Equine 2 Flashcards
1
Q
Name the 2 blood supplies to the liver
A
Hepatic artery
Portal vein
2
Q
Where does the blood from the sinusoids drain into
A
Central veins and thus into hepatic vein and caudal vena cava
3
Q
What organ(s) synthesize albumin and fibrinogen
A
Liver only
4
Q
The liver deaminates amino acids for use as energy substrates or precursors of _______
A
Gluconeogenesis
5
Q
What is the major toxic by product of amino acid catabolism
A
Ammonia
Which is eliminated by new amino acids if conversion to urea
6
Q
Name some important things the liver does
A
N excretion by urea excreted in urine
Regulation of synthesis, storage and release of glucose
Uptakes fatty acids and esterification into triglycerides
Oxidation of free fatty acids for energy
7
Q
What does not make up bile
A. Bile acids B. Conjugated bilirubin C. Cholesterol D. Lecithin E. Fatty acids F. Electrolytes G. Water
A
E
8
Q
The principal bile acids in horses (cholate and chenodeoxycholate) are conjugated with what
A
Taurine
9
Q
T/F. Bile flow is continuous in horses
A
True
10
Q
Urobilinogen in the gut can go to what 3 places
A
Feces (stercobilin)80%
Urine( urobilin) 2%
Enterohepatic circulation 18%
11
Q
What order does bilirubin enter each of the following
- Gut
- Reticuloebdothelial
- Liver
- Bloodstream
A
2
4
3
1
12
Q
What are inducers of metabolism of toxins
A
Barbiturate
Phenylbutazone
Inhibitors- chloramphenicol cimetidine and quinidine
13
Q
How much hepatic loss must occur before clinical signs are noticed
A
60-80%
14
Q
Chronic hepatic disease is usually associated with ________ of the hepatic parenchyma
A
Fibrosis
15
Q
What are some signs of hepatic disease or failure
A
Weight loss* Lethargic Obtunded* Inappetance* Colic* Diarrhea Icterus* Fever Edema PU PD Hepatic encephalopathy *
16
Q
T/F alanine transaminase (ALT SGPT) and lactate dehydrogenase (LDH) and both not useful to diagnose hepatocellular disease in horses
A
True
Aspartate transaminase (AST SGOT)- doesn’t correlate with degree of damage Sorbitol dehydrogenase (SHD)- volition but correlates with degree. are both more useful
17
Q
What is the most sensitive indicator of hepatocellular damage and is a leakage enzyme
A
Sorbitol dehydrogenase SHD
18
Q
In biliary tract disease ALP and ____ go up at the same time
A
GGT
19
Q
Foreign dyes such as BSP and indocyanine green tell information about _______
A
Clearance
20
Q
Bile acids are (increased/decreased) with prolonged fasting, (increased/ decreased) with liver disease, and (highest/ lowest) with biliary obstructions or shunts
A
Increased. Increased highest
21
Q
What is the most common cause of increased bilirubin
A
Not eating
22
Q
Hyperbilirubinemia can result from what
A
Hemolysis
Primary hepatocellular disease
Cholestatic disease
Associated with icterus or jaundice
23
Q
(Unconjugated/ conjugated) bilirubin is a more reliable indicator for hepatic disease
A
Conjugated
>25% hepatocellular dz
>30 % biliary dz
Is water solvable (urine)
Urobilinogen in urine indicated a patent bile duct
24
Q
Which is false regarding BUN and ammonia
A. Ammonia is converted to urea in liver
B. Liver dysfunction = decreased BUN and ammonia
C. Blood ammonia doesn’t tell severity
D. Ammonia is non specific for liver disease
A
B- decreased BUN and increased ammonia
25
PT and PTT are (increased/ decreased) with liver failure. Cholestatic disease causes a vitamin K ( deficiency/ toxicity) because of an abscence of bile salts
Increased. Deficiency
26
What are the most useful blood tests for hepatic disease
SDH, GGT,
serum bile acids -most sensitiv
US , liver biopsy (right 12-14th rib), laparoscopy can also be preformed
Hepatic scintigraphy - PSS in foals
27
What are some poor prognostic indicators for hepatic dz
```
Hepatoencephalopathy
IV hemolysis
Coagulopathy
Weight loss
Severe hepatic fibrosis
Decreased BUN
Increased GGT AP or bile acids globulins
```
28
How is liver failure treated
