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Equine Med Final (Old Material) > Respiratory Disease > Flashcards

Respiratory Disease Flashcards

1
Q

Eupnea

A
  • Normal breathing
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2
Q

Hyperpnea

A
  • Breathing fast but deep
  • Hypoxemia or pain
  • NOT like they are struggling to breathe
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3
Q

Dyspnea

A
  • Difficulty breathing
  • Nostril flare
  • Abdominal effort
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4
Q

Normal lung fields in a horse

A
  • Quite small
  • Draw a dorsoventral line behind the shoulder
  • Draw a line cranially from the tuber coxae
  • Draw a line connecting them from the level of the elbow
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5
Q

Rebreathing exam goal

A
  • Get them to take a deep breath
  • Easier to hear abnormal sounds
  • See how they can tolerate the bag
  • How long does it take to recover?
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6
Q

What lymph nodes should you be able to feel normally in the facial region? Which lymph nodes do we get very worried about if we can feel them?

A
  • Submandibular you should be able to feel

- Retropharyngeal if palpable that is quite worrisome (Strangles)

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7
Q

What sample is best to take if you want to culture?

A
  • Transtracheal wash

- Lower respiratory tract

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8
Q

Normal cytology for TTW

A
  • Greater amount of macrophages normal
  • Should be <20% neutrophils
  • Sampling lower respiratory tract
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9
Q

When to use bronchoalveolar lavage?

A
  • Inflammatory conditions or hemorrhage

- Not sterile

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10
Q

Where can you take arterial samples from in the adult horse?

A
  • Transverse facial artery only
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11
Q

Where can you take arterial blood gas from in the foal?

A
  • lateral metatarsal artery

- Transverse facial artery

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12
Q

Four structures that are caudal to the mandible?

A
  • Guttural pouch
  • Retropharyngeal lymph node
  • Thyroid
  • Salivary gland
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13
Q

Dfdx for a distended guttural pouch

A
  • empyema
  • Tympany
  • Hemorrhage
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14
Q

Important structures in medial guttural pouch (larger pouch)

A
  • IX-XII
  • Sympathetic trunk
  • Internal carotid
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15
Q

Diagnostics for a non-painful distention of GP

  • Worse on the right side
  • Acute
  • Afebrile
  • Only affected
A
  • Endoscopy (visualization, lavage, culture)
  • Sedation
  • Radiographs may help
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16
Q

Who gets GP tympany?

A
  • Arabians, fillies
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17
Q

Treatment for GP tympany?

A
  • Decompress
  • Good prognosis
  • can go in and cut a hole
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18
Q

Primary signs indicating dysphagia?

A
  • Nasal discharge of feed material

- NOT DROPPING OF FEED/QUIDDING

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19
Q

GP empyema etiology

A
  • Streptococcus equi sbsp zooepidemicus or equi
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20
Q

Diagnosis for GP empyema

A
  • endoscopy and culture or PCR
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21
Q

Treatment for GP empyema

A
  • Lavage and removal
  • Topical antibiotics (Penicillin best)
  • NSAIDs
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22
Q

What should you think about with an acute onset respiratory noise and distress with retropharyngeal lymph node enlargement?

  • Bilateral, no fever
A
  • Think of strangles

- Streptococcus equi sbsp equi

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23
Q

If a horse has fever and you suspect Strangles, is it shedding or not?

A
  • Not shedding
  • Fever occurs 1-2 days before shedding
  • You could prophylactically give Penicillin during an outbreak to prevent abscessation
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24
Q

Carriers of Strangles

A
  • 10% carriers
  • SILENT carriers
  • Maintained in the Guttural pouch
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25
Q

Complications of Strangles

A
  • Dyspnea/dysphagia
  • Metastatic abscessation (AKA Bastard strangles)
  • Myositis (poorly understood; if occurs, SUPER POOR PROGNOSIS)
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26
Q

Purpura hemorrhagica and Strangles

A
  • Vasculitis
  • Painful edema
  • Immune complex formation
  • High antibodies
  • If exposed and get the vaccine
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27
Q

What should you do prior to vaccinating for Strangles if your owner decides to do that, and what are you trying to prevent?

A
  • Measure antibodies

- If >1:3200, risk of purpura hemorrhagica

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28
Q

Diagnosis of Strangles

A
  • Culture or PCR of the discharge
  • GP lavage
  • Nasopharyngeal WASH
  • DO NOT DO A NASOPHARYNGEAL SWAB
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29
Q

How to determine if a horse has cleared Strangles?

A
  • 3 negative cultures done every 2-3 weeks
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30
Q

What protein does S. equi equi use to avoid phagocytosis?

