LA final (life is not good)

not cumulative!

what are causes of LA recumbency

-neurologic disease

-neuromuscular disease

-musculoskeletal disease

-metabolic disease

what are the viral neurologic diseases in equine

-west nile virus

-equine herpesvirus (EHV-1)

-encephalitis viruses (EEE/WEE/VEE)

^dont ask cause idk wtf

what are the core vaccines in horses

rabies, tetanus, EEE/WEE, WNV

what is a neurologic disease for all species

rabies

they be wearing this for what

EHV-1

parasitic neurologic disease for equine

equine protozoal myeloencephalopathy (EPM)

parasitic neurologic disease in camelids

parelaphostrongylus tenuis (meningeal worm)

true or false: horses are most sensitive to tetanus

true

a trauma related neurologic disease

calving paralysis

musculoskeletal disease in equine

-laminitis

-P3 (coffin bone) rotation

list some of the musculoskeletal diseases

-laminitis

-severe arthritis

-myositis

type of metabolic disease

milk fever (hypocalcemia)

list the types of metabolic disease

-milk fever (hypocalcemia)

-heat stress

-pregnancy toxemia

-copper deficiency - goat kid

-severe anemia (weakness), all species

managing LA recumbency includes

-moving the patient

-bedding

-slings

-float tank

-nutrition/fluids

different types of bedding

-deep bedding (straw, shavings, sand)

-waterbed

what type of sling is this

UC Davis Lift

what type of sling is this

Anderson Sling

what type of sling is this

Modified sling

complications of recumbency

-decubital ulcers (bed sores)

-muscle damage

-pneumonia

-corneal ulcers

-self trauma

-urine/fecal scald

what dis and what are treatments/prevention

decubital ulcers

treatment:

-clean wounds

-silver sulfadiazine (SSD)

prevention:

-deep bedding

-keep skin clean/dry

-rotate patient every 2-4 hrs

what causes muscle damage in recumbent LA

-pressure from weight —> muscle necrosis

-compartment syndrome

what this

corneal ulcer

inner layer/dressing items for bandaging

-release or non-stick gauze

-gel or “moist” pads in place of gauze

-silver impregnated pads

-foam pads

-wet to dry & wet to moist

release or non-stick gauze: characteristics

-still may adhere

-better for less exudative wounds

gel or “moist” pads in place of gauze: characteristics

-cost effective

-speed healing

silver impregnated pads: characteristics

-Ag - anti-bacterial

-treats and prevents infection

-aid in rapid healing

foam pads: characteristics

-absorbent

-ideal for exudative wounds

-do not disrupt wound bed when removed

what are disadvantages of wet to dry & wet to moist bandage dressing

-no longer considered “standard of care”

-impedes healing

-increased infection rate

-increased inflammation

-expensive

common middle layer bandaging items

-cotton bandage

-brown gauze

cotton bandage characteristics- middle layer

-sheet cotton (redi roll or roll cotton)

-provides padding and stability

-decreases mobility to allow healing

common outer layer bandaging materials

-VetWrap (NOT on skin)

-Elasticon (top and bottom, stick to skin)

cattle bandaging supplies

-non-stick pad over wound on 4×4 gauze

-cling wrap

-vet wrap

-white tape

-duct tape

*difficult to maintain bandage due to “cone-shaped” leg

indications for bandaging

-wounds/lacerations

-under splints/casts

-post-surgery

-support

-protection

types of bandages

foot bandages:

• protect sole, heel bulb lacerations

• duct tape or boot

distal limb bandages:

• extend from coronary band or fetlock to just below carpus

full limb bandages:

• robert jones (FATTTT bandage)

wut happened

bandage sore

steps for fracture stabilization and wound management

• assess the patient

• stabilize the patient

  • control hemorrhage

  • treat hypovolemia

  • provide pain relief

  • initiate wound management

• goals:

  • prevent additional damage

    • immobilize joint ABOVE and BELOW fracture

external coaptations for fracture stabilization

-bandage

-splint

-bandage cast

-cast

-bling

whats this

Kimsey leg saver splint

transportation with fractures

preferred:

