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Equine > Respiratory > Flashcards

Respiratory Flashcards

1
Q

pathogens of foal pneumonia 1-10mnths

A
  1. Bacteria
    - Strep equi subsp. zooepidemicus
    - Rhodococcus equi
    - Pasteurella sp, Bordetalla bronchiseptica, Actinobacillus
    - Salmonella, Klebsiella, Pseudomonas
    - Anaerobes
  2. Viruses: EHV-4
  3. Mycoplasma
  4. Parasites/Fungi
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2
Q

Empirical ABs for foal pneumonia

A
  • Penicillin
  • TMS
  • Doxycycline
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3
Q

age frame for rhodococcus equi bronchopneumonia

A

3wks - 6mo

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4
Q

non-resp form of Rhodococcus equi causes

A
  • abdominal abscessation
  • infectious synovitis (lame)
  • immune-mediated non-septic polysynovitis (not lame)
  • uveitis
  • ulcerative lymphangitis
  • placentitis
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5
Q

dx of rhodococcus

A
  1. CS
  2. Bloods
  3. Imaging; US, rads
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6
Q

tx rhodococcus

A
  1. Erythromycin + rifampin
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7
Q

US screening of rhodococcus is:

A
  • decision to tx based on number and size of abscesses if absence of CS
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8
Q

strangles pathogen

A

Streptococcus equi subsp. equi

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9
Q

Strangles CS progression

A
  1. Initial
    - depression, reduced appetite, fever
    - mucopurulent nasal discharge
    - pharyngitis and laryngitis
    - cough
  2. Later signs:
    - suppurative lymphadenopathy: sumandib + retropharyngeal (and dysphagia secondary to massive LNs)
    - purulent nasal discharge
    - asphyxiation
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10
Q

why is it appropriate to quarantine horses for 14-21days re. strangles?

A

initial signs occur 3-14days after exposure

– also asymptomatic carriers

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11
Q

what are bastard strangles?

A

metastatic strangles to abdominal LNs/haematogenous spread

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12
Q

dx of strangles

A
  1. Culture
  2. PCR infectious diseases panel: EVA, equine influenza, EHV1/4, Strep equi subsp equi
  3. Serological tests: antibodies to M-protein portion of the bacteria
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13
Q

tx of strangles in animal w/ systemic signs but no LN enlargement

A
  1. Pen 22mg/kg IM BID

3. NSAIDs: bute/flunixin/meloxicam

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14
Q

tx of strangles in horse w/ retropharyngeal LN abscessation resulting in airway compromise

A
  1. Pen +/- Rifampin
  2. NSAIDs
  3. Tracheostomy
  4. US guided/endoscopic LN drainage
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15
Q

what kills strep equi subsp. equi

A
  1. Heat, Povidone iodine, Chlorhex, Bleach

2. Pasture rest 4wks

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16
Q

site of strep equi subsp equi carriage?

A

guttural pouches

—> swab and tx positive animals w/ Pen + reculture

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17
Q

Strangles vaccines available in AUS

A
  • IM vaccines - minimise severity of disease, not protective assoc. w/ injection site xns –> 3 doses 2wks apart + annual
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18
Q

Define red, amber and green group when managing a strangles outbreak

A
  1. Red: CS
  2. Amber: exposed but no CS
  3. Green: not exposed to red group
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19
Q

protocol for horse entering a property re. strangles control

A
  1. ELISA blood test -> neg –> 2wks then rpt –> neg OKAY
  2. Any positives —> guttural pouch sampling + culture
  3. Guttural pouch positives –> tx
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20
Q

what is purpura haemorrhagica?

