CBL - Weaning and Yearling Flashcards
What do ‘comet tail’ artefacts tell us on the pleural surface ?
Pleural irregularity
What is this?
Abscessed lung
Do we often do thoracic radiographs?
Not in adults only in young foals
What might we see with rhodococcus equi on thoracic Xray?
Nodular lesions -> abscesses
Would it be worth doing abdominal Us for a case of rhodococcus equi?
yea - good to find extra abscesses
How can we confirm a diagnosis of rhodococcus equi?
Tracheal wash -> cytology, C & S, PCR for R.Equi (VapA gene)
If we get a positive PCR on general serology testing for rhodococcus - is this definitive?
NO - very Sensitive test also pathogen ubiquitous in environment so not deffo positive
describe rhodococcus equi?
- Intracellular gram +ve bacteria
- Ubiquitous in soil -> ingested & excreted in adults - perpetuates in environment
- Can aerosolize in dusty environments
- Transmission - oral or inhaled
Who does Rhodococcus affect?
- Foals 1-5 months
- Immunocompromised horses
- Immunocompromised humans
What does R.equi mainly cause?
Primary pneumonia, but extrapulmonary disease commin
Describe R.Equi penumonia
- Insidious & progressive dx
- Pyrexia - Lethargy
- Innapetance
- Ill-thrift Coughing
- Inc PCR
Describe Atypical R.Equi - extra-pulm dx
- Ulcerative enterotyphocolitis
- Peritonitis
- Internal abscess
- uveitis - Immune mediated polysynovitis
- Septic synovitis
- Osteomyelitis
Tx for R.equi case?
- Supportive -> anti-ulcer meds
- Pain relief = NSAIDs
- Speific AMs->
- Macrolides + rifampin (Erythromycin, clarithromycin, or azithromycin) but AEs include D+ hyperthermia, potentially fatal colitis
- Ab resistant strains more common
Should we give AMs to ALL foals with R.equi?
No recommendation is based on abscess scores -> if <8cm they usually resolve on their own
How can we prevent R.equi?
- Environmental management
- Passive immunity
- Mass AM tx not recommended
What concrete things can prevent R.equi?
- Hyperimmune plasma
- No vaccination yet tho :/
What would be involved in Environmental management for prevention of R.equi?
- R.equi is often endemic problem: saprophyte
- Ingested by horses & excreted through faeces
- Foal affected in early stage from environment
- Enhanced by high soil C° & dusty dry conditions
-> try and prevent by focusing on these
How would we treat a yearling failing to thrive bc of cyasthostomins ?
- Fenbendazole 5 days OR Moxidectin (also has efficacy against encysted larvae)
- Pain relief/anti-inf -> steroids to deal with reaction
What does this abdo US show?
Thickened SI (5mm instead of 3)
What are some of the main signs of proliferative enteropathy caused by Lawsonia intracellularis?
The clinical signs are usually non-specific, so further testing may be necessary to rule out protein loss in the urine, peritoneal and pleural cavities. However, animals may present with signs of oedema, depression, fever (ie, temperatures greater than 38.5°C), anorexia, weight loss, diarrhoea and colic
What ares ome typical clinicopathological findings of LAwsonia?
2). Clinicopathological findings
frequently demonstrate hypoproteinaemia (often profound
hypoalbuminaemia) and, on occasion, leukocytosis and/or
hyperfibrinogenaemia
What else further supports Lawsonia diagnosis?
Thickening of SI on US
How do we diagnose Lawsonia?
Combine Molecular and serological testing as high Sp btu variable Se -> oftne negative PCr in foals & neg serology EARLY in dx
What is the most accurate assay for determining presence fo L intracellularis antibodies in foals with EPE??
IPMA antibody test
What is we see a positive titre in a healthy hermate with no hypoproteinaemia?
probably past exposure with cubclin dx
Prognosis with L intracellularis?
usually a rapid clinical improvement
following treatment; however, it can take weeks for the hypoproteinaemia to resolve.
Prevenetion of Lawsonia?
- environmental management -> Wild animal/pest control & reduce stress
- Endemic farms -> PE & TP monitoring
-> serology for monitoring
-> weight charts
-> start 4 weeks earliest reported case in previous years
-> pig intra-rectal vaccine