A
  • M protein

- SeM ELISA is for the antibody against the M protein

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31
Q

ELISA for Strangles - what is it looking for? /

A
  • Antibody against the SeM protein
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32
Q

Immunity if you give penicillin to a horse with a fever in a Strangles outbreak

A
  • They won’t get the abscess, but they also won’t get immunity
  • NSAIDs
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33
Q

Purpura and myositis treatment

A
  • No need to give antibiotics
  • Corticosteroids
    Supportive care
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34
Q

Immunity post infection of Strangles

A
  • 75% immune >5 years
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35
Q

Vaccines for Strangles

A
  • Make sure you measure antibodies first
  • IM has a poor efficacy with the M protein extract
  • Intranasal MLV only to healthy horses <1 year old (not to foals; strain different than field; local immunity)
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36
Q

Clinical signs for recurrent airway obstruction

A
  • Respiratory distress at rest that is EXPIRATORY
  • Heave line
  • Weight loss (chronic problem)
  • No signs of infection (e.g. no fever)
  • Older horse (>7 years old)
  • Often worse in the winter, spring, and summer
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37
Q

Pathogenesis of RAO

A
  • Allergen –> lymphocytes –> neutrophils –> bronchospasm, mucus plugs, smooth muscle hyperplasia, airway wall thickening, fibrosis
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38
Q

Diagnosis of RAO

A
  • Bronchoalveolar lavage (>25% non-degenerative NT)***
  • Curschmann’s spirals
  • Maybe atropine to see if they get better
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39
Q

Treatment for RAO

A
  • No cure: progressive (you must tell the owner)
  • Minimize exposure to antigen
  • Medical treatment with steroids (prednisOLONE or dexamethasone; fluticasone) and bronchodilators (clenbuterol, albuterol)
  • Environmental management (decrease straw, feed on the ground, wet steam hay; clean)
  • During transport, don’t tie them up
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40
Q

Prognosis of RAO

A
  • Exacerbations
  • Always susceptible
  • Advanced changes suggest euthanasia :(
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41
Q

Interstitial Airway Disease physical exam findings

A
  • Normal auscultation of heart and lungs, thoracic ultrasonography, blood work
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42
Q

Interstitial Airway Disease Signalment

A
  • younger racehorses (Thoroughbred)
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43
Q

Clinical signs and history of Interstitial Airway Disease

A
  • Poor performance
  • Delayed recovery
  • Increased effort
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44
Q

Diagnosis of Interstitial Airway Disease

A
  • Exclusion diagnosis
  • Endoscopy may visualize mucus
  • Bronchoalveolar lavage and cytology (NT >5-10% BUT NOT as high as 25%; Mast cells >2-5%; EO >1-5%)**
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45
Q

Treatment for Interstitial Airway Disease

A
  • Corticosteroids
  • Rest
  • Environmental changes
  • IFN gamma maybe
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46
Q

Exercise Induced Pulmonary Hemorrhage signalment

A
  • younger TB colt

- Racehorses, barrel horses, polo ponies, etc.

47
Q

EIPH clinical signs

A
  • Few drops of blood from nostrils can be unilateral or bilateral
  • Often post exercise
48
Q

Diagnosis of EIPH

A
  • Post-work Endoscopy

- Blood in esophagus, possible RBCs or hemosiderin on BAL

49
Q

EIPH pathogenesis

A
  • Capillary stress failure

- Maybe high transmural pressures and high capillary pressures combined with a negative intra-thoracic pressure

50
Q

Treatment of EIPH

A
  • None really
  • Furosemide might help, by reducing volume
  • Don’t do nasal strips
51
Q

Which EHV is associated with abortion?

A
  • EHV-1!

- 1 is more severe

52
Q

Diagnosis of EHV

A
  • Best to do a PCR on a 6” nasal swab and blood (purple top)
  • Can do a test on the fetus too
  • Serology possible, but takes too long
53
Q

How soon after infection do horses shed EHV1?

A
  • 1-3 days after infection
  • BEFORE they get fever
  • By the time they have fever, everyone is exposed
54
Q

Clinical signs of EHV-1

A
  • Biphasic fever (very high)
  • Younger horses (yearlings and weanlings)
  • Serous nasal/ocular discharge
  • Submandibular LN sswelling
55
Q

When in gestation does EHV-1 cause abortions?

A
  • LATE in gestation
56
Q

Vaccination for EHV-1

A
  • Vaccinate!
  • Every 6 months if <5y or >5y and high risk
  • MLV in foals >3 m
57
Q

Transmission of equine viral arteritis

A
  • Semen
  • Urine
  • Respiratory secretion
58
Q

Who is the inapparent carrier for EVA?

