Podcast
Questions and Answers
What is the significance of determining the inciting pathogen in cases of equine pneumonia?
What is the significance of determining the inciting pathogen in cases of equine pneumonia?
- It primarily helps in predicting the horse's lifespan following diagnosis.
- It is mainly for research purposes and has limited impact on treatment.
- It is crucial for establishing an effective treatment plan. (correct)
- It is essential for preventing the spread of the disease to other animals.
Why is it important to avoid indiscriminate antimicrobial use in treating equine pneumonia?
Why is it important to avoid indiscriminate antimicrobial use in treating equine pneumonia?
- To reduce the cost of treatment.
- To minimize the risk of antimicrobial resistance. (correct)
- To prevent staining of the horse's teeth.
- To maintain the balance of gut flora.
Which factor contributes most significantly to the increased risk of pneumonia in young horses during their first two years of life?
Which factor contributes most significantly to the increased risk of pneumonia in young horses during their first two years of life?
- Fully developed immune system.
- Developing immunity coupled with potential immunosuppression from stress. (correct)
- Limited exposure to pathogens.
- Strictly controlled environmental conditions.
A 3-month-old foal presents with acute onset of dyspnea, fever, and cough. Which of the following diagnostic findings would be MOST consistent with a diagnosis of Rhodococcus equi pneumonia?
A 3-month-old foal presents with acute onset of dyspnea, fever, and cough. Which of the following diagnostic findings would be MOST consistent with a diagnosis of Rhodococcus equi pneumonia?
When evaluating thoracic radiographs of a foal suspected of having Rhodococcus equi pneumonia, which characteristic finding would be most indicative of the disease?
When evaluating thoracic radiographs of a foal suspected of having Rhodococcus equi pneumonia, which characteristic finding would be most indicative of the disease?
What is the primary mechanism by which Rhodococcus equi establishes infection in foals?
What is the primary mechanism by which Rhodococcus equi establishes infection in foals?
What is the role of VapA (Virulence-associated protein A) in Rhodococcus equi's pathogenesis?
What is the role of VapA (Virulence-associated protein A) in Rhodococcus equi's pathogenesis?
Considering the age susceptibility of foals to specific bacteria, in which age range is a foal most likely to be infected with Rhodococcus equi?
Considering the age susceptibility of foals to specific bacteria, in which age range is a foal most likely to be infected with Rhodococcus equi?
Which of the following is a primary clinical sign observed in foals affected by Rhodococcus equi pneumonia?
Which of the following is a primary clinical sign observed in foals affected by Rhodococcus equi pneumonia?
What is the most common isolate found during a transtracheal wash (TTW) in a horse with pneumonia or pleuropneumonia?
What is the most common isolate found during a transtracheal wash (TTW) in a horse with pneumonia or pleuropneumonia?
Which aspect of environmental management is most critical in reducing the risk of pneumonia in young horses?
Which aspect of environmental management is most critical in reducing the risk of pneumonia in young horses?
What diagnostic procedure is essential for identifying the specific bacterial cause of pneumonia in a horse, especially in cases unresponsive to initial treatment?
What diagnostic procedure is essential for identifying the specific bacterial cause of pneumonia in a horse, especially in cases unresponsive to initial treatment?
A horse being transported long distances is at an increased risk of developing pneumonia primarily due to which factor?
A horse being transported long distances is at an increased risk of developing pneumonia primarily due to which factor?
Which of the following clinical signs would suggest a progression from bronchopneumonia to pleuropneumonia in a horse?
Which of the following clinical signs would suggest a progression from bronchopneumonia to pleuropneumonia in a horse?
What is the primary goal of using antiulcer medication as an additional therapeutic in treating Rhodococcus equi infections?
What is the primary goal of using antiulcer medication as an additional therapeutic in treating Rhodococcus equi infections?
What is the primary reason for monitoring herd health with complete blood counts (CBC) and fibrinogen levels every two weeks in a population at risk for Rhodococcus equi infection?
