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Equine Medicine and Surgery > Lecture 22: Equine Lower Respiratory Tract disease: Bacterial > Flashcards

Lecture 22: Equine Lower Respiratory Tract disease: Bacterial Flashcards

1
Q

What are some signs of pneumonia

A

Creamy nasal discharge, increase HR, enlarged LNs, stertorous breathing, milked crackles, wheezes

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2
Q

What are some signs of pleuropneumonia

A

Muffled lung sounds, crackles/ friction rubs, plaque ventral edema, pleurodyna

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3
Q

Horse presents with suspected pneumonia what is an appropriate diagnostic plan on farm

A

SAA, lactate iSTAT, CBC/chem, fibrinogen, ultrasound, trans tracheal wash, nasal swab

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4
Q

Horse presents with suspected pleuropneumonia what is appropriate diagnostic plan on farm

A

Stabilize and refer

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5
Q

Streptococcus equi is a highly contagious pathogen of ___

A

Upper respiratory tract

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6
Q

What are some clinical signs of Strangles

A

Fever >103, mucopurulent nasal discharge, acute swelling, abscess formation in submandibular and retropharyngeal LN’s

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7
Q

What is the pathogenesis of strangles

A

Bacteria enters mouth or nose and reaches tonsil tissue within hours

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8
Q

Nasal shedding of S. Equi occurs when and lasts for how long

A

2-3 days after fever and persists for 2-6 weeks

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9
Q

If chondroids develop due to strangles horses can shed the virus for ___

A

Years

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10
Q

75% of horses recovered from strangles develop immunity that lasts for __yrs

A

5yrs

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11
Q

What is the cold standard to dx strangles

A

Culture of purple t material

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12
Q

What is the best sample to culture for strangles to the worst

A

Guttural pouch washes> nasopharyngeal wash> rostal nasal wash

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13
Q

To dx strangles you can do a PCR for ___ which is useful for detecting ___

A

M protein, asymptomatic carriers

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14
Q

To dx strangles you can do an ELISA for __ which is useful for __,___,___, or ___

A

SeM protein, useful for vaccination, exposure, purpura and bastard strangles

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15
Q

How would you manage group of horses that have evidence of strangles on farm

A

Isolate, undergo tx

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16
Q

How would you manage horses on a farm that were exposed to strangles

A

Isolate, twice daily temp checks, if fever tx with antibiotics

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17
Q

How would you manage horses on a farm that were not exposed to strangles, but still on same farm

A

Isolate, twice daily temp checks, vaccinate in 2 weeks

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18
Q

Horses shed strangles for ___weeks following last clinical sign

A

6 weeks

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19
Q

What are some appropriate biosecurity measures for prevent strangles spread

A
  1. Dedicated clothing and equipment to each group
  2. If personal must work with all groups clean in order: 3, 2,1
  3. Disinfect
  4. Pastures rested for 4 weeks
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20
Q

What is tx for mild strangles

A

Isolate, soft palate feeds, and NSAIDS

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21
Q

What is a complication of strangles (why it is called strangles)

A

Upper respiratory obstruction

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22
Q

What is the appropriate treatment for strangles causing upper respiratory obstruction

A
  1. Tracheostomy or drain LN
  2. Treat with penicillin- procaine penicillin G, NSAIDS, Iv fluids
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23
Q

What is the most common complication of strangles following obstruction

A

Pneumonia/ bronchopneumonia

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24
Q

What is tx for bastard strangles

A
  1. Potentiated sulfonamides + rifampin
  2. Cephalosporin
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25
Q

What is purpura hemorrhagic

A

Aseptic necrotizing autoimmune vasculitis characterized by petechial and ecchymotic hemorrhages

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26
Q

What is tx for purpura hemorrhagic

A

Corticosteroids (dexamethasone), antibiotics, NSAIDS, supportive care

27
Q

What is tx for Immune mediate myositis caused by strangles

A

Corticosteroids

28
Q

What vaccine is used against strangles

A

Live IN pinnacle- two administrations, 2 weeks apart

29
Q

Do not give the Live pinnacle IN vaccine in the ___, it will cause abscesses

A

Muscle

30
Q

What are the inductive sites for the strangles IN vaccine

A

Pharyngeal and lingual tonsils

31
Q

How long will horses test positive on PCR after strangles vaccine

A

6 weeks

32
Q

What is the most common bacteria implicated in pneumonia

A

Streptococcus

33
Q

Horses depend on ___head position for normal mucocillary apparatus so long ___with heads tied up can stop this defense mechanism

