Exam 2 Flashcards
What is the tx for interstitial pneumonia?
None
Supportive care only
Etiology of IAD?
Irritants of the airway
What would you use to flush the gutteral pouch? What if there are chondroids or pus?
Saline or LRS
Acetylcysteine to try to dissolve chondroids and pus
What breed is associated with post-anesthetic myopathy?
Draft horses
What drug is associated with causing a progressive granulomatous pneumonia due to repeated injections?
Equimmune
If a horse is lying in dorsal recumbency, what is this a sign of?
Gastric ulcers
What radiographic patterns are specific to R. equi infections?
Perihilar abscessation pattern
Miliary pattern
Classify the colic: Kicking at belly, pawing, up and down quietly, mild rolling
Moderate
What PCV is associated with IMHA?
10-20%
Tx for LH?
Laryngoplasty (tie-back)
If you see this on echo of a mitral valve insufficiency, it means the horse is unsafe to ride due to sudden death and possible rupture
Dilated pulmonary artery
What action in the heart creats the first heart sound (lub)?
Closing of the AV valves
What clinical signs are associated with severe mitral insufficiency?
Sudden death
Cordae tendinae rupture
At what age can horses that are homozygous for HYPP begin to develop clinical signs? Heterozygous?
Homozygous = 6 months
Heterozygous = 1 year
Tx for babesiosis/piroplasmosis in non-endemic areas?
Imidocarb
When treating RAO, what antibiotic might you add on to your primary antibiotic and what agent is it targeting
TMS
Actinobacillus
How is serum ferritin affected with anemia of chronic disease (ACD) and iron deficiency?
ACD = normal to increased
Iron deficiency = normal to decreased
Is persistent or intermittent DDSP more common?
Intermittent
What is the most common site for bacterial endocarditis?
Mitral valve
How are the retropharyngeal LNs affected by strangles?
Can rupture and cause respiratory distress
When is hyper immune serum most effective against R. equi?
First week of life
More of a preventitive than a tx
What is the conversion rate and recurrence rate of Afib of <4 month duration compared to >4 month duration?
95% conversion and 25% recurrence if <4 months
80% conversion and 60% recurrence if >4 months
What are the common clinical signs od DDSP?
Quitting
Choking down
Cheek puffing
When will the PCV begin to decrease with blood loss?
12-24 hours
What is the lowest PCV that you will see with anemia of chronic/inflammatory disease?
18-19%
What is the heart rate in a refluxing horse?
>60
BAL or TTW to help diagnose IAD?
BAL
When is the best time to collect a blood culture to diagnose vegetative endocarditis and why?
On upswing of fever because you can have a false + at peak of fever
If a horse has colic with a fever, whats the cause?
Infectious agent
What is usually the problem with cranial abdominal distension?
SI
What tends to be the presenting complaint with vegetative endocarditis?
Fever of unknown origin
Grading LH: Asynchronous movement of left arytenoid, incomplete abduction
Grade 3
What is the difference between mobitz 1 and 2?
PR interval increases with type 1 but stays the same with type 2
In what part of the lung field do you hear noise with RAO?
Entire lung field because its a diffuse disease
Seeing a mucus trail in the tracheobronchial tree helps in the diagnosis of what condition?
IAD
Is respiratory distress seen with horses that are heterozygous or homozygous for HYPP?
Young homozygotes
In the case of arthralgia/myalgia associated with viral respiratory disease, how would you know when to give phenylbutazone vs flunixin meglumine?
Phenylbutazone if arthralgia/myalgia is the only thing you are giving the NSAID for
Flunixin if there are other things going on that require an NSAID such as fever
Describe the abdominocentesis for a non-strangulating lesion
No change initially
Then increase in TP
Then increase in WBC
Then increase in RBC
What type of IAD and tx: >2% mast cells on BAL
Type 2
Tx with cromolyn sodium (mast cell stabilizer)
If a horse with strangles is not depressed and is eating ok, what is the best treatment?
No need to treat
What is the most important thing to consider with increased red cell destruction?
