emphysema (“fog fever”)  Extrinsic allergic alveolitis (hypersensitivity pneumonitis)  Reinfection syndrome (hypersensitivity to Dictyocaulus sp. or BRSV).  Milk allergy: type I hypersensitivity in cows sensitized to their own milk casein and lactalbumin.  Ingestion of moldy potatoes  contain 4-ipomeanol which is metabolized by mixed function oxydases in the lung (Clara cells) to a potent pneumotoxicant.
  • 115. “Fog Fever” Bovine pulmonary edema & emphysema (“fog fever”)  occurs in cattle grazing “fog” pastures (re- growth pasture after a hay or silage has been cut or lush green grass). L- tryptophan present in the pasture is metabolized in the rumen to 3- methylindole → absorbed into the blood and carried to the lungs → metabolized by the mixed function oxidases of non-ciliated bronchiolar epithelial cells (“Clara” cells) into a highly pneumotoxic compound that causes extensive necrosis of bronchiolar epithelial cells and type I pneumocytes (diffuse alveolar damage).
  • 116. “Extrinsic Allergic Alveolitis” (hypersensitivity pneumonitis)  Common; mainly seen in adult dairy cows in the winter.The human counterpart is referred to as “farmer’s lungs”.  Type III hypersensitivity reaction to inhaled organic antigens, most commonly fungal spores present in moldy hay (local deposition of Ag- Ab complexes in the lungs).  Gross lesions vary from subtle gray subpleural foci of granulomatous inflammation to severe lesions in which the lungs acquire a “meaty appearance” due to alveolar epithelial hyperplasia, interstitial inflammation and fibrosis.
  • 117. Pathogenesis of toxic and allergic pneumonias (“AIP”) in cattlle. * From McGavin’s pathology book
  • 118. Pneumonias of Sheep Viral pneumonias: Like in cattle PI-3 virus and RSV can produce pneumonitis in sheep. Maedi (maedi-visna): Lifelong, persistent disease of sheep that occurs in most countries with the exception of Australia and New Zealand. It is also known as Ovine Progressive Pneumonia (OPP). The disease is caused by a retrovirus of the lentivirus subfamily (ovine lentivirus) similar to the agent of CAE. Infection results in a lymphocytic interstitial pneumonia (LIP). The virus may also cause a non-suppurative encephalitis (Visna), lymphocytic arthritis, lymphofollicular mastitis and vasculitis. Maedi is characterized by dyspnea and an insidious slowly progressive emaciation despite good appetite. In goats, CAE virus can cause a lymphocytic interstitial pneumonia similar to OPP in sheep.
  • 119. Bacterial Pneumonias - Sheep Chronic enzootic pneumonia: Multifactorial disease –rarely fatal. In general it affects animals younger than 1-year-old. Etiologic agents include Mannheimia haemolytica, Pasteurella multocida,PI-3, adenovirus, reovirus, RSV, Chlamydophila, and Mycoplasmas (mycoplasma ovipneumoniae). Suppurative bronchopneumonia, sheep – Pasteurella multocida – from McGavin’s.
  • 120.  Ovine pneumonic Mannheimosis: Similar to shipping fever in cattle.  Septicemic pasteurellosis: Caused by  Mannheimia haemolytica (biotypeA) usually in lambs under 3 months.  Bibersteinia (Pasteurella) trehalosi (biotypeT) usually in lambs 5 to 12 months-old. Lesions:necrotizing pharyngitis and tonsilitis, septicemia with disseminated intravascular thrombosis and bacteremia.
  • 121. u Multifocal subpleural pneumonitis – Muellerius capillaris sheep, Cornell files Verminous bronchitis also occurs in sheep and goats. The etiologic agent Is Dictyocaulus filaria.
  • 122. Pneumonias of horses Viral pneumonias: Equine viral rhinopneumonitis (EHV-1, EHV- 4) and equine influenza are important diseases in horses worldwide. In addition, equine viral arteritis (EVA) virus and equine adenovirus can also cause pneumonia in horses. These viruses often cause only a transient broncho-interstitial pneumonia but impair the pulmonary defences and make horses susceptible to secondary bacterial pneumonias (P.Multocida, Streptococcus spp.,E.coli,Klebsiella pneumoniae,Rhodococcus equi etc.). It has also been suggested that viral respiratory infections may predispose horses to “airway hyper-responsiveness” and “chronic obstructive respiratory disease” (COPD).
  • 123. EquineViral Arteritis (EVA) virus – Arterivirus. Sporadic pansystemic disease of foals and horses: May result in interstitial pneumonia with vasculitis, pulmonary edema, hydrothorax and hydroperitoneum.
