Cigarette Smoking and the Respiratory Ailment of COPD

Cigarette smoking has been strongly linked to health conditions like heart disease and lung cancer. Other than these two dreaded disease, heavy smoking may also cause chronic obstructive pulmonary disease (COPD). This condition causes inflammation and damages the small airways of the lung tissue and may cause breathing difficulties. COPD is usually a combination of two similar conditions: chronic bronchitis and chronic emphysema. Because cigarette smoking is the major cause of these two conditions, they often occur together in the same person. COPD damage is progressive and permanent and has become one of the fastest-growing health problems. It has become the fourth leading cause of death in the United States and is responsible for more than 96,000 deaths annually. Because of these health conditions the need to quit smoking has become more important than ever. Understanding COPD is essential in encouraging smokers to quit this dreaded and potentially fatal habit.

Chronic Bronchitis

Chronic bronchitis is caused by inhaling bronchial irritants like cigarette smoke, chemical fumes, air pollution, and environmental irritants like mold or dust. Cigarette smoke may increase the risk for infection because it damages the cilia or the small hair-like projections that protect the lungs from bacteria and other foreign particles out of the lungs. This disease develops slowly, middle aged and older individuals have heightened risks of getting diagnosed with bronchitis. Symptoms of chronic bronchitis may include wheezing, expectorating cough, chest pains, and persistent fatigue.

Emphysema

Emphysema is a chronic respiratory disease that is characterized by the enlargement of the alveoli or air sacks. Emphysema may reduce the elasticity of the lungs and may result in the collapse of the bronchioles, the first airway that no longer contain cartilage. As this happens, air cannot leave the alveoli therefore hampering the function of the lungs. The lungs may lose their ability to shrink during exhalation. Reduced exhalation may also reduce the amount of air that is inhaled. Because of this condition, waste air is not easily removed from the lungs and oxygen-rich air is not restored. Individuals with emphysema may have a hard time breathing and oftentimes gasp for air. Emphysema is most common on individuals aged 50 and older and may occur with other respiratory disease like bronchitis.

Causes and symptoms of COPD may include the following:

Lifestyle. Cigarette smoking is by far the most important risk factor for COPD and accounts for at least 80% of all COPD cases. Cigar and pipe smoking can also cause COPD. Air pollution and industrial dust and fumes are the known air pollutants that worsen the ailment. Age. Chronic bronchitis is more common in people over 40 years old; emphysema occurs more often in people 65 years of age and older. Socioeconomic class. COPD-related deaths are about twice as high among unskilled and semi-skilled laborers as among professionals. Family clustering. It is thought that heredity predisposes people in certain families to the development of COPD when other causes, such as smoking and air pollution, are present. Lung infections that can either be viral or bacterial.

Treatment for COPD is dependent on the patient’s condition and the severity of the disease. With a health program that involves respiratory care, disability and other symptoms can be prevented and therefore reducing the occurrence of early deaths. However, no treatments are proven to cure this disease. Certain treatments are only designed to alleviate symptoms and increase survival rate.

Rather than focusing on the cure, lifestyle changes that may prevent the development of COPD should be emphasized. The occurrence of COPD may be prevented if individuals who smoke quit smoking, maintain good nutrition, drink lots of fluids, maintain proper weight, and exercise. Understanding the health risks of of COPD are essential in making smokers quit smoking.

Feline Asthma Investigation And Treatment

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.

Cats usually present with one or all the following signs:

1.Coughing
2.Wheezing
3.Difficulty 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.

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.

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.

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:

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Breathing Problems Precaution Is Better Than Cure

When you have breathing problem or breathing difficulties, it is very difficult for the patients who are facing such problems to take proper amount of oxygen in the body. The patient may feel that they are not getting enough air as per the requirements of the body. Sometime people face breathing problems because oppressive nose or hard exercise. But shortness of breath may create serious problems for the patient so proper precaution is needed to deal with such kinds of breathing difficulties.

There may be various causes of breathing, shortness of breath, breathlessness or dyspnea. Symptom of shortness of breathing can arise at the time of high intensity of activity, such as high effort of work, or because of unfavorable environmental surroundings such as high altitude or extremely hot or cold temperatures. These are some of common causes otherwise it may sign of medical problems. In both of condition it needs both precaution and prevention.

Those children engage themselves in exercise like swimming are away from lower respiratory tract infections, ear inflammation (otitis media) or tightness and wheezing in the chest. In an independent it has been found that between the age of 6-18 months, the occurrence of lower respiratory tract infections and otitis media were low in the children who were engaged themselves in exercise as compared to those who do did not exercise.

There can be several causes of short breathing or breathing problems. Breathing problems are very usual which causes several problems and chronic obstructive pulmonary disease (COPD) is one of them. It is a situation which is bronchitis and emphysema including asthma, chronic obstructive pulmonary disease (COPD), other problems like lung and heart disease.

Majority of people are having breathing problems. They are also aware with the conditions that when children struggle to catch their breath during asthma attack or ex-smokers find themselves easily winded due to emphysema.

There are many symptom of breathing problems which are following:

A patient who has breathing problem can experience sudden beginning of severe shortness of breath. It may be an eruption of chronic lung disease such as COPD, or it can become the cause of pneumonia or acute bronchitis or the onset of heart failure.

The patient can also feel a sudden pain in their chest, which is an indication of a heart problem but some time it also happens because lung problem, such as a collapsed lung or blood clot in the lung.

Some important way to prevent breathing problems:

Always carry a medical alert tag if you are facing with pre-existing breathing condition, such as asthma.

If you have symptom of severe allergic reactions, then it would better for you if you carry an epinephrine pen and wear a medical alert tag. Your doctor will make you understand how it can be used.

If you have symptom of asthma or allergies, then keep yourself away from household allergy triggers like dust mites and mold.

There are several remedies for breathing problems. Some remedies and treatments are available for curing respiratory or breathing issues. On the basis of patients age and viciousness of the disease, that treatment is decided upon. Drug can generally be classified into fast-relief and long-term control medications. So you can try as the severity of diseases.