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AAA Y4 SEM2 > Equine Tx > Flashcards

Equine Tx Flashcards

1
Q

Preparation for foaling - general health of mare

A
  • Nutrition
  • Dental
  • Worming status
  • Vaccinations
  • Farrier (remove shoes prior to foaling)
  • Biosecurity - keep preg mares separate + in small groups; min stress(dec movement + social change); avoid close proximity of preg mares in shared airspace (American barns)
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2
Q

Preparation for foaling - mare vaccs

A
  • EHV: @ 5 m, 7 m + 9 m of preg
  • Flu + tetanus vacc: last m of preg
  • Rotavirus (optional): bigger studs w/ higher amount of rotavirus in environment: @ 8 m, 9 m, 10 m of preg
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3
Q

Preparation for foaling - mare nutrition

A
  • Aim for moderate BCS - fit = lighter exercise until 9 m then field turnout
  • First 8 m - no special diet considerations
  • Last 3 m - slowly inc to maintenance + 20% (inc protein to 13 - 14%; crude fibre to 8 - 10%)
  • If April onwards - grass generally sufficient forage, check quality
  • Concentrate meals with a vitamin and mineral balancer
  • During Lactation: 2 x maintenance at peak lactation likely to require forage + mix
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4
Q

High-risk foaling mare - Hx - previous + current

A
  • Abortion
  • Dead Foal
  • Dystocia
  • Peri-parturient haemorrhage (age? Number of foals?)
  • Premature Foal
  • Placentitis/Premature mammary gland development + premature lactation, vag discharge
  • Rejected a foal
  • Neonatal Isoerythrolysis
  • Severe stress/systemic illness during gestation
  • Placentitis
  • Ruptured pre-pubic tendon - rapidly progressing large, painful oedematous swelling of ventral abdo
  • Hydrops - abdo distension, excessive foetal fluids, inability to palp foetus on rectal
  • Uterine torsion - colic signs = 7 - 9 m gestation
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5
Q

US monitoring late preg checks

A
  • CTUP normal values (combine thickness of uterus + placenta): < 7 mm = < 270 d; < 8 mm = 271 - 300 d; < 10 mm = 301 - 330 d; < 12 mm = > 330 d
  • Utero-placental integrity
  • Activity and presentation of the foetus
  • Foetal heart rate (range and reactivity) normal = 60 -120 bpm
  • Fetal fluid volume and clarity - foetal-placental circulation
  • IUGR: foetal aortic diameter, orbital diameter, thoracic diameter
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6
Q

‘High-risk’ preg mare at risk for placentitis - Tx

A
  • If foetal risk < 50% in last 3 y, monitored from 5 m gestation
  • Antimicrobials - TMPS
  • Altrenogest
  • +/- Inflam mediators - Firocoxib
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7
Q

Causes of abortion (in order)

A
  • Umbilical cord abnormalities!
  • Placentitis
  • Foetal abnormalities
  • Premature placental separation
  • EHV-1
  • Placental abnormalities
  • Twinning
  • Maternal illness
  • Other
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8
Q

Abortion biosecurity - assuming infectious before proven

A
  • 1). Isolate mare - double bag foetus/foal + placenta -> PME; cordon off area + disinfect
  • 2). Rule out EHV-1/EHV-4 - PCR testing, isolate sick live foals + submit nasopharyngeal swabs + bloods for EHV; ensure no contact of staff w/ other horses, esp preg mares
  • 3). If EHV indicated - divide in-contact preg mares into smaller groups + turn out into isolated paddocks; maintain any in-contact as closed group until EHV rules out; monitor other mares for signs of impeding abotion (pyrexia, mammary gland development, vag discharge)
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9
Q

Impending parturition - signs

A
  • 2 - 4 w prior - udder fills
  • Mammary development - last 2 w
  • Last w prior - croup/tailhead relaxes, teats fill + wax on teats 2 d prior
  • Vulval changes -2 to -1 d prior
  • Dorsopubic to dorosacric pos movement of foal
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10
Q

