Transcript Basic Physical Examination of Horses2

Basic Physical
Examination of
Horses
Chapter #5
LACP
Examination of Horses
• The history and physical examination are the most important
part of the database and serve as the starting point for
identifying the patient’s problems
History
• History
•
•
•
•
•
•
Coach the clientIndividual –food and water source, feeding practices
Management of the entire group
Environmental stresses- pasture management, new animals
Prior treatments- other veterinarians, or self medications/treatments
Do not pass judgment
Physical Examination
• Physical examination
• Baseline
• Potential problems
• Insurance examination
• Required
• Prepurchase examination
• Used in the sale of horses
• It is not a guarantee of horses future performance
Physical examination
• There are several types of physical examinations
for equines
• Insurance examination is required by the
insurance company before a horse can receive
insurance coverage
• Prepurchase examination, conducted before
completing the sale of an animal, the
veterinarian performing the examination is
presumed to be working in the buyer’s best
interest
Visual Observation
• Observe the animal from a distance
•
•
•
•
•
•
•
•
•
Gait
Posture
Hair coat
Behavior
Breathing pattern
Respiratory noises
Body swellings
Skin wound
Etc.
Observation From a Distance
Behavior
• Individual differences
• Affected by illness/pain
• Depending on environment, changes
throughout the day
• Eating, drinking
• Feces, urine
Body Condition Scoring
The Ideal Body Condition Score is between 5 and 6-1/2
1. Poor
Animal extremely emaciated; spinous processes, ribs, tailhead,
tuber coxae (hip joints), and ischia (lower pelvic bones)
projecting prominently; bone structure of withers, shoulders,
and neck easily noticeable; no fatty tissue can be felt.
2. Very Thin
Animal emaciated; slight fat covering over base of spinous
processes, transverse processes of lumbar vertebrae feel
rounded; spinous processes, ribs, tailhead, tuber coxae (hip
joints) and ischia (lower pelvic bones) prominent; withers,
shoulders, and neck structure faintly discernable.
3. Thin
Fat buildup about halfway on spinous processes; transverse
processes cannot be felt; slight fat cover over ribs; spinous
processes and ribs easily discernable; tailhead prominent, but
individual vertebrae cannot be identified visually; tuber coxae
(hip joints), appear rounded but easily discernable;
tuber ischia (lower pelvic bones) not distinguishable; withers,
shoulders and neck accentuated.
Body Condition Scoring
4. Moderately Thin
Slight ridge along back; faint outline of ribs discernible; tailhead prominence depends on
conformation, fat can be felt around it; tuber coxae (hip joints) not discernable; withers, shoulders
and neck not obviously thin.
5. Moderate
Back is flat (no crease or ridge); ribs not visually distinguishable but easily felt; fat around tailhead
beginning to feel spongy; withers appear rounded over spinous processes; shoulders and neck
blend smoothly into body.
6. Moderately Fleshy
May have slight crease down back; fat over ribs spongy; fat around tailhead soft; fat beginning to
be deposited along the side of withers, behind shoulders, and along sides of neck.
7. Fleshy
May have slight crease down back; individual ribs can be felt, but noticeable filling between ribs
with fat; fat around tailhead soft; fat deposited along withers, behind shoulders,and along neck.
8. Fat
Crease down back; difficult to feel ribs, fat around tailhead very soft; fat area along withers filled
with fat, area behind shoulder filled with fat, noticeable thickening of neck; fat deposited along
inner thighs.
9. Extremely Fat
Obvious crease down back; patchy fat appearing over ribs, bulging fat around tailhead; along
withers, behind shoulders and along neck, fat along inner thighs may rub together; flank filled
with fat.
Courtesy of Purina Mills
Attitude
Depressed attitude:
• Pain
• Weakness
• Cerebral dysfunction
Abnormal behavior:
• Pain
• Cerebral dysfunction
• The basic physical examination usually includes
temperature/pulse/respiration (TPR) heart/lung auscultation,
abdominal auscultation, hydratation status, examination of
mucous membranes, and height/weight measurement
Normal values- Adults (p. 149)
Body temperature- normal adult at rest: 99.0-101.5°F
—varies by age, breed, environmental temperature
Pulse rate/heart rate- normal adult at rest: 28-44 bpm
—varies by age, fitness level, 2° A-V block
Respiratory rate- normal adult at rest: 6-12 breaths per minute
—varies by age, environmental temperature
Gastrointestinal motility (p. 130) normal adult at rest: 1-3
borborygmi per minute
Borborygmus- rumbling or gurgling noises produced by movement
of gas in the alimentary canal and audible at a distance
Pink gums
6-10 piles of well formed manure per 24 hours
Normal Neonate
•
•
•
•
•
•
Temperature 99-102F
HR 80-120
RR 20-40
Pink gums
Nursing 4-6 times per hour
Fecal output 2-4 piles per day, pasty
Equine weight
measuring
tapes
Pull the tape so that is it snug and not tight around the
horse’s girth.
Read the number that meets the “weight arrow” end of your weight tape, this is
the animal’s weight in lbs.
• Page 487 CVTV
The height of a horse is measured from the
point of the withers to the ground.
Measuring height.
