Large Animal Practical questions

Question 1

Handling and restraining of ruminants.

Answer 1

Breed, age and training is important. Dairy cows are used to people but beef cattle out at
pasture are not. Usually put cows in stocks to examine. Use horn leaders or rope around neck
if no horns. Won’t bite but will squash and butt with head. General handling of cows can
use nose tongs – clamp onto nostrils & squeeze septum – tie up with this. Can also just use
fingers. Can pull tail over back but not recommended to use this method as the tail may
break. Bulls – nose ring with metal pole either side and 2 men as dangerous. Calves – fix
like foals – one hand round chest and bum (and can pull up tail). Sedatives – generally not
used. Can use alpha 2 agonists but cow very sensitive and slows down rumination.

Question 2

Handling and restraining of ungulates and the swine.

Answer 2

Pigs - use of pig board.
Sheep by horns or sit them up????
Goats – as sheep?
Horses.
● Restraint depends on breed, age and gender
● Foals - one hand round chest and bum (and can pull up tail). Don’t use a halter on a
foal as they can rear and fall over. As they get older and are weaned then will wear a
halter but remember they are young and unpredictable so do not try to tie up – have an
experienced handler present.
● After breaking at 4 years or so, they should tie up but check with owner.
● Different breeds need more sensitive handling e.g. TB v shire.
● TB – stocks can resemble starting gates and make them worse. Stocks mainly used for
rectal exam or can use half door of stable
● Stallions –handle with care as can strike with front legs, bite and kick with hind legs.
Use a chiffney. Ask if a breeding stallion or not. Don’t stand in front of them.
● Nose twitch – never ear twitch. Neck twitch with hand – often good for youngsters
● Can lift a front leg
● Chemical sedation not recommended as it can mask symptoms. May be necessary for
some procedure such as x ray. ACP not used at clinic as sedation lasts for 2 long and
can cause prolapse of penis. Use alpha 2 agonists such as domosedan or xylazine but
will cause bradycardia and AV block.

Question 3

Record the identification data and the general impression of the horse.

Answer 3

ID will be breed, sex, height, age (DOB), markings, brands, microchip. Can imprint
chestnuts. Can take hair for DNA sample – usually from tail and done as a foal. Silhouette.
General impression as small animals

Question 4

Record the identification data and the general impression of the cattle.

Answer 4

Colour, breed and ear tag number. Horns?

Question 5

Determine the basic clinical values of the horse and evaluate the results. Describe the
general impression

Answer 5

General as small animals
Temp: 37.5 – 38. Newborn 37.5-38.5
Pulse: 30-40 bpm. Facial, transverse facial, brachial, digital pulse
Resp: 10-15 breaths

Question 6

Determine the basic clinical values of the cattle and evaluate the results. Describe the
general impression

Answer 6

General as small animals, but BCS for dairy cattle 1-5, beef 1-9
Temp: 38-39. Newborn 39-39.5
Pulse: 60-80 bpm. Facial (turns just in front of mandible) , transverse facial, coccygeal –
close to base of tail between 2 muscles, saphenous
Resp: 10-30 breaths
Ruminal contractions. Push abdominal wall against rumen with fist (rumen left side in
paralumbar fossa). Will feel rumen contract. Generally 1-3 ruminal contractions per minute,
so measure over 5 minutes.

Question 7

Determine the basic clinical values of the sheep and evaluate the results. Describe the
general impression.

Answer 7

General as small animals
Temp: 38.5-39.5
Pulse: 60-80 bpm
Resp: 15-30 breaths
Ruminal contractions

Question 8

Determine the basic clinical values of the goat and evaluate the results. Describe the
general impression

Answer 8

General as small animals
Temp: 38.5-39.5
Pulse: 60-80 bpm
Resp: 15-30 breaths
Ruminal contractions

Question 9

Determine the basic clinical values of the pig and evaluate the results. Describe the
general impression

Answer 9

General as small animals
Temp: 38.5-39.5 Newborn 39-39.5
Pulse: 60-80 bpm. Coccygeal, auriclaris magna
Resp: 12-20 breaths

Question 10

Describe the findings of the skin examination of the horse.

Answer 10

History
General impression
Hair exam - hair should be shiny with density according to breed, species and season. No
alopecia. Hair is medium long and colour according to breed (e.g. Suffolk punch horse
should be chestnut!) Coat fits to skin and has good closure. Hair loss is physiologic and can

be plucked with medium effort. Stiffness according to breed. No broken hairs or ecto-
parasites.

Skin exam – Condition according to breed and age and surface is intact. Skin is light pink or
greyish white but depends on pigmentation. [true black EE horse has black skin???] No
haemorrhages and no unpleasant smell – depends on breed and species. Temperature of skin
is close to temperature of ambient skin parts, although the extremities will be slightly lower
and reflect the external temperature more. Moisture content is average and grease content is

slight. Medium turgor and thickness according to skin can be folded easily and pings back
into place quickly. Sensitivity is physiologic with no swellings or lesions
Hooves. Shape according to breed [and whether front or hind foot – front is more rounded,
than hind]. Slipper toe can be a rotation of P3. Pigment too – some horses have white feet
particularly if have white legs. Temperature is the same as the floor so hooves should be
cool – if hot laminitis? No pain on palpation. Consistency is hard and surface is intact. Look
for growth rings – sign of old laminitis/nutritional problems.

Question 11

Describe the findings of the skin examination of the cattle.

Answer 11

History
General impression
Hair exam - hair should be shiny with density according to breed, species and season. No
alopecia. Hair is medium long and colour according to breed (e.g. Suffolk punch horse
should be chestnut!) Coat fits to skin and has good closure. Hair loss is physiologic and can

be plucked with medium effort. Stiffness according to breed. No broken hairs or ecto-
parasites.

Skin exam – Condition according to breed and age and surface is intact. Skin is light pink or
greyish white but depends on pigmentation. [true black EE horse has black skin???] No
haemorrhages and no unpleasant smell – depends on breed and species. Temperature of skin
is close to temperature of ambient skin parts, although the extremities will be slightly lower
and reflect the external temperature more. Moisture content is average and grease content is

slight. Medium turgor and thickness according to skin can be folded easily and pings back
into place quickly. Sensitivity is physiologic with no swellings or lesions
Hooves. Shape according to breed [and whether front or hind foot – front is more rounded,
than hind]. Slipper toe can be a rotation of P3. Pigment too – some horses have white feet
particularly if have white legs. Temperature is the same as the floor so hooves should be
cool – if hot laminitis? No pain on palpation. Consistency is hard and surface is intact. Look
for growth rings – sign of old laminitis/nutritional problems.

Question 12

Describe the findings of the skin examination of the sheep.

Answer 12

As for horse but mention fleece and importance of it being in good condition.

Question 13

Describe the findings of the skin examination of the goat.

Answer 13

As horse. Male goats will smell!

Question 14

Describe the examination findings of the palpable lymph nodes of the horse.

Answer 14

Compare both on opposite sides as follows:
● Size – more than one and a half times normal size is suspicious. Black pepper sized,
coriander sized, cherry sized, pea sized, grape sized, golf ball sized, tennis ball sized.
● Shape – ellipsoidal, round, special
● Consistency – doughy – pressure causes pitting which persists, firm – similar to
normal liver, hard – bone like consistency, fluctuating – wave like movement
produced when alter consistency, emphysematous – structure s enlarged and puffy,
yields on pressure, produces a crackling sound due to the presence of air or gas in the
tissue
● Structure – homogenous or non-homogenous
● Painfulness – should be none
● Movability – should be moveable
● Surface – smooth and regular and intact
● Skin above – temp, elasticity, damage
Palpable:
● Mandibular. In inter-mandibular space. Fix thumb against masseter and use fingers to
palpate. Can pull lymph node against mandible.
● Superficial Inguinal. Is located on the inner thigh where the skin of the thigh turns
into the abdominal area. Careful not to be kicked!
Can be palpated when enlarged:
● Retropharyngeal – just behind and under the salivary gland.
● Prae-scapular
Rectal:
● Illeosacral
● Mesenteric (cranial mesenteric). Often affected if strangles

Question 15

Describe the examination findings of the palpable lymph nodes of the cattle.

