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749 - Ex 2 > Equine Ortho Emergencies > Flashcards

Equine Ortho Emergencies Flashcards

1
Q

DDx for Severe Lameness

A
  1. Fracture
  2. Infection in a closed space
    - hoof abscess
    - septic synovial structure
    - cellulitis
  3. Laminitis
  4. Severe soft tissue injury
    - tendon/ligament
    - luxations
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2
Q

Difference between foals and adults with septic arthritis

A

Foals:

  • hematogenous
  • multiple jts can be affected

Adults:

  • traumatic (wound)
  • IA: e.g. injections for OA
  • Single joint (can have multiple jt spaces affected ini same region)
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3
Q

Risk factors for Septic arthritis?

A
  • recent IA injection
  • recent sx
  • puncture wounds near jt

Foals: failure of passive transfer, sepsis and/or umbilical infection, GI tract (colitis)

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4
Q

How do we dx septic arthritis?

A
  1. Arthrocentesis - cytology
  2. Culture - synovial, blood (foals)
  3. Rads
  4. US
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5
Q

Normal Joint Fluid

  1. Appearance
  2. Protein
  3. Nucleated cells
  4. Neuts
A
  1. pale yellow, clear
  2. < 2.5 g/dL
  3. < 1000
  4. < 10% neuts (mononuclear)
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6
Q

Septic Joint Fluid

  1. Appearance
  2. Protein
  3. Nucleated cells
  4. Neuts
A
  1. Turbid, yellow to orange
  2. > 4 g/dL
  3. > 30,000
  4. > 90% neuts (degenerative or nondegen)
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7
Q

How do we treat Septic Arthritis?

A

The solution to pollution is dilution!

  1. Abx
  2. Jt irrigation/arthroscopy!**
  3. Anti-inflammatories
  4. Limb support (bandage, cast, splint)
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8
Q

Septic Cellulitis - acute infection with assoc’d inflammation of the dermis and SQ tissues

Dx, Tx

A

Dx:

  • CS
  • US
  • Rads
  • FNA or biopsy
  • Culture of abscess drainage (staph or strep common)

Tx:

  • systemic Abx
  • regional perfusion
  • anti-inflammatories
  • analgesics
  • bandaging
  • hydrotherapy/cryotherapy
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9
Q

Bacterial myositis

A

Rapidly progressing necrosis of mm due to bacterial infection
- wound, IM injection (banamine!), or hematogenous

  • Clostridium (anaerobic!), strep, staph, coryne, salmonella
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10
Q

Bacterial myositis

Dx, Tx

A

Dx:
- US and gram stain

Tx:

  • systemic Abx
  • anti-inflam/pain meds
  • sx fenestration and debridement
  • wound management
  • maggots
  • hyperbaric O2 therapy (clostridium)
  • supportive care
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11
Q

Casts…. if you have a fracture the ____ must be in the cast!

A

Foot! must be covered!

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12
Q

Cast care

  1. Rechecks
    - 2x daily eval –> check for heat, drainage, comfort
    - STRICT stall rest
  2. Changes
    - splints: _____ wks
    - casts: _____ wks (adults)
    - casts: ____ wks (foals)
A

1-2

3-4

1-2

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13
Q

Fracture immobilization - Hoof to distal MC

A

Bandage and apply DORSAL splint with leg non-WB

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14
Q

Fracture immobilization - Distal MC to distal Radius

A

Thick bandage (2 layers, RJ) and apply LATERAL and CAUDAL splint

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15
Q

Fracture immobilization - Distal radius to elbow

A

Bandage and apply CAUDAL splint to point of elbow and LATERAL splint extending above the point of the shoulder

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16
Q

Fracture immobilization - Elbow to scapula

A

No coaptation necessary and could make fracture worse

Exception: triceps app disable resulting in “dropped elbow” with olecranon fractures. CAUDAL splint will help fix carpus and make horse more comfortable

17
Q

Fracture immobilization - Fetlock and distal

A

Plantar splint

18
Q

Fracture immobilization - MT and tarsal fractures

A

Plantar splint to level of calcaneus and LATERAL splint up to stifle

19
Q

Fracture immobilization - Tibial fractures

A

Extended LATERAL splint

20
Q

Fracture immobilization - stifle, femur, hip

A

No coaptation necessary!

21
Q

Which direction should a horse face in trailer…
forelimb injury?
hindlimb injury?

A

Forelimb = face backward

Hindlimb = face forward

22
Q

Flexor Tendon Lacerations…

  1. Fetlock dropped, toe normal
  2. Fetlock dropped, toe pointed up
  3. Fetlock on ground, toe up
A
  1. SDF
  2. SDF and DDF
  3. SDF, DDF, and Suspensory ligament

Images on slide 45

23
Q

Flexor Tendon Lacerations…

Tx, Outcome

A

Tx:

  • +/- tendon suturing
  • tenoscopy if in DFT sheath
  • casting 6-8 wks +
  • shoe support

Outcome:

  • 50% return to work
  • depends on structures involved
  • worse in sheath? ADHESIONS!!!
24
Q

Treatment and Outcome of Extensor Tendon Lacerations?

A

Lacerations over dorsal cannon/fetlock

Tx:

  • +/- tendon suturing
  • bandage, splint, and/or cast (prevent knuckling)
  • stall rest 6-8 wks

Outcome:
75% return to full work
- stringhalt (hindlimbs)

25
Q

What should we be concerned with occuring in the Support Limb?

A

LAMINITIS!!

749 - Ex 2 (14 decks)

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