Respiratory disease of the foal and weanling

Question 1

T/F upper respiratory tract disease is common in foals

Answer 1

False- lower respiratory disease

Question 2

List 5 risk factors of lower resp tract disease in foals

Answer 2

Systemic sepsis (FPT)
Congenital abnormalities
Meconium aspiration
Milk aspiration
Birth trauma

Question 3

Describe how to treat acute respiratory distress syndrome in foals

Answer 3

Intranasal oxygen,
Ventilation
Anti-inflammatories – corticosteroids
Broad spectrum anti-microbials

Question 4

what is the prognosis for foals with Acute Respiratory Distress Syndrome

Answer 4

poor

Question 5

what is meconium aspiration syndrome

Answer 5

respiratory distress in a foal born through amniotic fluid stained with meconium

Question 6

List 5 things that meconium aspiration can lead to

Answer 6

Mechanical airway obstruction
Regional air trapping
Surfactant inactivation and displacement
Chemical pneumonitis and alveolitis
Persistant pulmonary hypertension

Question 7

Describe how to treat meconium aspiration syndrome

Answer 7

clear the nasal passages and pharynx
intubate and suck anything from past the pharynx
intranasal oxygen
mechanical ventilation
anti-inflammatory
pentoxyfylline
treat secondary bacterial infection

Question 8

List 4 things milk aspiration can occur secondary to

Answer 8

Generalised weakness
Poor suckle reflex
Dysphagia
Congenital abnormalities

Question 9

Describe how to diagnose milk aspiration in foals

Answer 9

history of milk regurgitation
PE findings
Endoscopic examination of URT
Thoracic radiography

Question 10

Describe how to treat milk aspiration

Answer 10

Correction of the cause
Naso-oesophageal feeding tube
Broad spectrum antimicrobial therapy- to protect against secondary bacterial infections

Question 11

Describe what is seen on radiographs with milk aspiration

Answer 11

Increased soft tissue opacity
Alveolar pattern

Question 12

where do most rib fractures occur in foals

Answer 12

Most commonly at the costochondral junction or immediately dorsal to it

Question 13

describe a flail chest in foals

Answer 13

occurs when foal has 2 rib fractures which results in section of rib cage becoming separated from thoracic wall

Question 14

List 2 things that are seen on physical exam with rib fractures

Answer 14

Crepitus at site of fracture
Auscultation – grinding or clicking sound

Question 15

what is the best way to diagnose rib fractures in foals

Answer 15

ultrasound
more sensitive than radiography in these cases

Question 16

Describe how to treat rib fractures in foals

Answer 16

box rest
avoidance of pressure during handling
analgesia
surgical repair- if multiple, of risk of damage to thoracic viscera

Question 17

what age of foals is viral pneumonia more common in

Answer 17

older foals

Question 18

List the causes of viral pneumonia in foals

Answer 18

EHV-1
EHV-4
Equine Influenza
Equine arteritis virus
Equine adenovirus

Question 19

which viral pneumonia presents similar to neonatal sepsis

Answer 19

EHV

Question 20

Describe how to diagnose EHV in foALS

Answer 20

pCR testing nasal secretions or whole blooddescr

Question 21

describe how to treat EHV in foals

Answer 21

Anti-virals (acyclovir, valacyclovir) – some efficacy in less severely affected foals
Supportive care

Question 22

what causes parasitic pneumonia in foals

Answer 22

larvated eggs of Parascaris spp

Question 23

Describe how to treat parasitic pneumonia in foals

Answer 23

ultimately self limiting
Anthelmintic treatment recommended- Fenbendazole or Pyrantel should be used

Question 24

what bacteria most commonly causes bacterial pneumonia in neonatal foals

Answer 24

E.coli
gram negative

Question 25

what is most common cause of bacterial pneumonia in foals aged 1-6 months

Answer 25

Strep equi subs. Zooepidemicus Rhodococcus Equi - second most common cause

Question 26

describe how Rhodococcus Equi is spread

Answer 26

inhalation foals uniquely suscepttible

Question 27

List the clinical signs associated with Rhodococcus Equi

Answer 27

insidious in onset lower resp tract infection fever lethargy coughing tachypnoea dyspnoea extrapulmonary disorders common- e.g. D+

Question 28

How to diagnose Rhodococcus Equi

Answer 28

ultrasound and radiography Transtracheal wash- cytology and PCR

Question 29

describe the scoring system for Rhodococcus Equi

Answer 29

Via ultrasound No. of abscesses identified is recorded and diameter measures – totaled to generate a total abscess score (cms) Foals less than 8-10cm typically not receiving treatment

Question 30

Describe how to treat Rhodococcus Equi

Answer 30

resp support NSAIDs cool shaded area antimicrobial therapy - Combination of a macrolide and rifampin Prevention - hyperimmune plasma