Post on 04-Jun-2018
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Always at least some minimumform of restraint required.
Minimum restraint required: halterand lead rope
A PE should never be attemptedwithout a halter and lead rope inplace with someone holding thehorse.
Never wrap lead around your hand,arm or any other body part
Never tie a horse unless you know itis accustomed to being tied.
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The general examination should start with theobservation of the horse from a distance inorder to detect abnormalities that might beobscured by handling and restraint.
Horses' stance and general behavior in the stallwill reflect their general mentation, which isfrequently affected by systemic illness,neurologic disease, and pain in various organs(P). The respiratory rate and effort should benoted prior to handling, as well as a generalevaluation of body condition (P).
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Examining the horse fromnose to tail along the left sideand then tail to nose along
the right side is one way ofensuring a complete generalexamination.
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Again, there are no strictrules regarding the properphysical examination
procedures.
It is recommended that aconsistent approach beadopted.
The mucous membranes arefirst examined by raising theupper lip as shown.
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Mucous membranes are examined formoistness, icterus, hyperemia, cyanosis, pallor,ulceration, and petechia. Capillary refill time is
also evaluated at this time by blanching the
mucous membranes.
http://research.vet.upenn.edu/Portals/62/images/equine/icterus1.jpghttp://research.vet.upenn.edu/Portals/62/images/equine/hyperem.jpghttp://research.vet.upenn.edu/Portals/62/images/equine/hyperem.jpghttp://research.vet.upenn.edu/Portals/62/images/equine/icterus1.jpg
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The retropharyngeal lymph nodes are not
readily palpated in the normal animal but maybe if enlarged. The facial artery is palpated at
the ventral aspect of the mandible.
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The thyroid gland isfrequently palpable inolder horses andshould not be
confused for a lymphnode .
The left jugular vein isthen occluded and
palpated to evaluate jugular fill and toexamine forthrombophlebitis.
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The heart is then auscultedin three locations on the leftcranial ventral thorax: overthe pulmonic, aortic, andmitral valves.
The normal resting heart rateof the horse is 28-42 BPM.
The hand is then run downthe forelimb to evaluatetemperature of the distalextremities if cardiovascular
shock is a concern and alsoto palpate temperature of thehoof and evaluate digitalpulses if laminitis is aconcern.
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A discussion of auscultation of the thorax and abdomen is included in the focused examination of the respiratory and gastrointestinaltracts respectively. The inguinal area is then carefully palpated to evaluate testicles in stallions, scrotal remnants in geldings, and themammary gland in mares. The distal hind limbs are visually inspected for joint effusion or distal limb edema. If edema is present, it
should be determined if it is warm or painful to palpation. The tail is then carefully raised from the side and a thermometer is inserted in
the rectum, noticing tail tone and anal reflexes.
http://research.vet.upenn.edu/LinkClick.aspx?link=3764&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3767&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3764&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3764&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3764&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3764&tabid=3763http://research.vet.upenn.edu/LinkClick.aspx?link=3767&tabid=3763
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temperature
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Sign Normal
Temperature 99.5oF to 101.5
oF
Heart rate 30-45 bpm
Respiratory rate 8-20 breaths per minute
Mucous membranes PinkCapillary refill time 1-2 seconds
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Temp. - PyrexiaAnorexiaDehydrationBehavior Change
TearsDiarrhea, constipation
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Most resting horses have rectal temperatures of 98.0°-101.5° F.
Examination is then continued on the left side for visualinspection of the integument and auscultation of the abdomenand thorax, as noted in the focused physical examination.
In the general examination, the right side of the heart is thenausculted, the right jugular vein is occluded, and the right sideof the head and neck are visually examined.
As one can see, this general physical examination can be easilyperformed in just a few minutes, yet it can provide importantinformation that would otherwise be easily missed.
