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EQUINE III > EQUINE PRACTICAL/ORAL EXAM > Flashcards

EQUINE PRACTICAL/ORAL EXAM Flashcards

1
Q
  1. Demonstrate the methods of physical restraint of the horse.
A
  1. Halter and Rope (Quick release knot)
    * Rope around nose and attached to halter for extra contoll
  2. Chiffney-bit
  3. Bridle and bit
  4. Twitch (rotate handle towards the horse)
  5. **Ear or neck-skin squeeze **with your hand
  6. Lift and Hold forelimb
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2
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.
    IDENTIFICATION
A

Signalment and identification of the horse
* Owners name and contact details
* Permanent data of the equid
o Species, breed, sex, color, white marks, whirls, feathers, microschip
* Non-permanent datas
o Age, bw, height at withers, body length, branding marks, tattoos
* Passport
* Colors: black, dark bay, chestnut, dun, light bay, gray, skewbald, piebald, dapple gray
* White marks on head
o Star, stripe, blaze, white face, snip, flesh mark, white muzzle
* White marks on the limbs
* Whirls, feathering
* History
o Duration of disease
o Abnormalities observed
o Prior veterinary interventions
o Reproductive status
o Transport
o Use of horse
o Yard / stable environment

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3
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.

DISTANT EXAMINATION

A
  • Size
  • Conformation
  • Body condition = 1-9 where 4-7 is normal
  • Posture
    o** Dog sitting posture** = distension of intestines, diaphragmatic pressure: diff breathing
    o Rocking horse = large colon impaction
  • Gait
  • Behavior
    o Bright, alert, responsive = normal —> Depressed
    o Aggressive?
  • Obvious pathological signs
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4
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.
    Basic clinical values
A
  • Rectal temperature
  • Heartrate/Pulse
  • Respiratory rate
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5
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.
    Basic clinical values
    Temperature
A
  • Rectal temperature
    o Adult: 37-38 degree
    o Foal: 37,5-38,5
    o Thermometer should be introduced as deep as possible and should be in contact with the rectal mucosa
    o Changes in rectal temperature
    § Physiological e.g. due to exercise
    § Pathological = systemic disease
    § Hypothermia
    § Hyperthermia = external stimuli such as sun or e.g. tetanus which cause muscle contractions which increase temp but not fever
  • Fever = elevated temperature by the brain
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6
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.
    Basic clinical values
    PULSE/HR
A

o Adult: 28-42 BPM
o Foal
§ At birth 60-80 BPM
§ 12 h 80-120 BPM
§ 24 h** 80-100 BPM**
§ 1-7 days 60-100 BPM
§ 1 week- 6 months 40-60BPM
o Palpation
§ Facial artery
§ Transverse facial artery
§ Medial and lateral digital artery

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7
Q
  1. Identify the horse, determine its vital parameters, and perform a distant examination.
    Basic clinical values
    RESPIRATORY RATE
A

o Adult: 10-18 breaths/ min
o Foal
§ At birth gasping
§ 12 h 30-49 breaths/min
§ 24 h 30-35 breaths/min
§ 1-7 days 20-35 breaths/min
§ 1 week-6 months 10-25 breaths/min
o Inspection: thoracic and abd wall
o Auscultation: over larynx, trachea or lungs

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8
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.
    STEPS
A

Steps to dermatologic diagnosis
* Chief complaint
* Signalment
* Dermatologic history
* Medical history
* Client creditability
* Physical examination
* Differential diagnosis
* Diagnostic and therapeutic plan
* Ancillary diagnostic methods
* Trial therapy
* Narrowing differential diagnosis
All details and info should be put into the dermatologic history sheet!

