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VET608 - Equine General Practice > Trimester 3 Exam > Flashcards

Trimester 3 Exam Flashcards

1
Q

What is causing the issue seen in this picture?

A
  • Left Head Tilt (Left eye lower)
  • Peripheral Left Vestibular
    *
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2
Q

Horses with endotoxemia usually have the following conmination of signs

  1. Tachycardia, pale MM
  2. Bradycardia, pale MM
  3. Tachycardia, congested MM
  4. Bradycardia, congested MM
A

Tachycardia, congested MM

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3
Q

If a horse is headpressing where does this indicate the lesion is?

A

Forebrain

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4
Q

What is different in the approach to a colicky foal compared to an adult>?

A

You still need ot differentiate between a Surgical and Non-surgical lesion

  • Differences between adult and foal
    • Pain tolerance
    • Rectal paplation not possible
    • Abdmoinal radiography - Plain and contrast possible with foal
  • Pain
  • Paunch
  • Pulse
    • Foal <1 month 80-100bpm
    • Foal <2months 70bpm
    • Foal <3months 60bpm
  • Perfusion
  • Peristalsis
  • Percussion
  • Pass a Nasogastric tube
  • Additional
    • PCV/TP
    • Lactate Concentration - good indicator of perfusion
    • Rectal Palpation - digital only
    • Peritoneal fluid - not routinely done in foals has increased complication
    • US - Very useful
    • Rads - useful in foal
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5
Q

When do you perform a TransTracheal Wash (TTW) or a Bronchoalveolar lavage (BAL) in a horse?

A
  • TTW
    • The horse has a history and clinical findings suggestive of infectious respiratory disease
  • BAL
    • The horse has history and clincal findings suggestive of non-infectious respiratory disease
      • TTW & BAL
    • The horse has history and clinical findings suggestive of non-infectious respiratory disease that has recently appeared to have progressed
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6
Q

What are teh three Guttural Pouch Diseases?

A
  • GP Empyema (Pus in GP - Young horses, ABx)
  • GP Mycosis (Fungal infection roof medial compartment Aspergillus, Haemorrhage from eroded Internal corotid, Surgery ligate Internal carotid & Anti-fungals)
  • GP Tympany (Non-painful air distention of GP, Surgery)
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7
Q

How do you diagnose Strangles?

A
  • History
  • Clinical Signs
  • Culture - highly recommended
  • PCR (respiratory panel)
  • Serological test - Antibodies to the m-protein portion of the bacteria
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8
Q

With Cervical Vertebral Stenoitc Myelopathy (CVSM) there are 2 major subtypes.

What are they, where is it located and what age horse do they effect?

A
  • TYPE 1 - Dynamic
    • ​Young Horse
    • C3-5
    • Stenosis is dependent on neck position
  • Type 2 - Static
    • ​Older Horse
    • C6-7
    • Stenosis not dependent on neck position
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9
Q

Most common pathologic arrythmia in the horse is?

A

Atrial fibrillation

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10
Q

What is the most common method ofr maintaining anaesthesia for up to 60 mins in the field?

A

Infusion (CRI) of GG, Ketamine, Xylazine

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11
Q

Lable the Anatomy of the upper airway /Larynx in a horse

A
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12
Q

How can you tell where the nasal discharge is originating from on a horse?

A

Rule of thumb =

Unilateral = URT, usually rostral from the nasal septum

Bilateral = Generally LRT

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13
Q

What is Bastard Strangles?

A

When Strepococcus Equi equi speads to the mesenteric lymphnodes, and abscesses form in the abdomen. Fever and inceased WBC and fibrinigon

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14
Q

List the anatomy of the colon of a horse in order

A
  • ileum
  • Caecum
  • Cecocolic Orifice (Narrow - place of obstruction)
  • Right ventral colon
  • Sternal Flexure
  • Left ventral colon
  • Pelvic Flexure (narrows)
  • Left Dorsal Colon
  • Diaphragmic Flexure
  • Right Dorsal Colon
  • Transverse Colon (Narrowing)
  • Descending Colon (Small colon)
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15
Q

What are the common pathogens that cause pneumonia in foals (>4weeks of age)

A
  • Bacteria
    • Streptococcus equi subspecies zooepidemicus
    • Rhodococcus equi
    • Pasteurella species, Bordetella bronchiseptica, Actinobacillus
    • Salmonella, Klebsiella, Pseudomonas
    • Anaerobes
      *
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16
Q

Whats the difference between a Persistent and a intermittent dorsal displacement of the soft palate in a horse?

A

Intermittent DDSP happens during exercise - causing Exercise intolerance

Glossopharyngeal CN IX and Pharyngeal branch of the vagus CN X

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17
Q

True or False

A TRH stimulation should be accurate if used between June and November

A

True

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18
Q

What are some risk factors that put horses at risk of broncho/pleuropneumonia?

A
  • Riskfactors
    • Racehorses
    • Preceded by stressful event
    • Viral respiratory disease
    • Long distance transportation (Decreased mucociliary clearance associated with cross tying)
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19
Q

How do you treat a Caecal impaction?

A

Large Colon Non-Strangulating

  • Caecal Impaction
    • No feed
    • Enteral and IV fluids
    • Analgesia
    • Surgery
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20
Q

How do you decrease nonstructral carbohydrates for a horse with EMS

A
  • Diet should contain less than 10% nsc
  • Remove grain & concentrates from diet
  • Remove excessive consumptions of treats - apples/carrots
  • No access to pasture - growing season
  • Restrict to late night/early morning grazing
  • Soak hay
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21
Q

a 22 yo SB gelding , HR90, violent colic, dark mucous membranes, no distension

  1. LC volvulus
  2. pedunculated lipoma
  3. ileal impaction
A

Pedunctulated lipoma

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22
Q

What is a Progressive Ethmoid Haematoma?

What aged horses normally get this?

Why does it happen?

A
  • Progressive Ethmoid Haematoma is an encapuslated masses originating from ethmoid turbinates or within sinuses
  • Usually middle aged to older horses
  • Repeated submucosal haemorrage and encapsulation
  • Can cause local destruction of tissue by expansion and pressure necrosis
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23
Q

What are some clinical signs seen with EMS?

What would some other DDx’s be for these Clinical signs?

A
  • Clinical Signs
    • Obese
    • Regional obesity
    • Easy keepers
    • Laminitis
  • DDX’s
    • EMS
    • PPID
    • Hypothyroidism
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24
Q

Where is the most common neurological disease in a horse located?

