Basics of Equine Respiratory Diseases Flashcards Preview

Equine Medicine > Basics of Equine Respiratory Diseases > Flashcards

Flashcards in Basics of Equine Respiratory Diseases Deck (124):
1

Guttural pouch tympany cause

congenital, secondary to URT, nasopharyngeal orifice

2

Guttural pouch tympany C/S

non-painful, elastic swelling in retrophar
resp noise
cough and dysphagia

3

Guttural pouch tympany Tx

surgery, fenestate median septum, salpopharyngeal fistula

4

Guttural pouch empyemia cause

secondary to URT infections, commonly strangles

5

Guttural pouch empyemia common etiology

strep equi

6

Guttural pouch empyemia C/S

intermittent discharge
cough, dysphagia

7

Guttural pouch empyemia tx if pus

daily drainge and lavage
AM

8

Guttural pouch empyemia tx if chondroids

flush
basket retrieval in surgery

9

Guttural pouch mycosis most important clinical sign

serious epistaxis with no related trauma or exercise

10

Guttural pouch mycosis cause

aspergillus spp. in dorsocaudal medial compart.

11

Guttural pouch mycosis tx

occlude artery affected

12

Guttural pouch mycosis prognosis

over 90% if technology o occlue

13

Strangles cause

strep equi equi

14

Strangles clinical signs

urt inflamm and discharge
abscessing lymph nodes
abrupt fever

15

Strangles who it hits most

young, on breeding farms

16

Strangles Dx

**Culture
PCR - doesnt tell if shedding
Serology - can't tell if Vx or infection

17

Strangles Tx with early

just let it run unless it causes dysphagia
If it does, AM therapy but risk bastard

18

Strangles Tx with LN abscesses

drain, lance if needed
isolate animal
flush

19

When to AM Tx Strangles

lymph node abscessing
advancd clinical signs

20

What to do with horses exposed to strangles

AM to prevent seeding

21

Strangles common complications

purpura hemorrhagica
metastatic spread - bastard
myositis
agalactia

22

Strangles - treating purpura

corticosteroids and supportive care
maybe AM

23

Strangles - treating bastard

probably just AM

24

Strangles prevention

isolate new arrivals (2 wks)
rectal temps in outbreaks
immediate isolation if something happens
Do nasal swabs, washes
vaccinate
water trough seperation (common cause of spread)

25

Strangles re-infection rate

75% within 5 years of getting it.

26

Strangles culture tells if shedding or not, but what is interesting about PCR?

3 X more sensitive
Looking for SeM (Antiphagocytic M protein)

27

Strangles vaccination protocols

2-3 dose primary for killed bacterin starting at 6 months of age
boosters annually 4-6 weeks before foaling

OR

Attenuated live intranasal (pinnacle by Wyeth) under the same program but not 4-6 wks before foaling

28

Influenza presentation/ clinical signs

sudden onset, spreads quickly
young horses
dry, harsh cough for 1-3 weeks
pyrexia for 4-5 days (biphasic - back and forth)
reluctant to move from myalgia, myositis and limb edema
SEVERE and possible die in 48 hours

29

Influenza pathogenesis

N changes MC apparatus --> H moves in and binds to sugars on epithelial cells --> replication --> cell necrosis/desquamation --> inflammation --> edema, lymphocytes --> 6 weeks repaired

30

Influenza Dx

Viral isolation
PCR
ELISA

31

Influenza Tx

symptomatic
treat the secondaries if possible

32

Influenza control

Vx
horses will shed for 7-10 days after last sign of illness so watch for that and then it's gone

33

Herpevirus (Rhinopneumonitis) etiology

EHV-1 and EHV-4

34

Herpevirus (Rhinopneumonitis) general C/S

URT edema, hyperemia, petech hem

35

Herpevirus (Rhinopneumonitis) 1 C/S

neurologic, reproductive, and respiratory signs
myeloencephalopathy
neonatal deaths, abortions, weak foals
fever, mucopur discharge

36

Herpevirus (Rhinopneumonitis) 1 neonatal death/weak foals have...

