Module 14 Wk 3 Flashcards
(supportive care of farm animals)
What are the main differences of supporting farm animal species compared to small animal and equine
- Limited time on the farm
- Re-visits are expensive
- variable nursing conditions
- Economics/lack of insurance
- limited hospitalisation facilities
- limited option for referral
- owners often experienced
Describe how you might do a clinical assessment of a farm animal?
- Take a history
- Clinical exam
- On farm diagnosic tests
- come up with a differentail list
- consider further diagnostic tests costs etc
- Give the farmer options!!!
- agree on a plan
- do diagnostic tests
- final diagnostics
- discuss off of these results herd/flock inplications
On a dairy farm what are some questions you should ask?
- When are you planning on selling her?
- Is she pregnant?
- DIM?
- heifer or bull calve?
On a beef farm what are some questions you should ask?
- Is he (bull) insured?
- Is she pregnant?
- Is the calf weaned?
- When planning on selling?
- When did she calve?
What on site diagnostic tests can you do on farm?
- Clinical exam
- Urine dip stick (urinalysis)
- Ketone meter (blood)
- Brix refractometer (colostrum or total protien)
- calafornia milk test
- Calf scour ELISA
What cases on farm need veterniary support?
- Down animal
- post op
- scouring calf/lamb
- dystocia calf/lamb and mother
- septicaemia
- after draining big pocets of fluid
What are the most commonly available NSAIDs licensed in farm animals in the UK?
- Meloxicam
- Ketoprofen
- Flunixin meglumine
- Flunixin transdermal
What are the advantages of using steroids in farm animals for anti-inflammatory purposes?
- Broader range of licensed products
- Increases appetite
What are the disadvantages of using steroids in farm animals for anti-inflammatory purposes?
- Increased side effects esp if long-term use
- There is limited evidence for specific uses
T/F there are licensed NSAIDs and steroids for sheep?
False always has to be on the cascade
What is the best option for an NSAID in sheep? and at what dose?
Meloxicam - 1mg/kg - SC or IV
Where is the ideal IM and SC injection site in farm animals?
- IM in the neck
- SC behind shoulder
Describe how you would do a dehydration assessment on a farm animal
- Skin tent – on the eyelid or on the side of the neck
- Position of the eye – particularly in cattle, useful if the eye is sunk back, but not in skinny cows, as that will naturally make the eyeball sink.
- Capillary refill time.
- Mucous membranes to see if they are tacky or moist.
What are the 4 levels of dehydration?
Mild - 4-7%
Moderate - 8-10%
Severe - 10% plus
What clinical signs will you see in a farm animal with alkalosis?
- LDA/RDA
- Ceacal disease
- Vagal indigestion
- Ecoli mastitis
What clinical signs will you see in a farm animal with acidosis?
Grain overload and lack of saliva
Unless an adult cow is suffering from grain overload, can you assume that the cow is alkalotic?
Yes rarely acidotic
What is the electrolyte abnormality when there is a lack of saliva produced/swallowed?
Low sodium
What is the electrolyte abnormality when there is anorexia and no salivation present?
Low sodium, low potassium, (low calcium)
What is the electrolyte abnormality when there is abomasal disease?
Low potassium, low chloride
What is the electrolyte abnormality when there is diarrhoea?
Low sodium, Low chloride
What is the electrolyte abnormality when there is calf scour?
High potassium
What is maintenance for farm animal fluid?
50ml/kg/day
T/F lactating animals need more fluid maintenance?
100ml/kg/day
When should you use IVFT over oral admin of fluids in farm animals?
Shock
endotoxemia
GIT compromised like no suckle reflex in calves
dehydration greater than 10%
T/F most dehydrated adult cows need potassium and sodium?
True
T/F you dont need to follow up with oral fluid in cows that have had hypertonic saline IV?
Flase you do
what is the rate for hypertonic saline in cows?
4ml/kg IV in 10mins
What is the main advantage of IVFT of hypertonic saline in cows?
Fast correction of dehydration and reduces volume of fluids required, so saves farmer money
What rate should you administered fluid orally in farm animals?
40l max in one admin
What rate should you administered fluid IVFT in farm animals?
- shock rate is 40-80mg/kg in 1st hour
- however giving set cant be open enough so max is 7l/hour max
Whats your important list for a down cow
- Severe acidosis
- Septicaemia (mastitis, metritis, peritonitis)
- Severe lameness
- Dislocation or fracture
- Botulism
- Anaemia from uterine injury/bleeding
- Nerve damage (sciatic, obturator, radial, brachial plexus)
- Toxic mastitis
- Hypophosphatemia
- Hypomagnesemia (staggers)
- Hypocalcaemia (milk fever)
Questions for down cow?