A

In the spinal cord

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25
You have a horse with Fever, Quiet demeanor, Lethargy, Anorexia Nasal flaring, increased RR, nasal discharge Weight loss and Ventral oedema (Chronic signs) You have Pneumonia on your DDX how do you diagnose?
* Diagnosis * Ausculation and Percussion * Haematology and fibrinogen * Acute - Haemoconcentration, Inflammatory leukogram, increased fibrinogen SAA * Chronic Hypoproteinemia * US and Rads * +/- Endoscopy * Tracheal aspirate * Thoracocentesis * Treatment * ABx * NSAIDS (Flunixin, Bute) * Drainage if significant pleural fluid * Supportive Therapy * Maybe hypovolaemic due to endotoxaemia * IV fluids * Enteral fluids
26
Why do we use benzodiazepines in combo with ketamine?
Benzo's offset muscle rigidity associated with ketamine as benzo;s are muscle relaxants
27
A horse has a regular heart beat A left sided systolic 4/6 murmur at Base Right sided Systolic 5-6/6 murmur What would your diagnosis me
Ventricular Septal Defect (VSD)
28
What is imporant to remember about Large Intestinal Volvulus in horses?
* EMERGENCY * time is everything * High mortality * Periparturient broodmares at risk * Rotation \>270 = Strangulation * Venous obstruction --\> arterial obstruction * Haemorrhage, oedema, distension * Post op care * Endotoxaemia - laminitis, DIC * Colon healing - Protein loss, diarrhoea
29
What are teh clincial signs of Oesophageal Obstruction? What is the Management of Oesophageal Obstruction? What are some complications of Oesophageal Obstruction?
* Oesophageal Obstruction - Choke * **Clinical Signs** * General/non-specific * Initial anxiety/distress * Inappetence * Lethargy * GI Signs * Head/neck extension * Retching * Ptyalism * Feed/Saliva at nares * **Management** * Sedation * Gentle lavage and pressure * Motility modifying drugs * Oxytocin * Buscopan * Acepromazine * **Complications** * **​**Aspiration pneumonia * Repeat Choke * Stricture/Rupture of Oesophagus
30
What paranasal sinuses are most commonly effected by disease?
* Maxillary * Rostral * Medial(Ventroconcal sinus) * Lateral * Caudal * Frontochonchal * Drains to caudal maxillary
31
What vital structures do the guttural pounches overly in a horse
* Medial Compartment * Internal carotid arteries * Glossopharyngeal nerve IX * Hypoglossal nerve XII * Pharyngeal branch of vagus X * Cranial Laryngeal Nerve * Lateral Compartment * External Carotid Artery
32
What other viruses can cause Neurological issues in a horse?
* EVH1 * Tetanus * Rabies (ABLV), Lyssavirus * Botulism
33
What drugs could we use on a EMS horse to intervene to inprove insulin sensitivity?
* Thyroxine - assists with weight loss and improved insulin senseitivity * Metformin - Insulin sensitizing drug - poor bioavailabilty in horses
34
What are the causes of Small intestinal non-strangulating obstrucions causing colic?
* Impactions * ileal * Ascarid * Other * Intussusceptions * Idiopathic focal eosinophilic enteritis
35
If you see a colicky horse with distention in the right side of the abdomen what is it likely to be situated?
* Right * Caecum * Left * Left Colons
36
How do we kill Strangels (Strep equi equi) bacteria in the environment?
* Rest pasture for 4 weeks * Organism readily killed by * Heat * Povidone iodine * Chlorhexidine * Bleach
37
How do you tell the difference between * Haematuria * Haemoglobinuria * Myglobinuria
* Haematuria * Spin Down, urine and RBC seperate * Haemoglobinuria * Spin Down stays pink * Myglobinuria * Myopathy - clinical signs and CK/AST
38
What is the Pathophysiology of PPID?
* Primarily hypothalamic disease * Loss of dopaminergic inhibition of the pars intermedia * Leading to hyperplasia or adenoma formation of pars intermedia * Oxidative stress and increased genetic risk
39
What are some predisposing factors of Laminitis?
* Excessive pasture exposure * Carbohydrate overload * Endotoxemia, systemic sepsis or toxaemia * Supporting limb laminitis-laminar failure * EMS/PPID * Previous episodes of laminitis * Corticosteroids * Triamcinolone * Long term treatment
40
What are the Inflammatory bowel diseases that Horses can get
* Malabsorptive, infilrative diseases * Idiopathic IBD * MEED * Lymphosarcoma * Proliferative enteropathy * (Mycobacterium)
41
When using a CRI (Continuous rate infusion) what is the major advantage when sedating \>45mins? 1. Quicker Recovery 2. Easy to Administer 3. Less Side Effects 4. Less Arousal 5. Better Sedation
Less Side Effects
42
Which class of drug is most effective in treating asthma in horse?
Corticsteroids
43
True or False The TRH test has a high chance of being falsely positive if used between Dec & May
True
44
What further endocrine testin would you do in Kevin? (multiple tests may be needed) * What treatment would you advise for Kevin
* Testing * Endogenous ACTH, fasting insulin (need to be aware if its normal will still need to do in feed glucose, if its abnormal then no need for further tests as this is diagnostic) in feed glucose test (better option) * Pergolide (increases amount of dopamine to shut down pars intermedia and stop it producing all the excessive Melanotrophs/POMC's)
45
What is the treatment for acute laminitis?
* Treat primary disease and remove predisposing factors * Confinment * Sole support-palmer half of foot to point of frog * Sand box, sole pack, dense foam, suppprot shoes * Analgesia and anti-inflammatories * Flunixin or phenylbutazone * ICE feet-ice boots, changed ice q2Hrs until resolution of endotoxic insult Post Acute Stage * Farrier attention * Rocker toe, bring break over back * Bar shoe with sole pack --\> palmer support * Continued palmer sole support and analgesia * Regular hoof care * Repeat reds to monitor progression * Avoid predisposing factors * Salvage procedures
46
You have a horse in mild/moderate abdominal pain (can become severe). Is dehydrated. On Rectal palpation you can feel you feel bands of the colon running transversley across the pelvic inlet, you cannot palpate the cecum. US- mesenteric vessels are against the body wall What is causing this?
* Right Dorsal Displacement of the Large Colon * If the pain isnt too high you can withhold food and see if it clears naturally. * If painful surgery is required. *
47
What are some viruses that cause Arboviral encephalomyelitides? * Alphavirus * Flavivirus
* Alphavirus * Ross River Virus * Flavivirus * West Nile Virus/Kunjin variant * Murray Valley Encephalitis/Japanese Encephalitis
48
Heaves is most commonly due to a hypersensitivity to what?
Hay, Mould and Dust
49
What clinicopathologic abnormality is diagnostic for hyperlipaemia
* Elevated Triglycerides
50
How long is the gestation of a Horse? What are the 3 stages of parturition?
* 341days (11months & 11days0 * Stage 1 * Behaviour of parturition -\> rupture of membranes * Can be days * Stage 2 * Rupture of membranes -\> deliver of foal * Quick 11 mins average. Should be less than 20mins * Redbag = Seperated chorium BREAK THIS NOW * Stage 3 * Delivery of foal -\> delivery of placenta
51
What is the differences between Primary and Secondary Peritonitis?
* Primary * Actinbacillus equi * Bacteral translocation * No underlying disease * Mild Illness * Secondary * Mixed inc anaerobes * Gut compromise * Underlying (GI) disease * Severe illness * Treatment * Primary * Antibiotics * Penicillin/tetracyclines * Anti-inflammatories * Good Prognosis * Secondary * Antibiotics * Broad spectrum inc anaerobes * Treat underlying disease * Treat endotoxaemia * Prevent complications * Abdominal lavage and drainage * Guarded prognosis
52
Equine Herpesvirus What are teh strains we need to be concerned about?
* EHV-1 : Abortion, neurological, perinatal disease, respiratour disease * EHV-4 : Respiratory Disease (Gerater Prevelance EKV4\>EHV1 * Diagnosis - PCR antigen detection - Nasopharyngeal swabs * Prevention - Commercial Vaccine for boe EHV4 & EHV1 available in Australia
53