Answer 15

● Size – more than one and a half times normal size is suspicious. Black pepper sized,
coriander sized, cherry sized, pea sized, grape sized, golf ball sized, tennis ball sized.
● Shape – ellipsoidal, round, special
● Consistency – doughy – pressure causes pitting which persists, firm – similar to
normal liver, hard – bone like consistency, fluctuating – wave like movement
produced when alter consistency, emphysematous – structure s enlarged and puffy,
yields on pressure, produces a crackling sound due to the presence of air or gas in the
tissue
● Structure – homogenous or non-homogenous
● Painfulness – should be none
● Movability – should be moveable
● Surface – smooth and regular and intact
● Skin above – temp, elasticity, damage
Palpable:
● Mandibular (mandibularis)
● Prae-scapular
● Subilliac
● Mammary
Can be palpated when enlarged: retropharyngeal, parotid.
Rectal: Illeosacral, Mesenteric

Question 16

Describe the examination findings of the palpable lymph nodes of the sheep and the goat.

Answer 16

● Size – more than one and a half times normal size is suspicious. Black pepper sized,
coriander sized, cherry sized, pea sized, grape sized, golf ball sized, tennis ball sized.
● Shape – ellipsoidal, round, special
● Consistency – doughy – pressure causes pitting which persists, firm – similar to
normal liver, hard – bone like consistency, fluctuating – wave like movement
produced when alter consistency, emphysematous – structure s enlarged and puffy,
yields on pressure, produces a crackling sound due to the presence of air or gas in the
tissue
● Structure – homogenous or non-homogenous
● Painfulness – should be none
● Movability – should be moveable
● Surface – smooth and regular and intact
● Skin above – temp, elasticity, damage

Not always palpable! Praescapular and superficial inguinal

Question 17

Describe the examination findings of the mucous membranes of the horse.

Answer 17

Inspection and palpation.
● Colour – normal is light pink
● Moisture – normal is shiny and moist. Look for mucus quality and quantity
● Membrane vessels – normal is they can be slightly recognised, if more - haemorrhage
● Surface – normal is smooth and intact. Conjunctiva can be moderately ruffled. Look
for lesions.
● Capillary refill time – under 2 seconds. Normal is one second. Longer if hypovolemia
Abnormal – pale, anaemic, cyanotic, yellow, dull, livid, dirty red, haemorrhage (petechiae,
suffusions, echymosis), sticky, dry (shock), injected (hyperaemia – press and it disappears or
haemorrhage – press it doesn’t disappear). If lesions – how many, size, shape, borders,
location, colour, consistency etc.
Look at conjunctiva, mouth (top lip), nasal, anal, genital – 1st clinical signs of icterus
Same small animal but use third eyelid and also look inside nose. Nasolacrimal gland is not a
lesion.

Question 18

Describe the examination findings of the mucous membranes of the cattle.

Answer 18

As small animals

Question 19

Describe the examination findings of the mucous membranes of the sheep and the goat.

Answer 19

As small animals

Question 20

Describe the examination findings of the upper airways of the horse.

Answer 20

Examine – nose and parnasal sinuses, coughing, larynx and pharynx (and guttural pouch),
trachea
Nose – external and internal exam. Inspection, palpation, percussion, smelling. Further exams
of nasal fluid – bacteriological, cytology, mycology, parasitic exam. Also x-ray, endoscopy,
biopsy, CT, MRI.
● Look at shape and form of nose. Symmetry, intact skin, consistency, temp,
painfulness, movability etc. Fine needle aspiration for cytology.
● occurrence of nasal stridor (stridor = specific sound if narrowing) – ok if faint regular
noise during expiration (pig and brachycephalic dog is more intensive). Abnormal if
stridor (inha/exhale) – try to determine origin. Sneezing – dog & young horse can be
normal – protects air passages. Horses – roaring – paralysis of left side of larynx
● expired air – strength & deepness of breathing, symmetry (hands or mirror), temp,
smell. Upper airway narrow expired air is weaker.

● nasal discharge – colour, quality, quantity, consistency, side, continuity, smell. So
water, mucus, foamy etc. All before choanae is one sided, behind choanae is double
sided discharge (e.g. horse guttural pouch). Bleeding from nose is epistasis.. Bilateral
– coagulopathy, unilateral – trauma or blood vessel rupture. Blood can be from as far
back as duodenum.
● Smell of breath.
● nasal openings and nostrils – shape, width, movability of allae (horse), symmetrical.
Facial paralysis – drooping ear, eyelid or nose. Check mucus membrane esp horse as
easy to see.
● palate, nasopharynx – Horse only by endoscopy and if sedated. Paralysis – roaring.
Surgical correction.
● Paranasal and frontal sinuses – inspection, percussion, palpation.
● In horse the guttural pouch. Borders – cranial is caudal mandible, ventral is
lingofacial vein, caudal is tendon of insertion of sternocephalicus – usually is a
sunken in hollow unless inflamed. If pus resonance is dull – should be gas filled.
Endoscope – check muscles, nerves, mucus membranes
● Coughing – squeeze larynx or first tracheal ring – intense, short, sharp, high, dry, non
painful, with snap which does not reoccur
● Trachea – inspection and palpation and Auscultation - weak stridor at pharynx of
horse. Endoscope – mucus and colour. Can take sample
● Carina – wall between 2 bronchi – should be thin- if it is rounded there is a problem
● Really need to gallop horse on endoscope exam.
● DO ENDOSCOPE EXAM!!!!

Question 21

Describe the examination findings of the upper airways of the cattle.

Answer 21

As horse

Question 22

Induce coughing in the horse and the cattle, describe the findings.

Answer 22

Horse – press larynx and/or tracheal rings close to larynx. Hard to do. Cough is intensive,
sharp, high, short, dry, painless, with snap, which does not reoccur
Cow. Close mouth and nose until air hunger. Medium intensive, medium deep. More dull.
Dry, held, painless, unsnapping

Question 23

Describe the examination findings of inspection and palpation of the equine and bovine
thorax.

Answer 23

Inspection, palpation, [percussion, auscultation not here but normally as part of exam]
Further – x-ray, ultrasound (rare), BAL (bronchial fluid sample (and analysis)– via endoscope

or trans-tracheal wash), thoracentesis, biopsy, scintigraphy, lung function, blood test/acid-
base tests

Inspection:
● Chest - skin, size, bi-lateral symmetry – Ru slight left side bigger ok as rumen, local
deformities – e.g. spinal problems such as lordosis will change shape of chest too.
Also long coat may make exam difficult so palpate. Oedema in chest can collect
ventrally and change the shape – can see in cattle.
● Respiratory movement
o Frequency. Increase – tachnpnoe – normal if excitement, work, obesity, high
temp, pregnancy. Abnormal – fever, hypoxia, hypercapnia (high CO2), pain
in respiratory organs. Decrease – bradypnoe – abnormal – CNS problems,
severe pain, barbiturate toxicosis, shock

o Rhythm –normally inspiration is a bit longer than expiration. Held inspiration
– narrowed upper airway or high abdominal pressure (pregnancy, ascites etc.),
Held expiration – decreased lung elasticity, microbronchitis, shorter
inspiration/expiration – pain, asymmetric breathing – pain in one lung lobe,
intermittent inspiration – long, exhausting work, normally during excitement.
Abnormal – pain in chest.
o Type – normally costabdominal in horses, dogs and cats. Ruminants is mainly
abdominal. Abnormal costal –problem with diaphragm, abdominal pain and
increased pressure- pregnancy, ascites etc. Narrowed upper airway or
compression of lung. Abnormal abdominal – painful chest diseases or
paralysis of intercostal muscles.
o Depth – normal is medium deep. Shallow – painful diaphragm/chest. Deep –
exercise, hypoxia, characteristic sign of dyspnoea.

