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Equine (fourth year) > Respiratory > Flashcards

Respiratory Flashcards

1
Q

what is the difference in how you feel when you have infectious vs non-infectious disease? (strangles vs asthma…)

A

infectious - under the weather, lethargic, inappetent…
non-infectious - just difficulty breathing

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2
Q

what are the three classic clinical signs of infectious disease?

A

group is affected
pyrexia
dullness

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3
Q

what changes on haematology would indicate an infectious disease?

A

increased white cells
increased acute phase proteins

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4
Q

what are the most commonly used acute phase proteins in horse used to identify infectious disease?

A

serum amyloid A (rapid increase)
fibrinogen

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5
Q

what is the main issue with using antibodies to detect infectious disease?

A

there is a lag - have to wait for them to increase in response to the pathogen

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6
Q

what are the subtypes of equine influenza based on?

A

glycoprotein surface antigens
haemagglutinin (H)
neuraminidase (N)

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7
Q

why are vaccines not great at preventing equine influenza outbreaks?

A

strong antigenic drift (especially H3N8)

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8
Q

how do the ciliated epithelial cells appear 6 days after equine influenza infection?

A

completely stripped of cilia

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9
Q

what is the incubation period of equine influenza?

A

5 days

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10
Q

what are the clinical signs of equine influenza?

A

fever, cough, oedema/hyperaemia (URT), nasal discharge, lethargy

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11
Q

how long is recovery of equine influenza usually complete by?

A

3 weeks (unless secondary infection)

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12
Q

what sort of cough is described with equine influenza?

A

dry/hacking that turn moist

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13
Q

how does the nasal discharge of horses with equine influenza appear?

A

serous that turn mucopurulent

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14
Q

what is initially found on haematology of equine influenza cases?

A

lymphopaenia
neutropenia

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15
Q

what occurs on haematology in equine influenza after the initial lymphopaenia and neutropenia?

A

monocytosis
neutrophilia
hyperfibrinogenaemia

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16
Q

how can serology be used to diagnose equine influenza?

A

looking for a rising antibody titre (x4) over 2-4 weeks

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17
Q

when is the best time after infection to swab for equine influenza?

A

2-5 days post infection (when clinical signs are showing) - most shedding

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18
Q

what are the treatment options for equine influenza?

A

supportive - hydration, NSAIDs…
(antibiotics is secondary infection)

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19
Q

how long do horses with equine influenza require off work?

A

1 week for every day of pyrexia

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20
Q

why are mortalities associated with equine influenza more common in foals?

A

more susceptible to developing myocarditis, secondary pneumonia and acute respiratory distress syndrome

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21
Q

how does the equine influenza vaccine help?

A

reduces the severity of clinical signs and duration of virus shedding

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22
Q

how long can equine influenza survive in the environment?

A

36 hours (killed easily by cleaning/disinfectant)

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23
Q

what do most foals do when infected with EHV 1/4?

A

seroconvert to become latently infected, this is then reactivated under stress

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24
Q

what are the forms of EHV ?

A

respiratory
abortion
neurological

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25
Q

where is EHV 1/4 found latently?

A

trigeminal ganglia
lymph nodes

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26
Q

how severe is the respiratory disease caused by EHV1?

A

mild

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27
Q

what happens on haematology in the acute phase of EHV1 respiratory disease?

A

decreased neutrophils and lymphocytes

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28
Q

after the initial decrease in neutrophils/lymphocytes in EHV1 cases, what happens to the haematology?

A

increased lymphocytes

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29
Q

what is done to treat EHV1?

A

symptomatic/supportive - rest, NSAIDs…
antibiotics for secondary infection

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30
Q

what age horse is Rhodococcus equi seen in?

A

3 weeks to 6 months old

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31
Q

what is Rhodococcus equi also known as?

A

rattles

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32
Q

what type of pneumonia is caused by rattle?

A

pyogranulomatous

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33
Q

what disease is rattles similar to in people?

A

Tb

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34
Q

how is rattles treated?

A

prolonged antimicrobials - macrolides and rifampin

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35
Q

why is Rhodococcus equi so effective and difficult to treat?

A

lives intracellularly in macrophages (hard to reach with antimicrobials)

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36
Q

what is strangles caused by?