What is the primary reason for monitoring herd health with complete blood counts (CBC) and fibrinogen levels every two weeks in a population at risk for Rhodococcus equi infection?
According to studies, what proportion of foals with small pulmonary abscesses due to Rhodococcus equi may recover without antimicrobial therapy?
According to studies, what proportion of foals with small pulmonary abscesses due to Rhodococcus equi may recover without antimicrobial therapy?
Why are foals born in January or February considered at higher risk for contracting R. equi?
Why are foals born in January or February considered at higher risk for contracting R. equi?
What is the most concerning adverse effect associated with macrolide use in equine medicine?
What is the most concerning adverse effect associated with macrolide use in equine medicine?
What is the appropriate treatment of Rhodococcus equi?
What is the appropriate treatment of Rhodococcus equi?
In addition to a Gram-positive bacteria, what other pathogen is more likely to be present in Equine Pneumonia?
In addition to a Gram-positive bacteria, what other pathogen is more likely to be present in Equine Pneumonia?
When is hyperimmune plasma needed in Equine Pneumonia?
When is hyperimmune plasma needed in Equine Pneumonia?
Which age range are weanlings in?
Which age range are weanlings in?
What age range do Yearlings fall into?
What age range do Yearlings fall into?
What is the best way to diagnose Pneumonia?
What is the best way to diagnose Pneumonia?
How does chronic disease lead to anemia?
How does chronic disease lead to anemia?
Which of the following medications would be used as a bronchodilation?
Which of the following medications would be used as a bronchodilation?
What is another clinical sign besides pneumonia that Rhodococcus equi can cause?
What is another clinical sign besides pneumonia that Rhodococcus equi can cause?
Which of the following is NOT a bacterial pathogen of equine pneumonia?
Which of the following is NOT a bacterial pathogen of equine pneumonia?
Which of the following diagnostics confirms Streptococcus zooepidemicus?
Which of the following diagnostics confirms Streptococcus zooepidemicus?
Besides bacterial infections, what other conditions can cause equine pneumonia?
Besides bacterial infections, what other conditions can cause equine pneumonia?
When would the patient not need rebreathing?
When would the patient not need rebreathing?
Where can a horse contract Rhodococcus equi?
Where can a horse contract Rhodococcus equi?
Besides azithromycin/rifampin, what is a second choice of medication to treat Rhodococcus equi?
Besides azithromycin/rifampin, what is a second choice of medication to treat Rhodococcus equi?
What does a thoracic radiograph of Rhodococcus equi present as?
What does a thoracic radiograph of Rhodococcus equi present as?
During a physical exam, what is a symptom that indicates the development of pneumonia?
During a physical exam, what is a symptom that indicates the development of pneumonia?
What is a bacterial pathogen found in adults that is unusual in foals?
What is a bacterial pathogen found in adults that is unusual in foals?
What does VapA do inside Equine Macrophages with Rhodococcus equi?
What does VapA do inside Equine Macrophages with Rhodococcus equi?
What is the BEST prevention method if you have a neonate shedding live bacteria in the feces?
What is the BEST prevention method if you have a neonate shedding live bacteria in the feces?
In managing a herd of young horses, what critical adjustment to environmental control can significantly minimize the risks associated with Rhodococcus equi pneumonia?
In managing a herd of young horses, what critical adjustment to environmental control can significantly minimize the risks associated with Rhodococcus equi pneumonia?
Considering the pathophysiology of Rhodococcus equi, which aspect of its interaction with the host immune system complicates treatment?
Considering the pathophysiology of Rhodococcus equi, which aspect of its interaction with the host immune system complicates treatment?
How does the presence of concurrent parasitic infections, such as Parascaris equorum, exacerbate the risk and severity of pneumonia in young horses?
How does the presence of concurrent parasitic infections, such as Parascaris equorum, exacerbate the risk and severity of pneumonia in young horses?
