Exam 3 (horses)

Question 1

Normal Estrus Cycle in Mares, estrus cycle length, length of estrus, length of diestrus

Answer 1

o Long day breeders (April- October)
o Photoperiodic control of reproduction

Estrous cycle length
 21 days

Length of estrus
 7 days (3 to 12 days)
 Ovulation occurs in the last 24 to 48 hours of estrus
 Estrogen causes uterine edema

Length of diestrus:
 14–15 days
 Progesterone causes max uterine tone

Question 2

Basics of Advancing Horse Breeding Season

Answer 2

o Start 60 days before desired breeding date
o Apply 16 hours of light per day
o 10 foot-candles at mare eye level, mare w/in 8 feet of 200 watt incandescent bulb, or mask
o Stallion needs to be on light
o light+ progesterone OR
o light + progesterone + GnRH OR
o Light + Dopamine antagonist

Question 3

Using Progesterone to Advance Breeding Season

Answer 3

o Used if mare is not transitioning fast enough

Short acting progesterone
 Average days to estrus: 4-7
 Average days to ovulation: 7-12

Long-acting progestogen
 Ovulation at 18 – 26 days

Question 4

Horse Breeding Options

Answer 4

o Natural cover (required for some breeds)
o Cooled semen (most common)
o Frozen semen
o Embryo transfer
o Oocyte transfer

Question 5

Requirements for Shipping Equine Semen in WA

Answer 5

o Current Coggins test and health certificate
o Negative EVA test from the current calendar year or proof of vaccination
o Semen permit number issued by the WSDA
o Semen evaluation paperwork

Question 6

How to Naturally Breed Horses

Answer 6

Pasture mating
 high risk for mares and stallions

In-hand mating (old approach)
 Tease and breed mare every 48 hours starting on the 3rd day of estrus
 Never go beyond 12 days of estrus

In-hand mating (modern approach)
 Limit # breeding in mares susceptible to endometritis
 Efficient use of stallions
 Use Minimum contamination breeding technique
 Monitor follicular growth and induce ovulation
 Breed at the time of induction of ovulation or 24 hours later

Question 7

When to Induce Ovulation & Timing of Artificial Insemination in the Mare

Answer 7

o Mare is monitored by ultrasonography

When to Induce Ovulation Pharmacologically
 Follicle > 30 mm (GnRH, Deslorelin)
 Follicle >35 mm (hCG)
 Presence of uterine edema

Timing of insemination
 Cooled shipped semen: 24 hours post induction (12 to 24 hours before ovulation)
 Frozen semen: 2 doses 24 and 40 hours post induction OR 1 dose after ovulation

Question 8

Drugs for Induction of Ovulation

Answer 8

Human chorionic gonadotrophin (hCG)
 LH activity
 Can cause anaphylactic reactions
 Less efficacious if repeated
 Ovulation in 24 to 48 hours

Deslorelin
 GnRH analogue
 ovulation in 42-52h

Question 9

Endometritis After Insemination

Answer 9

o Check ultrasound 24hrs post insemination for ovulation & fluid accumulation
o All mares will have some endometritis after breeding (insemination)
o NOT normal to have persistent endometritis

Question 10

Pregnancy Diagnosis in Mare; day 14, 25, 56, 90

Answer 10

14 days post-ovulation
 Check for double ovulation and twins
 Check quality of CL
 Place high risk mares on Progesterone therapy

25-30 days
 Fetal heartbeat

56-65 days
 Fetal sexing

90 –100 days
o Check mares w/ repro problems

o Check at 5 months

Question 11

Nutritional Care of Pregnant Mare

Answer 11

Up to 8mo
 Feed 1.5-2% BW

Last trimester
 Fetal grows 1lb /day
 Feed 2.25-2.5% BW
 Total protein of 12-14%
 Ca/P ratio 1.2- 1.5:1

Question 12

Vaccines / Deworming for Pregnant Mare

Answer 12

4- 6 weeks before due date
 Influenza
 Eastern and Western encephalitis
 Tetanus
 Rabies
 West Nile virus

5, 7, & 9 months of pregnancy
 Equine Herpesvirus 1 (EHV-1, Rhinopneumonitis)

Other Vaccines
 Botulism
 Rotavirus
 Streptococcus equi

Deworming
 Ivermectin 10 days before due date

Question 13

Equine Coital Exanthema; Transmission, Clinical Signs, Diagnosis, Treatment

Answer 13

o EHV-3

Transmission
 Direct contact with lesions
 Mechanical (instruments, personnel)
 Incubation 5 to 9 days

Clinical Signs
 Small (2-3 mm) papules progressing to pustules then ulceration on vulva & prepuce
 Erosions with scab
 Heal in 2-3 weeks
 Stallions have decreased libido

Diagnosis
 Serology
 Viral inclusion
 PCR

Treatment
 Ganciclovir bid for 13 days reduce severity of lesions and duration of excretion
 Do not breed until lesions heal

Question 14

Equine Viral Arteritis; Epidemiology, Transmission, Clinical Signs, Diagnosis, Prevention

Answer 14

Epidemiology
 Worldwide distribution
 Endemic in US, Standardbred population
 Reportable disease in 40 states
 Virus is androgen dependent
 Stallions can be lifelong carriers

Transmission
 Main source Shedding stallions
 Aerosol
 Vertical
 Fomites

Clinical Signs
 Incubation 2-14 days
 Edema due to arteritis
 vasculitis
 Fever
 Respiratory disease
 Abortion 8 to 30 days post infection @ 3-10mo old
 Foal can be born infected

Diagnosis
 Serology
 Virus isolation in semen

Prevention
 Vaccination of stallions
 Annual booster no less than 3-4 weeks prior to breeding
 Vaccination of mares bred to infected stallions
 Only breed to EVA negative stallions
 Horses need to be isolated for 3 weeks following vaccination

Question 15

Contagious Equine Metritis; Agents, Etiology, Clinical Signs

Answer 15

Agents
 Taylorella equigenitalis
 Taylorella asinigenitalis (donkeys)
 Gram (-) microaerophilic coccobacillus

Etiology
 Reportable
 Transmitted thru venereal from carrier stallions, fomite, or vertical

Clinical Signs
 No signs in stallions
 Copious gray vaginal discharge within 24-72 hours (persists for one cycle)
 Cervicitis persists longer and positive cultures may be obtained for as long as 6 weeks
 Endometritis, salpingitis
 Infertility
 Pregnancy loss