A
  • acute necrotizing vasculitis occurs in 1-2% strangles 2-4wks after acute infection
  • IgA combined w/ soluble protein (M-protein of Strep.equi subsp. equi)
  • immune complexes bind to neutrophils and mast cells causing release of cytotoxic products –> vasculitis
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21
Q

tx of purpura haemorrhagica

A
  • corticosteroids: dexamethasone
  • local cold hosing/pressure wraps
  • ABs to cover against persistent Antigen release
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22
Q

EIV incubation, shedding time

A

incubation 18hs to 7d
viral shedding 24hs after infection persists for 4-10days
CS 1-3days after exposure - resolve w/in 7-14days +/- cough 3wks

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23
Q

CS of EIV

A
  • fever >40degrees, peaks 2-4d
  • complete refusal of feed
  • dry non-productive and painful cough
  • lymphadenopathy
  • nasal discharge serous to mucoid after 3-4days
  • stiffness
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24
Q

dx of EIV

A
  • Antigen detection
  • Virus isolation: 1-2days after onset of signs only
  • Immunoassays
  • Reverse transcriptase PCR

NOTIFIABLE

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25
Q

tx of EIV

A
  1. Symptomatic: NSAIDs + secondary ABs if suspected

2. Rest 3-4wks min

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26
Q

vaccines types of EIV

A
  • inactivated strains

- mod. live strains

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27
Q

EHV-1 is associated with

A

abortion, neuro, perinatal, resp disease

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28
Q

EHV-4 is assoc. w/

A

resp. disease

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29
Q

Dx of EHV-4/1

A
  • virus isolation via nasopharyngeal swab
  • antibody detection -serology
  • PCR antigen detection (respiratory panel)
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30
Q

vaccines available against EHV-1 and EHV-4

A
  • inactivated vax avail in AUS

- live virus vax internationally

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31
Q

compare equine rhinitis A and B CS?

A 
A = fever (40degrees) 5d, nasal discharge, moist cough, mild regional lymphadenopathy
B = slight pyrexia, mild resp signs
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32
Q

EVA causes what in horses?

A

abortion - not an important resp. disease in horses.

Virus shed in semen

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33
Q

EVA CS

A
  • fever
  • conjunctivitis, periorbital oedema
  • cough/nasal discharge
  • body/limb oedema
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34
Q

EVA diagnosis

A
  • nasopharyngeal swab antigen detection
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35
Q

when are EVA vax indicated?

A

abortion storms only

- not avail in AUS/NZ

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36
Q

aerobic bacteria causing pneumonia adults

A
  1. Strep equi subsp. zooepidemicus, Strep penumonia
  2. Staph
  3. Pasteurella, Actinobacillus, B.bronchiseptica, Klebsiella, E.coli, Pseudomonas, Enterobacter
37
Q

anaerobic bacterial causes of adult pneumonia

A
  1. Bacteroides spp
  2. Clostridium spp.
  3. Eubacterium spp.
  4. Peptostreptococcus spp.
38
Q

when infectious aetiology suspected that has the potential to be life threatening - how should you get a sample (pneumonia)?

A

transtracheal aspirate (over transtrach wash via scope)

39
Q

what does fibrin in fluid look like?

A

echoic, wavy

40
Q

empirical ABs for adult pleuropneumonia

A

Pen, Gent, Metronidazole

41
Q

benefits of pleural drainage

A
  • improves ventilation
  • removes bacteria, inflam mediators and cellular debris
  • if not removed v. unlikely to resorb –> will result in increased fibrin deposition = poor prognosis
42
Q

tx of chronic pleural abscesses

A
  • rib resection

- intercostal incision

43
Q

complications/sequelae of pleuropneumonia

A
  • pulmonary abscessation
  • cranial mediastinal abscessation
  • bronchopleural fistulae/pneumothorax
  • laminitis
44
Q

cause of fungal pneumonia in WA

A

crypto gatii

45
Q

tx of fungal pneumonia

A
  1. Amphotericin B **caution - nephrotoxic

2. Fluconazole: >3months

46
Q

normal RR

A

8-20bpm

47
Q

what causes the heaves line

A

hypertrophy of rectus abdominus muscles –> heave line (obstructive breathing pattern)

