T2 Exam Flashcards
(35 cards)
Corneal Ulcer Classification
Superficial/uncomplicated
Complicated
- Non-healing >7days
- Penetrating
- Perforating
Corneal ulcer diagnosis
History, CS, ocular exam, positive fluorescein stain
How to treat a superficial, small, non-complicated ulcer sustained <2days ago?
- ABs e.g. chloramphenicol, tricin
- Systemic analgesia e.g. phenylbutazone
- Atropine (once off)
revisit in 2-3days
Corneal ulceration surgical options?
- debridement of melting and stromal abscesses
- Grafting
- Temporary tarsorrhaphies
- Enucleation
Steps when presented with a pruritic horse. (6)
- Skin scraping (superficial & deep)
- ectoparasites
Positive: treat
Negative: ascaricidal trial - Fungal culture
- detrmatophyte
Positive: treat
Negative: rule out - Bacterial infection
- cytology of papule fluid
- AB trial - Consider allergies
- insect bite trial - Adverse food reactions (food allergy)
- elimination diet - Atopic dermatitis
- serological/intradermal allergy testing
- response to therapy
Drugs for pain relief in a colic case
xylazine: 0.4-0.6mg/kg IV
(double dose for IM)
Flunixin 1.1mg/kg
- Only if we have a diagnosis otherwise masks pain so can’t cage prognosis
Fluid Therapy Calculation
Deficit= %dehydration x BW
Maintenance= 60ml/kg/day (adult)
= 100ml/kg/day (foal)
Ongoing losses= estimated NG reflux, Diarrhea frequency x volume
First half within first 3-6hrs (~5-10l/hr)
second half within 24hrs (1-2l/hr)
How much fluid would a 500kg horse require if its 10% dehydrated with high volume diarrhoea (1L every 2hrs) in the first 24hrs?
Deficit
= 0.1 x 500
= 50L
maintenance
= 0.06x500
= 30L
Deficit
= 1 x 12
= 12L
total = 92L
What are the radiographic signs of physeal dysplasia? (7)
- Physeal widening
- Irregular physis outline
- Sclerosis
- Bone lipping
- Asymmetry of metaphysis
- Wedging of epiphysis
- Asymmetry of cortical bone
At what age must you correct angular limb deformities of the Fetlock and Carpus/Tarsus?
Fetlock = 30-60days (closes ~90days)
Carpus/Tarsus = 6weeks-4m (closes around 6m)
Pyrrolizidine Alkaloid Toxicosis pathogenesis.
PAs alkylate nucleic acids and protein prevents cell division and protein synthesis results in formation of MEGALOCYTES. Fibrous tissue replaces parenchyma when megalocytes die = liver fibrosis CHRONIC NODULAR LIVER HYPOPLASIA
PA toxicosis Histopathological findings (3)
megalocytosis, bridging portal fibrosis and biliary hyperplasia.
Common plants containing PAs
- Paterson’s curse (Echium plantagineum)
- Rattlepod (Crotalaria crispata)
- Ragwort (Senecio spp) - not in AU
CS of hepatobiliary disease (6 common/6 uncommon)
Common = Icterus, weightloss, depression/lethargy, anorexia, colic, fever.
Less common = photosensitization, diarrhea, ventral oedema, ascites, encephalopathy, bleeding diathesis.
Liver enzymes for hepatocellular injury
AST, SDH, GLDH
Liver enzymes associated with Biliary injury/cholestasis
GGT, ALP
Suspected causes of Neonatal Maladjustment Syndrome
Maternal disease e.g.
- anaemia, lung/cardiac disease, cardiovascular shock (toxemia)
Placental disease
- premature placental separation, placental insufficiency, placentitis
Stage II labour
- placenta previa (red bag delivery), uterine inertia, dystocia, oxytocin
5 main differential for sick looking foals
- Sepsis
- Uroperitoneum
- Neonatal maladjustment syndrome
- Neonatal isoerythrolysis
- Prematurity
Most important bacterial cause of sepsis in foals
E.coli
In what circumstance would a horse with cardiac disease be unsafe to ride?
- Diastolic murmurs
- Aortic regurg until proven otherwise
- Risk of ventricular ectopy
- Systolic murmurs
- mitral valve regurg may lead to AF
- Bilateral murmurs
- VSD unsafe in unrestrictive
- Uncommon/sudden-onset murmurs
What are the types of perineal lacerations and their management?
First degree
- superficial mucosa and muscles of labia and vestibule
- local wound care e.g. AB’s, AI’s
- most will heal spontaneously
Second degree
- constrictor vulvae muscle & perineal body only
- debridement, superficial suturing, Caslick’s
- AB’s and AI’s
Third degree
- perineal body, anal sphincter and rectum
- delay corrective surgery for 6 weeks
- manual daily evacuation of vagina
- surgery = 2 stages
1. recreate shelf between rectum and
vagina
2. tension relieving sutures to restore
perineal body
What are the 4 grades of rectal tears?
Grade 1: mucosa & submucosa
Grade 2: mucosa, submucosa & muscular
layer prolapse
Grade 3: all layer except serosa (subtype
a) or mesentery (subtype b)
Grade 4: full thickness tear
Management of type 1 & 2 rectal tears?
CAREFULLY evacuate rectum and pack defect
Conservative management
- BS AB’s e.g. pent & gent
- tetanus toxoid
- flunixin
- supportive care e.g. IVFT
- Fast + stool softeners
Management of type 3 & 4 rectal tears?
REFER to surgical facility
Surgical management
- in-dwelling rectal liner
- suture per rectum
- colostomy
- laparoscopic repair
- euthanasia if extensive contamination
