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Equine Med & Surgery > Respiratory > Flashcards

Respiratory Flashcards

1
Q

URT infections-basics

A
  • primarily viral
  • pharyngitis, laryngitis, tracheitis
  • highly infectious with short incubation period
  • multiplication and desquamation of ciliated epithelium of upper airway
  • increased susceptibility to secondary bacterial infections
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2
Q

URT infection clinical signs

A
  • high fever
  • dry hacking cough
  • depression
  • anorexia
  • serous nasal discharge
  • normal to harsh BV lung sounds
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3
Q

primary viruses of clinical importance - URT infections

A
  • Equine influenza
  • Equine rhinopneumonitis
  • Equine rhinitis A
  • Equine viral arteritis
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4
Q

Why are vaccines for equine influenza not as effective?

A
  • virus has antigenic drift and shift
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5
Q

Certain strains of equine influenza can cause what other syndromes?

A

myalgia, myositis, myocarditis, pericarditis

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6
Q

Equine influenza-virus type?

A

myxovirus

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7
Q

Equine rhinopneumonitis-type of virus?

A

herpesvirus

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8
Q

5 manifestations of equine rhinopneumonitis

A
  • late term abortions
  • neurologic signs
  • respiratory disease
  • neonatal weakness/death
  • pulmonary vasculotropic infection
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9
Q

Which herpesvirus is most associated with repro problems?

A

EHV1

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10
Q

Equine rhinitis A causes __________

A
  • mild to severe upper and lower respiratory disease
  • exacerbation of IAD or RAO
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11
Q

Equine rhinitis A-type of virus

A

rhinovirus

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12
Q

Reportable URT viral infection

A

equine viral arteritis

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13
Q

Virus identification methods

A
  • Isolation/culture from nasal or nasopharyngeal swabs
  • PCR-nasal or nasopharyngeal swabs detect shedding; blood sample to detect viremia
  • Serology-acute and convalescent
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14
Q

What factors determine whether you should pursue virus identification?

A
  • severity of clinical signs
  • population at risk
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15
Q

Treatment for URT viral infection

A
  • Rest (allows respiratory mucosa to repair; decrease risk of secondary bacterial infections)
  • Isolation
  • supportive care
    • +/- NSAIDs, abx
    • minimize stress
    • maximal ventilation
    • palatable food
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16
Q

Bacterial pneumonia: foals vs. adults

A
  • Foals: around 2-3 months of age as maternal Ab wane
    • primary pneumonia
  • Adults: pneumonia more commonly follows a viral infection or some other insult to the immune system or stress
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17
Q

Bacterial pneumonia-clinical signs

A
  • productive cough
  • mucopurulent nasal discharge
  • fever (usu. lower than with a virus)
  • exercise intolerance
  • increased resp. rate
  • wheezes, crackles, dull areas on auscultation
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18
Q

Common organism implicated in bacterial pneumonia

A

Streptococcus zooepidemicus

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19
Q

S. zooepidemicus is sensitive to ______

A

ceftiofur (excede)

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20
Q

If prolonged bacterial pneumonia:

A
  • bloodwork
  • transtracheal wash-hold of abx if has been treated for 24h prior
  • thoracic ultrasound/radiographs
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21
Q

What are some signs that may indicate pleuropneumonia is present, not just simple pneumonia?

A
  • pain, reluctance to move
  • rapid, shallow breathing
  • decreased breath sounds ventrally
  • fluid line on percussion
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22
Q

Ultrasound findings with pleuritis/pleuropneumonia

A
  • pleural roughening
  • pleural fluid
  • surface abscesses
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23
Q

Diagnostic tests-pleuritis/pleuropneumonia

A
  • thoracic ultrasound
  • thoracocentesis/drainage
  • transtracheal wash
  • bloodwork
  • thoracic rads - post drainage
  • thoracotomy-when pleural effusion or surface abscess is too thick or too walled off into separate compartments to drain adequately via chest tube or when chunks of fibrin or necrotic lung need removed
    • wait until a good capsule exists so lung does not collapse when chest is opened
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24
Q

