Infectious Equine Resp 2

Question 1

Strep equi equi characteristics and pathogenesis

Answer 1

Strep equi equi is a gram positive, chain forming, beta hemolytic streptococcus that is facultatively anaerobic. The bacteria adhere to the URT epithelium, Lamina proprietary and then enter the lymph. The bacteria evade neutrophils and may spread through lymphatics (bastard strangles) or elicit and immune response (purpura rxn)

Question 2

Clinical disease of Strep equi equi is called __ and __ horses are at risk but immunocompromised are at the highest risk. Morbidity is up to __ while mortality is __. Horses may be carriers of the bacteria in the __.

Answer 2

Clinical disease of Strep equi equi is called strangles and all horses are at risk but immunocompromised are at the highest risk. Morbidity is up to 100% while mortality is 2-3%. Horses may be carriers of the bacteria in the gutteral pouch.

Question 3

Describe the clinical signs of classic strangles

Answer 3

The bacteria will incubate for 1 to 14 days post exposure and then the horse will have fever and nasal discharge for 2-4 weeks. The lymph nodes will swell and be palpable 2-3 days after exposure and then be a mature abscess at 2-3 weeks.

Question 4

Describe the clinical signs of Strep equi equi immune mediated disease

Answer 4

• Circulating antigens form immune complexes
• Leukocytosis vasculitis: purpura hemorrhagica
• Autoimmune thrombocytopenia, anemia
• Immune mediated myositis
• Agalactia

Question 5

Describe Bastard strangles clinical disease

Answer 5

• dissemination and abscess formation in other viscera
• general signs of weight loss, low grade fever elevated WBC count and fibrinogen

Question 6

Describe atypical strangles clinical disease

Answer 6

• subclinical disease or very self limiting disease that may be due to bacterial load and pathogenesis, prior exposure, hose specific characteristics

Question 7

How do you diagnose strangles?

Answer 7

You want to perform a bacterial culture or PCR with wash samples being superior. Alternatively, you can use serum to detect antibodies to SeM protein with a high titer indicating acute disease.

Question 8

An outbreak of strangles occurs on a horse farm near Blacksburg, how should you separate out the horses and treat them?

Answer 8

Separate them into groups based on clinical signs and treat in those groups:
1. Horses with obvious disease: hotpack their abscesses, bring to head and drain, only really need antibiotics of NSAIDs if they’re uncomfortable or if the abscess ruptures
2. Horses at risk but not apparent disease: take temp daily and start antibiotics if febrile
3. Unaffected horses: keep separate and use separate people and clothing if possible

Question 9

Horses recovering from strangles should have their __ cultured until the __ and __ are negative. Up to __ of horses may become carriers of the strep equi equi bacteria

Answer 9

Horses recovering from strangles should have their guttural pouches cultured until the PCR and culture are negative. Up to 50% of horses may become carriers of the strep equi equi bacteria

Question 10

T/F: The vaccines for strangles are very effective

Answer 10

F!

Question 11

Lower airway fungal pneumonia is typically caused by __ or __ in __ animals. Treatments include __, __ and __.

Answer 11

Lower airway fungal pneumonia is typically caused by aspergillus or fusarium in immunocompromised animals. Treatments include amphotericin , fluconazole and miconazole.

Question 12

Lung worm is typically in ___. You will see __ in a TTW and it typically responds to __.

Answer 12

Lung worm is typically in young horses housed with donkeys. You will see eosinophilia in a TTW and it typically responds to ivermectin.

Question 13

Parascarid infestation are typically __ by horses but can be treated with __ , moxidectin, fenbendazole.

Answer 13

Parascarid infestation are typically outgrown by horses but can be treated with ivermectin , moxidectin, fenbendazole.

careful with ivermectin in young horses bc they don’t have a mature BBB yet

Question 14

Parascarid infestation are typically __ by horses but can be treated with __ , moxidectin, fenbendazole.

Answer 14

Parascarid infestation are typically outgrown by horses but can be treated with ivermectin , moxidectin, fenbendazole.

careful with ivermectin in young horses bc they don’t have a mature BBB yet

Question 15

Infectious Pleuritis is common in __ horses due to stress, transport, recent viral infection, strenuous exercise, general anesthesia

Answer 15

Infectious Pleuritis is common in traveling horses due to stress, transport, recent viral infection, strenuous exercise, general anesthesia

Question 16

Clinical signs of pleuropneumonia

Answer 16

Depression, inappetence, acute weight loss, reluctance to move, base wide stance with abduction of forelimbs

Question 17

What might you hear on thoracic examination of a horse with pleuropneumonia?

