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LA DX & TX II > Exam 2 - Equine Hemolymphatic Disorders > Flashcards

Exam 2 - Equine Hemolymphatic Disorders Flashcards

1
Q

what is the etiology of ulcerative lymphangitis in horses?

A

corynebacterium pseudotuberculosis - 1 of 3 clinical presentations

streptococcus equi spp zooepidemicus - normal skin flora, opportunistic infection

sporothrix schenckii - fungal/yeast infection

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2
Q

are lymph nodes involved in ulcerative lymphangitis in horses?

A

NO

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3
Q

what is the pathogenesis of ulcerative lymphangitis?

A

bacterial or fungal infection of the cutaneous lymphatics (fly bite, puncture wound, dermatitis) that is most commonly seen in the HIND LIMBS

nodules abscess, ulcerate, & then drain

lymphatic vessels become corded/fibrotic with edema formation & eventual fibrosis

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4
Q

is this disease more commonly seen in the forelimbs or the hind limbs of horses?

A

hind limbs

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5
Q

what horses are predisposed to chronic progressive lymphedema?

A

draft breeds - potential breed related/genetic component

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6
Q

what is the onset of chronic progressive lymphedema? what is the cure?

A

early age - no cure

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7
Q

what is chronic progressive lymphedema in horses?

A

build up of lymph fluid in the lower legs, usually hindlimbs, that has progressive swelling with associated skin folds as well as nodules & ulcerations

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8
Q

what is the disease shown in this photo?

A

chronic progressive lymphedema

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9
Q

what is the general treatment used for treating ulcerative lymphangitis & chronic progressive lymphedema?

A

clip - especially feathers

pain management (NSAIDS), abx, hydrotherapy, topicals (chlorhexidine), & compression bandaging

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10
Q

what are the 3 forms of disease caused by corynebacterium pseudotuberculosis?

A
  1. external
  2. internal
  3. ulcerative lymphangitis
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11
Q

how is pigeon fever diagnosed?

A

culture & SHI test

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12
Q

what condition is shown here?

A

pigeon fever - caused by corynebacterium pseudotuberculosis

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13
Q

why is sporotrichosis scary?

A

zoonotic!!!!!!

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14
Q

what agent causes sporotrichosis in horses?

A

sporothrix schenckii (saprophyte)

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15
Q

how is sporotrichosis diagnosed?

A

cigar shaped yeast on a direct smear, IFAT, & histopathology

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16
Q

how is sporotrichosis treated in horses?

A

sodium iodide - itraconazole/terbinafine hasn’t been shown to be effective in horses

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17
Q

what kind of virus causes equine viral arteritis? what horses do we see it in?

A

RNA virus

prevalent in standardbreds, warmbloods, & thoroughbreds

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18
Q

when do horses develop clinical signs from equine viral arteritis?

A

clinical signs develop 3-7 days post infection

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19
Q

what clinical signs are seen in horses with equine viral arteritis?

A

edema!!!! periorbital, limbs, prepuce, scrotum, mammary glands, & ventrum

fever, anorexia, urticaria, nasal discharge, & abortion

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20
Q

how is equine viral arteritis spread?

A

aerosol or venereal contact

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21
Q

what is the pathogenesis of equine viral arteritis?

A

aerosol or venereal contact

virus replicates in the intima media of the arteries

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22
Q

T/F: stallions can become asymptomatic carriers of EVA (virus found in the accessory sex glands)

A

true

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23
Q

how do mares & geldings react to equine viral arteritis?

A

usually recover & eliminate the virus quickly

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24
Q

what happens to a pregnant mare that catches equine viral arteritis?

A

may abort during or shortly after acute illness or asymptomatic infection

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25
Q

T/F: equine viral arteritis is reportable in many states

A

true

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26
Q

T/F: a horse vaccinated against equine viral arteritis will have positive results for any diagnostic testing

A

true - they will be seropositive for life

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27
Q

what clinical signs are seen in horses with equine viral arteritis?