Impending parturition - parameters

A
  • Inc milk calcium, normal = > 10 mmol/L (400 ppm)
  • Dec sodium
  • Inc K, Ca, citrate, lactose
  • Inversion of Na : K ratio prior to foaling
  • pH < 7.0
  • Testing in late afternoon/early evening, ionic score > 35
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11
Q

Parturition stage II - foetal expulsion - when to intervene

A
  • (Should occur within 15 - 20 min of rupture of chrioallantois)
  • Head + two front feet present @ vulva within 15 min
  • Ensure amniotic sac ruptured / manually break
  • Can use gentle traction when mare actively pushing
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12
Q

Parturition stage II - premature placental separation, ‘red bag delivery’

A
  • Failure of chorioallantois to rupture at cervical star + dehiscence of chorion microvilli from endometrium
  • Emergency - O2 deprival of foal
  • Cut red bag immediately to deliver foal
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13
Q

Parturition stage III - normal passage of placenta

A
  • Examine placenta + check if RFM
  • If mare + foal nursing fine -> Oxytocin 1 mL (10 i/u) IM q 30 - 60 min
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14
Q

Dystocia - when to intervene

A
  • > 15 min have elapsed since the mare has ruptured her chorioallantois, but the foal has not been delivered
  • Mare in active labour for an extended period but making no progress
  • One leg protruding from the vulva and no more of the foal has appeared over 15 min
  • Break amnion + check both front feet + head presented
  • Can use gentle traction when mare actively pushing
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15
Q

Normal foetal presentation, posture + pos

A
  • Presentation - anterior
  • Posture - forelimbs first, followed by head
  • Pos - dorsosacral
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16
Q

Abnormal foetal presentations

A
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17
Q

Dystocia - examination of mare

A
  • Avoid sed
  • MM for H+/shock
  • Presence + nature of vulval discharge + foetal mems
  • Any foetal extremities visible or palp?
  • Internal exam - lube -> any pelvic abnormalities, foetus presentation + viability
  • Walk mare to control straining
  • Clenbuterol -> uterine relaxation
  • Epidural not recommended if referral an option (takes 20 min)
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18
Q

Dystocia - Tx

A
  • Assisted vag delivery for 10 - 15 min-> refer
  • Controlled vag delivery - GA + hind limbs hoisted upwards
  • C-section - if above fails
  • Fetotomy (disssect) - dead foal only!
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19
Q

Colostrum

A
  • Test mares w/ Brix refractometer
  • Adequate > 20 - 30%
  • Nurse 5 - 7 times q 1 h
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20
Q

Newborn foal - client advice

A
  • Dip umbilicus regularly until dry, clean + ensure no thickened, should shrivel up over first 48 h
  • Ensure meconium passed within first few h, faeces go from firm dark brown to soft yellow/brown, fleet enema needed if straining
  • Monitor urination - USG < 1.008: first urination in 6 h colts, 10 - 12 h fillies
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21
Q

Clinical examination of foal within first 24 h

A
  • General: Good affinity for mare, strong suck reflex (look from outside the box), bright, alert, difficult to catch & when disturbed should go towards the udder
  • Head: mm pink and moist, no signs of petechiation/injection, PLR may be slower due to increased sympathetic tone, no entropion (rolling in of eyelids), no milk staining or milk from nose, check for cleft palate, no menace response is norma
  • Thorax: normal RR (20 - 40 bpm) + effort, no pain, swelling or crepitus to suggest rib fractures, loud BV sounds over all lung fields, normal HR (80 - 120 bpm) & rhythm, holosystolic murmur will be present in most foals (PDA)
  • Abdomen: Relaxed, non-distended, borborygmic in all quadrants & milk faeces on perineum, umbilicus small, dry & non-painful
  • Limbs: Carpal valgus (lateral deviation) is common & usually improves as do slack pasterns. Limb contracture or varus (medial deviation) may need treatment
  • Temp: 37 - 39 C
  • 1-2-3 rule: 1 h = standing; 2 h = nursing; 3 h = placenta
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22
Q

