Term
| What are some potential immunodeficiencies of horses? |
|
Definition
-failure of passive transfer
-severe combned immunnodeficiency (SCID)
-IgM deficiency
-X-linked aggamaglobuliinemia
-fell pony immunodeficiency syndrome |
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Term
| What are some equine hemolymphatic disorders? |
|
Definition
-coagulopathy
-hemolysis
-IMHA
-IMTP
-neoplasia: lymphosarcoma, other |
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|
Term
| What is the most common immunodeficiency? |
|
Definition
| -failure of passive transfer |
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|
Term
| Describe failure of passive transfer? |
|
Definition
-immunologically naive: no memory response
-several innate immune mechanisms not equivalent to adults at birth
-due to risk of sepsis |
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Term
| With failure of passive transfer, treat it as if ______ is present. |
|
Definition
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Term
| What are some of the causes of FPT? |
|
Definition
-inadequate colostral intake: prematurity, hypoxic-ischemic encephalopathy
-leaking prior to parturition: placentitis
-agalactia: fescue toxicosis
-poor quality
-poor absorption
IgG less than 800 mg/dl at 24 hrs
-all breeds: neonate
-predisposition to sepsis |
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Term
|
Definition
|
|
Term
| What are the clinical signs of sepsis? |
|
Definition
| -lethargy, weakness, tachycardia, dehydration, diarrhea, petechiation, mm infection, edema, hypothermia |
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|
Term
|
Definition
-oral colostrum up to 24h (early intervention)
-REFERRAL TO INTERNIST
-IV plasma
-broad spectrum antimicrobials
-NSAIDs are risky
-fluid support
-pressor support: Dopamine, dobutamine, NE, vasopressin
-Nutritional support: IV PPN or TPN |
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|
Term
| Describe the pathophysiology of SCID. |
|
Definition
| -autosomal recessive state: lack ezyme responsible for gene rearrangement necessary to T and B cell Ag receptors (DNA dep protein kinase) |
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|
Term
| Describe the general signalment of SCID. |
|
Definition
-ARabians: 8% carriers, dogs, mice, humans
-foals 2-4m of age |
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|
Term
| What are the clinical signs of SCID? |
|
Definition
-normal at birth but see clinical signs at 1-3m of age
-failure to thrive, recurrent infections (resp dz, omphalophlebitis, arthritis, enteritis, adenovirus, pneumocystis carinii, R. equi, cryptosporidium |
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|
Term
| What diagnostics do we use for SCID? |
|
Definition
-CBC
-lymphopenia: B and T cells affected
-low immunoglobulins: IgM dec
-concurrent evidence of infection: neutrophilia and hyperfibrinogenemia
-Genetic testing: VetGen, Ann Arbor, MI
-PCR and Southern blotting
-whole blood |
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|
Term
|
Definition
-bone marrow transplant has been effective in one reported case
-donation for research
-euthanasia
-education regarding future pregnancies |
|
|
Term
| What ages of horses are typical for selective IgM deficiency? |
|
Definition
|
|
Term
| What levels of IgM are considered selective IgM deficiency? |
|
Definition
| -IgM greater than @X SD below normal |
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|
Term
| What usually happens to foals with selective IgM deficiency? What causes this outcome? |
|
Definition
-many die 10 moths to 2 years of age
-pneumonia Gm negative (Klebsiella), septic arthritis, enteritis, septicemia |
|
|
Term
| What clinical signs show in a adult horse 2-5y of age with selective IgM deficiency? |
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Definition
| -weight loss, lyphadenopathy, many develop lymphoma |
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|
Term
| Which group of horses is affected by X-linked aggamaglobulinemia? |
|
Definition
|
|
Term
| What age groups of male horses are affected by X-linked aggamaglobulinemia? |
|
Definition
|
|
Term
| How does X-linked aggamaglobulinemia present in male horses? |
|
Definition
-bacterial infection: pneumonia, enteritis, arthritis
-lack B cells and plasma cells |
|
|
Term
| What is aggamaglobulinemia? |
|
Definition
-no IgM or IgA
-IgG declines with age (colostral) |
|
|
Term
| Does aggamaglobulinemia respond to vaccination? |
|
Definition
| -no response to vaccination |
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Term
| What is the usual outcome of aggamaglobulinemia? |
|
Definition
| -usually succumb to infection by 1-2y of age |
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|
Term
| Which breeds are affected by Foal Immunodeficiency Syndrome? |
|
Definition
| -Fell and Dales Ponies and crosses |
|
|
Term
| Which age groups are affected by Foal Immunodeficiency Syndrome? When do they die? |
|
Definition
-2-3 weeks of age are affected
-death by 3m |
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|
Term
| What are the clinical signs of Foal Immunodeficiency Syndrome? |
|
Definition
| -poor condition, respiratory disease, glossal hyperkeratosis, diarrhea |