What are some major causes of PU/PD in a horse?
* Major Causes PU/PD * Renal Failure * PPID * Psychogenic polydipsia * Less Common * Iatrogenic * Central or Nephrogenic DI * Endotoxaemia/Sepsis
54
Progressive Ethmoid Haematoma Clinical Signs Diagnosis Treatment?
* Clinical Signs * Intermittent unilateral epistaxis * Serosanguinous to sanguinous * Low volume * Occasionally sinusitis and malodorous breath * Diagnosis * HX and Clinical Signs * Endoscopy * Rads/CT * Histology * Treatment * Surgical excision via bone flap if large * Intralesional 4% formaldehyde injection * Laser Ablation
55
A horse has a regular heart beat A left sided systolic 1-2/6 murmur at apex Right sided Systolic 3/6 murmur What would your diagnosis be
Mirtal Regurg & Tricuspid Regurg
56
What type of virus is Equine rhinitis virus?
* Equine rhinitis A & B * Picornavirus * Very Common in Australia
57
Would you use ice boots in a horse?
* Prevent laminitis from endotoxaemia * Treatment of acute laminitis
58
a 12 yo mare, 36hr colic duration, 4L net reflux, left kidney not seen on US 1. Left dorsal displacement 2. Right dorsal displacement 3. ileal impaction
Left Dorsal Displacement
59
The Presenting horse at Physical Exam :- * You are asked to examin a 3 month old thoroughbred filly that is experiencing an acute episode of respiratory distress * The foal is well grown and was fine up until yesterday * On examination the foal is tachpneic, tachycardic, and has a rectal temperature of 39.9C 1. What is your next diagnostic test (assuming physical exam and ausculated for the above foal)
1. Blood Work, CBC & Biochem
60
When can LACTATION TETNEY occur? What causes this? What are the clinical signs?
* Lactation tetany can occur 2weeks prior to foaling through to weaning * Due to loss of large amounts of calcium in the milk * Clinical signs * Profuse sweating * Tremor * anxious expression * tachycardia * +/- cardiac arrythmia * ileus * possibly colic * Treatment * Slow IV calcium - calcium borogluconate
61
When using a rebreathing bag, when we remove it how long till the horse should have recovered in a normal Horse?
Within 5 breaths
62
What is the treatment/management for EMS?
* Goal - decrease insulin dysregulation and restore insulin sensitivity * Weight Reductiuon * Exercise * Decrease intake * Decrease non structural carbohydrates.
63
Which treatments are useful in managing lyperlipaemia?
* Parenteral insulin, * IV glucose, * Correct fluid and electrolyte impalances
64
Secondary sinusitis in a horse could be cause by what teeth most commonly?
First molar (109,209)
65
What steps do you take to diagnose Foal Pneumonia? How would you manage Foal Pneumonia
* Diagnosis * Physical Exam * Haematology * Imaging * US & Rads * Tracheal aspiration * Gram stain, C&S * Management * Abx * Penicillin (not R.equi or gram -ve) * Ceftiofur (not R.Equi) * Trimethoprim-sulphadiazine * Doxycycline * Treat until signs are gone and then some (CBC is normal) * Bronchodilators * Corticosteroids (rarely) * Nebulisation
66
What is IAD and Heaves called in the horse?
Equine Asthma represent a spectrum of chronic inflammatory airway disease
67
What are teh signs of Placentitis in a mare? How heavy is a normal placenta from a foal?
* Looks like parturition * Vulval discharge * Baggin up * Waxing up * Running milk * COmmonly last trimester * Mare usually well * Normal Placenta = 11% of Foal body weight
68
What are the causes of Small intestinal sttrangulating obstructions?
* Volvulus * Mesenteric rents (inc gastrosplenic ligament) * Epiploic foramen entrapment * Pedunculated lipoma * Mesodiverticular bands * Hernias
69
What are some reasons for Dysuria/Stranguria in horses?
* Inflammatory or Infection reasons * Urolithiasis (Cystic calculi) * Cystitis * Neoplasia * Idiopathic haematria * Urethral defects in geldings
70
When a hose has colick and we are checking the perioneal fluid how do we do this? What Colour should this fluid be? What are the different colors mean?
Via Abdominocentesis
71
A horse has a irregularly irregular heart beat A left sided --- Right sided Systolic 2/6 murmur What would your diagnosis me
Atrial Fibulation Tricuspid Regurgitation
72
When considering a field anaesthesia of a horse what is the maximum lenght of anaesthesia time you can plan for before you should refer it to a gaseous clinic
\>60mins is not approoriate to consider field anaesthesia
73
Horses Inflammatory Bowel Disease Signalment? How is IBS characterised?
* Signalment * Young horses * Standardbreds * Weightloss with good appetite * Oedema (hypoproteinaemia) * +/- Diarrhoea * Characterised by cell type * Granulomatous * Lymphocytic-plasmacytic * Eosinophilic
74
What type of Ryegrass toxicity do we see here in WA most often?
Annual ryegrass toxicity
75
how do you diagnose EMS in horses?
* Bloodwork - * CBC/Biochem - WNL * Glucose - Most will be normoglycemic * Insulin levels - Fasting ( may be normal in upto 70% of EMS horses) * Oral Surgar Test * Fast as Baseline * 15mL/100kg "Karo Light" corn syrup orally * Blood @ 60-90mins * Normal Insulin \<45-60uU/mL * In feed glucose test \*Prefered test\* * Fast overnight * Time 0 blood glucose reading * Give 0.5-1g/kg glucose powder in non glycemic feed * Measure serum insluin and plasma glucose at 2hrs * Normal = * 0.5g/kg: 2hr insluin \<57uU/mL * 1g/kg: 2hr insluin \<87uU/mL * The greater the post feed insluin the greater the risk of laminitis occuring
76
When you have a colicky horse and you need to pass a tube why do you check the HR before and after? WHat does the volume of the reflux indicate?
* Pain from strangulation wont reduce (HR wont reduce) when you decompress therefore if HR changes you know this is non-strangulating * Reflux - * Large volumes - Gastric or Small Intestine origin * Small volumes - LC compression of SI
77
What location is the most common cause of Colic in horses?
* Large Colon Impaction * Pelvic Flexure --\> Dorsal colon --\> Elsewhere
78
Gutteral Pouch Disease Clinical Signs
* Clinical Signs * Distention in the GP region * Pain * Nasal discharge - usually unilateral * Respiratory noise - if compression of pharynx * Epistaxis * Neurological signs * Diagnosis * Clinical Signs * Radiology * Well outlined due to air density, fluid lines empyema (pus), increased density in focal regions * Endoscopy * Discharge from pharyngeal openings, Direct visulation of interior
79
What is the Grading system for rectal Prolapse?
* Grade 1 * Simple prolapse * Grade 2 * Complex prolapse * Grade 3 * Small colon intussusception
80
A horse has a irregularly irregular heart beat A left sided ---- Right sided ---- What would your diagnosis be
AF
81
What is the most common cause of abortion/premature parturition in a horse?
Placentitis
82
You have been presented with a foal what you have deduced has a Meconium Impaction, What therapy would you suggest?
* Initial Therapy * Supportive Care * Rehydration +/- Glucose * IV fluids if dehydrated * Moderate dehydration 6% = dull, tachycardic, dry MM and increased USG * Severe dehydration 8% = Stuporpus dehaviour * If USG \>1.020 fluids required (enteral or parenteral) * Control Pain * NSAID * Flunixin * Meloxicam * Ketoprofen * Opioids * Butorphanol * Alpha 2 agonists (Older Foals) * Xylazine * Enema(s) * Warm soapy water * Foley Catheter * 500-1000mL for 50Kg foal (Gravity fed) * If rthis doesnt work can yse acetylcysteine 4%
83
During Anaesthesia what are the 3 H's to remember?
* Hypoventalation - less common when using dissociative (ketamine) agents as a sole anaesthetic agent. * Hypotension - less common when using dissociative (ketamine) agents as a sole anaesthetic agent. * Hypoxaemia - * Horses are not meant to lay down, atelectasis will occur within 5 mins * Respiratory obstruction * Dislocated soft palate * Nasal congestion (prolonged recumbency)
84
What things would we expect to see on haematology/CBC with a foal with strep equi zooepidemicus? How long should the foal be treated for?