A

fever, lethargy, edema, conjunctivitis, nasal discharge, & abortions

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28
Q

what diagnostic testing is used for equine viral arteritis?

A

virus is not involved in respiratory secretions, so instead use a PCR/ELISA on blood, semen, & tissue (paired serum neutralizing assay 4x rise) & stallions, breeding them to seronegative mares & testing for seroconversion from semen

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29
Q

what is the global effect of EVA?

A

affects transport & exports of animals & semen

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30
Q

how is EVA prevented?

A

only breed carrier stallions to well vaccinated mares & isolate carrier stallions

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31
Q

how is the EVA MLV used?

A

used in breeding animals in endemic areas

protects negative stallions from infection/becoming carriers, given prior to the start of breeding season or at 6-12 months of age

protects negative mares that are bred with positive stallions

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32
Q

what ticks transmit equine granulocytic erhlichiosis? what cells are affected?

A

ixodes ticks - rickettsial disease, anaplasma phagocytophilia

tropism for neutrophils & eosinophils

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33
Q

T/F: equine granulocytic ehrlichiosis is a self-limiting disease that doesn’t affect younger horses as severely

A

true

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34
Q

what are the early signs seen in equine granulocytic erhlichiosis? what about signs that are seen as the disease progresses?

A

fever of unknown origin (102-106°)

limb edema, reluctance to move, weakness, ataxia, tachycardia, petechiation, & icterus

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35
Q

you see this on a blood smear of a horse that has limb edema, ataxia, & weakness - what are you concerned about?

A

equine granulocytic ehrlichiosis/anaplasma

inclusion bodies/morulae in the neutrophils

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36
Q

how is equine granulocytic ehrlichiosis diagnosed?

A

cbc - thrombocytopenia, mild anemia (IMHA, extravascular)

blood smear - inclusion bodies/morulae seen in the neutrophils

PCR on the buffy coat, IFAT

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37
Q

how is anaplasma/equine granulocytic ehrlichiosis treated?

A

oxytetracycline

38
Q

where do we find AST & CK in the body? which one rises more rapidly?

A

AST - liver & muscle

CK - skeletal muscle, rises more rapidly than AST

39
Q

what causes pigmenturia? how do you differentiate between hematuria, hemoglobinuria, & myoglobinuria?

A

centrifuge it - hematuria will have blood settle at the bottom

hemoglobinuria & myoglobinuria - don’t have RBC present

40
Q

what is a normal PCV/TP in an adult horse?

A

PCV: 37-42%

TP: 65-75

41
Q

why do we do a coggins test annually on horses?

A

looking for equine infectious anemia - >90% of horses are NON-CLINICAL

42
Q

what kind of virus causes equine infectious anemia?

A

RNA, retrovirus, lifelong virus

43
Q

how is equine infectious anemia spread?

A

blood borne - needles, biting flies, tabanids, etc

44
Q

what acute clinical signs are seen with equine infectious anemia?

A

fever, thrombocytopenia, bleeding/hemorrhage, death (though some horses recover)

45
Q

what chronic clinical signs are seen with equine infectious anemia?

A

lymphadenopathy, weight loss, anorexia, & intermittent fever

46
Q

what is the gold standard for diagnosing equine infectious anemia?

A

agar gel immunodiffusion (AGID)

47
Q

what are the federally accepted testing methods used for equine infectious anemia?

A

AGID - P26 Ig

C ELISA (fast) - P26 Ig

SA - ELISA - Gp45 Ig

48
Q

what states are high risk for equine infectious anemia?

A

TEXAS!!!! oklahoma, louisiana, & arkansas

49
Q

what do you do if you have a seroreactor horse that is identified for equine infectious anemia?

A

all in contact horses are quarantined & tested every 30 days (two negative tests are required for release from quarantine)

seroreactor is either euthanized or permanently quarantined at least 200 yards away from all other horses

50
Q

how is equine infectious anemia prevented?

