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389 Cards in this Set

  • Front
  • Back
Horses are what type of breeders?
Long day breeders, seasonal estrus
What is the average gestation period for horses?
340 days
In the mare, what are the signs for readiness of birth?
-relaxation of the perineum
-mammary gland engorges
-waxing of teats
-monitor milk electrolytes (decr Na, incr Ca..calcium spike more realiable)
-fetal heart rate 60-90 bpm late gestation
How long is stage 1 of parturition?
24-48 hours
How long is stage 2 of parturition?
20 mins max
How is stage 2 defined?
Time from the rupture of chorioallantois until foal is delivered
What is stage 3 of parturition?
Delivery of the placenta
Why is the equine placenta different?
It is epithelial microcotelyndondary placentation (like velcro)
Which side of the placenta is normally presented at partuitition?
The fetal side
When examining the placenta, what should you pay close attention to?
Tips of the gravid and non-gravid horns
Placentitis is usually a result of what type of infection?
-ascending
-hematogenous is possible
What are the most common pathogens of placentitis?
-bacterial (staph, kelbsiella)
-fungal
-nocardioform-like dz
What is the serious potential side effect of placentitis?
Can slough the mucus plug
What are the clinical signs of placentitis?
+/- vaginal discharge
+/- early mammary development
+/- premature dripping of milk
If placentitis is suspected, an U/S exam to measure CTUP is performed. What is CTUP?
Combined Thickness of the Uteroplacental Unit
What should a normal CTUP be?
12 mm at term
an increase suggests edema, inflammation
What other measurement is taken to dx placentitis?
Maternal serum progestins
His is placentitis tx?
-systemic abx
-Nsaids
-progesterone
Why is progesterone used in the tx of placentitis?
Promotes uterine quiescence
What are the potential consequences of placentitis?
-abortion
-still birth
-premature foaling
-retained fetal membranes
How many hours post delivery should the fetal membranes be passed?
within 3 hours
(considered retained if > 3 hours)
What are the potential complications of retained placenta?
-endotoxemia
-laminitis
-metritis
How is a retained placenta dx?
-examine placenta once passed
-palpate caudal repro tract
What is the tx for retained placenta?
-uterine lavage
-weight the placenta
-abx
-cryotx ?
Additional causes of equine abortion include what?
-viral (EHV1, EVA)
-parasitic causes
-chlamydia
-mycoplasma
During which part of gestation does uterine torsion occur in the mare?
Mid to late gestation
What are the signs of uterine torsion?
Variable colic signs
mild to severe
In relation to the cervix, where does uterine torsion occur in the mare?
Cranial to the cervix
How do you dx uterine torsion?
Rectal exam
If a uterine torsion occurs when the foal is < 10 months of gestation, what approach to tx should you take?
Standing, flank laporotomy
A complete examination of the uterus and GI tract can be made with a ventral midline celiotomy. What are the drawbacka to this approach?
-C-section requires general anesthesia
-cost
What is the 3rd way to correct a uterine torsion?
Roll the mare
What are the drawback to rolling the mare?
-requires general anesthesia
-unable to visualize the uterus
-unable to examine the GIT
What are the complication associated with uterine torsion?
-uterine rupture
-uterine ischemia
-complicating GU lesions
-Abortion
-failure to return to repro soundness
-survival of mare vs survival of foal
When does large colon volvulus tend to occur in periparturient mares?
30 days prior
60 days post foaling
What are the clinical signs of large colon volvulus?
-sudden onset of colic
-severe pain--> no response to analgesia
-rapid deterioration of CV parameters
-abdominal compartment syndrome
-gastric reflux may also be present if abdominal distention is severe enough to prevent gastric emptying
How can large colon volvulus be repaired?
-colopexy
-colonic resection
Peri-Parturient hemorrhage is due to a rupture of which artery?
Middle uterine artery

bleed into broad ligament=hematoma
bleed into peritoneum=hemoabdomen
What are the clinical signs of PPH?
-lethargy, colic signs may be severe
-anxious/frantic
-may die acutely
How is PPH diagnosed?
-anamnesis
-clincial signs (blood loss)
-U/S
How is PPH treated?
-quiet environment
-controlled hypotension
-monitor vitals/bloodwork
-pro-thrombotics
-antifibrinolytics
survival is 84%
49% return to repro soundness
What are the 3 P's of fetal position?
-presentation
-position
-posture
What are the potential complication of dystocia for the mare?
-potential loss of foal/mare
-retained placenta
-laminitis
-metritis
-risk of future repro soundness
What are the potential complications of dystocia for the foal?
-HIE
-PAS
-NE
-dummy
What are the risk factors/causes of dystocia?
-fetal malpositioning
-congenital malformation of the foal
-gestational compromise (placentitis, systemic illness of the mare)
How is dystocia diagnosed?
-anamnesis (has stage 2 labor begun)
-sterile vaginal/uterine palpation
What can you use to pre-med the mare for tx of dystocia?
-xyalzine
-buscopan
-lidocaine epidural
How do you determine if the foal is alive?
-pinch
-U/S
How would you first try to tx a dystocia?
-correct vaginally, deliver foal
What is involved in a controlled vaginal delivery?
-general anesthesia (O2 is important)
-lift hind legs of mare on hoist
-retropuslion of foal/uterus into abdomen
-deliver foal
What is the step you take in treating dystocia if controlled vaginal delivery fails?
C-section
How would you describe the intrauterine environment of the mare?
Hypoxic
How does the fetus adapt to this environment?
-greater oxygen affinity for fetal Hbg
-enhanced fetal oxygen extraction by tissues
-increased resistance of tissue to acidosis
Oxygenated blood flows from the mare to the placenta through which vessel?
Umbilical vein
During stage 2 of labor, placental separation begins, what is the affect?
Transient asphyxia
-increased resistance in umbilical circulation-->increased systemic vascular resistance