48
Q

normal rebreathing bag exam

A
  1. Inc RR in 60 seconds
  2. Recover w/in 5 breaths
    * no coughs
49
Q

commonly used tests to invest. resp

A
  • endoscopy
  • resp. tract sampling: transtracheal, BAL, thoracocentesis
  • US
  • Rads (URT/foals)
50
Q

direct transtracheal aspirate technique

A
  1. Mid trachea btwn tracheal rings: 12G 2 inch large bore IV cath + 22 inch 6Fr polyprolylene catheter
51
Q

BAL good for

A

diffuse diseases/non-infectious eg. asthma

52
Q

non-infectious LRT disease

A
  • IAD
  • Heaves
  • EIPH
53
Q

non-infectious URT disease

A

pharyngeal lymphoid hyperplasia

54
Q

grades of PLH

A

G1 - small number of follicles over dorsal pharyngeal wall
G2 - many small white follicles, some larger, pink and oedematous
G3 - many large pink follicles, may extend to soft palate and dorsal pharyngeal recess
G4 - numerous pink and oedematous follicles packed in close alignment and covering the entire pharynx

55
Q

Mild equine asthma CS

A
  • no increased RE at rest

+/- poor performance/recovery/cough (exercise induced)/ serous nasal discharge

56
Q

mild heaves CS

  • -> moderate
  • –> severe
A

Mild: exercise intolerance
Mod: cough, incRR/RE, marked exercise intolerance
Severe: weight loss, heave line, nostril flare, expiratory dyspnoea

57
Q

BAL technique

A
  • sedation: butorphanol + LA infusion

- lavage: 250-500ml

58
Q

BALF cytology with severe asthma

A

> 35-50% neuts

59
Q

BALF cytology with mild asthma (IAD)

A

5-10% = neutrophilic IAD
Mast cell associated = >2-5%
Eosinophilic associated IAD >1-5%

60
Q

management aims of non-infectious resp. disease

A
  1. Primary = reduce exposure to the offending agent (trigger) that causes the inflammation
  2. Secondary = reduce the inflammatory response and hyper reactivity (bronchoconstriction) that occurs as a result of exposure
61
Q

environmental causative agents in severe asthma often include:

A
  • endotoxin
  • moulds
  • volatile gases

—> straw/hay

62
Q

eg. systemic corticosteroids to tx heaves

A
  • dexamethasone

- prednisolone

63
Q

eg. inhaled corticosteroids to tx heaves

A
  • fluticasone + salmetorol

- dexamethasone

64
Q

EIPH dx

A
  • exercised -induced epistaxis –> endoscopy post exercise + BAL
65
Q

management of EIPH

A
  1. Tx underlying equine asthma if present
  2. Rest (4-12wks)
  3. Train on diuretics: frusemide 1-2hrs prior to fast work
  4. Race sparingly, in warm weather
66
Q

tx of progressive ethmoid haematoma

A
  1. Sx excision via bone flap if large
  2. Laser ablation if accessible via endoscope
  3. Intralesional injection of 4% formaldehyde: if <5cm, q2-3wks until resolution
67
Q

drainage from all major sinuses can be achieved by trephine and lavage of which two sinuses?

A
  1. Frontal

2. Rostral maxillary

68
Q

common pathogen of primary sinusitis

A

Strep. equi subsp zooepidemicus

69
Q

causes of secondary sinusitis

A
  • sinus cyst
  • trauma/facial fx
  • progressive ethmoid haematoma w/in sinus
  • neoplasia
  • dental: apical tooth root infection, alveolar periostitis, patent infundibulum, tooth fracture
70
Q

tx of sinusitis

A
  • indwelling foley cath for lavage (1-2L saline SID or BID 5days)
  • systemic ABs based on C&S
  • feed off ground + light exercise
  • NSAIDs
71
Q

intermittent DDSP results when?