  • 124.  Equine Morbillivirus (Hendra virus disease): Fatal respiratory disease in horses and humans (high mortality rates were seen in both horses and humans) which appeared in 1994 in Australia. Classified as a Morbillivirus, subfamily Paramyxoviridae.Affected horses have severely edematous lungs. Histologically there is vasculitis and the presence of multinucleated syncytial cells, typical of morbillivirus infections, in the endothelium of small pulmonary blood vessels and alveolar capillaries. No inclusion bodies are seen. Clinical signs are non-specific and include fever, anorexia, respiratory distress and nasal discharge
  • 125. Interstitial pneumonia-foal, Equine Viral Rhinopneumonitis, Texas A&M, JE.
  • 126. Interstitial pneumonia due to adenovirus or Pneumocystis carinii Infection are common complication in Arabian foals with SCID (Inherited disorder- autosomal recessive trait- characterized by lack of B and T lymphocytes  die before 5 months of age) Right: Pneumocystosis, Pig, AVC. Foamy eosinophilic proteinaceous material within alveoli. Fungal organisms are detected with Gomori’s methenamine silver stain (GMS). “Pneumocystosis is one of the most common and often fatal complications in AIDS patients”. Jack Russell Terrier
  • 128. Interstitial pneumonia due to Pneumocystis carinii infection with concomitant Rhodococcus equi infection in a foal (Arabian CID foal).
  • 129. Rhodococcus equi Important cause of morbidity and mortality in foals worldwide. Facultative intracellular gram positive bacterium that causes two major clinical syndromes. The organism may become enzootic in farms where the organisms has been shed earlier by affected foals. Virulence factors encoded by plasmids (virulence-associated proteins) appear to be responsible for the survival of the organism within macrophages (avoid phagocytosis by inducing defective phagosome-lysosome fusion). 6-week-old foal, Chronic pyogranulomatous pneumonia –Rhodococcus equi, Texas A&M University.
  • 130. 6-week-old foal, Chronic pneumonia –Rhodococcus equi, Texas A&M University. Mdx: Pyogranulomatous pneumonia Cytokines, lysosomal enzymes and bacterial toxins are responsible for extensive caseous necrosis of the lungs and recruitment of large numbers of neutrophils, macrophages and giant cells containing numerous intracytoplasmic organisms. Affected foals develop chronic coughing and weight loss. “Any foal with bronchopneumonia unresponsive to routine broad-spectrum antibiotic therapy should be suspected of having R. equi bronchopneumonia” Equine practice, vol 14 (1): 15-18, 1992.
  • 131. R.equi can infect people undergoing immunosuppression (AIDS, chemotherapy, therapeutically-induced immunosuppression because of organ transplantation).
  • 132. Foal, Rhodococcus equi– Texas A&M pyogranulomatous enterocolitis/ lymphadenitis
  • 133. Horse, idiopathic broncho-interstitial pneumonia. Note prominent Type II pneumocyte hyperplasia., HE
  • 134. Horse, embolic Aspergillus infection (Mycotic pneumonia), Texas A&M, Dr. John Edwards. Multifocal, necrotizing and hemorrhagic (or necro-hemorrhagic) pneumonia
  • 135. Pneumonias of pigs • Viral Pneumonias: Porcine reproductive and respiratory syndrome (PRRS): First recognized in Europe in 1987. PRRS is characterized by late-term abortions, stillbirths and respiratory disease in young pigs (interstitial pneumonia). Swine Influenza: Resulted from adaptation of the typeA influenza virus that caused the pandemic of human influenza duringWorldWar I. Low mortality unless complicated with secondary bacterial infections. H1N1 influenza pandemic in 2009. Postweaning multisystemic wasting syndrome (PMWS): Causes progressive emaciation in weaned pigs.The causative agent is PCV-2. May result in interstitial pneumonia. Porcine Respiratory Coronavirus (PRCV): Sporadic cause of mild bronchointerstitial pneumonia with necrotizing bronchiolitis.
  • 136. Interstitial pneumonia, feeder pig – highly suggestive of viral pneumonia Right: Pneumocystosis, Pig, AVC. Foamy eosinophilic proteinaceous material within alveoli. Fungal organisms are detected with Gomori’s methenamine silver stain (GMS). Infections with Pneumocystis carinii are common in pigs with PRRS and PMWS.
  • 137. Pig, enzootic pneumonia-Cornell. Multifactorial disease, Mycoplasma hyopneumoniae is the main pathogen involved. The organism induces a suppurative or cattarrhal bronchopneumonia with BALT hyperplasia that is quite characteristic. This highly contagious disease of pigs is influenced by immune status and management factors such as crowding, poor ventilation, humidity and temperature fluctuation in the barns. The disease is characterized by low mortality unless complicated with secondary pathogens.
  • 138. Porcine Enzootic Pneumonia : Mycoplasma pneumonia (Mycoplasma hyopneumoniae, young piglet, UCVM, O.Illanes. Multifactorial disease.
