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Endoscopy
- Use of a fiber optic camera to view into body cavities or organs
- Can be rigid or flexible
- Flexible scopes can be much longer, more adaptable and easier to manipulate
- Arthroscopes, rhinoscopes, laparoscopes
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Endoscopy output
- Can send image to eyepiece (fiber optic), TV screen, VCR or digital camera
- Can save images to paper, tape or computer disc
- Uses: upper and lower respiratory exams, stomach exams (ulcers), sinus and gutteral pouch(air-filled out-pouching of the auditory or Eustachian tube) exams, abdominal and thoracic surgery, joint surgery
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Flouroscopy
- “Real time” xray with images projected to a TV screen
- Useful because 3-D image can be gained very quickly, no xray retakes and extra farm calls, can do a quick scan of an entire leg for the cost of a computer disc
- VERY HIGH levels of radiation to operator’s hands and arms (40X reg. Rads)
- Negative images (black vs white)
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Scintigraphy
- “Nuc med”, “bone scan”
- Use of a radioactive isotope (Technetium 99) to locate areas of active inflammation and bone turnover
- Inject intravenously, wait 2-3 hours and scan for “soft tissue” phase, 3-4 hours for “bone phase”
- Images gathered using a gamma camera and saved to film similar to radiograph film
- Background and non-inflammed areas appear white, inflammed areas appear black, intensity of the black indicates severity of the inflammation
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Scintigraphy - uses
- Uses - vague lameness exam, lameness diagnosis in an uncooperative patient, indicates area to focus radiographs/UltraSound
- Isotope is excreted through urine, horse remains radioactive for 24 hours; must be cleared with a Geiger counter before release to the owner. Bedding and urine must be disposed in accordance with state and federal law
- No danger just being in vicinity of horse, wear rubber gloves if handling it, try to not sedate if possible
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Ultrasound
Pleisomorphic crystals in probe vibrate to produce sound waves which enter tissue, the amount of waves that bounce back are collected and turned into a grey scale
- White - all waves returned (bone, air)
- Grey - some waves returned (soft tissues)
- Black - no waves returned (fluid)
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Ultrasound - uses
- Useful for examining soft tissue structures and determining density of certain tissues (pneumonia), ultrasound guided procedures, reproductive exams, pregnancy diagnosis
- Best pictures are obtained if area is shaved (no air trapped under skin), but showhorse owners will object! Can soak hair with alcohol or ultrasound gel
- Increasing wavelengths cause decreasing penetration - 3 MHz probes penetrate very deeply but picture has less resolution(definition) than a 7.5 MHz
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Trailering
- Often called to help when it is too late - owner has been fighting with horse for a long time and everyone is tired and upset, horse is scared and tired
- Trailering issues are: problem loader, trailer accident, horse through floorboards
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Types of Trailers
- stock vs straight loads vs slant loads
- Bumper pull vs gooseneck vs Semi’s
- Ramps vs step up
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Trailering Isuues
- Common injuries - head bangs on roof of a trailer that is too short, body/head bangs on edge as the horse backs out or refuses to go in
- Lower legs - stumbles as loading, trying to keep balance in trailer, stumbling as unloading, “scramblers”
- Prevent these injuries by ensuring trailer is the proper size/type for the horse, head bumpers, shipping boots
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Chronic Obstructive Pulmonary Disorder (COPD)
- AKA “heaves”
- Horse version of asthma
- An allergic airway response to an environmental allergen, usually mold or dust in the hay or barn
- Seen mainly in older horses kept inside or ridden in indoor arenas
- Clinical signs - chronic dry coughing, especially when eating hay or starting exercise; intermittent white runny nose with no fever, mild to moderate dyspnea especially on expiration that may progress into “attacks” of severe dyspnea; formation of a heave line (hypertrophy of the diaphragm muscles) along the abdomen due muscles making extra effort to expire a breath
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COPD - diagnosis
- Diagnosis - clinical signs, endoscopic exam, bronchoalveolar lavage, response to treatment
- Endoscopy - increased mucous in trachea and bronchi
- Bronchoalveolar lavage - pass a flexible silicone catheter into the lungs until it wedges in a brochus; lavage with 240 ml saline in 60ml aliquots (60 in, aspirate as much as possible) - look at color, consistency and cytology
- Not a sterile sample, so culture is no good
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COPD - Tx
- Treatment - removal from the stimulus - keep outside as much as possible, remove moldy or dusty hay, soak hay in water for 20 minutes before feeding or take off hay completely, do not ride indoors
- Medical treatment – prednisone/azium pwd, bronchodilators (clenbuterol, albuterol), atropine for emergency attacks
- This is a progressive disease that will not go away and will get worse as the horse ages
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Laryngeal Hemiplegia
- Paralysis of one of the arytenoid cartilages in the larynx of the horse
- Usually the left side is paralyzed
- Most commonly diagnosed in racehorses and higher level sport horses
- Most likely caused by damage to the left recurrent laryngeal nerve where it wraps around the left jugular vein
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Laryngeal Hemiplegia - Diagnosis and tx
- Racehorses are never given IV injections on the left to prevent possible lawsuits if the horse becomes affected later on
- Clinical signs - loud inspiratory “roaring”, especially at speed or when head and neck are severely flexed, poor performance
- Diagnosis - endoscopy at rest for severe cases or on a high speed treadmill
- Treatment - surgical correction - prosthetic laryngoplasty (AKA “tie back”)
- Tie arytenoid cartilage in the fully open position - this will not scar, so the suture must hold for the animal’s entire career (it usually doesn’t)
- 50-70% of success
- With the cartilage tied open, the horse cannot completely cover the trachea during swallowing, so these horses may develop aspiration pneumonia
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Laryngeal Hemiplegia - grades
- Grade 1 - all movements are equal and normal
- Grade 2 - mild or intermittent failure to fully open cartilages
- Grade 3 - asynchronous, incomplete opening
- Grade 4 - complete paralysis
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