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Cardiopulmonary (Estrada-Fall 2014) > Lecture 19: Large Animal Cardiopulmonary Disorders (MacKay) > Flashcards

Lecture 19: Large Animal Cardiopulmonary Disorders (MacKay) Flashcards

1
Q

importance of resp. diseases in LA

A
  • 2nd only to MS system in limiting athletic performance of horses
  • sig. cause of morbidity and mortality in cattle
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2
Q

where is sterdor generated?

A

nose

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3
Q

where is stridor generated?

A

larynx

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4
Q

What should be included in a history of animal with resp distress?

A
  • signalment
  • intended use
  • nature, duration, and progression of CS
  • only 1 animal affected?
  • previous tx and response to therapy
  • vax history
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5
Q

unilateral nasal d/c typical of:

A

sinus infection

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6
Q

bilateral nasal d/c typical of:

A

pneumonia or guttural pouch issue

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7
Q

malodorous nasal discharge assoc. with

A

gram = bacteria

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8
Q

steps of resp. system exam

A
  • observe from distance
  • presence of nasal d/c?
  • evaluate airflow at nose
  • MM and CRT
  • palpate larynx/trachea/regional lymph nodes
  • percussion of paranasal sinuses
  • observe ventral abd, muzzle, and limbs for edema
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9
Q

char. of normal bronchovesicular lung sounds

A
  • produced by turbulent air flow in the central airways
  • louder ventrally than dorsocaudally
  • attenuated by aerated lung parenchyma
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10
Q

char. of abnormal (adventitious) lung sounds

A
  • crackles (short, non-musical)
  • wheezes (musical, high-pitched)
  • friction rubs
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11
Q

rebreathing CO2

A

helps to hear lung sounds

  • make horse breathe in bag, and they will breathe deeper
  • if takes longer than 6-8 breaths to recover, implies resp. insufficiency
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12
Q

percussion use

A
  • delineation of lung boundaries

- identify consolidation, abscesses and pleural effusion

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13
Q

structures evaluated in endoscopy

A 
nasal cavities
ethmoid
pharynx
larynx and epiglottis
trachea and bronchi
guttural pouches
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14
Q

what do you hit with tube if you accidentally go up middle meatus?

A

ethmoturbinate

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15
Q

rima glottidis

A

opening to lower airways

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16
Q

tube usually goes into which bronchus?

A

R

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17
Q

upper airway rad can visualize what structures?

A

Head: nasal cavities, sinuses, ethmoid, teeth
Pharynx: epiglottis, soft palate, guttural pouches

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18
Q

lower airway rad can visualize what structures?

A

Lungs: normal/alveolar/interstitial/bronchial/mixed pattern

Heart

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19
Q

can you visualize whole lung field on rad in adult horse?

A

No. Requires about 4 rads on each side!

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20
Q

branching of pulmonary vessels over aorta and caudal heart in horses is a sign of cardiac health

A

:)

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21
Q

ad/disad. of ultrasonography

A

ad:
-technique of choice for evaluating pleural space and peripheral lung
-penetrates water filled structures very well
-widely available
disad:
-doesn’t penetrate normal lung parenchyma
-can’t detect deep lung lesions w/ overlaying normal lung

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22
Q

nasal washes useful for:

A

detection of microbes that don’t normally colonize the upper airways such as viruses and strep. equi equi

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23
Q

Tracheobronchial aspirate (TBA)

A

technique of choice to obtain a culture of the lower airways when pneumonia is suspected. Collects from horizontal portion of trachea which collects secretions from the whole lung.

  • Normal cytology has mainly macs and ciliated epithelial cells
  • think video of cutting into trachea!
  • not a sterile procedure
24
Q

Bronchoalveolar lavage (BAL)

A

cytology correlates well with histopath. of the lungs when a DIFFUSE dz is present, but not useful when a FOCAL dz is suspected, such as pneumonia. Culture not sterile

25
Q

when to perform thoracocentesis?

A

when pleural effusion suspected. Includes cytology and culture.

