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Equine Medicine and Surgery > Lecture 25: equine lower respiratory disease: inflammatory > Flashcards

Lecture 25: equine lower respiratory disease: inflammatory Flashcards

(55 cards)

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1
Q

What is normal respiratory rate

A

8-12bpm

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2
Q

___should be twice as long ___ in normal breathing

A

Inspiration, expiration

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3
Q

___should be passive in normal breathing

A

Expiration

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4
Q

What are some signs of increased RR

A

Flared nostrils, prolonged expiration, grunts, abdominal push, noise, anxious facial expression

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5
Q

Asthma is mediated via ___, increased ___cells

A

IgE, mast cells

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6
Q

Cytokines are __in inflammatory airway disease

A

Increased

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7
Q

There is ___in the epithelial lining fluid in airway inflammation

A

Leukocytosis

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8
Q

What are some results of airway inflammation

A
  1. Decreased size of airway
  2. Mucus plug
  3. Broncospams
  4. Increases in airway wall collagen and smooth muscle
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9
Q

What are some signs of RAO

A

Increased expiratory effort at rest, flared nostrils, mucopurulent discharge, spasmodic productive cough, thin, crackles and wheezes, exercise intolerance

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10
Q

Horses with RAO tend to be >__yrs

A

7

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11
Q

What part of country is summer pasture associated RAO

A

Southern US

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12
Q

When and why does summer pasture associated RAO occur

A

Horses turned out in spring and summer, hot humid weather, high environmental contamination with fungal spores and grass pollens

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13
Q

Inflammatory airway disease typically affects who

A

Young horses in performance training, typically following virus insult

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14
Q

What is the predominant sign of inflammatory airway disease and some other signs

A

1 sign: Cough with exercise

Other: mucus in airways, prolonged exercise recovery, worsens in hot and humid weather

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15
Q

What is the best diagnostic for lower airway inflammation

A

Bronchoalveolar lavage

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16
Q

What is not a good diagnostic for lower inflammatory airway disease/ smaller airways

A

TTW

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17
Q

What sedative is good for BAL

A

Butorphanol-antitussive

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18
Q

How do you perform a BAL

A
  1. Pass tube until hit bronchus
  2. Trickle 1% lidocaine in trachea as you pass tube
  3. Fill cuff with air
  4. Instill 240ml of sterile saline
  5. Withdraw at least 50% back
  6. Submit for cytology
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19
Q

The presence of ___in a BAL confirms good sample

A

Surfactant

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20
Q

What are some BAL cytology findings indicative of RAO

A

Neutrophils >25%, mucus curschmann;s spirals- inspissated mucus casts

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21
Q

What are some BAL cytology findings indicative of Inflammatory airway disease

A

Neutrophils >5%, mast cells >2%, eosinophils >1%

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22
Q

What is the treatment the broad tx for RAO and inflammatory airway disease

A

Bronchodilator with steroid

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23
Q

You cant use bronchodilator without steroid because ___

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A

Rapid resistance

24
Q

What can you do to food to tx RAO and inflammatory airway disease

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A

Dampen hay, wet pellets, hay steamer, feed on ground

25
How do steroids tx RAO and IAD
Inhibit arachidonic acid pathway and limit production of leukotrienes and cytokines
26
What are some inhaled steroids to tx RAO and IAD
1. Fluticosone 2. Nebulized budenoside 3. Aservo equihaler
27
What are some systemic steroids to tx RAO and IAD
1. Dexamethosone 2. Prednisolone
28
What systemic steroid should you avoid in tx of RAO and IAD d/t laminitis
Triamcinolone
29
How do bronchodilators tx RAO and IAD
Increase ciliary beat frequency, decrease mucus production and release of inflammatory mediators
30
Which bronchodilators are preferred: inhaled or systemic
Inhaled
31
What are some inhaled bronchodilators to tx RAO and IAD
Albuterol- B2 agonist, ipratromiun- PNS
32
What systemic bronchodilators can be used to tx RAO and IAD
1. Clenbuterol 2. Albuterol syrup 3. Atropine 4. Buscopan
33
How do systemic parasympatholytics tx RAO and IAD and what are 2 examples
Block muscadine acetylcholine receptors preventing bronchoconstrictions Atropine, buscopan
34
How do mast cell stabilizers work
Block Ca2+ channel preventing release of histamine and tryptase
35
What antihistamine is commonly used to tx RAO and IAD
Certirizine
36
What is the goal RR in tx RAO and IAD
<20bpm
37
What is the eventual outcome of RAO
Pulmonary fibrosis, hypertension, right sided heart enlargement and failure, cor pulmonale
38
What is the pathophysiology of EIPH
Pulmonary hypertension with low inspiratory alveolar pressure, secondary stress failure of capillaries, reduced compliance of vasculature
39
What is clinical sign of EIPH
Epistaxis
40
What radiographic sign is indicative of EIPH
Caudodorsal interstitial pattern
41
What is grade 0 EIPH
Normal
42
What is grade 1 EIPH
One or more flecks of blood
43
What is grade 2 EIPH
Single stream of blood
44
What is grade 3 EIPH
Multiple streams of blood
45
What is grade 4 EIPH
Multiple convalescing streams of blood, covering 90% and pooling at thoracic inlet
46
What drugs/tx can you do to prevent EIPH
Furosemide: decrease pulmonary arterial pressure Nasal strips
47
Interstitial pneumonia is thought to be __ or __etiology
Toxic or infectious
48
What are some things that can cause interstitial pneumonia
Perilla ketones, oxygen therapy, smoke, sillcosis, SIRS
49
What is clinical presentation for interstitial pneumonia
Dying, pulmonary edema, restrictive rapid breathing pattern, severe respiratory distress, hypoxemia
50
What method is diagnostic for interstitial pneumonia
Pulmonary biopsy
51
What drugs are used to manage interstitial pneumonia
1. Dexamethasone 2. Beclomethasone 3. Beta 2 agonist, parasympatholytic
52
Prognosis for interstitial pneumonia in adults is __ and in foals ___
Guarded, favorable
53
What is cause of interstitial pneumonia, pulmonary fibrosis
EHV-5
54
What is tx for pulmonary fibrosis, interstitial pneumonia
Valcylovir
55
What is prognosis for pulmonary fibrosis, interstitial pneumonia
Guarded

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