Exam 2 Flashcards
Chronic Progressive Lymphedema
- Disease of lymphatic drainage of skin
- Breeds: Belgian, draught horses, Shire, Clydesdale, German breeds
- 50-90% develop clinical signs
- Initally: scratches-like, masked by feathering
- Genetic component
- Chronic and progressive
- Starts at ~2 years, euth at ~>6 years
- distal aspect limbs: lumpy skin/subcutis, back of pastern, recurrent secondary infections
- palliative care (control infections, compressive bandages, exercise
Cannon Keratosis (Stud Crud)
- Not related to urine splashing, not just males, not infectious
- middle-aged or older
- Genetic?
- Esp. cranial aspect of rear cannon
- lifelong
- hairloss
- Seborrhea: too much scale is being produced on surface of skin
- Non-painful unless secondary infections
- non fatal
- Treat with anti-seborrhea shampoos
Parasites (4)
- Lice: on skin
- Mites: in skin
- Onchocerciasis
- Summer sores
Summer sores
- Open, non-healing wounds
- Esp.: around eyes, on lips, external genetalia, fetlocks, coronary band
- Parasite + reaction: individual horses
- esp. bad in summer
- debulking + ivermectin
- Incidence decreases with routine systemic dewormers
Dermatophilus (Rain rot or Scald)
- Caused by Dermatophilus congolensis
- Painless swelling: hair loss
- Dorsum
- Trasmissible bacterium
- Characteristic appearance: thick crusts easily epilated, raw skin beneath
- Wet climates: rain sheets
- Anti-microbial shampoos
- Zoonotic
Dermatophytosis (Ringworm)
- Fungal infection (multiple)
- Esp. young and/or malnourished horses
- Higher incidence in fall/winter in temp climates
- Decrease of UV light exposure when stabled
- Zoonotic
- Raised, circular swellings initially, then hair loss and crusting
- Dilute bleach
- Antifungal shampoos
- Tack as fomites
Eosinophilic Grnauloma
- Collagenolytic granuloma or nodular necrobiosis
- Common!
- Painless blemish
- Fly bite sequel: hypersensitivity or allergic response
- Chest and back esp.
- Spring/summer
- May contain mineral (nodular necrobiosis)
- Remove surgically if nuisance
Aural Plaques (Ear Fungus)
- Thick skin plaques
- Bilateral
- Concave aspect of pinna
- Viral, not fungal: Papilloma virus
- Fly-transmitted: black flies
- More active in summer
- Blemish
- Sensitive ears
- Older horses
- Do not resolve
- Various treatments: imiquimod, blood rot
Equine Papilloma Viruses
- Esp. grass warts
- Common: 6 mo.-4 yr
- Papillomavirus
- Muzzle + lips
- Genital
- May be generalized
- Genital form, leads to SCC
- Spread: contact, insects
- Resolve in 3 months
- Persistent=immunosuppressed
Fistulous Withers
- Swelling of withers: Supraspinous bursa
- Draining tracts, fever, and pain
- Cause: trauma, ill-fitting saddles, overwork, overloading/poorly balanced loads
- Infections: Actinomyces bovis, Onchocerca cervicalis, Brucella abortis!
- Treatment: surgery, antibiotics
Anhidrosis
- Loss of ability to sweat: overstimulation of sweat glands by stress hormones in summer months
- Esp. warm humid areas
- Risk of heat stroke
- Sweating areas reduced to: jaw, neck, base of ears, between pelvic limbs, under saddle
- No age, sex, breed, color predisposition
- Esp. performance horses
- Diagnosis by series of dilutions of terbutaline
- Chronic: poor dry hair coat + lethargy during hot times of year
- Control: removal of severe climatic stress, limit exercise to cool parts of day, shade, movement of air, misters, cold-water hosing, recovery may occur after move to temperate climate
Hirsutism
- Long, non-shedding hair coat
- Older horses
- Associated with PPID (Equine Cushing’s Disease)
- Treat the underlying disease
Photosensitization
- Dermatitis of ALL unpigmented skin
- Secondary to hepatic injury: metabolit of chlorophyll enters skin due to impaired biliary excretion
- PA-containing plants (Pyrrolizidine alkaloids)
- Weight loss, jaundice, behavioral change if severe
HERDA
Hereditary Equine Regional Dermal Asthenia
- Asthenia=weak
- ‘Hyperelastosis cutes’
- Quarter horses: Some cutting horse bloodlines, normal at birth, develops at 2-4 years
- Hyperextensible skin + scars
- Esp back of affected horses
- Homozygous recessive trait: do not breed carriers
- Genetic test for cyclophilin B mutation
Linear Keratosis
- Esp. QH, TB, Standardbreds
- Unknown cause, genetic?