26
Q

complications of lung biopsy

A

hemorrhage, pneumonia

27
Q

arterial blood gas analysis measures:

A

gas exchange (PaO2) and ventilation (PaCO2)

28
Q

pulmonary function testing measures:

A

mechanical properties of lungs

29
Q

2 obstructive dzs of the upper RT

A

laryngeal hemiplasia

dorsal displacement of the soft palate

30
Q

4 infectious dzs of the URT

A

strangles
guttural pouch diseases
sinusitis
viral resp. diseases

31
Q

5 dzs of the LRT

A 
foal pneumonia
rhodococcus equi pneumonia
pneumonia/pleuropneumonia in adult horses
exercise induced pulmonary hemorrhage
heaves
32
Q

most infectious upper airway disease still in the U.S.

A

Strangles

33
Q

Strangles is caused by what bacteria

A

streptococcus equi subsp. equi

34
Q

Strangles transmission

A

direct contact, fomites

35
Q

morbidity and mortality of Strangles

A

high morbidity (30-100%), low mortality (<10%)

36
Q

pathogenesis of Strangles

A

1) ingest/inhalation
2) attach. to tonsils and translocation below the mucosa in the lymphatics
3) multiply and abscess in local lymph nodes
4) possible dissemination via lymph or blood

37
Q

CS of Strangles

A
  • fever (1st)
  • depression
  • bilateral nasal d/c
  • retropharyngeal and submandibular lymphadenopathy
  • resp. distress
  • abscesses throughout body
38
Q

Which worse: retropharyngeal or submandibular abscesses from Strangles?

A

retrophar. Don’t rupture to outside very easily and put pressure on larynx which can cause inspiratory dyspnea

39
Q

Explain Strangles and chronic carriers

A

Most horses stop shedding 3-6 wks after resolution of CS, however some will become chronic asymptomatic carriers. Carry bacteria primarily in guttural pouch and can shed for months-years

40
Q

Dx of Strangles

A
  • presumptive based on CS and abscessed lymph nodes

- Culture or PCR (PCR 10x more sensitive!) amplification

41
Q

How do you dx/detect chronic carriers of Strangles?

A

-abscess aspirate
-nasal or pharyngeal swab 3x
-nasal flush 3x
-guttural pouch flush
submitted for culture or PCR**

42
Q

Tx of Strangles

A
  • horses exposed or with early CS BEFORE abscess: penicillin

- horses with abscess: promote maturation/drainage, no Abx unless anorexic or in resp. distress, supportive therapy

43
Q

Complications of Strangles

A
  • pneumonia
  • guttural pouch empyema and/or chondroids
  • bastard strangles
  • myocarditis, endocarditis
  • glomerulonephritis
  • purpura hemorrhagica
44
Q

purpura hemorrhagica

A

acute necrotizing immune-mediated vasculitis

45
Q

Path of purpura hemorrhagica in Strangles

A

immune complex formation –> deposition in blood vessels –> complement activation and mediator release –> vessel wall necrosis

46
Q

CS/Dx of purpura hemorrhagica

A

-warm/painful edema of limb, ventral abd, face
-petechial hemorrhage
-fever
-stiffness
Dx: history, CS, skin biopsy

47
Q

Tx of Purpura hemorrhagica

A
  • systemic antimicrobials (penicillin +/- gram negs)
  • steroids
  • NSAIDs, hydrotherapy, bandages
48
Q

Strangles vaccination

A

-not very effective, but decreases severity/incidence
2 types:
1)IM: uses M protein extracts
2) Intranasal (Pinnacle IN): uses altered live virus, use in outbreaks, can cause CS in young horses, generates nasal immunity

49
Q

What can be visualized in medial compartment of guttural pouch?

A

internal carotid a.
cn 9,10,11,12
cranial cervical ganglion

50
Q

What can be visualized in lateral compartment of guttural pouch?

A

external carotid a.
maxillary a.
cn 7

51
Q

guttural pouch empyema

A

accumulation of exudate in the guttural pouch(es). May solidify to form chondroids

52
Q

CS of guttural pouch empyema

A

-nasal d/c when head down

rarely dysphagia, not usually malodorous

53
Q

dx/tx of guttural pouch empyema

A 
dx:
-endoscopy
-rads (fluid line, chondroids)
-culture for Strep. equi
Tx:
-lavage with large volume of saline
-systemic abx
54
Q

guttural pouch mycosis

A

fungal infection often over a major blood vessel (internal carotid most common)

55
Q

CS of guttural pouch mycosis

A
  • epistaxis**
  • dysphagia
  • Horner’s, laryngeal hemiplasia, facial paralysis,etc.

Cardiopulmonary (Estrada-Fall 2014) (9 decks)

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