A

Streptococcus equi var equi

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37
Q

is Streptococcus equi var equi an obpportunistic or obligate pathogen

A

obligate

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37
Q

where do carrier animals harbour Streptococcus equi var equi?

A

guttural pouch

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38
Q

what is the incubation period of strangles?

A

3-14 days

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39
Q

how do animals present in the incubation period of strangles?

A

asymptomatic
normally aren’t infectious

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40
Q

when do clinical signs appear in relation to shedding of the bacteria of strangles?

A

depression and fever appear 2-3 days before shedding

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41
Q

what are the clinical signs of strangles?

A

depression, fever
mucoid nasal discharge
slight cough
anorexia and difficulty swallowing
mild pharyngeal swelling

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42
Q

when monitoring horses in a strangles outbreak, what is done?

A

monitor their temperatures daily, as soon as this rises you isolate them before they begin to shed

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43
Q

what are the clinical signs of persistent strangles that has been present for more than a week?

A

purulent nasal discharge
lymph node enlargement and purulent discharge
retropharyngeal LN swelling

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44
Q

what do ruptured strangles abscesses of the retropharyngeal lymph nodes cause?

A

guttural pouch empyema

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45
Q

what can guttural pouch empyema from strangles lead to?

A

chondroid formation

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46
Q

why do we avoid cutting into the guttural pouch externally to remove chondroids from strangles?

A

carotid arteries, veins, cranial nerves (all of them easily damaged)

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47
Q

what are some possible complications of strangles?

A

cellulitis and local tissue damage
pneumonia and abscessation
immune mediated myositis/myocarditis
purpura haemorrhagica (vasculitis, type II hypersensitivity)
metastatic abscesses (bastard strangles)

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48
Q

where can you take a sample from to PCR for strangles?

A

nasopharyngeal swabs/lavage
guttural pouch wash/aspirate
aspirate from abscess

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49
Q

how can you confirm a horse is free from strangles?

A

nasal swabs - 3 negative in a week for 3 weeks
guttural pouch wash - one needed

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50
Q

what treatment is used for strangles?

A

symptomatic - NSAIDs, soft/wet food…
flush abscesses
tracheostomy if in respiratory distress

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51
Q

are antibiotics indicated for strangles?

A

not if an abscess is developing in the lymph nodes as it slows its maturation
give in outbreak when monitoring temperature (give on onset of pyrexia)

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52
Q

what is the best antibiotic to use for strangles?

A

penicillin

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53
Q

what is the best way to prevent strangles?

A

quarantine

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54
Q

what effect do the strangles vaccines have?

A

reduction of clinical signs and complications

55
Q

what is inflammatory airway disease?

A

mild/moderate equine asthma (with slight infectious component)

56
Q

what factors relating to the oxygen pathway contribute to the successful performance of the equine athlete?

A

gas exchange
haemoglobin concentration
heart size
skeletal muscle properties

57
Q

is anaerobic or aerobic respiration faster at making energy?

A

anaerobic (aerobic is cleaner)

58
Q

is anaerobic or aerobic respiration more efficient?

A

aerobic

59
Q

how fast can horses reach VO2max?

A

20 seconds (compared to 2 minutes in humans)

60
Q

what is VO2max?

A

the maximal aerobic metabolic rate (closely related to performance ability)

61
Q

does aerobic or anaerobic respiration contribute more in an exercising horse?

A

aerobic dominance

62
Q

what is the primary function of the respiratory system?

A

gas exchange

63
Q

what are the secondary functions of the respiratory system?

A

humidification, filtering, warming air
thermoregulation
phonation and olfaction
acid-base regulation
blood filtering and defence mechanism

64
Q

what does tidal volume times breaths/minute equate to?

A

minute ventilation

65
Q

what is anatomical dead space in the respiratory system?

A

anything where gas exchange isn’t happening - trachea, bronchus, non-perfused alveoli

66
Q

what does the rate of diffusion of gas into blood depend on?

A

pressure gradient
thickness of alveolar capillary barrier

67
Q

why does the horse have a very thick alveolar capillary barrier?

A

due to extremely high pressure in the pulmonary capillaries

68
Q

what three factors increase removal of oxygen from blood into the tissue?

