Clinical Examination of the horse
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. What would you like to do?
What type of questions should you be asking during history taking? (Remember SHED C)
- Signalment - age, sex, type of horse
- Health/health management - how many hours grazing vs how many stabled? What is their use? Etc
- Environment - are droppings normal/well formed? Do they break bounce or splat?
- Primary complaint
What do the following stand for a) BAR b) QAR c) DUDE?
- BAR = bright, alert, responsive
- QAR = quiet, alert, responsive
- DUDE = drinking, urinating, defecating, eating
What areas are you assessing during body condition scoring? What score is ideal?
Covering of ribs, roundness of rump, muscle on neck, etc. BCS 3 is ideal.
What is the normal temperature for an adult horse?
37.5-38.3°C (>38.8°C is significant)
What is the normal temperature for an adult donkey?
36.2-37.5°C (>38.0°C is significant)
What sites can you take the pulse from in horses?
Facial and transverse facial artery
What is the normal pulse rate for a) adult horses b) donkeys c) foals?
- a) 28-40
- b) 36-60
- c) 70-100
What should normal mucous membranes look like? What can be other abnormal presentations?
- Normal mucous membranes are pink and moist
- Abnormal mucous membranes include cyanotic, congested, icteric, petechiae
Apart from the oral mucosa, what other sites can you check the mucous membranes?
Conjunctiva of the eye, vulva and anus
What is the normal resting respiratory rate for a horse?
True or false: horses are obligate nose breathers?
How can you determine the hydration status of a horse?
Shiny eyes, moist mucous membranes, good skin elasticity
What are you looking for when you examine the nose?
- Air flow
- Normal on palpation
What can cause white mucoid material to discharge from the nose?
Allergic causes of increased mucous production
What can cause green mucopurulent material?
Seen in upper respiratory tract infections
What can cause bloody discharge?
Ethmoidal haematomas or exercise induced haemorrhage
What generally causes foul smelling discharge?
Sinusitis and dental disease
What causes unilateral discharge vs bilateral discharge?
- Unilateral - dental lesions, gutteral pouch empyaema/mycosis or progressive ethmoidal haematoma
- Bilateral - consider the lungs/trachea as a source of discharge
What are you looking for when examining the eyes?
- Is there vision - menace and PLR tests
- Pupil symmetry
- Ocular discharge
- Ocular opacities
What are you looking for when examining the head?
- Normal anatomy
- Check the sinuses
- Palpate submandibular lymph nodes
- Feel for mandibular thickness/symmetry - dental eruption bumps, dental root infections
- Lips, commissures
- Excessive salivation or bad odour
- Pharynx - gutteral pouch, lymph nodes, parotid salivary gland, bilobed thyroid gland (can be enlarged in horses, this is normal)
- Palpate larynx, slap test
What are you looking for when examining the neck?
- Oesophagus - should not be visible down the left side unless the horse is suffering from choke
- Jugular veins - pulsation
How does Horner's syndrome present in horses? What does it indicate?
- Miosis, ptosis, protruding third eyelid
- Ipsilateral sweating
- Ipsilateral facial vein with distension
- It indicates damage to the sympathetic trunk
What are you listening for during auscultation of the lungs?
- Normal breathing sounds
What is the apical impulse?
The point of maximal intensity (the point where the heart contracts most noticeably).
What valves are present on the a) left b) right side of the heart?
- a) MAP (caudal to cranial)
- b) T
What are the normal heart sounds?
'lu'lub dup de'
What are you listening for during auscultation of the heart?
Rate, rhythm, sounds, murmurs
What should you be looking for on external examination of the abdomen?
- Change in shape
- Loss of sub lumbar fossa
Describe how you would auscultate the abdomen
Each quadrant (4) should be auscultate for at least 1 min to determine whether intestinal contractions are present and normal in intensity or whether they are increased or decreased. This is described as borborygmi and can be rated 0,+,++,+++ (where zero is the worst with no sounds being heard)
What does the caecocolic orifice sound like?
This is a 'toilet flushing' sound that occurs every 30 seconds
What valve should you listen for when auscultating the abodmen?
What should you be looking for when examining the skin?
- General skin/hair condition
- Presence/absence of pruritus
- Presence of lesions - type, distribution, symmetry
- Should palpate entire skin surface for lumps/nodules
Where do horses tend to get marked pruritus e.g. due to sweet itch?
Along the neck, dorsum and tail base
What would you like to do?
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