2019.Iss2.controversiesinEquinemed & sx

Question 1

Diagnostic Testing for Equine Endocrine Diseases: Confirmation VS Confusion

What are instances that plasma ACTH concentration increased other than PPID?

Answer 1

chronic and acute disease
malnutrition
other stressors

Question 2

Diagnostic Testing for Equine Endocrine Diseases: Confirmation VS Confusion

Is there a gold standard test for diagnosis of Equine PPID?

Answer 2

No

Question 3

Diagnostic Testing for Equine Endocrine Diseases: Confirmation VS Confusion

What are normal insulin levels in the equine serum?

Answer 3

<20micoU/mL

Question 4

IS Electrical Nerve Stimulation the Answer for Management of Equine Headshaking?

What virus has a predilection for latency in the trigeminal nerve?

Answer 4

equine herpesvirus-1s

Question 5

Treatment Options for melanoma of gray horses

Locoregional control of melanoma masses depends on:

Answer 5

surgical removal
and/or
intralesions chemotherapy (poss. with adjunctive hyperthermia or electroporation)

Question 5

Treatment Options for melanoma of gray horses

What gene mutation do all gray horses have, that unbalances melanocyte behavior to cause graying and propensities to develop vitiligo & melanoma

Answer 5

STX17

Question 6

Treatment Options for melanoma of gray horses

when are melanomas seen in gray horses?

Answer 6

typically arise at 4-8 years of age, that increases approximately by 4-8% annually

Question 7

Treatment Options for melanoma of gray horses

Are melanomas malignant?

Answer 7

variable: sessile to aggressively invasive metastic multicentri ctumors

**early melanomas are considered pre-cancerous

Question 8

Treatment Options for melanoma of gray horses

Do melanomas shorten the average lifepsan of gray hroses

Answer 8

no reliable data that quantify the “gray effect” on longevity

Question 9

The Equine Sarcoid: Why are there so many treatment options

What are the 6 different types of sarcoids?

Answer 9

1. occult
2. verrucose
3. nodular
4. fibroplastic (pedunculated sessile)
5. Mixed
6. malignant

Question 10

The Equine Sarcoid: Why are there so many treatment options

What is the gold standard treatment of sarcoid?

Answer 10

radiation
+/- some form of surgery

Question 11

The Equine Sarcoid: Why are there so many treatment options

What are the treatment options available for sarcoids?

Answer 11

Question 12

The Equine Sarcoid: Why are there so many treatment options

What is the best treatment for sarcoids?

Answer 12

No
**there is a lot of treatment & combinations of treatments that are used worldwide

Question 13

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

What is considered the most sensitive indicator of EIPH?

Answer 13

bronchoalveolar lavage (BAL): 90-100% of horses having evidence of EIPH on BAL fluid cytology

Question 14

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

What is the best accepted method/timing for testing for EIPH?

Answer 14

tracheobronchoscopy conducted 30 minutes to 120 minutes after exercise
**preferably after racing

Question 15

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

When evaluating horses with EIPH that have a high score, does it mean that its negatively affecting their performance?

Answer 15

No
**horses should be re-examined to assess the grade prior to drawing conclusions abotu any negative race day performance. Horses with lower grades are more likely to have consistent EPIH grades at subsequent race starts, but this is also not guaranteed

Question 16

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

When hemosiderophages are seen on BAL fluid cytology, does this correlate to disease severity?

Answer 16

No

Question 17

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

Does EIPH affect racing performance?

Answer 17

Yes, however variable reports in severity affecting racing performance

Question 18

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

IS exercise induced pulmonary hemorrhage a progressive disease?

Answer 18

EIPH is described as a progressive disease based on histopathologic examination fo lung tissue from racehorses

Question 19

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

What is the recommended treatment for EIPH?

Answer 19

high-quality evidence exists that furosemide decreases the severity and incidence of EIPH

Question 20

Exercise Induced Pulmonary Hemorrhage: is it important & can it be prevented?

What are recommended management factors in treatment of EIPH?

Answer 20

-avoidance of cold weather racing and training
-increasing the intervals between races
-altering the racing strategy in horses with a history of mod-severe EIPH

Question 21

Equine Neonatal Encephalopathy: facts, evidence, and opinions

The mechanisms of equine neonatal encephalopathy can be divided into what 3 general categories/mechanisms?

Answer 21

1. adverse peripartum events, d/t ischemia/hypoxia in the prepartum period (placental disease), at partum (dystocia, c-section), or in the postpartum period (umbilical bleeding/compression, etc)
2. evidence of placenta dz with variable gestation length
3. no documented maternal disease, gestation length is normal and foaling is uneventful

Question 22

Equine Neonatal Encephalopathy: facts, evidence, and opinions

the pathophysiology of NE can be divided into what two broad categories?

Answer 22

1. ischemic/hypoxic: oxygen/energy deprivation, reperfusion, hemorrhage, edema, & inflammation
2. non-ischemic (metabolic & endocrine)

Question 23

Equine Neonatal Encephalopathy: facts, evidence, and opinions

The brain requires what percentage of oxygen and glucose?