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Collect blood
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Although blood of horses is usually collectedfrom a jugular vein, alternate veins forcollecting blood include the transverse facial
vein, cephalic vein, and the lateral thoracic vein
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Some horses have prominent lateral thoracicveins, especially draft horses , but for manyhorses this vein is difficult to find. Blood can be
safely collected from the saphenous vein inrecumbent foals or anesthetized horses.
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Indications
To collect blood from horses with thrombosisof one or both jugular veins
To avoid excessive venipuncture of the jugularveins of horses prone to venous thrombosis(e.g., horses with colitis)
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Materials
Alcohol and cotton for site preparation
When only a packed cell volume (PCV) is
needed, materials include a 25-ga, 5/8- in (0.5 x16 mm) needle, sealing clay, and a heparinizedmicrohematocrit tube.
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When larger quantities of blood are needed,materials include a 20-ga x 1.5-in (0.9- x 38-mm) needle, a 10- or 20-mL syringe, and EDTA
and plain glass tubes. Blood can also becollected directly into blood collection tubesusing a blood collection needle.
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Procedure
A needle is inserted through skin, below thefacial crest, on or rostral to a line perpendicular
to the facial crest drawn from the medialcanthus of the eye. To obtain only enoughblood for a PCV, a small gauge needle such as a25-ga, 5/8-in (0.5- x 16-mm) needle is inserteduntil the hub fills with blood. Then, the end ofa microhematocrit tube is placed into theneedle hub and allowed to fill by capillaryaction (Fig. 5.4). Or:
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A 20-ga needle with a syringe attached isinserted below the facial crest near a lineperpendicular to the facial crest drawn from
the medial canthus of the eye until the point ofthe needle strikes bone, the plunger of thesyringe is gently retracted, as the needle isslowly withdrawn, until the syringe begins to
fill with blood
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Complications Some horses become head shy after the procedure
has been performed numerous times. Hair loss over the site of venipuncture may occur,
possibly from skin irritation from repeatedapplication of alcohol. A transient hematoma at the venipuncture site
(rare) Facial nerve paresis has been reported, but
placement of the needle distal to the recommendedsite of venipuncture was the suspected cause. Thefacial nerve lies about 2-cm below therecommended site of venipuncture.
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Clinical Pathology - Normal Values Clinical Chemistry Normal Values for Horses ALB2.5 - 4.2 g/dLALKP109 - 315 U/LALT3 - 25 U/LAMYL< 30 U/LAST205 - 555
U/LBUN8 -27 mg/dLCa10.7 - 13.4 mg/dLIonized Ca 50 - 60 % of total CaCHOL51 - 109mg/dLCk90 565 U / LCl 94 - 102 mmol/LCO2 24 - 31 mmol/LCREA0.6 -1.8mg/dLGGT12 - 45 U/LGLU72 -114 mg/dLK 2.7 - 4.9 mmol/LLDH520 - 1480U/LLIPA460 - 870 U/LMg 1.6 - 2.5 mg/dLNa132 -141 mmol/LPHOS1.9 - 5.4mg/dLTBIL0.1 - 1.9 mg/dLTP 4.6 - 6.9 g/dLTRIG11 - 59 mg/dLURIC< 0.5 mg/dL
Hematology Normal Values for Horses WBC5,500- 12,500 /cubic mmPlatelets100,000-600,000 /cubic mmSegmented
Neutrophil 2700 - 6700/cubic mm or 30 - 65%RBC6,500,000-12,500,000 /cubicmmBands0-100 /cubic mm or 0-2%MCV34-58 flLymphocyte1500-5500 / cubic mm or25-70%Hemoglobin11 -19 g/dLMonocyte0 - 800 /cubic mm or 0.5 -7%PCV32 - 52%Eosinophil0- 925 / cubic mm or0 -11%ACL Fibrinogen 150 - 375 mg/ dLBasophil0-170 / cubic mm or 0-3%Fibrinogen
(Miller) 200 - 450 mg/dL