- Recent calving?
- Was there a problem?
- Has she stood since she calved?
- Can she stand at all?
- How long has she been down?
- What is her demeanour/appetite?
- Previous/recent cases?
- Has she received any treatment?
what does Watery/bloody milk indicate?
Ecoli mastitis
What does crepitus indicate?
Fracture
what does no deep pain indicate in down cow?
nerve damage
What does pale MM in down cow indicate?
Anaemia
What does fitting in a down cow indicate?
hypomagnesaemia
What are you testing Ca/Mg/Ph in a down cow for?
staggers
What are you doing PCV on a down cow for?
Anaemia
What are you testing creatine kinase and AST for in a down cow?
Muscle damage
(Equine Emergencies)
What are common emergencies seen in equine practice for the alimentary and Liver?
Colic
abdominal trauma
Choke (oesophageal obstruction)
poison/toxins
concentrate overload
What are common emergencies seen in equine practice for the respiritory?
Dyspnoea (obstruction)
thoracic trauma (open thorax)
What are common emergencies seen in equine practice for the Cardiovascular system, spleen and blood?
severe haemorrhage – wound or guttural pouch mycosis
What are common emergencies seen in equine practice for the Nervous system?
Trauma/fracture – cranial, spinal
Tetanus
Pharyngeal paralysis
Vestibular syndromes
What are common emergencies seen in equine practice for the special senses?
corneal laceration
closed eye
uveitis
corneal ulceration
eyelid laceration
What are common emergencies seen in equine practice for the urinary system?
obstruction to urine outflow
trauma to penis
What are common emergencies seen in equine practice for the musculoskeltal system?
Fractures and some tendon and ligament injuries
Wounds (laceration or puncture) atypical myopathy
synovial contamination
foot penetration
myopathy
laminitis
What are common emergencies seen in equine practice for the reproductive system?
Dystocia
‘red bag’ delivery
Retained placenta
foal not sucking
what equipment should you have to be prepared for an equine emergencies?
Personal protective equipment
Restraint - Head collar, twitch
Drugs
Equipment like Stomach tubes, funnel, rectal gloves, lube, clippers, torch, scrub, Bandages, suture material, surgical kit
Splints, IV fluids, catheters, sterile gloves
Farriery and dental equipment
Euthanasia
Over the phone what is your aim with a potential equine emergency?
Is this really an emergency?
Information - history and signalment
Guidance whilst they wait
What should your initial assessment entail at the scene of a potential equine emergency?
Is this really an emergency?
Take in the whole situation and assess risk, and surroundings
‘Stand back’ and observe the horse
Are there humans at risk?
Clinical exam
Prioritise one animal over another?
History
what should you take in to consideration before sedating a horse in a emergency?
- Human safety
- Animal safety
- Having a calm and logical approach
- Gain adequate restraint
- Then consider sedation
T/F you should sedate a horse in a quiet enviroment?
True
What should you base you choice of sedation on?
- Age, breed and temperament
- Clinical findings
- Procedure to be performed - Duration, expected pain level
- Previous sedation history
How is an Alpha 2 agonist as a sedative?
Reliable and dose-dependent
Why is it common for an Alpha 2 agonist to be combined with an opioid in horses?
It decreases the likelihood of being kicked
How is an Alpha 2 agonist as a analgesia?
Gives visceral and somatic analgesia
why might you want visceral analgesia in a horse?
Colic
Why would you use an alpha 2 agonist for muscle relaxation in a horse?
May aid with treatment of choke
What 3 alpha 2 agonists are licenced in horses UK?
Xylazine
Detomidine
Romifidine
For horses what is the route of choice for alpha 2 in horses?
IV
When is peak action following IV injection of an alpha 2 agonist?
2-5mins
What are the important side effects of alpha 2 agonists in horses?
- Bradycardia
- Arrhythmogenicity
- Reduce GI motility
- muscle relaxation
- take care in pyrexic horses
Why is bradycardia an importnat side effect to be aware of with an alpha 2 agonist in horses?
Alpha 2 agonists reduce cardiac output and are resp depressant
why might reduction of GI motility as a side effect of alpha 2 agonists in horses be a problem?
As it can impair the assessment of colic, and repeated doses or continuous rate infusion can cause colic.
Why might alpha 2 agonists causing muscle relaxation be a problem in horses with upper airway obstructions?
