CAL: airway inflammation Flashcards

1
Q

What do these images show?

A

Cytological Findings Mostly macrophages, occasional neutrophil Giant cell No intracellular bacteria Curshmann’s spiral Diagnosis Non septic lower airway inflammation (RAO)

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2
Q

Treatment - RAO

A
  • Oral clenbutarol - Beclamethasone via MDI - (Oral prednisolone = could be used but inhaled steroids more appropriate)
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3
Q

Define MDI

A

metered-dose inhaler

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4
Q

Pros and cons of oral clenbutarol

A

PROS: - Bronchodilator - Increases mucociliary clearance - Stabilises mast cells - Improves airway secretions CONS: - Variable absorption from GIT - Clinical efficacy variable at lower doses - Receptor down-regulation with prolonged use - Dose dependent side effects : tachycardia, sweating

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5
Q

Pros of oral prednisolone

A

Potent anti-inflammatory; decrease smooth muscle contraction and epithelial damage by inhibiting effects of inflammatory cells and the mediators they produce reduce mucus production.

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6
Q

Cons of oral prednisolonePros of oral prednisolone

A

Some improvement seen clinically after a few days, but takes a week for maximal clinical response. Side effects: immunosuppression, laminitis Variable absorption from GIT

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7
Q

Pros - beclamethasone via MDI

A

Use lower dose compared to systemic therapy, therefore lower risk of side effects, but still get high local concentration.

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8
Q

Cons - beclamethasone via MDI

A

May not provide therapeutic benefit for 24 to 72 hours Horse may not be co-operative to method of administration

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9
Q

What does sodium chromoglycate do?

A

Stabilises mast cells and reduces need for corticosteroid therapy

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10
Q

Cons - sodium chromoglycate

A

Only preventative, no role in therapy Need nebuliser to administer which is expensive, time consuming and horse may not cooperate Tend to cause horse to cough

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11
Q

What does this show?

A

Cytology: Increased amount of mucus Increased numbers of degenerate neutrophils Intracellular bacteria (gram positive chains of cocci) Interpretation: Septic airway inflammation

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12
Q

How should a septic airway inflammation (Step. zooepidemicus) be treated?

A

ABs that it is sensitive to (e.g. IM penicillin)

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13
Q

T/F: Ceftiofur is only licensed for IM administration in the horse

A

True

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14
Q

What does this show?

A

Cytology: Squamous epithelial cells with extracellular Simonsiella (only found in oropharynx) Interpretation: Oropharyngeal contamination –> repeat the sample!

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15
Q

What does this show?

A

Cytology: Predominantly macrophages, giant cells Interpretation: Resolving inflammation

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16
Q

What does this show?

A
  • Cell types in tracheal wash: macrophages, eosinophils - Organism present in second picture Dictyocaulus arnfieldi larvae - Interpretation: Lungworm infection – parasitic pneumonia
17
Q

What drugs are very effective against lungworm in the horse?

A

Oral ivermectin Oral moxidectin Oral fenbendazole