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Topic:Clinical Examination
Clinical examination in horses involves a systematic evaluation of the animal to assess its health status and identify any potential medical issues. This process typically includes a thorough physical assessment, which may cover observation of behavior and posture, palpation of body structures, auscultation of heart and lung sounds, and examination of the skin, eyes, and mucous membranes. Additional diagnostic tools such as thermography, endoscopy, or imaging techniques may be utilized to gather more detailed information. Clinical examination serves as a foundational step in veterinary diagnostics, aiding in the detection and management of diseases or injuries in horses. This page compiles peer-reviewed research studies and scholarly articles that explore methodologies, advancements, and findings related to clinical examination practices in equine medicine.
Future diagnostic methods. A brief look at new technologies and their potential application to equine diagnosis. We live in an age in which highly sophisticated computerized equipment and imaging methods are becoming increasingly available. Demand from clients requires that we as veterinary professionals keep our eyes on the future potential of these technologies for diagnosis and treatment. This article briefly reviews some of the techniques that are just around the corner for the progressive equine practitioner.
Nonsurgical removal of chondroid masses from the guttural pouches of two horses. Chondroid masses were successfully removed from the guttural pouches of 2 horses, using an endoscope, a snare, and a vacuum pump. This technique is an alternative to surgical removal of chondroid masses in patients when basic lavage of the affected guttural pouch is ineffective. Complications were not encountered. Advantages of this snare technique include avoidance of surgery and its potential complications, minimal recovery time, and minimal expense.
Treadmill exercise testing. Treadmill installation and training protocols used for clinical evaluations of equine athletes. The use of motorized treadmills has made it possible to evaluate equine poor performance with sophisticated diagnostic techniques during peak exercise. Treadmill exercise tests currently being used for clinical evaluations include treadmill gait analysis, dynamic hoof balancing, endoscopic evaluation of upper airway function, and exercise performance profiling. Large motorized treadmills (1 to 1.5 m in width and 4 to 5 m in length) are best suited for clinical evaluations. Ideally, the treadmill should be installed in-ground using a pit. This type of installation results in the tread surface b...
Dynamic evaluation of the equine upper respiratory tract. Each case of suboptimal equine athletic performance should be evaluated in a comprehensive manner, including physical examination; clinical pathologic analysis; and evaluation of the neurologic system, the musculoskeletal system, and the upper and lower respiratory system. A vital part of this examination is the clinical evaluation of dynamic upper respiratory tract function of the horse during treadmill exercise, which allows the observation of upper respiratory tract function during conditions simulating competitive racing. It generally is agreed that the endoscopic identification of an uppe...
Application of clinical exercise testing for identification of respiratory fitness and disease in the equine athlete. Maximal exercise testing is a valuable diagnostic tool for the evaluation of exercise intolerance and level of fitness in the equine athlete. A description of the standardized incremental exercise testing protocol and interpretation of the results of the test is followed by a discussion of more specific diagnostic techniques aimed at identifying pulmonary dysfunction as a cause of suboptimal performance.
The integration of radiography and alternative imaging methods in the diagnosis of equine orthopedic disease. There is increasing demand on equine practitioners to provide confirmation of their diagnoses. For obscure lameness and for many of the more difficult locomotory problems presented in referral hospitals, the question to be answered is not only how to make the most accurate diagnosis but also how to document the findings so that there is less doubt in the mind of the client. This article describes a quasi algorithmic approach to choosing the best combinations of the increasingly sophisticated imaging methods available for evaluation of orthopedic disease.
The role of scintigraphy in the lameness evaluation. Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculos...
Advances in diagnostic ultrasonography. A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be ...
Thermography as an aid to the clinical lameness evaluation. Thermography has been shown to be a practical aid in the clinical evaluation of lameness. This modality specifically increases the accuracy of diagnosis. Thermography represents skin temperature, usually pictorially. The techniques involve contacting and noncontacting modalities. Noncontacting thermography, which detects infrared radiation, is the most accurate. In order to be accurate, thermography must be performed in a temperature-controlled, draft-free area. The area should be protected from sunlight to avoid erroneous heating of the skin, and the hair length should be uniform. Thermograph...
Histamine inhalation challenge in normal horses and in horses with small airway disease. A histamine inhalation challenge (HIC) procedure was developed to assess hyperreactive states in horses. Following clinical evaluation, percutaneous lung biopsies were performed on nine light breed mares aged 6 to 15 years. Five horses, with normal small airways, were classified as group A and four subjects with small airway disease (SAD) lesions formed group B. Pulmonary mechanics parameters were monitored following an aerosol of 0.9% saline and every 5 min for up to 30 min after HIC with 0.5% w/v of histamine diphosphate, administered through a face mask for 2.5 min. Tidal volume (VT) and ai...
Use of phenytoin to treat horses with Australian stringhalt. Five horses with Australian stringhalt were treated with 15 mg/kg phenytoin orally for 2 weeks. During the second week of the trial, 3 of the horses were given an additional dose of 10 mg/kg phenytoin. The response to treatment was clinically assessed by grading the severity of the gait abnormality at the walk, trot, turning and backing twice daily. There was a significant (P less than 0.05) improvement in the gait abnormality when pre-treatment values were compared with the mean of the last 3 assessments before treatment stopped. When reassessed 2 weeks after treatment ceased, there remained ...