A
  • The stallion

- Mares can clear in 28 days

59
Q

EVA replication

A
  • Endothelial cells
  • Replicates in macrophages
  • Results in vasculitis
60
Q

Clinical signs for Equine Viral Arteritis

A
  • High fever
  • Lethargy
  • Conjunctivitis
  • Cough
  • Dyspnea
  • Ventral edema (vasculitis)
  • Fatal pneumonia in neonates
61
Q

Diagnosis of EVA

A
  • Nasopharyngeal swab or conjunctival swab
  • Blood (EDTA) during viremia
  • Fetal tissues
62
Q

Positive EVA

A
  • Notify state vet
  • Suspend breeding
  • Quarantine
63
Q

Positive EHV-1 or EHV-4

A

REPORT

64
Q

Treatment of EVA

A
  • If severe hind limb edema may want to give furosemide

- Can do wraps as well

65
Q

Vaccination for EVA

A
  • No US eradication

- Consult state vet for vaccine because you can’t tell it apart from the infection

66
Q

What is the agent of equine influenza?

A
  • H3N8
67
Q

Who is extremely susceptible to equine influenza?

A
  • DONKEYS
  • Yearlings too
  • leads to many outbreaks
68
Q

Clinical signs of Equine influenza

A
  • Biphasic fever (2nd fever due to secondary infection)
  • Limb edema
  • 2° bacterial infection!!** (2-3 weeks later, because it replicates in the epithelium of the respiratory tract and decreases clearance)
  • Serous nasal discharge
69
Q

Diagnosis of equine influenza

A
  • PCR on nasopharyngeal swab or TTW
  • ELISA Stall side test
  • Virus isolation on a swab
  • Serology (takes too long)
70
Q

Positive equine influenza result

A
  • Notify state vet
  • Quarantine 21 d after last clinical case
  • Strict biosecurity
  • Treatment is same as others
71
Q

Prevention of equine flu

A
  • Vaccine every 6 months
  • 4-6 weeks pre-foaling
  • Foals 3-6 months
  • Boost in an outbreak
72
Q

Vaccine types and pregnancy

A
  • Inactivated (okay for pregnant; will pass to offspring)
  • Canarypox vector (okay for pregnant; will pass to offspring)
  • Intranasal (MLV; does not pass to offspring)
73
Q

Signs of pleurodynia

A
  • Shallow breathing
  • Reluctant to move
  • Elbows abducted
  • Intolerant to rebreathing exam
  • Painful to percussion, pressure on thorax
  • Painful coughing
74
Q

Clinical signs of pleuropneumonia

A
  • Pleurodynia
  • Dyspnea
  • Elevated temperature (but not extremely high)
  • Signs of pneumonia (crackles, wheezes, tachypnea, fever; absent sounds)
  • Ventral edema
  • Dyspnea
75
Q

1 cause of pleural effusion in horses

A
  • Extension of pleuropneumonia (#1 by far)
76
Q

Pleuropneumonia risk factors

A
  • History of travel (>4 hr) or anesthesia
  • Previosu condition like respiratory virus or choke
  • All ages
77
Q

Pathogenesis of pleuropneumonia if extension of pneumonia

A

– Sterile inflammatory exudate into the pleural space followed by bacteria

  • Fibrin can deposit there normally; chronically turns into fibrosis
  • Fibrin serves as a nidus for bacterial development
  • Usually bilateral
78
Q

Diagnosis of pleuropneumonia

A
  • Clinical signs
  • Thoracic ultrasound
  • Drain + thoracic radiographs
  • TTW: culture and cytology*******
  • Pleural fluid may be sterile
79
Q

What is the gold standard for pleuropneumonia diagnosis?

A
  • TTW with culture and cytology
80
Q

Signs on TTW cytology for pleuropneumonia

A
  • Elevated protein
  • Low glucose
  • Degenerative neutrophils
  • +/- bacteria
  • 75,000 cells/µL
81
Q

What is the most common isolate of pleuropneumonia in horses?

A
  • Bacteroides fragilis is #1 isolate by far
82
Q

Treatment for pleuropneumonia in horses?**

A
  • Drain chest and leave a chest tube
  • K Penicillin (Gram positive and anaerobes)
  • Metronidazole (Bacteroides)
  • Gentamicin (after hydrating, for gram negative)
  • Flunixin
  • Can give inhaled antibiotics; oxygen; may need lavage, rib resection, thoracotomy
83
Q

Blood work for pleuropneumonia indicating inflammation

A
  • Neutrophilia
  • Monocytosis (chronic)
  • Thrombocytosis (inflammation)
  • Hyperfibrinogenemia (Inflammation)
  • Hyperglobulinemia (chronic)
84
Q

Complications of pleuropneumonia

A
  • Laminitis, thrombosis, sepsis/endotoxemia/diarrhea
85
Q

Prognosis for pleuropneumonia

A
  • Survival is only 40-78%
  • Expensive
  • Worse if anaerobic bacteria
86
Q

Neonatal pneumonia causes

A
  • Systemic infection (in utero; post-partum)
  • Aspiration (weakness; dysphagia)
  • Otherwise less common)
87
Q