Which aspect of managing a foal's environment is MOST likely to reduce the risk of Rhodococcus equi pneumonia?
Which aspect of managing a foal's environment is MOST likely to reduce the risk of Rhodococcus equi pneumonia?
What specific characteristic of VapA contributes directly to the persistence and severity of Rhodococcus equi infections in foals?
What specific characteristic of VapA contributes directly to the persistence and severity of Rhodococcus equi infections in foals?
In cases of equine pneumonia complicated by pleuropneumonia, what finding on thoracic ultrasound would MOST strongly indicate the need for drainage?
In cases of equine pneumonia complicated by pleuropneumonia, what finding on thoracic ultrasound would MOST strongly indicate the need for drainage?
Considering the complex interplay of factors contributing to equine pneumonia, which management strategy would be MOST effective in reducing disease incidence on a large breeding farm?
Considering the complex interplay of factors contributing to equine pneumonia, which management strategy would be MOST effective in reducing disease incidence on a large breeding farm?
Given the pathogenesis of Rhodococcus equi, why might aerosolized lipopolysaccharide (LPS) be used to prevent infection from R. equi?
Given the pathogenesis of Rhodococcus equi, why might aerosolized lipopolysaccharide (LPS) be used to prevent infection from R. equi?
What is the MOST significant rationale for carefully selecting and monitoring antimicrobial therapy in foals with Rhodococcus equi pneumonia?
What is the MOST significant rationale for carefully selecting and monitoring antimicrobial therapy in foals with Rhodococcus equi pneumonia?
In a foal diagnosed with Rhodococcus equi pneumonia and concurrent immune-mediated polysynovitis, what does the presence of the latter suggest about the disease process?
In a foal diagnosed with Rhodococcus equi pneumonia and concurrent immune-mediated polysynovitis, what does the presence of the latter suggest about the disease process?
What is the underlying mechanism by which chronic pneumonia can lead to anemia in horses?
What is the underlying mechanism by which chronic pneumonia can lead to anemia in horses?
Why are foals born in January or February at a particular disadvantage, predisposing them to a greater risk of contracting Rhodococcus equi?
Why are foals born in January or February at a particular disadvantage, predisposing them to a greater risk of contracting Rhodococcus equi?
In a clinical scenario where a foal with Rhodococcus equi pneumonia is non-responsive to initial macrolide and rifampin therapy, what would be the MOST appropriate next diagnostic step?
In a clinical scenario where a foal with Rhodococcus equi pneumonia is non-responsive to initial macrolide and rifampin therapy, what would be the MOST appropriate next diagnostic step?
In cases of equine pneumonia, what is the primary rationale for administering anti-ulcer medications as part of the treatment plan?
In cases of equine pneumonia, what is the primary rationale for administering anti-ulcer medications as part of the treatment plan?
What is the likely significance of identifying Streptococcus equi subsp. zooepidemicus as the causative agent in a case of pneumonia in a mature horse?
What is the likely significance of identifying Streptococcus equi subsp. zooepidemicus as the causative agent in a case of pneumonia in a mature horse?
An owner wants to adopt a neonate that has Rhodococcus equi, what is the BEST thing to tell them to prevent other horses from becoming infected?
An owner wants to adopt a neonate that has Rhodococcus equi, what is the BEST thing to tell them to prevent other horses from becoming infected?
If a 90-day old Thoroughbred foal shows signs of lethargy and increased respiratory rate, has crackles in cranioventral lung fields, and a fever of 103.5; what would be the next best differential?
If a 90-day old Thoroughbred foal shows signs of lethargy and increased respiratory rate, has crackles in cranioventral lung fields, and a fever of 103.5; what would be the next best differential?
What is the significance of identifying perihilar abscessation and alveolarization on thoracic radiographs for a foal suspected of having pneumonia?
What is the significance of identifying perihilar abscessation and alveolarization on thoracic radiographs for a foal suspected of having pneumonia?