Resection of a cervical tracheal bronchus in a foal. A 3-day-old Thoroughbred foal developed a large, air-distended, midcervical swelling that was diagnosed as a congenital tracheal bronchus with associated ectopic lung tissue. Clinical signs consisted of a compressible air-filled sac that enveloped the trachea. The nature and extent of the defect were evaluated endoscopically and radiographically. Surgical resection of the bronchus and associated air-filled sac resulted in a functionally and cosmetically acceptable outcome.
Head trauma in two horses. The initial clinical signs displayed by two horses with head trauma are described and related to the pathology and management of the condition, to illustrate the diversity of signs that may result from similar events. It is suggested that careful repeated neurological investigations are more reliable prognostic indicators in cases of equine head trauma than a reliance on the initial assessment.
[Possibilities of clinico-cytological diagnosis in contagious equine metritis (CEM)]. Clinical, bacteriological and serological examinations on a 6 years old pony mare were performed. Cytological alterations in the genital tract were also recorded. A cellular reaction was seen after infection with T. equigenitalis. This reaction is an evidence for infection but it is not specific for this organism. Cytological studies should be performed on mares especially in cases of latent infections to complete bacteriological examination and to prevent false positive or negative results.
The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part I: Subjective and objective laryngeal evaluation. Videorecordings of the laryngeal activity of 108 unsedated horses were obtained at rest by passing a flexible videoendoscope into the nasopharynx through the right ventral meatus. All videotaped images were reviewed once, and 72 were reviewed twice, by three veterinarians. Laryngeal cartilage movement was assessed subjectively with a five-tier grading system. The mean intraobserver agreement was 83.3% (range, 75.0%-90.2%) with a kappa statistic of .65 to .98. The mean interobserver agreement was 79.0% (range, 70.4%-80.6%) with a kappa statistic of .51 to .90. A computer program was developed t...
Clinical evaluation of poor performance in the racehorse: the results of 275 evaluations. A clinical sports medicine evaluation was applied to 275 racehorses with a history of poor racing performance. The poor performance evaluation included a) general physical examination and basic laboratory screening; b) respiratory examination including auscultation, thoracic radiographs, ventilation-perfusion lung scintigraphy and upper airway endoscopy at rest and during maximal treadmill exercise c) examination of the musculoskeletal system including lameness examination, video gait analysis at high speed, post exercise serum chemistry to identify obvious as well as sub-clinical myopathies, ...
[A method for the quantification of estrus symptoms in mares]. As part of the veterinary surveillance of horse breeding management, the veterinarian is increasingly often requested to predict ovulation and to give a breeding or insemination advice accordingly. The result of a teasing procedure is indispensable for this advice. A suggestion is made for the quantification of oestrus signs. Oestrus symptoms are classified into four categories. In addition, various factors are mentioned, which affect the result of a teasing procedure.
Clinical examination of the respiratory system. Aspects of a detailed examination of the respiratory system of the horse with suspected respiratory system disease are described. This review includes discussions of the terminology of signs associated with respiratory system disease; radiographic examination of the upper and lower airways and thorax; nuclear scintigraphy; percutaneous and endoscopic tracheal aspiration; bronchoalveolar lavage; electromyography; blood gas analysis; and pleuroscopy and pleural fluid examination.
Bacterial pneumonia. Bacterial pneumonia in the horse often occurs secondary to viral respiratory infection; however, primary infections can occur. A diagnosis of bacterial pneumonia is made on the basis of history, physical examination, and laboratory and radiographic findings. Treatment consists of appropriate antimicrobial therapy for at least 7 to 10 days; further therapy may be needed in more severe cases. Prevention of bacterial pneumonia includes attempting to prevent viral respiratory infections and appropriate management to prevent stress to the respiratory tract.
Upper airway obstruction in performance horses. Differential diagnoses and treatment. Abnormalities of the nasal cavity, pharynx, larynx, and trachea result in respiratory noise and exercise intolerance. Clinical features of common upper respiratory conditions of performance horses are reviewed with emphasis on diagnosis, treatment, and risk factors that affect the outcome of surgical treatment.
Application of lasers in equine upper respiratory surgery. The advantages and disadvantages of various surgical lasers are discussed. Included are aspects of laser safety, anesthesia and analgesia considerations for laser surgery, and diagnostic considerations. Horses with lesions such as ethmoid hematomas, nasal polyps, and lymphoid masses are ideal candidates for laser treatment. Other conditions that are suitably treated with lasers, such as dorsal displacement of the soft palate and entrapment of the epiglottis, are described.
Endoscopic findings in the upper respiratory tract of 678 Thoroughbred racehorses. The frequency of upper respiratory tract abnormalities was determined in a selected population of racing Thoroughbreds. The prevalence of pharyngeal lymphoid hyperplasia was 34.2%; left laryngeal hemiplegia was 1.8%; and epiglottic entrapment was 0.74%. Excluding pharyngeal lymphoid hyperplasia and tracheal exudate, 3.7% of the population examined had upper respiratory tract abnormalities.
Bronchoalveolar lavage fluid cytologic findings in horses with pneumonia or pleuropneumonia. Bronchoalveolar lavage was performed in 22 horses with pneumonia or pleuropneumonia. All horses had clinical evidence of pneumonia or pleuropneumonia on the basis of physical, radiographic, ultrasonographic, tracheobronchial aspirate or post-mortem findings. Results of lavage fluid analysis were normal in 9 horses, equivocal in 3 horses, and abnormal in 10 horses. Abnormal lavage fluid had increased total cell count, increased relative and absolute neutrophil counts, degenerative neutrophils, and decreased relative and absolute macrophage and lymphocyte counts.