-triggers gasping reflex in foal, clears airway expands chest
What happens to the foal as it moves through the pelvic canal?
-chest compression and evacuation/absorption of fluid from lungs
-inflation of lungs
As the foal is born the lungs inflate, what else happens in the circulation?
-increased alveolar O2 tension
-decr pulmonary vascular resistance
-decr right atrial pressure
-function closure of foramen ovale and ductus venosus
The establishment of adult cardiopulmonary circulation requires what?
Direct CO to lungs for gas exchange
In the foal, pulmonary hypertension, due to hypoxemia, can cause what change to circulation?
Can revert back to fetal right to left shunting of blood
What is the normal body temp of a foal?
99-102 F
What can cause an elevated temp in a foal?
-exertion
-infection
What can cause a lower temp in foals?
-environmental
-sepsis
What is a normal foal heartrate?
80-100 bpm first 30 days
60-70 bpm by 2-3 months
When would you be concerned about a murmur in a foal?
If the murmur lasts more than 3 days
What can be the cause of braycardia in a foal?
-uroabdomen
-hyperkalemia (>5.5 mEq/dl)
What are the normal respiratory rates of foals?
-at birth 60-80 bpm (moist lungs sounds immediately post foaling)
-30-40 bpm later
Ruib fxs are common with delivery, how do you dx rib fx?
-palpation
-U/S
What are the clinical signs of a rib fx in a foal?
-elevated respiratory rate
How could a rib fx cause a fatal hemorrhage?
mid shaft fx can severe a vessel
Examination of the foal GIT should include what?
-auscultation
-percussion
-palpation of abd, umbilicus, inguinal rings
-U/S
What conditions do you check for when examining a new born foals oral cavity and nasal passages?
-dental malocclusions (maxiallry prognathism)
-cleft palate
-campylorrhinus (wry nose)
-soft palate displacement
When examining the eyes of a new born foal, which reflex is not yet developed?
No menace response
What other eye problems should you look for?
-entropion (lower lid usually)
-corneal ulceration
-hypopyon/foibrin
Premature breakage of the umbilicus can result in what?
Hemorrhage
When examining the umilbicus you can use U/S to help determine what possible conditions?
-umbilical hernia
-testicles within the inguinal canal
What is the most common angular limb deformity of foals?
Carpal valgus
Why would you expect to see an increased ALP in neonatal foal bloodwork?
Increased osteoblastic activity
What other chem values will be elevated in a neonate?
-GGT
-Cretatinine
When observing foal behavior it is imperative that you confirm that the foal is doing what?
Nursing
What is a hippomane?
thick triangular shaped tissue present within the placenta
What is the term for a foal's first feces?
Meconium
What is meant by the term angel slippers?
Epinuchium
How quickly after birth should a foal stand?
within 1 hours
suckle w/in 30 mins
It is considered abnormal behavior if the foal does not stand within what timeframe?
3 hours
Foals receive which antibody from colostrum?
IgG
How are the colostral antibodies created?
vaccination of mare throughout gestation
Why is the ingestion of colostrum so important?
There is complete separation of the foal from the mare's circulatory system in utero, virtually no transfer of antibody
How do the antibodies enter the foal's system?
The GIT is line with special cells that pinocytose the maternal Ab. These cells are replaced by enterocytes within 24 hours
What conditions can lead to insufficient antibody within the colostrum?
-dripping milk prior to foaling
-high risk mare, sick during pregnancy
-old/very young mare/inadequate production
-breed associated (arab>qh>tb/stb)
-agalactia= fescue toxicity
In considering the foal, what causes can lead to lack of colosturm?
-sick/weak foal unable to stand and nurse
-very premature (special enterocytes may not be present)
-musculoskeletal abnormalities may not allow the foal to stand and nurse
Ingestion of what can cause pre-mature closure of the specialized enterocytes?
Anything other than colostrum
-dirty foaling environment
-dirty mare (foal ingests pathogens)
How much IgG should a foal ingest?
1 gram/ bwt kg
Specific gravity of colostrum is checked to determine the content of igG, what is a good specific gravity value?
1.060 = 30 g/l IgG
For a 50 kg foal, how much colostrum should be ingested?
1.5 -2 liters
What tool is used to test colostrum?
Colostrometer
What are the sources available for colostrum?
-mare (can be donor or banked)
-bovine
-commercial supplements (don't work)
What is the proper way to feed a foal with a bottle?
head extended forward, not up
risks of aspiration pneumonia
Foals born to high risk mares are at risk for failure of passive transfer What conditions are considered high risk in mares?
-placentitis
-possible dystocia
-prematurity/dysmaturity
-previously ill
When do you test a foal for IgG levels?
as early as 12 hours, as last eas 24-48 hours
What level of IgG is considered adequate? What level is considered partial FPT?
adequate = >400 mg/dl
partial FPT = 200-400 mg/dl
complete FPT = 200 mg/dl
What is the gold standard test to determine IgG levels?
Radioummunodiffusion assay
Foals with < 400 mg/dl of IgG should receive immunoglobulin from what sources?
-plasma transfusion
use a blood administration set
How long does passive transfer last?
8 weeks
What is the leading cause of death in foals < 7 days of age?
Sepsis
What are the risk factors for a foal developing sepsis?
-FPT
-unsanitary environment
-prematurity
-dystocia
-unhealthy mare
-lack of immunologic response from mare to environment
What is the gold standard test for confirming sepsis?
Blood culture
Sepsis is most often a result of which gram negative organism?
E coli
Why is blood culture so important?
To ensure that the correct tx is applied
What are the typical portals of entry of infection in foal sepsis?
-umbilicus
-respiratory tract
-GIT
Sepsis can localize in what areas, causing what types of dz?
-respiratory tract: pneumonia
-GIT: enterocolitis, ileus
-MSK: joint/physeal/umbilical
-CNS: meningitis
What are the 2 most common complications of sepsis in foals?
-septic arthritis
-septic osteomyelitis
Poor prognosis for sepsis include what factors?
-hypoglycemia (<60 mg/dl)
-hypothermia (<100 F)
-severe depression
What is the survival rate of foals with sepsis?
40%- 70%
When does dummy foal syndrome manifest?
During the 1st week of life
What is confusing about dummy foal syndrome?
Foals appear normal at birth
What neurologic disorders do dummy foals show?
-respiratory depression
-altered consciousness
-depressed reflexes
-seizure activity
What causes Hypoxic Ischemic Encephalopathy?
Insufficient oxygen delivery during the perinatal period
What is the most common manifestation of HIE?
CNS dysfunction (seizures)
What are the risk factors for developing HIE?
-hypoxia in utero (placentitis, twinning, fescue tox, decr bloodflow)
-hypoxia during parturition (dystocia, premature placental separation
-hypoxia in the neonatal period (c-section, meconium aspiration, immature respiratory developemtn etc)
Which organ system is most often affected by HIE (hypoxia)?
CNS
What drugs are given as anti-seizure therapy to HIE foals?
-diazepam
-phenobarbital
What other drugs can supplement the anti-seizure drugs?
Anti-oxidant tx
-Vit E
-magnesium sulfate
-Ascorbic acid
-Thiamine
-DMSO
HIE fooal may be in need of O2 tx (nasal or mechanical vent), what other stimulant can be used?
Caffeine tx
central stimulant to promote respiratory activity (give rectally)
When would fluid tx be indicated in a case of HIE?
A "flat foal"....CV compromise
(50 kg foal needs 1L)
For maintenance purposes, how milk should a foal be fed?
20% of BWT/day
1 liter of milk is equal to how much weight?
1 liter = 1 kg

