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X Clinical Veterinary Nursing Theory > Equine Respiratory Diseases > Flashcards

Equine Respiratory Diseases Flashcards

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1
Q

what are the overarching types of respiratory disease?

A

URT

LRT

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2
Q

are horses always systemically unwell when they have respiratory diseases?

A

no

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3
Q

what are disorders of the respiratory system second only in importance to in limiting athletic performance?

A

musculoskeletal

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4
Q

what issues would you expect to present at birth?

A

congential

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5
Q

what respiratory issues would you expect to present at 1-6 months?

A

Rhondococcus infection

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6
Q

what respiratory issues would you expect to see in weanlings/yearlings?

A

viral and bacterial URT infections

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7
Q

what respiratory issues would you expect to see in performance horses?

A

exercise induced pulmonary haemorrhage (EIPH)

inflammatory airway disease (IAD)

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8
Q

what respiratory issues would you expect to see in middle aged horses?

A

asthma

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9
Q

what about a horses environment or the environment it was exposed to help may be useful when looking at history?

A

mixing with new horses
local endemic infections
vaccination history (if so and when)
exposure to dust (bedding, feed or that of their neighbor)

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10
Q

what about prior medical issues may help to diagnose current respiratory issues?

A

may be related to current complaint e.g. viral disease may precede bacterial

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11
Q

what questions should be asked when gaining history about the presenting respiratory problem?

A

last normal
slow or quick onset
signs
did signs come on after strenuous exercise or following long distance travel
are there any new arrivals on the yard who have not been quarantined
signs seen at rest or only at exercise

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12
Q

what elements must be assessed in the physical exam of a patient with suspected respiratory disease?

A 
demenour
stance
nasal discharge
SM lymph nodes
RR
respiratory effort
heave line
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13
Q

what will the horses stance be like if they are finding it difficult or painful to breathe?

A

head and neck extended with elbows abducted

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14
Q

what is normal RR in horses?

A

8-10 brpm

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15
Q

what should respiratory effort be like in a healthy horse?

A

difficult to see breathing occurring - if visible there is probably an issue

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16
Q

what is rectus abdominus hypertrophy?

A

increased definition of rectus abdominus due to chronically increased respiratory effort

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17
Q

when auscultating the lungs may the horse appear normal at rest even if unwell?

A

yes

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18
Q

what should be done if a horse isn’t showing increased respiratory effort and sounds normal at rest?

A

rebreathing

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19
Q

describe the process of rebreathing to assess horses respiratory function

A

cover nose with a bag to increase CO2 levels and cause them to breathe harder and more deeply
auscultate throughout and then as bag is removed

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20
Q

what is the purpose of rebreathing during auscultation?

A

patient will breathe more deeply which will enable you to hear any crackles more clearly

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21
Q

why should you continue to auscultate the chest after bag is removed during rebreathing?

A

there will be a large breath after rebreathing ends which is useful to hear any lung sounds

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22
Q

what sampling techniques are available when testing for respiratory disease?

A

nasal swab
naso-pharyngeal swab
tracheal wash
brochoalveolar lavage

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23
Q

what imaging techniques are available to test for respiratory diseases in horses?

A

endoscopy
x-ray (head, thorax)
CT (head)
ultrasound (larynx, thorax)

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24
Q

when is endoscopy useful?

A

for all respiratory diseases

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25
Q

where should the endoscope be passed through the nose?

A

up ventral meatus

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26
Q

what can be examined by endoscopy?

A

URT down to tracheal bifercation
gutteral pouches
URT during exercize

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27
Q

what is the function of gutteral pouches?

A

unknown - special adaption of horses

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28
Q

what happens during sinoscopy?

A

sinuses are scoped via a trephine or a flap

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29
Q

how many views of the head need to be taken if using radiographs to diagnose respiratory disease?

A

many views

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30
Q

what views of the thorax may be taken by radiographs?

A

lateral to lateral thorax

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31
Q

how many plates are needed to fit the entire equine chest on x-ray?

A

around 5

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32
Q

what is the best imaging modality for the head in the standing, sedated horse?

A

CT

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33
Q

what can be imaged with CT in the horse?

A 
nasal turbinates
para-nasal sinuses
teeth
nasopharynx
gutteral pouches
skull
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34
Q

what is the issue with MRI for horses?

A

they are mostly to big to fit their head into a scanner

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35
Q

what level of sedation is required for equine CT?

A

standing sedation

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36
Q

what are the main methods of sampling respiratory secretions?

A

nasopharyngeal or nasal swab

washes

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37
Q

what can samples of the respiratory tract gained by swabs be used for?

A

bacterial culture
viral tests
PCR

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38
Q

what sample tubes are needed to collect washes?

A

EDTA - cytology

plain - culture

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39
Q

where does tracheal wash sample cells from?