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9
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.
    Physical examination
A
  • Basic clinical values and routine physical examination
    o Could it be a systemic disease with skin signs?
    o Could it be multiple, independent diseases?
  • Describe the lesion type
    o Primary: macule, vesicle, pustule, nodule, cyst
    o Secondary: alopecia, scar, erosion, ulcer, fissure * Localization of lesions
    o Some viral diseases have specific localization
    o Predilection sites of parasites
    o Specific anatomical localization of tumors
    o Do NOT forget special areas
    § Mucocutaneous junctions
    § Chestnuts
    § Hooves
    § Coronary band
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10
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.
    PRIMARY SKIN LESIONS
A
  • Macule
  • Papule
  • Vesicule
  • Pustule
  • Urticaria
  • Nodule
  • Tumour
  • Cyst
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11
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.
    SECONDARY SKIN LESIONS
A
  • Alopecia
  • Scaling
  • Crusting
  • Scar
  • Erosion
  • Ulcer
  • Lichinification
  • Fissure
  • Necrosis
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12
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.
    Ancillary diagnostic methods
A
  • Hematology = find a systemic disease
  • Biochemistry = photosensitivity
  • Skin scraping = parasitic diseases
  • Hair and follicle samples
  • Brushing = arthropods
  • Cellotape = Oxyuris equi
  • Swab, aspiration = Fungi, bacteria
  • Biopsyàhistopathology, immunohistochemistry
  • Intradermal allergy test
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13
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Skin biopsy

A
  • Several sites
  • New lesions
  • Without clipping and surgical preparation
  • LA only subcutaneously
  • Formalin is needed
  • detailed description of the lesion and photos
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14
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Types of skin biopsy

A
  • shave biopsy
  • punch biopsy
  • wedge biopsy
  • excisional biopsy
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15
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Indication of skin biopsy and skin diseases by etiology

A
  • to establish a specific diagnosis
  • to rule out differential diagnoses
  • to follow the course of the disease
  • to confirm the completeness of tumor excision

Skin diseases by etiology: parasitic, fungal, bacterial, viral, allergic, autoimmune, neoplastic, other granulomatous disorders.

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16
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Breed Predilections for nonneoplastic skin diseases

A
  • Appaloosa
    o Follicular dysplasia
  • Arabian
    o Atopic dermatitis
    o Lavender foal syndrome
    o Insect bite hypersensitivity
    o Vitiligo
  • Connemara, Friesian, Icelandic
    o Insect bite hypersensitivity IBH
    * Quarter horse
    o Atopic dermatitis
    o IBH
    o Linar alopecia
    o Linear keratosis
  • Shetland
    o IBH
    o Steatitis
  • Shire
    o Chornic, progressive lymphoedema
    o Coronary band dysplasia
    o IBH
  • Thoroughbred
    o Atopic dermatitis
    o Cellulitis
    o Linear keratosis
    o Spotted leukotricha
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17
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Parasitic skin disorders

A
  • Lice
  • Mange
    o Sarcoptes
    o Psoroptes
    o Chorioptes = foot often
  • Habronema
  • Oxyris equi = perianal area
  • Microfilaria
  • Hypersensitivity
  • Ivermectin
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18
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Fungal skin disorders

A

* Dermatophytosis/ringworm
o Trichophyton, microsporium
o Most common
o Zoonosis, contagious
o Popular then crusted, spread circumferentially, alopecia
o Contact sites
o Culture, biopsy

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19
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Bacterial skin diseases

A
  • Dermatophiliosis/rain scald
  • Dermatophilius congolensis
    o Chronic moisture and skin damage
    o Crusts, exsudative, moist mats of hair
    o Pasture: where the skin gets wet
    o Cytology or biopsy
  • Staphylococcus
  • Streptococcus
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20
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Viral skin diseases

A
  • Equine Herpes Virus 3
  • Vesicular stomatitis
  • Horse pox
  • Molluscucm contagiosum
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21
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders

A
  • Eosinophil granuloma
  • Urticaria
  • Insect bite hypersensitivity (sweet itch)
  • Food allergy - Type I, II, IV hypersensitivity
  • Drug allergy - Type I, II, II, IV hypersensitivity
  • Autoimmine skin disorders
  • Skin neoplasia
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22
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

How to treat skin diseases depending on causative agent

A
  • Anti-pruritic: selenium sulphide, hydrocortisone, colloidal oatmeal
  • Anti-bacterial: chlorhexidine 4% (hibi-scrub), povidone-iodine, triclosan
  • Anti-fungal: chlorhexidine, povidone-iodine, natamycin, nystatin
  • Anti-parasitic: synthetic pyrethorids(deltamethrin, permethrin), sulphur, benzyl benzoate
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23
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders
**Eosinophil granuloma **