```
Mineral oil
Activated charcoal
Lactulose
Neomycin
Low pt. High carb diet
-AA
- beet pulp, sorghum, milo, oat grass hay
Fluid- LRD, dextrose, vitamin B
NSAIDs
Vitamin K
No sunlight
```
29
What is the term for deep breathing
Hyperpnea
30
Name the borders of the lung field where auscultation occurs
Caudal border of triceps
Cranial border caudal scapula
Diagonally elbow to last rib/ tuber coxae
31
What is the only lymph node on a horse that should be palpable on a healthy horse
Submandibular
32
Stridor is the (upper/lower) airway
Upper
33
For cases that have difficulty breathing we normally sedate for endoscopy
T/F
False- no sedation
34
TTW are (sterile/ non-sterile)
Sterile for culture
| Less than 20% neutrophils but macrophages are normal
35
BAL are (sterile/ non-sterile)
Non
Lower resp tract
Cytology can tell you about inflammation or hemorrhage- done with asthma too
36
Nasal swabs are only used to detect what microbial diseases
Viral
37
Strangles is diagnosed with what type of wash
Nasopharyngeal
38
A thoracocentesis should be preformed at what intercostal space
6-7. 10cm dorsal to elbow
39
What 3 things can fill a guttural pouch
Air- tympany
Pus- empyema
Blood
40
GP tympany occurs genetically to what breed or gender
Arabian and fillies
41
GP empyema’s purple my material is made up of _________. Caused by this pathogen_________
```
Chondroids
Streptococcus equi (zooepidemicus)
```
42
How are GP empyema treated
Lavage and remove
Topical AB
NSAIDS
43
Streptococcus equi equi has what common clinical signs
```
LN enlargement
Fever
Enlarged GP
purulent nasal discharge
Dyspnea
Metastatic abscessation= bastard strangles
Myositis
Purpura hemorrhagica- painful edema, high Ab, >1:6400
```
44
How is streptococcus equi equi diagnosed
Culture or PCR (SeM)- antibodies, LN discharge, GP lavage, nasopharyngeal wash, 3 (-) every 2 weeks)
Purpura hemorrhagica= > 1:12800
45
```
Which is not used to treat s. Equi equi
A. Penicillin
B. NSAIDS
C. Drainage if enlarged LN
D. Tracheostomy if dyspnea
E. Antibiotics if purpura or myositis
```
E- only if ongoing infection but generally no AB. Corticosteroids with this stage
46
Vaccines don’t need to be given if a horse’s s. Equi titer is above what
3200
M-protein- b/c poor efficacy, 3 doses at first and high injection site reaction
Intranasal- only healthy, not <1 yr, 2 doses
47
What is a heave line
Breathing hard leading to hypertrophy of muscles
48
Severe asthma (recurrent airway obstruction) occurs in animals (>,
Greater than usually
| Genetic predisposition and allergens
49
Severe asthma is more associated with what 2 seasons and why
Summer
Winter
Dust
50
Bronchospasm-> mucus plugs-> smooth muscle hyperplasia-> airway wall thickening-> _____—
Fibrosis
No eosinophils
No histamine
51
How is severe asthma diagnosed
Cytology with a non sterile treachery tube
| BALF- sedation with butorphanol (not if in resp distress)
52
What is seen on a BALF test that diagnoses severe asthma
>25% non degenerative NT
| curchmann spirals
53
How is severe asthma treated
No cure. Progressive. Minimize antigen. Corticosteroids (dexamethasone, prednisolone, Beclomethasone, fluticasone ciclesonide)
Bronchodilators (clenbuterol albuterol)
Ciclesonide 8 actuations BID 5 days then 12 SID for 5 days
Steam hay
Straw isn’t good bedding
54
Mild asthma (inflammatory airway disease is (reversible/ no -reversible)
Reversible
55
Mild asthma is a Dx of exclusion. A BALF is preformed with NT at 10-15%, EO at 1-5% and mast cells at 2-5%. Endoscopy may find______
Mucus
56
What are some treatments for acute asthma
Corticosteroids
Change environment
IFN a
Mast cell inhibitor (neocromil sodium, cromolyn sodium)
57
EIPH causes what to be seen on BALF
RBC or hemosiderin
58
Epistaxis in EIPH is <7% bilateral with (decreased/ increased) swallowing
Increased. Excessive
59
What are some treatments of EIPH
Furosemide
| Nasal strip???
60
About what percent of horses have EHV -4 by 1 year of age
100
EVH-1 is 30% in winter
Most are carriers
61
How is equine herpes spread
35 ft aersol
62
What are some symptoms of herpes
```
Fever
Lethargy
Nasal or ocular discharge- serous
Submandibular LN swelling
Cough
Abortion on third trimester
```
63
What isn’t herpes treatment
A. Rest
B. NSAIDs
C. Antibiotics
D. Nursing care
C. Only if a retained placenta in abortion. Is okay to breed again
64
How often should a horse be vaccinated
q6 months
65
How is EVA spread
Urine- semen
| Resp secretions
66
Clinical signs of EVA
```
Fever
Lethargy
Rhinitis
Conjunctivitis
Cough
Dyspnea
Ventral edema
Abortion if at 2-3 months exposure
Neonates- fatal pneumonia
```
67
```
Which is not a diagnoses method for EVA
A. Nasopharyngeal swab
B. Conjunctival swab
C. Heparinized blood
D. Tissues- lung spleen, LN
```
C
68
Is EVA a reportable disease
Yes
69
```
Treatments of eva includ all the following except
A. Rest and nursing care
B. Fluids
C. NSAIDS
D. Furosemide
E. Decongestants
```
E
70
A MLV vaccine exists for EVA and is long acting and protective
T/F
True
71
Flu affects more ( older/ younger) horses
Younger
72
T/ F. Flu testing is best diagnosed by a blood test PCR
False. Not in bloodstream
```
Nasopharyngeal swab
TTW
ELISA stall test
Serology
NPS viral isolation
```
73
What are some clinical signs of flu
```
Fever
Lethargy
Serous nasal discharge
Submandibular nasal discharge
Dry cough
Limb edema
2 bacterial infection
```
74
When are horses vaccinated for flu when pregnant
4-6 weeks pre foaling inactivated and canarypox vector only
Q6 months in general
Foals at 3-6 months
Intranasal is MLV and is a local response
75
Which is not a characteristic of pleurodynia
A. Shallow breathing
B. Restlessness
C. Elbows abducted
D. Intolerant to rebreathing exam
E. Painful to percussion, pressure on thorax
F. Painful cough
B- reluctant to move
76
What can cause pleural effusion
```
Trauma
Neoplasia
Choke
Anesthesia
Respiratory virus
Travel history
```
77
Name some clinical signs of pneumonia
```
Crackles wheezes
Tachypnea
Fever
Pleurodynia
Dyspnea
Ventral edema
Low BCS if chronic
```
78
What must be done before thoracic radiography of pleural effusion
Drain
79
What are some common isolates of pleural effusion
Gram +
Streptococcus zooepidemicus
Staph. Aureus
Anaerobics
Bacteroides fragilis
Clostridium
Fusobacterium
```
G-
Pasteurella
Actinobacillus
Klebsiella
E. coli
Bordetella
```
80
Pleuropneumonia treatments include
Iv or inhales AB- PO once controlled
O2
If fibrin/abscess- lavage, rib resection, thoracotomy
81
What are additional complications of pleuropneumonia
A. Laminitis
B. Thrombosis of lateral thoracic or cephalon
C. Sepsis
D. Diarrhea
E. Renal Failure
A B C D
82
T/F prognosis is worse if the bacteria are aerobic
False. If anaerobic
83
What type of anemia is chronic
Normocytic normochromic with increased globulins
| When tachypnea, Dyspnea no lung sounds no fever abdominal effort- melanoma dif. Diagnoses
84
When can a neonate get pneumonia
In utero or post partum with failure of passive transfer
85
How is pneumonia diagnosed in neonatal foals
```
Blood culture
TTW
Arterial blood gas
X-ray
US
```
86
```
Which of the following should be used with caution in neonatal pneumonia treatment.
A. AB- broad spectrum
B. Anti- inflammatory
C. Intra nasal oxygen
D. Bronchodilator
```
D
| Progonis is variable for many reasons
87
Acute respiratory distress syndrome occurs in foals at what age
<8 months
| Alveolar pattern thoracic X-ray
88
ARDS is treated using
```
O2
Corticosteroids
Bronchodilator
Antimicrobial
Inhaled therapy
```
89
A progressive pneumonia that is unresponsive to treatment would suggest a foal is infected with what
EHV- 1
Occurs with infected mare
Foal is weak
90
Pneumocystis carinii causes foals to become immunocompromised. What is expected to be seen on cytology
Macrophages
91
Adenovirus (SCID) causes fatal bronchopneumonia in what breed
Arabian
92
Streptococcus zooepidemicus will cause a TTW to show what
G+ organisms. 80% degenerative NT
93
Rhodococcus equi is a gram + bacteria that affects only young foals worldwide. This bacteria leads to a (immunocompromised/ healthy) adult if treated correctly
Immunocompromised
Hide in macrophages
94
R. Equi can lead to what extra pulmonary lesions
```
Ulcerative colitis- diarrhea
Ulcerative lymphangitis
Arthritis- osteomyelitis
Abscess
Immune mediated- polysynovitis, thrombocytopenia, anemia
```
95
T/ F. R. Equi generally heals in it’s own in foals
True. 80%
96
What is the difficulty with diagnoses of r equi
TTW. But only 1 foal needs this to dx herd- PCR for VapA
X-ray, BW also done
97
In order to use rifampin to treat pneumonia from r equi it must be combined with what other drug
Macrolides
```
Need erythromycin (others mycin)
May cause hyperthermia and is a long, costly cure
```
NSAIDs may also be used
98
T/F. The r. Equi vaccine works with a 95% efficacy for prevention of extra pulmonary symptoms
False. No vaccine
| Hyper immune plasma at birth may prevent severe disease
99
What age does the parascaris equorum effect foals
4 months - 1 year old
Weaning age
Clinical signs seen when migration phase in lungs (eosinophils, larvae and inflammation from TTW or BAL)
Adults are immune
Tx with deworm at 2 month and 4 month etc. and fenbendazole but if clinical only fenbend. And water oil
100
What is average horse gestation
340
Longer with colts, older mares or if need early
101
Why is induction of parturition not recommended in horses
Last 48 hours of gestation = hypothalamic pituitary adrenal axis signals ready for birth, organ development crucial for organ development
102
Closer to parturition Ca goes (above/ below) 10 mmol/ L, K is (above/ below) 35 mmol/L and Na is (above/ below) 30 mmol/ L
Above
Above
Below
103
Stage 2 of parturition is defined by
Rupture of chorioallantois
Expulsion of foal
Average of 20 minutes
104
How long should stage 3 last (expulsion of fetal membrane)
No longer and 3 hours
105
Nursing should occur between what hours after birth
2-4
106
If a foal is icterus at birth it is most likely
Herpes
107
Say 12 hours post foaling the foal should be able to thermoregulate between what temps
100-102
108
Which general is more likely to have a bladder rupture during parturition
Male
Colts urinate at 6-8 hrs
Filly at 12-14
109
What is the meconium
First feces
110
Which breeds are more likely to have a scrotal hernia
Tennessee walking horse
| Standard bred
111
If a foal has uveitis it’s likely to also have
Sepsis
| Cataracts are heredity
112
Which is not a clinical sign of immature foal (<320 days)
A. Floppy ears
B. Tendon laxity
C. Course hair coat
D. Lack of ossification in Carpal and tarsal bones
C- silky
113
If the pcv in a neonate is above 46 what probably occurred
In utero hypoxia
114
If fibrinogen is greater than 200 at birth. What likely happened
In utero infection
115
```
Which are normally elevated in neonates.
A. Alkaline phosphatase
B. Creatinine
C. Bilirubin
D. Phosphorus
E. BUN
F. Lactate
```
A C D
116
What is the most common problem in neonates
Septicemia
Risk if fail of PT, perinatal stress, hypoxia, premature, unsanitary, pathogen exposure, old age, long gestation
117
What are some signs of an in utero infection
```
Leukocytosis
Fibrinogen less than a day old
Uveitis
Thin- inflammatory cytokines
If born with mare with placentitis may not be septic but increased WBC 2-4 days
```
118
How is SIRS or Fetal Sepsis
```
Antimicrobials
Pentoxyfylline
NSAIDS- flunixin meglumine or firocoxib
Altenogest- decrease myometrial response
Anti- oxidants. Vitamin E
```
119
Infection implies 2 events occurred
Foal exposed to microbes
| Defense response inadequate
120
How is post partum infection prevented
Clean stalls
Mares hygiene around foaling
Cleaning udder and Perineal regions
Umbilical care
121
Specific gravity of colostrum should be above what
1.060
IgG should be at lease above 400 12-14 hours old
122
When is colostrum replaced by milk
12-24 hours
123
Ability to absorb colostrum starts at what age
6-8 hours
Gone by 18
124
Neonatal sepsis is acquired in utero and signs are seen typically at what age
1-7 day range
| 3-4 day most common
125
Actinobacillus induced sepsis is seen 1-2 days old. What other microbes can be seen in sepsis
E coli, klebsiella, strep and staph
126
What are clinical signs of the foal with sepsis
```
Weak
Lethargic
Decreased suckle
Petechiae
Discolored mucous membranes - injection
Cold skin
Fever
Anterior uveitis
Swollen joints
Mare- placentitis vulvar discharge dystocia
Premature
```
127
CBC and chem changed in Sepsis include
```
Leukopenia
Neutropenia
Left shift
Toxic changes
Hypoglycemia
Elevated lactate
```
128
```
Which is not included in initial stabilization of a septic foal
A. Heat
B. O2
C. Caffeine
D. Insulin
E. Fluids
F. Plasma
G. Blood culture
H. Diazepam if seizures
```
D- glucose
129
What combo of Anton ironical should are used for a septic foal usually
Penicillin and aminoglycosides
Not nephrotoxic drugs if suspected birth asphyxia
Monitor creatinine, hydration, albumin
Cefiofur (alone or combo)
130
In herbal what is the treatment plan for foals with sepsis
```
Supportive care
Fluids
+/- corticosteroids or pressor
Plasma
O2
AB
Nutritional support
```
131
When evaluating CN 3 4 and 6. The pupil is in an abnormal position if it is
Dorsomedial. ( should be ventromedial)
132
CN 5 and 7 are sensory and motor to face If damaged what signs will you see
Hyper responsive to tactile stimulation
| Jerky head movements (cerebral)
133
Name all the nerves essential to nursing
5 7 9 10 11 12
Swallow
Lip movement
Jaw movement
Tongue movement
134
What are some perinatal complications that lead to seizures
Perinatal asphyxia
Intracranial hemorrhage
Cerebral contusions
135
What are some metabolic reasons for seizures
Decreased Na, Mg, Ca or glucose
Increased Na
Metabolic acidosis
Idiopathic- Arabian
136
What drugs can cause seizures
Theophylline
Toxin
Intracarotid injection
137
Tyzzers ( clostridium piliformus), sepsis and _________ are all infectious causes of seizures
Encephalitis
138
Diagnostic options for seizures include what
Imaging
CSF tap 5-10 ml
Pt higher than adults
139
Perinatal asphyxia syndrome results in what
Dummy foals ( wanderers/ barkers)
Hypoxic ischemic encephalopathy
Neonatal maladjustment syndrome
140
What causes hypoxia prenatally
Reduced o2 delivery
Reduced uterine blood flow
Placental disease
Reduced umbilical flow
141
What causes hypoxia intrapartum
```
Dystocia
PPS
Uterine inertia
Oxytocin induced labor
C section
```
142
What other organs are effected by hypoxia other than CNS
```
Kidney
Gi
CV
Lungs
Liver
```
143
What is the most prominent clinical sign of PAS
Cerebral dysfunction
Along with restlessness, head pressing, abnormal breathing, hyper responsive
144
WhAt can be seen on a CBC CHEM of a uncomplicated PAS
Normal
Maybe metabolic blood gas’s derangement
Normal or yellow CSF. ( yellow from blood)
145
What is PAS treated with
```
Fluids- LRS ascobic acid
Glucose
Electrolytes
Enteral nutrition
Maintain BP with pressors or inotropes
Thiamine
MgSO4
NSAIDS
Pentoxyfilline
Vitamin E sid
Allopurinol
```
146
Bacterial meningitis occurs due to immature IS and more permeable BBB. What is this treated with
AB
| poor prognosis
147
Hypnatremia may cause ( cerebral dehydration/ cerebral edema) while hypernatremia may cause ( cerebral dehydration/ edema)
Edema
Dehydration
Hypo Ca or Mg = titanic rigidity
148
Narcolepsy or cataplexy may occur in ponies or mini horses. How is it treated