As muscle relaxation can exacerbate pre-existing obstruction and can also impair endoscope assessment.
Why should you take care in pyrexic horses when using alpha 2 agonists?
As it can induce tachypnoea and can be antipyretic
What is the duration of sedation/analgesia of xylazine IV?
20/30mins
What is xylazine good for?
Assessment of a fractious colic
What is the duration of sedation/analgesia of detomidine IV?
40-60mins
What other routes is there for detomidine in horses?
- IM
- Oral Transmucosal
What is detomidine usually combined with?
Butorphanol
Compared to romifidine combined with butorphanol how does detomidine + but differ?
- Plants feet to ground better
- Has a greater muscle relaxation which causes greater instability and ataxia
- Has a greater sedation at a lower dose range with greater analgesia.
T/F you should use detomidine on its own when dealing with colic?
True
What is romifidines duration of sedation IV?
60-120 mins
T/F rom + but has a weaker sedation than Dom + but?
True
When using butorphanol (opiod) in a sedation for a horse what should you always combine it with?
An alpha 2 agonist
T/F butorphanol has good analgesia?
False - relatively poor
What are the side effects butorphanol can induce in horses?
- Reduction in SI activity but minimal effct on pelvic flexure
- Cardiovascular and resp depression
What are alternative opiods you can use in horses instead of butorphanol?
Morphine and buprenorphine
Give a dosage for Rom + But for a heavy sedation for standing castration
0.9ml/100kg rom + 0.2ml/100kg but
Give a dosage for dom + But for a heavy sedation for standing castration
0.1ml/100kg dom + 0.25ml/100kg but
Give a dosage for dom + But for a moderate sedation for dental exam
0.2ml detomidine and 0.3ml butorphanol
Give a dosage for rom + But for a moderate sedation for dental exam
1ml romifidine and 0.5ml butorphanol
What forms do ACP come in for horses?
IV, IM or oral gel
T/F ACP has sedation effects but not analgesia?
True
What is ACP on its own used for in horses?
To calm an anxious, but cooperative horse
What would you use ACP in combination with?
An alpha-2 agonist and butorphanol
what are your first line antimicrobials in horses?
penicillian
gentamicin
trimethoprim/sulphadiazine
metronidazole
what are your classical signs of colic?
pawing, flank watching, rolling
But also more generic signs: ‘distressed’, increased respiratory rate, sweating, odd stance, dull demeanour, not eating
what are the 7 classificaltions of colic?
- Spasmodic (40% of cases)
- Impactive
- Flatulent/tympanic
- Obstructive
- Non-strangulating infarction
- Enteritis (anterior enteritis colitis)
- Idiopathic
What is nasogastric intubation?
Where a tube is passed via ventral meatus
Why would you use a nasogastric intubation technique in horses?
Diagnostics
- more than 2L reflux indicates SI obstruction or ileus
- tube not going into stomach indicated choke
Treatment
- for short term treatment of SI obstruction
- prevent gastric rupture
- analgesia
- admin of fluid or medication
- small volume lavage for choke
What NSAIDs can you use for colic in horses?
- Phenylbutazone - NL
- Meloxicam - L
- Ketoprofen - L
- Fluxin Meglumine - L
What is the duration time for phenybutazone in horses?
2hrs
What is the most potent NSAIDs in horses?
Flunixin meglumine
What is the combination in somulose?
Quinalbarbitone and cinchocaine combination
T/F you have option to sedate with A2A prior to euthanasia?
True
How long should you inject somulose over?
10-15s
(Large animal rescue)
What types of rescues could you be called to involving large animals?
- Animals trapped in/down/over/under
- RTA
- Fire
- Natural disasters
Why are humans at risk when working with large animals?
They are prey animals so they react to most threats with flight motivated fear and have a built in flight and herd mentality so if feel threatedned risk of them attacking you.
With horses describe how their senses effect situations like a rescue?
Vision
- they have a 360 visual field so have excellent motion detection meaning they sense everything around them
Hearing
- Loud noises and high pitches can stimulate fear reaction
Olfaction
- strange smells like smoke and blood can induce fear
Touch
- often they are senstive around the face, head and ears
T/F owners of horses may cause problems in a rescue?
YES - they act irrationally putting them and everyone else at risk
What are the roles of fire and rescue service in an animal rescue?
Identify hazards to both human and animal
Control and mitigate risks to human and animal
Determine if rescue is required and if so viable
Rescue or remove animal(s) from a place of danger to a place of safety using the most humane and effective method
What is a vets role in an animal related rescue?