Infectious diseases
What type of IAD and tx: mild neutrophilia (5-20%)
Type 1
Tx with alpha-interferon
T/F: Clinical signs of HYPP are seen during exercise
False
Atypical to see with exercise
Severity of regurgitation in aortic insufficiency is best determined by what?
Arterial pulse quality rather than grade of the murmur
What type of IAD and tx: >3% EØ
Type 3
Tx with corticosteroids
What odor is associated with NG tube reflux?
Fermented
Do you see inspiratory or expiratory noise with epiglottic entrapment?
Both
Tx goal for babesiosis/piroplasmosis in non-endemic areas?
Completely eradicate organism
If you see vegetative endocardiosis affecting the tricuspid valve in the horse, what should you check?
Jugular catheter
What is the most likely valvular dysfunction leading to cardiac failure?
Mitral insufficiency
Grading LH: Complete paralysis
Grade 4
Management of HYPP?
Avoid high K feeds (alfalfa)
Feed frequently to avoid fasting episodes
Exercise
Avoid stress
Acetazolamide (not used as K wasting diuretic)
What drug can you use to limit muscle damage in a horse with an acute episode of rhabdomyolysis?
Dantrolene
What is the most common pathologic murmur?
Mitral insufficiency
Describe the following parameters for non-strangulating lesions:
Pain, HR, CV compromise, Distension, Rectal, Reflux
Pain - mild-moderate
HR - <70 (60-80)
CV compromise - none
Distension - none-minimal
Rectal - mild-moderate distension
Reflux - non-minimal
When do rou hear the “roar” at rest for laryngeal hemiplasia?
Only when its bilateral
When treating RAO, whats the first antibiotic you would give and what agent is it targeting?
Penicillin
Strep
What is the most common physiologic arrythmia seen in horses?
2nd degree AV block (mobitz 1)
Why is arytenoid chondritis difficult to tx?
Its cartilage and avascular
What does it mean if a horse’s shoulder or neck is marked with an A?
They have EIA
What is the DOC for complicated strangles?
Penicillin
When is strangles most infectious?
Day 7-14 when the affected LN ruptures
What disease is associated with accumulation of glycogen and abnormal polysaccharides in muscle cells?
PSSM
What heart condition is associated with a loud honking murmur?
Mitral insufficiency
At what grade of rhabdomyolysis do you see myoglobinuria?
Grade 3
What segment of the intestines is most commonly strangulating?
SI
What is the most frequently diagnosed disease of the upper airway?
Laryngeal hemiplagia
What action in the heart causes the “bah” sound (S4)?
Atrial contraction
Polysaccharide storage myopathy (PSSM) affects what breeds?
Quarter horse
Draft horse
What are the major presenting complaints for racehorses and performance horses with IAD?
Racehorses = slightly slowed racing times, cough
Performance = prolonged recovery, cough
What is the minimum amount of time a farm is isolated with a case of strangles?
6 months
What are the predisposing factors to colic?
Previous colic
Change in diet
Change in exercise
Which nerve is damaged with ILH?
LEFT laryngeal nerve
Why does sedation make it more difficult to place an NG tube?
Cant swallow
What action in the heart causes the “ahhh” sound (S3)?
Rapid ventricular filling
What antibiotics are used to treat gutteral pouch empyema?
Penicillin +/- TMS
How are the submandibular LNs affected by strangles?
Swell, drain, and can abscess
Classify the colic: Rolling severely, throwing itself down
Severe
What will you see on endoscopy in a horse with arytenoid chondritis?
Granuloma lesion associated with draining tract
What disease is associated with high RR, weakness, and tendon contracture of all 4 limbs?
Glycogen branching enzyme deficiency
Clinical signs associated with pleuropneumonia?
Fever
Absence of lung sounds ventrally
Louder cardiac ascultation caudodorsally
Weight loss
Pectoral edema
What disease has both inspiratory and expiratory noise but is more expiratory?
DDSP
Protracted exercise is associated with what type of rhabdomyolysis?
Type 2
How is Total Iron Binding Capacity (TIBC) affected with anemia of chronic disease (ACD) and iron deficiency?
ACD = normal to decreased
Iron deficiency = normal to increased
How does the resting membrane potential in a HYPP horse differ from a normal horse?
