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Case presentations Week two

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Page 1: Morocco presentations

Case presentationsWeek two

Page 2: Morocco presentations

Mule with strangles

• Presented on the 25/11 with a days inappetance, some coughing and a swelling of the ventral neck/jaw.

• T = 37.8, P = 44, R = 20 with abdominal effort and a noisy trachea.

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• Presentation typical of strangles (Streptococcus equi equi).

• Isolation controls, penicillin 20mg/kg BID, hot compress QID.

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Case PresentationsWeek 3

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Rectal Prolapse • Adult mare presented on

3/12 with rectal prolapse (since previous evening) and lameness.

• Rectum replaced under epidural (xylazine and lidocaine), and Bunna suture placed.

• Forefeet radiographed, trimmed and pads placed.

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Case PresentationsWeek Four

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Anterior Uveitis• Young adult, male, horse.• Presented on 8/12 with a

closed eye and overflowing tears following probable trauma when rubbing face on a branch three days ago.

• Examination facilitated by auriculopalpebral (motor) and supraorbital (sensory) nerve blocks.

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• Findings: blepharospasm, enophthalmos, epiphora, miosis, aqueous flare and hyphaema in ventral anterior chamber, and neovascularisation ventrally.

• Treatment: flunixin 1.1mg/kg BID IV, atropine eye drops BID/to effect, dexamethasone eye drops TID (sub palpebral lavage).

• Response: eye lids quickly opened, pupil partially dilated with no synchea formed, and anterior chamber beginning to clear.

• Plan: continue decreasing anti-inflammatory program while waiting for chamber to resorb debris. Ideally maintain treatment for one month after clinical signs resolved.

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Weak MuleAmerican Fondouk Case of Interest

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Presentation• Presented on 27th having been weak and shaking

since bought on 23rd.• Appeared ataxic/weak at walk, easily pulled by tail

and slow placement responses.• Odd style of eating, chomping at hay rather than

chewing properly.• T = 38.1, P = 80-100 fluctuating, R = 20, gut sounds

normal.• MM pale and slightly blue.

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Diagnostics

27/11/14 28/11/14 am 28/11/14 pm

HaematologyHCT 44%mild neutrophilia

TP 7g/dl

HCT 42%neutrophila increased

TP 7g/dl

PCV 40-42%TP 6.3 g/dl

Biochemistrymild low BUN mild low CREAmild high GGT

mild high ASTmild high BIL

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Treatment

• Cetiofur TID, gentamicin SID started 27/11.

• 0.9% NaCl IV fluid therapy started 28/11 running fast to replace estimated 8% dehydration (based on high HCT not clinical signs).

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Case Progression• Heart rate remained high but fluctuating.

• MM became pink from 2000 27/11 until 1200 28/11 but then became pale and blue again.

• Seen head pressing 1700 27/11 and developed dull demeanour.

• Weakness increased until recumbent and unable to rise or shift self along the floor approx. midday 28/11/14

• Exhalation grunt, nystagmus and rapid heart rate developed from 1200-1500.

• Euthanised 1540.

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Post Mortem Findings• Displaced SI between body

wall and spleen.

• Enlarged spleen speckled with congestion.

• Exceedingly firm nutmeg liver, rounded edges.

• No abnormalities detected in the heart, lung or kidney.

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Appendix

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