A

o Common
o Unknown etiology
§ Multifacotiral
§ IBD
§ Atopic dermatitis
§ Trauma
o Degeneration of collagen
o Popular or nodular lesions
§ Most often on neck, back, withers

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24
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders
Urticaria

A

o Type I hypersensitivity
§ Inhaled allergens: fungi or food particles, straw, polled, feather
§ Serum products, blood transfusion
§ Antibiotic, drug allergy
§ Food allergy (oat)
§ Chronic, purulent disease
§ Insect bite
o Clinical signs
§ Within min or hour
§ Papules, coalescing wheals, larger oedemas
o Diagnosis
§ Signs + allergen load
§ Elimination of allergens
§ Allergic skin test
o Clinical course
§ Usually fast healing
§ Purpura haemorrhagica or chronic recurrent allergic dermatitis may develop

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25
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders
Insect bite hypersensitivity (sweet itch)

A

o Seasonal
o Pruritus
o Broken mane and tail hair, alopecia
o Erosions, papules, crusts
o Ventral midline dermatitis

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26
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders
Autoimmine skin disorder

A

o Pemphigus foliacus
o Bullous pemphigoid
o Systemic lupus erythematoud like disease
o Discoid lupus erythematous

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27
Q
  1. Examine the skin of the horse and summaries the findings. Explain how to take skin biopsies from horses.

Allergic skin disorders
Skin neoplasia

A

o Papillomatosisàpapoavirus, less than 3 years of age
o Sarcoid
o Melanoma
o Squsmous cell carcinoma

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28
Q
  1. Demonstrate the examination of the lymph nodes and mucous membranes of the horse and summarize the findings.

Examination of the lymph nodes

A
  • Inspection
  • Palpation
  • Ancillary diagnostic methods
    o FNA (cytology)
    o Biopsy (histopathology)
    o Surgical excision
    o Diagnostic imaging = US, endoscopy
  • Palpable LN in the horse
    * Normal horses
    o Mandibular lymph node
    o Superficial inguinal lymph node
  • Only palpable when enlarged
    o Lateral retropharyngeal lympn nodes
    o Superficial cervical lymph nodes
    o By rectal palpation
    § Iliosacral LN
    § Mesenteric LN
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29
Q
  1. Demonstrate the examination of the lymph nodes and mucous membranes of the horse and summarize the findings.

Examination of the mucous membranes

A
  • Oral mucosa
  • Conjunctiva
  • Nasal mucosa
  • Anal mucosa
  • Genital mucosa
30
Q
  1. Demonstrate the examination of the lymph nodes and mucous membranes of the horse and summarize the findings.

Examination of the mucous membranes
NORMAL FINDINGS

A

o Light pink
o Smooth
o Shiny
o Moist
o Intact
o Blood vessels barely visible o CRT <2 sec

31
Q
  1. Demonstrate the examination of the lymph nodes and mucous membranes of the horse and summarize the findings.

Examination of the mucous membranes
ABNORMAL FINDINGS

A

o Pale, white: anemia
o **Dark red, dirty red **= hypovolemic, endotoxin shock, grass sickness, strangulation
o Icterus
§ Neonatal isoerythrolysis
§ Tyzzers disease
o Petechia
o Tumours
o Rectal prolapse

32
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Which parts does the upper airway consist of?

A
  • nose
  • paranasal sinuses,
  • GP,
  • cough,
  • larynx.
33
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Physical methods

A
  • Inspection
  • Smell
  • Palpation
  • Auscultation
  • Percussion

We always start with a general physical examination. Don ́t forget to check if pattern is costoabdominal, and examine the horse both in rest and during exercise