Normal = 70
HYPP = 55
When is tie-back indicated for LH?
Grades 3B,C, and 4
Surgical tx for epiglotic entrapment?
Laser - Nd:YAG laser
What is the most common congenital cardiac defect in the foal?
VSD
Clinical signs of rhabdomyolysis?
Fasciculations
Strained look (pulled back nares and lips)
Drop down from pain when palpate back
Hard muscles
Do not want to move
Myoglobinuria
What is the most common anemia in the horse?
Anemia of chronic/inflammatory disease
Describe the following parameters for strangulating lesions:
Pain, HR, CV compromise, Distension, Rectal, Reflux
Pain - moderate-severe
HR - >70-80
CV compromise - moderate-severe
Distension - typically present
Rectal - moderate-severe distension
Reflux - mild-severe
Usually the small intestine
What anti-inflammatory should you give if there are more severe signs of systemic involvement with viral respiratory disease?
Flunixin meglumine
What is the underlying cause of RAO?
Inhalation of molds in hay, irritants, or endotoxins
Hereditary predisposition
What are some causes of VPCs?
Electrolyte alterations
Endotoxemia
Myocardial inflammation
Hypoxia
When will the PCV bottom out with blood loss?
48 hours
What blood value indicates cardiac muscle disease and compromise?
Cardiac Troponin I
What is the gold standard for evaluating a regenerative anemia?
Bone marrow evaluation
How many bands can be palpated in the ventral colon, pelvic flexure, dorsal colon, small colon?
Ventral = 3
Pelvic flexure = 0
Dorsal = 2
Small colon = 1
Whats the best test for anemia of chronic/inflammatory disease? Second test?
Fibrinogen
Iron kinetic test
What is the gold standard for diagnosing EIA?
Coggins test
What type of diet do you want to use when managing a horse with chronic rhabdomyolysis?
High fat (rice bran), avoid high grain
Can use vegetable oil - not mineral oil
How many blood cultures should you do when trying to diagnose vegetative endocarditis?
2-3
Grading LH: Asynchronous movement of left arytenoid, full abduction of left arytenoid cartilages
Grade 2
How are marrow iron stores affected with anemia of chronic disease (ACD) and iron deficiency?
ACD = normal to increased
Iron deficiency = normal to decreased
Which valve is most frequently affected by vegetative endocarditis and what is the cause?
Mitral
Abscess hiding in the lungs
What is the normal temp range in a horse?
99-101
What muscle is responsible for abduction of the arytenoids?
Cricoarytenoideus dorsalis muscle
At what grade of rhabdomyolysis do horses become recumbant?
Grade 4 = transient
Grade 5 = rapid
Recurrent exertional rhabdomyolysis (RER) affects what breed?
Thoroughbreds
What anti-inflammatory is important to use for vegetative endocarditis and why?
Asprin
Reduces platelet aggregation and minimizes growth of lesion
What are the prognostic factors specific to aortic insufficiency?
Size of aortic root
Presence/abscence of concurrent left AV insufficiency
Classify the colic: Playing in water, looking at flanks, pawing, stretching out
Mild
Chondroids are associated with what disease?
Long term gutteral pouch infection
Why do you treat guttural pouch empyema as an isolation case?
Because you are worried about the agent being strep equi which causes strangles and is highly contagious
If you are having trouble passing the cardiac sphincter, what can you give the horse?
Mepivicaine (Carbocaine) - relaxes the sphincter
What is the first clinical sign of strangles? 2nd?
Fever
Swelling of LNs
What is the most common pathologic arrhythmia?
A Fib
What are signs of more severe systemic involvement with viral respiratory disease?
Depression, off feed, excessive fever (>104)
What are the most important contributing factors associated with post-anesthetic myopathy?
Muscle mass
Need to keep MABP > 60
What is the best way to diagnose RER?
Muscle biopsy - central nuclei
Prognostic factors of pleuralpneumonia?
Systemic fibrinogen (>1000 - poor)
E. coli
Amount of fibrin in pleural space
Foul odor to pleural fluid or breath (anaerobes)
Gas bubbles on US (anaerobes)
Which pathologic murmur leads to Afib that is resistant to quinidine conversion?
