Myocarditis and vascular disease Flashcards
What are signs of non-septic jugular thrombosis?
Thickening cording of the vein, reduction in patency
What are signs of septic jugular thrombosis?
Hot
painful
discharging tracts
What are the main clinical signs of jugular thrombosis?
Venous occlusion causing swelling in cheek, lips, tongue, supraorbital area, dysphagia and upper airway obstruction
Why do you get swelling of head structures with jugular thrombosis
Jugular vein is the main vessel draining blood from the head
__________________ or _______________ are the main causes of jugular thrombosis
IV catheterization or injection
List 5 predisposing factors of jugular thrombosis
Systemic inflammatory response syndrome
Multi-organ dysfunction syndrome
Irritant drugs
Poor catheter placement
Poor catheter use
So sicker horses at increased risk
How is jugular thrombosis diagnosed?
Ultrasound and culture of fluid aspirate/swab/blood
How is ultrasound used to diagnose jugular thrombophlebitis
Assess extent of thrombus
Identify sepsis (cavitation)
Assess patency of vein
Distinguish perivenous swelling from thrombosis
Select site for aspiration
How is jugular thrombosis treated?
Broad spectrum antibiotics- especially if think septic
anti-inflammatories (aspirin/NSAIDs)- try to reduce platelet build up
heparin anticoagulant
vasodilators
raise head
List 2 alternatives to jugular venous access
lateral thoracic
cephalic
What are some complications seen with jugular thrombosis?
embolic disease (bacterial endocarditis or septic pneumonia)
Long term poor performance due to:
- Recurrent laryngeal neuropathy
- Upper airway oedema during exercise
Where should IV injections be given and why?
Proximal third of neck to avoid carotid artery
What catheter material is the least thrombogenic?
Polyurethane
What is least thrombogenic: rigid over the needle catheters or flexible catheters?
flexible catheters
What is aortic thrombosis?
Partial/complete occlusion of the terminal aorta and external and internal iliac arteries by thrombus
Describe the aeitology of aortic thrombosis
Unknown
parasitic- unlikely
What are clinical signs of aortoiliac thrombosis?
Poor performance
Exercise-associated hindlimb lameness
Breeding failure in stallions
After exercise
- Cold limb
- Weak pulses
How is aortic thrombosis diagnosis?
Palpate thrombus/turgid vessel on rectal exam
Ultrasound -transrectally
Describe how to treat aortic thrombosis
NSAIDs
Aspirin
Fenbendazole- larvicidal anthelmintic
describe the prognosis for horses with aortic thrombosis
guarded
___________ is the most common cause of sudden death during exercise in horses
Vascular rupture
_________ and ____________ are the most common sites of vascular rupture
Aorta and pulmonary artery
What are some other differentials for severe distress following strenuous exercise with colic type pain, including vascular rupture?
stress fractures
exertional rhabdomyolysis
arrhythmias
When can Rupture of the Uterine Vessels occur
in Periparturient broodmares, particularly immediately before or after foaling but up to 3 weeks after
Describe how to manage a rupture of uterine vessels
conservative
support circulation
analgesia
avoid excessive movement
What is a aorto-cardiac fistula
Congenital or acquired defect of the aortic wall
there is a communication between the aorta and atrium
What horses are Aorto-Cardiac Fistula more likely seen in
intact males
List the clinical signs of Aorto-Cardiac Fistula
sudden death
distress
ventricular tachycardia
loud continuous murmur
Describe how to diagnose Aorto-Cardiac Fistula
echocardiography
what is the prognosis for a horse with a Aorto-Cardiac Fistula
hopeless
what vasodilators can be given to horses
glyceryltrinitrate
if bilateral thrombosis occurs, what may be required
tracheostomy
why do we use extension sets in horses
to avoid excessive manipulation
how often should you change ports/fluid lines
every 24 hours
define aneurysm
ballooning of a weakened portion of an arterial wall
List 3 things that can cause pre-existing aneurysms
medial degeneration
congenital
parasitic