- Birth-5 years
- Vertical bands: Alopecia + increased keratin, esp. neck, shoulder, thorax
- Asymptomatic blemish
- lifelong
- No treatment: may be mild progression
Disease of Pigmentation
Albinism
-Overo lethal white (non-functioning coon)
-Lavender foal syndrome (weakness, neuro signs)
Leukotrichia
-white hairs
-Retriculated = tiger-striping (>1 year old)
-other forms of pigment loss
Vitiligo
-autoimmunity to melanin
Sweet Itch
- form of hypersensitivity to midges
- active during summer
- horses kept in marshy areas
- esp in tail head, but can see it up to the mane
- Shave skin, inject allergens, where there is redness there is an inflammatory response
- seen in WY
- pretty common
- Treat with steroids
What are the 3 main types of cancer in horses?
- Squamous Cell Carcinoma
- Melanoma
- Sarcoids
What is cancer?
genes involved in promoting/inhibiting growth in in normal cells are being knocked out
What is metastasis?
can travel to another place, if can do that, is cancer
Characteristics of benign tumors
- slow growth
- usually encapsulated
- smooth surface
- local compression
- cells differentiated
- cells uniform and resemble each other
- blood vessels in tumor well formed
- minor or no necrosis
- NEVER metastisize
- DNA content usually normal
- karyotype usually normal
- normal mitotic figures
Benign tumors are not fatal unless….
- bleed out
- compression of vital organ
- growth in confined space
- hormone production
Characteristics of malignant tumors
- metastasis
- local invasion
- irregular surface
- little or no capsule
- may be large with rapid growth
- often death if untreated
- less well differentiated than benign neoplasm
- may not resemble tissue of origin
- loss of anchorage dependence
- loss of contact inhibition
- pleomorphism
- increased mitotic activity
- vessels numerous/poorly formed
- necrosis and hemorrhage
- DNA content increased
- additional chromosomes present
- karyotypic abnormalitites
- nuclei large hyeprchromatic
Common tumors of horses
- sarcoid
- viral papillomas/aural plaques
- SCC
- melanoma/malignant melanoma
- thyroid adenoma
- pituitary adenoma in pars intermedia
- lipoma
- ovarian tumors (=granulosa cell tumor)
- mast cell tumor
- lymphoma (leukemia)
- teratoma of undescended testicles
Sarcoid
-occur typically anywhere flies tend to land or there’s been a cut
Papilloma-Equine warts
- Mucocutaneous transitions
- EcPV-1 (muzzle and lips)
- EcPV-2 (genital areas, associated with genital SCC, like HPV-16, integrated into cell genome)
- young horses (<3y)
- hardy viruses
- immunity: disappearance 1-6mo after appearance
- chemical or freezing to remove
Aural Plaques
- in ears
- concave aspect, pinna
- esp. summer/fall
- papilloma virus on EM (not isolated)
- often bilateral
- non-painful
- bother owner more than horse
- no reported treatments
- do not regress
Common squamous cell carcinomas
Occular: -3rd eyelid, conjunctiva, cornea, eyelid -UV light/pale skin Penile/Preputial -Smegma (EcPV-2) -often aggressive in young horses Face -UV light/pale skin Perineal -UV light/pale skin, vulva/clitoral Stomach -often aggressive
Treatment of SCC
Surgical: -early small lesions -least successful on large, long standing lesions Other: -more advanced lesions -cryotherapy -cytotoxic chemicals -Immunomodulation (BCG) -Radiation: considered best, expensive, specialty clinics
Melanoma
- virtually in all gray horses: >6-8y, some families worse than others
- black tarry discharge
- esp. tail perineum but can be anywhere
- some become malignant
- surgery vs. other approaches
Lymphoma
- incidence: 1.3-2.8% of all tumors
- no viral association
- typically 4-10y old
- most commom: multicentric: LNs and internal organs
- generally diagnosed late in clinical course
- common subtype: T-cell rich, B-cell lymphoma
- chemotherapy and radiation therapy
- palliative glucocorticoid use more common
- most commonly internal
- leukemia unusual
- no effective treatment
- when skin involved: often indolent, cutaneous nodules, T-cell rich, B cell lymphoma
- may be stallion-like behavior
Thyroid adenoma
- Common in older horses: 30% for horses >10y, 75% in horses >20y
- unilateral or bilateral
- biopsy or needle aspirate to confirm
- no need for treatment unless: compression of adjacent structures, growing, hyperthyroidism
- other thyroid masses: goiter, cystic hyperplasia, adenocarcinoma of thyroid follicles or C cells
Granulosa cell tumor
Common -male/female hormones secreted -aggressive/stallion-like behavior -markedly prolonged estrus -unilateral -slow growing -do not metastasize Dx -palpation -ultrasound -testosterone + inhibin -anti-mullarian hormone
Pituitary adenoma, pars intermedia
- pituitary pars intermedia dysfunction (PPID)
- melanocyte-stimulating hormone (MSH) production
- typically >18y
- long hair coat
- pressure on hypothalamus (body temp, appetite, cyclic shedding)
- Polyuria/polydipsia (PU/PD)
- poor muscle tone and weakness
- somnolence
- abnormal distribution of adipose tissue
- swelling of periorbital fossa, laminitis
- increased infections
Lipoma
- common in older horses
- intra-abdominal
- long stalk=strangulation of SI
- cause of colic
What is the urinary tract?
- collect and removes fluid wastes from body
- when animal dehydrated urine is more concentrated to preserve fluids
- when animal well hydrated urine is more dilute
Structures of urinary tract
Kidneys, ureters, bladder, urethra
Equine urine usually looks…
Normally cloudy: abundant calcium carbonate crystals, mucus
Pollakiuria
Peeing too often, but normal total volume
- estrus
- calculi
- cystitis
Polyuria
Peeing too much urine
- many primary diseases of kidney
- pituitary pars intermedia dysfunction
- diabetes mellitus and diabetes insipidus
- behavioral problems
Suspect urinary problems when…
weight loss + abnormal urination
Diagnosis of urinary tract problems
- rectal palpation
- urinalysis
- blood work: blood urine nitrogen (BUN), creatinine, anemia, lowered chloride and sodium
- Ultrasound: morphology, presence of stones
- endoscopy
- kidney biopsy
Acute renal failure
- Kidneys stop working due to toxicity or severe dehydration
- toxins:
- some antibiotics
- overuse of NSAIDs
- heavy metals
- plants
- products of muscle breakdown or erythrolysis
- Diagnosis: elevated BUN and creatinine
- Treatment: IV fluids, dopamine (dilates blood vessels), furosemid (diuretic)
Where does acute renal failure cause problems?
In large intestine
Chronic kidney failure
- loss of 20-30% nephrons
- after damage occurred: chronic renal infection, post-intoxication
- symptoms: loss of appetite, weight loss, decline in performance, dilute urine
- cannot be cured: avoid NSAIDs, low protein diet, sodium bicarbonate, anemia, avoid dehydration
Pyelonephritis
- ascending bacterial infection of kidneys from bladder (fever, high WBC count in circulation)
- relatively rare in horses
- treatment: antibiotics, control kidney failure
- complications: formation of stones in urinary tract
Urolithiasis
- most commonly in bladder
- sequel to cystitis
- also: kidney, ureter, urethra
- symptoms:
- straining during urination
- inability of horse to urinate full stream
- colic
- blood in urine
- esp. mares, particularly geldings
- treatment: removal of stones: surgery, lithotripsy (shock waves), antibiotics
Uroliths in other locations
- kidney or ureter or urethra
- secondary to: passage of kidney stone or bladder stone
- rarely performed surgery
Cystitis
- inflammation of bladder: due to trauma, secondary to lumbar spinal cord disease, opportunistic bacterial infection
- symptoms: frequent urination, straining, urine leakage
- treatment: depends on underlying problem
- complications: risk for pyelonephritis or kidney failure
Psychogenic polyuria/plydipsia (PU/PD)
- drinks too much water due to boredom: upsets electrolyte imbalance, dilute urine
- Diagnosis: no sign of kidney failure, inability to concentrate urine
- treatment: 40ml/kg/day water intake
- change environment
Ruptured bladder in foals
- at/shortly after birth
- depressed within week of birth: urinary toxins in blood
- both foals and fillies
- life threatening: urine in abdomen, toxemia
- requires surgery to close
Patent urachus in foals
- when urachus fails to close, or leaks after birth
- risk of: urine scald of skin, ascending infection of urinary tract
- most close on their own
- may need caustic chemical to seal urachus
Renal neoplasia
- generally rare: prevalence <2%
- most primary
- others secondary (esp. lymphoma)
Pituitary Pars Intermedia Dysfunction (PPID)
- true Cushing’s disease
- common, in some part esthetic
- older animals
- predisposed to insulin resistance
- hypertrophy/hyperplasia in pituitary gland, with increased ACTH (increased cortisol released from adrenal glands)
- abnormal fat deposits
- long curly hair that wont shed (hirsutism)
- bulging supraorbital fat pads
Treatment of PPID
- body clip in summer months
- regular dental + hoof care
- Pergolide mesylate or cyproheptadine or combination
- increased risk of infections
What is hirsutism?
