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Equine Medicine > Medical aspect of upper airway disease > Flashcards

Medical aspect of upper airway disease Flashcards

1
Q

Physical examination of the upper airway

A

check the respiratory rate: 8-12

effort to breath? is there any?

examine the horse at different angles, at rest and during exercise

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2
Q

Definition of rhinitis?

A

infection of the nasal passage, independent of the sinuses

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3
Q

What can cause rhinitis (generally)

A

a variety of virus, bacteria, fungal and parasitic agents

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4
Q

Viral agents causing rhinits

A

Equine influenza

Equine herpesvirus 1-4

Equine rhinovirus and adenoviruses

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5
Q

Bacterias causing rhinitis

A

uncommon

can be secondary to trauma (locus minoris)

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6
Q

Fungi causing rhinitis

A

aspergillus spp

condidobolus

cryptococcus

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7
Q

Parasites that can cause rhinitis

A

Habronema (muscae)

Draschia (mega)

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8
Q

What diagnostic measures can be used to diagnose rhinitis?

A

physical exam

endoscopy: sampling for culture, PCR

radiography

treatment: systemic or local

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9
Q

Different sinusitis

A

primary and secondary

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10
Q

Causative agents of primary sinusitis?

A

bacterial and fungal

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11
Q

Causative agents of secondary sinusitis?

A

Dental disease (molar teeth)

Sinus cysts

Neoplasia

PEH - progressive ethmoid hematoma

Trauma

sinonasal polyps

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12
Q

How is the nasal discharge when there is a rhinits?

A

usually unilateral discharge

it an be mucopurulent/serosanguineus with a fetid (bad) odor

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13
Q

General clinical signs of rhinits?

A

facial swelling

respiratory noise

head shaking

unilateral nasal discharge

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14
Q

Is there a secific sign shown when the rhinits is involving the frontal/maxillary sinuses?

A

lacrimal and exopthalmus

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15
Q

Diagnosis of rhinits, steps (alternatives)

A
  1. history
  2. percussion
  3. oral examinaion
  • endoscopy/sinus scopy
  • radiography
  • CT
  • MRI
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16
Q

What are the most common bacteria causing rhinits?

A

streptococcus, staphylococcus, polymicrobial infections

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17
Q

What treatments are used agains rhinits?

A

antibiotics - if bacterial

debridement

flushing

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18
Q

Methods of debridement in rhinits?

A

trephination (make a hole into bone)

sinus flap - drilling to get room for ndoscope/flushing

drainage

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19
Q

Diseass of the guttural pouch

A

Mycosis

empyema

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20
Q

Where is the fungal plaque of the guttural pouch?

A

it is typically located in the dorsal aspect of the medial compartment

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21
Q

What are the dangers of fungal plaque in the medial compartment of the guttural pouch

A

within the medial compartment of the guttural pouch lies a nervovasular bundle: 3 cranial nerves and arteries

if the arteris are affected they can rupture and give a nasty bleed

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22
Q

What are the most frequent fungi infecting the guttural pouch

A

aspergillus spp

mucor

fusarium

trichosporon

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23
Q

Clinical signs of guttural pouch mycosis

A

epistaxis - nosebleed

dysphagia

recurrent laryngeal neuropathy

nasal discharge

coughing

horners syndrome

fungal encephalitis

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24
Q

Different treatments for mycosis of guttural pouch

A

Medical

Lavage

Local antimycotic treatment

supportive treatment

systemic antimycotic treatment

supportive therapy

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25
Q

How is lavage performed on guttural mycosis?

A

with sterile infusion solutions

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26
Q

What are the local antimycotic treatment of guttural mycosis?

A

nystatin

enilconazole

ketokonazol

thiabendazole

natamycin

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27
Q

Supportive treatment to guttural mycosis

A

NSAID

Vitamin B1, C, E, selenium

nutritonal support because of their dysphagia

potassium iodine

ethylene diamine

immunomodulants: levamisole (cheap anthelminitc), zylexis

DMSO

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28
Q

Which drugs can be used systemically to treat mycosis of guttural pouch?

A

Ampetricin-B

Itrakonazol

Flukonazol

Voriconazole - very good

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29
Q

What can cause guttural pouch empyema?

A

bacterial infection of the pouch

ruptured retropharyngeal abscesses

stenosis of GP opening - impaired drainage

inspissanted purulent material forming chondrosis

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30
Q

which bacteria often cuases empyema of guttural pouch?

A

streptococcus equi - strangels of horses

31
Q

what can cause stenosis of the GP?

A

neoplastic grwth

fluid accumulation

32
Q

Clinical signs of GP empyema

A

intermittent chronic discharge

submandibular lymphadenopathy

parotis enlargement

increased respiratory noise

neuropathy/dysphagy are uncommon

33
Q

how can empyema of GP be diagnosed?

A

endoscopy

radiography: fluid lines
ultrasound: abscesses

34
Q

How is a bacterial GP empyema handled/treated?

A

it is highly contagious so there need to be strict biosecurity protocols

removal of exudate, fluishing iwth saline

sedating the horse to achieve a low head position

local AB - penicillin mixed with gelatin catheter or endoscope

35
Q

How are chondroid removed from GP in case of empyseam

A

endoscopy (surgery)

36
Q

Define pharyngeal lymphoid hyperplasia

A

common in younger horses, but in older: chronic inflammtion of the pharyngeal lymphoid tissue

37
Q

What are some causative agents of pharyngeal lymphoid hyperplasia?

