EqMed Q2, Hemolymph II

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HLW
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212928
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EqMed Q2, Hemolymph II
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2013-04-11 19:47:56
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EqMed Q2 Hemolymph II
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EqMed Q2, Hemolymph II
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  1. Tx for piroplasmosis?
    Imidocarb (Efficacy? & +Side Fx)

    • Resolve c/s of acute infection
    • Clear carrier state if moving horse to non-endemic area
  2. Cuses of heinz body hemolytic anemia in horses? 4
    • Red maple
    • Onion
    • Brassica
    • Phenothiazines
  3. What time of year is red maple toxicosis most prevalent?

    How long after ingestion are signs seen?
    Late summer/fall (sept-oct) = Wilted leaves

    2-3 days after ingestion
  4. Does red maple lead to intravascular or extravascular hemolysis?
    Intravascular(from gallic acid)= Methemoglobin
  5. How does red maple lead to ARF?
    • Hemolysis
    • Hemoglobinuria -> pigment nephropathy

    Poor perfusion from decr. O2 carrying capacity
  6. what are MDB findings with red maple toxicosis? 6
    • Acute, severe Anemia +Heinz bodies
    • Eccentrocytes
    • Azotemia
    • Hemoglobinemia
    • Pigmenturia
    • Incr. methemoglobin concentration
  7. are steroids indicated as part of treatment for red maple toxicity?
    NO, associated with non-survival
  8. Causative agent of equine granulocytic erhlichiosis?

    Is it contagious?
    Anaplasma phagocytophila

    not contagious but infectious
  9. what cells are infected with anaplasma phagocytophila?

    Appearance?
    PMNs/eosinophils (granulocytes)

    Morulae free in cytoplasm
  10. How long is incubation period for granulocytic erhlichiosis?

    C/S? 5
    3-10days

    • <1yr old:
    • Fever Only

    • >1-3yrs old:
    • Fever
    • Depression
    • Limb edema
    • Ataxia
    • more progressive in older horses
    • (mimics viral infection)
  11. what is common finding on MDB with granulocytic ehrlichiosis?
    Pancytopenia (prone to secondary infection)
  12. how is granulocytic ehrlichiosis diagnosed?
    • Geography + CS + morulae in granulocytes
    • IFA/paired titers/PCR
  13. Granulocytic ehrlichiosis Tx?
    • Oxytetracycline
    • (Prompt improvement is diagnostic)
  14. Prognosis for granulocytic ehrlichiosis if no Tx?

    Will horse be carrier for life?
    Self limiting in 2-3 weeks; Excellent in uncomplicated cases

    No carrier state; immunity can last >2 years
  15. what are the 5 forms of lymphoma in the horse?
    • Multicentric/generalized
    • Alimentary
    • Splenic
    • Thoracic
    • Cutaneous
  16. C/S of lymphoma? 5
    • Lymphadenopathy (esp. submandibular) no heat or pain
    • Lethargy
    • Weight loss
    • Edema
    • Pyrexia
  17. what are findings on MDB with lymphoma? 4
    • Anemia
    • Lymphocyte usually WNL
    • Hyperglob
    • hypOalb
  18. Tx and prognosis for lymphoma?
    • Limited options
    • Prognosis is not good
  19. how do horses show signs of regenerative anemia?
    • No reticulocytes
    • Increased MCV
    • Anisocytosis
  20. Changes with acute blood loss be seen in RBC or protein count?
    • Protein drops first
    • (splenic contraction masks RBC loss at first)
  21. how much blood is lost in class I blood loss?

    C/S?
    <15%

    • Mild Tachycardia
    • Cooler Extremities
    • Few c/s
    •  -Fully compensated for by transcapillary refill
  22. How much blood is lost in class II?

    C/S?
    15-30%

    • ↑HR
    • *normal MAP*
    • orthostatic hypotension
    • ↓Urine
  23. How much blood is lost with class III?

    What is status of patient at this point?
    30-40%

    Decompensated hypovolemic shock/decr. BP - will die without intervention
  24. In acute traumatic bleed, first apply pressure/ligate to stop bleeding. Once controlled, start fluids.
    What Type fluids?
    What dose?
    40-80ml/kg (shock dose)

    hypertonic saline followed by isotonic crystalloids
  25. when are blood products indicated?
    • PCV<20% acutely
    • PCV <12% over 12-24 hrs following blood loss

    also consider HR, BP, jugular fill, etc.
  26. When giving blood, how much blood do you give?
    How long will these cells circulate?
    • 20-40% of blood lost
    • circulates 3-4 days (marrow won't kick out more til 5-9d)
  27. Calculation for amount of blood required
    PCV (desired) - PCV (donor) x (0.08xBW) divided by donor PCV
  28. Aspergillus is found in medial or lateral pouch?

    What vessel is cause of major bleeding?
    Medial pouch

    Internal Carotid A
  29. CrN's in medial pouch? 7
    • 9, 10, 11, 12
    • Sympathetic trunk
    • Cr Cervical ganglion
    • Cranial Laryngeal n.
  30. C/S's associated with guttural pouch mycosis? 5
    • Horner's syndrome
    • *dysphagia*
    • Idiopathic laryngeal hemiplasia
    • *epistaxis*
    • Mucopurulent discharge (often unilateral)
  31. Most effective Tx for guttural pouch mycosis?
    Intraarterial occlusion (proximal and distal occlusion - cut off blood supply and fungus dies)
  32. Med Tx options are available for Guttural Pouch Mycosis?
    • Enilconazole/Itraconazole
    • Fluconazole systemically
  33. What 2 breeds are prone to hypovolemic shock?
    Young or adult?
    • Arabs and Thoroughbreds
    • Adult horse
  34. what is important to keep in mind with fluid resuscitation of hemorrhaging patient?
    • Controlled hypotension (~60mmHg)
    • Maintenance fluid support
  35. is it indicated to give Acepromazine to horse with hemoabdomen?
    Yes, want to reduce stress and tranquilize
  36. Which tumor in the thorax can erode arteries and cause hemothorax?
    Hemangiosarcoma

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