Equine Respiratory Disease

Question 1

What are the differentials for a horse with mucopurulent discharge?

Answer 1

1. Paranasal sinus disease (primary or secondary) - bacterial disease, neoplasia, cysts
2. Guttural pouch empyema - strangles, strep equi subspecies zooepidemicus

Question 2

What is the most common cause of paranasal sinus disease?

Answer 2

Dental disease

Question 3

What history questions do you want to ask the owner of a horse with mucopurulent discharge?

Answer 3

Vaccinations up to date?
When was the last dental check up?
Duration and onset of discharge?
Any other horses on the yard affected?
Underlying conditions (e.g. PPID)?

Question 4

What are the key elements you want to include in your clinical examination of a horse with mucopurulent discharge?

Answer 4

Facial symmetry - check for swelling
Sinus percussion
Lymph nodes
Temperature
Auscultation

Question 5

Radiography is useful for differentiating primary from secondary paranasal disease. List the standard radiographic views to assess a horse with paranasal disease.

Answer 5

1. Dorsoventral
2. Latero-lateral
3. Right and left Dorso30lateral-ventrolateral views

Question 6

Outline the features of periodontal disease on radiography.

Answer 6

1. Periapical sclerosis and halo formation
2. Clubbing of tooth root apices
3. Widening of the periodontal ligament
4. Loss of lamina dura
5. Hypercementosis

Question 7

Name the anatomical site that mucous appears from on endoscopy of paranasal sinus disease.

Answer 7

Nasomaxillary aperture

Question 8

Chronic mucopurulent nasal discharge warrants investigation for secondary causes of paranasal sinusitis. State the duration of discharge which defines it as chronic.

Answer 8

2 months <

Question 9

Name the common organism which causes primary bacterial paranasal sinusitis.

Answer 9

Streptococcus equi subspecies zooepidemicus

Question 10

State how you treat acute primary bacterial sinusitus.

Answer 10

1. Antibiotics: penicillin G
2. Anti-inflammatories: phenylbutazone
3. Feed from the floor to facilitate drainage

Question 11

What are the indications for surgery in a horse with mucopurulent discharge?

Answer 11

Cyst
Neoplasia
Primary fungal paranasal disease
Chronic disease - inspissated pus
Dental disease - extraction

Question 12

When should you suspect Strangles?

Answer 12

Acute onset of fever, purulent nasal discharge, and enlarged lymph nodes.

Question 13

How do you diagnose strangles?

Answer 13

Sample: nasopharyngeal swab, aspiration from abscess, saline lavage of guttural pouch
Tests: culture and PCR

Question 14

You suspect a case of strangles on a yard. What should you do next?

Answer 14

Isolate the case and all other affected cases
Implement biosecurity measures: individual buckets and equipment, disinfect stables with bleach
Herd testing: paired serology for ELISA 3 weeks apart

Question 15

Outbreaks will have at least one horse which is an asymptomatic carrier for Strangles. How do you find the asymptomatic carriers?

Answer 15

Positive on one ELISA test showing exposure
Endoscopy reveals chondroids in the guttural pouches

Question 16

State the gol