Lecture 11 10/18/24

Question 1

Which cranial nerves pass through the guttural pouch?

Answer 1

-7
-9
-10
-11
-12

Question 2

What is tympany?

Answer 2

excessive accumulation of air in one or both guttural pouches

Question 3

What is empyema?

Answer 3

accumulation of purulent material in one or both guttural pouches

Question 4

What is a chondroid?

Answer 4

accumulation of concretions; chronic condition

Question 5

What is mycosis?

Answer 5

localized fungal colonization of one or both guttural pouches

Question 6

What is the etiology of tympany?

Answer 6

congenital or acquired abnormality of the pharyngeal opening

Question 7

What is the etiology of empyema?

Answer 7

primary or secondary upper respiratory infection

Question 8

What is the etiology of mycosis?

Answer 8

fungal infection, such as Aspergillosis

Question 9

What are the clinical signs of tympany?

Answer 9

-throat latch swelling
-dyspnea

Question 10

What are the clinical signs of empyema?

Answer 10

-throat latch swelling
-unilateral or bilateral nasal discharge
-dyspnea

Question 11

What are the clinical signs of mycosis?

Answer 11

-spontaneous epistaxis
-coughing
-dysphagia
-poor performance
-head tilt

Question 12

How are guttural pouch diseases diagnosed?

Answer 12

-history/clinical signs
-physical exam
-radiography
-endoscopy
-centesis

Question 13

What is the treatment for unilateral guttural pouch tympany?

Answer 13

fenestration of median septum

Question 14

What is the treatment for bilateral guttural pouch tympany?

Answer 14

resection of the excessive plica salpingopharyngeal flap

Question 15

What is the prognosis for tympany?

Answer 15

-uncomplicated cases have a favorable prognosis
-many will develop secondary bact. infections and require antibiotics

Question 16

What is the treatment for empyema/chondroids?

Answer 16

-isolate animal until culture comes back
-aggressive lavage
-systemic antimicrobials
-endoscopic removal of chondroids
-surgical treatment if other management fails

Question 17

What are the characteristics of mycosis presentation?

Answer 17

-emergency
-relatively uncommon
-must be ruled out in all horses with epistaxis
-no geographic, age, breed, or gender predisposition

Question 18

What is the treatment for mycosis?

Answer 18

surgery to embolize affected vessels; balloon cath. or coil

Question 19

Why is medical management alone not effective for mycosis?

Answer 19

it is not possible to get high enough concentrations of anti-fungals in the guttural pouch

Question 20

What are the characteristics of the causative organism in Strangles?

Answer 20

-Streptococcus equi spp. equi
-gram-pos. beta-hemolytic coccoid
-seen in pairs or chains
-not a commensal

Question 21

Which age range typically acquires Strangles?

Answer 21

horses ages 1 to 5 years old

Question 22

How is Strangles transmitted?

Answer 22

-direct contact
-fomites

Question 23

What are the sources of Strangles?

Answer 23

-asymptomatic carriers
-environment/water sources

Question 24

What are the virulence factors of Strangles?

Answer 24

-hyaluronic acid capsule
-M-like protein
-leukocidal toxin

Question 25

What is the incubation period and disease period of Strangles?

Answer 25

-incubation period of 3-14 days
-average course of disease of 23 days

Question 26

What is the pathogenesis of Strangles?

Answer 26

-organism enters through mouth or nose
-organism attaches to cells in the tonsillar crypts
-organism translocates to lymph nodes
-abscess formation
-hematogenous or lymphatic spread of organism possible

Question 27

What are the clinical signs of Strangles?

Answer 27

-fever
-malaise
-nasal discharge
-enlarged lymph nodes
-dysphagia
-resp. distress
-cough

Question 28

What are the clinical pathology findings with Strangles?

Answer 28

-neutrophilic leukocytosis
-hyperfibrinogenemia

Question 29

How is Strangles diagnosed?

Answer 29

-clinical signs
-culture
-PCR
-serology

Question 30

What are the treatment steps for horses exposed to Strangles, but without clinical signs?

Answer 30

-isolation
-monitor via temp. readings

Question 31

What are the treatment steps for horses with clinical signs of Strangles but no lymph node abscesses?

Answer 31

-penicillin for 3-5 days
-isolation
-monitoring

Question 32

What are the treatment steps for horses with Strangles and lymph node abscessation?

Answer 32

-penicillin to slow disease progression
-hot-packs on lymph nodes
-topical therapy

Question 33

What are the treatment steps for horses with systemic signs of Strangles?

Answer 33

-IV penicillin
-supportive care

Question 34

What are the characteristics of antibiotic use in Strangles treatment?

Answer 34

-used when diagnosis is made early
-contraindicated if lymph node abscessation is present
-used even with lymph node abscessation if patient has severe dyspnea, internal abscesses, bronchopneumonia, and/or is very depressed/anorexic

Question 35

What are possible sequelae of a Strangles infection?

Answer 35

-bastard strangles (spreads to lymph nodes throughout body)
-purpura hemorrhagica
-guttural pouch empyema and chondroids
-septicemia
-laryngeal hemiplegia
-suppurative necrotic bronchopneumonia

Question 36

What are the characteristics of horses that recover from Strangles?

Answer 36

-can shed bacteria for 3-7 weeks following resolution of acute disease
-75% will have solid immunity for 5+ years
-around 10% become subclinical carriers

Question 37

How is Strangles prevented?

Answer 37

vaccination in endemic areas or in animals at risk of exposure

Question 38

How does the killed strangles vx differ from the MLV?

Answer 38

killed:
-does not prevent disease
-injection site reactions possible
MLV:
-high level of immunity
-possibility of inducing mild disease
-forms abscess if it accidentally gets in the muscle

Question 39

How is strangles controlled?

Answer 39

-minimal movement of horses
-isolation for 3 weeks following exposure
-personal and premises hygiene
-screening of convalescent and recovered horses

-endoscopy and culture of guttural pouches