Work as a specialist member of a rescue team
Assess animal related risks
Assist in formulating a tactical plan
Provide Veterinary medical support
List some natural sedatives you can use to reduce wind up in horses?
Entrapment
Temperature
Feed – hay or grass
Companion animal
Minimise stimulation
Blindfold - dependant on demeanour
Owner - dependant on demeanour
What are the causes of a recumbent horse?
Colic, myopathy, laminitis, osteoarthritis, ‘winded’ following fall or Neurological
T/F you should move horse straight away in a rescue?
False - should wait 30mins-1hr
When should you use chemical control in a horse rescue?
During prep for extraction and during extraction to safe space.
T/F When the horse is wound up, you should use a higher dose of sedation?
True should be double
What drug should you not use in last trimester in cattle and why?
Alpha 2’s as risk to abortion
What is the percentage of the xylazine solution used in cattle?
2%
What route is Xylazine licenced to be administered via?
IM but can use IV under the cascade
T/F high doses of xylazine often induces recumbancy?
True
When would you use detomidine in cattle?
When you want a longer and deeper sedation
What are the three types of problems with equine anaesthesia?
- Intra-operatively (during)
- Post-operatively (recovery)
- Post-recovery
Focussing on systems in the body, what are examples of intra-operative problems in equine anaesthesia?
- Cardiovascular collapse
- Respiratory failure
- Metabolic diseases such as kidney or liver affecting the ana
What are examples of Post-operative problems in equine anaesthesia?
- Traumatic injury when recovering
- Myopathy
- Neuropathy
- Post anaesthetic colic
What are 2 examples of post-an recovery problems seen in equines?
- Laminitis
- Organ failure
What is the definition of hypotension?
Reduction in mean arterial blood pressure
What is an ideal mean arterial BP in equines?
70-90mmHg (concerning <60mmHg)
T/F hypotension is not a common complication of inhalent anaesthesia
False - It is
Why do horses develop hypotension?
- BP is affected by cardiac output and systemic vascular resistance
- Cardiac output is directly proportional to stroke volume multiplied by the heart rate
- If you have high systemic vascular resistance then the pressure of that stroke volume will increase the BP.
How do inhaled ana aid development of hypotension in horses?
- Decrease contractility = This will reduce stroke volume
- Decrease heart rate = reduce cardiac output
- Decrease systemic vascular resistance = will help drop BP too
what is the significance of hypotension in horses?
Causes reduced perfusion to organs and this can causes increased lactate build up which acts as a precurser fro equine post ana myopathy.
How can you measure BP non invasively in horse?
Cuff or Oscillometric
How can you measure BP in horses invasively or direct?
By placing a cannula in either the facial artery or Metatarsal
How to treat hypotension?
- Turn ana down if possible
- Treat hypovolaemia - crystalloids or colloids or saline but not colloids or saline without crystalloids.
- Dobutamine infusion to increase contractions
- Ephedrine to increase contractions and increase SVR
- Phenylephrine to increase SVR
What are the most common arrythmias in horses?
Primary or secondary atrioventricular block
T/F Ventricular and junctional arrhythmias are abnormal in horses
True
What are potential reasons for tachycardia in horses?
Hypovolaemia
Hypoxaemia
Pain/nociception
Drug induced
What are potential reasons for bardycardia in horses?
Hypertension
Hypoxaemia
Drug induced
What is Hypercapnia?
Hypoventilation
It is an increase in end tidal co2, reduction of exhaled co2
T/F hypoxaemia is a side effect of hypoventilation
True
Why do horses hypoventilate?
- ana agents
- positioning
What are the effects of ana inhalents on ventilation in horses?
Decrease ventilatory drive
Desensitise medullary and carotid body
Reduced minute ventilation
Respiratory acidosis
Increased atelectasis and V/Q mismatch which leads to hypoxaemia
What is hypercapnia?
it is the failure to eliminate adequate CO2
What does hypercapnia cause?
An increase in arterial concentration so leading to the development of acideamia
How should you treat hypoventilation?
- depth of anaesthetic
- provife IPPV
What are the 5 causes for hypoxaemia?
- Inadequate inspired oxygen
- Impaired diffusion across alveoli
- Hypoventilation -frequent under anaesthesia
- VQ mismatch -frequent under anaesthesia
- Shunting of blood -occurs a s a result of V/Q mismatch
How can you prevent ventricular-perfusion mismatch?
- positioning
- IPPV?
- air:o2 mixture for delivering gas
How can you treat ventricular:pressure mismatch
Bronchodilators - sabutamol or clenbuterol