Treatment of pleuritis/pleuropneumonia

A
  • Long term abx: based on culture and sensitivity
    • enrofloxacin good
  • drain chest as needed
  • supportive care
    • NSAIDs
    • other anti-endotoxic drugs-consider polymixin
    • foot support-ice
    • rest
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25
Q

Complications/sequelae associated with pleuritis/pleuropneumonia

A
  • hypoproteinemia/ventral edema-when drained
  • laminitis
  • jugular vein thrombosis (secondary to sepsis or long term IV catheter placement)
  • colitis
  • pulmonary abscessation
  • bronchopleural fistula
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26
Q

Do pulmonary abscesses involve the pleural space?

A

no

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27
Q

Features of pulmonary abscessation

A
  • history of prolonged pneumonia
  • intermittent or recurrent fever
  • weight loss, poor condition
  • +/- halitosis, hemoptysis
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28
Q

Limitation of thoracic ultrasound for pulmonary abscessation

A

can only see abscesses if they are on pleural surface

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29
Q

Do you need to do a transtracheal wash with pulmonary abscesses?

A

yes-need C/S to choose antibiotics

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30
Q

You could use ________ to increase penetration of antibiotics when treating pulmonary abscesses

A

rifampin, isoniazid

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31
Q

How are pleuropneumonia and pulmonary abscesses similar?

A
  • often mixed bacterial infections that are walled off
  • treatment requires long-term abx based on C/S
    • need to be able to penetrate capsules & work in a purulent environment
  • drainage is important!
  • complications from endotoxemia/sepsis
32
Q

________causes “equine strangles”

A

Streptococcus equi var equi

33
Q

Does S. equi affect lower or upper respiratory tract primarily?

A

upper

34
Q

Hallmark of S. equi var equi

A

abscessed retropharyngeal LN

35
Q

How does “strangles” spread?

A

purulent discharges, fomites

*community water source is big source

36
Q

Incubation period-strangles

A

2-6d

37
Q

morbidity & mortality associated with strangles

A

high morbidity, low mortality

38
Q

Confirm S. equi infection with

A

culture or PCR

39
Q

Samples to take for culture/PCR if looking for S. equi

A
  • pharyngeal swab
  • lymph node aspirate
  • transtracheal wash
  • guttural pouch lavage
40
Q

Appropriate treatment of S. equi

A
  • isolate
  • nursing care & let disease run its course typically
  • drain abscesses
  • NSAIDs indicated if very painful
  • +/- antibiotcs
    • may not be sensitive to TMS
    • penicillin or ceftiofur
41
Q

Complications of strangles

A
  • swollen LN-dyspnea; may require tracheotomy
  • guttural pouch infection
  • “bastard strangles”
  • myocarditis/myositis
  • purpura hemorrhagica
42
Q

Purpura hemorrhagica

A
  • immune reaction-thought to be secondary to S. equi equi
  • fever
  • petechiae
  • swollen limbs
  • glomerulonephritis
  • no specific treatment; supportive care and anti-inflammatory (steroids)
43
Q

Reasons why strangles can be difficult to control

A
  • highly infectious
  • difficult to clear environment
  • vaccinations not very effective
44
Q

Considerations of intranasal vaccine for strangles

A

don’t do on a day when you are also doing any injections or invasive procedures-aerosolized weakened version of bacteria-can get into areas and cause abscesses

45
Q

When does R. equi infection occur?