* Neutropenia * Leucocytosis * Anaemia (possibly) * Elevated fibronogen (acute phase protein) * Serum amyloid A (not included in CBC, stand-alone test) * Until the CBC returns to normal
85
A horse has a regular heart beat A left sided systolic 3/6 murmur at Apex Right sided ---- What would your diagnosis me
Mitral Regurgitation
86
When is field anaesthesia not considered appropriate?
Surgerys planned for greater than 60mins
87
What is it called when the soft palate covers the eppiglottis in a horse?
Dorsal Displacement of the Soft Palate (DDSP) Impeades inspiration slightly however during expiration the soft palate will viabrate and cause noise which can distress the animal.
88
A Horse is severly insulin dysregulated. We are unsure whether the horse has PPID or EMS and we decide to treaty with pergolide, what are the consequenses if it doesnt have PPID?
* Cost to the owner (Pergolide is expensive) * Clinical Signs wont improve * Adverse effects are reasonably rare.
89
We have a horse we done a ACTH test and we feel we have got a false positive. What other options do we have?
* Retest endogenous ACTH (when its at highest likelihood of being true result feb/apr) * TRH stimulation test (can be used at certain times of year, at other times has huge false positive results)
90
How do we do a withdrawl reflex on a horse?
* Only when they are recumbent * or a foal
91
Name some Initial and later clinical signs of Strangles in horses
* Initial Signes * Depression, reduced appetite * Fever * Mucopurulent nasal discharge * Pharyngitis and laryngitis * Cough * Later SIgnes * Suppurative lymphadenopathy * Submandibular * Retropharyngeal * Purulent nasal discharge * Asphyxiation, dysphagia
92
What is the meaning of Hyperlipidemia/Hyperlipemia?
Increased triglycerides in the blood
93
How can you tell is a colic for a horse is Strangulation or non-strangulating?
* Strangulating lesion * High heart rate * Altered Perfusion * MM - Colour, Dryness, CRT * Extremity Warmth * Non-Strangulating Lesion * Mild to moderate elevated heart Rate * Normal Perfusion
94
Peritoneal fluid from a horse - grossly turbid, degernerate neutrophils and red cells on coytology. What is the likely cause 1. Actinobacillus equi peritonitis 2. Strangulating small intestine obstruction 3. Duodenitis/proximal jejunitis
Strangulating Small Intestine Obstruction
95
How long after infection of strangles does the horse she the bacteria for??
* 4-6weeks after infection * 25% will shed for months to years after * Gutteral pouches are primary site of carriage * swap and treat positive animals with penicillin and reculture. * Prevention * Vaccination IM * 3 doses 2 weeks apart then annual dose
96
What is the most common methof of maintaining anaesthesia for up to 60 mins in the field? 1. 1/3 dose of xylazine/ketamine given twice 2. 1/3 dose of xylazine/ketamine given three times 3. Infusion of GG/Ketamine/Xylazine 4. Infusion of GG/Ketamine/Thiopentone 5. Thiopentone alone
* Infusion of GG/Ketamine/Xylazine 1/3 dose of xylazine/ketamine given twice can be used for upto 30-40mins
97
What are some clinical signs of **Rhodococcus equi** What are some of the clinical signs assoicated with R. equi forms
* Clinical Signs * **Bronchopneumonia** * Acute presentation despite chronicity of lesions * Cough and nasal discharge inconsistent * Fever * Tachypnea * Dyspnea * **Intestinal Form** * Intestinal involvement common, ulcerative colitis uncommon * Lymphnodes * **Abdominal abscessation** * **Infectious synovitis** * **Non-septic polysynovitis** * **Uveitis** * **Ulcerative lymphangitis** * **Placentitis** * Diagnosis * Clinical Signs * Lab data * Serology - limited value * Imaging (US & Rads) * Treatment * Toxicity, treatment, cost * Erythromycin and rifampin * Azithromycin +/- rifampin * Clarithromycin +/- rifampin * Prevention * Screening with US and haematology
98
Which of the folloing require surgery? Pelvice Flexure retroflexion Left Dorsal Displacement of LC Right Dorsal Displacement of LC
* Pelvice Flexure Retroflexion - beginnings of RDDLC * Surgery Often required * Left Dorsal Displacement of LC - Wont see left kidney with US * can cause Nephrosplenic entrapment * Treatment - Concervative * Exercise * Rolling under Anaesthesia * Right Dorsal Displacement of LC * US - Mesenteric vessels against body wall * Surgery required \>50% of cases
99
12yo mare with 36hr duration mild colic, with reduced faecal output, bands left to right on rectal 1. Left dorsal displacement 2. Right dorsal displacement 3. LC volvulus
* Right Dorsal displacement (this is one of me more common displacement)
100
During a Neuro exam on a horse and your assessing for Gait abnormalities/posture what are you looking for?
* Proprioceptive deficits (Aware of deep pressure, and location of limbs and joints * Ataxia * Paresis * Dysmetria
101
The 12 P's of Colic and their meaning?
102
For a horse what pH should their urine be? And what could it be if its opposite?
Normal pH shoudl be Alkaline (8-8.5) If its acidic it could be cyctitis
103
The Presenting horse at Physical Exam :- * You are asked to examin a 3 month old thoroughbred filly that is experiencing an acute episode of respiratory distress * The foal is well grown and was fine up until yesterday * On examination the foal is tachpneic, tachycardic, and has a rectal temperature of 39.9C 1. You have done Haematology and Thoracic Rads. What can you see? 2. What is your Diagnosis?
* Haematology * Leucocytosis * Increased fibrinogen * Neutrophilia * XRay * Large cavity masses on x-ray * Diagnoses * Rhodococcus equi (its a gram positive intracellular pathogen of macrophages usually 3 weeks to 6 months old, soil inhabitant found in faeces of herbivores, variable occurrence dependent on bacterial virulence
104
A horse with hypocalcaemia would have what stand out clinical sign and what is causing this?
* Hypocalcaemic tremor * - caused by low calcium, sodium channels become activated by smaller changes in the resting potential causing the clinical signs of increased neuromuscular excitibility * Decreased extracellular calcium leads to decreased smooth muscle contractility
105
Why are Benzodiazepines used in combination with ketamine?
Ketamine causes muscle rigidity and benzodiazepines can offset this effect
106
What is the cause and treatment?
* Acute necrotising vasulitis - due to strangles * Occurs 2-4weeks after acute infection * Treatment * Corticosteroids to treat vasculitis (care risk of laminitis) * Local Therapy - * Cold hosing * pressure wraps * ABx - cover against persistent antigen release
107
A Horse urine is cloudy yellow and ahve a number of mucus and crystals what does this mean?
Nothing this is normal
108
In a horse how do you diagnose Chronic Renal Failure
* Persistent isosthenuria - USE 1.008-1.014 (regardless of hyderation status) * Anaemia (Mild) * Azotaemia * Hypoproteinaemia (hypoalbuminaemia) * Electrolyte disturbances * Decreased Na, Cl, Ph; Increased Ca * +/- acid base abnormalities (metabolic acidaemia) * Management * Irreversible * Control clinical signs, * prevent complications * Nutrition * Monitor creatinine * Grave Prognosis * Always have water available * Dont use nephrotoxic drug * let them eat anything except Lucerne hay
109
How do you diagnose Primary polydipsia in a horse?
* Clinical exam * Not azotaemic * Rule out renal causes * Water Deprivation test * USG at 0, 6, 12, 18, 24hrs * Evidence of urine concentration ability (USG \>1.025) ​
110
A horse is Dehydrated how do we work out how much fluid to give them?
* Deficit * %dehydration x Bodyweight(Kg) * Give Half quickly (first 3-6hrs), then the other half slowly(first 24hrs), recheck often * Maintenance * 60mL/kg/day - Adult * 100ml/kg/day - Neonate * Ongoing Losses * Estimate eg NG reflux, diarrhoea frequency x volume * Recheck * HR * Mentation * Urine production * Refill times * PCV * TS * Lactate