When evaluating treatment methods on a farm with endemic Rhodococcus equi, how effective is antimicrobial therapy on foals with subclinical pulmonary abscesses?
When evaluating treatment methods on a farm with endemic Rhodococcus equi, how effective is antimicrobial therapy on foals with subclinical pulmonary abscesses?
What is the initial response to anti-microbial therapy in Arabian foals around 7 months old infected with Streptococcus zooepidemicus pneumonia?
What is the initial response to anti-microbial therapy in Arabian foals around 7 months old infected with Streptococcus zooepidemicus pneumonia?
Which findings would necessitate that a clinician should rebreath a horse diagnosed with Bronchopneumonia?
Which findings would necessitate that a clinician should rebreath a horse diagnosed with Bronchopneumonia?
Identify the immune component from the options, that plays a significant role in the prevention of Equine Pneumonia?
Identify the immune component from the options, that plays a significant role in the prevention of Equine Pneumonia?
Recognizing that transportation can elevate a horse's susceptibility to contracting pneumonia, what underlying cause primarily supports the condition?
Recognizing that transportation can elevate a horse's susceptibility to contracting pneumonia, what underlying cause primarily supports the condition?
How can a veterinary professional recognize/confirm the presence of Streptococcus zooepidemicus?
How can a veterinary professional recognize/confirm the presence of Streptococcus zooepidemicus?
Which of the following could be a cause of Equine Pneumonia excluding bacteria?
Which of the following could be a cause of Equine Pneumonia excluding bacteria?
During an examination, which of the following could indicate that the patient has developed Pneumonia?
During an examination, which of the following could indicate that the patient has developed Pneumonia?
When bacteria such as Rhodococcus equi are found, what function does VapA gene regulate inside Equine Macrophages?
When bacteria such as Rhodococcus equi are found, what function does VapA gene regulate inside Equine Macrophages?
Why do veterinarians complete blood counts and fibrinogen levels every two weeks in at-risk populations?
Why do veterinarians complete blood counts and fibrinogen levels every two weeks in at-risk populations?
Which factor plays a key role in predisposing horses during long-distance transport to pneumonia?
Which factor plays a key role in predisposing horses during long-distance transport to pneumonia?
Select which of the following is least likely to be used to treat Rhodococcus equi.
Select which of the following is least likely to be used to treat Rhodococcus equi.
A group of yearlings must travel to a different facility, list what would improve their immunity and reduce their chances of developing pneumonia.
A group of yearlings must travel to a different facility, list what would improve their immunity and reduce their chances of developing pneumonia.
A neonatal foal is found to be shedding a live bacteria in its feces in its stall. What prevention method should the veterinarian prescribe?
A neonatal foal is found to be shedding a live bacteria in its feces in its stall. What prevention method should the veterinarian prescribe?
If the patient requires additional therapeutics while fighting Rhodococcus equi infection, which of the following would be the BEST choice?
If the patient requires additional therapeutics while fighting Rhodococcus equi infection, which of the following would be the BEST choice?
A client lives in a very dusty environment; to help prevent Equine Pneumonia from developing, what can the owner utilize to prevent this?
A client lives in a very dusty environment; to help prevent Equine Pneumonia from developing, what can the owner utilize to prevent this?
Under what circumstances may bacterial pneumonia in adult horses need to use multiple therapeutics?
Under what circumstances may bacterial pneumonia in adult horses need to use multiple therapeutics?
Flashcards
Equine Pneumonia
Equine Pneumonia
Inflammation of the lungs in horses, affecting both young and adult animals.
Equine pneumonia: young horses
Equine pneumonia: young horses
Horses in their weanling (6-12 months) and yearling (12-24 months) stages.
Disease Risk in Horses
Disease Risk in Horses
Foals possess developing immunity, making them prone to disease. Stress can suppress their immune system.