Palpation:
● Temp of skin, symmetry, palpate intercostal spaces up to down looking for pain
● Fremitus pectoralis – can find during dry pleurisy, bronchitis, fibrinous pericarditis,
stenotic cardiac valve/valve insufficiency. Have fremitus in grade 5 or 6 heart murmur
● Painfulness
● Deformities

Question 24

Describe the findings of thoracic auscultation (heart, lung) in the horse.

Answer 24

Auscultation – mainly indirect (also direct):
Lungs - Front to back. From up to down. In each third of the thorax. In a quiet environment.
At least 5 places put stethoscope. Can say hear ‘normal respiratory sounds’ Horse should be
very quiet. Soft inspiration, weak expiration
Practical says start from 3-6 intercostal space as most problems here. If here nothing can put
on muzzle – when take of big inspiration – listen.
Heart
3-6 intercostal space left and 3-5 intercostal space right side.
● Inspection
● Palpation. Check for pulse deficit. Ventricular contraction and pulse should be the
same in number. Palpate to check if heart is/is not in correct position – hydrothorax,
fluid, neoplasm. Can also feel fremitus from palpation – can be a severe heart
murmur. Palpate left and right side
● Auscultation – If COPD and can’t hear heart over the lung sounds, cover the nose to
stop breathing. FRIDA – Frequency – normal (30-40 beats per min), Rhythm –
regular but horse can have pronounced respiratory arrhythmia – can get conduction
disturbance and second degree AV block. Or dropped beat – no ventricular
contraction. This is normal, particularly in fit competition horses. Intensity – strong
and even. Demarcation – normal – no splitting of beat or galloping rhythm (unless
after hard exercise), Adventitious sounds – none. Grading of heart murmurs. Grade 1 –
very soft – only hear after a few seconds in a quiet room. Grade 2 – very soft but
easily heard directly on auscultation. Grade 3 – moderate intensity with good
audibility. Grade 4 – loud murmur, good audibility but no precordial thrill (fremitus).
Grade 5 – very loud murmur with precordial thrill, Grade 6 – loudest murmur – can
hear with stethoscope lifted from chest wall.
● Horse can have 4 heart sounds, usually just 2.
● Percussion. Can pull foreleg forward to do it. Absolute cardiac dullness, then relative
cardiac dullness left and right sides as heart in contact with thoracic wall.

Question 25

27. Describe the findings of thoracic auscultation (heart, lung) in the cattle.

Answer 25

As horse but cattle lung sounds: Inspiration are strong rugged and blow like. Expiration is
weak
As horse but only relative dullness on percussion.

Question 26

Describe the findings of thoracic auscultation (heart, lung) in the sheep and the goat.

Answer 26

As cow

Question 27

Describe the findings of thoracic percussion in the horse.

Answer 27

Normal sounds of thorax:
● Medium and large animals – 40-500kg – sharp, short, low – resonant/non resonant.
[carnivores is sharp, long, low/high and resonant]
Lung borders: (Tuber coxae, tuber ischiadicum, point of shoulder)
● Horse – 16, 14, 10
Heart is dull – short sound with low intensity. Behind caudal border of the heart and before
diaphragm is diernhofer triangle – will disappear if fluid in ventral thoracic cavity. Pull leg
forward to do percussion – left 2-6 space, right 3-5. Absolute and relative dullness over heart.
Order is from back to front and up to down.

Question 28

Describe the findings of thoracic percussion in the cattle.

Answer 28

Normal sounds of thorax:
● Medium and large animals – 40-500kg – sharp, short, low – resonant/non resonant
Lung borders: (Tuber coxae, point of shoulder)
● Ruminants – 11 – 8
Heart is dull – short sound with low intensity. Behind caudal border of the heart and before
diaphragm is diernhofer triangle – will disappear if fluid in ventral thoracic cavity. Just
relative dullness.
Order is from back to front and up to down.

Question 29

Describe the findings of the lower respiratory system in horse.

Answer 29

Trachea to lungs. Lung borders: (Tuber coxae, point of shoulder). Normal respiratory sounds. Use 3 points on trachea to
auscultate. Heave line if more abdominal breathing (instead of costal abdominal)

Question 30

Describe the findings of the lower respiratory system in cattle.

Answer 30

Normal sounds of thorax:
● Medium and large animals – 40-500kg – sharp, short, low – resonant/non resonant
Lung borders: (Tuber coxae, point of shoulder)
● Ruminants – 11 – 8
Heart is dull – short sound with low intensity. Behind caudal border of the heart and before
diaphragm is diernhofer triangle – will disappear if fluid in ventral thoracic cavity. Just
relative dullness.
Order is from back to front and up to down

Question 31

Describe the findings of the lower respiratory system in sheep.

Answer 31

Normal sounds of thorax:
● Medium and large animals – 40-500kg – sharp, short, low – resonant/non resonant
Lung borders: (Tuber coxae, point of shoulder)
● Ruminants – 11 – 8
Heart is dull – short sound with low intensity. Behind caudal border of the heart and before
diaphragm is diernhofer triangle – will disappear if fluid in ventral thoracic cavity. Just
relative dullness.
Order is from back to front and up to down

Question 32

Describe the findings of the lower respiratory system in goat.

Answer 32

Normal sounds of thorax:
● Medium and large animals – 40-500kg – sharp, short, low – resonant/non resonant
Lung borders: (Tuber coxae, point of shoulder)
● Ruminants – 11 – 8
Heart is dull – short sound with low intensity. Behind caudal border of the heart and before
diaphragm is diernhofer triangle – will disappear if fluid in ventral thoracic cavity. Just
relative dullness.
Order is from back to front and up to down

Question 33

35.Examine the pulse of the horse and cattle and describe the findings.

Answer 33

Horse – facial, transverse facial, median arteries (auxiliary region), medial and lateral
digital arteries, coccygeal artery. 30 -40 bpm
● Cattle and small ruminants – facial and coccygeal artery. 60-80bpm,

Look at:
● Rate - physiological
● Rhythm -regular
● Evenness –even
● Symmetrical – yes
● Quality (size, strength, duration, compressibility and fullness of artery – all
even/normal).

Question 34

Examine the pulse of the sheep and the goat and describe the findings.

Answer 34

Cattle and small ruminants – facial and coccygeal artery. 60-80bpm,

Look at:
● Rate - physiological
● Rhythm -regular
● Evenness –even
● Symmetrical – yes
● Quality (size, strength, duration, compressibility and fullness of artery – all
even/normal).

Question 35

Perform physical examination of the equine heart and describe the findings.

