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Year 3 respiratory > horse diseases > Flashcards

horse diseases Flashcards

1
Q

what pathogen causes strangles?

A

streptococcus equi subsp equi

G+ve

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2
Q

how is strangles spread?

A

direct contact
fomites
environment
shedding carriers (56m ) from guttural pouthc

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3
Q

what is the incubation time of strangles?

A

2-6 d

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4
Q

what are the clinical signs of classic acute strangles?

A 
fever
depression
cough
mucoid to purulent nasal discharge
abscessation of LN (rupture in 7-10d) (suppurative lymphadenitis)
dyspnoea
dysphagia
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5
Q

how can you treat very early strangles?

A

can give penicillin but have to weight up as may inhibit immunity
nursing
soft food

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6
Q

how do you manage abscesses from strangles?

A

poultice and drain
abx controversial
nursing
soft food

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7
Q

what determines if strangles presents classically of atypically?

A

strain

own immunity

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8
Q

what are the signs of atypical strangles?

A 
mild infl of URT
slight nasal discharge
cough
fever
self limiting lymphadenopathy
NO abscess
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9
Q

how can you diagnose strangles?

A
  • leucocytosis
  • hyperfibrinogenaemia
  • 1 x GP lavage or 3x nasophargyngeal swabs then culture or pcr
  • US / rectal for abd abscess
  • endoscopy or rads for GP empyema and chondroids
  • blood test for AG
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10
Q

how can you manage an outbreak of strangles?

A
  • isolate horse and premises
  • phenolics disinfectant for equipment
  • iodophores and chlorhexidine for staff
  • blood test for asymptomatic carriers
  • remove chondroids and put penicillin in GP
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11
Q

how can you prevent strangles?

A
  • intramucosal vax not very effective

- test new horses for carrier status

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12
Q

what are some possible complications of strangles?

A
  • internal abdominal abscessation
  • purpura haemorrhagica
  • generalised vasculitis
  • death
  • GP empyema and chondroids(solid pus)
  • retropharyngeal abscess
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13
Q

what can be the consequence of internal abscesses from strangles and how can you treat it?

A
  • colic, pyrexia, anorexia, depression, wt loss

- 6w penicillin/trimethoprim sulfa / rifampin

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14
Q

how can you treat purpura haemorrhagica?

A 
penicillin
immune suppression
NSAIDs
fluids
pallative care
guarded prognosis
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15
Q

why do you get generalised vasculitis with strangles?

A
  • caused by type 3 hypersensitivity and get thrombosis of small arteries
  • necrosis, petechial haemorrhages on mm
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16
Q

what is rhodococcus equi?

A 
G+ve
intracellular
obligate aerobe
lives in soil +manure
late spring and summer
foals 1-6mo
more in US, australia and ireland
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17
Q

what is the pathogenicity of the respiratory form of rhodococcus equi?

A
  • foals infected in first few days after birth but dont get signs till later
  • bacteria destroy macrophages giving a pyogranulomatous response
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18
Q

what are the clinical signs of respiratory rhodococcus?

A 
bronchopneumonia
abscess formation (caseous necrosis in lungs + LN)
anorexia
depression
fever
dyspnoea and tachypnoea
cough
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19
Q

how do you diagnose respiratory rhodococcus?

A 
fibrinogen
high neutrophilia
tracheal wash - PCR for VapA gene of bacteria
rad for abscess
US for surface abscess
PM
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20
Q

how can you treat rhodococcus?

A
  • erythromycin and rifampin
  • clarithromycin or azithromycin with rifampin
  • treat until resoluved on rad and CBC / fibrinogen normal
  • 4-12 w
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21
Q

what are some complications of giving erythromycin and rifampin to foals?

A
  • some resistance
  • hyperthermia
  • tachycardia
  • increased liver enzmes
  • fatal colitis in dam if she licks foal
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22
Q

how can you prevent rhodococcus?

A
  • difficult as shed in faeces
  • increase ventilation
  • decrease dust
  • rotate pastures
  • collect manure
  • isolate infected
  • try prophylaxis with hyperimmune plasma
  • check TPR, monthly CBC and fibrinogen
  • Screen rads / US
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23
Q

what is the intestinal form of rhodococcus?

A
  • ulcerative entercolitis with mesenteric lymphadenitis and abscess formation
  • from swallowing infected sputum
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24
Q

what are the signs of intestinal rhodococcus?

A 
depression
fever
diarrhoea
colic
wt loss
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25
Q

what can equine rhinovirus cause?

A

subclinical / mild URT signs in young horses

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26
Q

what is the pathogenesis of equine viral arteritis?

A
  • venereal or droplet spread
  • stallions can be chronic shedders
  • 3-14d incubation
  • replicates in macrophages then travels to local LN - leucocyte associated viraemia - virus localising in endothelial cells - necrotising arteritis - oedema and haemorrhage
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27
Q

what are the signs of EVA?