111
Seizures are a sign of what disease in horses? 1. Cerebellar Disease 2. Forebrain Disease 3. Brainstem Disease
Forebrain Disease cause seizures
112
What bacteria causes Strangles? Whats imporant to remember about Strangles? How is it transmitted? How long can Strangles live in the envrironment?
Streptococcus equi subspecies equi 1. Highly infectious and contagious 2. Transmission both direct (horse to horse0 and indirect (fomites) 3. Short-term survival in environment (up to 9weeks)
113
What is the pathophysiology of Equine Metabolic Syndrome And what is the clinical consequence on the horse?
* Pathophysiology of EMS revolves around * Increased adipose stores * Adipose tissue produces Adipokines \>100 --\> Increases Local Cortisol production --\> Inflammatory Cytokines - Lipotoxicity * Insulin Dysregulation/Resistance Clinical Consequence = * Laminitis * increased predisposition to hyperlipidaemia
114
A Neonate Foal presents in the first few days of life * Hx - * Born normal * Lethargic, not drinking * Increased abdominal distension +/- tachypnoea * Stranguria or pollakiuria * Diarrhoea * Throwing themselves on the floor all feet off the ground What do you think this is and how would you diagnose?
* Uroabdomen (Ruptured Bladder/urethra/ureters/Patent Urachus) * Diagnosis * Bloodwork * Azotaemia * Electrolyte abnormalities * Hypochloraemia * Hyponatraemia * Hyperkalaemia * Metabolic acidemia * Ultrasound * ++ anechoic PF * Small Bladder * +/- defect * Adbominocentesis * Peritoneal creatine \> 2x serum creatinine * Treatment * MEDICAL EMERGENCY * MUST control electrolyte derangements prior to surgery * Hyperkalaemia * K+ free fluids * Calcium Gluconate 9cardioprotective) * Sodium Bicarbonate/Glucose/Insulin * Check IgG Status * Broard Spectrum ANx * Surgery repair
115
A horse with colic signs has an elevated HR where is the likely lesion 40-60bpm \>80bpm
* 40-60bpm * Mild to moderate elevation - Large Colon obstruction * \>80bps * Severe elevation - Strangulating lesion
116
What are the USG's figures for the following in horses? * Hyposthenuria * Isosthenuria * Hypersthenuria * Normal for horses
* Hyposthenuria - \<1.008 * Isosthenuria - 1.008-1.014 * Hypersthenuria \>1.014 * Normal for horses 1.025-1.040
117
If a horse is not responging to treatment with pergolide within 4 weeks what should you do?
Could change to Cyproheptidine (If 110% sure horse has PPID) if not 100% sure its PPID then could pursue other diagnostics to confirm PPID
118
This horse has what neurological issues?
* Horners syndrome * Ptysos * Sweating on one side * Blood vessels are dilated causing sweat glands to activate * Ear is paralysed?
119
A horse with a cardiac murmur should be investigated if 1. it is a 3/6 left sided systolic 2. it is a 3/6 right sided systolic 3. it is a grade 1/6 but increases to 2/6 with exercise
We would investigate if ti is a 3/6 left sided systolic murmur * on the right side we will generally wait until it is 4/6 to investigate * if it changes intensity with exercise more likely to be physiologic flow murmur
120
What are the 3 non-strangulating displacement in a horse? What is the lenght of the Large colon and what is its volume?
* Pelvic flexure retroflexion * Left Dorsal displacement of the large colon (LDDLC) * Right dorsal displacement of the large colon (RDDLC) * Large Colon * Length = 3.4m * Volume = 80L * Diameter 10-50cm * Minimal attachments, (caecum and transverse colon)
121
A horse has a regular heart beat A left sided Dyastolic 4/6 murmur Right sided Dyastolic 2/6 murmur What would your diagnosis be
Aortic Regurgitation
122
Primary sinusitis is commonly caused by what pathogen?
Streptococcus equi subsp zooepidemicus
123
Which treatment should be given to treat hypocalcaemia tetany?
* Calcium Borogluconate 500mls in 5L of LRS given as IV bolus to effect
124
A horse with respiratory disease has **inspiratory dyspnoea** where is the pathology likely?
Inspiratory dyspnoea = URT pathology May be due to obstruction or restriction of breathing but normal gas exchange
125
What is Pollakiuria?
Frequent small urination
126
What treatment do you give for a mare with retained foetal membranes?
* Treatment * Oxytocin (causes contractions) * Uterine Lavage * Burns technique - into the uterine horns * Dutch technique - into the uterine vessels * Gental traction
127
zHow/where are Large intestine non-strangulating obstructions caused/located?
* Large Intestine non-strangulating obstructions * Impactions * Caecal * Colonic * Sand * Displacements * RDDLC * LDDLC * Pelvic flexure retroflexion * Non-Strangulating volvulus * Intusseptions * Enterolithiasis
128
Hyperlipemia and Hyperlipidemia occurs more commonly in what type of horses?
* Ponies, Donkeys, Mules, American Miniture horses, Minature donkeys * Mares \> 18months in the last trimester of gestation or lactating. * Primary - Shetland ponies/Donkey
129
What can you see? What is the treatment
* F-Waves ... Atrial Fibrillation * Treatment = Quinidine by nasogastric tube
130
What are the 7 P's when approaching a horse suspected of colic?
* Pain * Paunch * Pulse * Perfusion * Peristalsis * Percussion * Pass a nasogastric tube
131
Regarding EMS How are obesity, insluin and laminitis linked?
* Increases circulating inflammatory products * Increased glucose may aaffect laminar vessels * Increased insulin has been shown to cause laminitis
132
What would be some clinico pathologic abnormalities for PPID?
* Mild Anemia * Leukocytosis * Hyperglycemia and glucosuria * Hyperinsulinaemia * +/- hepatic enzymes elevated * Routine bloodwork is not useful to diagnose PPID only supportive
133
How do you test Spinal reflexes in a horse?
* Thoracolaryngeal adductor response (SLAP TEST) * Spinal segmental * Cervicofacial * Panniculus * Tail/anal
134
What is the normal urination output for a horse / day?
* Urination * Normal output = 5-15L/day (3-18ml/kg/day) * Urinate 4-6 times a day * Polyuria = \>25L/day * Water Intake * Normal = 25-30L/day * Polydipsia = \>50L/day
135
A horse has a irregularly irregular heart beat A left sided systolic 2/6 murmur at Base Right sided Systolic 3-4/6 murmur What would your diagnosis be
AF & VSD
136
What sex gets cyctitis more often and why? Clinical SIgns? Diagnosis and treatment?
Females due to the shorter urethra Clinical signs :- stranguria, pollakuria, scalding Diagnosis :- Cytology \>10WBC/hpf +/- RBF, C&S, Cystoscopy Treatment :- Urine-Excreated abx (Beta-Lactams, TMPS), Bladder Lavage
137
How do you treat an umbilical Hernia?
* Irreducible or strangulation --. immediate SUrgery * Abscess - drain first +/- abx the repair
138
Clinical signs of PPID are due to? What are the common clinical signs of PPID?
* Increased circulation of POMC's (alpha-MSH, CLIP, Beta-endorphin and ACTH) * Loss of neuroendocrine function of adjacent tissues * Common Clinical Signs of PPID * Hypertrichiosis (55-80%) but it is a late stage clincal sign * Hyperhydrosis * Supraorbital fat pads or bags under the eyes * Weight loss (upto 88%) * Pot belly appearence * wasted topline * PU/PD (17-76%) * Lethargy * Recurrent infections * Laminitis (\>50%) - * POMC cause insluin dysregulation * And being \>15years
139
What are the common respiratoyr pathogens isolated in tracheal aspirates (Transtracheal sampling)
* Strep equi zooepidemicus * Actinobacillus * Pasteurella
140
Hendra Virus How long is the incubation period and when does the virus start to shed? If Hendra is on your DDX what MUST you do? How do you test for Hendra?
1. 5-16 days incubation, Virus sheds 2 days before clinical signs are seen. 2. MUST wear PPE and do an exclusion test 3. ELISA virus isolation PCR, Nasal swabs, EDTA blood, serum
141
What are the goals of a colic exam in a horse?
* Do I need to refer * Is it surgical or Medical * Is it strangulating or non-strangulating * Is it Large intestinal of Small intestinal
142