-load hind limb fractures forward

-load front limb fractures backward

indications of LA fluid therapy

-dehydration

-shock

-replace losses

-diuresis

-administer other products and treatments

what is dehydration

-loss of total body water

-occurs over time

-cells shrink

what are the 3 body water compartments and their percentages

-total body water = 60% of patient’s body weight

-intracellular fluid ~ 67% (2/3) of TBW

-extracellular fluid ~ 33% (1/3) of TBW

summary of Equine Protozoal Myeloencephalitis

-Transmission: by ingesting material contaminated with opossum urine/ feces that contains the pathogen S. neurona
-Prevention: better biosecurity
-Treatments: drugs, PT, and supportive care
-Clinical Signs: dullness, dysphagia, head tilt/ leaning, facial nerve abnormalities

summary of West Nile Virus

-Transmission: mosquitos
-Prevention: vaccination and mosquito control
-Treatment: supportive care 30% of cases die or are euthanized
-Clinical Signs: fever, muscle fasciculations, personality changes, cranial nerve defects, spinal abnormalities

summary of Eastern and Western Equine Encephalitis

-Transmission: mosquitos
-Prevention: vaccination and mosquito control
-Treatment: supportive care
-Clinical Signs: depression, fever, lethargy, anorexia

summary of tetanus

-Transmission: toxic bacteria clostridium tetani in open wounds
-Prevention: vaccination, wound management, biosecurity
-Treatment: antitoxin injection, controlling muscle spasms, general supportive care 50% mortality
-Clinical Signs: muscle stiffness, difficulty moving/ eating, protruding third eyelid, seizures, muscle spasms

rabies symptoms in horses

-fever

-colic

-lameness

lyme symptoms in horses

lameness, joint swelling, muscle stiffness, lethargy, poor performance

summary of botulism in horses

-Transmission: exposure to Clostridium botulinum (found in round bales)
-Prevention: vaccination and biosecurity
-Treatment: antitoxin injection, IV antibiotics, supportive care
-Clinical Signs: progressive muscle weakness, dysphagia, muscle tremors, lethargy, respiratory difficulties

what is hypovolemia

-loss of blood volume; loss of intracellular fluid (plasma volume)

-decreased perfusion of organs —> shock

clinical signs of dehydration

-prolonged skin tent

-sunken eyes

-dry corneas

-tacky MM

-dark urine

mild dehydration symptoms: 5-7%

• 1-3 second skin tent

• moist or slightly tacky MM

• <2 sec CRT

• HR: 40-60 bpm

• decreased urine output

moderate dehydration symptoms: 8-10%

• 3-5 sec skin tent

• tacky MM

• 2-3 CRT

• 61-80 bpm

• decreased arterial BP, slight to moderate sunken eyes, decreased glisten of cornea

severe dehydration symptoms: 10-12%

• 5+ sec skin tent

• dry MM

• >4 sec CRT

• 80+ bpm

• reduced jug fill, barely palpable pulses, obvious sunken eyes, no corneal glistening

clinical signs of hypovolemia

-decreased mentation

-tachycardia

-weak pulse pressure

-cool extremities

-pale MM

routes of fluid administration

-PO

-IV

-SQ

-IP

-IO

what are fluid additives

-Potassium

-Calcium

-Sodium bicarbonate

-Dextrose

-DMSO

-CRI: lidocaine, ketamine, butorphanol, insulin

what 3 things must you account for when developing a fluid plan

1. replace deficit

2. provide maintenance

3. account for OGL

maintenance fluid requirements for neonate, juvenile, and adult

-neonate (<2 weeks): 100 mL/kg/day

-juvenile: 80 ml/kg/day

-adult: 60 ml/kg/day

how much do you bolus if dehydrated

bolus ½ the deficit in first 1-2 hours

what is the shock dose for equine

give in boluses of 6-20 ml/kg and reassess

what is fluid diuresis

-promoting increased or excessive production of urine

-most commonly used in cases of acute kidney injury or chronic kidney disease

true or false: coiled sets are the best fluid lines for ambulatory animals

true

true or false: you should keep foals with the mares if hooked up to CRI

false

Which gauge catheter is best used for moderate to large volumes of fluid for your hospitalized horse?

14g

How often should you roll a recumbent horse patient to prevent decubital ulcers?

q 2 hours

Your patient is a 1045 lb horse that is estimated to be 8% dehydrated.
a. What is the volume (in Liters) needed for dehydration replacement?
b. What is the volume (in Liters) needed for maintenance requirements (per
day)?
c. What is the total volume for dehydration and maintenance combined for 24
hrs?
d. What is the hourly IV fluid rate (in Liters per hour) ?

a. 38 L

b. 28.5 L

c. 66.5 L

d. 2.8 L/hr

PCV = 9% (normal = 25-35%)
Weight = 750 lbs
Diagnosis: anemia from chronic GI parasitism
He needs a blood transfusion!
Donor (a llama): PCV = 30%