A 
abortion and stillbirth
fever
anorexia
oedema
lacrimation
conjuctivitis
nasal discharge
coughing
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28
Q

how can you diagnose EVA?

A

blood serology
nasal swabs / semen for viral isolation and PCR
*notifiable in stallions / mares inseminated in last 14 d

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29
Q

how can you prevent EVA?

A

vaccinate

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30
Q

what can cause profuse epistaxis

A

GP mycoses - aspergillus nidulans

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30
Q

how can you diagnose paranasal sinusitis?

A
  • reduced resonance on percussion
  • sinus and facial swelling
  • reduced airflow
  • rads
  • CT
  • sinuscopy
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30
Q

what can cause GP disease?

A

GP empyema from strangles
GP catarrah (infl - - excessive mucus)
mycosis - aspergillus nidulans
neoplasia

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30
Q

where would you see a swelling associated with GP disease?

A

viborgs triangle

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30
Q

how do you diagnose GP disease?

A

endoscopy

rad

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30
Q

how can you treat GP disease?

A
  • medical - pouch lavage and abx
  • remove chondroids before lavage or else get mushy
  • surgical drainage
  • tacheostomy if dyspnoeic
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30
Q

What are common sites of URT obstruction?

A

Nostrils - alar collapse, incomplete dilation

Nasal passage - septal disease, small passage, eruption bumpbs, mass lesion

Sinuses - cysts, mass

Pharynx - DDSP, postural compression, cysts

Larynx - RLN , epiglottic entrapment, arytenoid chondroitis

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30
Q

what disease can cause abnormal resp noise / poor performance?

A

DDSP - dorsal displacement of the soft palate

pharyngeal cysts

RLN - recurrent laryngeal neuropathy

Epiglottic entrapment

arytenoid chondritis

dynamic obstruction

foal stridor

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30
Q

what is DDSP?

A
  • dorsal displacement of the soft palate
  • common in the young horse
  • the palate is normally buttoned onto the larynx forming an airtight seal
  • in DDSP the palate moves dorsally towards the epiglottis during exercise causing a functional obstruction and increased resistance to airflow
  • most commonly due to neuromuscular dysfunction
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30
Q

what are common signs of DDSP?

A
  • choking down (when airway blocked)
  • expiratory stertor
  • decreased performance
  • mouth breathing
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30
Q

how can you diagnose DDSP?

A

dynamic endoscopy at exercise

-assess GP

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30
Q

how do you treat DDSP?

A
  • treat concurrent GP disease
  • keep mouth closed during exercise to maintain negative pressure
  • Tongue-tie
  • cornell collar to mimic thyrohyoideus muscle
  • llewelyn procedure
  • thermal palatoplasty - stiffen soft palate
  • laryngeal tie forward
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30
Q

what is RLN?

A
  • recurrent laryngeal neuropathy
  • degenerative axonopathy of the recurrent laryngeal nerve
  • normally left side affectes
  • impaires function of cricoarytenoideus dorsalis muscle and primary abductor of the arytenoid cartilage
  • get airway collapse
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30
Q

what are the signs of RLN?

A
  • ok at rest or low level exercise
  • inspiratory stridor with exercise
  • impaired athletic performance at high levels of exercise
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30
Q

how is RLN graded in resting, unsedated horses?

A

Grade 1 = synchronous full abduction of both arytenoid cartilages

Grade 2 = asynchronous movement of L arytenoid cartilage. Full abduction of the L arytenoid cartilage inducible by nasal occlusion

Grade 3= asynchronous movement of L arytenoid cartilage. Full abduction cannot by induced.

Grade 4 = marked asymmetry at rest. no substantial movement of the L arytenoid cartilage

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30
Q

how do you treat grade 3C and grade 4 RLN?

A

laryngoplasty (tie cartilage open) and ventriculocordectomy

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30
Q

what are complication after RLN surgery?

A

non-protected airway so can get cough and aspiration pneumonia etc

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30
Q

What is epiglottic entrapment?

A

envelopment of the epiglottis of the subepiglottic mucosa and aryepiglottic folds

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30
Q

what are the signs of epiglottic entrapment?

A

expiratory stridor

reduced performance

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30
Q

how do you surgically treat epiglottic entrapment?

A

midline division of entrapping tissue

  • can get re-entrapment
  • the correction may predispose to DDSP
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30
Q

what is arytenoid chondritis?

A

chronic infection of the cartilage resulting in thickening and intraluminal granulation

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30
Q

what are the signs of arytenoid chondritis?

A

inspiratory stridor with exercise

30
Q

how can you treat arytenoid chondritis?

A

excision of intraluminal protuberances

-parital / complete removal of affected cartilage

30
Q

what is choanal atresia?