IS pneum
hypoplastic thymus and spleen

37

What is not a dependable C/S of EHV 1, 4

coughing

38

When do they get EHV

around training starting, 1 year

39

Herpevirus (Rhinopneumonitis) prevention

Vx for 1 and 4 - mod live, divalent killed
maternal Ig for a month

40

Herpevirus (Rhinopneumonitis) Vxs don't prevent

abortions or neurologic disease

41

Herpevirus (Rhinopneumonitis) abortions are tricky because

the serology is gone because titer is short-lived

42

Equine Viral Arteritis etiology

arterivirus

43

Equine Viral Arteritis outbreaks with

respiratory and abortions

44

Equine Viral Arteritis C/S

subclinical to death
pyrexia, anorexia, depression
edema in funny places (eye, scrotum, limbs)
dyspnea cough and discharge
tearing up

45

Equine Viral Arteritis C/S in neonatal foals

severe resp
lots die
fever
leukopeni, thrombocytpeni

46

Equine Viral Arteritis neonatal PM

IS pneum, lymphocytic arteritis and periarteritis
renal tubular necrosis

47

Equine Viral Arteritis differentiates from influenza with

lymphocytic arteritis (EVA)
lymphocytic infiltration to IS space

48

Equine Viral Arteritis abort when?

3-8 wks after infection, late

49

Equine Viral Arteritis can stallions transmit?

yes

50

Bacterial Pneumonia etiologies

strep zoo ****
strep equi
pasteurella, ecoli, pseudo, kleb, enterbac (complicating things)
anaerobes (clost, bact)

51

Bacterial Pneumonia acute C/S

fever
tachypnea
discharge
coughing
exercise intolerance

52

Bacterial Pneumonia chronic c/S

acute signs
weight loss
decreased appetite

53

DDx for infectious pulmonary dysfunction

Bacterial
viral
fungal, aspergillosis follows GI Dz
parasitic

54

DDx for non-infectious pulmonary dysfunction

RAO
IAD
Neoplasia (LSA, Mets)

55

Common mets to lungs

renal/gastric carcinoma
melanoma

56

Dx of Bacterial Pneumonia special features (besides the PE, U/S, regular Clin path, TTW, Thor rads)

end ins crackles
expiratory wheezes
ascult/percuss/rads/us --> pleural effusion

57

Causes of end inp crackles

transient atelectasis
secretions

58

causes of exp wheezes

inflamed/narrowed airways from secretions

59

Sounds to be heard with PPneum

rubbing sounds
nothing on the ventral thorax (line)

60

What to do with pleural effusion?

drain it, culture it, cytology. Likely not as good as TTW

61

Bacterial Pneumonia pathophysiology

defense gone - MC clear, PAMs, CMI/hum
inhaled something and spread from there

62

Bacterial Pneumonia tx

do C/S first from TTW
Gr - --> aminoglycosides
GRam + --> penicillin
anaerobes --> metronidazole

Common Pen-Gent

63

EMPF (Equine Multinodular Pulmonary Fibrosis) etiology

gamma herpes virus - same as MCF
EHV-5

64

EMPF (Equine Multinodular Pulmonary Fibrosis) definitive/Histologic lesions

IS lung, up to 5 cm diameter fibrosis
only in alveolar parenchyma --> inflamm cells but still the right architecture

65

EMPF (Equine Multinodular Pulmonary Fibrosis) Tx

supportive
AM, AV,
Pain control
steroids

66

EMPF (Equine Multinodular Pulmonary Fibrosis) prognosis

76% die

67

DDx for foal pneumonias

all the adult causes
rhodococcus equi
actinobacillus equi (sepsis)
e coli (sepsis)
strep equi zooepidemicus ***** most common
anaerobes

68

What do we know about bacterial pneumonias in foals?

most frequently in under 1 month
most commonly a manifestation of septicemia (so when sepsis, worry about pneumonia)

69

How is the diagnostic approach different for neonatal foals with pneumonia than older foals and adults? So what are our mainstays?

there will be tachypnea and increased respiratory effort but that may be all
NO lung sounds or mucous necessarily.

