EIPH Flashcards
1
Q
Clinical signs of exercise-induced pulmonary haemorrhage (EIPH)?
A
- Most commonly no signs (most don’t bleed significantly enough to cause epistaxis)
- poor performance
- sudden onset exercise limitation
- swallowing after exercise
- epistaxis
2
Q
How does exercise-induced pulmonary haemorrhage develop?
A
- typically located in the caudodorsal lung lobes
- Capillary stress failure theory
- High pressures in pulmonary vasculature in the galloping horse due to CO and it ruptures
3
Q
Why does EIPH occur generally in the caudodorsal lobes?
A
- Higher blood flow
- lower intrinsic vascular resistance
- Displacement of the diaphragm causes transient falls in alveolar pressure
- Lower alveolar pressure leads to greater transmural pressure
4
Q
EIPH - Predisposing conditions?
A
- Prevalence increases with age
- Lower airway disease
- Upper airway disease
- Cardiac disease
- Increases pulmonary artery pressure
5
Q
EIPH – diagnosis?
A
- Clinical evidence of EIPH (in severe cases)
- Endoscopy
- Bronchoalveolar lavage
- RBCs, haemosiderophages
- Radiography
- Scintigraphy (experimental)
6
Q
EIPH: case management?
A
- Identify and address any predisposing diseases
- Break haemorrhage-inflammation cycle
- Modify training programme to reduce episodes
- Dust-free environment
- Furosemide (Not allowed in racehorses in the UK)
- ?antibiotics
7
Q
Effects of Furosemide on EIPH?
A
- Diuretic effect
- Reduce circulating volume
- Reduce weight
- Vasodilator effect
- Not allowed in racehorses in the UK
8
Q
How are nasal strips used for EIPH?
A
- Not allowed in UK racing
- Can train with them - Improve fitness and ability
- Work by dilating the nostril thereby reducing airway pressures and promoting oxygen uptake
9
Q
EIPH: prognosis?
A
- GOOD TO FAIR
- If having minimal impact on performance
- If you can identify a primary cause and address it
- POOR
- for idiopathic bleeders with performance limitations
10
Q
Infectious causes of URT disease?
A
- VIRUSES
- Equine influenza
- Equine Herpes Virus 1&4
- Equine Viral Arteritis
- BACTERIA
- Streptococcus equi equi
11
Q
Viral causes of LRT disease?
A
- Equine influenza
- Equine Herpes virus 1&4
- Equine Rhino virus
- Equine Viral Arteritis
12
Q
Bacterial causes of LRT disease?
A
-
Streptococcus zooepidemicus
- The most important
- Streptococcus pneumoniae
- Pasteurella/actinobacillus
- Rhodococcus equi
- Streptococcus equi equi
13
Q
Which mycoplasma species is associated with inflammatory airway disease?
A
- Mycoplasma felis. Implicated as a cause of IAD
- Isolated less commonly than other bacteria
14
Q
Which antibiotic is Mycoplasma felis sensitive to?
A
Sensitive to oxytetracycline
15
Q
Strains of equine herpes virus and what they cause?
A
- EHV1 - respiratory disease, abortion, neonatal, neurological
- EHV2 - respiratory disease in foals
- EHV3 - penile vesicles
- EHV4 - respiratory disease
- EHV5 – Equine Pulmonary Nodular Fibrosis
16
Q
Transmission of equine viral arteritis ND?
A
- Transmission by respiratory and venereal routes
- direct contact with an infected horse and its secretions
- Reservoir of infections
- Stallions that are chronic shedders
- Until they are castrated will continue to spread disease
17
Q
Clinical signs of equine viral arteritis ND?
A
- abortion and still birth
- peripheral oedema
- rhinitis and bronchitis/brochiolitis
- conjunctivitis and periorbital oedema
18
Q
General supportive treatment for equine lung disease?
A
- Rest
- Improve environement - dust free management
- Anti-pyretics
19
Q
How should you ideally manage an outbreak of EHV-1?
A
- Impose isolation policy on premises (Identify high and low risk animals and separate them)
- Serology on all in-contacts
- Separate negative and positive horses, re-test two weeks later
- Repeat until all horses have two negative samples
- Handlers and vets are important fomites so good hand hygiene is vital
20
Q
Risk factors for neonatal respiratory disease?
A
- Placentitis
- Placental insufficiency
- Maternal illness
- Early lactation
- Poor colostrum
- Prematurity
- Dystocia
- Premature placental seperation
- Failure of passive transfer
- Other neonatal illness
21
Q
What is respiratory distress syndrome in neonates?
A
- Atelectasis (collapse/failure of the lungs to expand due to lack of surfactant) due to
- Inadequate surfactant function
- Structurally immature lung and muscles of respiration
- Associated with prematurity and dysmaturity
22
Q
How does meconium aspiration occur in neonates?
A
- Stress in utero or during parturition leads to defecation,
- meconium enters airways with fetal fluid,
- aspirated when foal is born and starts breathing
- secondary bacterial pneumonia
23
Q
Clinical signs and diagnosis of meconium aspiration?
A
- Clinical signs: respiratory distress, nasal discharge
- Diagnosis: meconium staining
24
Q
What can cause aspiration pneumonia in neonates?
A
- Dysphagia
- neurological - uncommon, transient, manifestation of NMS
- Cleft palate
- Inappropriate bottle feeding
25
How does pneumothorax & haemothorax occur in neonates?
* due to trauma at birth causing rib fractures
26
How does Perinatal Asphyxia Syndrome develop?
* Ischaemia, oedema and reperfusion injury to foal’s brain, kidneys, intestine and other organs due to lack of oxygen (especially CNS depression)
* *In utero* hypoxia
* Interruption of oxygen supply during birth
27
Clinical signs of Perinatal Asphyxia Syndrome?
* May not be apparent until the foal is 12-24 hours old
* Severe cases may have central respiratory depression
* Almost stop breathing completely
28
Management and prognosis of perinatal asphyxia syndrome?
* Require lots of 24 hour nursing care, especially by the time they are severe. (very expensive)
* Prognosis of this condition is dependent on whether they receive this intensive nursing
* Without this they will die
* With this they will either die or recover 100% and regain full athletic function and be able to be a performance animal as they should have been, no in between
29
Why is lung auscultation not a sensitive diagnostic tool in foals?
Normal foal lungs have harsh bronchovesicular sounds (don’t have normal lung sounds like adults)
30
Signs of sepsis in the mucous membranes of a foal?
* Signs of sepsis: congestion/injection, petechiae
* Congested mucous membranes – dark red not pink
* Inside the ear pinna is showing the petechiae
31
How is *Rhodococcus equi* transmitted?
* Inhaled pathogen
* Ingested from soil (via faeces)
* Lives in environment
* Farms that have it tend to get it year to year
32
When does *Rhodococcus equi* tend to be seen in foals?
* Foals 2-6 months of age
* As MDA reduces
