Non-infectious Respiratory Disease 2 Flashcards

1
Q

What type of anti-inflammatory drug is not effective for equine asthma?

A

NSAIDs

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2
Q

What are some systemic corticosteroids used for asthma?

A

Dexamethasone (PO)
Prednisolone (PO)

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3
Q

Which steroids can be inhaled?

A

Fluticasone and Ciclesonide

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4
Q

When should you use systemic therapy?

A

Severe Airway disease
-Switch to oral later
-Cheaper
-Less labor and equipment

-Effects all of immune response, makes them more suseptible to infection and heavy parasite load/skin disease
-Increase risk of laminitis

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5
Q

What are some inhaled meathods?

A

Flexineb and equihaler
-nebulizers
-Mild to moderate horses
-Ciclesonide - inactive, activated in lung when reach airway epithelium

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6
Q

What are some advantages of inhaled therapy? Disadvantages?

A

Advantage: local effect - rapidly degraded when enters blood, minimal side effect, best for long term maintenance

More expensive, labor and equipment intense

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7
Q

What is treatment of asthma based on?

A

Severity of clinical signs

-Mild - change environment first
-Fails to respond then more changes
-Mild- severe - IV corticosteroid and oral bronchodilator (clenbuterol)

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8
Q

When do you stop a corticosteroid?

A

Low dose and no evidence of clinical signs returning, Enviromental modification in place

Recheck BAL - confirm airway inflammation resolved (No neutrophilic inflammation) - recheck every 3 weeks

Always taper

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9
Q

When maintaining remission what is critical?

A

Client Education
-Ask about nasal discharge, cough, temp, other horses affected, change in management
-Recommend changes in environment
-Can reproscribe for time of year

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10
Q

What are some additional considerations for equine asthma horses?

A

Weight loss - untreated
Poor Response - Bronchial malacia (Bronchiectasis) - melting bronchi

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11
Q

What does IAD stand for?

A

Inflammatory Airway Disease

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12
Q

What are some other names for IAD?

A

Small airway inflammatory disease, lower respiratory tract inflammation, small airway disease, noninfectious airway disease, bronchiolitis, allergic airway disease

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13
Q

What is the common signalment for IAD?

A

Young 2–3-year-old racehorses, no history of recurrence or seasonality

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13
Q

What are some clinical signs of IAD and what does it look like on cytology?

A

Persistent, intermittent cough, nasal discharge, tracheal mucus

5-205 neutrophils in BAL, mainly nondegenerative

No response antibiotic

Reversible if caught early

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14
Q

Where does inflammation and injury occur?

A

-Injury to airway epithelium
-Decreased clearance and accumulation of debris
-Vicious cycle

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15
Q

What occurs in the IAD Cycle?

A

Epithelial injury -> mucociliary disruption -> Accumulation mucus and debris-> persistence epithelial inflammation and injury -> more mucociliary damage -> accumulate mucus and debris _> epithelial damage

16
Q

Does bacteria play a role in IAD?

A

Not typically - if bacteria secondary to decreased mucous clearance

17
Q

How do you diagnose IAD?

A

Signalment, breed, history

Signs: Cough, mucus, exercise intolerance

18
Q

How can you sample for IAD?

A

Tracheal Wash

or

Bronchoalveolar Lavage (Preferred for IAD) - sample right dorsal diaphrgmatic lung lobe (lower airway better indicator disease status)

19
Q

What does the typical inflammation from cytology of IAD look like?

A

Neutrophils, mast cell, eosinophil - less bacteria

(Hint at allergy)

20
Q

What is the most important part of treatment of IAD?

A

Enviromental management - barn, turnout, medicate if not better with prednisolone

21
Q

What is EIPH?

A

Exercise Induced Pulmonary Hemorrhage

22
Q

What are factors that increase the risk of epistaxis?

A

Racing
Steeplechase
Older (2-4 or 9-10)
Female

23
Q

What is the pathophysiology that causes EIPH?

A

Extreme negative pressure in alveoli of exercising horse and extreme positive pressure due to increase blood flow = increased transmural pressure on capillary = bust

Hemorrhage = inflammation
Inflammation = neo-vascularization
New vessel rupture = cycle start over

24
Q

What area of the lung is effected by EIPH?

A

Dorso caudal region

25
Q

How do you diagnose EIPH?

A

Endoscopy - single or repeat
TTW - poor with postmortem
BAL - method of choice
Rads
Echocardiography

26
Q

How do you treat EIPH?

A

Furosemide - decrease plasma and blood volume, reduce RA, PA pulmonary wedge and pulmonary capillary pressure

Equine concentrated Serum - IgG and other immunoglobulins - intratracheal