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Equine Medicine and Surgery > Lecture 25: equine lower respiratory disease: inflammatory > Flashcards

Lecture 25: equine lower respiratory disease: inflammatory Flashcards

1
Q

What is normal respiratory rate

A

8-12bpm

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2
Q

___should be twice as long ___ in normal breathing

A

Inspiration, expiration

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3
Q

___should be passive in normal breathing

A

Expiration

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4
Q

What are some signs of increased RR

A

Flared nostrils, prolonged expiration, grunts, abdominal push, noise, anxious facial expression

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5
Q

Asthma is mediated via ___, increased ___cells

A

IgE, mast cells

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6
Q

Cytokines are __in inflammatory airway disease

A

Increased

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7
Q

There is ___in the epithelial lining fluid in airway inflammation

A

Leukocytosis

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8
Q

What are some results of airway inflammation

A
  1. Decreased size of airway
  2. Mucus plug
  3. Broncospams
  4. Increases in airway wall collagen and smooth muscle
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9
Q

What are some signs of RAO

A

Increased expiratory effort at rest, flared nostrils, mucopurulent discharge, spasmodic productive cough, thin, crackles and wheezes, exercise intolerance

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10
Q

Horses with RAO tend to be >__yrs

A

7

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11
Q

What part of country is summer pasture associated RAO

A

Southern US

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12
Q

When and why does summer pasture associated RAO occur

A

Horses turned out in spring and summer, hot humid weather, high environmental contamination with fungal spores and grass pollens

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13
Q

Inflammatory airway disease typically affects who

A

Young horses in performance training, typically following virus insult

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14
Q

What is the predominant sign of inflammatory airway disease and some other signs

A

1 sign: Cough with exercise

Other: mucus in airways, prolonged exercise recovery, worsens in hot and humid weather

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15
Q

What is the best diagnostic for lower airway inflammation

A

Bronchoalveolar lavage

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16
Q

What is not a good diagnostic for lower inflammatory airway disease/ smaller airways

A

TTW

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17
Q

What sedative is good for BAL

A

Butorphanol-antitussive

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18
Q

How do you perform a BAL

A
  1. Pass tube until hit bronchus
  2. Trickle 1% lidocaine in trachea as you pass tube
  3. Fill cuff with air
  4. Instill 240ml of sterile saline
  5. Withdraw at least 50% back
  6. Submit for cytology
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19
Q

The presence of ___in a BAL confirms good sample

A

Surfactant

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20
Q

What are some BAL cytology findings indicative of RAO

A

Neutrophils >25%, mucus curschmann;s spirals- inspissated mucus casts

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21
Q

What are some BAL cytology findings indicative of Inflammatory airway disease

A

Neutrophils >5%, mast cells >2%, eosinophils >1%

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22
Q

What is the treatment the broad tx for RAO and inflammatory airway disease

A

Bronchodilator with steroid

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23
Q

You cant use bronchodilator without steroid because ___

A

Rapid resistance

24
Q

What can you do to food to tx RAO and inflammatory airway disease

A

Dampen hay, wet pellets, hay steamer, feed on ground

25
Q

How do steroids tx RAO and IAD

A

Inhibit arachidonic acid pathway and limit production of leukotrienes and cytokines

26
Q

What are some inhaled steroids to tx RAO and IAD

A
  1. Fluticosone
  2. Nebulized budenoside
  3. Aservo equihaler
27
Q

What are some systemic steroids to tx RAO and IAD

A
  1. Dexamethosone
  2. Prednisolone
28
Q

What systemic steroid should you avoid in tx of RAO and IAD d/t laminitis

A

Triamcinolone

29
Q

How do bronchodilators tx RAO and IAD

A

Increase ciliary beat frequency, decrease mucus production and release of inflammatory mediators

30
Q

Which bronchodilators are preferred: inhaled or systemic

A

Inhaled

31
Q

What are some inhaled bronchodilators to tx RAO and IAD

A

Albuterol- B2 agonist, ipratromiun- PNS

32
Q

What systemic bronchodilators can be used to tx RAO and IAD

A
  1. Clenbuterol
  2. Albuterol syrup
  3. Atropine
  4. Buscopan
33
Q

How do systemic parasympatholytics tx RAO and IAD and what are 2 examples

A

Block muscadine acetylcholine receptors preventing bronchoconstrictions

Atropine, buscopan

34
Q

How do mast cell stabilizers work

A

Block Ca2+ channel preventing release of histamine and tryptase

35
Q

What antihistamine is commonly used to tx RAO and IAD

A

Certirizine

36
Q

What is the goal RR in tx RAO and IAD

A

<20bpm

37
Q

What is the eventual outcome of RAO

A

Pulmonary fibrosis, hypertension, right sided heart enlargement and failure, cor pulmonale

38
Q

What is the pathophysiology of EIPH

A

Pulmonary hypertension with low inspiratory alveolar pressure, secondary stress failure of capillaries, reduced compliance of vasculature

39
Q

What is clinical sign of EIPH

A

Epistaxis

40
Q

What radiographic sign is indicative of EIPH

A

Caudodorsal interstitial pattern

41
Q

What is grade 0 EIPH

A

Normal

42
Q

What is grade 1 EIPH

A

One or more flecks of blood

43
Q

What is grade 2 EIPH

A

Single stream of blood

44
Q

What is grade 3 EIPH

A

Multiple streams of blood

45
Q

What is grade 4 EIPH

A

Multiple convalescing streams of blood, covering 90% and pooling at thoracic inlet

46
Q

What drugs/tx can you do to prevent EIPH

A

Furosemide: decrease pulmonary arterial pressure
Nasal strips

47
Q

Interstitial pneumonia is thought to be __ or __etiology

A

Toxic or infectious

48
Q

What are some things that can cause interstitial pneumonia

A

Perilla ketones, oxygen therapy, smoke, sillcosis, SIRS

49
Q

What is clinical presentation for interstitial pneumonia

A

Dying, pulmonary edema, restrictive rapid breathing pattern, severe respiratory distress, hypoxemia

50
Q

What method is diagnostic for interstitial pneumonia

A

Pulmonary biopsy

51
Q

What drugs are used to manage interstitial pneumonia

A
  1. Dexamethasone
  2. Beclomethasone
  3. Beta 2 agonist, parasympatholytic
52
Q

Prognosis for interstitial pneumonia in adults is __ and in foals ___

A

Guarded, favorable

53
Q

What is cause of interstitial pneumonia, pulmonary fibrosis

A

EHV-5

54
Q

What is tx for pulmonary fibrosis, interstitial pneumonia

A

Valcylovir

55
Q

What is prognosis for pulmonary fibrosis, interstitial pneumonia

A

Guarded

Equine Medicine and Surgery (27 decks)

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