A, Proper position for the height/weight tape for
measuring height.
B, Height is read at the highest point of the withers
Physical Examination
•
•
•
•
By systems (skeletol, neuro, etc)
Always use the same approach
Record your findings
Look at “the whole picture”
Body temperature
Look Familiar?
99-101.5
• Temperature is almost
always taken rectally
using a standard
mercury thermometer
or a digital
thermometer for large
animals
When inserting rectal thermometer, stand facing caudally and maintain
contact with the horse
Grasp the tail at the base and move it gently to the side
Never stand directly in back of the horse’s rear end.
Insert the thermometer. 60 seconds
• consider environmental
factors when taking rectal
temperatures
• A, The thermometer has been inserted and secured
with the clip to the tail hairs.
• B, Thermometer secured to hair coat with the clip.
Pulse Rate/Heart Rate
• The pulse rate is taken by palpation of arteries
• Heart rate and pulse rate are nor the same: heart rate
refers to the number of heart bests/minute (bpm); pulse
rate refers to the number of palpable arterial pulse
waves/minute
• In normal animals heart rate and pulse rate are equal
• Arterial pulses may be palpated at several locations
• Pulse deficit (heart rate ↑ pulse rate↓)
• Pulse is described as strong, bounding, weak, thready, or
other non-specific terms
• Facial artery is the most convenient location where it
courses over the ventral aspect of the mandible,
rostral to the origin of the masseter muscle
• B, Identify the facial artery along the medial aspect
of the mandible.
• C, Press the vascular bundle against the medial
aspect of the mandible
Transverse facial artery
• Is located in a horizontal depression about 1 inch caudal to
the lateral canthus of the eye and just below the zygomatic
arch.
Coccygeal artery
• Supplies the tail and is
located along the
ventral midline of the
tail.
Dorsal metatarsal artery
• Is located between the
metatarsal 3 and 4
(cannon bone and
lateral splint bone) on
the hind limp
• E, Location of the lateral digital artery over the lateral
proximal sesamoid bone and proximal to the lateral
collateral cartilage. F, Palpation of the digital arteries over
the proximal sesamoid bones. G, Palpation of the digital
arteries proximal to the collateral cartilages.
Heart Auscultation
• Horses are athletes: the heart of the average horse
may be as large as a basketball.
• Auscultation may be done on the left or right side
of the chest, though most of the heart valves and
sounds are heard best from the left side
• The most common cause of an irregular heart
rhythm in the horse is the second degree
atrioventricular (A-V) block
Landmarks for the heart
• The horizontal marks indicate the level of the
shoulder and elbow joints. The vertical mark
indicates the caudal border of the triceps muscle.
Auscultating the heart.
• A, Gently lift the triceps muscle away from the chest
wall.
• B, Place stethoscope against the chest wall, deep to
the triceps muscle.
Respiratory rate
The number of respirations/minute can be
counted in several ways:
1. Using a stethoscope to listen to air
movement in the trachea or chest
2. Using a hand to feel movement of air in and
out of a nostril
3. Simply counting chest excursions (rise and
fall of the thoracic wall)/minute
Landmarks for the lung. Borders of the left lung
field for auscultation
Lung auscultation
• The stethoscope is placed in
several locations within the
lung field to listen to several
breaths at each location
Abdominal Auscultation
• Borborygmi or borborygmus-abdominal gut sounds
• A stethoscope is used to listen to abdominal sounds, which are
created by movements of the intestines
• commonly referred to as gastrointestinal motility or GI motility
Landmarks for abdominal auscultation in the flank area are the
point of the hip (tuber coxae) and the last rib.
Abdominal Auscultation (cont’d)
• Should listen in each quadrant (4) for at least 1
minute each, on left and right side
• 0 = no motility
• +1 = hypomotility
• +2 = normal motility
• +3 = hypermotility
Standard four point auscultation
A, Auscultation of the upper left abdominal quadrant. B, Auscultation of the
lower left abdominal quadrant. C, Auscultation of the upper right upper
abdominal quadrant. D, Auscultation of the lower right abdominal quadrant.
Mucous membranes
• Mucous membranes are tissues that have the ability
to make and secrete mucus.
• Mucus membranes’ color is helpful for disease
diagnosis
• Cyanosis is bluish coloration- low oxygen of the blood
• Brick red coloration indicates septicemia or shock or
both, colic, endotoxemia
• Purple gum line indicates endotoxic shock
• Yellowish coloration of the gum indicates icterus
• Pale mucus indicates anemia
Examination of mucous membranes
4 areas:
• .A, Examination of the gums.
• B, Examination of the conjunctiva
Examination of mucous membranes
• C, Examination of the mucosa of the nares.
• D, Examination of the vulva in the female.
Mucous membrane color. Normal gum
color.
Hydration Status
• Skin turgor test
–
–
–
–
At the point of the shoulder
1 second or less is normal
1 second or more- >5%
>8 seconds: Severely
dehydrated
• Capillary refill time
– Less than 2 seconds
– Dehydration; shock 5 to 8
seconds
Neurological Examination
• Confirm disease
• Find where
• More tests usually
needed
Neurological Examination (cont’d)
How you durin?..…...