A

annual testing for all horses (coggins)

fly control

don’t reuse needles!!!!

51
Q

what agents cause equine piroplasmosis? how are they transmitted?

A

babesia caballi & theileria equi

babesia caballi - transmitted vertically

theileria equi - transmitted horizontally

52
Q

what ticks transmit equine piroplasmosis?

A

dermacentor sp. - potential for USA spread

hyalomma spp

rhipicephalus spp

53
Q

what agent causes a more pathogenic disease of equine piroplasmosis?

A

theileria equi

54
Q

T/F: all equids, including donkeys & zebras, are susceptible to equine piroplasmosis & once infected, are infected for life

A

true

55
Q

what are the main clinical signs seen in equine piroplasmosis?

A

fever & hemolytic anemia are the big ones!!!

icterus, hemoglobinuria, anorexia, lacrimation, incoordination, nasal discharge, eyelid swelling, recumbency, colic, & death

56
Q

how is equine piroplasmosis diagnosed?

A

blood smear - giemsa stain

serology - CFT, cELISA, IFA

57
Q

what does it mean if you see this on a blood smear of a horse with fever & hemolytic anemia?

A

maltese cross - infection with theileria equi causing equine piroplasmosis!!!

58
Q

how is equine piroplasmosis treated?

A

imidocarb to eliminate carrier status - beware of toxic doses in donkeys!

59
Q

why use flow cytometry for a horse with hemolytic anemia?

A

use flow cytometry to quantify the percentage of antibody coated cells in the sample (IgG, IgM, IgA) - clue you in to IMHA but won’t differentiate between primary & secondary

60
Q

you run an ECG & cardiac troponin I test on a horse with marked tachycardia, marked/progressive limb & ventral edema, grade 4/5 LH lameness, acute & marked anemia, icterus, & pigmenturia - you see this on ECG & get a cardiac troponin I of 41.83 ng/mL (reference is 0-0.07 ng/mL)

what do you see that is concerning?

A

ventricular premature complexes & evidence of myocarditis!!!!

concerned about purpura hemorrhagica

61
Q

what pathology does purpura hemorrhagica cause in horses?

A

aseptic necrotizing vasculitis

62
Q

what type of hypersensitivity reaction is purpura hemorrhagica?

A

type III - acute, immune complexes deposited places

deposition of immune complexes in blood vessel walls (IgA)

63
Q

purpura hemorrhagica is most commonly associated with infection from what bacteria?

A

strep equi equi

64
Q

what is seen on histology of purpura hemorrhagica?

A

leukocytoclastic vasculitis (a bunch of neutrophils)

65
Q

what is infarctive purpura hemorrhagica in horses?

A

immune-mediated vasculitis with infarction of:

skeletal & cardiac muscle

skin

gi - most severe & fatal colic

lungs

66
Q

what is important about MRSA & staph associated purpura hemorrhagica?

A

staph superantigens cause a massive stimulation of T cells & production of cytokines that cause tissue damage such as:

IL-1B, IL-2, IL-6, IL-8, & TNF-a

also causes polyclonal production of IgA & IgG which leads to immune complex formation

67
Q

how is purpura hemorrhagica treated?

A

remove the inciting cause!!! & dexamethasone at 0.1-0.2 mg/kg followed with a tapering dose

abx, laminitis treatment, NSAIDs, vitamin e, supportive care

68
Q

what is the most common hematopoietic neoplasia in horses?

A

lymphoma

69
Q

T/F: in the horse, there is no form of lymphoma that isn’t malignant

A

true

70
Q

what lymphoma types are most common in the horse?

A

t-cell rich b-cell or t-cell lymphoma

71
Q

what is the median age in which we see lymphoma in horses?

A

10 years old but can occur at any age

72
Q

what may lymphoma be associated with in horses?

A

may be an association with EHV-5 or IgM deficiency

73
Q

what is the prevalence of lymphoma in horses?

A

2-5%

74
Q

what are the 4 forms of lymphoma seen in horses?