Drainage from all major sinuses can be achieved by what methord and where?
* Trephining and lavage * Frontal Conchal sinus * Rostral Maxillary Sinus
143
When seperating horses exposes or possible exposed to strangles at what temp do we move the horse into the red group?
\>38.3C
144
List the 12P's (11P & I) used int he workup iof clolic in the horse
* Pain * Paunch * Pulse * Perfusion * Peristalsis * Percussion * Pass a Nasogastric tube * Palpations * Pictures (US) * PVC TS Lactate * Peritoneal Sampling * Paperwork
145
List the components of an Equine Neurological Examination
* Behaviour/mentation * Cranial Nerves * Spinal Nerves * Gait examination inc limb placement
146
What are the main causes of Colic in foals?
147
What are the 4 main Nerve blocks we use in the head of a horse?
* Maxillary Foramen * Infraorbital Foraman * Mandibular Foramen * Mental Foramen
148
a 6yo TB broodmare, abdo distention, HR 40, dark mucous membranes, violent colic 1. LC volvulus 2. pedunculated lipoma 3. ileal impaction
LC Volvulus
149
One of the most common causes of weight loss with a good appetite in a horse is? 1. Gastric impaction 2. Granulomatous enteritis 3. Parasite burden
Parasite burden
150
What clinical signs are we likely to see in a foal \>4weeks of age with respiratory disease
* Dependent on pathogen involved * Nasal discharge * Fever (\>38.9c) * Coughing * Off Suckle * lethargy * Dyspnoea
151
A normal equine neurological exam consists of?
Behaviour --\> CNs --\> Reflexes --\> Gait
152
A horse has a regular heart beat A left sided systolic 2/6 murmur at base Right sided Systolic 4/6 murmur What would your diagnosis be
VSD If the right side murmur is louder then the left side murmur AND the left side murmur is at the base Its a VSD
153
What type of horses get EMS? And during what season is the most common?
* EMS * Signalment * 6-20years * Pony Breeds, Arabians, Morgans, Warmbloods * Quater Horses less likely to be affected * Seasonal * Late Spring * Early Summer
154
With cervical spinal cord disease in the horse we expect 1. Quadrilateral ataxia with strenght 2. Ataxia in hindlimbs, LMN weakness in forelimbs 3. Quadrilateral ataxia, worse in hindlimbs
With cervical spinal cord disease in the horse we expect ## Footnote C : Quadrilateral ataxia, worse in hindlimbs
155
What is a common cause of central vestibular syndrome in a horse?
Trauma
156
What are teh 4 grades of rectal tears in Horses?
157
With Equine Gastric Ulceration syndrome What are teh risk factos for Squamous vs Glandular What is the only definitive way to diagnose EGUS?
* Risk Factors * Squamous * High concentrate feeds * Meal eating * Low Forage * Isolation (from other horses) * Radio/Noise * Time in training * Crib biting * Glandular * Warmbloods * Exercise \> 4days/week * Multiple handlers/riders * Management * Proton Pump inhibitors * Sucralfate * Bethanechol * Nutrition/fluid therapy * Anagesia (NOT NSAIDS) * Diagnosis of EGUS * Can only be done definitively by **Gastroscopy** * **Treatment** * **​**Squamous * Oral omeprazole * Glandular * Oral Omeprazole & Sucralfate * Oral Misoprostol * Injectable omeprazole *
158
A horse has a regular heart beat A left sided systolic 5-6/6 murmur at Base Right sided Systolic 4/6 murmur What would your diagnosis be
ToF
159
When you have vestibular syndrome how do you know where the lesion is located when you have :- 1. Head tilt 2. Nystagmus 3. Ataxia
1. Head Tilt * Poll towards lesion 2. Nystagmus * Fast phase away from lesion - Horizontal or rotary peripheral * Horizontal or rotary or vertical - central 3. Ataxia with strenght (if peripheral) * Truncal sway * Lean or circle towards lesion
160
Horses Sinusitis.. Clinical Signs Diagnosis Treatment
* Clinical Signs * Unilateral nasal discharge * Malodorous breath or discharge if dental origin * Facial distortion (less common) * Diagnosis * Clinical Signs * Percussion of the sinuses * oral examination - dental mirros or endoscopy for patent infundibular or gingival disease * Endoscopy - drainage from nasomaxillary opening * Rads - fluid lines in sinuses, peroapical dental disease * Trephination - aspiration of fluid for culture and sensitivity * Sinoscopy - Direct visualisation of sinus mucosa * CT * Treatment - Primary Sinusitis * Systemic Abx based on C&S 7-14days * Sinus lavage via indwellling foley catheter * 1-2L saline or dilute povidone iodine * SID or BID 5-7days * Feed off ground and light exercise to facilitate drainage
161
What is the treatment for a horse with Nutritional secondary hyperparathyroidism?
* Treatment * Dietary modification * Ca:P ratio \>4:1 * reduce grain * increase hay (lucerne) * Supplement calcium * Prevention * Feed a diet with a ration of 1:1 - 2:1 (Ca:P)
162
What is the most common type of Urinary crystals causing Urolithiasis/Cystic Calculi in horses?
* Calcium Carbonate * Spiculated type 1 - 90% * Smooth type 2 * Males 75% \> female due to poor elasticity of the urethra
163
How do you manage a rectal teat in a horse?
* Give Buscopane - stops the motility of the gut * Evacuate rectum * Pack past the defect with cotton wool tampon soaked with betadine * Aminister Broad spectrum Antibiotics * NSAID - Flunixin * Drench with a laxative * Surgical - Blue cup thing
164
When anaesthesising a horse why do we use a padded head collar?
These can have 2 ropes attached giving more control on the head Hey also dont have buckles like a normal halter. these buckles can case facial nerve paralysis (usually temporary)
165
What does Grade 5 ataxia in ahorse mean?
Horse is down and cant get up
166
We have done a resting Endoscope on a horse with Laryngeal Hemiplegia and graded it a 3/4. What does this mean? What treatment is available for this horse
* 3 out of 4 = Resting asymmetry and asynchronous movement fully abduction cannot be obtained. * Treatment * Surgical * Ventriculectomy/ventriculocordectomy * Removal of lining of lateral ventricle, to reduce inspiratory noise * Prosthetic laryngoplasty * prosthesis replaces function of CAD muscle, Arytenoid cartilage permanently abducted and therefore stabalised
167
A horse has a large colon obstruction what treatment would you give this horse?
* Analgesia * Xylazine to examine * Flunixin to treat * Light Exercise * Withhold feed * Intestinal lubrication * Mineral oil * osmotic agents (Magnesium sulphate) * Sodium sulphate * Fluid therapy * Enteral isotonic salt solution * Oral or rectal, bolus or CRI * Enteral fluids5-10mL/kg/hr * IV Fluids (only if dehydrated, and only a small amount) * Surgery * Sand Impaction (do not give to colicky horse) * Psyllium Husks in oil * 1g/kg daily by nasogastric tube for 3-14days
168
What is the most common cause of colic in WA?
Sand
169
A common valvular pathology in horses is 1. Subaortic Stenosis 2. Endocarditis 3. Mitral Valve Regurgitation
Mitral Valve Regurgitation
170
With treatment of PPID, what will happen with the ACTH levels?
* PPID is a chronic life long disease * With treatment ACTH should improve and reduce back to normal range but sometimes it doesn't * ACTh might not improve however improvement in clinical signs might mean othe POMC's are improving
171
How often shold horses with PPID be re-evaluated?
* Horses with PPID should be re-evaluated twice each year including ACTH
172
What treatment should be considered for a horse with confirmed PPID?
* Treatment * General Health Care * Regular teeth care * Regular anthelmintic treatemnt * Aggressive treatment on infections * Address laminitis * Regular hoof care * Access laminitis risk * Measurement of glucose and insulin * Oral glucose challange * Pharmacological * Increaser dopaminergic control of the pituitary gland usign dopamine agonists * Pergolide
173
How do you diagnose and treat Hyperlipidaemia/Hyperlipemia? What is the prognosis?