Answer 35

Go round whole area left and right, not just apex, Stay in each area a few seconds.
Needs to be silent and quiet.
● 4 normal heart sounds, but hear usually first two 2 in most species. In horse may hear
4.
o 1st sound is start of systole. Ventricle contracts – aortic and pulmonary valves
(semi lunar valves) open, bi and tri-cuspid valves close.
o 2nd sound is end of systole. Aortic and pulmonary valves close as less pressure
o 3rd sound is start of diastole - bi and tri cuspid valves open (as atria full of
blood)
o 4th sound is end of diastole – weak atrial contraction.
● If increase in rate can’t distinguish between the sounds.
● Galloping rhythm – can be seen in sick horse with colic or fever. Is abnormal unless
horse is exercising very hard.
Changes in heart sounds – FRIDA
● Frequency – evaluate in association with physical status. If abnormal frequency do an
ECG. Also each cycle should generate and coincide with a pulse. – if not - pulse
deficit.
● Rhythm – normal is regular. Symp and para-symp control – heart rate can decrease
during expiration as vagus more active. Horse respiratory arrhythmia can be more
pronounced – can get conduction disturbance and second degree AV block. Or
dropped beat – no ventricular contraction. This is normal, particularly in fit
competition horses, but is pathological in other species.
● Intensity - strong and even.
● Demarcation (distinctness) – normal - so splitting of the heart sounds, especially if 2
valves don’t close together e.g. galloping rhythm in horses.
● Adventious sounds – heart murmurs
Heart on left – 3- 6 intercostal space, on right 3-5.
Grading of heart murmurs (horses prone so watch out for this!!!)
● Grade 1 – very soft – only hear after a few seconds in a quiet room.
● Grade 2 – very soft but easily heard directly on auscultation.
● Grade 3 – moderate intensity with good audibility.
● Grade 4 – loud murmur, good audibility but no precordial thrill (fremitus).
● Grade 5 – very loud murmur with precordial thrill,
● Grade 6 – loudest murmur – can hear with stethoscope lifted from chest wall.
Find puncta maxima of murmur.

Question 36

Perform physical examination of the bovine heart and describe the findings.

Answer 36

AS FOR HORSES BUT HEART IS REALLY UNDER FOREARMS
Go round whole area left and right, not just apex, Stay in each area a few seconds.
Needs to be silent and quiet.
● 4 normal heart sounds, but hear usually first two 2 in most species. In horse may hear
4.
o 1st sound is start of systole. Ventricle contracts – aortic and pulmonary valves
(semi lunar valves) open, bi and tri-cuspid valves close.
o 2nd sound is end of systole. Aortic and pulmonary valves close as less pressure
o 3rd sound is start of diastole - bi and tri cuspid valves open (as atria full of
blood)
o 4th sound is end of diastole – weak atrial contraction.
● If increase in rate can’t distinguish between the sounds.
● Galloping rhythm – can be seen in sick horse with colic or fever. Is abnormal unless
horse is exercising very hard.
Changes in heart sounds – FRIDA
● Frequency – evaluate in association with physical status. If abnormal frequency do an
ECG. Also each cycle should generate and coincide with a pulse. – if not - pulse
deficit.
● Rhythm – normal is regular. Symp and para-symp control – heart rate can decrease
during expiration as vagus more active. Horse respiratory arrhythmia can be more
pronounced – can get conduction disturbance and second degree AV block. Or
dropped beat – no ventricular contraction. This is normal, particularly in fit
competition horses, but is pathological in other species.
● Intensity - strong and even.
● Demarcation (distinctness) – normal - so splitting of the heart sounds, especially if 2
valves don’t close together e.g. galloping rhythm in horses.
● Adventious sounds – heart murmurs
Heart on left – 3- 6 intercostal space, on right 3-5.
Grading of heart murmurs (horses prone so watch out for this!!!)
● Grade 1 – very soft – only hear after a few seconds in a quiet room.
● Grade 2 – very soft but easily heard directly on auscultation.
● Grade 3 – moderate intensity with good audibility.
● Grade 4 – loud murmur, good audibility but no precordial thrill (fremitus).
● Grade 5 – very loud murmur with precordial thrill,
● Grade 6 – loudest murmur – can hear with stethoscope lifted from chest wall.
Find puncta maxima of murmur.

Question 37

Perform physical examination of the heart in sheep and goat and describe the findings.

Answer 37

AS FOR HORSES BUT HEART IS REALLY UNDER FOREARMS
Go round whole area left and right, not just apex, Stay in each area a few seconds.
Needs to be silent and quiet.
● 4 normal heart sounds, but hear usually first two 2 in most species. In horse may hear
4.
o 1st sound is start of systole. Ventricle contracts – aortic and pulmonary valves
(semi lunar valves) open, bi and tri-cuspid valves close.
o 2nd sound is end of systole. Aortic and pulmonary valves close as less pressure
o 3rd sound is start of diastole - bi and tri cuspid valves open (as atria full of
blood)
o 4th sound is end of diastole – weak atrial contraction.
● If increase in rate can’t distinguish between the sounds.
● Galloping rhythm – can be seen in sick horse with colic or fever. Is abnormal unless
horse is exercising very hard.
Changes in heart sounds – FRIDA
● Frequency – evaluate in association with physical status. If abnormal frequency do an
ECG. Also each cycle should generate and coincide with a pulse. – if not - pulse
deficit.
● Rhythm – normal is regular. Symp and para-symp control – heart rate can decrease
during expiration as vagus more active. Horse respiratory arrhythmia can be more
pronounced – can get conduction disturbance and second degree AV block. Or
dropped beat – no ventricular contraction. This is normal, particularly in fit
competition horses, but is pathological in other species.
● Intensity - strong and even.
● Demarcation (distinctness) – normal - so splitting of the heart sounds, especially if 2
valves don’t close together e.g. galloping rhythm in horses.
● Adventious sounds – heart murmurs
Heart on left – 3- 6 intercostal space, on right 3-5.
Grading of heart murmurs (horses prone so watch out for this!!!)
● Grade 1 – very soft – only hear after a few seconds in a quiet room.
● Grade 2 – very soft but easily heard directly on auscultation.
● Grade 3 – moderate intensity with good audibility.
● Grade 4 – loud murmur, good audibility but no precordial thrill (fremitus).
● Grade 5 – very loud murmur with precordial thrill,
● Grade 6 – loudest murmur – can hear with stethoscope lifted from chest wall.
Find puncta maxima of

Question 38

Evaluate the electrocardiogram of the horse.

Answer 38

Leads at centre of chest, girth area (ventrally), centre of forehead and lastly at withers
ECG in a horse is for heart rate only due to the arrangement of the purjkinje fibres. Generally
just used for arrhythmias. Can use radio-telemetry so no leads. Frontal axis is not determined.
If atrial fibrillation get very small complex (looks very different anyway - is all upside down).
Abnormality in slides was 2nd degree AV block.

Question 39

Demonstrate the methods of opening the mouth of the horse and describe the findings.

Answer 39

Use space between teeth on lower jaw – use finger to press gum and can grasp tongue and
keep out of corner of mouth. Can only see teeth, tongue, mucus membranes, hard and soft
palate. Cannot see larynx, pharynx, epiglottis etc. – need laryngoscope to examine properly.

Question 40

Demonstrate the methods of opening the mouth of the cattle and describe the findings.

Answer 40

Use space between teeth on lower jaw – use finger to press gum and can grasp tongue and
keep out of corner of mouth. Can only see teeth, tongue, mucus membranes, hard and soft
palate. Cannot see larynx, pharynx, epiglottis etc. – need laryngoscope to examine properly.- use dental plate on mandible to open mouth though. Watch out for vesicles – F &
M which is notifiable.

Question 41

Demonstrate the methods of opening the mouth of the sheep and goat and describe the findings.