A

increased temperature
decrease pH
increased carbon dioxide

69
Q

how is horses breathing described?

A

they are obligate nasal breathers

70
Q

how much does the minute ventilation increase in an exercising horse?

A

massively (from 80L/min at rest to 1800L/min)

71
Q

how is ventilation increased during exercise?

A

increased tidal volume, frequency and decreased physiological dead space

72
Q

how is diffusion of gases increased during exercise?

A

increased gradient and blood flow
hypercapnia, acidosis and hyperthermia

73
Q

how can a horse increase its oxygen carrying capacity?

A

contracts its spleen to increase haemoglobin concentration

74
Q

how is respiration and stride linked?

A

expire when feet hit the floor (pressure on diaphragm)
inspire when feet off the floor

75
Q

what factors can decrease pulmonary gas exchange?

A

increased pulmonary resistance
decreased alveolar/pulmonary compliance
dynamic airway collapse
respiratory muscle/chest wall disease
decreased cardiac output
decreased haemoglobin

76
Q

what is exercise induced pulmonary haemorrhage?

A

haemorrhage into the airway that occurs in horses that are exercising at high intensity

77
Q

when does EIPH become epistaxis?

A

EIPH - just one nostril
epistaxis - both nostrils

78
Q

what is used to diagnose EIPH?

A

endoscopy post exercise

79
Q

how does EIPH present on the lung on post mortem?

A

blue discolouration to caudal lung due to haemosiderin pigment

80
Q

how is grade 1 EIPH defined?

A

flecks of blood extending less than a quarter of the tracheal length

81
Q

what is grade 2 EIPH defined as?

A

continuous stream of blood extending at least one half of the tracheal length

82
Q

how is a grade 3 EIPH defined?

A

multiple streams of blood covering more than one third of the tracheal surface

83
Q

what is a grade 4 EIPH defined as?

A

pooling and abundant blood covering the tracheal surface

84
Q

what are some possible causes of EIPH?

A

extremely high vascular pressure
high inspiratory pressure
inflammation
locomotory shockwaves

85
Q

how does the prevalence of EIPH change with age?

A

increases as the horse gets older

86
Q

does EIPH effect performance?

A

grade 1 and 2 do not (doesn’t effect welfare either)
grade 3 and 4 are associated with poor performance (welfare concerns)

87
Q

why does EIPH lead to inflammation?

A

blood is removed slowly - initially neutrophils dominate but then macrophages get involved

88
Q

how is EIPH treated?

A

rest and anti-inflammatories

89
Q

what is the only agent proven to reduce EIPH?

A

fireside - reduces blood volume and pressure

90
Q

what is inflammatory airway disease and recurrent airway obstruction (heaves) now known as?

A

equine asthma

91
Q

what can cause allergic asthma?

A

holds, bacteria/endotoxins, mites, plant debris, inorganic dust, noxious gases

92
Q

what is the mediator of equine asthma after the particle enters the airway?

A

inflammatory mediator release

93
Q

what effects does the release of the inflammatory mediator due to an allergic particle entering the airway have? (equine asthma)

A

increase blood flow and vascular permeability (oedema…)
airway smooth muscle tone increases
cell accumulation/activation
increased mucus production
neural reflex mechanisms increase
antibacterial activity

94
Q

what receptors are activated on the smooth muscle by the inflammatory mediators?

A

muscarinic receptors (bronchoconstriction)

95
Q

what receptors are inhibited on the smooth muscle by the inflammatory mediators?

A

beta2 adrenergic receptors

96
Q

what contributes to the narrowing of airways in equine asthma cases?

A

mucosal hyperplasia and oedema
increased mucous production and decreased clearance (mucociliary escalator)
increased inflammatory cells
(chronic - fibrosis)

97
Q

how is equine asthma usually subdivided?

A

mild-moderate
severe

98
Q

what age is severe asthma seen in?

A

horses older than 5 year

99
Q

what are the clinical signs of mild-moderate asthma?

A

occasional coughing and poor performance - usually seen at exercise

100
Q

how long does mild-moderate asthma last for?

A

often self limiting with reoccurrence low

101
Q

what four things occur in cases of chronic asthma?