* Diagnosis * Hyperlipidaemia = Tryglycerides \>85-500mg/dl * Hyperlipemia = Tryglycerides \>500mg/dl and opalescent plasma * Liver enzymes elevated * Azotemia * Glucose * Metabolic acidisos * Treatment * Goals * Treat primary disease * **Improve energy intake and balance** * Decrease circulating TGL and improve uptake by peripheral tissue * Treat liver disease * Prognisis * Mortality * Primary upto 80% * Secondary 22-50% (often depends on the underlying disease) Always consider Hyperlipaemia in any pony/donkey presenting with illness
174
What are the common causes of Foal Diarrhoea?
* Causes * Non-infectious * Foal heat * Related to Coprophagy (eating poo * Nutritional * Lactose intolerance * Milk replacers - osmotic diarrhoea * Systemic Disease * Sand ingestion * Infectious * Parasites * Nematodes (Strongyles) * Cryptosporidium * Viruses * Rotavirus (Most common viral cause in foals) - Maternal Vaccination Suggested 8,9,10 months gestation * Coronavirus * Adenovirus * Bacteria * Clostridium perfringens A & C - Haemorrhagic Diarrhoea * Closteridium difficile * Salmonella
175
What is Sinoscopy used for in horses??
* trephination of affected sinus * Allows direct visualisation of frontal and maxillary sinuses * Diagnosis, biopsy, surgery
176
What is the morbidity rate in strangles? How long after exposure are initial signs seen? What lymphnodes swell up with strangles? How long should youe quarantine new horses for?
1. Morbidity (30-100%), Mortality (0-10%) due to asphxiation or complications 2. Initial signs are seen 3-14days post exposure 3. Retropharyngal lymphnodes & Submandibular Lymph nodes 4. Quarantine all new horses for a minimum 14days
177
A horse is BAR, CR nerves intact, grade 3/5 hindlimb symmetric ataxia, normal forelimbs, urine scalding 1. Neurolocation? 2. Likely Diagnosis?
1. Neurolocation --\> Thoracolumbar Sacral 2. Likely Diagnosis --\> Herpes I
178
What would be your next step in the workup of a foal with fever, nasal discharge and a cough?
* Physical exam * Auscultation of lungs (without re-breathing back - care when using them in foals that are dyspnoeic as can make them collapse as become quite distressed) * Blood work * Thoracic US and/or RADs (very useful in neonates) * respiratory secretions (transtracheal aspirate vs BAL vs Nasal swab --\> wouldn't do nasal swab as lots of upper airway pathogens if concerned of lower airway involvement...transtracheal sample is better for more diffuse disease... BAL would get contamination from oropharynx and usually only gets focal area... in this case use transtracheal
179
Most colicas are what type of colics in horses?
* Most colics are: * Treatable in the field * Medical * Non-strangulating * Large intestine in origin If you see pain in a donkey or draft horse you know this is BAD. All horses in pain NEED NSAIDS do not withold
180
What are the key differences between Duodenitis/proximal jejunitis and Strangulation SI Obstruction ?
* **Duodenitis/Proximal jejunitis** * HR decreases if you decompress * 50% have pyrexia * **Strangulation SI Obstruction** * Decompression does not reduce HR due to pain from ischemia * No pyrexia
181
What are the clinical signs of Endotoxemia in horses?
* Common * Fever * Tachycardia * Tachypnoea * Dark MM * Toxic gingival line * Increased CRT * Less common * Diarrhoea * Haemorrhage * Colic * ileus * Fasciculations * Sequelae * DIC * Laminitis * Renal Failure
182
* What clinical signs are associated with PPID in Alice? * Do we need to do any further diagnostic testing to confirm PPID on Alice? * Do we need any further diagnostics on Alice? If so what? * What treatment could we give? * What other management options would you do for Alice?
* Clinical Signs Alice * PU/PD * Weight Loss * Hypertrichosis (Curly coat) * Pot bellied appearance * Unilateral Purulent nasal discharge (Left) * Left maxillary sinus is dull on percussion - (Infection?) * We have hypertrichosis and therefore further diagnostic testing is not required as hypertrichosis develops later on in the PPID disease process * Endogenous ACTH (must observe seasonal ranges, test most sensitive in Feb/April * Treatment * Peroglide - dopamine agonist * Management * Regular foot care * Clipping in summer * Special attention to body condition * Dentistry and parasite control * Fed senior diet and appropriate hay supplementaion and pasture
183
A horse with respiratory disease has **expiratory dyspnoea (Noise on exhale)** where is the pathology?
Expiratory Dyspnoea = LRT pathology May be caused by a decrease in gas exchage
184
What drugs do we use to premed a horse?
* Acepromazine * Xylazine
185
In a horse Neurological exam we grade Ataxia out of 5 What are grade 1 - 5?
* Grade 1 * Mild/inconsistent ataxia at the walk, worse when manipulated * Grade 2 * Obvious ataxia at the walk, worse when manipulated * Grade 3 * Prominent ataxia and may fall over if manipulated * Grade 4 * Severe ataxia and at risk of falling over * Grade 5 * Recumbent and cant get up
186
What are the most common non-infectious respiratory disease in horses? URT LRT
* URT * Pharyngeal lymphoid hyperplasia * LRT - Equine Asthma * IAD * Heaves (RAO) * EIPH
187
What are the consequences of not treating a horse with PPID with Peroglide?
* Clinical signs will not improve * May get breakthrough laminitis and more signs of CS will develop as horse ages
188
Annual ryegrass toxicity 1. Has a guarded prognosis 2. Has an excellent prognosis 3. Has a hopeless prognosis
Annual ryegrass toxicity has a guarded prognosis
189
Horses A proliferative enteropathy caused by lawsonia intracellularis typically affects 1. Neonates 2. Weanlings 3. Adults
Weanlings
190
What age does the Non-Infectious respiratory disease "**Pharyngeal Lymphoid Hyperplasia**" effect horses? How is PLH graded?
* Typically restriced to young horses 9months - 3 years * Chronic inflammatory disease of the lymphoid tissues * PLH is graded 1-4 depending on the size and number of follicles on the pharyngeal wall * Clinical Signs * Usually asymptomatic * Reported signs :- * bilateral nasal discharge, regional lymphadenopathy, cough, poor athletic perfornamce (rare) * Treatment * Rarely needed
191
A horse has quadrilateral ataxia, with no central signs. its hindlimbs are more severly affected. What location is this disease and what could it be from?
C1-C6 --\> hindlimbs affected force as usually compressive disease
192
What are some clinical signs of Heaves?
* Mild exercise intolerance * Moderate - cough, increased respiratory rate and effort, marked exercise intolerance * Sever - Weight loss, heave line, nostril flare, expiratory dyspnea
193
What are some non-infectious causes of Diarrhoea in horses
* Dietary * Antibiotic-Induced * Heavy metals (arsenic) * Cantharidin (Blister beetle) * NSAID * CHO-overload (carbohydrates) * Intestinal anaphylaxis * Acorns
194
In a horse why can we not use alpha2 agonists and opioids over longer periods? 1. Sedation 2. Addiction 3. Too Expensive 4. Ileus 5. Not Licenced
Long periods of Alpha 2's and opioids can cause ileus!
195
What are the measurements which class in horses Polyuria Polydipsia
* Polyuria - 50ml/kg/day * Polydipsia - 100ml/kg/day
196
Name some pathogens that can cause pneumonia in foals (\>4 weeks of age)
* Rhodococcus equi * Lung worm * Strep Equi subspecies zooepidemicus * Klebsiella (occurs more in neonates) * Actinobacillus * Pseudomonas * Mycoplasma * Salmonella (occurs more in neonate)
197
Which is incorrect?
Incorrect - Common clinical signs of strangles early in course of disease....
198
How do you diagnose PPID?
* Diagnosis * Singnalment and history * Clinical signs * Older horses with convincing hirsutism (hypertrichosis) have \>90% chance of PPID * Confirm Diagnosis * Measuring increased POMC's * ACTH * Colllect in plastic chill within 3 hrs. Can freeze Plasma but not whole blood * Testing the hypothalmic pituitary axis * TRH stimulation test and measure ACTH * Testing the hypothalmic pituitary adrenal axis * Dexamethasone suppression test (Not recommended)
199