Answer 41

Use space between teeth on lower jaw – use finger to press gum and can grasp tongue and
keep out of corner of mouth. Can only see teeth, tongue, mucus membranes, hard and soft
palate. Cannot see larynx, pharynx, epiglottis etc. – need laryngoscope to examine properly.- use dental plate on mandible to open mouth though. Watch out for vesicles – F &
M which is notifiable

Question 42

Examine the oral and the pharyngeal cavity of the horse and describe the findings.

Answer 42

Use space between teeth on lower jaw – use finger to press gum and can grasp tongue and
keep out of corner of mouth. Can only see teeth, tongue, mucus membranes, hard and soft
palate. Cannot see larynx, pharynx, epiglottis etc. – need laryngoscope to examine properly. Findings as with small animals – mucus membranes, teeth etc.
Horse has 40-42 teeth depending on sex. I3C1P3M3 (top and bottom) Male horses and some
females have an extra tooth – the wolf tooth on the upper jaw.

Question 43

Examine the oral and the pharyngeal cavity of the cattle and describe the findings.

Answer 43

Use space between teeth on lower jaw – use finger to press gum and can grasp tongue and
keep out of corner of mouth. Can only see teeth, tongue, mucus membranes, hard and soft
palate. Cannot see larynx, pharynx, epiglottis etc. – need laryngoscope to examine properly. Findings as with small animals – mucus membranes, teeth etc.
Cows have 32 teeth – no incisors on top jaw – instead have dental pad. I4 (lower
only), C 0, P3, M3 F&M v bovine viral diarrhoea.

Question 44

Examine the abdomen and the abdominal digestive organs of the horse and describe the
findings.

Answer 44

Abdomen
Inspection - watch from behind, side and front. Look at posture. Look at shape and size.
Palpation – temperature, thickness, pain etc.
Auscultation – normal is gurgling, murmuring, rumbling. Tinkling and splashing are
abnormal. Increased boyborygmi – early stages of enteritis. Reduced or absent sounds –
impaction, shock etc. 3 minutes at each side – 1 minute per area.
Percussion:
Left side - dorsal and middle third are dull tympanic, ventral third is dull.
Right side – dorsal third is deep tympanic, middle third is dull tympanic and ventral third is
dull or dulled.
Stomach
● Stomach is deep within the diaphragmatic done. Can be colic with negative rectal
findings if stomach is involved.
● Nasogastric intubation – quality, quantity, colour, smell, PH, components and foreign
bodies (e.g. worms) should be examined in the gastric juice.

● Primary and secondary gastric contents? Gastroscopy can also be used.
Liver
● Deep within diaphragmatic dome so physical examination is impossible
● Use ultrasound, biopsy.
● Also lab exams – liver function, serum levels of hepatic enzymes, bile salts, ammonia,
glucose, bilirubin, clotting factors, plasma proteins.
Pancreas
● Physical examination is impossible. Is located behind the liver, above the duodenum
in the dorsal part of the epigastricum. Is also difficult to examine with laparotomy
● Lab exams – serum amylase and lipase activity, amylase activity in peritoneal fluid
(so exocrine pancreas tests)

Question 45

Examine the abdomen and the abdominal digestive organs of the cattle and describe the
findings.

Answer 45

Rumen
● Inspection – size, presence and grade of bloat – look for left sided distension.
● Palpation – ruminal contractions on left flank. Usually 1-3 contractions per minute
depending on when fed. Put fist in hollow of flank (paralumbar fossa) for 30 seconds
● Percussion – upper third is mildly tympanic, lower third is dull. In frothy bloat the
gasses are more finely dispersed so the sound is moderately tympanic.
● Auscultation – continuous mild crackling sounds until there is a ruminal contraction
in which case the noise is loud – gurgling fluid and booming gassy noise.
Reticulum:
● Zone test (Kachlschmidt probe) – take head. At beginning of expiration move or
scratch skin on head – if pain in reticulum will stop expiration and may groan.
● Back grip – grip skin of back and try to lift it on expiration – if problem with
reticulum cow will stop breathing and groan
● Pressure test (knee-elbow probe) – put fist on xiphoid cartilage and balance elbow on
knee – push up hard – if pain cow will groan
● Pole test – need 2 helpers and a pole. Lift cow up with pole under abdomen. Start
caudally and move forward. Lift pole slowly and let cow down quickly – will groan if
pain
● Pain percussion – hit cow hard with percussion instrument on xiphoid cartridge.
Omasum and Abomasum are difficult to examine without secondary tests. Can auscultate
abomasum.
Abdomen exam – quality, quantity, colour and smell of faeces. Percussion – on the right side
a steel like sound on top of back is the caecum, just below it is the small intestine.

Question 46

Additional exams – ruminectomy, ruminography, examination of ruminal fluid, rectal
examination.

Answer 46

Ruminectomy – put a trochar through the wall of the rumen to release gas in case of bloat.
Ruminography – using an endoscope can see visual pictures of the rumen.
Examination of ruminal fluid:
● Odour:
o normal is aromatic.

o Abnormal – is ammonia (urea poisoning), mouldy rotting small (protein
putrefaction), acidic/sour (excess lactic acid/grain overfeeding)

● Colour:
o olive to brownish green normal if hay feeding, deeper green if lots of grass,
yellowish brown (grain or silage).
o Abnormal is milky grey – grain overfeeding or lactic acidosis, dark greenish
brown (ruminal stasis/decomposition) or grey with lots of milk clots (calves
with abomasal reflux)

● Consistency:
o Normal is slightly viscous
o Abnormal is increased viscosity (saliva contamination), decreased viscosity,
watery with a few feed particles (inactive bacteria or protozoa) or excess froth,
stable bubbles (frothy bloat, indigestion)

● Sedimentation time/floatation test. Allow ruminal fluid to sit in a test tube for 4-8
minutes, It should sediment with smaller particles sinking and larger ones floating.
● PH – 2-4 hours after concentrates/4-8 after TMR. PH paper/meter. Runinocentesis
values lower. PH is 6.2-7.1. Grain fed cow slightly lower PH. Increased PH –
ruminal alkalosis – saliva contamination, ruminal indigestion/urea indigestion,
reduced feed for 2 days. Low PH (ruminal acidosis – grain overfeeding, chronic
ruminal acidosis)
● VFA – propionic, butyric and acetic acid. HPLC – look at ratio
● Redox potential to see if ruminal flora is healthy – e.g. if can reduce methylene blue
● Nitrate reduction tests
● Measurement of ammonia – spectrophotometer but hard as very volatile
● Chloride in ruminal fluid
Rectal exam:
● Landmarks – pelvic inlet, pelvic rim and iliac shafts.
● Cervix is in middle of floor of pelvic cavity and is moveable but depends on condition
– fixed after 70 days pregnancy, pyometra etc. May also find uterine horns. Can also
palpate uterus
● Bladder ventral to reproductive tract but can’t palpate if empty
● Palpate rumen from left of midline and cranially. Palpate size and consistency
● The left kidney is to the right of the rumen!
● Small intestine and caecum are ventral and to the right of left kidney. Right side of
abdomen feels empty if everything is normal

Question 47

Examine the abdomen and the abdominal digestive organs of the sheep and the goat
and describe the findings.