Imipramine or atropine but no real tx
| Is dx with physsostigmine test
149
Cerebellar abiotrophy is when a cerebellum never fully formed resulting in ataxia no menace
T F
False- degeneration after fully formed. In Arabians and Oldenburgs
Euthanasia
150
Occipitoatlantoaxial malformation causes paresis and ataxia in which limbs
All
Dx- X-ray ( hypoplastic den, fusion of occipito/ atlas)
Euthanasia
151
Shaker foals occur with with toxin
Botulinum
Exotoxin that effects PNS. Prevents acetylcholine at NMJ
Ingection of bacteria then toxin made in GIT
Cl signs- dribbling of milk from nose, pupillary dilation. Recumbency - need antitoxin and ventilator
152
Small intestinal distention occurs when what part of the GIT is asphyxiated or septic
Illeus
Enteritis- origin of systemic sepsis
153
Colonic tympany is secondary to _________, or _________
Meconium impaction
Illeus- colitis
Congenital conditions
154
Peritoneal effusions are caused by
Uroperitoneum
| Peritonitis
155
A digital rectal exam in neonates looks for what
Feces
For colic - also check inguinal area, costochondral junction to detect rib fractures. US
156
What is the most common cause of colic in neonates
Meconium impaction- immature colonic pacemaker neurons (cajal)
157
What do we see in meconium impactions
```
Decreased suckling
12-24 hours old
Depression
Straining
Distention
Colonic tympany
```
158
What is meconium composed of
Bile mucus epithelial cells
| US gas distended colon and X-rays to dx
159
What are treatments for meconium impactions
Fleet enema- phosphate (multiple doses)
Oral laxative- mineral oil. Milk of magnesia
Enema- ivory soap
Enema- acetylcysteine (breaks disulfide bonds with Na HCO3 Catheter in for 30-40 min)
Flunixin butorphanol buscopan for pain
160
What are some differentials for colic in neonates
```
Sepsis
Diarrhea
GI Ulcer
Volvulus
Peritonitis
Gas distention
Atresia coli
Lethal white foal
```
161
What are clinical signs of Foal Diarrhea
Fever, obtunded, decreased nursing, fecal PCR,
162
What are some diagnostics for Foal Diarrhea
Bacterial toxin assay
- c. Dificile toxin A and perfringens entertoxin
Parasitology
Electron microscopy
163
T/ F illeus and enteritis both can have low WBC
True
164
How is enteritis in neonates treated
AB- broad
Anti- endotoxin (flunixin meglumine, polymixin B)
Fluids
GI Protestants ( bio sponge bismuth subsalicylate)
165
Foal heat diarrhea is the most common cause of diarrhea in foals
T/F
True
Occurs 7-12 days old
Hypersecretion into SI overwhelms absorptive capacity of immature colon (changing of microbiome)
166
After 12-24 hours of life what should USG be
<1.008
167
The umbilical vein becomes the (round ligament/ falciform ligament) the umbilical arteries become (round ligament/ falciform ligament)
Round
| Falciform
168
Patent urachus is a preliminary feature of
Umbilical infection
169
Uropertoneum is most commonly caused by
Ruptured bladder
Ureteral rupture
Urachal leaks
170
Which of the following are increased in uroperitoneum
A. Na
B. K
C. Creatinine
B C
Na decreased
171
Abdominal fluid of a uroperitoneum has a ( higher/ lower) creatinine than serum
Higher. 2x
172
What is addressed first in a uroperitoneum
Hyperkalemia
Drain urine
LRS. Dextrose
173
Omphalophlebitis involves what structures
Arteritis
Phlebitis
Urachitis
US helps Dx
174
Omphalophlebitis is treated with
AB
Chloranphenicol
Trimethoprim sulfa with rifampin
175
What are we looking for when we ultrasound an umbilical hernia
Bowel
Omentum
Fluid
Measure wall thickness and distention and peristalsis
176
Inguinal hernia may occur from what
Large inguinal rings (Tennessee walking, standardbred, draft)
Trauma
Straining- increased abdominal pressure
177
Describe the difference between a direct and indirect inguinal hernia
Indirect- GIT through intact vaginal ring (within vaginal tunic), reducible Manual reduction in few days
Direct- sx. Vaginal tunic tears, GIT under skin, not reducible
>5cm will unlikely heal on own
178
Ectopic ureters are diagnosed by
Urine dribbling
179
Increased K usually means an azotemia is
Post renal
180
With Hyperkalemia fluids and dextrose are given why
Will make insulin to drive K into cell
181
What are some non nephrotoxic AB
Gentamyacin
Aminoglycosides
Tetracycline
182
If a horse has calculi its beat that they don’t eat what
Alfalfa because high K
183
What are some clinical signs of bladder stones
```
Hematuria (post exercise)
Dysuria
Colic
Pyuria
Incontinence
```
PU- males
Manual extraction in female
184
If urine is turbid what is likely in it?