34
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Examination of the nose

A
  • All physical methods can be used
  • Direct auscultation (w/o stetoscope)
  • Percussion on the bones with the tip of the middle finger
  • Normal findings
    o Temperature of the region is equal to the surroundings
    o Palpation is not painful
    o Percussion sound is shaprp, bone-like
  • Nasal discharge
    o Continuous or temporary
    o Uni or bilateral
    o Amount and grade of discharge
    o Quality, color, and smell
    § Serous, mucous, purulent, hemorhagic, froathy
    o Origin
    § Nose, paranasal sinuses, pharynx, guttural pouch, trachea, lung, stomach
  • Expired air
    o Intensity of airflow
    o Temperature
    o Smell of expired air
    o** Normal findings**
    § Medium strength and temperature
    § Odor is characteristic, not unpleasant
    § Airflow is symmetrical bilaterally
35
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Examination of the paranasal sinuses

A
  • Sinuses almost totally communicate
  • Thin septum separates the rostral and caudal maxillary sinus
  • Maxillary sinus is affected most frequently
    o Primary disease
    o Diseases of the upper check teeth
    * The sinuses
    o Rostral maxillary sinus
    o Caudal maxillary
    o Dorsal concha sinus
    o Frontal sinus
    o Ethmoidal sinus
    o Sphenopalatine sinus
  • Physical method of examination
    o Inspection, palpation, percussion
  • Normal findings
    o Skin is intact, no alopecia or abnormal shape
    o Temperature is equsl to the surroundings
    o Palpation is not painful
    o Percussion sound is sharp- bone-like
36
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Diseases of the paranasal sinuses

A

Sinusitis
* Extensive network of 6 pairs of sinuses
* Communication with nasal cavity through the apertura nasomaxillaris (middle meatus)
* Primary sinusitis
o Bacterial: streptococcus, staphylococcus
o Fungal
* Secondary sinusistis
o Dental diseases
o Sinus cyst
o Neoplasia
o PEH
o Trauma
o Sinonasal polyps
* Signs
o Usually unilateral nasal discharge with fetid odor
o Facial swelling
o Respiratory noice
o Lacrimation / exopathalmus
o Head shaking
* Diagnosis
o History, percussion, oral examination (teeth)
o Endoscopy/sinoscopy = sampling for cytology o X-ray, CT, MRI
* Treatment
o Antibiotics
o Debridement
§ Trepinatino
§ Sinus flap
§ Drainage
o Flushing!

37
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Examination of the guttural pouches

A
  • Diverticulum of the eustachian tube
  • Between the base of the skull. Atlas and pharynx
  • Stylohyoid bone splits it, smaller lateral and larger medial recess
  • Left and right pouches do not communicate
  • Examination – physical method
    o Inspection, palpation, percussion
  • normal finding
    o the skin is intact, no alopecia is seen
    o temperature is equal to the surroundings o palpation is not painful
    o percussion sound is resonant

softtissue - percussion finger to finger - resonent sound.

38
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Diseases of the guttural pouches

A
  • Guttural pouch mycosis
  • Guttural pouch empyema
39
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.

Guttural pouch Mycosis

A
  • Fungal plaque typically in the dorsal aspect of the medial compartment
  • life threatening = fatal hemorrhage
    * If epistaxis is present always check GP!
  • More
  • Signs
    frequent Aspergillus sp, Fusarium. Trichosporon
    o Epistaxis
    o Dysphagia
    o Recurrent larungeal neuropathy
    o Coughing
    o Horners syndrome (miosis, dropping of eyelid) o Fungal encephalitis
  • Diagnosis
    o Endoscopy but be careful if bleeding is preent not dislodge the clot!
    o Radiology
  • Treatment
    o Medical
    § Endoscope guided debridement
    o Lavage = only with sterile infusion!! Saline, Ringer
    o Local antimycotic treatmentànystatin, enilconazole, thiabendazole, natamycin
    o Systemic antimycotis = Amphotericin B, itrakonazol, flukonazol, Voriconazol o Supportive therapy
    § NSAIds
    § Vit B1, C, E, selenium
    § Potassium iodine
40
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.
    ​
    Guttural pouch empyema
A

* Bacterial infections of the guttural pouch
* Most commonly Streptococcus equi sups. Equi = strangles!
* Ruptured retropharyngeal abesses
* Stenosis of the GP opening can lead to impaired drainage = fluid accumulation, neoplastic growth
* Signs
o Intermittent chronic nasal discharge
o Submandibular lymphadenopathy
o Parotis enlargement
o Increase resp noice
o Dysphagia uncommon
* Diagnosis
o Endoscopy = sample collection
o Radiography = fluid lines
* Treatment
o Strept. Equi spp equi is highly contagious!!
o Biosecurity protocols
o Local AB; penicillin mixed with gelatin, administered thorugh an endoscope