  • 139. Mycoplasma pneumonia, young piglet, UCVM, OI. The bronchopneumonia is mild to moderate (low mortality) unless complicated with Pasteurella multocida, Arcanobacterium pyogenes, Bordetella bronchyseptica, Haemophilus spp., Mycoplasma hyorhinis etc.).
  • 141. 3-month-old pig, fibrinous pleuritis and pneumonia, may be a component of Glasser’s disease (Haemophilus parasuis) CVM, Western University of Health Sciences, O.Illanes
  • 142. Porcine Contagious Pleuropneumonia, Actinobacillus pleuropneumoniae Highly contagious often fatal fibrinous bronchopneumonia of pigs 2-5 months of age. Dorsal area of the caudal lung lobes are often affected. Lesions are severe and characterized by hemorrhage, necrosis and thrombosis. Except for the distribution lesions are similar to those of pneumonic mannheimiosis of cattle. Cornell files
  • 143. Porcine Contagious Pleuropneumonia, Actinobacillus pleuropneumoniae, CVM, Western University of Health Sciences, O.Illanes. Top: Cut surface, contagious pleuropneumonia, pig. Nebraska Diagnostic Laboratory – From McGavin‟s 2012.
  • 144. Pneumonias of Dogs Pneumonias are not as common in dogs as in food- producing animals.  Infectious pneumonias: Infectious tracheobronchitis (Kennel cough) and canine distemper are the most common.  Non-infectious: Uremia and paraquat (widely used herbicide) toxicity are most common
  • 145. • In addition to distemper, canine adenovirus type 2 (CAV-2), canine herpesvirus 1 (CHV-1) and canine influenza virus can produce pneumonias in dogs. • Bacterial pneumonias are often secondary to distemper virus infection or aspiration of gastric contents (when pulmonary defence mechanisms have been impaired). Pasteurella multocida,Streptococcus spp.,E.Coli,Klebsiella pneumoniae and Bordetella bronchiseptica can be involved.
  • 146. Broncho-interstitial pneumonia, canine distemper From McGavin’s Path. Basis of Vet. Disease
  • 148. Granulomatous pneumonia, Blastomyces dermatitidis, dog -OVC
  • 149. Dog, mycotic pneumonia (granulomatous pneumonia). Left: Blastomycosis, Bottom: Histoplasmosis McGavin’s –Path Basis of Disease
  • 151. Pneumonias of cats  Upper respiratory infections: Common  Pneumonias: Rare The viruses that produce upper respiratory disease may also induce pneumonia, but unless complicated with secondary bacterial infections they usually do not pose a significant clinical problem.
  • 152. Cat, Dr. King, Cornell
  • 153. Aelurostrongylus abstrusus Snails and slugs are the intermediate hosts. Subpleural nodules contain larvae and eggs, HE.
  • 154. Pulmonary neoplasia  In comparison to humans primary pulmonary tumors are rare in animals  Most are malignant an appear as solitary masses of variable size  In domestic animals they are most common in dogs and cats.
  • 156. Ovine pulmonary carcinoma (pulmonary adenomatosis). 3-year-old sheep, University of Zaragoza, Spain – in McGavin’s Caused by a transmissible retrovirus. Found around the world but not in New Zealand or Australia. Mainly seen in mature sheep. Slowly progressive signs of respiratory disease  death after several months from the initial onset of respiratory signs.
  • 157. Metastatic neoplasms are relatively common. Primary pulmonary neoplasms, largely carcinomas are relatively rare but more common in aged dogs and cats.
  • 158. Dog, Morphologic diagnosis? Cornell Files
  • 159. Hydrothorax, 8-y-old dog, AVC From McGavin’s Path. Basis Of Vet. Disease Chronic liver disease (end-stage liver, cirrhosis). Pleura & pleural cavity
  • 160. Hemothorax, dog with ruptured aortic aneurism.
  • 162. From McGavin’s Path. Basis Of Vet. Disease Fibrnous pleuritis, horse.
  • 164. Chronic pleuritis with “sulfur granules”, nocardiosis (Nocardia asteroides), Cat. From McGavin’s Path. Basis Of Vet. Disease
  • 165. Mesothelioma – In domestic animals seen mainly in cattle – can be congenital. In humans has been associated with inhalation of asbestos (mining, construction, ship building).
  • 167. Fibrinosuppurative pleuropneumonia, rabbit –P. Multocida, Atlantic Veterinary College. Pasteurellosis is a common disease in domestic rabbits. P.multocida can result in rhinitis (“snuffles”), pneumonia, abscesses, reproductive tract infections, ear infections and septicemia.
  • 168. Emu, AVC Mycotic airsacculitis – Aspergillus spp. infection
  • 169. Emu, granulomatous pneumonia – Aspergillus, spp., AVC-1996