Commonly implicated bacteria in neonatal pneumonia

A
  • Gram negatives (E. coli, Klebiella, Actinobacillus; Streptococcus zooepidemicus)
88
Q

Risk factors for neonatal pneumonia

A
  • FPT
  • Placentitis
  • Prematurity
89
Q

Gold standard for diagnosis of neonatal pneumonia

A
  • Blood culture
  • Auscultation can be MISLEADING!!!)
  • Most foals are too sick for TTW culture and cytology
90
Q

Treatment of neonatal pneumonias

A
  • Treat the primary condition
  • Broad spectrum antibiotics
  • Anti-inflammatories
  • Intranasal oxygen
  • CAREFUL WITH bronchodilators
91
Q

Which antibiotics to use in neonatal pneumonia?

A
  • K penicillin (gram positive and anerobes)
  • Amikacin (gram negative; hydrate)
  • Unlikely to do metronidazole as a first choice
92
Q

Atypical interstitial pneumonia signs and mortality

A
  • <6 months respiratory distress

- High mortality

93
Q

EHV-1 Pneumonia

A
  • Weak foal
  • Progressive pneumonia
  • Secondary bacteria
  • Look for other signs at the farm
94
Q

Pneumocystis carinii diagnosis and treatment

A
  • Diagnose with cytology

- TMS treatment

95
Q

Adenovirus what should you suspect if you diagnose in a foal?

A
  • Underlying condition: e.g. SCID!
  • Arabians
  • Immunosuppressed foals
96
Q

Signs that a foal never stood up after foaling?

A
  • Have epomicium

- Covering on the hoof

97
Q

Older foal pneumonia likely etiology

A
  • Streptococcus zooepidemicus
98
Q

Physical exam findings for an older foal pneumonia

A
  • Slight fever
  • May have a slightly elevated heart rate
  • BAR often but dyspneic
  • Often can’t hear abnormal lung sounds
  • Agitated and not nursing well
  • 1.5 months old ish
99
Q

Diagnosis of pneumonia in an older foal

A
  • Ultrasound is helpful

- Can see a consolidated lung on ultrasound

100
Q

Antibiotic for Streptococcus zooepidemicus

A
  • Penicillin
101
Q

What signs on bloodwork are indicative of an abscess?

A
  • High fibrinogen and high globulins!!!
102
Q

What is one of the features of Rhodococcus equi that makes it pathogenic?

A
  • Vap A protein (allows it to escape macrophages
103
Q

Who gets R. equi?

A
  • Young foals
  • Immunosuppressed adult horses
  • Infected early in life
  • If ingested, diarrhea; if inhaled, pneumonia
104
Q

Clinical signs of R. equi

A
  • Febrile
  • Tachycardic
  • Dyspneic
  • Lethargic
105
Q

Extrapulmonary lesions with R. equi

A
  • Ulcerative colitis (Diarrhea)
  • Ulcerative lymphangitis
  • Arthritis/osteomyelitis (BAD NEWS)
  • Abscesses
  • Immune mediated polysynovitis, thrombocytopenia, anemia
106
Q

Diagnosis of R. equi

A
  • Can see an abscess on the ultrasound
  • Bloodwork with a high fibrinogen and high globulins will suggest abscess
  • TTW is definitive diagnosis; cytology and culture; PCR for VapA
  • Need a positive culture plus a septic neutrophilia!
107
Q

Treatment of R. equi

A
  • 80% don’t need treatment

- Often if small enough, don’t need treatment

108
Q

Treatment of R. equi

A
  • Macrolides + rifampin

- Azithromycin example

109
Q

Warnings for treatment

A
  • Watch out for hyperthermia

- Will also urinate orange

110
Q

Prevention

A
  • Small abscesses no treatment
  • Clinical pneumonia (Antibiotics and NSAIDs)
  • No vaccine
  • Hyperimmune plasma may help?
111
Q

Hyperimmune plasma for R. equi

A
  • At birth - dose?
  • Decreases severity
  • Expensive
112
Q

Parascaris equorum age affected and clinical signs

A
  • Weanlings (4m-1 year)
  • Occasional cough
  • No other signs
  • Self-limiting
  • Migration phase in lungs leads to inflammation and eosinophils
113
Q

Diagnosis for parascaris equorum

A
  • TTW and BAL (eosinophils and larvae)

- Non-specific blood work

114
Q

Treatment for Parascaris equorum

A
  • Fenbendazole
  • Multiple doses
  • Be really careful because if the worms die all at once, can cause an impaction

Equine Med Final (Old Material) (11 decks)

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