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79 Cards in this Set
- Front
- Back
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What are the ANCILLARY DIAGNOSTICS used to investigate RESPIRATORY DZ in equids? |
1) ENDOSCOPY (bronchoscopy) 2) THX US 3) THX RADS 4) ARTERIAL BLOOD GAS 5) CYTOLOGY (of the airway)** gold standard 6) BACTERIOLOGY 7) BX of lung |
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Discuss ENDOSCOPY as it pertains to the investigation of RESPIRATORY DZ in equids. |
TRACHEAL SECRETION VOLUME (usually look at thoracic inlet) -Score 1-5 -rate of prod v. rate of clearance -Score of 2 or more--> Performance Limited Also looking at epithelium/walls for inflamm, lesions, masses, stricture, thickening, collapse, etc... |
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Discuss THORACIC ULTRASONOGRAPHY as it pertains to the investigation of RESPIRATORY DZ in equids. |
Assess wall, pleura, subpleura Limitation: air/ST interface |
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Discuss THORACIC RADIOGRAPHY as it pertains to the investigation of RESPIRATORY DZ in equids. |
** Need a POWERFUL machine -Can only take LATERAL views -Not very sensitive Remember: use a GRID, LIMBS FORWARD, shoot on INSPIRATION, SAFETY!!! |
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Discuss CYTOLOGY (airway) as it pertains to the investigation of RESPIRATORY DZ in equids. |
1) TRANSTRACHEAL ASPIRATION (TA)*** (Gold Standard) 2)Endoscopic TA -contamination 3) BAL -endoscope or catheter -contamination from URT -Neutrophilia or Eosinophilia >5% indicative of dz -RBCs/Heamosiderophages |
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Discuss BACTERIOLOGY as it pertains to the investigation of RESPIRATORY DZ in equids. |
Per-q TA v. Agar-plugged endoscopic catheter |
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Discuss BIOPSIES (lung) as they pertain to the investigation of RESPIRATORY DZ in equids. |
Trans-endoscopic punch Bx Per-q Bx -rarely indicated -FREQUENT COMPLICATIONS--incl. DEATH |
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What diseases might be indicated if there is NEUTROPHILIA >5% present in the BALF of a equid? |
RAO SPAOPD IAD Bronchopneumonia Pleuropneumonia Abscesses Acute viral dz (<10d) |
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What diseases might be indicated if there is EOSINOPHILIA >5% present in the BALF of a equid? |
Lungworm Parascaris equorum migration Idiopathic Pulmonary Eosinophilia IAD-eosinophilic subtype |
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What diseases might be indicated if there are RBCs or HAEMOSIDEROPHAGES present in the BALF of a equid? |
EIPH TRAUMA (sample collection-RBCs only) Neo, abscess, coagulopathy (rare) |
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Discuss ENDOSCOPIC TAs |
-catheter through endoscope once at distal trach -protrudes from end -10-15 ml sterile saline -pools in inlet -aspirate -only get small proportion back -mostly ciliated ep. and macrophages |
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Discuss TRANSTRACHEAL TAs |
-aseptic technique -good for CYTOLOGY AND CULTURE -Lower 1/3 cervical tracha -Cannula inserted b/w 2 tracheal rings into lumen -Catheter threaded through -passed to level of inlet -Lavage with 20-30 ml sterile saline Can make Gram stain Do aerobic and anaerobic cultures Complications Damage to cartilage Broken catheter (will usually cough up) Infxn/cellulitis at puncture site laceration of Carotid A. |
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Discuss BAL. |
-sterile, pre-warmed saline -50 ml increments--total ~300 ml -50-80% retrieval -will appear foamy--surfactant--indicative of good sample -Cytology -Small airways and alveoli** -Endoscope-guided or blind Problems -don't know exact location being lavaged/assessed |
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List NEONATAL RESPIRATORY DZs. |
1. Neonatal PNEUMONIA** 2. Neonatal FRACTURED RIB SYDROME** 3. (Prepartum EHV-1 Infxn) 4. (Meconium Aspiration) 5. (Prematurity/Dysmaturity) |
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List RESPIRATORY DZs of GROWING FOALS/WEANLINGS |
1. RHODOCOCCUS EQUINE PNEUMONIA ** 2. (Strep. equi var. zooepidemicus) |
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List ACUTE, INFECTIOUS respiratory dzs of ADULT equids. |
Viral 1. Influenza 2. EHV-4 (EHV-1) 3. Equine Viral Arteris (EVA) 4. Rhinovirus Bacterial 1. Strangles** (Strep. equi var. equi) -Bastard strangles -Purpura haemorrhagica -Guttural pouch empyema |
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List RESPIRATORY DZs of INDIVIDUAL ADULT equids. |
1. RAO 2. SPAOPD 3. IAD 4. Lungworm 5. Idiopathic Pulm. Eosinophilia 6. Interstitial (restrictive) lung dz 7. Pulm. Edema 8. Thoracic Neoplasia 9. Pulmonary abscesses/Pleuropnuemonia 10. Pleural Effusion 11. Pneumothorax 12. Diaphragmatic hernia 13. EIPH |
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What is the PATHOGENESIS of NEONATAL PNEUMONIA? |
-Sequelae to septicaemia/bacteraemia |