41
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.
    ​
    Cough
A
  • mode of emergence
    o spontaneous, induced
  • frequency
  • intestiny
  • tone
  • occurance ( at rest, during exercise)
  • duration
  • amount of secretion
  • pain
    * induction of cough
    o press the arytenoid cartilages of larynx
    o press the first tracheal rings
  • normal finding
    o no spontaneous cough
    o difficult or impossible to induce cough
    o the induces cough is** strong, sharp, low, short, dry, non painful, does not recur**
42
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.
    ​
    Examination of the larynx
A
  • physical method: inspection, palpation, auscultation
  • normal finding
    o skin is intact, no alopecia, shape is normal
    o temperature is equal to surroundings
    o no alterations on palpation
    o very mild stridor on auscultation
43
Q
  1. Examine the upper airway of the horse, induce cough, and summarise the findings.
    ​
    What could you tell abour Rhinitis
A

Rhinitis = common cold
* infection of the nasal passage independent of the sinuses
* viral, bacterial, fungal or parasitic
o viral: equine influenza, herpesvirus, equine rhinoviruses and adenoviruses
o bacterial is uncommon
o fungal: aspergillus, cryptococcus, conidobolus
o parasitic: habronema, draschia
* diagnosis
o physical exam
o endoscopy = sampling for culture, PCR
o Radiography
* Treatment: systemic or local

44
Q
  1. Examine the lower airway of the horse and summarize the findings.
    Examination of the trachea
A
  • physical methods
    o inspection, palpation, auscultation
  • normal finding
    o skin is intact, no alopecia, shape is normal
    o temperature is equal to the surroundings
    o no alterations on palpation
    o laryngeal noise is audible in a weaker form on auscultation

Lower airways: trachea and thorax.

45
Q
  1. Examine the lower airway of the horse and summarize the findings.
    Examination of the thorax
A
  • Physical methods o Inspection
    § Shape, size, symmetry of hemithoraces
    §** Breathing**: respiratory rate, rhythm, type, depth
    § Dyspnea? Inspiratory, expiratory and mixed types
    § Dyspnea = shortness of breath
    § Curly hair, sweating old horse = equine cushings
    o Palpation
    o Auscultation
    § Respiratory noises of the horse are weak § Systemic approach
  • Start cranially behind the scapula
  • Move 2-4 ICS caudally
  • Start dorsally in each ICS, move ventrally by 5-10 cm
    § Basic resp noises: weak and soft in normal horse
  • Weaker than normal (decreased airflow, superficial breathing)
  • Missing (pleural effusion, consolidated lung)
  • Increased in intensity, louder, harsher (dyspnoe, incr air flow)
    § Adventitious respiratory sounds
  • Musical: whistling
  • Non-musical: clicking, rattling, rackling noises
    o Percussion
    § Pleximeter and percussion hammer
    § Percussion sound: noise created by instruments, sound of the chest wall
    § Resontant sound of the air-filled lung
    § Features
  • Intensity: strong/sharp or weak
  • Frequency: high or low
    Tone: sonorous/resonant or dull Duration: short or long
    § Normal finding: strong/sharp, low, resonsant, short
46
Q
  1. Examine the lower airway of the horse and summarize the findings.
    Normal lung boarder
A

§ Deltoid tuberosity 7th ICS
§ Point of shoulder 10th ICS
§ Ischiadic tuber 14th ICS
§ Tuber coxae 16th ICS

47
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
A
  • Endoscopy
  • Ultrasonography
  • Radiography
  • CT
  • Thoracocentesis
  • Throacoscopy
  • Lung function test
  • Nasal and pharyngeal swabs
  • Tracheal wash
  • Bronchoalveolar lavage
  • Arterial blood gas analysis

Lower airway diseases: IAD

48
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Endoscopy
A

o resting endoscopy
o dynamic endoscopy
§ could diagnose severe RAO
§ recurrent laryngeal neuropathy