Question 16

Contagious Equine Metritis; Diagnosis

Answer 16

 Culture requires special media
 Serology not recommended
 PCR is now the gold standard (University of Kentucky)
 Test imported stallions
 Breed and test if mares become positive

Sample Location
* Clitoral fossa, sinus, or vaginal discharge form mares
* Pre-ejaculatory fluid
* Semen
* Urethral & fossa swab in stallion

Question 17

Contagious Equine Metritis; Treatment

Answer 17

Stallions
* Wash penis daily for 5 days w/ 5% chlorhexidine gluconate ->
* rinse and pack with nitrofurazone ointment ->
* parenteral penicillin ->
* re-culture 7 days after

Mares
* Intrauterine: Penicillin, ampicillin
* Clean the clitoral fossa and flush clitoral sinus: chlorhexidine gluconate 4%, pack with nitrofurazone 0.2% or silver sulfadiazine 1%
* Clitoral sinusectomy

Question 18

Dourine; Agent, Epidemiology, Clinical Signs, Diagnosis, Treatment

Answer 18

Agent
 Trypanosoma equiperdum
 Protozoa

Epidemiology
 Venereal disease
 No vectors known
 Reportable disease

Clinical Signs
 Slow to develop (up to 20 weeks)
 Genital edema, vaginal or urethral discharge, weight loss ->
 Fever, edema and ulceration of external genitalia, Cutaneous plaques (silver dollar), Ventral edema ->
 Anemia, neurologic disorders, paresis, death

Diagnosis
 CF test
 PCR

Treatment
 Euthanasia

Question 19

Contraception Options in Horses

Answer 19

o Owner education
o Ovariectomy
o Immunization against GnRH (very good but not available in US)
o tubal ligation
o vasectomy of stallions

Question 20

Options for Estrus Suppression in Mares

Answer 20

Altrenogest
 Ovarian activity will continue
 0.044 mg/kg

Progesterone
 Ovarian activity will continue
 0.2 mg/kg

Glass marbles
 poor efficacy, dangerous, counter-indicated

Oxytocin injections
 Downregulates ability to produce PGF2-alpha
 efficacy 70%, 45 to 50 days
 60 IU, IM SID from day 7 to day 14 after ovulation
 60 IU, IM SID for 30 days

Question 21

Granulosa-theca Cell Tumor; Basics, Clinical Signs, Diagnosis

Answer 21

o Most common ovarian tumor in the mare
o Typically benign, slow growing, non-metastatic
o Affected ovary is large and non-affected ovary is very small

Clinical Signs
 Stallion-like, aggressive (most common)
 Anestrus
 Nymphomania

Diagnosis
 Transrectal palpation (different size ovaries)
 Transrectal ultrasonography
 Testosterone >100 pg/mL
 Inhibin >0.8 ng/mL
 Anti-Mullerian Hormone 3.8-8.0 ng/mL (diagnostic >8)

Question 22

Anestrus Due To Persistent Corpus Luteum; Basics, Treatment

Answer 22

o Diestrus can last 60 to 90 days
o Normal ovarian size but CL present
o Uterus has tone (no pregnancy)

Treatment
 PGF2α (Dinoprost thrometamine – may cause colic)
 PGF2α Analogue (cloprostenol, less side effects)
 Spontaneous recovery possible

Question 23

Anestrus Due To Persistent Endometrial Cups; Basics, Diagnosis

Answer 23

o Embryonic Death (>35 days)
o Endometrial cups already formed

Diagnosis
 Normal genital tract on palpation
 eCG (commercial kits)
 Biopsy or hysteroscopy
 Check for reasons of embryonic loss: Fibrosis, metritis, iatrogenic

Question 24

Anestrus Due to Ovarian Tumors

Answer 24

o Not very common
o Granulosa-Theca cell tumor (GTCT)
o Luteoma (rare)
o Need to differentiate from other causes of ovarian enlargements

Question 25

Reasons for Abnormal Estrus Cycle in the Mare

Answer 25

Abnormal interval between ovulations  Aging  Anovulatory hemorrhagic follicles  Unilaterally functional ovary? Abnormal duration of estrus  Short or Split-heat (common in transitional mares)  Long estrus (NO OVARIAN FOLLICULAR CYSTS IN THE MARE!!!) Abnormal duration of the luteal

Question 26

Reasons for Abnormal Luteal Function in the Mare

Answer 26

Failure of ovulation  Anovulatory hemorrhagic follicle  Equine metabolic disease Short luteal phase  Early release of PGF2α from the endometrium (endometritis, intrauterine treatment)  Abnormal corpus luteum function Lengthened luteal phase  Persistent CL with spontaneous recovery  Early embryonic death

Question 27

Oviductal Mass in the Mare; What, Diagnosis, Treatment

Answer 27

o Failure to fertilize o Type I collagen o At the ampulla-isthmus junction Diagnosis  By exclusion of all other causes Treatment  Application of PGE2 onto the oviduct (laparoscopy)  Application of PGE1(misoprostol) by intrauterine infusion  Hydrotubation (hysteroscopy)

Question 28

Early Embryonic Loss

Answer 28

 If the embryo dies before Day 14-15, the mare will return to estrus within a normal interval  Embryo quality  Uterine environment (MOST common)  Abnormal hormonal environment

Question 29

Uterine Cysts; Factors, Origin, Effect on Fertility, Treatment

Answer 29

Factors * Aged mares Origin * Vascular changes * Lymphatic cysts Effect on fertility * Reduced embryo mobility * Abnormal placentation * Compromised cervical tone Treatment * Aspiration * Cauterization, laser ablation

Question 30

Endometriosis; Risk Factors, DIagnosis

Answer 30

Major cause of infertility in mare o Risk Factors  Older  Breed  Abnormal anatomy  Endocrine disorders (PPID, metabolic syndrome etc) Diagnosis  Large thick edematous uterus, Overt uterine edema, & Intrauterine fluid accumulation found on transrectal palpation and ultrasound  Cervicitis or fluid in the vagina/discharge on Vaginal exam  Endometrial cytology >2PMNs per high power field  Endometrial culture (best to culture from biopsy)  Biopsy (GOLD STANDARD)

Question 31

Endometritis; Common Agents, Treatment

Answer 31

Common Agents  Strep  E. coli  Pseudomonas  Klebsiella  Can have fungus as well Treatment  Correction of predisposing factors (caslicks etc)  Intrauterine antibiotics  Uterine lavage  Elimination of biofilm  Immunostumulation  Systemic antibiotics  Anti-inflammatories  Breeding management

