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Equine Medicine > Severe equine asthma, recurrent airway obstruction > Flashcards

Severe equine asthma, recurrent airway obstruction Flashcards

1
Q

RAO or heaves definition

A

recurrent airway obstruction that is reversed by a change in environemtn or use of bronchodilators

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2
Q

What are the different RAO phenotypes?

A

Airway neutrophilia

Airway obstruction - bronchospasm

Mucus accumulation in airways

Bronchial accumulation in airways

Bronchial hyperactivity

poor performance, exercise intolerance

airway remodelling

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3
Q

Breeds predisposed to RAO

A

thoroughbred, arabian, morgan and standardbred

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4
Q

aetiology of RAO

A

complex genetics

(RAO and IL-4 receptor gene

RAO and decreased strongyle egg sheding

RAO and increased risk of allergic skin disease)

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5
Q

What are some environmental factors causing RAO?

A

moulds

endotoxins

mites and their faeces

plant material

inorganic dust ingredients

gases -ammonia

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6
Q

Wat moulds/fungi can be causative to RAO

A

aspergillus fumigatus

faeni rectivirgula

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7
Q

What is meant by summer.pasture associated RAO? (SPARAO)

A

time when the clinical signs gets worse due to

warm and humid weather

high fungal spore concentration

high pollen concentration

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8
Q

RAO has many different pathogenesis, mention some of them

A
  • complex immune-mediated hypersensitivity
  • probably type IV allergic reaction is the most important
  • Oxidative stress
  • matrix metalloproteinase
  • release of inflammatory mediators
  • bronchospasma
  • increased mucus production
  • airway remoddeling
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9
Q

Describe the lung function in RAO

A

airway is obstructed leading to inceased pulmonary resistance and decreased compliance. The hor has to increase the respiratory effort to acheve the necessary todal volume.

this will lead to a ventilation-perffuison mismatch and hypocaemia

increased respiratory drive + airway obstruction will give hives

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10
Q

what kind of dyspnoea will a RAO horse have

A

expiratory

abdomnial respiratory component - not synchronized ith outflow, increased oxygen and energy consumption contributing to cahexia

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11
Q

When diagnosing RAO how does the x-rays look?

A

normal and concave diaphragm

increased interstitial pattern

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12
Q

Diagnosing RAO - what are the cytological procedures?

A

tracheal wash and BALF

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13
Q

How can RAO be diagnosed with BALF?

A

neutrophils persistent in the lungs after corticosteroid therapy

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14
Q

differential diagnosis to RAO

A

SPARAO

IAD

Pneumonia

Pleuritis

pulmonary fibrosis

thoracic neoplasia

lungworm infection

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15
Q

What are the environemntal managemet measures taken - known as air hygiene, to treat RAO?

A

pasture turnout

external stable for the sick horse

good ventilation

separte air-space from hay and straw

alternative beddings

alternate roughage instead of dry hay

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16
Q

GGC given orally to RAO patients

A

prednisolone

dexamethasone

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17
Q

GGC given IM to RAO patients

A

dexamethasone, triamcinolone

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18
Q

Drug categories of bronchodilators

A

B2- adrenergic agents

Anticholinergic agents

MEthyl xanthine derivatives

19
Q

B2-adrenergic agents given to RAO patients

A

celbuterol

salbutamol/albuterol

salmetrol

20
Q

anticholinergic agents given to RAO patients

A

atropine sulphate - IV

glycopyrrolate

ipratropium bromide - inhaled

21
Q

methyl xanthine derivatives

A

aminophylline

pentroxifyline

22
Q

mucolytics goven to RAO patients

A

dembrexine

acetylcystein

bromhexine

23
Q

Exercise induced pulmonary hemorrhage (EIHP) definition

A

rupture of microbronchial and alveolar capillaries in the caudodorsal lung segment during exercise - often in exhausting competitions, racehorses, three-day-eventers - showjumpers

24
Q

What are the cuases and pathogenesis of EIPH?

A

unknown origin

  • lesions of the capillary wall

genetic predispostion

small airway disease

environemtnal

RAI, IAD,resp infection

25
Q

How can mechanicla forces cause EIPH?

A

pressure of the diaphragm and forelimb locomotory impact forces

the capillary pressure forces open the pareital connection of the endothelial and epithelial cells

26
Q

Clinical signs of EIPH

A

foamy, light red nasal discharge

27
Q

How can EIPH be treated?

A

With furosemide

it should be given before the competition

it will improve the state of the capillary walls

also vitamin C, flavenoids and conjugated estrogens

28
Q

Causative agents of pneumonia - pleuropneumonia

A

secondary to viral infections, aspiration, bacteremia

immunosuprresion, alterations in mucociliar clearance

29
Q

predisposing factors of pneumonia

A

strenous exercise

transportation

faults of stable managementgeneral anesthesia

30
Q

Aetiological agents for pneumonia

A

streptococcus equi

staphylocccus aureus

E.coli

klebsiella pneumoniae

bordetella bronchisepica

pasteruelle, bacteroides, clostridium

Actinobacillus equuli, suis

31
Q

hy do an ultrsound when suspecting pneumonia?

A

check quantity and quality of fluid

check for gas echos

and help with the positioning for sampling

32
Q

What is the prognosis if anaerob bacteria are found during thoracocentesis?

A

poor

33
Q

What is the course of treatment for pneumonia?

A
  • first: AB therpay
  • drainage
  • long term antibiotics therpay
  • NSAIDS
  • bronchidilator, muoltics inhalation
  • fluid and electrolyte therapy, energy supply
  • stall rest
34
Q

In what case will rhodococcus equi cause pneumonia?

A

during specific weather conditions

when the maternal immunity is decreasing

if there is a EHV-2 infection or a extrapulmonary ongoing disease

35
Q

How can a horse be infected with rhodococcus equi?

A

aerogen route from soil or other foals

36
Q

Clinical signs of rhodococcus equi

A

resp symptoms

growth retardation, weaker, poor haircoat

fibrinogen level will increase

neutrophil granulocytes

37
Q

How is r.equi infection seen on X-ray?

A

nodular increase in radiodensity so we can see nodular interstitial pattern and air bronchograms

38
Q

How is R.equi diagnosed with ultrasound?

A

cna see abscess in the peripheral lung field

39
Q

What treatment is the best choice for R.equi?

A

clarithromycin with rifampin

40
Q

What should you be aware of when giving macrolides to foals (rifampin)

A

hyperthermia can occur

41
Q

How can R.equi be prevented?

A

Separation

Cleaning of pastures and stables

Avoidance of overcrowded conditions

Vaccination against EHV-2

Vaccination against Rh. Equi

Supportive therapy

42
Q
A
43
Q
A

Equine Medicine (6 decks)

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