Neonatal Foal Immunity
Neonatal Foal Immunity
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Six Months of Age Immunity
Six Months of Age Immunity
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Immunity factors
Immunity factors
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Clinical Signs of Equine Pneumonia
Clinical Signs of Equine Pneumonia
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Signs of Pneumonia
Signs of Pneumonia
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Bacterial Pathogens
Bacterial Pathogens
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Rhodococcus equi
Rhodococcus equi
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Rhodococcus equi
Rhodococcus equi
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R. equi Exposure
R. equi Exposure
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VapA
VapA
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Clinical Signs of Rhodococcus equi
Clinical Signs of Rhodococcus equi
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Thoracic Radiograph Findings
Thoracic Radiograph Findings
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Additional Therapeutics
Additional Therapeutics
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Hyperimmune Plasma
Hyperimmune Plasma
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Pneumonia in the Young Horse
Pneumonia in the Young Horse
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Bacterial Pneumonia: adults
Bacterial Pneumonia: adults
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Bronchopneumonia → Pleuropneumonia
Bronchopneumonia → Pleuropneumonia
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Clinical Approach to Pneumonia / Pleuropneumonia
Clinical Approach to Pneumonia / Pleuropneumonia
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Equine Pneumonia Summary
Equine Pneumonia Summary
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Study Notes
- Equine pneumonia affects both young and adult horses
Equine Pneumonia in Young Horses
- Weanlings are horses between 6-12 months old.
- Yearlings are horses from 12-24 months old
- Stress and extensive use can lead to immunosuppression in horses.
- Immunity develops during the first two years, making horses susceptible to disease
Immunity
- Neonatal foals get host immunity and pathogen exposure.
- Foals at six months experience a loss of maternal antibodies
- From 6-12 months of age, foals can start vaccination
- Stress from Travel and Competition can affect immunity
- Environmental management, considering indoor versus outdoor settings, is important
Clinical Signs
- Clinical signs of Equine Pneumonia include:
- Fever
- Depression
- Abnormal lung sounds
- Purulent nasal discharge
- Elevated fibrinogen, neutrophilic leukocytosis
- Predisposing factors include EHV-4, weaning, overcrowding, parasitic pulmonary migration and transportation
Bacterial Pathogens
- Bacteria that can cause equine pneumonia:
- Streptococcus equi subsp. zooepidemicus
- Streptococcus pneumoniae
- Actinobacillus equuli
- Pasteurella spp.
- Klebsiella spp.
- Escherichia coli
- Bordetella bronchoseptica
- Rhodococcus equi
Diagnosing Systemically Ill Foals
- Bloodwork, including complete blood count and serum chemistry analysis
- Transtracheal wash
- Thoracic ultrasound and radiographs are performed
Rhodococcus Equi
- R. equi is a gram-positive, pleomorphic, intracellular bacterium.
- R. equi multiplies within alveolar macrophages and is a common cause of pneumonia in foals between 2-3 months old
- Acute manifestation can occur because of chronic disease
- Clinical signs of R. equi:
- Acute onset of dyspnea, fever, and cough
- Marked neutrophilic leukocytosis
- Hyperfibrinogenemia
- Possible diarrhea and abdominal abcess formation
- Possible immune-mediated polysynovitis and/or osteomyelitis/septic arthritis
- R. equi can be detected via thoracic radiographs with perihilar abscessation and alveolarization
R. Equi Transmission
- R. equi is transmitted via:
- Inhalation from stalls and paddocks
- Exhaled air from infected foals
- Acquisition of infection within the first week of life
- January/February foals are at higher risk
- R. equi is endemic on many high-traffic broodmare farms
Virulence Factors in R. equi
- Virulence associated protein A = VapA
- VapA is a virulence factor that supports pathogenicity, survival and replication within macrophages
- Key characteristic is granulomatous inflammation
Treatment for Rhodococcus equi
- Treatment includes Azithromycin +/- Rifampin typically for 3 to 5 weeks
- Other options:
- Clarithromycin at 7.5 mg/kg PO BID
- Erythromycin at 25 mg/kg PO QID on an empty stomach
- Gamithromycin IV diluted and not IM.