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What are the SIGNS of NEONATAL PNEUMONIA? |
Early: -non-specific (dull, pyrexic) Later: -Pyrexia -Tachypnoea* (>cough>dischgarge) -crackles, wheezes (normally more audible than adult. there can be significant pathology w/o abnormal sounds on auscultation) -Other sequelae |
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What DIAGNOSTICS can you do for NEONATAL PNEUMONIA? |
-Bronchoscopy (pus, mucopus) -Culture (TAs, blood) -TA -Thx Rads -Thx US -auscult -percuss/palpate -serum IgG -haematology -APPs (acute phase proteins) |
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What are the TREATMENT options for NEONATAL PNEUMONIA? |
-Plasma transfusion (IgG) --if FPT -ABX (broad spectrum--cephalosporin, penicillin/gentamicin) -Intranasal O2 (mask, trans-nasal tube) -Intensive nursing (food, fluids, sternal) |
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What is the PROGNOSIS for NEONATAL PNEUMONIA? |
Variable -speed of Tx -bacteria involved -serverity etc... |
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What is the PATHOGENESIS of RIB FRACTURES in FOALS? SEQUELAE? |
COMMON foaling injury (20-40%) -usually asymptomatic or only local injury SEQUELAE: -Pneumothorax -Haemothorax -Laceration *lung *pericardial/cardiac laceration -Diaphragmatic herniation |
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How do you DIAGNOSE RIB FRACTURES? |
-CAREFUL PALPATION -US (>rads) |
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How do you TREAT RIB FRACTURES? |
-STABILIZE (bandage) -CONFINE (Flail chest---> Sx!!!) |
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Discuss the PATHOGENESIS of RHODOCOCCUS EQUI in GROWING FOALS. |
-PYOGRANULOMATOUS -IC G+ bacteria-Macrophages --> multifocal pulm. abscesses -GROUP PROBLEM-intensive rearing -warm, dry climates -spread by inhalation, ingestion -infected early but takes time to establish -SIGNS @ 2-6 months -possible systemic spread-->abscessation elsewhere |
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What are the SIGNS of RHODOCOCCUS? |
-Ill-thrift/wasting -Pyrexia -PROGRESSIVE DYSPNOEA (>cough>discharge) (systemic/general signs + dysp) -abnormal lung sounds -extrapulmonary (poorer Px) -D+, polysynovitis |
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How do you DIAGNOSE RHODOCOCCUS? |
-Rads (lesions) -US (comet tail, hypoechoic) -Culture (TA) Heam+SAA-hyperfibrinogen, neutrophilia, TCP--not specific Serology-not 100% accurate **REMEMBER: SCREEN IN-CONTACTS** |
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How do you TREAT RHODOCOCCUS? |
**Can be successful even with advanced Dz** ABX--PROLONGED (6-8w) -Rifampin + macrolide (azithro, clarithro, erythro)--Work IC Hyperimmune Serum (available some places) |
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Discuss CONTROL MEASUREMENTS that can be taken for RHODOCOCCUS. |
MANAGEMENT -move feeders -collected faeces -Decrease density -Decrease mixing MONITORING (@high risk facilities) -weigh weekly -US -Serology/Haematology (Prophylaxis?) |
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Discuss the APPROACH to OUTBREAKS of RESPIRATORY dz in ADULTS (acute, infxs) |
IDing cause OFTEN NOT POSSIBLE (only 40% with extensive testing) -$$$ -Delays in results **ESSENTIAL TO TEST FOR STRANGLES** -methods diff. than viruses |
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What are COMMON PRESENTING SIGNS for ACUTE, INFXS respiratory dzs? |
-Pyrexia -Dull -A+ -Cough -Bilat. Nasal Discharge (mucoid,mucopurulent,purulent) -Bilat. SMLN enlargement (signif-->prob strangles) (quick spread--> prob flu) |
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What are COMMON DIAGNOSTICS used for ACUTE, INFXS respiratory dzs? |
Hx (vax) Surveillance Data Rate of SPREAD (flu>strangles>EHV) SEVERITY (flu>strangles>EHV) STRANGLES -Nasopharyngeal swab + Gut. Pouch Wash VIRUS SCREEN -NP swab -TA -BALF -Serum -heparinised blood -ELISA on secretions--flu--rapid (~4h) (EVA--vasculitis) |
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What are COMMON MANAGEMENT PRACTICES for OUTBREAKS of ACUTE, INFXS respiratory dzs? |
REST -clean air (dust free env.) -isolation FEED FROM GROUND ABX-RARELY -febrile >4-5d -purulent -marked increase in respiration Others? Clenbuterol (mucocil. clearance), mucolytics, immunostim? |
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Discuss the AETIOPATHOGENESIS of EQUINE VIRAL ARTERITIS (EVA) |
-diff. from other acute, infxs resp dzs -clinical dz not recorded in UK -VENEREAL & RESP transmission VAX AVAILABLE |
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What are the SIGNS of EVA? |
MOSTLY ASYMPTOMATIC -dull -pyrexia -severe conjunctivitis (pink eye) -ocular/nasal discharge -LN enlargement -vasculitis-->oedema (PERIORBITAL OEDEMA is pathognomonic**) -resp. signs -abortion |
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Discuss the DIFFERENCES in LATE stage v. EARLY/ATYPICAL Strangles. |
Late-EASILY Dx Early/Atypical--MUST CULTURE -nasal or NP swab +/- PCR diff management diff sequelae -LN abscesses -Gut pouch empyema/Chondroids -Bastard Strangles - (IM vasculitis/purpura hemorrhagica, IMHA) |