A

mucus plugging
smooth muscle hypertrophy
epithelial cell hyperplasia
peribronchiolar fibrosis

102
Q

what does mucus plugging, smooth muscle hypertrophy, epithelial cell hyperplasia, peribronchiolar fibrosis causes to happen in the lung/airway?

A

airway remodels and lung function becomes progressively impaired

103
Q

what clinical signs are associated with severe asthma that has been going on for some time?

A

tachypnoea, increased expiratory effort, cough, nostril flare and discharge

104
Q

is the dyspnoea associated with severe asthma inspiratory or expiratory?

A

expiratory

105
Q

what does the increased expiratory effort from severe equine asthma cause?

A

heave line

106
Q

what is found when the airway of a horse with equine asthma is endoscopes?

A

excessive mucous

107
Q

when airway cytology is carried out on a horse with equine asthma, what is found?

A

increased neutrophils and eosinophils

108
Q

is it best to use a tracheal aspirate or bronchoalvelar lavage to diagnose equine asthma?

A

BAL

109
Q

what percentage neutrophils on a BAL would correlate with a horse having equine asthma?

A

> 25%

110
Q

what is the most common adventitious respiratory sound caused by URT stenosis?

A

inspiratory wheeze

111
Q

what are the three factors used to treat equine asthma?

A

environmental control
corticosteroids
bronchodilators

112
Q

what is the aim of environmental control to manage equine asthma?

A

reduce respirable particles (dust, moles, fungi…) - increase airflow and time outside

113
Q

what form of asthma is it difficult to control using environmental management?

A

summer pasture associated pulmonary disease (allergy to pollen…) - get worse when turned out

114
Q

how can feed be managed to control equine asthma?

A

wet concentrates
eat from floor
(feed wetter foods)

115
Q

how can housing be managed to control equine asthma?

A

remove horse around mucking out
put them outside
low dust bedding
no deep litter system
consider other horse stables

116
Q

what effects do corticosteroid have to control asthma?

A

reduce cell accumulation/activation
reduce vascular changes
reduce bronchoconstriction

117
Q

what systemic corticosteroids can be given for equine asthma?

A

prednisolone
dexamethasone

118
Q

how can corticosteroids be administered for controlling asthma?

A

topically (inhaled)
systemically

119
Q

what types of drugs can be used as bronchodilators for equine asthma?

A

beta2 adrenergic agonists
muscarinic antagonists

120
Q

what are the indications for using bronchodilators in asthma cases?

A

emergency (rescue) therapy in flare up
before other inhaled medication
before exercise

121
Q

what are some beta2 agonists used as bronchodilators?

A

clenbuterol
salbutamol
salmeterol

122
Q

what are some muscarinic antagonists used as bronchodilators?

A

atropine
buscopan
ipratropium bromide (inhaled)

123
Q

what are dembrexine and saline nebulisation used for in asthma cases?

A

mucolytics (soften mucous)

124
Q

what lung lobes are most effected by bacterial colonisation?

A

right ventral lobes

125
Q

what are the clinical signs of bronchopneumonia?

A

dyspnoea (tachypnoea), systemic illness, adventitious lung sounds, cough

126
Q

what are the clinical signs of pleuropneumonia?

A

reduced ventral lung sounds and dull on percussion

127
Q

what are the three stages of pleuropneumonia?

A

acute exudative stage
fibrinopurulent stage
organisational stage

128
Q

what happens in the acute exudative stage of pleuropneumonia?

A

inflammation of lung/pleura produces a sterile protein rich pleural exudate

129
Q

what happens in the fibrinopurulent stage of pleuropneumonia?

A

bacteria invade and multiply in pleural fluid and fibrin is deposited on the pleural surface

130
Q

what is used to treat broncho/pleuralpneumonia?

A

broad spectrum antibiotics - penicillin, gentamicin, metronidazole
anti-inflammatories
supportive therapy

131
Q

is the equine lungworm called?

A

Dictyocaulus arnfieldi

132
Q

what conditions has to be met for a horse to get lungworm?

A

must cograze with donkeys (donkeys are asymptomatic carriers)

133
Q

what is used to treat equine lungworm?

A

ivermectin

134
Q

what is equine multi nodular pulmonary fibrosis associated with?

A

EHV 5

Equine (fourth year) (11 decks)

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