Mitral insufficiency
What drugs can cause IMHA?
Penicillin
Sulphas
Phenylbutazone
What is the only valve heard on the right side of the horse?
Tricuspid
How many VPCs do you need to diagnose Vtach?
4 or more
If a colicy horse presents depressed, whats the issue?
Inflammatory disease
Rupture
Endurance horses and high competition horses are associated with what type of rhabdomyolysis?
Type 2
Tx for VPCs?
Lidocaine IV bolus
Tx for heart failure?
Furosemide
Digoxin
Enalapril
Hydralazine
What complications are associated with strangles?
Dyspnea/distress d/t retro[pharyngeal LN enlargement
Gutteral pouch empyema
Purpura hemorrhagica (aseptic vasculitis)
How does the values in an abdominocentesis in strangulating lesions differ from non-strangulating lesions?
TP, WBC, and RBC increase at the same time to the same degree
What are the signs associated with a secondary bacterial infection of viral respiratory disease?
Fever > 72 hours
Mucopurulent nasal discharge
Crackles and wheezes in cranioventral lung fields
What should you do on a follow-up of a horse with vegetative endocarditis?
Blood culture 60 days after cessation of antimicrobials
What bacteria are most common with vegetative endocarditis?
Strep
Actino
E. coli
What tests do you want to run on the reflux?
Ph of the fluid
Culture
Tx for R. equi?
Erythromycin estolate + Rifampin
Is there inspiratory or expiratory difficulty with RAO?
Expiratory
Why should you freeze and thaw samples you send for R. equi?
Its intracellular
What has a better prognosis, degenerate or inflammatory valvular disease?
Degenerate
Tx goals of babesiosis/piroplasmosisin endemic areas?
Alleviate clinical signs
DO NOT CLEAR ORGANISM - presence of organism is required for maintenance of immunity
Is aortic insufficiency a systolic or diastolic murmur?
Diastolic
T/F: Cough is diagnostic for IAD
False
Its an insensitive indicator
What risk factors are associated with pleuropneumonia?
Long distance travel (>2hrs)
Exposure to viral respiratory disease pathogens
Eating while trailering (especially with head tied)
What risk factors are associated with IAD?
Stabling
Age (young)
Exposure to airway irritants
Deep inhalation of foreign material
Long distance transport
Etiology of HYPP?
Point mutation of alpha subunit of the voltage dependent sodium channel
Does arytenoid chondritis cause distress?
Depends on severity and progression
Surgical tx for DDSP?
Laryngeal tie-forward
What is the source of monensin and lasalocid toxicities in horses?
Monensin - cattle feed
Lasalocid - poultry feed
Limited exercise is associated with what type of rhabdomyolysis?
Type 1
Where do you measure the NG tube to in order to make sure you are in the right place?
13th rib
What action in the heart creates the second heart sound (dub)?
Closing of the semilunar valves
What is the cause of anemia of chronic/inflammatory disease?
Iron sequestration
How soon after blood loss will the PCV start to increase?
How long does it take the PCV to return to normal?
3-4 days
4-6 weeks
Which antimicrobials are used to tx vegetative endocarditis?
Penecillin IV
Gentamycin IV
Is mitral insufficiency a systolic or diastolic murmur?
Systolic
Tx for effesive and constrictive pericarditis?
Effusive - drainage
Constrictive - pericardectomy
What is the criteria to determine the need for a blood transfusion?
Absolute PCV
Severity of loss - rapidity with which PCV decreases
Time - acute vs chronic
What segment of the intestines is most commonly non-strangulating?
LI
What prognostic factor is specific to mitral insufficiency?
Size of pulmonary artery
When will you see a decrease in TP with blood loss?
4-6 hours
What is the most common cause of iron deficiency? Rare cause?
Common = blood loss
Rare = nutritional deficiency
What is the cause of a functional obstruction?
Ileus
What breed is associated with HYPP?
Quarter horses
Tx for HYPP during an episode?
IV calcium gluconate
Dextrose/insulin