A

the level of the tracheal pull

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40
Q

what cells are sampled during tracheal wash?

A

respiratory secretions and cells that accumulate in the trachea and are a collection from the entire respiratory tract

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41
Q

where does bronchoalveolar lavage happen?

A

at the level of the lungs

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42
Q

what cells are sampled by bronchoalveolar lavage?

A

specific peripheral lung segment

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43
Q

where is the tracheal pull?

A

level of the neck where the trachea slopes less and so secretions collect

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44
Q

what is the most common wash used in practice?

A

tracheal wash

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45
Q

what are the benefits of tracheal wash?

A

general sample

less invasive

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46
Q

what is the disadvantage of tracheal wash?

A

cells have degenerated so less accurate

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47
Q

what is the advantage of bronchoalveolar lavage?

A

more accurate

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48
Q

what are the disadvantages of bronchoalveolar lavage?

A

more invasive
sedation and LA required
only samples a specific area so may miss disease

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49
Q

what equipment is needed for bronchoalveolar lavage?

A

long scope or a BAL tube

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50
Q

what signs will the horse show during a BAL?

A

will cough a lot

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51
Q

how far should the tube/scope be advanced for BAL?

A

should be as far into the lung as possible and stuck

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52
Q

what must be done once BAL tube/scope is stuck in the lung?

A

keep pressure (scope) or inflate the cuff (tube)

53
Q

how much fluid needs to be instilled into the lung during BAL?

A

300-500ml

54
Q

how much of the fluid should be drawn back to be sampled during BAL?

A

50-80%

55
Q

what indicates a BAL sample is good?

A

froth (is surfactant)

56
Q

what is ultrasound used for in respiratory medicine?

A

peripheral lung disorders

57
Q

what may ultrasound need to be combined with in order to gain full picture when diagnosing respiratory disease?

A

x ray

58
Q

what is the most common presenting complaint for horses with disorders of the nasopharynx and larynx?

A

abnormal respiratory noise during exercise

59
Q

how can respiratory noise during exercise be heard?

A

audible stood near the horse while exercising without stetheoscope

60
Q

depending on the severity of the disorder and the sue of the horse what are disorders of the larynx and pharynx likely to cause?

A

poor athletic performance

exercise tolerance

61
Q

what is DDSP?

A

dorsal displacement of the soft palate

62
Q

what happens during DDSP?

A

soft palate comes over the top of the epiglottis

63
Q

when does DDSP most commonly occur?

A

racehorses during strenuous exercise but can be seen in sport or pleasure horses

64
Q

what signs is DDSP associated with?

A

poor performance

abnormal expiratory noise (gurgle)

65
Q

why is DDSP associated with poor performance?

A

reduced air supply as size of larynx is reduced

66
Q

how is DDSP diagnosed?

A

exercising endoscopy

67
Q

what causes DDSP?

A

not understood

68
Q

what treatment is available for DDSP?

A

conservative treatment such as rest

surgery

69
Q

what surgical options are available for DDSP?

A

soft palate cautery

laryngeal tie forward

70
Q

what is the aim with soft palate cautery to treat DDSP?

A

idea is to stiffen soft palate so it can’t flap about and displace

71
Q

what occurs during a laryngeal tie forward?

A

larynx is pulled forwards

72
Q

what is the benefit of a laryngeal tie forwards?

A

if the larynx is further forwards then it is harder for the palate to displace

73
Q

what is arytenoid cartilage collapse also known as?

A

recurrent laryngeal neuropathy (RLN)
laryngeal hemiplegia (LH)
laryngeal paralysis

74
Q

what is arytenoid cartilage collapse thought to be caused by?

A

recurrent laryngeal neurophathy

75
Q

how does arytenoid cartilage collapse occur?

A

recurrent laryngeal nerve innervates cricoarytenoideus dorsalis muscle which abducts the arytenoid cartilages and so opens the larynx
left nerve is really long so the end dies off leading to affected left side of larynx as muscle can no longer abduct cartilage

76
Q

what are the clinical signs of arytenoid cartilage collapse?

A 
inspiratory noise (whistling, roaring)
exercise intolerance
77
Q

how is arytenoid cartilage collapse diagnosed?

A

resting endoscopy may give some indication

exercise endoscopy is best

78
Q

what is the treatment available for arytenoid cartilage collapse?

A 
ventricolochodectomy (Hobday) - removes noise
prosthetic laryngoplasty (tie back) - holds open arytenoid cartilage
79
Q

what is the risk associated with prosthetic laryngoplasty?

A

aspiration pneumonia as can’t close of the airway when swallowing food

80
Q

what is sinusitis?

A

accumulation of exudate within sinus cavities

81
Q

what is the primary cause of sinusitis?

A

follows bacterial or viral URT disease

82
Q

what is sinusitis usually secondary to?

A

dental disease

83
Q

what is the main clinical sign of sinusitis?