49
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Ultrasonography
A

o Pleural effusion
o Comet tail artefarct
o Reverberation artefact

50
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Radiography
A

o Could se if diaphragm is abnormally concave
o Increased interstitial pattern

51
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Thoracocentesis
A

o Only performed after percussion, auscultation and then confirmed fluid on US
o Spinal needle or stab incision probe
o Lowest and most cranial part of the thorax (6-7th ICS), but needle in front of ribs because veins, arteries and nerves are located behind
o How do we know if we are in thorax? Hear the pleural popping sound
o We can get rid of fluid from both sides because of fenestrated mediastinum in horses
o Do not remove all fluid at once!

52
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Throacoscopy
A

o Not frewuently used
o If all other options have been done without a diagnosis

53
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Lung function test
A

o Transpleural pressure change
o Pneumotachography, flow measurement
o Resistance
o Dynamic compliance
o Arterial blood gas analysis much more frequently used

54
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Tracheal wash
A

o Sample is suitable for bacterial and fungal culture and cytology
o Clip lower third of the beck, prepare it surgically
o Go in between 2 tracheal rings, move catheter and face it downwards, and use some sterile infusion for flush
o Pros: can be done totally sterile
o NOT suitable for diagnosing equine asthma

55
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Bronchoalveolar lavage
A

o Sample is suitable for cytology
o Always sedate
o Check for RAO, use clean endoscope!
o For a 500kg horse 500ml ringer lactate
o Remember during winter: warm up!
o Fluid should come out easilyàusually a lot of white foam (surfactant) on top,
this is a good sign. The more inflamed airway the less surfactant

56
Q
  1. Interpret the findings of respiratory ancillary methods in the horse.
    Ancillary diagnostic methods
    Arterial blood gas analysis
A

o Arteries used for blood sample: jugular artery, thoracic artery, transverse facial and in foals dorsal metatarsal artery.
o Acid-base: use the** citrate tube (blue)**
o Gives information about pH (acidosis, alkalosis) and oxygen and CO2

57
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Methods of cardiovascular examination
A
  • Physical examination
    o Inspection - trauma or deformities
    o Palpation - location and intesinty of heart beat, HR, pain, fremitus, murmurs
    o Auscultation
    o Percussion
  • Ancillary diagnostic aids
    o Electrocardiography ECG
    o Echocardiography
    o Phonocardiography PCG
    o Blood pressure measurement
    o Pericardiocentesis
    o Cardiac catherization
    o Laboratory tests ( AST, CK, LDH, Cardiac troponin I)
    Topography of the cardiac region
    * Location of the heart
    o Heart base: 2nd to 6th ICS
    o Twisted anticlockwise
    o Right side: almost cranially
    o Left side: almost caudlally
  • Location of heart beat
    o Left side 3rd-5th ICS
    o Right side 3rd-4th ICS
58
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Heart sounds in horses
A

* S1 (LUB) closing of AV valve after atria have pumped blood into ventricles
o Beginning of systole (ventricle contraction)
o Caused by the initial movement of the ventricle, the abrupt arrest of blood flow as AV valves tense, and the early part of ejection
* S2 (DUB) closing of aortic and pulmonary valves after ventricles have injected blood
o End of systole
o Caused by the change in direction of flood flow, closing the semilunar valves
* S3
o Termination of rapid ventricular filling/relaxation = diastole
o Commonly heard at or caudal and dorsal to the apex beat
* S4
o Atrial contraction and sudden arrest of the distended ventricle
* All four sounds might be audible in healthy horses
* Diastole is longer than systole, therefore LUB-DUB than a small pause, LUBDUB a