so feed 20% of the foals BWT over 12 feedings

50kg foal 20% = 10L =833 ml 12 times a day
When beginning enteral feeding, what volume should you start with?
5% of body weight
feed every 2 hours
check for reflux, endure foal is standing or in sternal recumbency
Nutritional supplementation can be from what sources?
-mares milk
-goats milk
-mares milk replacer
A foal must show what pysiologic function prior to enteral feeding?
Good GI motility

(checked by US)

monitor daily weight gain
Why are HIE foals at risk for sepsis?
-FPT
-prematurity
-pulmonary dz
-recumbency
-IV/urinary catheter
-Gi dysfunction
-nosocomial infection
What abx do you tx HIE foals with?
-broad spectrum
-beta lactams
-K+ pcn
-3rd gen cephalosporins
Nursing care of a HIE foal include what steps?
-maintain in sternal recumbency
-turn q 2 hrs
-keep foal clean, dry, warm
-padded enivro
-contact with mare
-monitor body weifht
Meconium is comprised of what?
Cellular debris, glandular secretions swallowed in utero
Why does meconium impaction occur more often in colts than in fillies?
Colts have a narrower pelvic brim
How does a meconeum impaction cause colic?
-abdominal distention
-ileus
What are the clinical signs of a meconium impaction?
-flagging tail
-straining
-constipation
+/- abd distention
How is a meconium impaction dx?
-absence of milk feces
-PE and blood work (healthy foal)
-digital rectal exam
-contrast rads (barium enema)
How do you tx a meconium impaction?
-enemas
-analgesics
-nsaids
What type of enema is used, and what type should be used with caution?
-warm, soapy water
-use a Fleet enema with caution (high phosphorus content)
What is the primary drug in a retention emena?.
Acetlycysteine
-given through a Foley catherter
Which dx technique is NOT used to diagnose meconium impaction?
Abdominocentesis
What are the clinical signs of a urinary bladder rupture in a foal?
-foal is 24-72 hours old
-mild to moderate colic
-posture to urinate
-abdominal distention
-foals are sick
+/- recumbent
-dehydrated
What electrolyte abnormalities are seen with a ruptured bladder?
-hyponatremia
-hypochloremia
-hyperkalemia

