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Respiratory > Coughing in Horses > Flashcards

Coughing in Horses Flashcards

1
Q

Differential diagnosis for coughing in foals and weanlings (URT)

A

EHV 1/4
Equine influenza
Streptococcus equi equi

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2
Q

Differential diagnosis for coughing in foals and weanlings (LRT)

A 
EHV 1/4
Equine influenza
Undifferentiated resp tract infection
Rhodococcus equi
Streptococcus equi equi
Parascaris equorum
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3
Q

What are the causes of undifferentiated bacterial pneumonia in horses…

A

Streptococcus zooepidemicus

Actinobacillus, Klebsiella, Staph aureus, Bordetella, Mycoplasma

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4
Q

What are the clinical signs of undifferentiated bacterial pneumonia?

A

Auscultable changes
Mild pyrexia
Cough
Usually bright and hapy

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5
Q

How can you diagnose undifferentiated bacterial pneumonia in horses?

A

History
Clinical signs
Diagnostic tests:
- Mucopurulent exudatein trachea on endoscopy
- Bronchointerstital pattern on radiography
- BAL/tracheal aspirate
+ Degenerate neutrophils increased, intracellular bacteria

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6
Q

What is the treatment for undifferentiated bacterial pneumonia in horses?

A

ABs on C+S
Rest
Dust free environment

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7
Q

Differentials diagnosis for infectious causes of coughing in adult horses (URT)?

A 
Equine influenza
EHV 1/4
EVA
Equine Rhinitis Virus
Streptococcus equi equi
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8
Q

Differentials diagnosis for infectious causes of coughing in adult horses (LRT)?

A 
Equine influenza
EHV 1/4
Equine Viral Arteritis
Equine Rhinitis Virus
Streptococcus equi equi
Streptococcus zooepidemicus
Streptococcus pneumonia
Pasteurella/actinobacillus
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9
Q

How does infection spread between URT and LRT?

A

Causes of URT infections always start there then spread to LRT

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10
Q

Epidemiology of upper airway disease (infectious)

A

Less common that lower airway
Mainly young horses, then get some form of immunity
Usually caused by viruses

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11
Q

Epidemiology of lower airway disease (infectious)

A

Common in racing age groups
Seen in all ages
Bacterial infection more common but can occur in combination

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12
Q

What are the clinical presentation of upper respiratory tract infection in horses?

A 
Fever
Nasal discharge
Coughing
Enlarged LNs
Dull and depressed
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13
Q

Clinical presentations of lower respiratory tract infections in horses?

A 
Coughing
Mucoid tracheal secretions
Poor performance
May be subclinic
\+/- fever
\+/- nasal discharge
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14
Q

How prevalent is EHV 1+4 in the UK?

A

Endemic in the UK

75% of horses have latent infection acting as reservoir

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15
Q

What may activate a latent EHV1/4 infection?

A

Stress
Transport
Other illness
Vaccinations

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16
Q

Epidemiology of EHV 1&4

Site of latency
First exposure
Immunity
Re-infection
How serious?
A

Site of latency:
Bronchial LN
Submandibular LN
Trigeminal ganglia

EHV2 may be involved in reactivation

First exposure as foals and weanlings

Source of infection lactating mare (stress due to pregnancy)
Foal to foal spread

Immunity short lived (3-5 months)
Vaccination ineffective

Re-infected during breeding or racing careers
Respiratory secretions, foetus/placenta, fomites

Re-exposure usually causes mild or inapparent infection

Except in broodmare (abortion last trimester if infected when pregnant)

Also get neurologic disease

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17
Q

Pathogenesis of EHV1

A

1) Inhalation of virus
2) Incubation 3-7 days
3) Replicates in URT epithelium (URT signs)
4) Disseminated to LRT (LRT signs)
5) Transported to other organs in T lymphocytes
6) Viraemic up to 3 weeks
7) Vasculitis
- Neurological disease
- Abortion
- Chorioretinopathy (damage to retina)
8. May be accompanied by secondary bacterial infection

(May be subclinical)

18
Q

Pathogenesis of EHV4

A
  1. Inhalation of virus
  2. Incubation 3-7 days
  3. Replication in URT (URT signs)
  4. Disseminated to LRT (LRT signs)
19
Q

Epidemiology of equine influenza virus

A 
2-3yr old racehorses
H3N8
Worldwide
Antigenic drift (not shift)
Most common cause of URT infection
Aerosol and direct contact spread
Vaccinated animals susceptible to infection within 2-3 months
Partial immunity may suppress clinical signs but allow shedding
20
Q

How can you diagnose lower airway infection in horses?

A 
Clinical signs/loss of performance
Endoscropy and LRT samples
Mucopus
Degenerate neutrophils
Haematology
Neutropaenia(early)/neutrophillia(late)
Lymphopaenia(early)/lymphocytosis(late)
Hyperfibrinogenaemia
Imaging not very useful
21
Q

How can you identify specific respiratory pathogens in the horse?

a. Bacteria
b. Viruses

A

a. Culture and cytology of LRT samples

b. Rarely performed (treatment is the same for all)

22
Q

Diagnosis of EHV1&4?