Our mainstays are the PE, thor rads, blood gas and cultures,

70

what are some special cellular/immunity characteristics in neonatal foals that may contribute to bacterial pneumonia

less cells (Macrophages) in the BAL by 3-6 weeks
mostly macrophages there
maternal ig are waning, and the amount they had in the first place is important

71

How to diagnose bacterial pneumonia in the older foal?

TTW, thor rads, and thor U/S

72

Who does undiff. RTD hit

80-90% 4-5 mo foals

73

Undiff RTD etiologies

strep zoo***
staph epidermidis
r. equi
maybe viruses

74

Undiff RTD clinical signs

crackles, wheezes, mucopur discharge, cough, tachypnea

75

Undiff RTD rads will show

bronchoIS pattern

76

Undiff RTD BAL will show

neutrophils and possible cocci.

77

Undiff RTD Tx

ampicillin, penicillin, or TMS all BID

78

Undiff RTD prognosis

30% relapse, but hard to know

79

Rhodococcus equi pneumonia for sure clinical signs

fever
crackles,
wheezes
tachypnea

80

Rhodococcus equi pneumonia variable signs

mucopur nasal discharge
cough
respiratory distress

81

What is the clinical manifestion (PM would find for ex) of Rhodococcus equi pneumonia

chronic suppurative bronchopneumonia with extensive abscessation . They are remarkably able to deal with it considering how mild the signs are.

82

Rhodococcus equi pneumonia Dx (Need)

Clinical signs
PCR - especially the presence of the VAP-A gene
Cytology from TTW

83

Rhodococcus equi pneumonia Txs. Which is better?

6-8 wk minimum Erythromycin and rifampin
OR
azithromycin and clarithromycin (better concentriaons in the BAL cells and pulmonary epithelial lining)

84

Rhodococcus equi pneumonia Dx (help with it)

rads - alveolar, and abscesses
serology showing exposure
US showing abscesses
CBC and Fibrinogen

85

What is the source of contamination and route of infection?

foals feces, and inhaling dust and virulent r. equi

86

When does Rhodococcus equi pneumonia hits these guys?

2-5 months old. It is the most devastating of dz from 3wk to 5 month foals

87

Rhodococcus equi gram, behaviour, and site of replication/habitat

grm pos,
facultative IC pathogen
replicates in pulmonary macrophages

88

Rhodococcus equi pneumonia most important epidemiological point

Overcrowding, dusty conditions predispose, especially with related weather changes

89

Rhodococcus equi comes from?

the soil - lives there a long time

90

Acute respiratory Distress Syndrome is also

Bronchointerstitial pneumonia (this pattern will be on rads too)

91

Acute respiratory Distress Syndrome hits who

1-7 months of age

92

Acute respiratory Distress Syndrome clinical signs

tachypnea, increased resp effort, cyanosis
hypoxemia, hypercapnia --> respiratory acidosis

93

Acute respiratory Distress Syndrome Tx

NOT AM because will not respond
GIve O2, bronchodilators and steroids

94

Acute respiratory Distress Syndrome prognosis

guarded, especially for athletics
tend to die in 1-2 days

95

Acute respiratory Distress Syndrome cause

we don't know (looks like r equi and pneumocystis carinii)

96

IAD important characteristics

mucoid/mucopur exudate in nasopharynx, trachea, and bronchial bifur
AND
non-septic inflammation

97

IAD is mainl yin

young, performance horses

98

How many coughing horses have IAD

85%

99

IAD cause?

related to RAO?
unknown
dust, molds, pollutants
possibly low grade persistent infections

100

IAD clinical signs

mostly subclinical, but
poor performance
coughing
NOT febrile
MAYBE EIPH evidence

101

IAD Dx

endoscope for exudate in the airways
and R/O other causes
BAL

102

IAD BAL will be significant when...