also azotemia
Why does a uroabdomen have the triad of hyponatremia, hypochloremia, hyperkalemia?
mare's milk is low in sodium and high in potassium, fluids equilibrate
Uroabdomen casues azotemia due to what?
-post renal
-low USG
-high creatinine in urine
What technique is the key to dx uroabdomen?
U/S
With U/S what procedure should you perform in a foal with uroabdomen?
Abdominocentesis
What values do you measure when performing an abdominocenteisis for uroabdomen?
Creatinine
Cr should not be in peritoneal fluid, compare with serum Cr values
Prognosis of uroabdomen is dependent of stabilization of the patient. Which electrolyte level can be life threatening?
Hyperkalemia--> fatal arrhythmias
How do yo utx hyperkalemia?
-IV fluids (isotonic saline 0.9%)
-calcium tx
-HCO3-
What treatment steps are taken for uroabdomen?
-place urinary catheter
-drain peritoneal fluid
-correct e-lyte imbalances
-surgical repair
Where is the most common location for the bladder to rupture?
Dorsal bladder
How is neonatal isoerythrolysis characterized?
Destruction of rbc's by alloantibodies of maternal origin
Form where are the maternal Ab's absorbed?
Through colostrum
What is the result of NI?
massive intravascular hemolytic anemia
Which blood types are at risk for NI?
-Qa and Aa
What conditions have to be met for NI to occur?
-mare has to be negative for antigen
-mare has to be sensitized to antigen
-foal has to acquire antigen from sire
What are the clinical signs of NI?
-progessive weakness
-lethargy
-icterus mucous membranes
-evidence of hypoxemia
-decreased PCV
- increased T bili
What is kernicterus?
Bilirubin toxicity--> may lead to CNS signs
What test is used to Dx NI?
Coomb's test
How is NI treated?
-improve O2 carrying capacity
-blood transfusion
-fluid therapy
-restrict exercise
-nutrition--> feed IV if not hypoxemic
Blood transfusion is given when the PCV is at what level?
<15%
What is the source of the blood for a transfusion?
Mare--wash the red cells
Which organism is a common cause of pneumonia is foals?
Rhodococcus equi
When are foals infected?
from 3weeks to 5 months of age
What type of organism is R. equi?
Gram positive intracellular bacteria
-resides in alveolar macrophages
Where is R equi found?
Soil contaminant
R equi infection causes what type of pneumonia?
Chronic suppurative bronchopneumonia
early dx of R equi is difficult, the subacute form can lead to what?
Foal death
What are the presenting complaints in a foal with R equi?
-pneumonia
-lameness
-fever
-tachypnea
What diagnostics are used to dx R equi?
-bloodwork
-rads
-US
-transtracheal wash
What is the tx for R equi?
-erythromycin (keep away from mare)
-azithromycin
-az + rifampin
-doxycycline
-good nursing care
What other signs of R equi infection might you see?
Extrapulmonary lesions:
-GI
-polysynovitis
-panopthalmitis (green eyes)
Diagnosis of muscle dz in horses includes what components?
-PE
-HX
-biochem
-U/A
-exercise testing
-U/S
-electrmyography
-muscle bx
Creatinine kinase is released in response to what?
Breakdown of muscle
-short T1/2
-is specific
Is AST specific to muscle dz?
No, supports a rise of CK
How quickly does serum CK rise?
Within hours or muscl insult (falls off in hours)
How do you perform an exercise test?
-take pre-exercise blood sample
-trot for 15 mins
-check Ck 4 hours later
When would you NOT perform an exercise test?
If there is already increased Ck, could cause more damage
U/S can help dx what conditions of the muscles?
-edema
-hematoma
If taking a muscle bx, which muscle is the sample taken from?
-gluteal
-semimembranosus/tedinosus
What is rhabomyolysis?
Syndrome of muscle cramping that occurs during physical exertion or exercise
Causes of rhabdomyolysis have been categorized into what 4 groups?
-exertional (recurrent exertional, PSSM)
-nutritional (myodegeneration)
-Inflammatory (clostridal myonecrosis)
-Traumatic (post anesthetic myoneuropathy)
Recurrent Exertional Rhabdomyolysis is seen more in which breed?
TBs
What are the predisposing environmental triggers to RER?
-gender (67% female)
-temperament
-diet (starch, CHO)
-excitement
-exercise duration and intensity
-lameness
What are the clinical signs of RER?
-severe cramping in hind musculature
-anxiety, sweating, refusal to move, incr HR/RR
-most cases recover in several hours
-severe cases-->recumbency
What blood chem results are seen with RER?
-significantly elevated CK
-elevated AST
-+/- azotemia (pigment nephropathy)
-myglobinuria
What results are seen on histopath of a muscle bx of a horse with RER?
-increased centrally located nucleus
-normal glycogen staining
-incr sensitivity/contracture to halothane or caffeine
How do you tx an acute episode of RER?
-IV, oral fluids (avoid ARF due to myoglobin tox)
-Nsaids w/ caution
-sedative.tranqs to reduce anxiety/pain
How do you prevent RER?
-daily exercise routine
-low CHO diet/high fat (add corn oil, rice bran for additional calories
-Dantrolene: administer prior to exercise
What is a common name for Polysaccharide Storage Myopathy?
Monday morning sickness
PSSM is a form of what dz?
Exertioanl rhabdomyolysis
PSSM is a glycogen storage disorder resulting in glycogen and ploysacchrides accumulating where?
in the myocytes
What would lead you to suspect PSSM?
perisistently elevated CK/AST...even at rest
-chronic muscle pain
-exercise challenge results are supportive
-muscle bx = definitive diagnosis
On histopath, abnormal glycogen storage is seen with which stain?
PAS
PSSM horse have an increased ability to do what?
Synthesize glycogen (incr sensitivity to insulin, high CHO diets inncrease glycogen synthesis)
Glycogen in PSSM horses can't be used as energy due to what?
Glygogen branching synthase-1 deficiency
What does rhabdomyolysis occur from?
A separate dysfunction within energy metabolism
How can PSSM be treated?
-manage to minimize clinical signs
- prevent stall confinement > 48 hours
-strict exercise routine
-decrease CHO, incr fat
-must combine diet with exercise
Nutritional rhabdomyolysis (myodegeneration) is also known as what?
White muscle disease
Does nutritional myodegeneration affect cardiac or skeletal muscle?
Both
nutritional myodegeneration is primarily a deficiency of what?
Selenium/ Vit E

affects young animals <1 year
What are the 2 forms of nutritional myodegeneration ?
-Cardiac form: acute, sudden myocardial decompensation

