Bệnh của chó, mèo

Bệnh viêm đường hô hấp trên mạn tính ở mèo

Ngày đăng: by Khoa Thú y

Bệnh viêm đường hô hấp trên mạn tính ở mèo là một trong các căn bệnh phổ biến và lây lan mạnh cho mèo độ tuổi dưới 1 năm, là vấn đề phức tạp của các hộ gia đình nuôi nhiều mèo và các trại nuôi sinh sản. Bệnh khiến mèo thường xuyên chảy nước mũi, ho, đôi khi gây viêm kết mạc, nghiêm trọng hơn có thể gây viêm phổi và tử vong.

I. Tổng quan

Bệnh đường hô hấp trên (Upper Respiratory Tract – URT) mạn tính (còn được gọi là chảy dịch mũi mạn tính) là một vấn đề tương đối phổ biến ở mèo và có thể do nhiều nguyên nhân gây ra.

Hội chứng đề cập đến bệnh mãn tính ảnh hưởng đến mũi hoặc vòm họng (đường dẫn khí ngay sau mũi). Một trong những dạng phổ biến nhất được gọi là viêm mũi mạn tính sau virus (viêm hoặc nhiễm trùng trong mũi). Trong tình trạng này, nhiễm vi-rút (ví dụ, nhiễm trùng đường hô hấp trên cấp tính do herpesvirus ở mèo – FHV hoặc calicivirus ở mèo – FCV) gây ra tổn thương cho lớp niêm mạc mỏng manh bên trong mũi, và thậm chí đối với các xương nhỏ bên trong mũi; nhưng các dấu hiệu mãn tính liên quan đến nhiễm trùng thứ cấp do vi khuẩn xảy ra do đường mũi bị tổn thương. Điều này có thể dẫn đến các dấu hiệu mãn tính dai dẳng hoặc không liên tục như hắt hơi, chảy nước mũi và nghẹt mũi.

  1. Nguyên nhân Bệnh viêm đường hô hấp trên mạn tính ở mèo

Nhiều bệnh khác nhau có thể gây tổn thương lâu dài cho mũi hoặc vòm họng và dẫn đến bệnh lâm sàng. Một số nguyên nhân quan trọng nhất bao gồm:

  • Viêm mũi sau virus hoặc vô căn – Nhiễm trùng đường hô hấp trên cấp tính do FCV hoặc FHV thường gặp ở mèo, đặc biệt là mèo non. Mức độ nghiêm trọng của các bệnh nhiễm trùng này rất khác nhau giữa các con mèo, nhưng trong một số trường hợp (đặc biệt là nhiễm FHV), nhiễm virus có thể gây tổn thương vĩnh viễn cho lớp niêm mạc mỏng manh của hốc mũi và cũng có thể làm hỏng xương bên dưới. Điều này có thể dẫn đến những thay đổi vĩnh viễn khiến khoang mũi dễ bị nhiễm vi khuẩn thứ cấp tái phát lâu dài. Đây được gọi là viêm mũi sau virus, và được cho là một trong những nguyên nhân phổ biến nhất gây viêm mũi mãn tính ở mèo. Trong một số trường hợp nghiêm trọng, nhiễm trùng do vi khuẩn có thể lan đến xương bên dưới và gây ra viêm tủy xương (nhiễm trùng trong xương). Các xoang trong xương xung quanh mũi cũng có thể bị ảnh hưởng trong bệnh viêm mũi mãn tính, vì vậy thuật ngữ viêm xoang mũi (rhino-sinusitis) đôi khi được sử dụng. Không biết có bao nhiêu trường hợp viêm mũi không đặc hiệu hoặc vô căn do biến đổi sau virus, nhưng người ta nghi ngờ rằng trường hợp này có thể chiếm một tỷ lệ đáng kể.
  • Nhiễm nấm – bệnh nhiễm nấm mũi phổ biến nhất ở mèo là do sinh vật có tên là Crytpococcus neoformans hoặc Crytpococcus gatii. Nhiễm Crytpococcus gatii phổ biến hơn ở các vùng khí hậu nhiệt đới và cận nhiệt đới trong khi Crytpococcus neoformans phân bố rộng hơn. Nhiễm trùng lây nhiễm qua đường hô hấp của sinh vật từ môi trường. Các sinh vật nấm khác đôi khi cũng có thể gây nhiễm trùng mũi ở mèo bao gồm Aspergillus và các sinh vật khác.
  • Polyp viêm – thỉnh thoảng, nhiều polyp (sưng viêm nhỏ/phát triển) phát sinh trong khoang mũi. Phổ biến hơn là một khối polyp lớn phát sinh từ tai giữa hoặc ống eustachian (ống nhỏ nối mũi với tai giữa) phát triển và khối này có thể phát triển trong vòm họng gây cản trở hô hấp.
  • Neoplasia (ung thư) – hai dạng phổ biến nhất của khối u ảnh hưởng đến khoang mũi là u lympho (một khối u đặc của tế bào lympho, một loại tế bào bạch cầu) và ung thư biểu mô tuyến.
  • Dị vật – ở mèo, dị vật ở mũi phổ biến nhất là vật liệu thực vật như lưỡi cỏ hoặc hạt cỏ. Trong một số trường hợp, chất này có thể bị hít vào mũi hoặc cũng có thể đọng lại trong mũi sau khi mèo đã ăn chúng nôn ra.
  • Viêm mũi dị ứng – mặc dù không phổ biến, một số mèo sẽ phát triển bệnh viêm mũi dị ứng tương tự như cái gọi là ‘sốt cỏ khô – hay fever’ ở người.
  • Bệnh răng miệng – đôi khi bệnh răng miệng nghiêm trọng có thể dẫn đến bệnh ảnh hưởng đến chân răng (ví dụ, phát triển áp xe) có thể ảnh hưởng đến khoang mũi.
  • Các tình trạng khác – nhiều loại bệnh khác có thể xảy ra, bao gồm bệnh do cấu tạo trên khuôn mặt (ví dụ: mèo Ba Tư cực kỳ “mặt phẳng”), hẹp vòm họng (nơi vòm họng bị thu hẹp bất thường) và chấn thương.

