Pleuro pneumonia in horses treatment and Prognosis

1st line antibiotics for pneumonia

-penicillin + gentamicin iv

1st line antibiotics in aspiration pneumonia

-penicillin + gentamicin + metronidazole

when might adjustments be made to abx choices

c+s

potential inhaled drugs

-gentimicin

-ceftiofour

-cefquinome

advantage of jet nebuliser

-cheap

-easy to use

disadvantage of jet nebuliser

-inefficient

-needs compressed gas

-needs additional tubing

ultrasonic nebuliser advantages

-easy to use

-+ efficient than jet

ultrasonic nebuliser disadvantages

-large residual volume

-difficult w/ viscous liquids

-degradation due to heating

mesh nebuliser advantage

-fast, quiet, portable

-easy to use

-self contained power

-most efficient

disadvantages of mesh nebuliser

-more expensive

-cleaning between cycles

jet nebuliser antimicrobial

cefquinome

ultrasonic antimicrobial

gentamicin

mesh nebuliser antimicrobial

ceftiofour

thoracocentesis placement

-ID to drain with US (avoid thoracic vein)

-7/8 ICS above ostochondral junction

prep for thoracocentesis

-clip, prep aseptically and sedate(local)

thoracocentesis method

-stab incision cranial edge of rib

-advance drain through incision and hear pop

-withdraw trocar, advance blunt tube

-secure with chinese finger trap suture and use heimlich valve

why do we want to be at the cranial edge of the rib for thoracocentesis

damage neurovascular bundle

what does heimlich valve do

prevent air in but allow fluid out

diagnostic value of thoracocentesis

-culture and sens

-cytology

therapeutic value of thoracocentesis

-drain pro inflam products

-remove bacteria

-decrease adhesion formation

-resp function improvement if lots of fluid in thorax

if untreated with thoracocentesis

rapid progression if untreated

referral considered if

-no initial response to antibiotics

-systemic or resp compromised

-require intensive care

how c and s performed

-TTW and pleural effusion

-include anaerobic coverage

if horse has pleuropneumonia what to do

drain