-Skeletal form: muscular weakness/stiffness.recumbency
What serum chem results are seen with nutritional myodegeneration ?
-elevated Ck and AST during acute phase
-myoglobinuria
Diagnosing nutritional myodegeneration requires the measurement of Se/Vit E in tissue and whole blood. Why is GSH-Px also measured.
Glutathion peroaxidase is Se dependent and formed in RBCs
Which food source is usually Vit E deficient?
Poor quality hay
What results of nutritional myodegeneration are found on necropsy?
-bliateral symmetrical myodegeneration
-pale discoloration
-white streaks in muscle bundles
What is the prognosis of the cardiac form of nutritional myodegeneration ?
Poor
Is the skeletal form of nutritional myodegeneration treatable.
Possible: Se and Vit E supplementation
-supplement mares during gestation
-allow access to green forage
Inflammatory Rhabdomyolysis is also called what?
Clostridial myonecrosis
An infection of Clostridial myonecrosis is characterized by what?
-fever
-systemic toxemia
-very high mortality
Is Clostridial myonecrosis contagious?
No , it is infectious
What are the synonyms for Clostridial myonecrosis?
-black leg
-malignant edema
-gas gangrene
Most commonly, an infection with Clostridial myonecrosis occurs when?
Following an IM injection
(likely spores are present in the muscle in dormant form)
Once inoculated into the tissues, what do the spores do?
Convert into vegetative, toxin-producing form
-proliferation of spores in devitalized tissues
What is the tx for Clostridial myonecrosis?
-agressive PCN tx
-aggressive tissue debridement (fasciotomy, aerate tissue)
-supportive care (IV fluids, anti-endotoxemic tx, laminitis prophylaxis)
Traumatic rhabdomyolysis is also called what?
Post anesthetic myoneuropathy
What are the 2 categories of Post anesthetic myoneuropathy?
-localized
-systemic (malignant hyperthemia)
Localized myopathy is a resul tof the use of what?
Inhalation anesthetics, elevated muscle enzymes
(ischemia from hypoperfusion)
What is the tx for localized Post anesthetic myoneuropathy?
Supportive care
Hyperkalemic Periodic Paralysis is an autosomal dominant trait from which sire?
Impressive
What do episode of HYPP look like?
-myotonia
-proplapse of the 3rd eyelid
-sweating/muscle fasiculations
-muscular weakness
-respiratory distress from uscular paralysis of URT
In horses with HYPP, what happens to the resting membrane potential?
Closer to threshold

inward flux of ns outward flux of K
Is HYPP a complete or incomplete prenetrance condition?
Incomplete
What is the definitive test for HYPP and what type of sample do you submit?
DNA
hair root sample
What other tests could be performed?
-EMG
-Oral Ca++ chloride challenge (not recommended
In the case of an acute episode of HYP{P what tx would you provide?
-karo syrup
-calcium
-IV dextrose
What long term tx can you give to a HYPP horse?
K+ wasting diuretic (acetazolamide)
Dietary management ( decr K+, avoid alfalfa/molasses
-regular exercise
-small frequent meals
What is thumps?
Synchronous diaphragmtic flutter
What causes thumps?
E-lyte imbalance
-hypocalcemia
-metabolic alkalosis
How do you dx thumps?
Observe contracture of diaphragm in synchrony with the heart beat
Cushing's dz is a dz of what age of horse?
Middle age to older
What is the cause of Cushing's in horses?
Dysfunction of the pars intermidia of the pituitary (humans and small animals its the pars distalis)
What conditions of the pars intermedia can cause Cushing's?
Hyperplasia/hypertrophy
Melanotropes with excess production (innervated by the dopaminergic nT's of the hypothalamus, loss of inhibition by dopamine
Loss of dopaminergic innervation leads to increased systemic release of what?
POMC- proopioidmelanocortin peptides
POMC--> ACTH
The pars intermedia dysfunction also leads to what increased levels of what?
-increased alpha MSH
-increased beta endorphines
-increased CLIP
The action of ACTH on the adrenal cortex leads to what condition?
Syndrome of corticol excess
Clinical signs associated with PPID result from what?
A combination of compression of adjacent pituitary/hypothalamic tissues and increased circulating POMC peptides
What are the clinical signs of PPID?
-hirsutism
-weight loss/muscle wasting
-PU/PD
-chronic laminitis
-suspensory ligament laxity
-chronic infections
-poor wound healin
-coat color changes
-docility/blidness/seizures
-infertility/pseudolactation
-abnormal fat deposition
-secondary (type II) diabetes
What dx test can be run for PPID?
Overnight dexamethsone test
How is the Overnight dexamethsone test performed?
-baseline blood sample
-inject dex
-19 hrs later sample again
-normal response is to suppress endogenous cortisol
What other tests can be performed?
-endogenous ACTH concentration
-ACTH stim
-TRH stim
TRH directly stimulates what part of the pituitary?
Melanotropes
What drugs are used to treat PPID?
-Pergolide
-Cyproheptadine
what effect does Pergolide have?
Increases Dopamine
What type of management is needed for horse with PPID?
-strict husbandry
-diligent foot care
-good dentistry
-parasite control
-coat clipping during summer
What is the prognosis for PPID?
many horses are managed for years with Pergolide and proper foot care

