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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
T/F: equine viral arteritis is reportable in many states
true
26
T/F: a horse vaccinated against equine viral arteritis will have positive results for any diagnostic testing
true - they will be seropositive for life
27
what clinical signs are seen in horses with equine viral arteritis?
fever, lethargy, edema, conjunctivitis, nasal discharge, & abortions
28
what diagnostic testing is used for equine viral arteritis?
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
29
what is the global effect of EVA?
affects transport & exports of animals & semen
30
how is EVA prevented?
only breed carrier stallions to well vaccinated mares & isolate carrier stallions
31
how is the EVA MLV used?
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
32
what ticks transmit equine granulocytic erhlichiosis? what cells are affected?
ixodes ticks - rickettsial disease, anaplasma phagocytophilia tropism for neutrophils & eosinophils
33
T/F: equine granulocytic ehrlichiosis is a self-limiting disease that doesn't affect younger horses as severely
true
34
what are the early signs seen in equine granulocytic erhlichiosis? what about signs that are seen as the disease progresses?
fever of unknown origin (102-106°) limb edema, reluctance to move, weakness, ataxia, tachycardia, petechiation, & icterus
35
you see this on a blood smear of a horse that has limb edema, ataxia, & weakness - what are you concerned about?
equine granulocytic ehrlichiosis/anaplasma inclusion bodies/morulae in the neutrophils
36
how is equine granulocytic ehrlichiosis diagnosed?
cbc - thrombocytopenia, mild anemia (IMHA, extravascular) blood smear - inclusion bodies/morulae seen in the neutrophils PCR on the buffy coat, IFAT
37
how is anaplasma/equine granulocytic ehrlichiosis treated?
oxytetracycline
38
where do we find AST & CK in the body? which one rises more rapidly?
AST - liver & muscle CK - skeletal muscle, rises more rapidly than AST
39
what causes pigmenturia? how do you differentiate between hematuria, hemoglobinuria, & myoglobinuria?
centrifuge it - hematuria will have blood settle at the bottom hemoglobinuria & myoglobinuria - don't have RBC present
40
what is a normal PCV/TP in an adult horse?
PCV: 37-42% TP: 65-75
41
why do we do a coggins test annually on horses?
looking for equine infectious anemia - >90% of horses are NON-CLINICAL
42
what kind of virus causes equine infectious anemia?
RNA, retrovirus, lifelong virus
43
how is equine infectious anemia spread?
blood borne - needles, biting flies, tabanids, etc
44
what acute clinical signs are seen with equine infectious anemia?
fever, thrombocytopenia, bleeding/hemorrhage, death (though some horses recover)
45
what chronic clinical signs are seen with equine infectious anemia?
lymphadenopathy, weight loss, anorexia, & intermittent fever
46
what is the gold standard for diagnosing equine infectious anemia?
agar gel immunodiffusion (AGID)
47
what are the federally accepted testing methods used for equine infectious anemia?
AGID - P26 Ig C ELISA (fast) - P26 Ig SA - ELISA - Gp45 Ig
48
what states are high risk for equine infectious anemia?
TEXAS!!!! oklahoma, louisiana, & arkansas
49
what do you do if you have a seroreactor horse that is identified for equine infectious anemia?
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
how is equine infectious anemia prevented?
annual testing for all horses (coggins) fly control don't reuse needles!!!!
51
what agents cause equine piroplasmosis? how are they transmitted?
babesia caballi & theileria equi babesia caballi - transmitted vertically theileria equi - transmitted horizontally
52
what ticks transmit equine piroplasmosis?
dermacentor sp. - potential for USA spread hyalomma spp rhipicephalus spp
53
what agent causes a more pathogenic disease of equine piroplasmosis?
theileria equi
54
T/F: all equids, including donkeys & zebras, are susceptible to equine piroplasmosis & once infected, are infected for life
true
55
what are the main clinical signs seen in equine piroplasmosis?
fever & hemolytic anemia are the big ones!!! icterus, hemoglobinuria, anorexia, lacrimation, incoordination, nasal discharge, eyelid swelling, recumbency, colic, & death
56
how is equine piroplasmosis diagnosed?
blood smear - giemsa stain serology - CFT, cELISA, IFA
57
what does it mean if you see this on a blood smear of a horse with fever & hemolytic anemia?
maltese cross - infection with theileria equi causing equine piroplasmosis!!!