A

early age: 1-2 weeks

46
Q

When are clinical signs seen with R. equi

A

usually not obvious until 2-3 months (severely affected by then)

47
Q

R. equi and S. equi equi abscesses may seed to:

A
  • lymph nodes
  • mesentery
  • joints
  • physes-including spinal cord
48
Q

Dx and expected findings for R. equi

A
  • CBC
    • incr. WBC and neutrophils, fibrinogen
  • thoracic rads
    • multiple pulmonary abscesses
  • thoracic ultrasound
    • pleural roughening and surface abscesses
  • culture and/or PCR
49
Q

Antibiotics known to work against R. equi

A
  • erythromycin + rifampin
  • azithromycin
  • claritrhomycin & rifampin
50
Q

potential problem with clarithromycin

A

colitis, diarrhea in adults or older foals

51
Q

Does R. equi affect lower or upper respiratory tract?

A

lower

52
Q

Is R. equi transmission between foals possible?

A

no

53
Q

Horses usually have immunity to Parascaris equorum by what age?

A

1-2 years of age

54
Q

Parascaris equorum larvae cause:

A
  • eosinophilic reaction
  • mucous exudation
  • mast cell degranulation
55
Q

Parascaris equorum pathogenesis

A

larvae appear in lung 1-2 wks after ingested, then migrate to GIT

56
Q

Respiratory signs-P. equorum

A
  • moist cough
  • tachypnea
  • mucoid or mucopurulent nasal discharge
57
Q

Dictyocaulus arnfeldi is primarily a problem in _____

A

donkeys-cold, wet climates

58
Q

D. arnfeldi cause:

A
  • eosinophilic rxn
  • bronchial exudate
59
Q

Life cycle-D. arnfeldi

A
  • ingested larvae penetrate GIT & migrate to lungs
  • adults within 39 days
60
Q

Ddx for RAO in horses

A

D. arnfeldi

61
Q

Treatment for D. arnfeldi

A
  • Ivermectin
  • Levamisole
  • Diethylcarbamazine
  • treat the donkeys!
62
Q

Most common non-infectious airway dz of horse

A

RAO

63
Q

Pathogenesis of RAO

A

bronchiolar inflammation–>mucous exudation & bronchoconstriction–>airway narrowing and wheezes

64
Q

Clinical signs with varying severity of RAO

A
  • moderate dz: most common
    • chronic intermittent cough +/- nasal discharge, +/- dyspnea
    • afebrile
  • mild dz
    • no obvious signs; reduced performance
  • respiratory cripple
    • severe hypoxemia, dyspnea
    • weight loss
    • may develop secondary pulmonary infections
65
Q

Pulmonary function testing results consistent with RAO

A
  • increased transpleural pressure and resistance with decreased dynamic compliance at rest
  • histamine challenge: bronchoconstriction at lower concentration of histamine
66
Q

What does neutropenia in a horse with severe RAO indicate?

A

secondary infection

67
Q

Treatment for RAO

A
  • environmental change
  • anti-inflammatory therapy (corticosteroids)
  • bronchodilators-will decr. work of breathing but may increase V/Q mismatches
    • anticholinergics
    • B-adrenergics
    • xanthine derivatives
68
Q

Most potent bronchodilators

A

anticholinergic drugs

69
Q

undesirable side effects of anticholinergics

A
  • GI stasis (ileus)
  • tachycardia
  • others
70
Q

Benefits of steroids in RAO treatment

A
  • decrease inflammation
  • prevent down-regulation of B2-adrenergic receptors
71
Q

Concern with steroid administration

A

increase likelihood of laminitis

72
Q

xanthine derivatives

A
  • aminophylline
  • theophylline
  • etamiphylline camsylate
73
Q

drawback of xanthine derivatives

A

low margin of safety

not used much now

74
Q

Sodium chromolyn

A

supposedly prevents mast cell degranulation (?)

75
Q

Incidence of equine induced pulmonary hemorrage (EIPH) is related to what factor?

A

SPEED

76
Q

Primary Lung Tumors

A
  • granular cell tumor
  • bronchial myxoma
  • pulmonary carcinoma
77
Q

Primary thoracic tumors

A
  • lymphosarcoma
  • pulmonary chondrosarcoma
  • pleural mesothelioma
  • thymoma

Equine Med & Surgery (11 decks)

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