chronic laminits leads to euthansia in many cases
Why does PPID cause laminitis?
Insulin resistance
hyperinsulinemia
What are the signs of equine metabolic syndrome?
-obesity
-insulin resistance
-subclinical/clincial laminitis
Which breeds have genetic predisposition to EMS?
ponies>morgan>arabs>fjords

diet and exercise play a role
What diagnostics are used to dx EMS?
-resting hyperinsulinemia
-combined glucose-insulin test
How is the combined glucose-insulin test performed?
-collect baseline blood glucose
-admin 150 mg 50% dextrose IV
-foloow with .10 U insulin
-elevated blood glucose above baseline for >45 mins =insulin resistance
What diet changes should be made to a horse with EMS?
-remove CHO
-feed grass hay
-restrict pasture grazing
Which exercise is best for EMS?
swimming
What is the effect of giving Levothyroxine?
Improves insulin sensitivity
Hypothyroidism in the mare is asscoiated with what syndromes?
Fescue toxicity
-enophyte alkaloids= dopamine agonists
-prolonged gestation in mares
-agalactia
What effects of hypothyroidism can be seen in foals?
-incomplete ossification
-msk deformities
-mandible prognathism
-goiter
What is the common neoplasia of the thyroid gland in horses?
Thyroid adenoma
Most thyroid adenomas are benign, when would tx be considered?
If it is a space occupying lesion
(compression of the respiratory/alimentary tracts)
What is another name for Nutritional secondary hyperthyroidism
Bran dz
Big head dz
Nutritional secondary hyperthyroidism causes what condition in the horse?
osteoporosis
What is the cause of Nutritional secondary hyperthyroidism?
Diets low in Ca++/ high in phosphorus
induces hyperparathyroid
PTH inhibits Vit D synthesis, increases bone resorption/bone loss
none replaced by unmineralized conn tiss
What are the clinical signs of Nutritional secondary hyperthyroidism?
-facial bone enlargement
-difficult mastication due to bone loss
-molar fxs
-long bone fxs
-unthriftiness
-shifting lamness
-physitis/limb deformities
What is the tx for Nutritional secondary hyperthyroidism?
-eliminate grain/oxalate containing feeds
-Supplement calcium (limestone)
-confinement for severe cases
-nsaids
What can cause hypervitiminosis D?
Ingestion of plants containing Vit D like compounds (cestrum)
What is the result of hypervitiminosis D?
-hyperphosphatemia
clin signs= wt loss, mineralization of soft tissue
poor prognosis
What is the goal of an equine neuro exam?
Establish whether a neuro problem is present and determine the anatomic location of the problem
When taking the hx for a neuro case, what info should you ask for?
-duration.progression of signs
-diet, changes, stresses, injuries
-vaccination, herd problems
What is the first part of a neuro exam?
Observe the animal
mentation/behavior/postures, coordination
How can you test Cn 1 on a horse?
feed test
A CN 3 deficit will show what kind of strabismus?
Ventral lateral
For a Cn 7 (facial) deficit, does the muzzle deviate away or towards the affected side?
Away
Deficits of Cn 8 (vestibulocochlear) will show what clinical signs?
head tilt, nystagmus
Atrophy of the neck muscles can occure with a deficit of which CN?
11 spinal accessory
Yellow star thistle ingestion can lead to a deficit of which cranial nerve?
12- hypoglossal
can't hold tongue against presure
Damage to which nerve fibers can cause Horner's?
-sympathetic fibers
-from brachial plexus avulsion
-injury to cranial thoracic spine
-cervical sympathetic trunk injury
-guttural pouch dz
What are the clinical signs of Horner's in a horse?
-ptosis
-enopthalmos
-prolapse of 3rd eyelid
-miosis
-sweating along affected side
Animals can walk without cerebral function, when are the deficits seen?
When performing complex motor activities
What are the requirements for a normal gait?
-musculature
-motor and sensory peripheral nerves
-local spinal reflexes
-ascending and descending pathways of spinal cord
-motor centers in the brainstem
What are the signs of paresis?
-toe dragging and wear
- bounce to stride
-difficulty backing
-muscle fasiculation
What are the gait tests for paresis?
-sway test
-tail pull
-incline
-hopping response
What are the signs of ataxia?
-inability to finely coordinate muscle activity during voluntary movement
-inconsistent foot placement
-side to side motion
What are the tests used for ataxia detection?
-circling
-incline
-obstacles
-move with head elevated
-blindfold
What is hypometria?
-ataxia characterized by under reaching
-decreased motion at joints
-limb stiffness
What is hypermetria
-over reaching
-exaggerated joint motion
-high stepping gait
What is the definition of a proprioceptive deficit?
Loss of perception of the movement of the body to the limbs
Is proprioception dependent or independent of vision?
Independent
What are the clinical signs of a proprioception deficit?
-abnormal stance
-abnormal or inconsistent foot placement
-sisde to side swaying of trunk
CSF collection at the AO joint requires what?
general anesthesia
CSF analysis of normal fluid should have what parameters?
-clear
-low TP <100 mg/dl
-low cellularity
-no rbc's
What is xanthochromia?
Yellow fluid
xanthochromia of csf is a result of what?
-traumatic cord injury
-hemorrhage of cord
-EHV
Rabies spreads by which routes?
Spread in saliva, enters through broken skin, mucus membranes or respiratory tract
How does rabies migrate to the brain?
Up the peripheral nerve to the spinal cord
Death from rabies is due to what?
respiratory depression...viral efffects on medullary function
The cerebral form of rabies is also called what?
Furious form
What are the clinical signs of the furious form?
-aggression
-photophobia
-convulsion
-self mutilation
-hyperesthesia
-straining, tremors
-hypersalivation
What are the clinical signs of the dumb or brainstem form of rabies?
-lethargy
-dementia
-ataxia
-Cn signs
What is the gold standard dx test for rabies?
-indirect fluoresce3nt Ab test
-need brain tissue
-negri bodies in hippocampus
How can rabies be prevented?
Vaccination
-vaccine protects after 30 days of administration
-wear gloves
-reportable dz
Equine protozaol myeloencephalitis is caused by which protozoan parasite?
Sarcocytsis neurona
Which animal is the definitive host for Sarcocytsis neurona?
Opossum
Which animals are the intermediate host for Sarcocytsis neurona and how are they infected?
-amadillo, raccoon (cat, skunk?)
-eat sporocyst, develop muslce sarcocyst
What are the clinical signs of EPM?
Cranial nerve deficits
-head tilt
-facial nerve paralysis
-dysphagia
-sensory deficits
Gait deficits
-incoordination
-weakness
-asymmetric ataxia
-may resemble lamness