Answer 47

Rumen
● Inspection – size, presence and grade of bloat – look for left sided distension.
● Palpation – ruminal contractions on left flank. Usually 1-3 contractions per minute
depending on when fed. Put fist in hollow of flank (paralumbar fossa) for 30 seconds
● Percussion – upper third is mildly tympanic, lower third is dull. In frothy bloat the
gasses are more finely dispersed so the sound is moderately tympanic.
● Auscultation – continuous mild crackling sounds until there is a ruminal contraction
in which case the noise is loud – gurgling fluid and booming gassy noise.
Reticulum:
● Zone test (Kachlschmidt probe) – take head. At beginning of expiration move or
scratch skin on head – if pain in reticulum will stop expiration and may groan.
● Back grip – grip skin of back and try to lift it on expiration – if problem with
reticulum cow will stop breathing and groan
● Pressure test (knee-elbow probe) – put fist on xiphoid cartilage and balance elbow on
knee – push up hard – if pain cow will groan
● Pole test – need 2 helpers and a pole. Lift cow up with pole under abdomen. Start
caudally and move forward. Lift pole slowly and let cow down quickly – will groan if
pain
● Pain percussion – hit cow hard with percussion instrument on xiphoid cartridge.
Omasum and Abomasum are difficult to examine without secondary tests. Can auscultate
abomasum.
Abdomen exam – quality, quantity, colour and smell of faeces. Percussion – on the right side
a steel like sound on top of back is the caecum, just below it is the small intestine.

Question 48

50.Perform reticular pain tests in the cattle and describe the findings.

Answer 48

Reticulum:
● Zone test (Kachlschmidt probe) – take head. At beginning of expiration move or
scratch skin on head – if pain in reticulum will stop expiration and may groan.
● Back grip – grip skin of back and try to lift it on expiration – if problem with
reticulum cow will stop breathing and groan
● Pressure test (knee-elbow probe) – put fist on xiphoid cartilage and balance elbow on
knee – push up hard – if pain cow will groan

● Pole test – need 2 helpers and a pole. Lift cow up with pole under abdomen. Start
caudally and move forward. Lift pole slowly and let cow down quickly – will groan if
pain
● Pain percussion – hit cow hard with percussion instrument on xiphoid cartilage

Question 49

51.Examine the cattle to exclude dilatation and displacement of the abomasum.

Answer 49

Location:
● Abomasum is like a sling sitting underneath the cows abdomen.
Abomasal displacement:
● Most commonly found in lactating dairy cattle. Seem most often in first 6 weeks after
calving. Well managed herds the rate can be less than 3%
● 90% of displacements are to the left side
● Right sided displacement is often more severe, and can result in volvus or torsion
● If displaced to left, that side will be very hard. Palpate ventral abdomen.
● Cow will produce less milk and will not want to eat
● Cow may have ketoneurea, tachycardia. Temperature, heart rate and respirations are
usually normal.
● Use percussion and auscultation simultaneously and should hear resonance – high
pitched ‘ping’ This is the most important test. The test is performed on the
upper/middle third of the abdomen, roughly between ribs 9 and 13.
● May be decrease in faeces production and mild dehydration. With right sided
displacement dehydration is more acute and may also have metabolic alkalosis
● This is in general a multifactorial disease. At and before calving food intake may
decrease and less food in rumen may cause an accumulation of gas. Fat cows will eat
less at calving increasing the risk.
Abomasal Dilation
● Impaction will cause dilation of the abomasum.
● Late gestation animals are most often affected
● Clinical signs – metabolic alkalosis, decrease in rumen motility, anorexia, decrease in
faeces production, dehydration and distension of abomasum.
● Distension of abomasum can be seen by palpation or ballottement of the lower right
flank. Look for skin turgor re dehydration and also less faeces production.
● Cause is feeding poor quality roughage such as straw. \also sand or gravel getting into
the feed or also neurological problems and pylorus obstruction.
● Use surgical correction or lubricate impaction with mineral oil. Will also need to treat
any alkalosis with balanced electrolytes.

Question 50

Perform rectal examination in the horse and describe the findings.

Answer 50

Use glove with lubricant (obstetric or paraffin oil) and a cone shaped hand, introduced
slowly and gently with a gliding, drilling movement. Wash area of rectum free of
faeces. Tie up/bandage tail
● Relaxant such as buscopan can be used. However careful re rules if horse competing.
● May need restraint such as stocks (or half a stable door) or a twitch/lift leg
● Usually do a rectal exam when horse has colic. Therefore need to know strength of
pain, so not so good to give painkillers. Can give xylazine if have to as only 30
minute duration of action (better than metdetomidine). Also do rectal exam in
pregnancy, urogenital problems etc.
● Always get permission from owner for a rectal exam as it is possible to cause a
rupture

● X ray and CT are useful for foals and ponies only. Ultrasound can give lots of
information, also abdominal centesis. Fluid should be pale yellow with a nucleated
cell count of less than 5000. Protein content under two and a half grams per decilitre.
If lots of fluid in abdominal cavity with a high protein, RBC count and total nucleated
cell count can suspect strangulation of intestines as the necrosis causes increased
permeability of the intestine walls.
Exam:
● Look at the anal and perianal areas first
● Insert then withdraw hand to see if any blood
● Peritoneum – if greasy can be intestinal content, ampulla of rectum, bony pelvis and
aorta (dorsal and pulsating)
● Reproductive organs. Internal inguinal rings (beware of hernia – if so testes will be
enlarged), prostate. Vagina, ovaries uterus
● Urinary bladder
● Small colon, cranial root of mesentery, left kidney
● Spleen, nephrosplenic ligament, nephrosplenic space – if no space can be left dorsal
displacement of the large colon
● Peritoneum, left ventral colon (haupstrum), left dorsal colon and pelvic flexure
● Ampulla of colon, head of caecum, ventral/medial Tania of caecum
● Small intestines (hard to find)
Left Side Abdomen
● Left ventral colon (H)
● Pelvic flexure
● Left dorsal colon
● Left kidney
● Spleen (to left of left
kidney, ventral to it)

Ventral Abdomen
● Bladder
● Inguinal Rings
● Cervix
● Uterus
Dorsal Abdomen
● Abdominal aorta
● Root of mesentery
● Nephrosplenic
ligament and space

Right Side of Abdomen
● Caecum
● segments of small
colon

General
● Can’t palpate duodenum and jejunum – use ultrasound. Can palpate ileum if distended
and impacted. Is in middle of abdominal cavity. Caecum is in the middle of the
upper right of the abdominal cavity. Can’t palpate right ventral colon
● Left ventral colon with haupstrum, pelvic flexure and left dorsal colon can be
palpated. If hauptsrum are on top have a 180 degree torsion.
● Small ball on left upper side is the ovary. Right ovary is more cranial.
● Can only palpate left kidney.
● Structure dorsally and pulsating is the aorta

Question 51

Perform rectal examination in the cattle and describe the findings.

Answer 51

Use glove with lubricant and a cone shaped hand, , introduced slowly and gently.
Wash area of rectum free of faeces.
● Landmarks – pelvic inlet, pelvic rim and iliac shafts.
● Cervix is in middle of floor of pelvic cavity and is moveable but depends on condition
– fixed after 70 days pregnancy, pyometra etc. May also find uterine horns. Can also
palpate uterus
● Bladder ventral to reproductive tract but can’t palpate if empty
● Palpate rumen from left of midline and cranially. Palpate size and consistency

● The left kidney is to the right of the rumen!
● Small intestine and caecum are ventral and to the right of left kidney. Right side of
abdomen feels empty if everything is normal

Question 52

Examine the musculoskeletal system of the horse and describe the findings.