long curly hair that wont shed
Most common PPID infections
- sole abscesses
- dermatitis
- dental and gum disease
- enteric parasitism
- respiratory infections
Equine Metabolic Syndrome (what it looks like)
- aka: ‘peripheral Cushing’s, easy keeprs, insulin-resistant’
- humans: insulin-resistant (similar to pre-diabetics), obesity = increased risk for secondary diabetes mellitus +coronary artery disease
- Horses: esp. ponies (genetic component), cresty neck and thick sheath, insulin resistance, obesity = increased risk of laminitis
Equine Metabolic Syndrome
- typically 5-15 years
- common esp. in ponies
- insulin insensitivity: glucose intolerance, increase insulin, increased leptin, pro-inflammatory state, hyperinsulinemia affects ~22-29% of susceptible equine population
- overfeeding nonstructural carbohydrates
- obese horse with cresty neck + predisposition to laminitis
- weight reduction + exercise
Distinguishing EMS from PPID
EMS: -onset earlier -laminitis -test: increased fasting insulin -few progress to diabetes -control: weight loss PPID -onset in middle/old age -laminitis -hisutism -excessive sweating -PU/PD -skeletal muscle atrophy -test: low dose dex suppression test, increased ACTH -control: counteracting effect of ACTH
Sick euthyroid syndrome
- ‘eu’ because thyroids healthy: low circulating thyroid secondary to other illness
- ‘hyperthyroidism’: true hypothyroidism RARE in horses
Thyroid adenoma
- common in older horses
- generally asymptomatic
- diagnosed by palpation or biopsy
- may be bilateral
- thyroid carcinomas-rare
Goiter with musculoskeletal disease
- western USA + Canada
- musculoskeletal + goiter (mandibular prognathia, flexural deformation)
- avoid: adequate iodine
- affected foals: good odds if not severe and survive 1st week of life
Pheochromocytoma
- tumor of adrenal medulla
- increased epinephephrine and norephinephrine
- anxiety, sweating, increased heart/respiratory rates
- generally untreatable
Ovarian Diseases
- granulosa cell tumor
- relatively common
- benign
- hormone producing: persistent estrus, anestrus, masculinization
- confirmation by hormone tests
- can be bred after removal of affected ovary-usually 1 year later
Anhidrosis
- loss of ability to sweat
- factors: familial trait, semi-tropical/tropical climates, TBs and warmbloods, born west/midwest the moved to warm climates
- onset: sudden vs. gradual, esp. in summer
- prevalence: 10% at farm level, 2% at animal level
- risk of hyperthermia (heat stroke)
- confirmation: intradermal sweat test
- move to cooler climate
Big Head-Bran Disease
- secondary hyperparathyroidism
- associated with high phosphate diets with low calcium hay
- esp. foals and lactating mares
- PTH hormone productio + increased activity of vitamin D
- end result: poorly mineralized bone with fibroplasia = ‘big head’
Management of big head
Avoid: -care with high phosphate diets Manage: -calcium supplementation -restricted exercise -NSAID for pain
What is the immune system responsible for?
protecting the horses body against the constant influx of pathogens from its environment
What are external influences on the immune system?
weaken the function of the immune system
-stress: transportation, performance, change of routine, pain, fear
What are the physical barriers of the immune system?
-skin and mucous membranes
What is the internal protection of the horse?
