Colic Flashcards
Briefly outline 8 useful pieces of info for investigating the history of a resp case.
Duration and progress of clinical signs In-contact horses - are others affected? Recent travel? Poor of decreased performance? Exercise intolerance Changes in management Vaccination status Previous or current illnesses / co-morbidity
Common clinical signs that are diagnostic of both Upper and Lower Resp Tract
Increased respiratory effort Nostril flare Tachypnoea / Dyspnoea Cough?
Only LRT
Adventitious lung sounds Nasal discharge (bilateral)
Only URT
Respiratory Noise (stridor / stertor) Nasal discharge (unilateral) Unilateral airflow from nostrils Epistaxis Enlarged regional lymph nodes Guttural pouch enlargement Facial deformity Ocular damage
What are systemic signs?
Dullness / lethargy Anorexia Congested mucous membranes Tachycardia Pyrexia (T >38.4 dC)
What is the normal resp rate of horses?
8-12 bpm
Rebreathing Bag Exam: what and when?
What? To increase the respiratory effort of the horse. Makes them take big breaths in. A normal horse will increase breathing depth in 45 seconds. Also, easier to hear lung sounds and fluid over trachea.
When? To determine if upper or lower resp disease. Do NOT do in a horse in respiratory distress.
CBC Complete Blood Count: What and when?
What are you expecting to see?
Infectious cases = abnormal. Inc. bacterial.
Increase in WBCs (lymphocytes and neutrophils; any toxic changes; degree of increase; marked, left shift?)
Toxic changes indicate bacterial infection
Fibrinogen = marker of inflammation. Can show if its an active, ongoing process.
Expect normal results for non-infectious - asthma, inflammatory airway disease.
.
Biochemistry: what, when, expectations?
Most resp cases, biochemistry is normal.
Allergic response - increase in immunoglobulins and decrease in albumins due to negative feedback response.
Arterial Blood Gas Analysis: What, where, when?
What? Good measure for oxygen saturation. Determine resp acidosis or alkalosis.
Requires referral; not available in GP.
Valuable tools for foals that may be hypoxic.
Cryptococcal Testing: What?
Tests for common fungal disease in horses.
Monitor response to therapy.
Higher the tider, worse the disease.
Tracheal wash cytology.
When do you do a tracheal aspirate?
When suspect bacterial pneumonia. Submit for culture.
Takes samples for culture and cytology from tracheal secretions and exudates.
Nasopharangeal Test: When?
When worried about infectious cause.
- Strangles
- Equine Herpes Virus 1-4
- Influenza virus
- Hendra virus
Bacterial culture.
Bacterial and viral PCR.
When to do a tracheal wash?
Cytology.
Neutrophils
Macrophages
Eosinophils
Lymphocytes
Mast cells
What diagnostic test require referral?
Blood Gas Analysis
Radiography
Thoracocentesis
Lung Biopsy
Bronchiolar Lavage: When? What?
Non-infectious lower airway disease.
- equine asthma
- inflammatory disease
- exercise induced pulmonary haemorrhage (EIPH)
Cytology only.
For exercise induced pulmonary haemorrhage will see an increase in hemosiderophages (alveolar macrophages, that have ingested and digested RBC from previous episodes of EIPH).
Go through nose, nasopharynx, larynx airway - hence, do NOT submit for culture.
Under sedation.
Use 300-500 mLs of saline.
Do not do in a horse with respiratory distress and / or suspected infectious or pneumonia.
Always do ultrasound BEFORE radiographs.
U/S good coz:
- Non-invasive
- Easy and quick
- Gives lots of info about the pleural lining of the lung
- Determine if hemothorax; consolidated lung or collapsed lung
- Watch brightest line for movement.
When to do radiographs? Head and lungs.
Lungs:
- Referral
- U/S has shown no fluid in the lungs
- Bronchiolar Interstitial patterns
- Cryptococcus
- Worried about lower airway disease.
Head:
- Field
- Sinus disease; look at paranasal sinuses
- Easily do with portable x-ray machines
What does this coloured peritoneal fluid indicate?
Strangulation
Name these types of peritoneal fluid.
L-R: Normal, Peritonitis, Strangulation, Rupture, Splenic Tap