Question 32

Endometritis; Antibiotic Choice

Answer 32

 Culture and sensitivity results and disposition in uterine tissue  Do not mix antibiotics unless synergistic effect well documented  Amikacin & gentamycin need to be buffered  Enrofloxacin & Baytril® very harmful  Infuse daily for 4 to 5 days  Volume depends on size of the uterus  Maiden mares: 35 to 50 ml  Older mares: 60 to 150 ml  May need to treat vagina and clitoral sinuses

Question 33

Treatment of Fungal Endometritis

Answer 33

 Correction of anatomical defects  Uterine lavage  Uterine infusion w/ 250 ml 2% acetic acid for 3 to 4 minutes  Systemic +/- topical antifungals  Topical treatment of vagina and clitoris  Azoles or Polyenes

Question 34

Persistent Mating Induced Endometritis; Treatment

Answer 34

Oxytocin * 10-20 IU, IM (3 to 4 times /day starting 4 hours post AI) Carbectocin * Long acting oxytocin analogue (not available in the USA) Cloprostenol * 250 μg IM, 4 to 8 hours post AI * More sustained uterine contractions compared to oxytocin * Premature luteolysis if given frequently or used more than 2 days post-ovulation

Question 35

"Old Maiden Mare Syndrome”; Factors, Treatment

Answer 35

Factors  Tight cervix  Fluid accumulation pre and post insemination Treatment  Relax cervix  Topical PGE1 (misoprostol)  Topical N-butylscopolammonium bromide

Question 36

Pyometra; Causes, Clinical SIgns, DIagnosis, Treatment

Answer 36

Causes  Cervical stenosis or fibrosis  Vaginal adhesions  Prolonged progesterone treatment  CL not always present Clinical Signs  Intermittent purulent discharge  Overdue  Anestrus Diagnosis  Transrectal palpation  ultrasonography Treatment  Broodmare * oocyte aspiration  Pleasure mare * Ovariectomy * Ovariohysterectomy * Cervical stent * Cervical wedge resection

Question 37

Uterine Masses/Neoplasias; Tumors, Clinical Signs, Treatment

Answer 37

Tumors  Leiomyma (most common)  Adenocarcinoma  Lymphosarcoma Clinical Signs  Usually, solitary  Well-circumscribed  Involves myometrium Treatment  Large masses require partial hysterectomy (mares can still carry a pregnancy)

Question 38

Persistent Hymen

Answer 38

o Incidental finding in maiden mares o Accumulation of mucus in the vagina and uterus can bubble out of the vulva o Easily ruptured manually but may require surgical excision

Question 39

Mastitis; Clinical Signs, Diagnosis, treatment

Answer 39

o Usually occurs after weaning Clinical signs  Swollen, warm udder  Ventral edema  Fever  Hind limb lameness Diagnosis  Cytology and culture of milk  SerS. equi ous, serosanguinous or purulent  zooepidemicus most common isolate  Ultrasound Treatment  Systemic antibiotics,  NSAIDs  Frequent milking  Hot-packing or hydrotherapy

Question 40

Mammary Gland Neoplasia; Clinical Signs, Diagnosis, Treatment

Answer 40

o Adenocarcinoma is MOST common Clinical signs  Mammary gland enlargement  Pain  discharge  Skin lesions  Weight loss Diagnosis  Ultrasonography  Cytology (FNA)  Biopsy Treatment  Mastectomy  Chemo  Radiation

Question 41

"Witch’s Milk"

Answer 41

 Lactating Neonatal Fillies  Elevated lactogenic hormones of maternal origin in fetal circulation

Question 42

Galactorrhea; Basics, Treatment

Answer 42

 Milk production in non-pregnant /foaling mares  Elevated prolactin  Pituitary Pars Intermedia Dysfunction  Rule out mastitis Treatment * Treat PPID with pergolide or cyproheptadine * Treat others with pergolide or bromocriptine * decreased feed (protein and energy) * Do not milk out as it will stimulate more lactation

Question 43

Signs of impending pregnancy loss

Answer 43

o Irregular and indented vesicle o Fluid in the uterine lumen o Echogenic spots (speckling) of the embryonic vesicle o No fetal heartbeat o Poor definition of fetal structures o Increased echogenicity of fetal fluid o Largest diameter of the fetal vesicle is 2 standard deviation smaller than the mean of the age of pregnancy o Slow growth in size o Failure of fixation o Echogenic ring within the vesicle o Disorganized membranes and collapsed amnion o Increase edema and exaggerated endometrial folds o Presence of fluid surrounding the embryonic vesicle

Question 44

Fetal Heart Rate

Answer 44

o 1.5 to 1.8x that of the dam o Faster in early pregnancy o Decreases from 120 bpm in the first 3 months to 60 bpm in the last couple of weeks o Fetal activity and increased heart responses occur 48 to 72 hours prior to parturition

Question 45

Normal Combined Uteroplacental Thickness

Answer 45

o Seen on transrectal US 151-270 days  <7mm 271-300 days  <8mm 301-330 days  <10mm >331 days  <12mm

Question 46

Progesterone & Estrogen During Pregnancy

Answer 46

Progesterone/Progestogen  Main source in the first trimester is the Ovary  Main source past 80 days is the placenta  Don’t want to see large jumps or drops in progesterone levels  Progestin Decreases myometrial activity and prevents abortion  Progesterone peaks 24-48hrs prior to parturition Estrogens  From fetal gonads  Total estrogens should be > 1000 pg/ml

Question 47

Symptoms of Fetal Stress & Imminent Abortion

Answer 47

Fetal Stress o Persistent fetal tachycardia or bradycardia o Large or progressively enlarging areas of placental detachment o Rapid drop in progestins Imminent Abortion o Large or progressively enlarging areas of placental detachment o Premature mammary development and lactation

Question 48

Managing Compromised Pregnancy

Answer 48

Limit effect of prostaglandin  Flunixin acutely  Firocoxib longer term Ensure myometrial quiescence  Altrenogest  Isoxsuprine  Clenbuterol Antibiotics (placentitis)  TMS  Potassium Penicillin  Gentamicin Improve oxygenation and reduce effect of inflammation byproducts  Vit E  Pentoxifyline  Oxygen insufflation Support fetal metabolism  Dextrose

Question 49

Bacterial Abortion: Placentitis; Ascending Agents, Hematogenous Agents, Focal Agents

Answer 49

Ascendent agents  Streptococcus spp.  Staphylococcus spp.  E.coli  Klebsiella spp  Enterobacter spp.  Pseudomonas spp. Hematogenous Agents  Lepto Focal Agents  Nocardioform