Ca carbonate
185
Azotemia + Isosthenuria=
Pre renal
Renal
Post renal
Renal
186
NSAID nephrotoxity is seen as what in a necropsy if the kidney
Papillary necrosis
187
When should ARF be checked regardless of clinical signs
Dehydration- few other symptoms
Will see azotemia, decreased NaCl and increased K
188
What is seen on a UA of a horse with AKF
```
Isothenuric
RBC
Pt
Granular casts
GGT
```
Treat with Fluids and dopamine if not working. Banamine 1 time
189
How much is considered polyuria in a horse
>50ml/kg/day
>25 L a day
About 100/ml/kg/day of drinking is normal
190
What is the most common cause of polydipsia in horses
Psychogenic
| Low USG b/c of this (<1.005)
191
What are other reasons for polydipsia
Renal failure
PPID (older horse)
Sepsis (endotoxin on brain)
Diabetes insipidus
192
When should a water deprivation test be stopped
If BW loss is > 5% Or if dehydrated
| Modified- 40ml/kg/day throughout day
193
CRF is considered congenital if the horses is younger than 5 years old and there is no____
ARF
| Acquired is more common
194
What are some signs of CRF
```
Lethargy
Weight loss
N waste- toxic to gut= GIT ulcers
Pt losing enteropathy
NH4 in brain = sleepy
Tartar on teeth
Ventral edema- decreased on orig pressure, decreased albumin and increased urea and renin
PU PD
Decreased EPO
Fish smell
Pt in urine
```
195
CRF treatment in causes good quality grass, no alfalfa, fat and omega 3
T/F
True
196
Preputial or mammary gland swelling is a sign of _____
Obesity
197
T/F there seems to be no genetic component that may predispose a horse to EMS
False- probably is
198
An enhanced metabolic efficiency may lead to ______
Obesity- less calories to maintain body weight
199
T/F Glucose concentrations are normal in horses with insulin dysregulation
True. Decreased insulin receptors
200
```
What are elevated in horses with EMS
A. GGT
B. AST
C. Lipid accumulation
D. Glucose
E. Triglycerides
```
A
B
C
E
201
Name the mechanisms that lead to insulin resistance
Defects in IR receptors
Defects in insulin signaling pathway
Defects in glucose transporter 4 synthesis, translocation or function
202
Inflammation in EMS causes all the following. Except
A. Higher mRNA expression of IL- 8 and 6 in uncalled ligament adipose tissue
B. Support cresty neck
C. Decreased leptin
D. Decreased adiponectin
C- increased leptin (released by adipose tissue when energy is plentiful or stimulating)
203
How is EMS diagnosed
Glucose insulin (regular, fasting, after feeding, after dextrose and insulin given)
204
Glucose above 110 can be indicative of
Diabetes
| Insulin dysregulation
205
Fasting insulin >50 is indicative of
Dysregulation of insulin or EMS
206
What test is Gold Dtandard for diagnosing ID or EMS
Combined Glucose Insulin Test
| Not practical in field
207
What percent of the ideal body weight should be fed to a horse we are trying to have lose weight
1.5%. Then 1.2 if no improvement
| With carbs less than 10%
208
What can be given if all other weight loss strategies have not worked
Levithyroxine sodium- increases thyroxine and stimulated nasal metabolic rate
Metformin hydrochloride- activates AMP- activated protein kinase
Sodium glucose transporter receptor 2 inhibitor - expensive
209
What acts on the pars intermedia
Dopamine- inhibitory
thyrotropin releasing hormone (TRH)
Makes ACTH
A-MSH
CLIP
B- endophorins
210
PPID means a horse doesn’t have enough what
Dopamine
211
What does MSH decrease
Inflammatory cytokines
Chemokines
Potent
212
Corticotropin like intermediate lobe peptide deduces what
Pain. Analgesia associated with inflammation
213
ACTH and MSH are created in what season
Fall
214
What is the most important risk factor in PPID
18-20 yo
215
What is the most common cause of laminitis
Endocrine disease
216
Loss of ADH from pressure on para nervosa leads to
PU PD. (Hypercortisolemia)
| Insulin resistance occurs is PPID