Answer 52

Topographical (bones, muscles, tendons – axial and abaxial) or functional approach
(spontaneous and provoked locomotion).
History. Any lameness, reluctance to get up from lying down, doesn’t want to go for walks,
doesn’t want to climb stairs etc.
General Impression. Look at posture. Watch animal walking up and down, in a circle, up a
hill or off a step. Can it sit and lie down then get up from that position easily. Usual general
impression.
Physical Examination.
Bones
● Look for deformities and lesions in inspection. Palpation the same but also look for
pain, surface/contour, consistency and abnormal movement (e.g. patellar luxation,
particularly small breeds) crepitation. Do this carefully and gently. {Percussion – any
abnormal sounds or pain.
● Look to see if the bones correct in alignment or are there abnormalities e.g. lordosis in
a very old horse is normal to have a dipped back. Kyphosis – upwards curvature of
the spine. Scoliosis – lateral deviation. Spondylosis – degenerative osteoarthritis of
the joints
● Further examinations. Rectal palpation, x ray, CT, MRI, arthroscopy, ultrasound,
myography, biopsy/puncture, blood chemistry – Calcium and phosphorus.
Ligaments
● Inspect for angles, swelling, deformities. Palpation – temperature, deformities, fluid
accumulation, painfulness, movability – extension, flexion, rotation.
● Further examinations – radiography, arthroscopy, puncture – synovial fluid analysis,
microbiology etc.
Muscles and tendons
● Inspection - is the horses musculature symmetrical? Size. Lesions. Is there muscle
wastage? Systemic diseases could cause muscular problems e.g. secondary
hyperparathyroidism - i.e. Cushing’s which can cause muscle atrophy. Also Lyme
disease, selenium deficiency. Palpation – temperature, consistency, pain, tone,
contraction
● Further examinations – biopsy, ultrasound of tendons, CT, myography. Urine analysis
– myoglobin – increased levels indicates breakdown of muscles (rhabdomyolysis).
Blood chemistry – CK (creatine kinase – see increased levels if severe muscle
breakdown (or heart attack)), AST (aspartate amino transferase – liver problems),
Selenium (deficiency can cause severe muscle breakdown called rhabdomyolysis) and
LDH (lactic acid dehydrogenase – when muscles are damaged LDH is released into
the blood).
Normal findings – posture, gait and musculature characteristic for the breed. All four limbs
weight bear equally. Bone contour has a flowing line. No crepitation, looseness or pain.
Temperature should be same as surrounding areas. Percussion on bones is bone like. By

palpation can be easily flexed, extended and rotated. Joints and bones are symmetrical.
Muscles are also flowing and continuous. Should be no rhythmic contractions and
temperature is the same as the rest of the body. Consistency is muscle like and no abnormal
tone. Deep palpation does not cause pain. Should be symmetrical.

Question 53

Examine the musculoskeletal system of the cattle and describe the findings.

Answer 53

Topographical (bones, muscles, tendons – axial and abaxial) or functional approach
(spontaneous and provoked locomotion).
History. Any lameness, reluctance to get up from lying down, doesn’t want to go for walks,
doesn’t want to climb stairs etc.
General Impression. Look at posture. Watch animal walking up and down, in a circle, up a
hill or off a step. Can it sit and lie down then get up from that position easily. Usual general
impression.
Physical Examination.
Bones
● Look for deformities and lesions in inspection. Palpation the same but also look for
pain, surface/contour, consistency and abnormal movement (e.g. patellar luxation,
particularly small breeds) crepitation. Do this carefully and gently. {Percussion – any
abnormal sounds or pain.
● Look to see if the bones correct in alignment or are there abnormalities e.g. lordosis in
a very old horse is normal to have a dipped back. Kyphosis – upwards curvature of
the spine. Scoliosis – lateral deviation. Spondylosis – degenerative osteoarthritis of
the joints
● Further examinations. Rectal palpation, x ray, CT, MRI, arthroscopy, ultrasound,
myography, biopsy/puncture, blood chemistry – Calcium and phosphorus.
Ligaments
● Inspect for angles, swelling, deformities. Palpation – temperature, deformities, fluid
accumulation, painfulness, movability – extension, flexion, rotation.
● Further examinations – radiography, arthroscopy, puncture – synovial fluid analysis,
microbiology etc.
Muscles and tendons
● Inspection - is the horses musculature symmetrical? Size. Lesions. Is there muscle
wastage? Systemic diseases could cause muscular problems e.g. secondary
hyperparathyroidism - i.e. Cushing’s which can cause muscle atrophy. Also Lyme
disease, selenium deficiency. Palpation – temperature, consistency, pain, tone,
contraction
● Further examinations – biopsy, ultrasound of tendons, CT, myography. Urine analysis
– myoglobin – increased levels indicates breakdown of muscles (rhabdomyolysis).
Blood chemistry – CK (creatine kinase – see increased levels if severe muscle
breakdown (or heart attack)), AST (aspartate amino transferase – liver problems),
Selenium (deficiency can cause severe muscle breakdown called rhabdomyolysis) and
LDH (lactic acid dehydrogenase – when muscles are damaged LDH is released into
the blood).
Normal findings – posture, gait and musculature characteristic for the breed. All four limbs
weight bear equally. Bone contour has a flowing line. No crepitation, looseness or pain.
Temperature should be same as surrounding areas. Percussion on bones is bone like. By

palpation can be easily flexed, extended and rotated. Joints and bones are symmetrical.
Muscles are also flowing and continuous. Should be no rhythmic contractions and
temperature is the same as the rest of the body. Consistency is muscle like and no abnormal
tone. Deep palpation does not cause pain. Should be symmetrical.

Question 54

Examine the musculoskeletal system of the sheep and the goat and describe the findings.

Answer 54

Topographical (bones, muscles, tendons – axial and abaxial) or functional approach
(spontaneous and provoked locomotion).
History. Any lameness, reluctance to get up from lying down, doesn’t want to go for walks,
doesn’t want to climb stairs etc.
General Impression. Look at posture. Watch animal walking up and down, in a circle, up a
hill or off a step. Can it sit and lie down then get up from that position easily. Usual general
impression.
Physical Examination.
Bones
● Look for deformities and lesions in inspection. Palpation the same but also look for
pain, surface/contour, consistency and abnormal movement (e.g. patellar luxation,
particularly small breeds) crepitation. Do this carefully and gently. {Percussion – any
abnormal sounds or pain.
● Look to see if the bones correct in alignment or are there abnormalities e.g. lordosis in
a very old horse is normal to have a dipped back. Kyphosis – upwards curvature of
the spine. Scoliosis – lateral deviation. Spondylosis – degenerative osteoarthritis of
the joints
● Further examinations. Rectal palpation, x ray, CT, MRI, arthroscopy, ultrasound,
myography, biopsy/puncture, blood chemistry – Calcium and phosphorus.
Ligaments
● Inspect for angles, swelling, deformities. Palpation – temperature, deformities, fluid
accumulation, painfulness, movability – extension, flexion, rotation.
● Further examinations – radiography, arthroscopy, puncture – synovial fluid analysis,
microbiology etc.
Muscles and tendons
● Inspection - is the horses musculature symmetrical? Size. Lesions. Is there muscle
wastage? Systemic diseases could cause muscular problems e.g. secondary
hyperparathyroidism - i.e. Cushing’s which can cause muscle atrophy. Also Lyme
disease, selenium deficiency. Palpation – temperature, consistency, pain, tone,
contraction
● Further examinations – biopsy, ultrasound of tendons, CT, myography. Urine analysis
– myoglobin – increased levels indicates breakdown of muscles (rhabdomyolysis).
Blood chemistry – CK (creatine kinase – see increased levels if severe muscle
breakdown (or heart attack)), AST (aspartate amino transferase – liver problems),
Selenium (deficiency can cause severe muscle breakdown called rhabdomyolysis) and
LDH (lactic acid dehydrogenase – when muscles are damaged LDH is released into
the blood).
Normal findings – posture, gait and musculature characteristic for the breed. All four limbs
weight bear equally. Bone contour has a flowing line. No crepitation, looseness or pain.
Temperature should be same as surrounding areas. Percussion on bones is bone like. By

palpation can be easily flexed, extended and rotated. Joints and bones are symmetrical.
Muscles are also flowing and continuous. Should be no rhythmic contractions and
temperature is the same as the rest of the body. Consistency is muscle like and no abnormal
tone. Deep palpation does not cause pain. Should be symmetrical.

