Equine

what to assess during clinical exam

demeanour

behaviour - responsive, usually eating, interested in movements of other horses

stance - recumbent?unwilling to rise/ move spontaneously?weight shifting? resting one leg?

signs of previous treatment

what to assess in the horses environment

signs of colic

presense/absence of faeces - signs of scour

signs of eating/ uneaten food

type of bedding - dusty? edible? disturbed?

mucus on doors or floor

nearby horses - coughing? stamping, colicking?

most relevant questions for general history

what is the horse used for

how old is it

how is it kept

what does what the horse is used for influence

potential problem

• exercised related fractures common in race horses but laminitis isnt

future expectations

• do we need to return horse to athletic function or would pasture sound do

timescale for resolving problem

drugs/ treatments that might be used

• if needs to be out of system for race on weekend

what does age influence

type of problem - certain condiitons are age related

owners expectations

type of treatment

what does how its kept influence

many problems associated with management systems

horses at pasture much more likely to suffer trauma than stabled horses

problems often associated with changes in routine esp colics

might influence treatment

what questions to ask to gain specific history

when did it start

how has it progressed

has he had it before

have you given it any treatment yourself

vital signs

HR,RR, temp

not always required e.g chronic lameness

sometimes esssential

HR = good reflection of levels of pain/stress

pyrexia not always consistent sign

take temp of dull horse, anything you think might have infection

Taking the temperature on a colicking horse might reveal a peritonitis or a impending colitis. It also allows you to assess whether the horse will tolerate a rectal exam

pattern recognition

clinical diagnosis based on previous experience and probability

fast - suitable for emergencies

efficient

may make assumption or jump to false conclusions

no use if presented with a new or novel condition

often used by experts and in first opinion practise

systemic exam

clinician gathers as much info as possible to rule out possible causes before choosing treatment

• methodical

• gathers large amount of data about patient - may reveal other problems besides presenting condition

• unlikely to miss problems or jump to conclusions

• useful if unfamiliar condition

slow

inefficient

can result in undiagnostic tests being carried out

inflexible

often used on second-opinion practice or by novice clinicians

example of routines

colic - violent colic, non-violent colic

coughing

lame

off colour

wounds

weightloss

types of colic

non-violent = safe to examine

violent = not safe to examine

violent colic routine

non-violent colic routine

coughing horse `routine

weightloss routine