Care of the Hospitalized Equine Patient Monitoring and Lab tests
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| technicians are responsible for the care of equine patients in the hospital setting some of these duties include | IV fluid administration, signs of discomfort, heart rate, respiratory rate, hydration status, CRT, abdominal pain, respiratory distress, shock, laminitis and gastrointestinal motility.
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| an increased heart rate in the equine patient is | a rate of 60 beats per minute or greater and is an indication of pain
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| patient monitoring forms are useful for | designed to identify trends in physical signs
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| patient treatment forms | coordinate treatment periods when several individuals may be responsible for administering medications
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| monitoring and treatment forms are considered | a permanent part of the medical record, which represents a legal document or record of all events during the patients hospitalization
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| horses that are contagious should | be hospitalized in isolation facilities
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| some of the common contagious disease in horses are | colitis (salmonellosis), strangles (S. equi equi), and neurologic form of equine herpesvirus (EHV-1)
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| technicians responsible for the care of patients in isolation setting should take the following precausions | wear boots, disposable gloves and body suits which should be disposed of upon leaving the isolation area. a disinfectant foot dip should be used when entering and leaving the area
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| the most common problems resulting in recumbency in horses are | neurologic and musculoskeletal diseases
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| recumbent horses and foals can develop pressure sores over what areas | pelvis, elbows and head
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| as a result of pressure and decreased circulation what can become damaged | muscle and underlying bony structures
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| to prevent fecal impaction horses should | be offered fresh grass to facilitate fecal evacuation and those unable to defecate need to have fecal material removed twice a day
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| what can be done to reduce the possibility of pressure sores? | deeply bedded on straw, placed on a padded mat or placed on a mattress, rotated every 6 hours
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| recumbent adult horses can be managed for a period of | 1-2 weeks without the development of complications such as pneumonia, colic
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| a component of the cell wall of gram-negative bacteria are called | endotoxin
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| endotoxemia refers to | the group of clinical signs caused by endotoxin circulating through the bloodstream
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| the signs of endotoxemia include | fever, tachycardia, hyperemic mucous membranes, leukopenia, laminitis and depression
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| the most common cause of endotoxemia is | gastrointestinal disease that compromises the intestinal wall such as diarrhea or colic, allowing translocation of bacteria across the intestinal wall and into the blood stream
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| other causes of endotoxemia can include | retained placenta, metritis (uterine infection), pneumonia, peritonitis and large wounds
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| the best course of treatment for endotoxemia is | the removal of the source
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| nutrition is important in hospitalized patients and can range in the following based on the patients disease and needs | bran mash, pellets, water-soaked hay, parenteral IV nutrition.
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| care needs to be taken when parenteral nutrition is provided because | the risk for septic thrombophlebitis can occur. a dedicated line and aseptic technique are recommended
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| IV catheters can be useful in horses to administer medications, fluids and nutrition the catheter should be checked for the following | infection at the catheter site whether in the SQ tissue or the vein
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| infection at the catheter site in the vein is called | septic thrombophlebitis and can be life threatening
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| ideal antimicrobial is characterized by | its effectiveness against a wide range of bacterial organisms, easy to administer, and nontoxic
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| Penicillin is good for treating | Gram-positive pathogens (streptococcus zooepidemicus, S. equi equi ex procaine penicillin) and frequently administered IM or IV (potassium penicillin)
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| aminoglycoside antimicrobials are efficacious against | gram-negative pathogens administered IM and IV ex. gentamicin, amikacin sulfate
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| aminoglycoside antimicrobials sometimes affect | renal function
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| trimethoprim-sulfa antimicrobials have a moderate effect against | gram-positive negative pathogens
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| the medication to treat anaerobic bacterial infections include | metronidazole
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| other antimicrobials are not widely used because of the risk of | antimicrobial-induced colitis
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| some of the analgesic medications used for horses include | phenylbutazone, flunixin meglumine, firocoxib, are NSAIDS to treat mild to moderate pain
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| medication most effective for the treatment of musculoskeletal pain is | phenylbutazone
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| a medication that may combat the effects of endotoxemia in horses with gastrointestinal tract disease is | flunixin meglumine
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| sedatives that also provide analgesia include | lidocaine (some anti-inflammatory effects) xylazine and detomidine
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| depending on the needed duration of analgesia may determine the appropriate sedative | xylazine provides up to 20 minutes of sedation, where detomidine provides up to 1 hour.
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| a narcotic agonist that provides up to 1 hour of sedation and analgesia for moderate to severe pain is | butorphanol
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| corticosteroids have potent anti-inflammatory properties and are administered for | allergic airway disease, allergic skin conditions, immune-mediated disease and joint inflammation
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| corticosteroids can be administered | orally, topically, parenterally (IV/IM) and intra-articularly
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| adverse affects of corticosteroids include | immunosupression, polyuria or polydipsia, poor hair coat, muscle wasting, poor wound healing, laminitis, and progression of degenerative joint disease
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| an anti-inflammatory drug that is used occationally in horses to relieve swelling and edema associated with CNS trauma, traumatic musculoskeletal injuries, laminitis and myositis is | DMSO
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| because the veterinary technician plays a central role in the day to day monitoring and care of hospitalized patients they must be able to | be observant and to perform a through physical examination
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| Laboratory Studies clinicopathologic testing provides information to identify | impairment of an organ system, confirm a clinical diagnosis, assess patient response to therapy and formulate a prognosis
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| hematology | a complete blood count (CBC)
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| CBC provides information pertaining to | RBC count, WBC count, RBC morphology, WBC differential (including neutrophils, lymphocytes, eosinophils and monocytes), WBC morphology and fibrinogen concentration
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| RBCs are most easily estimated using the | PCV pack cell volume which is normal between 32% and 45%
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| Low PCV less than 30% is indicative of | anemia
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| What happens to the PCV after excitement and exercise | it can be elevated by as much as 50%
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| what happens to the protein levels in response to massive blood loss | it will decrease while lactate levels will increase
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| to identify the presence of infection what needs to be evaluated | the total and differential WBC count will be elevated along with the fibrinogen concentrations
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| a profoundly low WBC count (leukopenia) characterized by low neutrophil count (neutropenia) and immature band neutrophils is indicative of | gram-negative septicemia (endotoxins released from the cell walls of GN bacteria) or gastrointestinal disease, with inflammation allowing mucosal absorption of gram-negative bacteria.