Question 50

Bacterial Abortion: Placentitis; Clinical Signs

Answer 50

 Premature mammary gland development  Mucopurulent vaginal discharge (ascendant placentitis)  Persistent fetal tachycardia  Uteroplacental unit  Thickening of the uterine wall (>13 mm)  Increased CUPT (>17.5 mm)  Areas of placental separation on ultrasound  Increased total progestogen concentration  Decreased total estrogens  Elevation of acute phase proteins (Serum amyloid A and Haptoglobin)

Question 51

Leptospirosis; Clinical Signs of Mare & Fetus

Answer 51

Mare  Fever  Hematuria  Acute renal failure  Uveitis may develop weeks after abortion  Stillborn or weak foals  Mid to late term abortion (last 3 months of gestation)  Not all infected mares abort  Placentitis not involving cervical star Fetus: * Mild to moderate icterus * Liver enlargement, hepatitis * Tubulonephrosis and interstitial nephritis

Question 52

Leptospirosis; Diagnosis, Prevention

Answer 52

Diagnosis  Fetal and placental lesions  Fetal antibodies Isolated from placenta or renal tubules  Immunohistochemistry of the placenta umbilical cord or fetal kidney and liver  PCR  High-titers agglutinating antibody in mare (>1:6,400 often > 12,800) Prevention  Isolation of aborting mare for 14 to 16 weeks  Urine testing by FAT for shedding  Antibiotics for shedders  Limit exposure to stagnant water  Control of reservoir animals  Vaccine is available

Question 53

Nocardioform Placentitis; Clinical Signs

Answer 53

 Chronic placentitis  Late term abortion or premature birth, low birth weight  Severe exudative, mucopurulent, and necrotizing placentitis at the junction of the placental body and horns  Fetus severely underdeveloped

Question 54

EHV Abortions; Agents, Transmission, Clinical Signs, Diagnosis, Prevention

Answer 54

Agents  EHV-1 most common  EHV-4 possible but rare Transmission  Respiratory  Abortion may be stress related  May occur in vaccinated mares (reactivation of latent infection) Clinical Signs  Abortion usually 7 months to term  Abortion- fresh fetus  Fetuses > 8 moths present characteristic lesions particularly with EHV-1 Diagnosis  Necropsy of fetus  Virus isolation  PCR Prevention  Vaccine at 5, 7, 9 months of pregnancy  Separate pregnant mares form carriers

Question 55

Fungal Abortions; Agents

Answer 55

 Asper  Mucor

Question 56

Mare Repro Loss Syndrome

Answer 56

o Eastern Tent Caterpillars from cherry trees o Early & late fetal loss o Placentitis o Foal uveitis o Foal endocarditis

Question 57

Abortion & Twinning; Unilaterally Vs Bilaterally Fixed

Answer 57

Unilaterally Fixed  Usually reduced to one foal at 40 days Bilaterally Fixed  Mid to late term abortion of both  Premature foaling

Question 58

Abortion & Twinning; Diagnosis, Treatment

Answer 58

Diagnosis  Transrectal ultrasound up to 70 days  Don’t get confused w/ uterine cyst Treatment  Crush one of the oocysts

Question 59

Treatment Options for Twin Pregnancies Past 30 days & Past 65 Days

Answer 59

>30 Days  Transvaginal ultrasound guided aspiration of one vesicle  Intra-cardiac injection  Wait and see  Abort both and loose season >65  Transabdominal Intra-cardiac injection  Cervical dislocation  Surgical removal  Abort both and loose season  Complications

Question 60

Most Common Non-Infectious Causes of Abortion in Mare

Answer 60

Twins (most common cause of lawsuits) Umbilical cord torsion  Thoroughbreds  Cord longer than 90cm  Greater than 7 twists

Question 61

Uterine Torsion; Clinical Signs, Diagnosis, Treatment

Answer 61

Clinical Signs  Colic  ADR Diagnosis  Transrectal palpation Treatment  Mare on side of torsion -> plank on other side -> role at least 3 times  Midline laparotomy  Standing Flank laparotomy (preferred)

Question 62

Hydrops; Types, Diagnosis, Treatment

Answer 62

Hydrops allantois  Excessive accumulation of allantoic fluid Hydrops amnii  Excessive amount of amniotic fluid  edematous umbilical cord  abnormal fetus Diagnosis Diagnosis  Palpation  Girth measurement Treatment  Induction of abortion/parturition  Conservative management  Humane euthanasia

Question 63

nduction of Parturition & Termination of Pregnancy

Answer 63

o Manual cervical dilation o Allantochorion punctured with scissors o 34 Fr Foley Catheter with 100ml balloon into allantoic cavity o Controlled drainage o Ensure hydration

Question 64

Fescue Toxicity; Toxins, Endocrine Effects, Clinical Signs, Treatment

Answer 64

o Endophyte: Acremonium coenophialum o Alkaloids: Ergovaline, Loline Endocrine effects  Low plasma progesterone concentration  Low relaxin level Clinical effects  Prolonged gestation  Placental edema thickening  Premature placental separation (Red bag)  Abortion  Agalactia  Weak /immature foals Treatment  Remove from pasture  Domperidone

Question 65

Mustard Toxicity; Toxins, Endocrine Effects, Clinical Signs

Answer 65

o Brassica spp Endocrine effects  goitrogenic Clinical effects  Prolonged gestation  Mandibular prognathism  Poor development (prematurity signs)  Incomplete ossification of the cuboidal bones (very important for survival)  Flexural deformities of the forelimbs  Ruptured digital extensors  Hydrocephalus, patent urachus

Question 66

Body Wall Defects in the Mare; Causes, Diagnosis, Management

Answer 66

Causes  Severe ventral edema  Hernia  Prepubic tendon rupture  Rupture of the mammary ligament  Udder edema Diagnosis  Age  Look for PPID  Transrectal palpation  Ultrasound Management  Confine / control exercise  Control food and water intake  Symptomatic treatment in case of ventral wall edema  Support body wall  Pain management  Close monitoring for foaling  Induction of parturition when appropriate

Question 67

Equine Gestation Length

Answer 67

o 335-342 days o <320d = high risk foals

Question 68

Foaling Management

Answer 68

o Move to foaling location & open Caslick’s 4-6wks before expected foaling o Check mare frequently o Plan for colostrum supply o Educate client on expected behavior

Question 69

Biochemical Tests on Mammary Secretions for predicting and monitoring readiness for foaling