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|
Term
| Describe the clinicopathology of Foal Immunodeficiency Syndrome? |
|
Definition
-anemia and immunodeficiency
-anemia: severe non-regenerative
-normal or hypogammaglobinemie
-low B-cells, no plasma cells
-Low MHC II expression on lymphocytes
-T cells normal
-lymphocyte proliferation is normal |
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|
Term
| Is Foal Immunodeficiency Syndrome dominant or recessive? |
|
Definition
|
|
Term
| What are some examples of acquired coagulopathy? |
|
Definition
| -DIC, vasculitis, thrombocytopenia, moldy sweet clover, warfarin |
|
|
Term
| What are the two types of coagulopathy? |
|
Definition
|
|
Term
| DIC is most commonly associated with severe ______. |
|
Definition
|
|
Term
| True or False: In regards to DIC, bleeding tendencies are more common than hypercoagulation. |
|
Definition
| -FALSE, hypercoagulation more common than bleeding tendencies |
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|
Term
| Are congenital coagulopathies common or rare? |
|
Definition
|
|
Term
| What are some examples of congenital coagulopathies? |
|
Definition
-vWF
-VIII, IX, XI
-prekallikrein |
|
|
Term
| What are the two types of hemolytic anemia? |
|
Definition
| -intravascular or extravascular |
|
|
Term
| Describe the clinical picture of hemolysis. |
|
Definition
-anemia variable 6-20%
-hemoglobinemia/hemoglobinuria
-hyperbilirubinemia: indirect
-MM pale or icteric
-Tachycardia
-other |
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|
Term
| Describe the clinical picture of hemolytic anemia. |
|
Definition
-anemia variable 6-20%
-hemoglobinemia/hemoglobinuria
-hyperbiliruinemiea: indirect
-MM pale or icteric
-tachycardia |
|
|
Term
| What are the uncommon causes of hemolysis in the horse? |
|
Definition
-iatrogenic: hypertonic or hypotonic fluids: DMSO, home made fluids without electrolytes
-DIC
-fulminant hepatic failure
-ARF: hemolytic uremic syndrome |
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|
Term
| What are some common causes of hemolysis in the horse? |
|
Definition
-IMHA
-oxidative injury: red maple toxicosis, onions
-piroplasmosis |
|
|
Term
| What is IMHA commonly secondary to in the horse? |
|
Definition
-bacterial infection: Strep, clostridium perfringens
-Viral: eIA
-Neoplasia: lymphosarcoma
-Drugs: penicillin |
|
|
Term
|
Definition
-stop all mediations
-fluid support if hemoglobinemic
-blood transfusion
-corticosteroids: dexamethasone, prednisolone |
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|
Term
| Describe the clinical pathology of oxidative injury. |
|
Definition
-methemoglobinemia
-brown mm along with icterus
-hemoglobinuria
-bilirubinemia, bilirubinuria
-Heinz bodies |
|
|
Term
| How do we treat red maple toxicosis? |
|
Definition
-remove source
-exame all other exposed :charcoal
-fluid support
-blood transfusions
-vitamin C
-methylene blue is ineffective |
|
|
Term
| What are the clinical signs of red maple toxicosis? |
|
Definition
-pigment nephropathy
-colic
-diarreha
-laminitis
-acute death |
|
|
Term
| What is the prognosis of red maple toxicosis in horses? |
|
Definition
|
|
Term
| What are some of the causes of immune-mediated thrombocytopenia in horses? |
|
Definition
-most often idiopathic
-secondary to bacterial or viral infection
-neoplasia (lymphosarcoma)
-drugs
-autoimmune diseases: AIHA, vasculitis, glomerulonephritis |
|
|
Term
| What are the clinical signs of IMTP? |
|
Definition
-petechiation
-ecchymosis
-epistaxis
-melena
-hyphema
-bleedng after vnipuncture (platelet counts typically <30,000/ul) |
|
|
Term
| What are the PT and PTT results with IMTP? Bone marrow? Flow cytometry? |
|
Definition
-normal
-normal to increased megakaryocytes
-flow cytometry has been used to demonstrate platelet bound IgG and IgM |
|
|
Term
|
Definition
-stop anyt current medications
-PRP or fresh whole blood
-dexamethasone
-Prednisolone
-Azathioprine
-Vincristine |
|
|
Term
| Which ages of horses are affected by equine lymphosarcoma? |
|
Definition
|
|
Term
| What are the anatomical forms of equine lymphosarcoma? |
|
Definition
| -generalized, intestinal, mediastinal, cutaneous |
|
|
Term
| What are the clinical signs of lymphosarcoma? |
|
Definition
| -lethargy, weight loss, ventral edema, organ dependent signs: thorax (cardiac), abdomen, CNS |
|
|
Term
| Describe the clinical pathology of lymphosarcoma. |
|
Definition
-VARIABLE
-chronic inflammation: neutrophilia, hyperfibrinogenemia, non-regenerative anemia, hypergammaglobulinemia
-often have low IgM
-lymphocyte counts normal to low
-rarely leukemia
-rare neoplastic cells in effusions
-biopsy of mass preferred oveer aspirate for cytology |
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|
Term
| Give a few examples of paraneoplastic syndromes. |
|
Definition
-hypercalcemia
-IMHA
-IMTP
-hypereosinophilia |
|
|
Term
| What is the prognosis of lymphosarcoma? |
|
Definition
|
|
Term
| What are some other examples of hemolymphatic neoplasia? |
|
Definition
-myeloid neoplasia any age: granulocytic, monocytic, myelomonocytic, eosinophilic myeloproliferative disorder
-myelophthisis: hemorrhage
-plasma cell myeloma: rare |
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