Respiratory Flashcards
Abduction of the elbows is a sign of what? (in relation to respiratory disease)
Pleural pain (pleurodynia)
What should the respiratory rate of an adult horse in a cool environment be?
8-12 breaths per minute
List which structures should be examined in a physical examination for respiratory disease:
- Nares
- Oral mucous membranes
- Lymph nodes (submandibular and retropharyngeal)
- Paranasal sinuses
- Palpate the larynx
- Auscultate the trachea
- Evaluate the abdominal musculature
- Auscultate the entire thorax
Are respiratory sounds typically louder on inspiration or expiration?
Inspiration
Which is the only acceptable anticoagulant for blood gas samples?
Heparin
Which blood-gas measurement is the most accurate evaluation of ventilation and within what reference ranges should it be?
PaCO2 (35-45mmHg)
At what PaO2 values is hypoxaemia defined?
Relative - PaO2 <80mmHg
Absolute - PaO2 <60mmHg
What does a comet tail artefact on lung ultrasound indicate?
Plueral roughening / pulmonary inflammation
What does foaming of pleural fluid indicate?
Elevated protein content
Can tracheal or broncheoalveolar lavage samples be sent off for bacterial culture?
Only tracheal wash fluid
How do glucose and lactate measurements in pleural fluid provide evidence of bacterial infection?
- Glucose in fluid <50% of systemic glucose (evidence of bacterial utilsation)
- Bacteria metabolise glucose to lactate - elevated lactate in fluid compared to systemically evidence of sepsis
What condition is shown in this image and in what breed does the highest incidence occur?
Wry Nose (Campylorrhinus lateralis)
Highest incidence in Arabians
What is the most common cause of mycotic rhinitis?
Aspergillus fumigatus
What is primary sinusitis most commonly associated with?
Previous respiratory tract infection, accumulation of mucous and obstruction of drainage
What are causes of secondary sinustus?
- Dental disease
- facial fractures
- granulomatous lesions
- cysts
- neoplasia
- ethmoid haematomas
What can be seen in this endoscopic image?
Discharge from nasomaxillary aperture
What are the principles of treatment of sinusitis?
- Treat underlying disease if present
- Antibiotics
- Management
- feed on ground
- pasture turnout - low dust environment
- Trephination & sinus lavage
- ensure good drainage
- Topical instillation of antifungal agents
- Surgery through sinus flap / osteotomy
What is a progressive ethmoid haematoma, are they common and how are they best treated?
- Idiopathic
- Slowly expanding, non-neoplastic mass that originated from the submucosa of the ethmoid turbinates
- COMMON
- Treat with endoscopic intralesional formalin
- 5-10ml 10% formalin injected at 2-4wk intervals for 2-5 treatments
This endoscopic image is from a 10yr old mare with mild, intermittent unilateral epistaxis and ocassionally abnormal respiratory noise at exercise. What is your top DDx?
Ethmoid haematoma
What is your diagnosis for this image and how should it be treated?
Severe pharyngeal lymphoid hyperplasia
Treatment: Rest (reduce training) and topical anti-inflammatory throat spray
When during exercise is intermittent dorsal displacement of the soft palate likely to occur?
When during respiration will you hear abnormal sounds?
How can you diagnose?
At the end of strenuous exercise.
Abnormal respiratory noise on exhalation.
Diagnose: endoscopy at rest and treadmill.
What are your options for treating dorsal displacement of the soft palate?
Conservative
- Rest and anti-inflammatory treatment
- Tongue tie
- Cornell collar
- Treat concurrent disease
Surgical
- Laryngeal tie forwards
How should you treat guttural puch empyema?
- indwelling gutteral pouch catheter
- gutteral pouch lavage for 5-7 days
- feed horse from ground to encourage drainage
- systemic antibiotic therapy
- chondroids: manual crushing
- biosecurity if Strep equi ss equi
What is the most important thing to rememvber when examining a horse with suspected guttural pouch mycosis?
DO NOT DISLODGE CLOTS OR PLAQUES - could result in fatal haemorrage due to arterial erosion