Answer 69

o Increase in Calcium (>200 ppm) o Decreased pH (<6.5) o Inversion of Na+/K+ (decrease in Na+ and increased K+)

Question 70

Clinical Signs of Imminent Parturition

Answer 70

o Pelvic ligaments relaxation o Elongation & edema of the vulva o Mammary development: Increase in size 1 month before parturition o Colostrum formation 1 to 3 days o Change in secretions o Waxing 24 to 48 hours before parturition

Question 71

What Happens During Stage 1, Stage 2, & stage 3 of Labor

Answer 71

Stage 1 of Labor o 1-4hrs o Myometrial contractions, increased oxytocin release o Restlessness o Tail switching o Looking at the flank o Frequent micturition, defecation o Laying down and getting up frequently o Yawing o Flehmen o Sweating (neck, shoulder, flank) o Foal turns from dorso-pubic to dorso-sacral presentation o Ends with rupture of the chorioallantois Stage 2 of Labor o 17-20 mins o Should not go beyond 30 mins o Passage of foal through the cervix into the birth canal o Powerful expulsive abdominal contractions Stage 3 of Labor o Placenta expelled inside out o Most mares deliver placenta within 45 minutes of foaling o Retained placenta if fetal membranes are not expelled within 3 hours

Question 72

Induction of Parturition; Risks, Requirements, Drugs

Answer 72

o Increased risk of foal hypoxia, retained placenta, and dystocia Requirements  Mares should be at least 330 days  Cervix should be relaxed  Mammary gland secretions 200 ppm Drugs  Oxytocin  bolus delivered in 60 mins  small dose  larger dose in 1L saline w/ slow infusion

Question 73

When to Intervene in Stage 1 & 2 of Labor

Answer 73

1st Stage of Labor  Increasing and more intense signs of discomfort w/out progression  Premature placental separation (“Red bag”) 2nd Stage  No progress 5 minutes after the appearance of the amniotic sac  Assess presentation, position, posture

Question 74

Approach for Standing Manipulation During Dystocia; Drugs, Ideal Reasons

Answer 74

Sedation  Xylazine + butorphanol  Detomidine + butorphanol Caudal epidural  5-8 ml of lidocaine 2%  Xylazine in 10 ml of 0.9% sterile saline  Combination of lidocaine 2% + Xylazine Uterorelaxant  Clenbuterol  Buscopan Ideal for  Some postural abnormalities  Uterine inertia (selenium deficiency)  large breeds  fetotomy  Keep manipulation to no more than 20 minutes

Question 75

Controlled Vaginal Delivery; Drugs, Timing, Reasons

Answer 75

o General anesthesia w/ xylazine, xylazine+butorphanol, ketamine, ketamine+diazepam o Hoist o Manipulation should be kept to 15 mins Reasons  Shoulder flexion  Ventral deviation of head & neck  Hock flexion  Unilateral and bilateral hip flexion

Question 76

C-Section

Answer 76

o Anterior presentation most common reason o Posterior presentation second most common reason o Sooner rather than later

Question 77

Fetotomy

Answer 77

o Ideally in standing position o Attempt only if one has experience with technique o Birth canal is wide enough and fetus is easily accessible and does not show severe abnormalities o Provide heavy sedation and caudal epidural anesthesia o Provide ample lubrication and give clear instruction to assistant o Well-planed cuts based on determination of the position and posture of the fetus. o Partial fetotomy (2 or less cuts) preferred o Supportive therapy intravenous fluids, broad spectrum antimicrobials, pain management, NSAIDs

Question 78

General Care Post-Dystocia; Foal, Mare

Answer 78

Foal  Resuscitation and routine foal care  Check for broken ribs Mare (see details in "postpartum disorders")  Monitor Defecation (fecal softener, mash, mineral oil)  Monitor Urination  Pain management  Uterine lavage  Tetanus prevention  Monitor temperature daily for at least 3 days  Monitor digital pulse

Question 79

Reproductive tract examination of the Post foaling mare

Answer 79

o Use vaginal speculum NOT tube speculum o Look for lesions to vaginal wall, urethral opening, & cervux o Manually feel the cervix for lesions o Red/brown discharge is normal lochia unless smelly o Look for symmetry of mammaries o Brix test on colostrum

Question 80

Postpartum Exam of Foals; Basics to look for, milestones

Answer 80

o Don’t handle TOO much or may be rejected by mare o Disinfect umbilicus w/ Chlorhex o Temp 99-101.5 o Check IgG for passive transfer at 12-18hrs Mile Stones  Spontaneous breathing w/in 1 min  Sternal in 1-2min  Suckling reflex w/in 2-20mins  Stand in 1-2hrs

Question 81

Neonatal Foal Distress Scoring

Answer 81

o Check at 1 minute and again at 4 mins post delivery o Normal foal will have 7-8 points o Depressed foal 4-6 points o Markedly depressed 0-3 Heart Rate  Absent = 0  <60 – 1 point  >60 – 2 points Respiration  Absent = 0  Slow/irregular = 1  >60 & regular = 2 Muscle Tone  Limp/floppy = 0  Some flexion = 1  Sternal = 2 Nasal Stimulation  No response = 0  Slight grimace = 1  Cough/sneeze = 2

Question 82

Postpartum & the Placenta

Answer 82

o Should be passed in 3hrs or less o Collect all fetal membranes & refrigerate Weight of placenta  Should be 9-12% of foal's weight  Heavy placenta may be indicative of placentitis  Light Placenta may indicate fetal abnormalities Examine Placenta for Completeness  Lay out in F shape w/ fetal uterine horn as long arm  Non-fetal horn has high chance of staying attached to mare  There is normal avillous chorionic surface at the cervical star and tips of the uterine horns

Question 83

Placental Abnormalities

Answer 83

o Plaques o Mucopurulent discharge o Avillous areas o Too small o Incomplete (emergency) o Placentitis (emergency) o Submit smears and/or culture of anything weird on placenta

Question 84

Normal Mare Timeline Postpartum

Answer 84

o Postpartum estrus at 5-7 days o Uterine involution by 7 days o Lochia reslved by 15 days o Fine to breed mare who is ovulating 10 days postpartum o Do not breed mares who are ovulating earlier than 10 days postpartum

Question 85

Instructions to Owner During Emergency

Answer 85

o Confine foal & mare to quiet area o Do not use sedatives on mares (hypotension is BIG risk) o Allow dead foal to stay w/ mare for ~3hrs o Bring placenta to hospital o Bring foal anywhere you take mare