muscle atrophy
focal sweating
sensory deficits
How is EPM dx antemortem?
-hx and cs
-CFS analysis
cytology and protein normal, western blot for S. neurona antibodies

rule out other diseases
What does a serum postive result for S neurona anitbodies mean?
EPM exposure, nor necessarily disease
What indicates consistency with EPM disease?
CSF positive + clinical signs
What pathologic findings are seen with EPM?
Multifocal hemorrhage
-hemorrhage, nonsuppurative inflammation and necrosis
-perivascular cuffing with mononuclear cells
-fewer than 50% of cases visualization of lesions
What is the older tx used for EPM?
Folic acid inhibitors
Whcih coccidiostat can be used to tx EPM?
What is it's MOA?
Trizine
distupts plastid bodies of merozoite and energy metabolism of protozoa
What are the side effects of using Thiazolise antiparasitic tx?
diarrhea
colic
laminitis
What other supportive tx can be used in EPM?>
-nsaids
-dmso
-steroids
-vit e, thiamin
What is still unknown about EPM?
-clearance of parasite fro nervous system
-duration of anti-parasite antibodies in nervous system
-definition of cure
-optimal tx duration
What is the px of EPM?
-60% show improvement
-fewer return to normal
-early dx incr outcome
-appropriate type and duration of tx
How can EPM be prevented?
-prevent wildlife access to horse feed
-keep barn clean
-limit bird dropping
-EPM vacc but no efficacy data, NOT recommended
What is the mechanical vector of the zoonotic togavirus?
Mosquito
Which animal is the amplifier host?
Passerine birds
Which species is the accidental host of the togavirus?
Horse
What are the clinical signs of an alphavirus (togavirus) ecephalitis?
-brain & spinal cord dysfunction
-biphasic fever spike
-initial virmeic phase non-specific signs
-progression to neuro signs
-sleeping sickness
What is the distribution of Eastern equine encephalitis?
East of the Mississippi
Does EEE have a viremic phase?
Transient viremia but not signficant
which species are the dead end hosts for EEE?
horse
human
deer
What is the px of EEE?
Poor, 90% mortality
Does Western EE have a viremic phase?
No, horse is dead end host
What animal is the reservoir for WEE?
Birds

mosquito is the vector
What is the px of WEE?
fair to poor, 50% mortality
What is the viremic stage of Venezuelan EE like?
constant/high horse is significant amplifier
VEE is transmitted by mosquitos, what is the reservoir host?
rodents
What is the px of VEE?
poor, 50% mortality
How do you dx EEE/WEE/VEE?
-clinical signs
-seasonality of vector
-CSF neutrophilai, xanthochormia, incr protein
Def Dx: virus isolation from brain
What is the tx for the alphavirsues?
-supportive care is the only option
-prevention is key
-mosquito control
-vacc in spring
West Nile Virus is in what viral family?
Flavivirus of the togavirus family
How is WNV transmitted?
Culex mosquito
Which animals are the reservoir for WNV?
birds (crows are susceptible)
Which species are the dead end hosts for WNV?
Humans
HorsesLow
What are the clinical signs of WNV?
-fever
-acute onset ataxia, weakness (rear limbs usually)
-muscle fasiculations, primarily facial
-somnolence
How do you dx WNV?
-IgM capture Elisa
-viral isolation
-PCR on tissue

