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DIAGNOSTIC APPROACH TO EQUINE RESP - Coggle Diagram
DIAGNOSTIC APPROACH TO EQUINE RESP
Initial
Sx/ presenting complaint
Hx: narrow Ddx (other animals, season, use, travel, illness/med, vacc)
Examination
Distance: rate, rhythm, character
increased= many dz
Dyspnoea (normal= 6-8bpm)
decreased gas exchange (LRT, exp dyspnoea)
Obstruction/ restriction of breathing (URT= insp dyspnoea)
General: oedema? SC emphysema? jugular v. distension
of
Resp tract:
nasal discharge? Cough?
only concerns based on context E.g. spontaneous cough= sig.
Auscultate trachea and both hemithoraces
CHANGE IN SOUND
Lung parenchyma and chest wall thickness
Obese horse?
Lung consolidation
Bronchovesicular sounds
Ancillary Tests
Standing endoscopy
sedation affects URT
Dynamic endoscopy: induce hyperpnea
CO2 challenge
Nasal occlusion
Exercise
Transtracheal sampling
Endoscopically
contaminants= bacillus sp, coagulase negative staph, pseudomonas, staph, proteus, ANAEROBES
Direct Aspirate
between tracheal rings= limited contamination
BAL
NOT FOR FOCAL DZ
use for e.g. Asthma
Culture not useful
Sedation: Cutorphanol (mitigate coughing)
Use V greater than 200mls
vs TTW
Use TTW if infectious (febrile, coughing, unswell, multiple horses
if recently progressed= do BOTH
Thoracic US
severity and type of parenchymal dz, classify pleural fluid, thoracic mass ID
How
high freq transducer initially, can lower depending on path.
white line= normal visceral pleural surface.