III. Triệu chứng lâm sàng

Các dấu hiệu chính của bệnh viêm đường hô hấp trên mạn tính ở mèo là:

  • Chảy nước mũi
  • Hắt xì
  • Khó thở
  • Thở nặng hoặc ngủ ngáy do khó thở
  • Thở dồn dập (thở ồn ào bằng miệng do cản trở luồng không khí qua mũi hoặc vòm họng)

Triệu chứng Viêm đường hô hấp trên mạn tính ở mèo

Bản chất của một số dấu hiệu này có thể giúp bác sĩ thú y của bạn khám phá ra nguyên nhân cơ bản của bệnh:

  • Có ảnh hưởng gì đến một hoặc cả hai bên mũi không?
  • Có tiết dịch từ một hoặc cả hai lỗ mũi không?
  • Bản chất của nước mũi là gì – có trong, nước, nhầy, mủ không?
  • Có lẫn máu trong dịch tiết không? (thường, nhưng không phải lúc nào cũng là dấu hiệu của bệnh nặng hơn như nhiễm nấm hoặc ung thư)
  • Có sưng mặt và thay đổi hình dạng của khuôn mặt hoặc mũi không? (thường, nhưng không phải lúc nào cũng là dấu hiệu của bệnh nặng hơn như nhiễm nấm hoặc ung thư)
  • Có bất kỳ tiết dịch nào ở mắt (‘chảy nước mắt’) hoặc liên quan đến mắt không?
  • Có bằng chứng nào về sự dính líu của đôi tai không? (đôi khi được thấy với các polyp viêm đặc biệt)
  • Có hạch to quanh đầu và cổ không? – nếu vậy, những điều này cũng cần được điều tra
  • Có bất kỳ sự thay đổi rõ rệt nào về sự thèm ăn hoặc cân nặng không – mèo mắc bệnh URT thường giảm cảm giác thèm ăn, nhưng sụt cân rõ rệt có thể gợi ý bệnh nặng hơn
  • Các dấu hiệu lâm sàng bắt đầu đột ngột hay dần dần?
  • Các dấu hiệu ngày càng trở nên tồi tệ hơn?

Đây là tất cả những câu hỏi mà bác sĩ thú y cần để chẩn đoán chính xác, vì vậy chủ thú cưng hãy cố để trao đổi với bác sĩ thú y một cách chi tiết nhất.

III. Phương pháp chẩn đoán

Đôi khi, dựa trên tiền sử của mèo, các dấu hiệu lâm sàng hiện có và khám lâm sàng, bác sĩ thú y của bạn có thể biết rất rõ vấn đề cơ bản là gì và có thể không cần kiểm tra thêm. Tuy nhiên, trong những trường hợp khác, và đặc biệt là với bệnh nặng, khi các dấu hiệu lâm sàng ngày càng nặng hơn hoặc cũng có bằng chứng về bệnh ở những nơi khác, thì có thể phải kiểm tra sâu hơn.

Những điều tra nào cần thiết sẽ khác nhau tùy từng trường hợp, nhưng có thể bao gồm:

  • Xét nghiệm máu và nước tiểu – bao gồm khảo sát FeLV và FIV khi thích hợp. Xét nghiệm máu cũng có thể giúp phát hiện một số nguyên nhân lây nhiễm khác (chẳng hạn như nhiễm trùng Cryptococcus).
  • Chụp X-quang mũi, hầu, ngực và có thể cả bụng. Chúng có thể rất có giá trị để tìm kiếm những thay đổi trong mũi và những nơi khác. Trong một số trường hợp, hình ảnh nâng cao hơn (chẳng hạn như chụp CT hoặc quét MR) sẽ có sẵn và được sử dụng – những hình ảnh này có thể cho hình ảnh rõ ràng hơn nhiều về các cấu trúc bên trong mũi và hầu.
  • Nội soi (nội soi rhinoscopy) – trong khi được gây mê để chụp X-quang, bác sĩ thú y cũng sẽ kiểm tra mèo kỹ hơn – thường bằng cách sử dụng một ống nội soi nhỏ đặt qua lỗ mũi và / hoặc qua miệng để nhìn vào phía sau mũi . Điều này cho phép hình dung trực tiếp một số cấu trúc trong mũi.
  • Sinh thiết – thường là một kỹ thuật có giá trị, sinh thiết nhỏ có thể được thu thập từ các mô trong mũi để bác sĩ bệnh học kiểm tra mô học và cũng để nuôi cấy để xem những sinh vật nào có thể có mặt. Lấy mẫu sinh thiết sẽ gây ra một lượng máu nhỏ, nhưng thường là rất nhỏ.
  • Cũng cần nhớ rằng nhiều xét nghiệm này có thể trả lại kết quả bình thường hoặc không đặc hiệu trong trường hợp viêm mũi mãn tính sau vi-rút, vì đây là bệnh thường được chẩn đoán bằng cách loại trừ các nguyên nhân có thể khác (với bằng chứng hỗ trợ từ sinh thiết, v.v.) ).
  1. Điều trị viêm đường hô hấp mạn tính

Điều trị Bệnh viêm đường hô hấp trên mạn tính ở mèo sẽ phụ thuộc vào nguyên nhân cơ bản. Một số bệnh sẽ có thể chữa khỏi, một số có thể kiểm soát được (để kiểm soát các dấu hiệu lâm sàng), nhưng trong một số trường hợp, việc điều trị có thể không khả thi hoặc không phù hợp với mèo. Ví dụ về một số phương pháp điều trị bao gồm:

  • Khối u – ung thư biểu mô tuyến có thể khó điều trị (mặc dù xạ trị có thể là một lựa chọn trong một số trường hợp), nhưng ung thư hạch ở mũi có thể đáp ứng tốt với điều trị bằng thuốc (hóa trị) và / hoặc xạ trị trong một số trường hợp
  • Nhiễm nấm – những loại này có thể đáp ứng tốt với liệu pháp thích hợp, nhưng trong một số trường hợp, thuốc chống nấm cần được kết hợp với phẫu thuật để loại bỏ các mô bị nhiễm trùng
  • Các polyp bị viêm – những polyp này thường sẽ đáp ứng tốt với phẫu thuật cắt bỏ, mặc dù – một số trường hợp có thể tương đối dễ giải quyết trong khi một số trường hợp khác có thể cần phẫu thuật phức tạp hơn.
  • Dị vật – những dị vật này thường có thể được lấy ra dưới sự gây mê, mặc dù trong một số trường hợp có thể phải phẫu thuật tiếp cận khoang mũi
  • Viêm mũi vô căn / sau virus – những trường hợp này có thể khó quản lý và kiểm soát thực tế hơn là mục tiêu chính của việc chữa khỏi bệnh. Các lựa chọn điều trị có thể được xem xét bao gồm:
  • Sử dụng kháng sinh ngắt quãng – bệnh thường liên quan đến nhiễm khuẩn thứ phát và kháng sinh thường cải thiện các dấu hiệu lâm sàng. Tuy nhiên, các dấu hiệu thường không khỏi hoàn toàn khi dùng kháng sinh và / hoặc tái phát trở lại sau một thời gian
  • Liệu pháp phun sương có thể hữu ích – máy phun sương có thể được lấy từ bác sĩ thú y của bạn và tạo ra một đám mây giọt nước rất mịn. Chúng được hít vào và giúp làm ẩm đường thở trong mũi – điều này rất hữu ích trong bệnh viêm mũi mãn tính vì chất tiết ở mũi có thể rất đặc, do đó, việc phun sương sẽ cải thiện điều này và làm cho việc hắt hơi hiệu quả hơn.
  • Nên tránh dùng thuốc thông mũi độc quyền của con người – những loại thuốc này có thể gây độc cho mèo và / hoặc gây bệnh nặng hơn
  • Một số con mèo có thể được lợi từ việc thỉnh thoảng được rửa mũi nhẹ nhàng và làm sạch (có thể dưới sự gây mê)
  • Trong một số trường hợp, việc sử dụng corticosteroid tại chỗ (thuốc nhỏ mũi) hoặc toàn thân (viên nén hoặc tiêm) có thể có lợi – những loại thuốc này giúp giảm viêm và trong một số trường hợp viêm mũi vô căn (ví dụ: nơi viêm được gọi là ‘lymphoplasmacytic’ – một loại viêm có thể gợi ý phản ứng miễn dịch hoạt động quá mức) việc sử dụng chúng có thể có giá trị
  • Chăm sóc nuôi dưỡng tốt cũng cực kỳ quan trọng, giữ cho khuôn mặt của mèo sạch sẽ và không có chất thải ra ngoài, đồng thời khuyến khích mèo ăn bằng cách cung cấp thức ăn đã hâm nóng có mùi thơm.

Nguồn tham khảo: https://eravet.vn/benh-viem-duong-ho-hap-tren-man-tinh-o-meo-chronic-upper-respiratory-tract-disease/

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