Flashcards in CS: Cough Deck (22):
What is ivermectin effective against? (horse parasites)
- Large strongyles (redworms),
- adults and 4th larval (arterial) stages of Strongylus vulgaris,
- adults and tissue larval stages of S. edentatus
- adults of S. equinus.
What does scanty growth of E.coli from the tracheal aspirate suggest?
Not significant - although not a normal 'commensal' of the RT, this is not wholly abnormal as it is present in the GIT.
What does a BALV with a high cellularity (36% neutrophils suggest)?
Should be <15% so high.
How are RAO and IAD diferentiated?
Typically done on signalmnet - IAD in younger horses, RAO seems to have a genetic component unlike IAD.
RAO: neutrophils >15%
IAD, neutrophils, eosinophils or mast cells present.
How should RAO be treated? 4
- Environment changes (reduce dust)
- Reversal of bronchoconstriction (oral or inhaled clenbuterol)
- Decrease pulmonary inflammation (oral prednisolone, a steroid, best given inhaled but can also be given IV but greater risk of side effects)
- Decrease pulmonary mucus accumulation
Why does clenbuterol have a lower efficacy if you use with steroids such as prednisolone?
How quickly does clenbuterol work?
within 5 minutes (but always administer any other drugs, eg. steroids, after)
What other management changes can be made for RAO?
- Soak the hay prior to feeding
- Avoid round bale hay ( major cause of RAO)
- Complete commercial feeds eliminate the need for roughage.
- Hay cubes and hay silage
- Stable should not be in the same building as an indoor arena.
- Hay should not be stored overhead.
- Perhaps turn out to pasture more (day and night)
- Addition of good ventilation to the stable
T/F: NSAID, antihistamines, and leukotriene-receptor antagonists have all failed to demonstrate therapeutic benefit in RAO.
Side effects - clenbuterol
Sweating (due to action on the beta-2-receptors to relieve bronchoconstriction but these receptors are also present in skin.
Tachycardia (beta-2-receptors also present in heart)
Side effect - systemic steroid
Laminitis (if you have a horse at risk of laminitis associated with systemic steroids you may consider inhaled steroids from the outset but expensive).
T/F: there is a risk of iatrogenic cushings in horses given inhaled or systemic steroids
True - make sure to wean them off so there is no sudden drop but there is no protocol for this.
What do elevated fibrinogen and SAA suggest on biochemistry results?
Both APPs so suggests an inflammatory problem. You can't differentiate between septic and non-septic causes of inflammation on this basis.
Which 2 ABs are the most protected for human health?
Cephalosporins and Fluoroquinolones
What should you do if you have a bacterial pneumonia, run a culture and sensitivity test and find that the only agent that treats both bacteria that are implicated is a cephalosporin or fluoroquinolone.
Don't use either as 1st line treatment. Instead use ABs that target the different implicated bacteria separately.
What is the main side effect of gentamycin (AB) in horses?
What is the MIC for ABs for most equine pathogens?
T/F: it is not uncommon for horses with an infection to be treated and then have an inflammatory lower airway disease.
Treatment - bacterial pneumonia that has cleared followed by LRT inflammation.
Rest, environmental management, mucolytics, bronchodilators, (neutroceuticals). Steroids – own more indicated (infection cleared). Use inhaled bronchodilator and steroids because the inflammation problem is local.
What do these results suggest ( High globulinaemia, high APPs, total WBC high )?
Treatments - EIV - 3
• Rest, isolate (prevent other horses becoming infected).
• NSAIDs – the horse is sad! Flunixin, phenylbutazone (not for this horse, but it tales it out of the food chain, doesn’t mean you can’t, but it would take an income source away from this owner), meloxicam.
• ABs – prophylactic – not indicated because although dull, not eating and unhappy, it is only a small proportion of horses that will acquire a secondary infection so don’t blanket treat in the interest of AB resistance.