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How do you DIAGNOSE STRANGLES? |
LN ABSCESSES on CE--Late stage CULTURE/PCR--EARLY -NP swab -gutt pouch wash |
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How do you TREAT STRANGLES? |
Isolation Rest ABX NSAIDs Feed from Floor LANCE ABSCESS VAX For Empyema/Chondroids: -Catheter Flush -Basket Forceps -Sx |
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When is a horse considered RECOVERED from STRANGLES? |
After 3 NEGATIVE SWABS for S. equi var. equi -NP swabs -@weekly interval |
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Discuss EHV-4. |
(cf. EHV-1--abortion, encephalomyopathy more common) -Acquire EARLY -asymp. carriers--latent -->recrudescence with stress/dz -immunity is short-lived (vax ineffective) -causes prolonged immunsuppression -problematic in young horses |
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Discuss Equine INFLUENZA |
VERY INFECTIVE -low burden needed -aerosol *Vax available--req. in UK racehorses |
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Discuss the AETIOPATHOGENESIS of RECURRENT AIRWAY OBSTRUCTION (RAO). |
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What are the SIGNS of RAO? |
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What ANCILLARY DIAGNOSTICS are used for EARLY PRESENTING cases of RAO? |
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What is the TREATMENT for acute RAO? |
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What MANAGEMENT practices are recommended for horses with RAO? |
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Discuss the AETIOPATHOGENESIS of SUMMER PASTURE ASSOCIATED OBSTRUCTIVE PULMONARY DZ (SPAOPD). |
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What are the SIGNS of SPAOPD? |
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How do you DIAGNOSE SPAOPD? |
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How do you TREAT SPAOPD? |
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How do you MANAGE SPAOPD? |
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Discuss the AETIOPATHOGENESIS of INFLAMMATORY AIRWAY DZ (IAD). |
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What are the SIGNS of IAD? |
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How do you DIAGNOSE IAD? |
-Signs -Endoscopy (volume of secretions) -TA/BAL --->CYTOLOGY (incr. neutrophils or MCs or eosinophils) --->CULTURE (ID pathogen) ** Can be bacterial or non-bacterial IAD** |
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How do you TREAT IAD? |
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Discuss LUNGWORM in horses. |
DICTYOCAULUS ARNFIELDI |
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Discuss the AETIOPATHOGENESIS of PULMONARY OEDEMA. |
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What are the SIGNS of PULMONARY OEDEMA? |
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How do you DIAGNOSE PULMONARY OEDEMA? |
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How do you TREAT PULMONARY OEDEMA? |
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What are the most common NEOPLASMS you may find in the LUNGS? |
-Lymphosarcoma -Metastases |
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Discuss the AETIOPATHOGENESIS of LUNG ABSCESSES/PLEURAL PNEUMONIA. |
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What are the SIGNS of LUNG ABSCESSES/PLEURAL PNEUMONIA? |
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How do you DIAGNOSE LUNG ABSCESSES/PLEUROPNEUMONIA? |
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How do you TREAT LUNG ABSCESSES/PLEUROPNEUMONIA? What's the PROGNOSIS? |
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Discuss ASPIRATION PNEUMONIA. |
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Discuss the AETIOPATHOGENESIS of PLEURAL EFFUSIONS. |
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What are the SIGNS of PLEURAL EFFUSIONS? |
-Dyspnoea (insp and exp.)--flared nostrils -Reluctance to move/lie down |
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How do you DIAGNOSE PLEURAL EFFUSION? |
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How do you TREAT PLEURAL EFFUSION? |
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Discuss the AETIOPATHOGENESIS of a PNEUMOTHORAX. |
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What are the SIGNS of a PNEUMOTHORAX? |
-tachypnoea/dyspnoea (sometimes cyanosis) |
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How do you DIAGNOSE a PNEUMOTHORAX? |
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How do you TREAT a PNEUMOTHORAX? |
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Discuss the AETIOPATHOGENESIS of EXERCISE-INDUCED PULMONARY HAEMORRHAGE (EIPH) |
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What are the SIGNS of EIPH? |
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How do you DIAGNOSE EIPH? |
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How do you TREAT EIPH? |
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