A

membrane retained over nasopharynx in foals

30
Q

what disease can present as epistaxis?

A

progressive ethmoidal haematoma (PEH)
GP mycosis
fungal sinusitis

30
Q

what is progressive ethmoidal haematoma?

A

-progressively enlarging, non-neoplastic mass lesion originating in ethmoid turbinate

30
Q

how can you diagnose PEH?

A

histology - resp mucosa capsule, stroma of blood, fibrous tissue, macrophages and haemosiderocyts

endoscopy - smooth green-black to red-brown mass

Rad / CT

30
Q

how can you treat PEH?

A

radical excision
will recurr
laser to thermally destroy
intralesional formalin causing mass to slough -careful if through cribiform plate as will get into brain

30
Q

why do you get epistaxis with GP mycoses?

A

injury of internal carotid a
external carotid a
maxillary a

30
Q

how can you classify nasal discharge?

A
  • character - serous/ purulent etc
  • laterality
  • odour
30
Q

what does a unilateral nasal discharge tell you about its origin?

A

likely to be more rostral to the nasal septum

30
Q

what nasal discharge is likely to have no odour?

A

LRT disease
sinusitis
pharyngitis
pouch empyema

30
Q

what nasal discharge is likely to have a foul odour?

A

dental disease
neoplasia
necrotic disease

30
Q

how can you classify an URT obstruction/noise?

A
  • constancy - fixed/ dynamic
  • quality - stridor / stertor
  • phase - insp/exp/both
30
Q

what are fixed lesions?

A

mass lesion
chondritis
strictures

30
Q

what are dynamic lesions?

A

RLN
DDSP
AEE

30
Q

what is stridor and what causes it?

A

narrowed airway

RLN
chondritis
mass lesion
stricture

30
Q

what is stertor and what causes it?

A

tissue vibration

DDSP
nostril problem

30
Q

what causes inspiratory noise?

A

RLN

30
Q

what causes expiratory noise?

A

DDSP

AEE

30
Q

What causes inspiratory and expiratory noise?

A

mass lesions

chondritis

30
Q

how can epistaxis be classified?

A
  • laterality
  • association with work
  • quantity
30
Q

what can cause exercise induced epistaxis?

A

EIPH

30
Q

what can cause epistaxis at rest?

A

GP mycosis
ethmoid haematoma
fungal sinusitis

30
Q

what can cause modest epistaxis?

A

EIPH
ethmoid haematoma
fungal sinusitis

30
Q

what disease can present as nasal discharge?

A

nasal passage disease - neoplasia / FB
paranasal sinusitis
guttural pouch disease
pharynx/larynx issues

30
Q

what can cause nasal passage disease?

A

bacterial / fungal infection of septum/turbinates
neoplasia
FB

30
Q

what are treatment options for nasal passage disease?

A
  • laser to resect
  • nasal septal resection
  • rhinotomy
30
Q

what can cause paranasal sinusitis?

A 
dental disease
bacteria
fungi
neoplasia
inadequate drainage
30
Q

what are some treatment options for paranasal sinusitis?

A
  • medical - sinus centesis and lavage and abx
  • surgical - sinoscopy and fenestration of ventral conchal bulla to encourage drainage
  • flap sinusotomy if more sever
  • treat dental disease
30
Q

how is RLN graded at exercise?

A

Grade A = full abduction

Grade B = not fully abducted from resting position

Grade C = dynamic collapse

30
Q

how do you treat grade 1 and 2 and 3A RLN?

A

no treatment

30
Q

how do you treat grade 3B RLN?

A

ventriculocordectomy (stops noise) +/- laryngoplasty

30
Q

how do you diagnose GP mycoses?

A

endoscopy and see blood exiting pharyngeal opening

rad - fluid line in pouch

30
Q

how do you treat GP mycoses?

A

ligation of vessels
systemic antifungals
supportive care

30
Q

what are signs of GP mycoses?

A
  • dysphagia (CN IX, X)
  • nasal dishcarge
  • Horner’s syndrome - symp trunk
30
Q

what are some diseases that can present at URT swelling?

A

atheroma
sinus cysts
sinus neoplasia
GP tympany

30
Q

what is an atheroma?

A

sebaceous cyst in nasal diverticulum

30
Q

how do you treat an atheroma?

A
  • normally just cosmetic
  • surgical excision en toto via nostril / over atheroma
  • drainage and chemical ablation of secretory lining
30
Q

what are signs of a sinus cyst?

A

sinus swelling
reduced airflow
nasal discharge
epiphora (excess tears)

30
Q

how do you treat a sinus cyst?

A

breakdown of cyst wall via sinusotomy

30
Q

what diseases causing URT swelling occur in 1-2 yo?

A

atheroma

sinus cysts

30
Q

what are signs of sinus neoplasia?

