Bovine CRS Exam

Question 1

Thorax auscultation

Answer 1

HR (48-84)
RR (10-30)
Possible findings: noises, wheezes, rasping, crackles
(Ping/percussion?)

Question 2

What is found at each intercostal space?

Answer 2

Left
3rd ICS pulmonary valve
4th ICS aortic valve
5th ICS atrioventricular valve (bicuspid)

Right
3rd ICS atrioventricular valve (tricuspid)

Question 3

Possible abnormal findings

Answer 3

Pericardial effusion (ICS 3-5, purulent fluid in pericardial sac +/- fibrin)
Bacterial endocarditis (murmur, can have palpable thrill)
Congenital abnormality: VSD/tetralogy of fallot (VSD, pulmonary stenosis, RV hypertrophy, overriding aorta)
Lung pathology

Question 4

Describe the image

Answer 4

Normal lung (fat cow)
Skin in near field, fat layer, intercostal muscle, visceral pleura (bright white line at 1.5cm)

Horizontal lines are reverberation artefacts

Question 5

Edge of pleural surface going from thorax into abdomen

Answer 5

Largely normal
Bright white line is parietal pleura with visceral pleura right beneath
Comets/rocket tails: quite normal at this point of lung in large animals that live outdoors in slightly dusty/mouldy environment

Question 6

Answer 6

Pulmonary oedema secondary to severe respiratory disease (white comet tails with pleural surface that is not completely smooth)

Question 7

Answer 7

Shred sign/nodule (spherical lesion with air within it)

Question 8

Cranioventral lung field

Answer 8

Shred sign (associated with inhalational pneumonia in this area)

Question 9

Answer 9

Shred sign (severe pneumonia)
Right: hepatisation (solid lung that looks like liver)
Left: normal

Question 10

Middle region of hemithorax in calf

Answer 10

Spherical echogenic areas/lung consolidation likely to be pulmonary abscesses (can’t diagnose on ultrasound)

Question 11

Treatment of TRP

Answer 11

Early: magnet placed, broad spectrum antibiotics (amoxicillin/oxytetracycline)
Late: prognosis poor, euthanasia on welfare grounds

Question 12

Treatment of bacterial endocarditis

Answer 12

Long term antibiotics (3w, penicillin/amoxicillin)
Furosemide if CHF present
Analgesia (meloxicom)

Consider euthanasia due to antimicrobial stewardship and practicality of extended antibiotics

Question 13

Treatment of lung pathology in cows

Answer 13

Meloxicom
Antibiotics (oxytetracycline first line)
Electrolytes?
TLC

Question 14

Lungworm treatment

Answer 14

Ivermectin
(Vaccinate herd? Put on pasture two weeks after)