tx by supportive care
How can you prevent WNV?
-vaccs (decr viremia and mortality)
-mosquito control
EHV 1 causes what type of dz?
-myeloencephalitis
abortion
-rhinopneumontitis
What dz does EHV2 cause in foals?
mild respiratory and conjunctivitis
EHV 3 causes what dz?
coital exanthema
Rhinopenumonitis is also caused by which EHV?
EHV 4
What are the clinical signs of EHV myeloencephalitis?
-acute onset (may be epizootic)
-rear limb ataxia
-bladder paresis
-fecal retention
-perineal hypalgesia
-occasional cranial nerve deficits
-pyrexia, respiratory signs
EHV is a vrial infection of which cells?
Endothelial cells of CNS
What other rxn may play a role in EHV enceph?
Immune mediated type III hypersensitivy (Arthus)
What other signs of EHV infection can be seen on pathology?
-arteriolar vasculitis
-white matter ischemia
-clinical signs from CNS infarct & necrosis
How do your dx EHV myeloencephalitis?
-clin signs
-hx of abortion, fever or resap dz on farm
-virus isolation from nasal swab or buffy coat
-CSf antibody titer or PCR for virus
-CSF xanthochromia, high protein, low cells
How is EHV myeloencephalitis? treated?
-supportive care
-anti-inflammatory
-manage rectal impaction and urine retention
-Valcylovar may decr viremia
-prognosis worse if recumbent
How can EHV myeloencephalitis be prevented?
-pregnant mares are susceptible
-isolate affected animals, rapid spread
-vaccinate for respiratory and abortion forms of disease, not protective against neuro form
What is the cause of leukoencephalomalcia in horses?
Fumonsin B1 toxin of Fusarium moniliforme found in corn, corn screening sometimes oats and pellets
How does fumonsin affect the brain?
Interfers with sphingolipid production, build up of metabolic products results in neuronal damage
What are the clinical signs of leukoencephalomalcia?
-dementia, blindenss, convulsion, death, toxic hepatopathy (less common in horse)
How do you dx leukoencephalomalcia?
-identify toxin (not just mold) in feed
-CSF leukocytosis and high protein
-clin signs in corn fed animals
How do you tx leukoencephalomalcia?
-supportive
-remove contaminated feed
-usual fatal in 48-72 hours
What is the causative agent of botulism?
clostridum botulinum
What is the MOS of botulism?
Nwuromuscular blockade- blocks release of Ach at neuromuscular junction
Forage poisoning botulism usually occurs from what?
Carcass contamination of large bales (type C, rare in horses)
What are the signs of forage poisoning
-dysphagia
-muscle tremor
-hyometria, weakness
-ileus, bladder atony
-death from respiratory paralysis
-herd outbreaks may occur
Toxins produced in the GIT in foals causes what syndrome?
Shakers (c botulimun type B)
dysphagia, weakness, tires easily
-poor PLR, poor tone eyelid,tail

(dysphagia in foals = milk from nose)
How is botulism dx?
-isolation of C botulinum
-tongue stress test
-toxin rarely isolated
-mouse assay
How do you tx botulism?
K+ or Na+ PCN (procain pcn potentiates NM blockade)
-polyvalent antiserum
-may need to ventilate
-prevent w/ toxoid in hi risk areas
-exercise restriction --> depletes Ach
Tetanus is an infection with what agent?
Clostridium tetani
Where are C tetani spores found?
soil and feces
resistant to high temps and common disinfectants
Tetanus favors what type of environment?
Low O2...wounds/punctures
necrotic tissues
What is the key to tetanus prevention in horses?
vaccination
How does tetanospasmin work?
Toxin inhibits the neurotransmitters GABA and glycine
-irreversibly binds inhibitory neuron (inhibits the inhibitor) causes muscle spasm, interruption of autonomic control
What are the clinical signs of tetanus?
-extreme muscle rigidity
-saw horse stance
-normal conscious proprioception
-CN deficits
What are the goals for tetanus tx?
-neutralize unbound.circulating toxin
-debridement of wound
-abx targeting C tetani (PCN)
-sedatives for muscle spasms
-supportive/symptomatic care
What is the mortality rate of tetanus?
80%
What is the purpose of giving tetanus toxoid?
-inactivated intact toxin from C tetani
-stimulates active immunity
What is the purpose of giving tetanus antitoxin?
-serum contains antibody to tetanus
-confers passive immunity
-will bind circulating toxin
Cervical stenotic myelopathy is also called what?
Wobbler's dz
In which breed does wobblers occur more often?
TB
males > females
What type of compression occurs in foals 6-18 months?
Dynamic compression
(static in 2-4 y/o)
What are the dietary factors that contribute to wobbler's?
-decreased copper
-increased zinc
-increased CHO
(cartilage doesn't form properly)
What are the clinical signs of cervical stenotic myelopathy?
-spinal ataxia
-weakness
-dysmetria
-symmetrical
-rear limbs usually worse than front
Cervical verterbral instability causes dynamic compression of the cord when?
During flexion and extentsion
What are the common sites of compression?
C3-C4 and C4-C5
Cervical vertebral malformation causes static compression the cord at what levels?
C5-C6 and C6-C7
What narrowing is seen from the malformation?
Ventral-dorsal narrowing

also Wallerian degeneration of neurons
How do you calculate the saggital ratio of the c spine?
Ratio of widest part : narrowest part of the cord
How do you dx Wobbler's?
-signalment, hx, pe
-lameness and neuro exams
-cervical rads
-CSF analysis
-myelography
What is the tx for cervical stenotic myelopathy?
-minimize spinal cord injury and inflammation
-stall confinement
-anti-inflammatory drugs
-restricted diets
-sx: ventral stabilization of malarticulation, basket sx
Cauda equina syndrome is also known as what?
Polyneuritis equi
What is the suspected etiology of Polyneuritis equi?
Immune mediated or inflammatory syndrome (antibodies to P2 myelin protein)
How does the acute form of Polyneuritis equi manifest?
Hyperastesia or perineal and/or head region
How does the chronic form of Polyneuritis equi manifest?
Paralysis of tail, anus and rectum with fecal retention +/- incontinence
-muscle atrophy & ataxia of hind limbs
-Cn dysfunction
How do you dx Polyneuritis equi?
-chronic active inflammation on blood work (fibrinogen)
-CSF elevated total protien, incr WBC
-presence of P2 myelin antibody supportive but not definitive

Post mortem: granulomatous inflammation at nerve roots
How do you tx Polyneuritis equi?
-corticosteroids
-supportive care