Question 86

Evaluation of ADR Mare Post Foaling

Answer 86

o CBC/Chem o If mare is depressed, colicky, ataxic, not urinating, etc, ultrasound & abdominocentesis If a single parameter is changed:  increased TP, increase WBC or % neutrophils  monitor & repeat abdominocentesis in a few hrs If 2 parameters are changed  TP>30 g/L, WBC >15 x109/L, >80% neutrophils  immediate action is required

Question 87

Retained Placenta; Treatment

Answer 87

Oxytocin  10-20 IU every 2 hours  Or CRI 1IU/min  No Oxytocin needed if foal is alive & nursing Chorioallantoic distension (Burns technique)  Start w/ this technique if retained placenta is fresh  If uterus is tight/contracted give Buscopan first  Destend chorioallantoic sac w/ sterile saline  Results within 5 to 40 minutes  Evaluate Ca levels in non responsive mares and spike fluids with Ca gluconate if needed Umbilical vessel catheterization and infusion  Must be retained <8hrs  Oxytocin 10-20IU IM  Incise umbilical vessel & place stallion catheter inside  Connect water hose  Success w/in 5-10 mins

Question 88

Toxic (Septic) Metritis; Agents, Clinical Signs, Clin Path, Diagnosis, Treatment

Answer 88

Agents o E. coli o Klebsiella Clinical Signs o Retained Placenta for >6hrs o Thick brown foul smelling vaginal discharge o Endotoxemia o fever, depression, o tachycardia, o injected mucous membranes, o toxic line, o bounding digital pulses, o laminitis, o gastric reflux Clin Path o Hyperfibrinogiemia o Leukopenia/cytosis o Elevated TP & WBCs on abdominocentesis Diagnosis o Transrectal Ultrasound to look for fluid filled uterus and maybe retained tissues Treatment o Fluids o Flunixin o Systemic Iv antibiotics o Lavage, lavage, lavage uterus w/ warm fluids & salt o Monitor first lavage w/ ultrasound to ensure fluid isn’t leaking into abdomen thru a uterine tear

Question 89

Perineal Lacerations / Rectovaginal Tears; Degrees

Answer 89

First degree lacerations  Mucous membrane of the vestibule  skin of vulvar lip Second degree laceration  Vestibular mucosa & submucosa  skin of the dorsal commissure of the vulva and the perineal body muscle Third degree RV-tea8u  “Cloacal formation”  Rectal mucosa & submucosa,  perineal septum  anal sphincter  no more perineal body

Question 90

Perineal Lacerations / Rectovaginal Tears; Management

Answer 90

Medical management  Antimicrobials  NSAID’s  tetanus preventative  Fecal softener (bran mash)  Artificial insemination for foal heat  Need to be completely healed if regular breeding at foal heat Surgical management  Usually for 3rd Degree  2-3x/day: clean vagina & place tampon w/ lanolin to avoid adhesions  Wait MINIMUM 6 weeks to allow second intention healing

Question 91

Perineal Bruising & Vulvar Hematoma; Basics, treatment

Answer 91

o Hematomas may occur in conjunction with bladder atony o Large contained hematomas may become retroperitoneal hemorrhage o Pressure necrosis from the foaling may lead to seroma/abscess formation w/in the pelvic canal which may eventually break out into the vagina, perineum, or into the abdominal cavity o Hematomas can prevent urination & defecation o Can cause perivaginal fat necrosis in high body condition mares Treatment  Support  Make sure they can urinate and defecate

Question 92

Cervical Laceration; Causes, Diagnosis, Treatment, Prognosis

Answer 92

Causes  Oversized fetus  Obstetrical chains/ fetotomy wire  “Normal” parturition Diagnosis  Manual palpation of the cervical canal Treatment  Can heal on own in ~7days if partial thickness  Surgery if full thickness 4-6wks after parturition Prognosis  fertility variable, depends on degree

Question 93

Postpartum Hemorrhage; Locations, Predisposing Factors, Clinical Signs

Answer 93

o Common postpartum emergency & cause of postpartum death Location  Broad ligament  Intra-uterine  Intra-abdominal  Vaginal  Vestibular-vaginal sphincter Predisposing Factors  Older  Dystocia  Pregnancy sclerosis  Cu deficiency  R side more common  Anesthetizing for controlled vagina delivery & mare drops to quickly -> uterine artery Clinical Signs  Colic, sweating  pale or normal mucous membranes  tachycardia  Flehmen response  muscle fasciculation  w/in 24 hours of foaling (or of artery rupture)  may have hemorrhagic vaginal discharge

Question 94

Postpartum Hemorrhage; Diagnosis, Treatment

Answer 94

Diagnosis  Weak thready pulse  hypovolemic shock  Transrectal palpation of distended broad ligament (if it is the site of hemorrhage)  Ultrasound transrectally or transabdominally  Demonstrate site of hemorrhage  Abdominocentesis shows hemoabdomen  Anemia or normal PCV(splenic contraction)  Hypoproteinemia  Hypofibrinogenemia  Leukopenia/leukocytosis Treatment  be very careful w/ sedation to avoid sudden changes in blood pressure  Sedation (acepromazine) -> hypotension -> collapse  Twitch or excitement -> hypertension -> bleed more  Minimize excitement, Place in dark, quite stall  Flunixin meglumine + butorphanol  Corticosteroids (to prevent shock)  Nasal insufflation + Pentoxifylline  Fluid therapy hypertonic saline followed by LRS (too fast may cause increased bleeding)  Whole blood transfusion if PCV < 15%  Naloxone hydrochloride  Aminocaproic acid  Yunnan Baiyao

Question 95

Uterine Tears or Rupture; Locations, Clinical Signs, Diagnosis

Answer 95

o Dystocia or NORMAL parturition Locations  dorsocranial to cervix  tip of gravid horn Clinical Signs  Depend on site/size of tear and progression of peritonitis  Fever  Peritonitis  tachycardia  Severe pain/colic after uterine lavage  High risk of evisceration into the uterine tear  Associated with retained placenta Diagnosis  Abdominal ultrasound  Contamination in abdominocentesis

Question 96

Uterine Tears or Rupture; Treatment

Answer 96

Surgical: * Ventral midline celiotomy * Flank laparoscopy * Vaginally in dorsal recumbency Medical: * If small tear, may heal on its own * May incur higher costs than surgery due to ongoing management * Antibiotics * Anti-inflammatories * Anti-endotoxin therapy * Abdominal lavage * Laminitis prevention

Question 97

Partial inversion (intussusception) of the uterine horn and uterine prolapse ; Risk Factors, Clinical Signs, Diagnosis, Treatment