A
  • muscles of nasopharynx have abnormal contraction or weakness
  • air turbulence and neg pressures cause loss of palate control
  • during maximal exercise
72
Q

causes of persistent DDSP

A
  • CN damage; IX, X (pharyngeal branch(

- head trauma

73
Q

CS of DDSP

A
  • gurgling/choking down/tongue swallowing when riding

- poor performance

74
Q

conservative tx of intermittent DDSP

A
  • medical tx of URT inflam: dex + glycerin + DMSO + bute + AB (if indicated)
  • spell 2-3months
  • tack: tongue-tied, dropped noseband
  • change disciple/head position ie. dressage = band
75
Q

sx tx of intermittent DDSP

A
  • palatoplasty (stiffen soft palate)
  • epiglottis augmentation (stiffen position)
  • staphylectomy (soft palate caudal margin extension)
  • laryngeal advancement procedure (tie forward)
76
Q

compare simple and complicated epiglottic entrapment?

A 
simple = thin fold of mucosa overlying epiglottis w/ no inflammation
complicated = thickened, inflamed, ulcerated or adhered fold of mucosa
77
Q

roarer presentation

A
  • TBS, WBs, Clydesdales
  • M, >15hh, 3-7yo
  • left sided: recurrent laryngeal nerve –> atrophy of CAD and CAL –> paresis/paralysis of arytenoid cartilage and vocal cord
  • dynamic axial collapse –> exercise intolerance/poor performance + roaring sound/whistling
78
Q

Grades 1 RLN

A

normal symmetrical and synchronous movement, full abduction obtained and maintained

79
Q

Grade 2 RLN

A
  • asynchronous movement/flutter +/- intermittent resting asymm (2.1)
  • asym and async movement at rest, but full abduction obtained and maintained on swallow (2.2)
80
Q

grade 3 RLN

A
  • full abduction achieved but not maintained (3.1)
  • obvious asym, full abduction never achieved (3.2)
  • marked asym, minimal movement + full abduction never achieved (3.3)
81
Q

Grade 4 RLN

A

total paralysis of arytenoid cartilage (hanging in the airway)

82
Q

sx tx of RLN

A
  1. Ventriculectomy/cordectomy
  2. Prosthetic laryngoplasty “Tie-back”
  3. Partial arytenoidectomy
  4. Nerve-muscle pedicle graft for C1/C2 nerve transplantation
83
Q

which procedure achieves permanent abduction/stabilisation of the left arytenoid cartilage?

A

Prosthetic laryngoplasty (prosthesis replaces function of CAD muscle)

84
Q

list of dynamic upper respiratory tract obstructions diagnosed on exercising endoscopy

A
  1. Intermittent DDSP
  2. Axial deviation of the aryepiglottic folds
  3. Vocal cord collapse
  4. Laryngeal hemiplegia
  5. Nasopharyngeal collapse
  6. Palatal instability
  7. Ventromedial luxation of the apex of the corniculate process of arytenoid cartilage
  8. Epiglottic retroversion/flaccidity
85
Q

important structures in the guttural pouches

A
  • internal and external carotid arteries
  • CN IX, X, XII
  • cranial laryngeal nerve
86
Q

medical management of guttural pouch empyema

A
  1. ABs: systemic and local after lavage
  2. Lavage w/ saline daily
  3. Feed from ground - draining
87
Q

guttural pouch mycosis common pathogen

A

aspergillus

88
Q

sequelae of guttural pouch mycosis

A
  1. Fungal plaque over vessels –> epistaxis, exsanguination, death (1st bleed to fatal w/in 3wks)
  2. Fungal plaque over nerves –> dysphagia, horner’s, laryngeal hemiplegia, DDSP
89
Q

guttural pouch mycosis medical tx (indications)

A

ONLY if no bleeding

  • daily antifungal lavages via indwelling catheter
  • systemic antifungals

Equine (7 decks)

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