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Y3 MOD > Equine clinical exam > Flashcards

Equine clinical exam Flashcards

1
Q

When does a clinical exam begin?

A

As soon as you see the horse

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2
Q

What can be assessed from initially seeing the horse?

A
  • Demeanour
  • Behaviour
  • Stance
  • Signs of previous treatment e.g. clipping, bandage
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3
Q

What can be assessed when looking at the horses environment

A
  • signs of colic
  • presence or absence of faeces
  • signs of eating
  • type of bedding
  • mucus on doors/floor
  • nearby horses: coughing, stamping
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4
Q

What are the 3 most relevant questions when obtaining a general history/

A
  • What is the horse used for?
  • How old is it?
  • How is it kept?
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5
Q

What is the importance of asking what the horse is used for?

A
  • Potential problem: exercised related fractures might be common in racehorses, but laminitis is not
  • Future expectations: return the horse to athletic function or would pasture-sound do
  • Timescale for resolving the problem: “he needs to go hunting on the weekend”
  • Drugs/treatments that might be used: “whatever you give him, needs to be out of his system by the race on Saturday”
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6
Q

What is the importance of asking the age of the horse?

A

Type of problem: certain conditions age related.

  • Owners expectations: “he’s only two, he got his whole career ahead of him” or “he’s only two and already broken”
  • Type of treatment
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7
Q

What is the importance of asking how the horse is kept?

A
  • Many problems associated with specific management systems e.g. Pelvic flexure impactions a disease of stabled horses. Grass sickness a disease of horses at pasture
  • Horses at pasture much more likely to suffer trauma than stabled horses
  • Problems often associated with changes in routine
  • Might influence treatment (“how can I Box-rest him ?– we’ve only got the field!”)
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8
Q

What are some specific questions that need to be asked relating to a problem?

A
  • When did it start?
  • How has it progressed?
  • Has he had it before?
  • Have you given any treatment yourself?
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9
Q

The overall framework of a general exam consist of which 3 steps?

A
  • general inspection
  • vital signs
  • specific exam
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10
Q

What is the ‘food test’?

A
  • Horses are greedy
  • Heathy horses will not refuse food or a treat
  • Any horse that refuses is probably ill or colicking
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11
Q

Which vital signs should be assessed?

A

Heart rate, respiratory rate, temperature (TPR)

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12
Q

Why is pyrexia always significant in a horse?

A
  • When it occurs it suggest systemic inflammation

- Taking the temperature on a colicking horse might reveal a peritonitis or impending colitis

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13
Q

Describe pattern recognition in your clinical reasoning

A

Clinical diagnosis based on previous experience and probability.

  • Inductive reasoning
  • Type 1 thinking
  • Fast thinking
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14
Q

What are the pros and cons of pattern recognition?

A

Pros:
- Fast and efficient
- Suitable for emergencies
Cons:
- May jump to conclusions or make assumptions
- Cant use if presented with a new condition

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15
Q

Describe a systematic exam

A
  • Deductive reasoning
  • Type 2 thinking
  • Slow thinking
  • The clinician gathers as much information as possible, to rule out possible causes before choosing treatment
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16
Q

What are the pros and cons of a systematic exam?

A

Pros:
- Methodical
- Gathers large amount of data about the patient – maybe revealing other problems beside the presenting condition.
- Unlikely to miss problems or jump to conclusions
- Useful if presented with an unfamiliar condition
Cons:
- Slow
- Inefficient
- Can result in unnecessary diagnostic tests being carried out

17
Q

You are presented with a coughing horse. What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • Gather history
  • Observe at rest: tachypnoea, dyspnoea
  • Examine nostrils: airflow, wheezing, discharge
  • Palpate submandibular LN
  • Auscultate chest
18
Q

Purulent nasal discharge in a coughing horse could be indicative of?

A

Respiratory tract infection

19
Q

Mucoid nasal discharge in a coughing horse could be indicative of?

A

Marked airway inflammation but not necessarily bacterial

20
Q

Where in the respiratory tract is likely to be affected if abnormal sounds are heard on auscultation?

A

LRT

21
Q

If you suspect a coughing horse is infectious what steps must be taken?

A

ISOLATE!
Nasopharyngeal swab for respiratory pathogens
Antibiotics?
NSAIDS?

22
Q

You are presented with a lame horse. What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • History
  • Observe at rest
  • See it move at walk
  • See if it can trot
  • Try and observe which leg is affected
  • Examine the limb carefully
  • Draw up a plan
23
Q

If a horse is not lame at a walk, what should you do next?

A

See if its lame at a trot, then see if its lame when you lunge it

24
Q

If following a careful limb examination you can not find the likely problem causing lameness, what are the next steps?

A
  • Either trial rest and NSAIDS for set period (2-4 weeks) and re-exam
    OR
  • Start Nerve blocks
25
Q

You are presented with an ‘off-colour’ horse. What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • Obtain a history
  • See if it passes the food test: if yes its not likely to be colic
  • Examine mm and HR
  • Rectal temp
26
Q

You are presented with a wounded horse. What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • Get history
  • Assess demeanour
  • Alert and responsive?
  • Inspect the wound
  • See if the horse is lame
  • Restrain (sedate) horse and clip and clean wound edges
  • See if would can undergo primary closure, if not debride and bandage
27
Q

Which drugs should be given at the end of treating a wounded horse?

A

Antibiotics
NSAIDs
Tetanus

28
Q

You are presented with a horse suffering with weight loss. What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • History, BCS, weight, assess management
  • Examine for signs of illness in the horse
  • Either way take blood samples and bichem, faecal sample
29
Q

You are presented with a horse suffering with weight loss.

Following tests the results come back as abnormal, what are the next steps?

A

Consider Peritonitis, abdominal abscess, hepatitis, neoplasia, CHF

  • Abdominal ultrasound
  • Rectal exam
  • Liver biopsy
30
Q

You are presented with a horse suffering with weight loss.

Following tests the results come back as normal, what are the next steps?

A

Could try management changes (feed more!).

If after 6 weeks horse still loosing weight, or owner not happy with this then investigate further.

31
Q

What is the first vital step that has to be done when treating a colic?

A

Assess level of pain.
Is it safe to examine?
Yes = non-violent colic
No = violent colic

32
Q

You are presented with a horse suffering with a violent colic.
What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • Get a HR
  • Sedate (xylazine)
  • Rectal exam to feel for a surgical lesion
  • If present then consider referral
  • If no surgical lesion felt then perform a peritoneal tep
33
Q

You are presented with a horse suffering with a violent colic.
A surgical lesion is felt on rectal exam but the owner will not refer, what are the options?

A
  • Euthanasia

- (Possibly try strong analgesia and hope for the best?)

34
Q

You are presented with a horse suffering with a violent colic.
No surgical lesion is felt on a rectal exam, what are the next possible options?

A
  • Administer analgesia and refer

- If O not willing to refer can administer analgesia and reassess in 2 hours

35
Q

You are presented with a horse suffering with a non-violent colic.
What steps would you take as part of your routine of assessment, diagnosing and any other steps?

A
  • Check mm, HR, gut sounds
  • Rectal exam (sedate?)
    Same as violent colic

Y3 MOD (23 decks)

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