Answer 97

Risk factors  Aggressive traction on a retained placenta  Excessive use of oxytocin Clinical signs  Colic not responsive to tranquilizers  Tachycardia  Prolapse visible Diagnosis  transrectal palpation  Abdominocentesis may show an increased TP but stable WBC Treatment  Caudal epidural or general anesthesia is required for replacement  Manual replacement and distension of the uterus with large volume of warm water with added salt and iodine (if partial prolapse)  Clean prolapsed tissue. Can apply osmotic agents (ie, sugar). Manual replacement without perforating the tissues (if complete prolapse)  Can place Caslicks to keep everything in but not always necessary

Question 98

Vaginal Prolapse; Secondary to, Treatment, Prognosis

Answer 98

Secondary to  Dystocia  Persistent straining Treatment  Keep tissues clean and moist  Caudal epidural  Place urinary catheter to decrease size of bladder Prognosis  Must differentiate vaginal prolapse from bladder eversion through a vaginal rent

Question 99

Rectal Prolapse / Evisceration

Answer 99

o Prolonged dystocia o Forceful obstetrical manipulation o Tenesmus o Needs Surgical treatment

Question 100

Large Colon Volvulus in Postpartum Mare

Answer 100

o Most common colic postpartum o So much space after parturition -> very easy for colon to twist o Very painful, tachycardia, toxic/blue MMs o So colicky that often unsafe to examine o Good prognosis with prompt surgical correction (within 30-60 minutes) o Can be fatal with prolonged interval to treatment (> several hours)

Question 101

Ruptured Cecum & Peritonitis in Postpartum Mare

Answer 101

o Abdominocentesis will show feed material in the abdomen

Question 102

Ischemic necrosis of small intestine, small colon, and/or mesentery in Postpartum Mare

Answer 102

o due to compression by the foal o May only be identified at surgery o may have indications on abdominocentesis or transabdominal ultrasonography

Question 103

Eclampsia (Lactation tetany); Risk Factors, Clinical Signs, Diagnosis, Treatment

Answer 103

Risk Factors  Draft horses  Minis or ponies Clinical Signs  Restlessness  Tachypnea  Dull eyes  Muscle fasciculations  Clonic spasm  Recumbency Diagnosis  Low serum Ca levels Treatment  IV fluids w/ Ca borogluconate

Question 104

Agalactia; Basics, Causes, Treatment

Answer 104

o No mammary development & lactogenesis o Failure of passive transfer risk for foals Causes  Fescue toxicity  Malnutrition in late gestation Treatment  Domperidone (dopamine antagonist; most commonly used) OR  Sulpiride twice daily (more bioavailable)  Start one med above 10-15 days before foaling and continue for 5 days after foaling

Question 105

Treatment for Foal Rejection

Answer 105

o Positive reinforcement when foal is around o high dose prostaglandin PGF2α (causes pain like foaling)

Question 106

Selecting Stallions for Breeding

Answer 106

o capable of achieving 75% pregnancy rate in the breeding season if: o Natural cover: 40 mares o Artificial insemination: 120 - 140 mares

Question 107

Breeding Soundness Exam for Stallions

Answer 107

Testicular palpation and measurements  Total scrotal width  Length, height, and width  Volume converted to grams  16-20 million sperm per gram of testicular tissue Semen collection and evaluation  2 ejaculates one hour apart  Measure Total number of sperm/ejaculate  Total number of normal progressively motile sperm should be at least 1 billion in the second ejaculate

Question 108

Cryptorchidism; Basics, Treatment

Answer 108

o Considered if both testes are not in scrotum at birth o most common development abnormality o abdominal common for L or bilateral o inguinal common for R Treatment  hCG or GnRH to help inguinal testes descend (Tibary does not like)  Castration (best to not breed cryptorchid males)

Question 109

Cryptorchidism; Diagnosis

Answer 109

 HCG Stimulation Test * Give hCG * test Testosterone before & 2hrs after hCG * >100 usually means teste present  Anti-Mullerian Hormone * Secreted by Sertoli cells * Best single test * May be low if testicular degeneration  Transabdominal or transrectal ultrasound * Determine location of testes for sx * Determine size * Determine any associated pathology

Question 110

Balanitis / Balanoposthitis causes

Answer 110

Lesions on Penis Viral  Most common  Coital exanthema (EHV-3) Smegma accumulation  Cause secondary bacterial or fungal issues Parasites  2nd most common cause  Summer sores due to Habronema larvae

Question 111

Penile Neoplasia; Types, Diagnosis, Treatment

Answer 111

Types  Squamous cell carcinoma on penis & aggressive  Melanoma found on scrotum in gray horses Diagnosis  Histo Treatment  If SCC is small – 5-fluoracil or cisplatin  If larger – Sx: reefing or phallectomy

Question 112

Paralysis of the Penis; Causes, Symptoms, Treatment

Answer 112

Causes  Exhaustion & starvation (most common)  Damage to sacral nerves  Infectious dz  Tranquilizers  Trauma Symptoms  Flaccid penis w/ edema or excoriation Treatment  Medical/physical management if early  Phallectomy

Question 113

Hydrocele of Testicle; Causes, Diagnosis, treatment

Answer 113

Causes  High temp & humidity  Following abdominal sx Diagnosis  Fluid around testicle on ultrasound  May be palpated Treatment  Exercise  Areas to cool off in  Sterile drainage

Question 114

Seminoma; Clinical Signs, Treatment

Answer 114

Clinical Signs  Enlargement of one teste  Soft/fluctuant testicle  NO overproduction of hormones  Common mets Treatment  Castration w/ as much of spermatic cord as possible

Question 115

Self-mutilation in Stallions; Causes, Management

Answer 115

o Flank biting & vocalizing Causes  Pain  Smell of another stallion  Learned behavior Management  Address pain  Physical device treatments to reduce self-mutilation  Provide distractions  Diet change  Long-acting tranquilizers (fluphenazine)  Tricyclic anti-depressants (imipramine and clomipramine)  Nutritional supplement of l-tryptophan  Progesterone treatment (only for VERY aggressive; affects fertility)  Odor masking

Question 116

Impotentia generandi Vs coeundi

Answer 116

Impotentia generandi o Ejaculation issues o Poor semen quality Impotentia coeundi o Mounting problems o erection failure

Question 117

Poor Libido

Answer 117

o Often learning problems in young stallions or stallions retired from performance o No response to an estrous mare after a period of 10 minutes o No secondary behaviors o Donkeys may take a lot longer