* 10mcg/kg/hr IV of detomidine CRI +/- opioid * 1.4ml detomidine in 500ml saline (14mg/500ml) * how many drops per second?
* If using standard giving set * Sedation with bolus 10ug/kg detomidine IV * 10mcg/kg/h IV * for 500kg horse * 1.4ml detomidine in 500ml saline (14mg/500ml = 0.028mg/ml = 28micrograms/ml) * 10mcg x 500kg x hr = 5000mcg/hr * 5000mcg/hr / 28 mcg/hr = 178.5ml/hr * 20drops/ml x 180ml/hr =3600drops / hr * 3600drops/60mins = 60drops/min / 60sec * = 1 drop/sec or to effect
200
How do we treat Strangles?
Depending on the Scenario * Animal with abscessed lymph nodes without airway obstruction * Local therapy to facilitate drainage (submandibular vs retropharyngeal) * Flushing * NO ABX * Animal with early clinical signs (fever, coughing) but without lymph noe abscessation * Penicillin, IM, BID * NSAIDS * Animal that has been exposed to infected animal but without any clinical signs * Monitor for increase in rectal temp * Procaine penicillin G
201
What drugs are used to induce a horse
* Ketamine * Diazepam (any benzodiazepine)
202
Hendra Virus Once a horse is confrimed positive what happens? What is the hate of deaths in Human cases? How can we control Hendra?
1. All horses are euthanised when confirmed Hendra 2. 4/7 human deaths 3. OH&S (Biosafety level 4) and Vaccination (Safer than tetanus vax)
203
When testing ACTH for a horse with suspected PPID when is the best time to do the test? What is the gray zone?
* Most sensetive and specific time to test is during the peak of the dynamic phase * Feb- April If doing a ACTH test and the horse is not in the Negative or Positive range this is the gray zone. Recommend retesting in feb/april
204
This horse has facial nerve paralysis, what side is the lesion?
Right side is paralysed Muzzle pulls away from the lesion
205
In a horse if you see the following in urine cytology/sediment analysis what could it be? * Calcium Carbonate Crystals * Casts
1. Calcium Carbonate Crystals = Normal 2. Casts = Indicitive of renal toxicity
206
Which test is most effective to determine if a horse is a carrier of strangles?
PCR of guttural pouch wash
207
What options do you have to increase lenght of anaesthesia in a horse?
* Option 1 * Incremental alpha2 agonist (eg xylazine/romifidine) * use 1/3 dose used for sedation and induction. Maxiumum 2 boluses (remember ketamine = all reflexes are normal) * Option 2 * Constant Rate of infusion of triple drip * Xylazine 500mg + Ketamine 1000mg + 500mL 10% Guaifensin @ 1mL/kg/hr * \>60min will elad to poor recovery * Longer than 60mins refer to hospital with gaseous anaesthetic
208
A horse has the following clinical signs - * Abnormal urination * Dysuria/Stranguira/Pollakiuria * Haematuria post exercise * Pyuria * +/- mild abdominal pain - "renal" colic * +/- urine scalding (incontinence) How do we diagnose what this is and what treatment do we have
* Diagnosis - Urolithiasis * Custocopy * Rectal * Ultrasound * Treatment * Fragmentation * Laser * Shockwave * Transurethral * Females * Perineal urethrotomy * Males * Laparoscopy or Celiotomy
209
What is it called when there is a failure of the CAD muscle to abduct the arytenoid cartlige and vocal fold during inspiration at exercise? What side is it 95% of the time?
* Laryngeal Hemiplegia * Left side due to the Left Laryngeal Nerve looping aroudn the aorta
210
A horse has presented with colic and you have worked out it is Ascarid impaction. Where would this be located, is it strangulating or non-strangulating and does it require surgery?
* Ascarid impactions are small intestine non-strangulation obstruction. * They are associated with deworming * They require diagnosis via Ultrasound and will need surgery.
211
Australian stringhalt is due to?
False dandelion ingestion
212
What is the best option for sedating a horse?
Alpha 2 (Xyalizine), Acepromazine + Opioid
213
What are some infectious causes of Diarrhoea in horses
* Salmonella * Clostridium defficile * Clostridium perfringens * Neorickettsia risicii (Potomac Horse Fever * Larval Cyathostomiasis * Viral * Coronavirus
214
When is the best tome to of year to evaulate ACTH?
Autumn (Feb-April)
215
What causes Stringhalt in horses
Ingestion of False Dandelion Takes weeks to month to recover once removed form weed.
216
When you see a sick donkey what the first thing you put on your DDx (and must rule it out)?
Hyperlipidemia
217
What are some clinical signs associated with Hyperlipidemia in horses?
* Initial Signs * Depression * Lethargy * Failure to drink * Reduced GOT motility and faecal output * Mid * Mild colic * Stretching liver capsule * Diarrhoea * Disturbance of feed intake * Icterus * Liver disease * Subcutaneous oedema * CNS signs * Hepatic encephalopathy * Late * Recumbency * Convulsions * Death
218
What do we need to remember about equine influenza?
* Most common cause of upper airway epidemics world wide. * **Its a notifiable disease** * Short incubation time * Viral Shedding 24hrs after infection for 4-10 days * Transmission via aerosolized droplets & fomites * Clinical Signs * Very High fever \>40C peaking 2-4 days * Diagnosis * Antigen detection (PCR) * Antibody Detection * Treatment * NSAIDS * Abx is secondary bacterial infection is suspected * Rest minimum 3-4weeks * Prevention * Vaccines
219
When treating Equine Gastric Ulcerative Symdrome we give omeprazole what is the timing for this?
* Timing of Omeprazole - imporant * After 8 hours of fasting * 30-60mins bre-hard feed * timing with exercise doesnt matter
220
What can be the causes of Vestibulr syndrome Peripheral Central
* Peripheral * Temporohyoid osteopathy * Trauma * Middle/inner ear disease * Idiopathic * Central * Trauma * EPM * Abscess/neoplasia/mass * Migrating paracites * Tremorgenic toxins * Diffuse encephalitis
221
True or False FEB, March, April is the best time to test using ACTH as sensitivity and specificity of the test is high? What disease is this testing for?
* True * PPID
222
Why can we not use alpha 2's and opioids over longer times periods in horses?
ileus
223
What are some risk factors for Large colon impaction in a horse?
* Sand * Inadequate exercise * Parasites * Poor quality fibre * Dental Disease * Recent change in feed * Decreased water intake * Recent changes in stabling
224
How do you diagnose IAD or Heaves?
* Diagnosis * History and clinical findings * Supportive diagnostic findings - eg tracheal mucus * BAL cytology * +/- TTW * Treatment * **Environmental** **management** (reduce exposure to Dust/improve ventilation, Mould, and hay(Dampen or remove) * **Corticosteroids** - Reduce the inflammatory resonce and the hyperreactivity the occurs as a result of exposure. * Inhaled are more expensive but lower risk of adverse effects * Observe withdrawal times for competition horses * Systemic * Dexamethasone * Prednisolone * **Bronchodilators**
225
A horse presents with sudden onset of Severe abdominal pain. Upon rectal you feel an extremely enlarged and distended colon. The horse's heart rate is rapid, the animal's status deteriorates rapidly, and there is poor peripheral perfusion. Distention of the abdomen is marked. What is causing this?
Large Colon Volvulus This is an EMERGENCY situation Surgery must be done now
226
Where do we ausculate to listen to the lung fields on a horse?
You really need to do a rebreathing exam to hear anything as room air is hard to hear. 17th ICS - level with the tuber coxae 15th ICS - Tuber Ischiac 13th ICS - Mid chest dorsal to ventral 11th ICS Point of shoulder Point of shoulder Cough reflex, pressing the trachea and getting more then one cough is abnormal.
227
If a nasal swab/transtracheal culture returned a strep equi zooepidemicus what would be your antimicrobial of choice?
* Penicillin is the most effective Abx against strep equi zooepidemicus * Oxytet will also have some effect against streps (easier to give as IV)

VET608 - Equine General Practice (3 decks)

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