Answer 17

Auscultation: Lung sounds may be absent or amplified

Percussion: air filled lung has a tympanic sound and pleuritis may cause a dull sound starting at the fluid line and continuing ventrally

Question 18

Describe the different CBC clin path abnormalities you might observe of a horse with pleuropneuomia

Answer 18

1. Acute hemoconcentration: leukopenia with a left shift, azotemia
2. Chronic (4-7 days): anemia of chronic disease, leukocytosis with neutrophilia, hyperfibrinogenemia
3. Chemistry of a chronic case may show azotemia, hypoalbuminemia, hypergammaglobulinemia

Question 19

What is the method of choice for imaging pleuropneumia? What should you do along with the imaging?

Answer 19

ULTRASOUND, you should see comet tails and possibly fibrin in the cranioventral portion of the thorax. Then drain the chest by a thoracocentesis:
- drain both sides if there’s fluid present, IC 7 or 8 on the Left and IC 6 or 7 on the Right
- a small amount may just use a teat cannula while a large amount will beed a blunt tipped chest tube with a one way valve

Question 20

What factor should you evaluate on a sample from thoracocentesis for pleuropneumonia?

Answer 20

Cytology with c/s, glucose and pH

Ask for anaerobic if it smells really bad

Question 21

A horse is diagnosed with pleuropneumonia, how do we want to treat it?

Answer 21

• Broad spectrum antibiotics (penicillin - gram + and anaerobes , aminoglycosides gram - or metronidazole anaerobes)
• NSAIDs, pentoxyfilline, 10% solution of DMSO in 5% dextrose given IV, recombinant tissue plasminogen activator
• laminitis prophylaxis
• fluids and nutritional support

Question 22

Severe pleuropneumonia may be treated by __ which will evaluate necrotic tissue and abscess capsules. To do this insert a scope at rib __ . This may also be done with __ resection to remove the __ and establish __.

Answer 22

Severe pleuropneumonia may be treated by thoracotomy which will evaluate necrotic tissue and abscess capsules. To do this insert a scope at rib 8-12 . This may also be done with rib resection to remove the necrotic lung and establish drainage.

Question 23

The prognosis of pleuropneumonia is __ for acute cases with minimal effusion and fibrin but __ for those with chronic disease with a consolidated lung, effusion or fibrin. __ is an indicator of a poor prognosis (malodorous breath or effusion)

Answer 23

The prognosis of pleuropneumonia is good for acute cases with minimal effusion and fibrin but poor for those with chronic disease with a consolidated lung, effusion or fibrin. Anaerobic bacteria is an indicator of a poor prognosis (malodorous breath or effusion)

Question 24

Generally __ of treated horses return to work and __ return to racing for pleuropneumonia

Answer 24

Generally 61% of treated horses return to work and 89% return to racing for pleuropneumonia

Question 25

Infiltrative disease that cause granulomatous disease may have non infectious causes such as__ or infectious causes such as __. In both scenarios you should treat the underlying disease +/- corticosteroids.

Answer 25

Infiltrative disease that cause granulomatous disease may have non infectious causes such as silicosis or hairy vetch toxicosis or infectious causes such as fungal, bacterial, coccdial, or parasitic. In both scenarios you should treat the underlying disease +/- corticosteroids.

Question 26

Equine multimodula pulmonary fibrosis is associated with __ and prognosis is __ since there’s not a lot of treatment

Answer 26

Equine multimodula pulmonary fibrosis is associated with EHV5 and prognosis is poor since there’s not a lot of treatment

Question 27

Multisystemic eosinophilic epitheliotropic disease (MEEDS) is when eosinophils infiltrates the __ and other tissues causing respiratory disease, weight loss, __ and __. Treatment is __.

Answer 27

Multisystemic eosinophilic epitheliotropic disease (MEEDS) is when eosinophils infiltrates the lungs and other tissues causing respiratory disease, weight loss, skin lesions and eosinophils in blood. Treatment is Corticosteroids.

Question 28

__ are the most common neoplasia that invade the interstitium or airway, can see with an endoscope

Answer 28

Granular cell tumors

Question 29

Clinical signs of a horse with pneumothorax

Answer 29

• restless to severe anxiousness
• tachypnea, tachycardia
• flared nostrils, abdominal component to respiratory effect
• asymmetric thoracic movement

Question 30

What is the most useful tooL for pneumothorax diagnosis?

Answer 30

Ultrasound or rads to see reverberation lines from air on AUS or air on rads

Question 31

How do you treat pneumothorax?

Answer 31

Place on oxygen air and reinflate the chest but prognosis is not great

Question 32

Describe the clinical signs and treatment of pulmonary edema

Answer 32

Clinical signs will show harsh lung sounds, tracheal fluid, and respiratory distress

Treatment includes: evaluating the cardiac function, treating underlying diseases, furosemide, nasal oxygen, corticosteroids, bronchodilators and hetastarch or plasma to increase the oncotic pressure in the blood.