A

Lowered, trailer rides

34
Q

What are some clinical signs of bronchitis

A

May be normal at test with a cough at exercise +/- fever

35
Q

What are some signs of bronchopneumonia/ pneumonia

A

Fever, anorexia, nasal discharge, cough, weight loss, tachypnea, respiratory distress

36
Q

What are some signs of pleuropneumonia/ pleuritis

A

Pleurodynia, unwillingness to move, grunting, abducted elbows, pleural friction rubs, plaque ventral edema

37
Q

What is the pathogenesis of pneumonia

A

Infiltrate neutrophils, consolidation of lung parenchyma or focal abscess that interfere with gas exchange

38
Q

What occurs inn severe pneumonia pathogenesis

A

Sterile fluid fills pleural space, bacteria invade pleural fluid, results in septic exudate and fibrin deposition

39
Q

25% of horses with pleuropneumonia have a history of ___

A

Recent long distance transport

40
Q

12% of horses with pleuropneumonia have a history of ___

A

Recently undergoing anesthesia

41
Q

What are some clinical pathology signs associated with pneumonia

A
  1. Leukocytosis with neutrophila +/- left shirt
  2. Hyperfibrinogenemia
  3. Increase SAA
  4. Hyperglobinemia
  5. Anemia of chronic dz
42
Q

What is an SSA value indicative of infection and what is normal

A

Infection >50
Normal <15

43
Q

What is an valuable diagnostic imaging for pleural disease

A

Ultrasound

44
Q

What is the most helpful diagnostic in pleural disease

A

Transtracheal wash

45
Q

How can you collect tracheal fluid

A

Pop needle into trachea or via endoscopy

46
Q

What cytology of transtracheal wash is indicative of pleural dxz

A

Neutrophilic with intra and extracellular bacteria

47
Q

Why is a thoracocentesis helpful for pleural dz

A

Diagnostic and therapeutic

48
Q

What is an appropriate anti microbial therapy for mild pleural dz/ pneumonia

A

Cephalosporins (Excede), potentiated sulfonamides

49
Q

What is typically cause of mild pleural dz/ pneumonia

A

Streptococcus equi zooepidemicus

50
Q

What is an appropriate tx for moderate pleural dz/ pneumonia

A
  1. Penicillin/Gentamicin
  2. Cephalosporins/ Gentamicin
51
Q

What is an appropriate antimicrobial therapy for severe pleural dz/ pneumonia

A
  1. Pencillin/ Gentamicin/ metronidazole
  2. Pencillin/ Enrofloxacin/ metronidazole
52
Q

Bacteriodes fragilis is typically present in severe pleural dz/ pneumonia and is resistant to ___, so must use ___ to tx

A

Pencillin, metronidazole

53
Q

Which aerobe that can cause pleural dz/ pleural pneumonia carriers a guarded prognosis, 48% don’t survive

A

Klebsiella spp

54
Q

Which has a worse prognosis for return to athleticism: aerobes or anaerobes

A

Anaerobes

55
Q

What is the appropriate supportive therapy on the farm for pleural dz/ pneumonia

A

NSAIDS, Iv fluids

56
Q

What is the appropriate tx for pleural dz/ pneumonia in hospital

A

Opioids, oxygen, cryotherapy, nebulization of antimicrobials, pleural drainage/lavage, heparin to prevent microthrombi

57
Q

Why is early pleural drainage best

A

Fibrin deposition forms loculation that impair drainage

58
Q

What are some complications associated with pleural dz/ pneumonia

A

Thrombophlebitis and coagulopathies, diarrhea, endotoxemia, laminitis, pleural abscesses, bronchopleural fistula, pericarditis

59
Q

To perform a thoracotomy and rib resection you must have a ___

A

Closed mediastinum

60
Q

T or F: thoracotomy incision is left open and closes by granulation over 2-3 months

A

True

61
Q

What is prognosis for mild to moderate bronchopneumonia

A

Good prognosis for return to previous athletic performance

62
Q

What is prognosis for pulmonary abscess

A

50-90% returned to previous athletic performance

63
Q

What is prognosis for uncomplicated pleuropneumonia

A

56-61% returned to previous athletic performance

64
Q

What is prognosis for complicated pleuropneumonia

A

88% survive to discharge, 46% returned to previous level of activity

Equine Medicine and Surgery (27 decks)

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