58
how is equine piroplasmosis treated?
imidocarb to eliminate carrier status - beware of toxic doses in donkeys!
59
why use flow cytometry for a horse with hemolytic anemia?
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
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?
ventricular premature complexes & evidence of myocarditis!!!! concerned about purpura hemorrhagica
61
what pathology does purpura hemorrhagica cause in horses?
aseptic necrotizing vasculitis
62
what type of hypersensitivity reaction is purpura hemorrhagica?
type III - acute, immune complexes deposited places deposition of immune complexes in blood vessel walls (IgA)
63
purpura hemorrhagica is most commonly associated with infection from what bacteria?
strep equi equi
64
what is seen on histology of purpura hemorrhagica?
leukocytoclastic vasculitis (a bunch of neutrophils)
65
what is infarctive purpura hemorrhagica in horses?
immune-mediated vasculitis with infarction of: skeletal & cardiac muscle skin gi - most severe & fatal colic lungs
66
what is important about MRSA & staph associated purpura hemorrhagica?
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
how is purpura hemorrhagica treated?
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
what is the most common hematopoietic neoplasia in horses?
lymphoma
69
T/F: in the horse, there is no form of lymphoma that isn't malignant
true
70
what lymphoma types are most common in the horse?
t-cell rich b-cell or t-cell lymphoma
71
what is the median age in which we see lymphoma in horses?
10 years old but can occur at any age
72
what may lymphoma be associated with in horses?
may be an association with EHV-5 or IgM deficiency
73
what is the prevalence of lymphoma in horses?
2-5%
74
what are the 4 forms of lymphoma seen in horses?
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
what is the most common thoracic neoplasia seen in horses?
mediastinal/thymic lymphoma
76
what are the most common clinical signs of lymphoma in the horse?
weight loss is the most common presentation lethargy, pyrexia, lymphadenopathy, edema, diarrhea/colic/IBD
77
what clinical signs may indicate paraneoplastic syndrome in a horse with lymphoma?
pruritus, alopecia, hypercalcemia, IMHA, & IMTP
78
how is lymphoma diagnosed in horses?
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
what is the prognosis of lymphoma in horses?
guarded
80
how is lymphoma treated in horses?
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
what are 3 potential causes of ulcerative lymphangitis in horses?
1. corynebacterium pseudotuberculosis 2. streptococcus equi spp zooepidemicus 3. sporothrix schenckii
82
are lymph nodes typically involved in ulcerative lymphangitis in horses?
NOPE
83
because equine viral arteritis has a significant impact on the breeding industry, what 2 types of animals should you consider vaccinating against it?
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
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?
neutrophils
85
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?
RNA, retrovirus, so lifelong infection!!!!! need to test yearly, & euthanize or isolate animals forever AGID is the gold standard
86
what 2 hemoparasites are associated with equine piroplasmosis in horses? which one is more pathogenic?
1. babesia caballi, vertically transmitted 2. theileria equi, horizontally transmitted theileria equi is more pathogenic
87
purpura hemorrhagic is most commonly associated with what infectious disease/vaccine?
strep equi spp. equi
88
is equine lymphoma generally t-cell or b-cell? what about cattle?
horses - t cell rich b-cell & t-cell cattle - diffuse large b cell lymphoma
89
what are the most common clinical signs of lymphoma seen in the horse?
weight loss is most common lymphadenopathy, IBD signs, respiratory signs/dysphagia
90
what do you think is wrong with this 10 year old horse with a history of unexplained weight loss?
lymphoma
91
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?
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
what differential should you always consider if you have a horse present with fever, thrombocytopenia, & lymphadenopathy?
equine infectious anemia

LA DX & TX II (44 decks)

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