1. What is the total blood volume (in liters) of the camel?
Blood volume (L) = 8% of BW (kg)
2. Use the following equation to calculate how much blood to give the camel
[example uses 25 for normal PCV]
Deficit = blood volume x ([normal PCV – actual PCV]/donor PCV)
Then give 20-40% of the deficit

Body weight 750 lbs/2.2 = 341 kg
1. Blood volume = 341 kg x 0.08 = 27 L
2. Deficit = blood volume x ([normal PCV – actual PCV]/donor PCV)
= 27 L x ([25-9]/30) = 14.4 L
Give 20-40% of deficit
20%: 0.2 x 14.4 = 2.89 L
40%: 0.4 x 14.4 = 5.76 L

Give 3-5.5 L

Initial diagnostics reveal hypoglycemia (Glucose = 24; reference range 80-120
mg/dL)
Problems: dehydration and hypoglycemia

1. What is the fluid deficit?
2. If you decide to add 2.5% dextrose to 1 L of fluids, how many mL of 50%
dextrose would you add? Hint: use C1V1=C 2V2 calculation

1. 4 lbs = 1.8 kg; 1.8 kg x 0.06 = 0.10 L = 100 mL
2. (2.5%) x (1000 mL) = (50%) x V2
2500 mL/50% = 50 mL
* you would add 50 mL of 50% Dextrose to a 1 L bag of fluids

general considerations for post-op care

-PE

-suture removal; 10-14 days

-drugs: label, check and re-check

-paper work

LA anesthetic recovery considerations

padded recovery stall

-good footing

-safe environment

-access to animal*

assisted recovery:

-head and tail ropes

-sling, pool

-foals

-dark, quiet environment

LA anesthetic recovery grading scale

1. excellent

2. good

3. poor

4. serious complications

   1. anesthesia recovery related death

preparing patient for anesthetic recovery

-remove shoes and/or tape feet

-remove halter

-sedation (xylazine)

-ropes if desired

-good footing

problems encountered in anesthetic recovery

-myositis/neuritis

-trauma during recovery- tongue/face common

-post anesthetic hypoxia- protect airway

-fractures- tibia, femur, cannon bone, hip luxation

-exhaustion- severe colics

true or false: vomiting is a sign of colic

false

What is the most common cause of emergencies in horses

colic

whats this

laceration

• caused by bad bandage maintenance

• observe cast for:

  • discharge

  • swelling above cast

  • cracks- fetlock, foot

  • sore development

• common in hind legs

what is this

-caesarian section

-trueeeee emergency for live foal

-similar observations to colic surgery

-blood loss

-retained placenta- 50%

what is this

-tracheotomy

-relief/prevention of resp diseases

-performed ventral neck region

-palpate trachea

-standing w/ local ax

what are the elective surgeries

• castration/crytorchids

  • bleeding. swelling

  • eventration

• orthopedic surgery

  • lameness

  • incisions

  • bandages/splints/casts

• resp surgery

  • tie back

  • laser

  • laryngotomy

  • sinusotomy

• foal surgery

  • elective or emergency

true or false: It is best to feed your sick horse in a hay net off the ground to prevent respiratory issues and colic.

true

what is a form of assessing dehydration that is only reliable in foal

sunken eyes

fluid requirements: total volume=

maintenance + deficit + ongoing losses

fluid deficit =

body weight (kg) x % dehydration

true or false: SQ fluids are inadequate for replacing fluid deficits in LA

true

in equine, using the intravenous route of administration allows rapid ?

fluid administration/restore fluid volume

4 phases of fluid therapy

resuscitation, rehydration, maintenance, ongoing losses

fluid of choice for maintenance fluid therapy

crystalloid fluid

How soon will clinical signs for rabies occur?

1 week after bite

What is a parasitic neurologic disease camelids can contract?

meningeal worm

What are some clinical signs of otitis interna?

Ear, eyelid, and face drop, Cranial nerve 7, the facial nerve, is affected by this

whats this

float tank

where can LA get decubital ulcers?

bony prominences, skin folds

What can cause corneal ulcers? (Bedding)

straw

Why are bandages on lower limbs of horses so common?

They are more prone to damage. Low muscle mass and high amount of tendons, ligaments, nerves, and blood vessels. Muscles at the end of the carpus

How often should you monitor a bandage? Why?

Minimally every day. Check for swelling and wounds.

Where are distal limb bandages applied?

From the top of the metacarsus/metatarsus to just below the coronary band.

How many layers are there for a bandage in a leg that has a wound?

5 layers. Layers one and two include a wound dressing and a layer to hold wound dressing. If no wound, not needed.

In a limb bandage that does not have a wound, what are the layers?

1) padding

2) securing layer

3) finishing layer