A

Virus isolation
Blood
Nasopharyngeal swab and PCR to looks for bits of viral DNA

Serology
Paired samples

23
Q

Diagnosis of equine influenza?

A

Serology
Paired samples 14 days apart

Nasopharyngeal swab
Virus isolation (not from blood)
PCR

24
Q

Treatment for viral respiratory infection in the horse?

A 
Isolate
Symptomatic and supportive
Limit stress
Maintain hydration
NSAIDs to limit pyrexia and improve appetite
REST
(Specific antiviral therapy too expensive)
Monitor for secondary infection
25
Q

Treatment for respiratory bacterial infection in the horse?

A 
Antibiotics
Rest
Dust free environment
Anti-pyretics
Mucolytics
Bronchodilators
26
Q

Describe equine influenza vaccination..

A

Start >6months due to maternal anitbodies

  1. 1st vaccination
  2. 2nd vaccination 21-92 days from 1st
  3. 3rd vaccination 150-215 days after second
  4. Therefore annually
  5. Horses can’t race until 8th day after vaccination
27
Q

Describe EHV1&4 vaccination…

A 
Can vaccinate from 4 months
Natural immunity short lived (unlikely to improve with vaccination)
Reduced clinical disease, nasal shedding, days of viraemia
Not complete protection
Not currently available in UK
2 doses 4-6 weeks apart
Booster at 6 months
Pregnancy = 5th,7th,9th month
28
Q

Non-infectious causes of coughing in adult horses

A 
Equine asthma
Aspiration pneumonia
Pleuropneumonia
Pulmonary abscesses
Left heart failure
Epiglottic entrapment
URT foreign body
TB
Lungworm
Tracheal stenosis
Neoplasia
29
Q

What are the types of equine asthma?

A

Mild to moderate = IAD

Severe = RAO/SPAOPD

30
Q

Describe mild-modere equine asthma…

A 
Young racehorses
Excessive mucous in airways
May exhibit cough/reduce performance
NO increased respiratory effort at rest
Signs are chronic (>4weeks)
Frequently subclinical
31
Q

Pathogenesis of mild-moderate equine asthma…

A 
Unknown
Inhaled dusts, ammonia causes
Bacterial infections
Viral infections
Blood from EIPH
- Inflammation
- Secondary infection
32
Q

Diagnosis mild-moderate equine asthma?

A

Endoscopy
- increased mucous

Tracheal aspirate/BAL
- increased mucous, neutrophils, eosinophils, mast cells

33
Q

What is the treatment for mild-moderate equine asthma?

A 
Environmental changes
ABs
Interferon
Steroids
Bronchodilators
34
Q

Describe severe equine asthma…

A

Naturally occurring lower airway disease characterised by periods of reversible airway obstruction

Neutrophil accumulation
Mucous production
Bronchospasm
Usually >7 years
Life long condition
35
Q

Pathogenesis of severe equine asthma?

A
  1. Spores and allergens deposit in bronchioles
  2. Immune reactions
    Type 1 (mast cell degranulation)
    Type 3 (immune-complex)
    Type 4 (delayed)
  3. Bronchoconstriction
  4. Mucous production
  5. Airway inflammation
  6. Tissues primes
  7. Can become hypersensitive
  8. Respond to non-specific allergens
36
Q

Clinical signs of severe equine asthma?

  1. Acute
  2. Chronic
A
  1. Increased respiratory effort, dyspnoea

2. Poor performance to overt respiratory dysfunction with/without coughing and hypertrophy of abdominal muscles

37
Q

How can you diagnose severe equine asthma?

A 
History
Physical exam
Assess airway inflammation
- Transtracheal wash
- BAL
Rule out bacterial pneumonia
Evaluate response to treatment
38
Q

How can endoscopy be used to assess airway inflammation?

A 
Rules out pharyngeal disease
Airway inflammation
- Hyperaemia
- Corina blunting
Assess tracheal mucous
Obtain tracheal aspirates
39
Q

Pathogenesis of equine influenza…

A
  1. Inhalation
  2. Incubation 1-3days
  3. Infects epithelial cells of URT and LRT
  4. Loss of ciliated epithelium
  5. URT/LRT signs
  6. Associated with secondary bacterial infection
  7. NO VIRAEMIA
40
Q

Treatment of severe equine asthma?

A

Environmental management
Reversal of bronchoconstriction
Decreased pulmonary inflammation
Decrease pulmonary mucous accumulation

41
Q

Describe lower respiratory tract bacterial infection in horses…

A

Streptococcus zooepidemicus
Streptococcus pneumoniae
Pasteurella/actinobacillus

Inhaled and overcome defence mechanisms

LRT signs only

May occur secondary to viral infection or non-infectious airway diseases

Respiratory (16 decks)

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