Foal clin path

A
  • Blood test for IgG SNAP ELISA - > 8 g/L = adequate transfer of immunoglobulins (< 8 g/L = FTPI)
  • Haem: WBC, SAA, Fibrinogen - early signs of sepsis
  • 1500 IU tetanus given at birth
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23
Q

Vet exam of mare post-parturition

A
  • Foaling injuries - vag injury, uterine tear, H+
  • Systemic compromise -> internal injury
  • RFM = > 3 h, placenta should weigh 11% of foal birthweight
  • Milk production - mastitis?
  • Bonding + behaviour towards foal
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24
Q

Retained foetal membranes (RFM)

A
  • > 6 h -> inc risk of endometritis/septicaemia/laminitis
  • Heavy breeds more susceptible
  • Risk factors: dystocia, previous Hx, age > 15 y, hormonal imbalance
25
Q

RFM - Tx

A
  • Tie placenta in knot
  • Low vol oxytocin boluses (1ml IM/IV q 30 - 60 min)
  • Flunixin Meglumine
    +/- Broad-spectrum antibiotics,
    +/- Ice boots
  • Manual Removal: controversial - CARE not to tear! Gentle traction only, often comes out easily, usually tip of non pregnant horn that is ‘stuck’
  • Other Methods: Oxytocin drip (10 mL Oxytocin in 1L Hartmanns); high volume
    uterine lavage (care if large dependent uterus with poor myometrial activity); Burns
    Technique (lavage volume of lavage fluid introduced into the allantoic cavity followed by manual occlusion of its entrance for 10 - 15 min), injection of umbilical vessels with water
26
Q

Neonatal foal care

A
  • Identify foals at risk
  • New-born: assist nursing if struggling, keep warm, umbilical stump Tx, soapy water enema
  • Blood sample for POC: IgG conc, SAA, glucose + lactate; routine haem to identify early signs of sepsis/bacteraemia
  • Tetanus prophylaxis - 1,500 IU tetanus antitoxin IM -> 4 - 6 w protection
  • Antimicrobials - prematurity/dysmaturity, assisted foalings/interventions, poor environment/management, lab findings
27
Q

AB choice - foal

A
28
Q

Failure of transfer of passive immunity (FTPI) (IgG conc <8g/L)

A
  • Gut barrier closure 12 h - admin before
  • 1). Supplementation w/ donor colostrum
    -2). Give IgG via IV (commercial plasma transfusion from hyper-immunised donors) - 1 L raising IgG by 2 - 3 g, monitor HR, RR, mentation for adverse reactions
  • Sedatives - diazepam (valium) (recum), easy to admin reversal; straight high dose butorphanol
  • Madigan squeeze
  • Monitor SNAP IgG after 12 - 24 h
29
Q

Emergency resuscitation (foal)

A
  • Epinephrine
  • Isotonic crystalloid, Hartmann’s
  • 10 mL/kg bolus then reassess to correct dehydration/hypovolaemia
  • Energy - 1% or 20 mL/L of 50% glucose added to IVFT over 20 min
  • Maintenance therapy - Hartmanns + 5% glucose (50 : 50)
  • Prevent sodium overload: <3mEq/kg/day
  • Maintenance fluid rate = 4 mL/kg/hr
30
Q

Insufficient/ineffective suckling (FPTI) - foal

A
  • Establish nutritional supplementation plan
  • Assisted nursing
  • Intermittent ‘top-ups’ w/ nasogastric tube
  • Indwelling nasogastric tube for continual supplementation
31
Q

Dehydration (FPTI) - foal

A
  • Enteric feeding if stable
  • Supportive IVFT - esp if evidence of hypovolemia
  • 1 L crystalloids over 10 - 15 min for 50 kg foal
  • Foal not nursed for 3 h = dehydrated
  • Foal not nursed for 4 - 6 h + = hypovolaemic
32
Q

Neonatal isoerythrolysis

A
  • JAUNDICE - 5 h - 5 d after birth
  • Prevent nursing from mare temporarily - alternative colostrum/milk for 72 h to ensure not absorbing reactive mare Ab
  • Blood transfusion
  • Supportive care
  • Inotropes/pressors for foals w/ sepsis if FT insufficient to support perfusion
33
Q

Neonatal maladjustment syndrome (NMS)

A
  • Dummy foal, hypoxic ischaemic encephalopathy
  • Referral
  • Supportive
  • Sedation if seizing - diazepam (IV/per rectum)/midazolam (IV/IM)
  • NG tube
  • Foal squeeze
34
Q

Neonatal sepsis

A
  • Referral
  • Plasma transfusion - boost immunity
  • AB
  • Nutrition
  • Hydration
  • Nursing care
35
Q

Treat/prevent sepsis foal

A
  • Broad spectrum AB: Ampicillin/amikacin (first line); ceftiofur, no effect on renal func (or penicillin, gentamicin, cefotaxime, piperacillin, TMPS)
  • Ensure adequate passive transfer
  • Colostrum at < 12 h
  • Plasma - 1L per 2g IgG required
  • Hygiene + clean environment
36
Q

Nutrition (foal)

A
  • Fresh mare’s milk; mare’s milk frozen; commercial milk replacer; skimmed cow’s milk + dextrose; goat’s milk
  • Ensure 10% BW/day e.g. 50 kg foal = 420 mL every 2 h
  • Trophic feeding - 25 mL milk every 6 - 8 h when not tolerating enteral nutrition
  • Parenteral nutrition - concentrated supply of IV carbohydrate, protein + fat
37
Q

Respiratory support (foal)

A
  • Keep foals in sternal recumbency
  • Intranasal O2 - low rate of humidified nasal O2, 1 - 15 L/min
  • Non-invasive techniques
38
Q

Seizure control (foal)

A
  • Diazepam IV (or per rectum)
  • Midazolam IV or IM
  • 0.1 - 0.2 mg/kg
39
Q

Orphan foal

A

Vet intervention:
- Nutritional support plan: 20 - 25% BW fed per day
- Monitor: weight/growth, development, signs of illness
- Fostering: good mare + healthy foal, can take 24 - 48 h

40
Q

Abnormal foal care - diarrhoea

A
  • Biosecurity key!
  • No Tx required if ‘foat heat’ D+ = transient, mild, self-limiting, hind gut fermentation + adjustment to ingestion of roughage
41
Q

Abnormal foal care - infectious D+

A
  • Rotavirus most common - malabsorption, lactose intolerance, hypersecretion
  • Dx - identify virus in faeces via enzyme immunoassay
  • High morbidity, low mortality, Tx = IVFT, GIT protectants, nursing
  • Vacc of mares where high incidence
  • More serious enterocolitis: Salmonella, Clostridia perfringens, Clostridium dificile -> refer, screen D+ for pathogens
42
Q

Infectious D+ - foal Tx, intestinal protectants

A
  • Peptobismol - binds bacterial toxins, stimulates intestinal absorption
  • Biosponge - bind to clostridial exotoxins
  • Ranitidine - antacids, prevents ulceration
  • Omeprazole - suppresses stomach acid secretion, prevents ulceration,
43
Q

Gastric ulceration (foal)

A
  • Foals have more alkaline gastric pH (so acid blockers should be avoided)
  • Sucralfate - localised, binding effect (20 mg/kg PO QID)
  • Acid-suppressing medication e.g. omeprazole (4 mg/kg PO SID)
44
Q

Abnormal foal care - respiratory disease

A
  • Bacterial pneumonia due to sepsis, aspiration pneumonia, 2y bacterial infection following viral disease, infectious bacterial pneumonia (Rhodococcus equi)
  • US for Dx
  • Trans-tracheal aspiration for Dx sampling
45
Q

Flexural limb deformities - tendon laxity

A
  • If pronounced laxity post-maturity
  • Protection of ‘dropped’ fetlock
  • Controlled exercise to encourage strengthening of tendon
  • Farriery - heel extensions
46
Q