- Tulathromycin or tilmicosin are not used
- Macrolides have adverse reactions:
- Anhidrosis and hyperthermia
- Enterocolitis
- Fatal entercolitis in dams
- Additional Theraputics:
- Antiulcer medication
- Flunixin meglumine
- O2 insufflation
- Bronchodilation
Prevention of Rhodococcus equi
- Use hyperimmune plasma to bind circulating bacteria during the first 1-2 days of life
- Avoid overcrowding and separate affected foals
- Monitor herd by checking CBC and fibrinogen every 2 weeks
- Do ultrasonographic screening as majority of foals with subclinical infection will resolve lesions
- The spontaneous recover rate is between 60-88%
Laboratory Results
- For a 7 month old Arabian foal with transient response to ceftiofur and TMS:
- TTW culture showed Streptococcus zooepidemicus
- Parascaris and strongyle were detected
- Parascaris was 910 epg
- Strongyle was 1840 epg
- This indicates additional diagnostic testing is needed
Other Causes for Bacterial Colonization
- R. equi for 2-4 month olds
- S. equi subsp. zooepidemicus for 4-12 month olds
- Other potential pathogens along with deworming history and resistance
Diagnosing a 90-Day Old Foal
- For a 90 day old Thoroughbred foal with lethargy and increased respiratory rate:
- Crackles in cranioventral lung fields with paroxysmal cough
- Audible tracheal rattle and a fever of 103.5
- Thoracic ultrasound reveals peripheral hypoechoic areas measuring 2-6 cm in diameter, which are multiple and bilaterally present
- Thoracic radiographs show alveolar and nodular patterns
- The foal exhibited inflammatory leukogram with hyperfibrinogenemia, further testing with transtracheal wash
Equine Pneumonia in Adult Horses
- Viral causes
- Secondary invaders
- Influenced by long distance travel
- Pneumonia can develop following esophageal obstruction or co-mingling
Bacterial Pathogens
- Bacteria that can cause equine pneumonia in adults include:
- Streptococcus equi subsp. zooepidemicus
- Escherichia coli
- Actinobacillus equuli
- Pasteurella spp.
- Klebsiella spp.
- Anaerobes
- Bacteroides
Bronchopneumonia and Pleuropneumonia
- Characteristics of includes:
- Pyrexia
- Lethargy
- Exercise intolerance -Influenced by Long distance transport and Esophageal obstruction
- Abnormal auscultation
- Need to hear breath sounds with increased inhaled C02 and deeper breaths
Diagnosing Pleuropneumonia
- Leukopenia during acute stages
- Leukocytosis later and with chronicity
- Hyperfibrinogenemia may be marked
- Anemia with chronicity is anemia of chronic disease (ACD)
- Azotemia may be associated with severity of illness and suggests a more guarded prognosis
Clinical Approach to Pneumonia / Pleuropneumonia
- Conduct a physical examination, hematology, serum chemistry profile and thoracic ultrasound
- Perform a transtracheal wash for bacterial isolates and antibiotic susceptibility profile. Streptococcus equi subsp. zooepidemicus is the most common isolate
- Assess pleural fluid through thoracocentesis, cytology and culture
- Obtain thoracic radiographs and select antimicrobial intervention
- Develop a long term plan dependent on response to therapy
Summary of Diagnosing Equine Pneumonia
- Bronchopneumonia can happen in young, adult and geriatric horses
- Determining the inciting pathogen is key to an effective plan
- A definitive diagnosis and appropriate treatment plan provides the most favorable prognosis
- Streptococcus equi subspecies zooepidemicus is the most common pathogen of the equine lung
- Treat for disease resolution but avoid wide use of antimicrobials to prevent AMR/MDR organisms
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