A
  1. multicentric/generalized - 83% of cases, 2+ organ systems affected
  2. cutaneous - 19% of cases, firm slowly progressive non-painful masses that wax & wane
  3. alimentary - most common neoplasia of the alimentary tract in horses (IBD), if small intestines are affected, use altered glucose absorption tests & biopsy to diagnose
  4. mediastinal/thymic - most common thoracic neoplasia in the horse, dysphagia or pleural effusion may be present
75
Q

what is the most common thoracic neoplasia seen in horses?

A

mediastinal/thymic lymphoma

76
Q

what are the most common clinical signs of lymphoma in the horse?

A

weight loss is the most common presentation

lethargy, pyrexia, lymphadenopathy, edema, diarrhea/colic/IBD

77
Q

what clinical signs may indicate paraneoplastic syndrome in a horse with lymphoma?

A

pruritus, alopecia, hypercalcemia, IMHA, & IMTP

78
Q

how is lymphoma diagnosed in horses?

A

molecular clonality assay - PCR for antigen receptor rearrangement (PARR) clonality testing

hematology/biochemistry - hyperglobulinemia!!!!! anemia, leukocytosis/neutrophilia, hyperfibrinogenemia, hypoalbuminemia (PLE), & may see leukemia (rare)

79
Q

what is the prognosis of lymphoma in horses?

A

guarded

80
Q

how is lymphoma treated in horses?

A

surgical excision followed by radiation therapy that is deep on the location affected

medical therapy - steroids (palliative) high dose pulse therapy

chemo - doxorubicin, but risk of toxicity

81
Q

what are 3 potential causes of ulcerative lymphangitis in horses?

A
  1. corynebacterium pseudotuberculosis
  2. streptococcus equi spp zooepidemicus
  3. sporothrix schenckii
82
Q

are lymph nodes typically involved in ulcerative lymphangitis in horses?

A

NOPE

83
Q

because equine viral arteritis has a significant impact on the breeding industry, what 2 types of animals should you consider vaccinating against it?

A
  1. negative breed stallions - protect them from infections & becoming carriers, vaccinate prior to the start of breeding season or at 6-12 months of age
  2. negative mares bred to positive stallions - protect negative mares
84
Q

you are treating a horse with a fever of unknown origin & limb edema, and you suspect anaplasma - in what cell type on the blood smear do you expect to be able to see morulae?

A

neutrophils

85
Q

what type of viruses cause EIA, and why is this important in regards to testing & disease control? what is the gold standard, federally accepted test?

A

RNA, retrovirus, so lifelong infection!!!!! need to test yearly, & euthanize or isolate animals forever

AGID is the gold standard

86
Q

what 2 hemoparasites are associated with equine piroplasmosis in horses? which one is more pathogenic?

A
  1. babesia caballi, vertically transmitted
  2. theileria equi, horizontally transmitted

theileria equi is more pathogenic

87
Q

purpura hemorrhagic is most commonly associated with what infectious disease/vaccine?

A

strep equi spp. equi

88
Q

is equine lymphoma generally t-cell or b-cell? what about cattle?

A

horses - t cell rich b-cell & t-cell

cattle - diffuse large b cell lymphoma

89
Q

what are the most common clinical signs of lymphoma seen in the horse?

A

weight loss is most common

lymphadenopathy, IBD signs, respiratory signs/dysphagia

90
Q

what do you think is wrong with this 10 year old horse with a history of unexplained weight loss?

A

lymphoma

91
Q

a client brings you their stallion draft horse that has waxing & waning peripheral edema in their hindlimbs that began at an early age - what do you tell them about what’s going on & if they are wanting to breed this stallion?

A

chronic progressive lymphedema - there is no cure

don’t breed this horse because there is a potential breed/genetic related component to the disease

92
Q

what differential should you always consider if you have a horse present with fever, thrombocytopenia, & lymphadenopathy?

A

equine infectious anemia

LA DX & TX II (44 decks)

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