Equine Med- Respiratory 2

wilsbach's version from 2016-04-12 21:05

Case 4

Question Answer
what does a "heave line" tell you? where do you see it?Chronic lower airway inflammation. bc its hard to expire air bc of inflammation, they have to push abd mm really hypertrophy of abd mm in that area.
upper airway respiratory distress is generally caused by obstruction, 3 examples of problems like this are?(1) Swelling/obstruction of nasal passages (Allergic reactions/snake bites/SIRS/trauma) (2) Laryngeal issues ( Swelling, collapse, mass, paralysis, HYPP) (3) Tracheal collapse
who is prone to tracheal collapse?miniature horses
what can sound like rattling when breathing?built up mucus
does equine influenza affect upper or lower airway?both
what age is more affected by equine influenza?younger (adults have better immunity to it)
CSs of equine influenza? a particular sign to look out for?High fever, ADR, nasal discharge, ****cough....can lead to dec performance
how do you dx equine influenza?usually based on signs. PCR nasal swab or paired ELISA can be used.
tx for equine flu?just supportive. Rest, antivirals available but not used
is there vx for equine flu? Killed, MLV or canary pox (might work a little bit. Will dec amount of CSs you will see (arent as sick) but doesnt prevent dz.)
Equine Herpesviruses--> which two types are the most common offenders? is it upper or lower or both affected?Upper AND lower resp affected, usually EHV 1 AND 4
are young or old animals usually more affected by EHV?younger
if there is a herpes outbreak, which strain is usually implicated in outbreaks?EHV4
CSs of EHV?Fever, ADR, nasal discharge
how do you dx EHV?usually clinical signs: PCR nasal swab or paired titers
***what did she say the CBC will be like with viral infections?NORMAL
is there a EHV vx?Yes- usually recc for horses co-mingling with each other. Often in combo with flu vx
If you see changes in the CBC, are you thinking bact or viral infection?bact!! Viral you don't really see changes (Neutrophilia & Hyperfibrinogenemia)
bacterial pneumonia often happens when there are compromised respiratory defenses, such as when there is..Viral infection, shipping, heavy training, post anesthesia (bc ET tubes arent sterile and shove down into trachea )
what are some common agents which cause bacterial pneumonia?Strep, Staph, Actinobacillus & Pasturella sp.-- anaerobics too
**when should you DEF avoid doing a TTW?AVOID in respiratory distress!!!
CSs of bacterial pneumonia?Fever, abnormal lung sounds, intolerant of rebreathing exam, cough, nasal discharge, SIRS
If youre gonna take chest rads, how many images will you need to take for a complete set?4!
handy tip for trying to ultrasound the lungs between the ribs?Can use a rectal probe- sweeet. You will prolly need to clip or SOAK wil alcohol and clean the horse to get a good image too.
tx for bact pneumonia? antibiotics, supportive care, NSAIDs, oxygen if needed
what are some common complications which can happen because of bacterial pneumonia?Pleuropneumonia – fluid in thorax, abscessation, penumothorax, systemic decomposition (laminitis)
What age is affected by Rhodococcus equi?Affects only foals 1-6 months of age!!
where is rhodococcus equi found?in the environment on farms everywhere- doesnt cause any problems unless its a foal- esp if theyre immunocompromised.
how does rhodococcus equi infect the foal, and what does it do once its in the body?They inhale it--> forms abscesses in lungs. Extra pulmonary infections common, you will see Polysynovitis, uveitis, GI infection
dx of rhodococcus equi? PCR or culture on TTW fluid
what would abscesses in the lungs look like on rads? what dz might you suspect?Rhodococcus equi-
what would abscesses in the lungs look like on US? what dz might you suspect?Rhodococcus equi-
What's going on in this US? arrows= bubbles= anaerobic bact. Horse ties to wall it off, makes cobweb of scar tissue, so then really hard to get fluid out. On lungs, some aeration (white) but lots of of consoludation
how do you tx rhodococcus equi? Cautions? Macrolide antibiotic and rifampin (Azithromycin or Clarithromycin).. CAUTION: NOT IN ADULTS. will kill an adults well developed flora. And they can get it indirectly from licking foals mouth too.
what are two dzs which are part of NON-infectious pneumonia?(1) Recurrent Airway Obstruction (RAO) (2) Inflammatory Airway Disease (IAD)
Recurrent Airway Obstruction (RAO) VERSUS Inflammatory Airway Disease (IAD): What are the ages of the horses affected by this?(1) RAO= OLD (O FOR OLD) so basically mature horses. (2) IAD= young!! around 2 yr
Recurrent Airway Obstruction (RAO) VERSUS Inflammatory Airway Disease (IAD): which is a genetic predisposition?RAO (o for old and predisposition)
Recurrent Airway Obstruction (RAO) VERSUS Inflammatory Airway Disease (IAD): how does their hx differ?RAO= HIGH RR AT REST. Will see seasonal affects, might depend on housing. IAD: will see exercise intolerance.
Recurrent Airway Obstruction (RAO) VERSUS Inflammatory Airway Disease (IAD): Etiology?RAO: Molds/pollens, genetics. IAD: previous viral infection, strenuous exercise.
CSs of both RAO and IAD?Both inflammation in the airways: Bronchospasm, Excess mucous, Tissue damage, Constriction/scarring of airways. ("scarred down angry airways" she said)
which can present as an ER- RAO or IDA?ROA (trouble breathing/inc RR- she said "breathing like a freight train, or some nasty bact infection, viral not as likely)
tx for RAO/IAD?Reduce allergens, reduce inflammation and spasm and reduce mucus
what can you give to reduce bronchospasm in emergency? If not an ER? (4 drugs total)ER: Atropine. Inhaled: Albuterol. Oral: Aminophylline/Pentoxyfylline
what's all this junk from a BAL? Curschmann's spirals (prolly dont need to know this word she just mentioned it) it means its mucus
What drugs can you use to reduce inflammation from RAO? which drugs can't you? (3 drugs)NSAIDs ARE USELESS GO WITH STEROIDS! Can either do SYSTEMC: Dexamethasone, prednisolone (not prednisone, horses can't absorb that) or can do INHALED: fluticasone
which is better to manage RAO: inhaled or systemic? pros and cons?INHALED is better than systemic (more efficacious), but it is inconvenient due to frequent dosing and is also expensive.
prog of RAO?Good with appropriate care (there is individual variation). Response to environmental changes takes several weeks.