Mast cells >2%
PMNs cells >5%
or eosinophils > 1%

103

IAD Tx

Envirnomental stuff: turn out to pasture, rest them, decrease all exposure

Steroids - but we need to know there is not an underlying problem first

Bronchodilators
Sodium cromoglycate (if mast cells are the problem --> inhibit them)
Decrease EIPH

104

RAO (not COPD) hits

middle-aged horeses

105

RAO (not COPD) is associated with

stabling
hay, straqw and molds
rarely summer pastures
Hypersensitivity? not really.

106

RAO (not COPD) etiologies

organic dust
hypersensiticvity to poorly cured hay
aspergillus fuigatus
faenia rectivirgula
some pollensv --> SPAOPD

107

RAO (not COPD) pathogenesis if a hypersensitivity

exposure to allergens --> asymp to clinical in 4-6 hours --> neutrophil influx --> clinical signs (mucopurulent nasal discharge, exp effort, heave line, incr. RR, Advent lung sounds, etc)

108

RAO (not COPD) pathogenesis if a chronic bronchiolitis

mucopur in airways --> bronchospasm --> peribronchiolar infiltration --> goblet cell hyperplasia and viscous mucus

109

RAO (not COPD) pathogenesis if a non-specific hyper-responsiveness

cold air, Nh3, exercise

110

RAO (not COPD), basically what happens

neutrophil accum --> changes walls or airways --> then mucous accum. --> bronchospasm --> les lung compliance ---> lung resistance --> increase work of breathing --> arterial hypoxemia w/o hypercapnia

111

RAO (not COPD) pathogenesis changes acutely and chronically how?

acute- edema in airway causes mucous accumulation
Chronically - airway remodelling causing mucous metaplasia, smooth muscle hypertrophy, peribronchial fibrosis and inflammation

112

RAO (not COPD) Clinical signs

chronic spont. cough
mucopur nasal discharge
expi effortt
heave line (hypertrophy of abdom oblique and rectus abdominus
higher RR
advent lung sounds
doesn't like exercise
weight loss
NOT A FEVER

113

RAO (not COPD) Dx

History and C/S
Wheezes and crackles on exp
Expanded lung field
bronchointerstitial pattern
Endoscope
TTW - neutrophils/copious mucous
BAL - for increase neutrophils, nondegen, non-septic inflammation
Atropine/Glycopyrrolate test (GP is LA and 2X potency)

114

What are normal levels of neutrophils on BAL

115

RAO (not COPD) treatment

Environmental management
Corticosteroids
Bronchodilators
Mast cell stab (disdoium cromoglycate again)
mucolytics and kinetics
maybe AM

116

Because of the possibility of hypersensitivity causing RAO (not COPD), Dx may include

Intradermal skin testing and
serum allergen testingf

117

What are the mucolytics and kinetcs?

dembrexine hydroCl (sputolysin)
acetylcysteine

118

EIPH is characterized by

strenuous exercise associated with extravasation of RBCs from pulmonary vasc into the IS space and alveolie and airways

119

EIPH shows in which part of the lung

caudal dorsal

120

EIPH only consistent finding is

a direct consequence of intense exercise

121

EIPH potential causes/pathogenesis

increase cap pressure--> decrease IPleural pressure
abdominal contents hit the dorsocaudal lobe
pulmonary hypertension to being with

122

EIPH clinical signs

excessive swalloing
10% actually bleed
decreased performance
some coughing and labored breathing

123

EIPH Dx and what to see with the tests

Hx and PE
Endoscope WITHIN 90 MINUTES OF EXERCISE to see blood in the trachea
BAL - hemosiderophages, RBCs, neutrophils (degen and not degen), maybe bacteria
Rads for IS pattern

124

EIPH Tx (there are a lot of them but the main ones are..)

Furosemide
Nasal strips (seem to bring down 30-40%)
post-race anti-inflammatories/corticosteroids/bronchodilators--to prvent IAD
AM because blood is a good agar for bacteria