59
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Heart murmurs in horses
A
  • Prolonged audible vibrations
  • Developing usually in a silten period of the cardiac cycle
  • Normal (functional) murmurs are usually caused by vibrations that attend the ejection of blood from the hert during systole or the rapid fillin of the ventricles during early diastole
    o Systolic murmur (physiologic)
    § Grade 1-3/6
    o** Diastolic murmur** (ventricular filling, common in young horses) § Grade 1-3/6
60
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Classification of endocardial murmurs
A
  • Timing
    o Early
    o Mid
    o Late
  • Duration
  • Grade
    o 1/6: quite murur, heart only after careful auscultation
    o 2/6: quiet murmur, heat immediately one the stetoschope is placed over its PMI o 3/6: audible over a larger area
    o 4/6: loud, very good audibility, without fremitus (fremitus=vibration?)
    o 5/6: louder than grade 4, with fremitus, audible with loose contact of the thoracic
    wall
    o 6/6: loudest, audible when the stethoscope is help apart from the thoracic wall
  • PMI
    o Pulmonary: left 3rd ICS below point of shoulder
    o Aortic: **left 4th ICS **below point of shoulder
    o Mitral – **left 5th ICS **halfway **between shoulder and sternum **
    o Tricuspid – right 4th ICS
  • Quality
    o Band/pleuta
    o Crescendo - increase in intensity
    o Decrescendo decrease in intensity
  • Frequency
  • Radiation
  • Effect of changing heart rate
61
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Blood tests
A

* CK
o Creatine Kinase
o Cardiac muscle contains mainly MB dimer in humans, but MM in horses
* LDH
o Lactate dehydrogenase
o 5 isoenzymes, cardiac muscles contains msinly LDH1 (and 2)
* AST
o Aspertate amino transferase
* Test for** cardiac troponin I **and T are available in horses

62
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
A

Very different compared to small animals. Horses are kept for use, so if they have a heart condition and can ́t to what their meant to do - euthanasia often. Often not clinical signs, might be detected at a check before sale when the horse is examined.

63
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    **Clinical signs of heart failure **
A

o Exercise intolerance
o Slow return to resting values
o Weight loss
o Cough
o Tachycardia
o Tachypnoea
o Ventral edema
o Pulmonary congestion, edema o Colic-like signs

64
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    Causes of CHF
A

o 32 % valvular heart disease
o 28& VHD + arterial fibrillation
o 8 % DCM

65
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    ***Treatment of CHF
A

o Digoxin
o Furosemide
o Potassium chloride (best for longer periods)
o ACE inhibitors
§ Expensive
§ Not enough data in horses

66
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    Congenital diseases
A

Congenital diseases - rare
o Ventricular septal defect atrial septal defect
o Malformed / abnormal valves e.g. tricuspid atresia o Complex cardiac defects e.g. tetralogy of Fallot
o Vascular malformationsàe.g. PDA

67
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    VSD – ventricular septal defect
A

VSD – ventricular septal defect
o Most common congenital disease
o Inherited or foetal injury
o Usually basal area
o Clinical signs often develop at older age o Signs depends of size of VSD
§ <2.5 usually innocent
§ > 2.5 cm left to right shunt
§** Eisenmengers syndrome**: right to left shunt
o Cardiac murmur
§ Holo or pansystolic, grade 3-5/6 PMI below tricuspid
§ Usually heard better on right side
o Diagnosis
§ Doppler echocardiography
o Treatment
§ Surgery would be possible
§ Trestment of CHF
§ But often euthanasia
o Horse should be excluded from breeding

68
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    Acquired heart diseases could be affecting either?
A
  • Endocardium and valves
  • Myocardium
  • Arrythmias
  • Pericardium
    o Pericarditis
    o Idiopathic pericardial effusion
    o Neoplasia
    Valvular disease
    o Stenosis is usually congenital and rare
    o Acquired insufficiency is much more frequent
69
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    Acquired heart diseases
    Endocardium and valves
A

o Bacterial endocarditis (not so common) - left side more common
o Degenerative thickening of the valves
o Valvular dysfunction
o Ruptured chordea tendinea
o Prolapse of valves
o Aortic regurgitation
o Mitral regurgitation
o Tricuspid regurgitation
o Pulmonary regurgitation
o Regurgitation = insufficiency

70
Q
  1. Examine the cardiovascular system of the horse and describe the findings.
    Cardiac diseases in horses
    Acquired heart diseases
    Myocardium
A

o Myocarditis
o Myocardial fibrosis
o Myocardial degeneration (Selenium deficiency)
o Myocardiu, neoplasia
o Dilated cardiomyopathy

EQUINE III (2 decks)

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