Equine Top 20 Diseases - Part 4

Question 1

what is the classic case presentation of a horse with atrial fibrillation?

Answer 1

athletic horses with exercise intolerance, exercise-induced epistaxis, or pleasure/idle horses - incidental finding

Question 2

how is atrial fibrillation in a horse diagnosed?

Answer 2

irregularly irregular heart beat ausculted & ECG to confirm - no p waves, fibrillation waves with normal QRS, irregular R-R intervals

Question 3

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

Answer 3

true - also don’t treat if horse is retired

Question 4

when would you treat a horse with atrial fibrillation?

Answer 4

lone afib (no underlying cardiac disease) & desired athletic performance (medical cardioversion with quinidine IV or PO or transvenous electrical cardioversion under GA)

Question 5

what is the prognosis for atrial fibrillation in horses?

Answer 5

good if lone AF, poor for athletic performance if AF is secondary to underlying cardiac disease

Question 6

what predisposes normal horses to atrial fibrtillation?

Answer 6

large atrial size & high vagal tone

Question 7

what is the classic case presentation of equine gastric ulcer syndrome?

Answer 7

can be inapparent - colic, inappetance, weight loss, ill thrift, grumpiness especially during girthing

Question 8

what is the only way a definitive diagnosis of equine gastric ulcer syndrome can be made?

Answer 8

fasting gastroscopy

Question 9

where is the most common anatomic site for squamous ulceration of the equine stomach? what about glandular?

Answer 9

squamous - squamous mucosa of lesser curvature just proximal to margo plicatus glandular - pylorus

Question 10

how is EGUS treated?

Answer 10

omeprazole proton pump inhibitor (gold standard), H-2 receptor antagonists (ranitidine), & frequent feeding/turnout, & decreasing stress

Question 11

what is the prognosis of EGUS?

Answer 11

excellent with appropriate treatment & management changes

Question 12

which is more difficult to treat, glandular or squamous ulcers in horses with EGUS?

Answer 12

glandular more difficult than squamous

Question 13

T/F: EGUS is very common with 60% of performance horses being affected

Answer 13

TRUE

Question 14

what horses may require prophylactic therapy for EGUS?

Answer 14

performance horses under constant transport & training stress

Question 15

what is the classic case presentation of esophageal obstruction in a horse?

Answer 15

ptyalism, feed material/saliva coming out of nostrils, retching/coughing, & palpable lump in esophageal area

Question 16

how are esophageal obstructions in horses diagnosed?

Answer 16

clinical signs usually diagnostic, unable to gently pass an NG tube, advanced cases use esophageal endoscopy/ultrasound

Question 17

how are esophageal obstructions in horses treated?

Answer 17

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)

Question 18

what is the prognosis of a horse with an esophageal obstruction for the first time?

Answer 18

excellent

Question 19

older horses with what may be more predisposed to getting an esophageal obstruction?

Answer 19

dental issues

Question 20

what are some common complications of esophageal obstructions in horses?

Answer 20

aspiration pneumonia, esophageal stricture, diverticulum, or esophageal rupture

Question 21

what is the lay term for esophageal obstruction?

Answer 21

choke

Question 22

what are the 2 most common types of lower airway inflammatory disease in horses?

Answer 22

recurrent airway obstruction & inflammatory airway disease

Question 23

what is the classic case presentation of a horse with recurrent airway obstruction?

Answer 23

older horse with a heave line (muscle definition from abdominal expiration), wheezing, & tachypnea at rest during episodes

Question 24

what is the classic case presentation of a horse with inflammatory airway disease?

Answer 24

any age horse but usually younger performance horses with no tachypnea at rest

Question 25

how is recurrent airway obstruction diagnosed? what about inflammatory airway disease?

Answer 25

BAL with increased percentage of inflammatroy cells (neutrophils & spirals for RAO, neutrophils/mast cells/eosinophils for IAD) - endoscopy is supportive showing increased tracheal mucus

Question 26

what is the most important part of treatment for horses with lower airway inflammatory disease?

Answer 26

environmental management!!!!! decrease dust & allergens

Question 27

what treatment is used for horses with lower airway inflammatory disease?

Answer 27

systemic or inhaled meds - corticosteroids for anti-inflammatory & bronchodilators to open airway

Question 28

what is the prognosis for horses with lower inflammatory airway disease?

Answer 28

good with environmental modification - guarded if chronic, poorly managed RAO

Question 29

RAO is similar to what human disease?

Answer 29

asthma

Question 30

what are the 3 components of recurrent airway obstruction?

Answer 30

mucus production, bronchospasm, & neutrophil accumulation

Question 31

what is the classic case presentation of a horse with colic?

Answer 31

abdominal pain, rolling/pawing side, tachycardia, tachypnea, decreased appetite/fecal passage, & shock in severe cases

Question 32

what is the goal when working up a horse with colic?

Answer 32

ID the part of the gi tract involved & define the type of colic

Question 33

what diagnostics are performed for a horse with colic?

Answer 33

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)

Question 34

when is surgery recommended for treating a horse with colic?

Answer 34

if pain is repeatedly refractory to analgesics and/or exam suggests strangulating lesion

Question 35

what treatment is used for a horse with colic?

Answer 35

sedatives/analgesics, parasympatholytics (buscopan) for spasmodic colic, NGT for decompression, enteral fluids if no significant reflux, & IV fluids

Question 36

how are colic types divided?

Answer 36

medical vs surgical, small intestinal vs large intestinal, & strangulating vs non-strangulating

Question 37

what are the 3 most common causes of colic encountered in practice?

Answer 37

spasmodic/gas colic, impaction colic, & strangulating obstruction (large colon volvulus & strangulating lipoma)

Question 38

what are some examples of specific causes of colic associated with certain horses?

Answer 38

large colon volvulus in brood mares, fecaliths in mini horses, lipomas in old horses, & enteroliths in arabian horses