(pleuro) pneumonia Flashcards

1
Q

what are the three stages of pleuropneumonia ?

A

◦ Exudative stage – sterile transudate ↑ in pleural space
◦ Fibrinopurulent stage - bacterial invasion + fibrin deposition
◦ Organisation stage – Fibroblasts grow into exudate (pleural peel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the risk factors for the development of pneumonia?

A
  • After viral infections
  • Strenuous exercise
  • Transportation & elevation of the head
  • General anesthesia
  • Overcrowding & inclement weather
  • Dysphagia (aspiration)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the risk factors for the development of pleuropnumonia?

A
  • Long distance transportation
  • Elevated head for prolonged periods of time?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the risk factors fo th development of aspiration pneumonia?

A
  • Dysphagia
    ◦ Pharyngeal & postpharyngeal
  • Oesophageal obstruction
  • General anaesthesia
  • Cleft palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the pathogens that cause pneumonia in horses?

A
  • Streptococcus equi subsp. zooepidemicus
  • Staphilococcus aureus & S. pneumoniae
  • Actinobacillus spp (gram negative nonenteric)
  • Escherichia coli, Pasteurella spp, Enterobacter spp, Klebsiella spp & Bordetella bronchiseptica
  • Bacteroides fragilis
  • Fusobacterium & Peptostreptococcus anaerobius
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the clinical signs of pneumonia?

A
  • Tachycardia /tachypnea
  • Respiratory distress
  • Fever
  • Anorexia, depression
  • +/- nasal discharge
  • Exercise intolerance
  • Auscultation
    ◦ crackles
    ◦ dull areas

Pleuropneumonia additionally can have:
* Pain intercostal spaces
* Reluctance to walk, colic
* Grunting during respiration
* Abduction of elbows
* Ventral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what adventitious lung sounds can be heard with pneumonia?

A
  • Crackles & wheezes
  • Dull areas
  • Dull area follows flat line (pleuropneumonia)
  • Pleural rubs (pleuropneumonia)
  • Radiation of cardiac sounds (due to fluid or consolidation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the diagnostic approach used for pneumonia? what is seen on clinical pathology?

A
  • Suspicion based on PE & rebreathing bag
  • Haematology & biochemistry
  • Endoscopy
  • TTW & BAL
  • Thoracic ultrasonography
  • Radiography
  • Thoracocentesis
  • Thoracoscopy

Clinical pathology
* CBC
◦ Neutrophilic leukocytosis
◦ Leukopenia
◦ Anaemia (chronic cases)
* ↑ Fibrinogen & SAA
* ↓ Fe2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is seen on ultrasonography of pneumonia?

A
  • B lines (commit tails)
  • consolidation
  • pleural fluid
  • hyperechoic fibrin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the treatment for pneumonia in horses?

A

Antibiotic treatment
1st line
* Penicillin + Gentamicin IV
* Penicillin + Gentamicin + Metronidazole (aspiration pneumonia)
Adjustments based on Culture + Sensitivity

Inhaled drugs:
* Gentimicin
* Ceftiofour
* Cefquinome

inhailed drugs can be given via, jet, ultrasonic or mesh nebuliser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when shoudl referal be consided with pneumonia?

A

◦ No initial response to antibiotics
◦ Systemic or respiratory compromised
◦ Require intensive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what samples should culture and sensitivity be performed on with pneumonia?

A
  • Culture & sensitivity should always be performed
    ◦ TTW & Pleural effusion! (both if available)
    ◦ Include anaerobic coverage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how is throacocentesis performed in horses? what is the diagnostic value of this ? what is the therapeutic value of this?

A
  • identify the site to drain with US (avoid thoracic vein)
  • 7/8 ICS above costochondral junction
  • Clip, prep aseptically & local anaesthetic, under the skin and into the muscle. Often done under standign sedation
  • Stab incision cranial edge of rib
  • Advance drain through incision (pop!)
  • Withdraw trocar, advance blunt tube
  • Secure w/ Chinese finger trap suture (Heimlich valve!)

Diagnostic value
* Culture & sensitivity
* Cytology

Therapeutic
* Drain proinflammatory products
* Remove bacteria
* Help decrease adhesion formation
* Respiratory function improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what procedure should be done to horses with pleuropneuminia?

A

drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly