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Unit 4 Objectives
Care of the Hospitalized Equine Patient Monitoring and Lab tests
| Term | Definition |
|---|---|
| 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. |
| an increased heart rate in the equine patient is | a rate of 60 beats per minute or greater and is an indication of pain |
| patient monitoring forms are useful for | designed to identify trends in physical signs |
| patient treatment forms | coordinate treatment periods when several individuals may be responsible for administering medications |
| 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 |
| horses that are contagious should | be hospitalized in isolation facilities |
| some of the common contagious disease in horses are | colitis (salmonellosis), strangles (S. equi equi), and neurologic form of equine herpesvirus (EHV-1) |
| 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 |
| the most common problems resulting in recumbency in horses are | neurologic and musculoskeletal diseases |
| recumbent horses and foals can develop pressure sores over what areas | pelvis, elbows and head |
| as a result of pressure and decreased circulation what can become damaged | muscle and underlying bony structures |
| 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 |
| 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 |
| recumbent adult horses can be managed for a period of | 1-2 weeks without the development of complications such as pneumonia, colic |
| a component of the cell wall of gram-negative bacteria are called | endotoxin |
| endotoxemia refers to | the group of clinical signs caused by endotoxin circulating through the bloodstream |
| the signs of endotoxemia include | fever, tachycardia, hyperemic mucous membranes, leukopenia, laminitis and depression |
| 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 |
| other causes of endotoxemia can include | retained placenta, metritis (uterine infection), pneumonia, peritonitis and large wounds |
| the best course of treatment for endotoxemia is | the removal of the source |
| 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. |
| 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 |
| 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 |
| infection at the catheter site in the vein is called | septic thrombophlebitis and can be life threatening |
| ideal antimicrobial is characterized by | its effectiveness against a wide range of bacterial organisms, easy to administer, and nontoxic |
| Penicillin is good for treating | Gram-positive pathogens (streptococcus zooepidemicus, S. equi equi ex procaine penicillin) and frequently administered IM or IV (potassium penicillin) |
| aminoglycoside antimicrobials are efficacious against | gram-negative pathogens administered IM and IV ex. gentamicin, amikacin sulfate |
| aminoglycoside antimicrobials sometimes affect | renal function |
| trimethoprim-sulfa antimicrobials have a moderate effect against | gram-positive negative pathogens |
| the medication to treat anaerobic bacterial infections include | metronidazole |
| other antimicrobials are not widely used because of the risk of | antimicrobial-induced colitis |
| some of the analgesic medications used for horses include | phenylbutazone, flunixin meglumine, firocoxib, are NSAIDS to treat mild to moderate pain |
| medication most effective for the treatment of musculoskeletal pain is | phenylbutazone |
| a medication that may combat the effects of endotoxemia in horses with gastrointestinal tract disease is | flunixin meglumine |
| sedatives that also provide analgesia include | lidocaine (some anti-inflammatory effects) xylazine and detomidine |
| 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. |
| a narcotic agonist that provides up to 1 hour of sedation and analgesia for moderate to severe pain is | butorphanol |
| corticosteroids have potent anti-inflammatory properties and are administered for | allergic airway disease, allergic skin conditions, immune-mediated disease and joint inflammation |
| corticosteroids can be administered | orally, topically, parenterally (IV/IM) and intra-articularly |
| adverse affects of corticosteroids include | immunosupression, polyuria or polydipsia, poor hair coat, muscle wasting, poor wound healing, laminitis, and progression of degenerative joint disease |
| 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 |
| 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 |
| 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 |
| hematology | a complete blood count (CBC) |
| CBC provides information pertaining to | RBC count, WBC count, RBC morphology, WBC differential (including neutrophils, lymphocytes, eosinophils and monocytes), WBC morphology and fibrinogen concentration |
| RBCs are most easily estimated using the | PCV pack cell volume which is normal between 32% and 45% |
| Low PCV less than 30% is indicative of | anemia |
| What happens to the PCV after excitement and exercise | it can be elevated by as much as 50% |
| what happens to the protein levels in response to massive blood loss | it will decrease while lactate levels will increase |
| 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 |
| 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. |
| high eosinophil counts (eosinophilia) are indicative of | massive parasite ingestation or allergic disease |
| low lymphocyte counts (lymphopenia) may be observed with | early viral infection |
| serum chemistry panels provide specific information pertaining to the | liver, kidney, muscle, and serum electrolyte concentration. |
| the normal color of a horses serum is | yellow as a result of increased serum bilirubin levels because horses do not have gall bladders |
| low serum ALB levels are consistent with liver compromise in most species, horses | maintain ALB levels even with marked impairment of the liver function |
| 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 |
| chronic renal failure in most species would indicate a low Ca high phosphorus, horses are considered | obligate calcium exterters, with increased Ca concentration |
| reliable indicators of renal failure in horses include | high CREA and BUN and electrolyte abnormalities (decreased Na, Cl, K) |
| 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 |
| an indicator of muscle damage in all species is noted with an increase in | creatine phosphokinase CK. |
| 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 |
| the enzyme found in muscle tissue following muscle trauma, disease or liver disease is | asparatate aminotransferase (AST) elevated |
| 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 |
| The most common cause of elevated lactate levels (hyperlactatemia) is | hypovalemia (decrease in volume of blood plasma) seen mainly with colic and diarrhea |
| 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 |
| other causes of increased blood lactate levels include | anemia, cardiac disease and respiratory disease |
| 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 |
| blood gas analysis provides information on the | oxygen and carbon dioxide content, pH, base deficit and bicarbonate levels of a patient |
| arterial samples are indicated to evaluate patients with | respiratory disease |
| venous samples are indicated in patients with | diseases affecting metabolic acid-base status such as diarrhea and kidney disease |
| urinalysis is essential for evaluation of | primary renal disease |
| 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 |
| because of mucous glands located within the renal pelvis urine may appear | thick and mucoid |
| red urine can be caused for many different reasons | primary urinary tract infection, hemolytic anemia, or myoglbin/myositis |
| specific gravity indicates | the ability of the kidney to concentrate urine in horses no greater than 1.030 |
| urinary electrolyte excretion ratios indicate | the ability of the kidney to conserve electrolytes |
| WBC and the presence of bacteria are indicative of | primary urinary tract infection |
| the presence of protein, glucose and casts is indicative | renal disease |
| evaluation of body fluids (CSF, joint, abdominal) provides important information pertaining to | inflammation, infection or neoplasia within that particular body cavity |
| boy fluids can be analyzed for these products | total protein, total cell count, differential cell count, bacterial culture and testing for specific infectious diseases |
| abnormalities in protein and cell counts can identify | an inflammatory, infection, neoplastic process |
| CSF tap can detect several antibodies for neurologic diseases including | equine protozoal myelitis, herpes myeloencephalopathy, enquine encephalomyelitis |
| clinical signs making abdominocentesis necessary are | abdominal pain, abnormal rectal exam, abdominal distention, idiopathic fever |
| cocmplications of abdominocentesis include | tramatic bowel rupture, bowel rupture, trav |
| techs play an important role in bacterial testing of specimens collected from patients with infectious disese from | bodily fluid, feces, urine, wound exudate |
| a laboratory technique that identifies and amplifies a specific segment of genetic meaterial from bacteria, viruses, or animals | polymerase chain reaction PCR |
| 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 |
| PCR can be used to diagnose genetic disorders by | identifying the segment of DNA specific to the disease |
| fasting hyperbilirubinemia | a normal response to serum bilirubin concentrations when feed is withheld for 24 hours in horses |
| 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 |
Created by:
tnewhouse
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