Answer 23

20% oxygen
20% glucose

Question 24

Equine Neonatal Encephalopathy: facts, evidence, and opinions What is considered important in the delayed lesion severity and disease progression of NE?

Answer 24

reperfusion injury & blood redistrubtion in response to ischemia

Question 25

Equine Neonatal Encephalopathy: facts, evidence, and opinions Describe the pathogenesis of inflammation in NE.

Answer 25

microglial cells release inflammatory mediators & promote cerebral infiltration by peripheral luekocytes

Question 26

Equine Neonatal Encephalopathy: facts, evidence, and opinions describe the phases of cerebral injury after an ischemic-hypoxic event.

Answer 26

phase 1: neurons deprived of energy & oxygen, shifting to anaerobic metabolism, release of inflammatory mediators, cell swelling, cell death, etc. phase 2: secondary energy failure; 6 hours to day glutamate release, continuation of reperfusion injury, cell necrosis, apoptosis phase 3: tertiary brain injury; weeks to years: ongoing brain injury: astrogliosis, delayed cell death, remodeling, tissue repair

Question 27

Equine Neonatal Encephalopathy: facts, evidence, and opinions What is the primary main excitatory neurotransmitter, with prolonged exposure leads to neuronal injury & death.

Answer 27

glutamate

Question 28

Equine Neonatal Encephalopathy: facts, evidence, and opinions When is glutamate released?

Answer 28

-continuously released from neurons & removed by astrocytes in an equilibrium that can be disrupted & reduced ATP supply

Question 29

Equine Neonatal Encephalopathy: facts, evidence, and opinions What is the proposed mechanism for magnesium sulfate administration in NE foals?

Answer 29

glutamade excitotoxicity can be blocked by NDMA and AMPA receptors

Question 30

Equine Neonatal Encephalopathy: facts, evidence, and opinions Why is astrocyte dysfunction in NE foals detrimental to continued neuronal damage?

Answer 30

astrocytes provide a steady source of energy for neurons

Question 31

Equine Neonatal Encephalopathy: facts, evidence, and opinions What are the risk factors for equine NE/NMS?

Answer 31

maternal: any condition resulting in systemic inflamm or ischemia/hypoxia can impair perfusion placental: placentitis, placental separation fetal: congenital anomalies, twins, prematurity/dysmaturity, sepsis, umbilical cord compression, dystocia

Question 32

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment What are the 3 types of laminitis?

Answer 32

1. endocrinopathic laminitis: assoc with insulin dysregulation, which may be primary (EMS), assoc with PPID or iatrogenic (secondary to corticosteroid admin) 2. Sepsis related laminitis: systemic illness characterized by systemic inflammation, particularly in response to endotoxemia (eg, colitis, metritis, pneumonia) 3. Support Limb laminitis: develops in horses with painful limb conditions such as fractures or synovial sepsis, this form primarily affects the limb contralateral to the primary injury, but often multiple limbs affected

Question 33

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment What are the major forms of laminitis & their corresponding experimental models?

Answer 33

Question 34

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment Glucose consumption by the lamellae is performed by what?

Answer 34

GLUT-1 transporter **uptake is non-insulin dependent

Question 35

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment What are preventative & early therapeutic efforts should be aimed at for laminitis?

Answer 35

1. perfusion enhancement sin horses at risk of SLL 2. Control of local & systemic inflammation for SRL 3. early diagnosis & careful management of ID for endocrinopathic laminitis

Question 36

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment What therapeutic has a marked antiinflammatory effect in experimental models in sepsis related laminitis?

Answer 36

continuous digital hypothermia (cryotherapy)

Question 37

Are there shared mechanisms in the pathophysiology of different clinical forms of laminitis and what are the implications for prevention & treatment What are strategies to minimize ongoing lamellar damage:

Answer 37

-anti-inflammatory therapy -confinement and restriction of locomotor activity -mechanical foot support -digital hypothermia

Question 38

What do we know about hepatitis viruses in horses? List causes of hepatitis in horses

Answer 38

Question 39

What do we know about hepatitis viruses in horses? what is known about equine parvovirus?

Answer 39

Question 40

What do we know about hepatitis viruses in horses? What is known about equine hapcivirus?

Answer 40

Question 41

Fetal membrane removal in the mare: proactive vs reactive approaches what factors are associated with a higher occurrence of retained fetal membranes?

Answer 41

mare age previous RFM breed peripartum complications: abortion, dystocia, placentitis, prolonged gestation, hydropic conditions

Question 42

Fetal membrane removal in the mare: proactive vs reactive approaches What are the potential risks of controlled fetal membrane removal:

Answer 42

-increased risk of hemorrhage when separating the microvilli from the endometrium -tearing membranes during removal, thus causing RFM -retained microvilli, which can provide a nidus for infection -uterine horne eversion/intussusception or prolapse