A

nasal discharge

84
Q

how is sinusitis diagnosed?

A

endoscopy (check for other causes)
x ray
CT
sinoscopy

85
Q

what will often be performed at the same time as sinoscopy?

A

treatment for sinusitis

86
Q

how is sinusitis treated?

A

lavage
open and ensure better drainage
treat underlying cause if secondary

87
Q

what is found within the gutteral pouch?

A

lots of important structures

88
Q

what is the issue with gutteral pouches?

A

don’t always drain well

89
Q

what is gutteral pouch mycosis?

A

life threatening fungal infection of gutteral pouch

90
Q

what vessel may be affected by gutteral pouch mycosis?

A

carotid artery - lies very close to gutteral pouch and my be eroded

91
Q

what are the signs of gutteral pouch mycosis?

A

epistaxis

some may have cranial nerve dysfunction

92
Q

why may cranial nerves be affected by gutteral pouch mycosis?

A

located in gutteral pouch so may be invaded by fungus

93
Q

how many horses will die following repeated epistaxis caused by gutteral pouch mycosis?

A

50%

94
Q

how is gutteral pouch mycosis diagnosed?

A

gutteral pouch endoscopy

95
Q

how is gutteral pouch mycosis treated?

A

surgical occlusion of vessels

topical antifungal

96
Q

will patients all recover from any cranial nerve deficits caused by gutteral pouch mycosis?

A

no and may take up to 9 months

may have such a severe impact on function that it is unethical to wait and see (e.g. unable to eat)

97
Q

what is strangles caused by?

A

streptococcus equi bacteria

98
Q

what is strangles?

A

URT bacterial infection

99
Q

where are strangles ulcers often seen?

A

near SML nodes

100
Q

what are the clinical signs of strangles?

A 
dull
fever
purulent nasal discharge
enlarged, absecessing SML nodes
enlarged, abscessing retropharyngeal lymph nodes (seen on GP endoscopy
101
Q

what element of the strangles infection is hugely contagious?

A

the pus

102
Q

what are the complications of strangles?

A

difficulty breathing
abscesses may be seen around body
immune mediated complication

103
Q

what must happen to strangles patients and any close contacts?

A

must be isolated

104
Q

how is strangles diagnosed?

A

culture or PCR from abscess

endoscope and GP lavage for culture

105
Q

how is strangles treated?

A

penicillin in some

drain abscessed lymph nodes

106
Q

how does influenza spread?

A

inhalation in common airspaces

107
Q

where does influenza replicate?

A

URT and LRT

108
Q

what are the signs of influenza?

A 
coughing
pyrexia
serous nasal discharge
submandibular lymphadenopathy
inappetance
depression
109
Q

how is influenza diagnosed?

A 
virus detection (PCR or ELISA on nasal or nasopharyngeal swab)
virus isolation (nasal or nasopharyngeal swab)
serology (rising titre of antibodies)
110
Q

how is influenza treated?

A

rest

NSAIDs

111
Q

how can influenza be prevented?

A

vaccination - strict competition and import rules

112
Q

what are the various types of equine herpes virus?

A

different signs:
respiratory
neurological
abortive

113
Q

what are the most concerning types of EHV?

A

neurological and abortive

114
Q

what types of EHV is there a vaccine for?

A

EHV 1 and 4

115
Q

what is pleuropneumonia also known as?

A

shipping fever

116
Q

which horses are at risk of pleuropneumonia?

A

horses travelling long distances

117
Q

what is pleuropneumonia caused by?

A

opportunistic infection from the pharynx to the lungs by bacteria

118
Q

what opportunistic bacteria often cause pleuropneumonia?

A

streptococcus zooepidemicus

119
Q

what are the signs of pleuropneumonia?

A 
history of long distance travel
fever
dull
nasal discharge
difficulty breathing
weight loss
120
Q

what tests are used to diagnose pleuropneumonia?

A 
clinical exam
chest x ray
chest ultrasound
tracheal wash sample
pleural fluid sample (cytology and culture)
121
Q

how are pleuropneumonia patients treated?

A

aggressive treatment
penicillin
chest drains

122
Q

what is asthma also known as in horses?

A

RAO or COPD

123
Q

what is asthma?

A

allergic airway disease

124
Q

what is asthma usually caused by?

A

dust in stables, straw or hay

125
Q

what are the signs of asthma?

A 
increased mucous
bronchoconstriction
coughing and wheezing
increased respiratory effort
heave line
126
Q

how is asthma diagnosed?

A

endoscopy
tracheal lavage
bronchoalveolar lavage

127
Q

what are the white blood cell findings in equine asthma?

A

neutrophillia

128
Q

how is asthma treated?

A

environmental management

inhaled or nebulised steroid and bronchodilator

X Clinical Veterinary Nursing Theory (70 decks)

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