Equine Top 20 Diseases - Part 4 Flashcards
what is the classic case presentation of a horse with atrial fibrillation?
athletic horses with exercise intolerance, exercise-induced epistaxis, or pleasure/idle horses - incidental finding
how is atrial fibrillation in a horse diagnosed?
irregularly irregular heart beat ausculted & ECG to confirm - no p waves, fibrillation waves with normal QRS, irregular R-R intervals
T/F: in a horse with atrial fibrillation, don’t treat it if there is underlying cardiac disease because it won’t work & there is an increased risk of fatal arrhythmia
true - also don’t treat if horse is retired
when would you treat a horse with atrial fibrillation?
lone afib (no underlying cardiac disease) & desired athletic performance (medical cardioversion with quinidine IV or PO or transvenous electrical cardioversion under GA)
what is the prognosis for atrial fibrillation in horses?
good if lone AF, poor for athletic performance if AF is secondary to underlying cardiac disease
what predisposes normal horses to atrial fibrtillation?
large atrial size & high vagal tone
what is the classic case presentation of equine gastric ulcer syndrome?
can be inapparent - colic, inappetance, weight loss, ill thrift, grumpiness especially during girthing
what is the only way a definitive diagnosis of equine gastric ulcer syndrome can be made?
fasting gastroscopy
where is the most common anatomic site for squamous ulceration of the equine stomach? what about glandular?
squamous - squamous mucosa of lesser curvature just proximal to margo plicatus glandular - pylorus
how is EGUS treated?
omeprazole proton pump inhibitor (gold standard), H-2 receptor antagonists (ranitidine), & frequent feeding/turnout, & decreasing stress
what is the prognosis of EGUS?
excellent with appropriate treatment & management changes
which is more difficult to treat, glandular or squamous ulcers in horses with EGUS?
glandular more difficult than squamous
T/F: EGUS is very common with 60% of performance horses being affected
TRUE
what horses may require prophylactic therapy for EGUS?
performance horses under constant transport & training stress
what is the classic case presentation of esophageal obstruction in a horse?
ptyalism, feed material/saliva coming out of nostrils, retching/coughing, & palpable lump in esophageal area
how are esophageal obstructions in horses diagnosed?
clinical signs usually diagnostic, unable to gently pass an NG tube, advanced cases use esophageal endoscopy/ultrasound
how are esophageal obstructions in horses treated?
withhold feed/water, sedation (buscopan/nsaids), pass NG tube/lavage esophagus with the head low if not resolved in 4-6 hours, prophylactic antibiotics for aspiration pneumonia, & severe prolonged cases may require IV fluids, anesthesia, or surgical intervention (esophagostomy)
what is the prognosis of a horse with an esophageal obstruction for the first time?
excellent
older horses with what may be more predisposed to getting an esophageal obstruction?
dental issues
what are some common complications of esophageal obstructions in horses?
aspiration pneumonia, esophageal stricture, diverticulum, or esophageal rupture
what is the lay term for esophageal obstruction?
choke
what are the 2 most common types of lower airway inflammatory disease in horses?
recurrent airway obstruction & inflammatory airway disease
what is the classic case presentation of a horse with recurrent airway obstruction?
older horse with a heave line (muscle definition from abdominal expiration), wheezing, & tachypnea at rest during episodes
what is the classic case presentation of a horse with inflammatory airway disease?
any age horse but usually younger performance horses with no tachypnea at rest
how is recurrent airway obstruction diagnosed? what about inflammatory airway disease?
BAL with increased percentage of inflammatroy cells (neutrophils & spirals for RAO, neutrophils/mast cells/eosinophils for IAD) - endoscopy is supportive showing increased tracheal mucus
what is the most important part of treatment for horses with lower airway inflammatory disease?
environmental management!!!!! decrease dust & allergens
what treatment is used for horses with lower airway inflammatory disease?
systemic or inhaled meds - corticosteroids for anti-inflammatory & bronchodilators to open airway
what is the prognosis for horses with lower inflammatory airway disease?
good with environmental modification - guarded if chronic, poorly managed RAO
RAO is similar to what human disease?
asthma
what are the 3 components of recurrent airway obstruction?
mucus production, bronchospasm, & neutrophil accumulation
what is the classic case presentation of a horse with colic?
abdominal pain, rolling/pawing side, tachycardia, tachypnea, decreased appetite/fecal passage, & shock in severe cases
what is the goal when working up a horse with colic?
ID the part of the gi tract involved & define the type of colic
what diagnostics are performed for a horse with colic?
physical exam (determine pain level, HR/RR/gi sounds), abdominal palpation on rectal (location/dilation of gi tract), NG tube (abnormal if > 2 L net reflux), abdominal ultrasound (location/motility/dilation of gi tract & peritoneal fluid evaluation), & abdominocentesis (increased TP, serosanguineous color, & high lactate suggest the need for surgery)
when is surgery recommended for treating a horse with colic?
if pain is repeatedly refractory to analgesics and/or exam suggests strangulating lesion
what treatment is used for a horse with colic?
sedatives/analgesics, parasympatholytics (buscopan) for spasmodic colic, NGT for decompression, enteral fluids if no significant reflux, & IV fluids
how are colic types divided?
medical vs surgical, small intestinal vs large intestinal, & strangulating vs non-strangulating
what are the 3 most common causes of colic encountered in practice?
spasmodic/gas colic, impaction colic, & strangulating obstruction (large colon volvulus & strangulating lipoma)
what are some examples of specific causes of colic associated with certain horses?
large colon volvulus in brood mares, fecaliths in mini horses, lipomas in old horses, & enteroliths in arabian horses