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| high eosinophil counts (eosinophilia) are indicative of | massive parasite ingestation or allergic disease
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| low lymphocyte counts (lymphopenia) may be observed with | early viral infection
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| serum chemistry panels provide specific information pertaining to the | liver, kidney, muscle, and serum electrolyte concentration.
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| the normal color of a horses serum is | yellow as a result of increased serum bilirubin levels because horses do not have gall bladders
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| low serum ALB levels are consistent with liver compromise in most species, horses | maintain ALB levels even with marked impairment of the liver function
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| reliable indicators of liver dysfunction in horses are | high Y-glutamyltransferase (GGT), high serum sorbitol dehydrogenase (SDH), high bile acid concentrations, low BUN and increased ammonia levels
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| chronic renal failure in most species would indicate a low Ca high phosphorus, horses are considered | obligate calcium exterters, with increased Ca concentration
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| reliable indicators of renal failure in horses include | high CREA and BUN and electrolyte abnormalities (decreased Na, Cl, K)
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| diarrhea in horses can often be detected in advance because | the large colon in horses exchanges large amount of electrolytes and fluids on a daily basis, with low electrolyte levels indicating water loss into the lumen of the colon thus resulting in diarrhea
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| an indicator of muscle damage in all species is noted with an increase in | creatine phosphokinase CK.
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| Because horses have large muscle mass, or exercise in an unconditioned horse, transport, rolling from abdominal pain you can expect CK levels to be | elevated, it is a concern when the level is 200 times normal values
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| the enzyme found in muscle tissue following muscle trauma, disease or liver disease is | asparatate aminotransferase (AST) elevated
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| a by product produced by cells underggoing anaerobic metabolism owing to lack of oxygen is | lactic acid or lactate; levels increased when conditions of decreased oxygen delivery to tissues
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| The most common cause of elevated lactate levels (hyperlactatemia) is | hypovalemia (decrease in volume of blood plasma) seen mainly with colic and diarrhea
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| lactate levels in venous blood can provide an objective measurement of | the magnitude of hypovolemia and can help in monitoring the response to fluid therapy
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| other causes of increased blood lactate levels include | anemia, cardiac disease and respiratory disease
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| in colic cases comparing the lactate level in peripheral blood with an abdominal fluid sample can be useful in determining | the viability of the intestine; in colic cases where blood supply is compromised such as large colon volvulus or a strangulating small intestinal lesion result in an elevated lactate level
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| blood gas analysis provides information on the | oxygen and carbon dioxide content, pH, base deficit and bicarbonate levels of a patient
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| arterial samples are indicated to evaluate patients with | respiratory disease
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| venous samples are indicated in patients with | diseases affecting metabolic acid-base status such as diarrhea and kidney disease
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| urinalysis is essential for evaluation of | primary renal disease
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| normal urine in horses contains | calcium carbonate crystals and is usually alkaline pH 7-9, which would lead to a false positive in protein readings
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| because of mucous glands located within the renal pelvis urine may appear | thick and mucoid
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| red urine can be caused for many different reasons | primary urinary tract infection, hemolytic anemia, or myoglbin/myositis
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| specific gravity indicates | the ability of the kidney to concentrate urine in horses no greater than 1.030
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| urinary electrolyte excretion ratios indicate | the ability of the kidney to conserve electrolytes
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| WBC and the presence of bacteria are indicative of | primary urinary tract infection
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| the presence of protein, glucose and casts is indicative | renal disease
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| evaluation of body fluids (CSF, joint, abdominal) provides important information pertaining to | inflammation, infection or neoplasia within that particular body cavity
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| boy fluids can be analyzed for these products | total protein, total cell count, differential cell count, bacterial culture and testing for specific infectious diseases
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| abnormalities in protein and cell counts can identify | an inflammatory, infection, neoplastic process
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| CSF tap can detect several antibodies for neurologic diseases including | equine protozoal myelitis, herpes myeloencephalopathy, enquine encephalomyelitis
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| clinical signs making abdominocentesis necessary are | abdominal pain, abnormal rectal exam, abdominal distention, idiopathic fever
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| cocmplications of abdominocentesis include | tramatic bowel rupture, bowel rupture, trav
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| techs play an important role in bacterial testing of specimens collected from patients with infectious disese from | bodily fluid, feces, urine, wound exudate
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| a laboratory technique that identifies and amplifies a specific segment of genetic meaterial from bacteria, viruses, or animals | polymerase chain reaction PCR
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| PCR allows for very sensitive and specific diagnostic testing for bacterial and viral pathogens, genetic disease because | the DNA sample are unique to each organism
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| PCR can be used to diagnose genetic disorders by | identifying the segment of DNA specific to the disease
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| fasting hyperbilirubinemia | a normal response to serum bilirubin concentrations when feed is withheld for 24 hours in horses
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| capitalization of veterinary technician skills in food animal practice can help with | meeting client and patient needs and can improve practice productivity, efficiency and revenue
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