Question 55

Evaluate the cranial nerve function of the horse and describe the findings.

Answer 55

I – olefactory. Use food/strong smelling substance
● II – optic nerve:
o Falling cotton ball test. Cotton makes no sound – animals eyes should fallow
ball – make sure object doesn’t cause vibration e.g. dropping keys onto table
not good.
o Pupil light reaction – may need to dilate eye first so cover animal’s eyes
before test. If direct light comes onto one eye the other should also constrict –
this is the consensual pupillary light reaction. Sensation is the optic nerve but
the III (oculomotor) is also involved as the efferent (motor) part.
o Menace reflex – blink at approach of hand to eye. May not be present in v
young foal. Careful not to produce air current that may hit cornea.
o Leading animal to object – should step over or avoid
● III – oculomotor, IV – trochlear, VI – abducent
o Provocation of physiological nystagmus. Turn head from side to side and up
and down. Eye should follow movement gradually. Also tests vision – if no
reaction may be blind. Pathological result – if it appears spontaneously – sign
of ataxia. Can be horizontal, vertical or rarely rotary. May get Strabismus –
uni or bilateral movement of eyeball (they are not parallel) if problems

● V Trigeminal - Mixed nerve – sensory and motor:
o Palpebral reflex - touch eyelid and should blink – touch inside and outside.
This is afferent. The efferent is the facial nerve (VII) to cause the blink.
o Corneal reflex – touch with finger on corneal surface or use Q tip. Blink and
may retract eyeball into orbit so see third eyelid. Efferent is facial (VII). Make
sure stay out of field of vision or could provoke menace reflex.
o Prehension of food, drink and chewing. (motor)
● VII Facial - mixed motor nerve. Sensory – caudal third tongue taste sensation. Can
have uni or bi-lateral paralysis.. Motor nerve is involved in
o palpebral reflex,
o corneal reflex
o menace reflex.
● VIII Vestibulo-cocclear – Test hearing by calling, clapping hands etc.
● IX Glossopharyngeal and X Vagus
o Swallowing/gag reflex - Small – can stimulate by reaching to base of tongue.
Make sure no danger of rabies!!! Large – nasogastric tube or syringe water
into mouth.

● XI Accessory – can’t really tests. Innervate neck and mouth – just palpate neck and
see if atrophy – trapezius, sternophalic and brachiocephalic muscles

● XII Hypoglossal. Look at position and movability of tongue and how well it can be

retracted. Horse – grab tongue. Small – offer food or water – will lick nose
afterwards. If can lick nose ok is normal.

Question 56

Perform neurologic examination of the neck and the forelimbs of the horse and describe
the findings.

Answer 56

History – exceptionally important as often animal excited at clinic. Need to know undisturbed
state at home (video). Symptoms may be transient.
● Onset – symptoms, esp ataxia, muscle weakness, behaviour, pain
● Environment and housing – indoor/outdoor animal
● Vaccinations
● Breed pre-disposition and age – wobblers young horses. Arabs – epilepsy.
General Impression:
● Posture – head, body, spine, locomotion.
● Mental state and behaviour,
● Movement:
o Towards away from you – slowly and quickly – so walk and trot
o Circling both ways – small and large circles (you stand still, horse circles
round you)
o Uphill and downhill if possible

Physical examination:
● Inspection – abnormal shape, position or luxation. Muscles – symmetrical. Wastage.
● Palpation and careful bending to see signs of pain. Cervical concentrate on lateral
processes, lumbar on dorsal processes. Sensitivity of skin and mucus membranes.
Active and passive flexion of neck.
Nociceptive reflexes (spinal reflex) important

o anal/perianal – gentle squeeze skin round anus or squeeze vulva – see anus
contract and tail may lower. Afferent and efferent is n. pudendalis, tail
movement is n. rectalis.
o Panniculus reflex. Use forceps to grab skin along back – should twitch. Caudal
to cranial – skin should twitch. M. cutaneous trunci. Also use needle to scratch
spine skin – is afferentation from each spinal segment & reflex centre is C7-
T1. Efferent – m. cutaneous trunci. Spinal cord injury – no reflex caudally
from injury, if no reflex at all injury is at reflex centre – localise this way.

Examination of proprioception is complex – involves spinal reflexes and central co-
ordination for movement and posture. Will see lots of weakness (ataxia) if there is a spinal

cord problem: Tests for postural reflex and body position:
● Hopping test:
o Hold up one front leg and push horse over to the side. It should be able to hop
● Correction test:
o Crossing over – cross legs and see if animal puts to correct position. Cross
front leg over the front of the other front leg

● Optical placing
o Can horse step over an object or go around it
● Pushing/swaying reflex. Push sideways. Use leadrope to pull horse towards you
suddenly. For hind limbs can pull tail.

Cortical and brain stem get bilateral problem. However, cerebellum, spinal cord and
peripheral nerves get ipsilateral result in tests (ipsilateral – to one side where lesion is)
Examination of pain is last step in spinal/neuro exam - always get a reaction from head no
matter where pain is in body . 2 types of exam for pain:
● Superficial – pinch/[prick skin –can see with panniculus test already performed. If
superficial pain response no need to continue to deep.
● Deep pain perception. Only do if very mild stimulus does not elicit a response. V
important if suspect spinal cord injury. Tread on rim of coronary band. If deep
pain absent – very bad prognosis L
● Percussion of vertebral column with hammer. Palpate as detailed above.
General comments from lecture
● Horse standing with a wide base can be a sign of ataxia. If you want to distinguish
vestibular problems with spinal cord problems use a blindfold. A horse with
vestibular problems will worsen as it has been using its eyesight to help compensate.
● Head tilt – deviation at poll.
● Box walking can be a sign of mental anguish or it can be a sign of neurological
problems
● Behaviour problems can be ammonia toxicosis or neurological
● Slap test. Do in conjunction with endoscopic exam. When horse is slapped the larynx
should move.
● Horners syndrome – look for drooped eyelid, myosis, enophalamus and may see third
eyelid. Signs are unilateral on the affected side. Horse may also sweat on the affected
side Cause is due to damage [to sympathetic] nervous system.
● Wobblers syndrome – degeneration in cervical spine similar to osteochondrosis. Seen
in young horses often when first put into work. Hyper[flexion] of front limbs, but
hypo in back limbs. Dark Prince at clinic has wobblers syndrome.
● Shaker foal disease is due to botulism poisoning
● Arabs can be prone to epilepsy or cerebellar atrophy

Question 57

Perform neurologic examination of the trunk, the hindlegs and the tail region of the
horse and describe the findings.

Answer 57

In general as above except examine and palpate spine and do tests on hindlimbs.
● Can be very hard to differentiate lameness from neurological signs in the horse. For
example, stringhalt – is it a lameness problem or is it neurological? Shivering
(muscle trembling when hind legs raised for shoeing etc.) is a muscular problem but
can look like stringhalt. Heavy breeds are more prone to these type of problems,
including Monday morning disease.
● West Nile virus – clinical signs include lameness on one limb, so can look like an
injury. This is neurological as the virus affects the spinal cord.