-when the physical barriers are breached, immune system is activated
Organs of the immune system
- spleen: active immune cells’ information modulated form the vagus nerve
- bone marrow: in neonate, thymus is active in construction of immune system
- lymph nodes: multiply and produce antibodies
- autonomous nervous system: informs anatomical sites of the immune system
Cell Mediated Immunity in the Equine
- non specific
- leukocytes respond to a threat by degranulation (releasing substances to help destroy the threat) and phagocytosis
- body cells participating in this part die off and are pus
Humoral Branch of the Immune System
- must be previously exposed for this part to work
- previous exposure primes lymphocytes and complement system
- involve plasma cells and antibodies that are capable of colonal expansion (can multiply and produce more antibodies to fight threat)
- complement system functions to break down/remove damaged cells
What happens (steps) when immune system starts working?
- immune system reacts violently
- inflammation that causes swelling
Some examples of when the immune system reacts
lameness, injuries, colic!
Drugs to use for inflammation and swelling
Bute, banamine, previcox
Shock organ in the horse is the…
lungs
What is involved in shock? specific aspects
- vagus nerve system
- inflammatory cells form the immune system
- humoral factors like TNFalpha
Pigeon Fever (Corynebacterium pseudotuberculosis) from Dr. Weiss
- lives in dry hot dusty soil and manure (as in feed lots)
- infection through open wounds, biting flies, inhalation
- as bacteria stays in abscesses they create, they are difficult to reach with antibiotic therapy
Clinical presentation of Pigeon fever (Dr. Weiss)
- one or more abscesses on chest/face
- febrile/anorexic horses might have mutliple abscesses
- may get ulcerative lymphagitis along extremities
Important things to know about Pigeon Fever (Dr. Weiss)
- ruminants suffer same disease, can only infect eachother if have same strain
- infected individuals need to be isolated
- difficult to eradicate
- treatment is similar to strangles, anti-inflammatories, warm poultices on abscesses so they can drain, antibiotics only in select cases
- prevention includes fly control, remove manure, husbandry
Autoimmune diseases
- COPD
- Hives
- all kinds of allergies
- some conditions are genetically anchored, others caused by influence of environment on immune system
Laboratory support of autoimmune diseases (tests)
- allergen testing
- intradermal skin testing
- IgE measurements of blood in horses
- IgE measurements do not work for food allergies
Why do we vaccinate? (Dr. Weiss)
protect horses against catastrophic contagious diseases by preparing the immune system
What will the horse’s immune system make from vaccination?
antibodies for protection
-these immunoglobulins are circulating in blood stream or waiting in the tissue
Core vaccines
- tetanus
- WEE/EEE
- west nile
- rabies
What is immunology?
study of the immune system
What 3 areas of study (-ology) work together to help avoid situations where the immune system needs to be activated?
epidemiology, serology, immunology
What is the conformation of the brood mare reproductive tract?
- vulvar labia presents a barrier for contamination
- no retrograde urine contamination
- cervix is a barrier to keep infections out
- uterine body, pooling of fluid is not possible and bacteria can’t cause infection
What is a healthy environment of the uterus?
low pH=acidic
Where does the placenta evolve from?
chorion-a thin membrane that lines the egg shell on the inside
What kind of placenta does a horse have?
diffuse-epitheliochorial placenta
What position is used to check that the entire placenta has been expelled?
lazy “F” position
When should you avoid vaccinating a pregnant mare?
in the first trimester to avoid any complications
If ____ is in good working order, an infection can be avoided?
the local immune system
Hematogenous infection
mare is systemically sick and the bacteria/virus infect the uterus, placenta, and fetus causing inflammation and infection
Ascending infection
Noxious agents enter mare’s repro system through cervix, causes inflammation and disrupts oxygen and nutrient supply for foal by destroying the villi of the chorioallantois membrane (placental membrane)
Unidentified infection
cause for infection cannot be determined
What are the most common noxious agents in infections of brood mares?
EIS, EHV1, EVA, CEM
Is a retained placenta life threatening?
yes
In situations of infections causing stillbirth, what can be seen and why?
dystocia or premature placental separation from the retention of parts of the placenta
What is a red bag?
premature placental separation
If a retained placenta is addressed promptly after birth, what can you do?
- remaining membranes can be removed with copious lavage
- manually picking off placenta
- anti-infammatories and antibiotics
If retained placenta is not addressed, what happens?
- toxins released into mare’s blood stream
- sepsis, laminitis, schock
- chronic infection/inflammation in mare’s endometrium
What should the mare produce before birth and what is in this?
Colostrum
- nutrients
- calcium
- antibodies
What is agalactia?
when the mare does not produce any milk at all
-treatment can include keeping mare away from foal, pain killers, and fluids