Question 118

Erection Failure Causes

Answer 118

 Painful lesions on penis  Compromised blood flow  Penile deviation due to use of stallion rings

Question 119

Ex-copula Induction of Ejaculation for Ejaculation Issues

Answer 119

o Give Imipramine o Give Xylazine a couple of hours later

Question 120

Musculoskeletal Problems & Ejaculation Problems; Stats, Management

Answer 120

o 50% of ejaculatory disorders Management  NSAIDs prior to breeding or sperm collection  Enhance sexual arousal  Accommodate for musculoskeletal deficiencies  Ex-copula induced ejaculation  Be aware that Musculo-skeletally compromised stallions may have poor semen quality

Question 121

Hemospermia; Causes, Diagnosis, Treatment

Answer 121

Cause  Urethral defects / rents at ischial tuberosity (most common)  Vesiculitis  Urethritis  Urolithiasis  Lesions on penis  Early squamous cell carcinoma Diagnosis  Examine urethral process w/ endoscope Treatment for Urethral rent  Sexual rest is easiest but cost owner time  Sub-ischial urethrotomy left to heal by 2nd intention (most common)  Sub-ischial urethrotomy w/ PU if severe  Can try to wash/remove blood from ejaculate if low quantity

Question 122

Urospermia; Signs, Diagnosis, Management

Answer 122

Signs  Large ejaculate volume  Change in color  Urinary sediment in ejaculate  Poor sperm motility due to pH change Diagnosis  Smells like urine  Creatinine >2  Azostix Management  No real treatment  Can fractionate ejaculate or “wash”

Question 123

Reasons for Azoospermia Vs Oligozoospermia

Answer 123

Azoospermia  Complete testicular degeneration  Orchitis  Testicular hypoplasia  Epididymal blockage (bilateral) Oligozoospermia  Defined as <2 billion sperm in 2nd ejaculate  Testicular degeneration  Incomplete ejaculation (sperm accumulator)  Retrograde ejaculation

Question 124

Work-up for Azoospermia

Answer 124

o Measure alkaline phosphatase AlkPhos 7,000-36,000  Testicular problem  Measure testes  Ultrasound testes & spermatic cord  Testicular biopsy AlkPhos <1000  Some sort of obstruction  Transrectal ultrasound/palpation to look for outflow obstruction  Examine urine for retrograde ejaculation

Question 125

Sperm Accumulation; Signs, Diagnosis, Treatment, Management

Answer 125

Clinical Signs  infertility  Multiple azoospermia ejaculates followed by ejaculate highly concentrated w/ semen Diagnosis  Transrectal ultrasound shows large, dilated ampullae Treatment  Rectal massage of ampulae  Oxytocin  PGF2-alpha Management  Collect semen on regular basis to avoid re-stasis

Question 126

Testicular Degeneration; Causes, Clinical Signs, Treatment

Answer 126

Causes  Commonly, use of steroids or altreogest  Age  Malnutrition Clinical Signs  Increased spheroids in ejaculate  Teratozoospermia Treatment  None

Question 127

Pyospermia/Seminal Vesiculitis; Cause, Clinical Signs, Diagnosis, Treatment, Management

Answer 127

Cause  Bacteria  Urethritis  Cystitis  Iatrogenic due to endoscopy Clinical Signs  Inflammatory cells in ejaculate  +/- microscopic blood in ejaculate  May strain/posture after breeding or urinating  Can be transmitted to mares and cause endometritis Diagnosis  Catheterize, massage, culture Treatment  Direct flushing of vesicles  Systemic antibiotics Management  Minimal contamination breeding through:  putting antibiotics in mare before breeding  using extender  fractionating ejaculate

Question 128

Priapism; Cause, Pathophysiology, Treatment

Answer 128

Causes  Acepromazine  Spinal cord lesions  Purpura hemorrhagica  Neoplasia Pathophysiology  Failure of sympathetic stimulation necessary for detumescence ->  Increased carbon dioxide tension and increased viscosity of the stagnant blood leading to venous occlusion ->  Urinary difficulty or blockage leads to more metabolic compromise Treatment  manual massage and lubrication in conjunction with cold hydrotherapy or ice water baths  Suspension of the penis with a bandage/sling  Slow IV administration of anticholinergic (benztropine mesylate)  Systemic diuretics, corticosteroids, Diphenhydramine, terbutaline  Surgical flushing of the corpus cavernosus penis (final action done at referral center)

Question 129

Penile or Preputial Injury Treatment

Answer 129

 Massage to reduce edema  May use glycerine to reduce edema  Bandage  Sling  Hydrotherapy  Protection of tissue  Empty bladder if stallion is painful & difficulty urinating  Reduction of edema can take several weeks  Sexual rest for 3-4 wks after recovery

Question 130

Spermatic Cord Torsion; Clinical Signs, Diagnosis, Treatment, Fertility

Answer 130

Clinical Signs  Sudden Testicular/Scrotal Enlargement  None to sever colic depending on degree of torsion (none if <180)  Very tight prepuce Diagnosis  Palpation of scrotum  Ultrasound of scrotum looking for lack of fluid, thickened vessels Treatment  Unilateral castration Fertility  Good post castration if no complications

Question 131

Testicular Hemorrhage; Clinical Signs, Diagnosis, Treatment

Answer 131

Clinical Signs  Sudden Testicular/Scrotal Enlargement  Very tight prepuce Diagnosis  Evidence of hemorrhage on ultrasound Treatment  Unilateral castration

Question 132

Inguinal / Scrotal Hernia; Clinical Signs, Diagnosis, Treatment

Answer 132

Clinical Signs  Sudden Testicular/Scrotal Enlargement Diagnosis  Movement of intestinal loops on ultrasound of scrotum Treatment  Unilateral castration

Question 133

Orchitis; Agents, Clinical Signs, Diagnosis, Treatment

Answer 133

Agents  Strep equi  Salmonella abortus Clinical Signs  Sudden Testicular/Scrotal Enlargement Diagnosis  Testicular abscess seen on ultrasound Treatment  cold water hydrotherapy  systemic antibiotics  unilateral castration

Question 134

Scrotal Abscess; Clinical Signs, Diagnosis, Treatment

Answer 134

Clinical Signs  Sudden Testicular/Scrotal Enlargement  +/- lesions or necrotic tissue on prepucial skin Diagnosis  Ultrasound shows abscess in scrotum (not involving testicle) Treatment  NSAIDs  Systemic antibiotics  Drainage of abscess