A 
sinus swelling
facial swelling
reduced airflow
nasal dishcarge
epiphora
pain
difficulty eating
30
Q

how can you treat a sinus neoplasia?

A

excise via flap sinusotomy and chemo

lateral obliteraion

30
Q

what is a common sinus neoplasia?

A

sq cell carcinoma

very aggressive

30
Q

what is GP tympany?

A

excessive accumulation of air in GP

30
Q

how can you get GP tympany?

A

congenital - abnormal formation of pharyngeal opening of pouch

acquired - swelling involving pharyngeal opening of pouch

30
Q

what are some signs of GP tympany?

A

tympanitic swelling
dysphagia
resp distress

30
Q

how can you treat GP tympany?

A
  • if unilateral fenestrate the median septum via viborgs triangle / transendoscopic laser / electro scalpel
  • if bilateral fenestrate median septum and restrict lateral lamina of auditory tube so air goes into nasopharynx and out
30
Q

what anthelmintics work against dictycaulus arnfieldi?

A

ivermectin every 8 weeks

moxidectin every 12 weeks

100
Q

what is normal jugular pulse and filling?

A

should fill not more than 1/3 up neck
when occluded should take 4-5 secs for veing to fill up
-if prolonged suggests reduced venous return

101
Q

common foal and weanling URT pathogens?

A

EHV 1+4
Equine influenza
step equi equi

102
Q

common foal and weanling LRT pathogens?

A 
EHV 1+4
Equine influenza
Bacterial pneumonia
strep. zooepidemicus
r.equi
strep equi equi
parascaris equorum
103
Q

common horse URT pathogens?

A 
Equine influenza
EVA
EHV1+4
strep equi equi
equine rhinovirus
104
Q

common horse LRT pathogens?

A 
Equine influenza
EHV 1+4
EVA
strep.zooepidemicus
strep.pneumonia
pasturella
actinobacillus
strep equi equi
105
Q

What are some common ddx for horse coughing?

A 
aspiration pneumonia
pleuropneumonia
pulmonary abscess
LSHF
epiglottic entrapment 
URT FB
106
Q

what are the clinical signs of RAO?

A 
intermittent
neutrophilia
bronchospasm
dyspnoea
poor performance
heave lines
107
Q

what is the pathogenesis of RAO?

A

lifelong condition

-hypersensitivity reaction to an allergen in the stable

108
Q

How can you diagnose RAO?

A
  • endoscopy to asses mucus amount and inflammation

- get tracheal sample and cytology - non-degenerate neutrophils, lots of mucus, curshmann’s spirals

109
Q

how can you control RAO?

A

bronchodilators
reduce mucus production
control environment
out in field

110
Q

what is the difference between RAO and SPAPD

A

RAO is allergen in stable

summer pasture associated disease is for allergen at pasture

111
Q

What are the signs of inflammatory airway disease and who is it common in?

A

cough
reduced performance

-young performance horses

112
Q

what causes and how can you treat inflammatory airway disease?

A

unknown definitive cause

  • decrease dust
  • Abx
  • interferon
  • corticosteroids
113
Q

What pathogens are common in bacterial pneumonia?

A

Strep. zooepidemicus and rhodococcus equi

114
Q

what are the signs of bacterial pneumonia?

A

pyrexia
cough
change on auscultation

115
Q

how can you diagnose bacterial pneumonia?

A
  • mucopurulent exudate in trachea
  • bronchointerstitial pattern on rads
  • degenerative neutrophils with intracellular bacteria
116
Q

Where is EHV often latent and what activates it?

A
  • bronchial Ln
  • submandibular LN
  • trigeminal ganglia

-stress eg lactating mares

117
Q

what are some signs of EHV?

A
  • abortion in last trimester
  • neuro signs
  • vasculitis
  • viraemia
118
Q

can you vaccinate against EHV?

A
  • not really as natural immunity is short lived

- also different Ag for different strains

119
Q

who is equine influenza common in?

A

2/3 Yo rachehorses

-highly infectious

120
Q

what does influenza virus attack?

A

ep cells of RT - loss of ciliated ep so get secondary bacterial inf (starts upper and may spread to lower)

121
Q

how long does influenza vax last and why is it needed?

A
  • 2-3m

- needed of jockey club and FEI

122
Q

What is clenbutarol and what is it used to treat?

A

for RAO

  • bronchodilator
  • increases mucociliary clearance
  • stabilises mast cells
  • improves airways secretions
123
Q

What are some anthelminitcs effective against dictycaulus arnfieldi in the horse?

A

oral ivermectin
oral moxidectin
oral fenbendazole

124
Q

what are some secondary bacteria in horses?

A

strep zooepidemicus
strep pneumoniae
actinobacillus sp
mycoplasma

125
Q

signs of EIV?

A

cough
pyrexia
depression

Year 3 respiratory (11 decks)

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