A

Viral: EHV 1-2-4, influenza

Bacteria: streptococcus

38
Q

How is Pharyngeal lympoid hyperplasia diagnosed

A

endoscopy and graded from 1-4

39
Q

Clinical signs of Pharyngeal lympoid hyperplasia

A

nasal discharge

enlarged lymhnodes

coughing

poor performance

40
Q

Treatment of Pharyngeal lympoid hyperplasia

A

mild:reduce training

antiinfammtory treatment: dexamethasone, throath spray iwth nitrofurazone, dexamethasone, DMSO

systemic immunomodulators: interferon alpha

41
Q

Causative agent of strangles of horses

A

streptococcus equi spp equi

42
Q

Whate age groups does strangles usually affect?

A

younger horses 1-5y

43
Q

morbidity and mortality of starngles?

A

morbidity: 100%
mortality: 10%

44
Q

For how long is the virus of strangels shedded?

A

4-6w

45
Q

how long is the incubation period for strangels?

A

2-12d

46
Q

clinical signs of strangles?

A

fever, lethargy

serous to mucopurulent nasal discharge

hyperaemic nasal/ocular mucous mmbranes

mucopurulent ocular dicharge

firm then fluctuant lymph nodes

sowllen/painful throatlatch - stands with a stretched neck

refuse to eat

47
Q

Diagnosis of strangles?

A

clinical sign

bacterial cultur and PCR

48
Q

Treatemtn for strangels?

A

supportive care

soft palatable feed

NSAID: fluxin, bute

antibiotics after consideratoin

49
Q

How is AB considered for strangels case with no abscess formation?

A

early clinical signs, but no abscess formation - penicillin for 5 days - should be isolated

50
Q

how should horses with strangles that get abscess oframtion be treated with AB?

A

is they are stable: it is contraindicated,

51
Q

horses that are systemically ill or have complications from strangles - how should they be treated?

A

supportive care, IV penicillin, broad spectrum antibiotics

52
Q

What are some complications that can occur from strangels?

A

abscess formation in the mesentery/organs

purpura hemorrhagica

GP empyema/chondroid

septicaemia/septic arthritis

pneumonia

DNS disease

infarctive purpura hemorrhagica

immune mediated myositis

53
Q

What is purpura hemorrhagica?

A

leakage from the vessels, forming red spots on membranes and skin. edema of limbs

54
Q

General clinical signs of inflammatory airway diseases (IAD)

  • general?

secretions?

auscultation?

respiratory rate?

abdomnial breathing?

A

often subclinical

poor performance

chronic cough

increased airway secretion: mucous, muco-purulent nasal discharge

thoracic auscultation often noral

slighlt ucreased resp rate

abdomnial breathing increased

55
Q

What can be the cause if there is tracheal secretion at rest?

A

lower airway inflammation

56
Q

What causes horses with IAD to have poor performance(findings?

A

airway mucus

impaired gas exchange: hypoxaemia

BALF neutrofilia

57
Q

How would you check if the horse has IAD?

A

history and clinical signs

endoscopy

BALF cytology

throacic ultrasonography

Thoracic radiography

lung function test

respiratory endoscopy after work

58
Q

what is tracheal mucus scoring?

A

quantifying mucus accumulation

grading:

  • 2-5: poor performance in race horses
  • 3-5: poor performance in sport horses
59
Q

What is expected to find when performin BALF cytology in IAD case?

A

elevated nucleated cell count

mild neutrophilia, lymphocytosis and monocytosis

eosinophilia

mastocytosis

abnormal BALF - poor performance

60
Q

What is tracheal wash? and how is it as a diagnostic tool for IAD?

A

Collection of tracheal respiratory secretions for cytology and bacteriology using a fiberoptic endoscope or videoendoscope and collection catheter, to aid in the investigation of pulmonary disease.

not suitable to diagnose IAD

61
Q

How will a thoracic ultrasound look like in a ultrasound?

A

normal or comet tail artefacts (marked acoustic mismatch between small fluid-filled lung spaces and surrounding air.)

62
Q

How ill IAD look on the radiography

A

bronchial pattern

poor sensitivity

63
Q

What are the differential diagnosis of of IAD?

A

RAO

Upper airway disease

pleuropneumonia

viral infection

EIPH

Neoplasia

Lungworm infestation

64
Q

What is a simple treatment to fight IAD?

A

environmental management

change to shavings instead of hay

proper ventilation of the stable

65
Q

What medical treatment can be applied to treat IAD

A

Antibiotics

glucocorticoids

sodium-chromoglycate

interferon-alpha

bronchodilators

omega-3 FA

66
Q

When is glucocortiocids given in IAD case?

A

if infectious cause could be ruled out

67
Q

how long is usually the treatment of IAD?

A

2-4w

68
Q

what are the names of inhalational GGC?

A

fluticasone

beclomethasone

69
Q

Systemic GGC given to trat IAD

A

prednisolone

dexamethsone

70
Q

name a mast cell stabilizer given to treat IAD

A

sodium chromoglycate

71
Q

how is interferon alpha used in IAD case, what is its properties

A

one week rest treatment for 5 days

anti inflammatory properties

72
Q

Clenbuterol, salbutamol and salmeterol are?

A

B2 adrenergic agonists

73
Q
A

Equine Medicine (6 decks)

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