Flexural limb deformities - tendon contracture

A
  • Hyperflexion of joint (carpal/fetlock)
  • Mild - controlled exercise
  • Severe/unresponsive: slow IV oxytetracycline (2 - 3 g, diluted in 250 mL saline); splints/casts to encourage straightening
47
Q

Angular limb deformities

A
  • Mild - mod - corrective trimming, shoeing, hoof extensions
  • Severe - Sx
  • Timing of intervention depending on GP: fetlock < 2 m/o; hock < 4 m/o; carpus < 6 m/o
48
Q

Helminths - high mort w/ larval stages

A
  • S. vulgaris (large) - verminous arteritis due to L4 migration through cranial mesenteric a. -> thromboembolic infarction of colon
  • Cyathostome spp. (small) - re-emergence of hypobiotic L3 larvae from caecal/colonic mucosa -> colitis, D+, weight loss + PLE
49
Q

Helminths - high mort w/ heavy burdens of adult endoparasites

A
  • Parascaris equorum - SI -> ill-thrift + colic in weanlings)
  • Anaplocephela perfoliata - distal ileum -> colic, ileocaecal hypertrophy, intussusception
50
Q

Helminths - sub-clinical disease

A
  • Gastrophilus spp. - larvae -> subclinical gastric lesions
  • Oxyuris equi (pinworms) - eggs in perineum -> perianal/perineal irritation
  • Bots (Gasterophilus spp.)
  • Stomach worms - Habronema, Draschia
  • Lungworm (Dictyocaulus arnfeldi)
  • Foals - threadworm (Strongyloids westeri)
51
Q

Anthelmintics (wormers)

A
  • Benzimidazoles = Fenbendazole - strongyles (Cyathastomes) resistant
  • Macrocyclic lactones = Avermectins - Parascaris equorum resistant to Ivermectin, cyathastomes developing resistance
  • Tetrahydropyrimidines = Pyrantel
52
Q

Helminth/endoparasite prevention - interval dosing

A
  • Tx every horse q 8 - 13 w during grazing season
53
Q

Helminth/endoparasite prevention - strategic dosing (EBVM)

A
  • Discouraging anthelmintic resistance
  • Establish drug effectivity
  • Target high shedders - those requiring Tx
  • Monitor Tx efficacy
  • Maintain parasite refugia - parasite stages not exposed to anthelmintic drugs at time of Tx, not selected for resistance e.g. stages on pastures, encysted cyathostome larvae in LI wall
  • FEC (McMaster’s) = estimation of patent adult population within lumen of GIT - perform regularly during grazing period, at end of grazing period, late winter/early spring, to check drug effectiveness (FECRT), Tx when > 250 eggs per 1 g of faeces
54
Q

Cyathostome larvae - control

A
  • Tx of ‘high shedders’
  • Moxidectin - kills larval stages, most effective, but resistance developing
  • Late Autumm/winter
  • Dx - serum ELISA - detects IgG/Ag + encysted larvae
55
Q

Tapeworm - Dx + control

A
  • Dx - ELISA - serum + saliva - confirms exposure not infection
  • Control - strategic, evidence-based dosing - single annual Tx at end of risk period (autumn/late spring): praziquantel (BOVA) or double dose Pyrantel
56
Q

Simple parasite control measures

A
  • Remove faeces from paddock - manually/mechanically (vacuum)
  • Individual grazing paddocks
  • Rotating grazing w/ livestock / resting over-grazed paddocks
57
Q

Faecal egg count reduction test (FECRT)

A
  • Evaluates efficacy of anthelmintic based on reduction of FEC output after Tx
  • Perform FEC on a group of > 5-10 horses on a farm
  • Deworm all horses with one anthelmintic
  • Repeat FEC 14 days after treatment (use same FEC technique)
  • Calculate FECR of individual horse based on formula; % FECR = (FEC pre - FEC post)/FEC pre x 100
58
Q

Parasite Tx - Donkeys

A
  • Targeted worming as for horses
  • Consider lungworm in donkeys or horses
    grazing with donkeys
  • Beware differences in anthelmintic license (check VMD website)
  • Mules treated as donkeys

AAA Y4 SEM2 (8 decks)

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