Download Clinical finding

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts
no text concepts found
Transcript
Medicine
4th stage
Lec 4
Dr. Ali Rabee
Diseases of the buccal cavity and associated organs
 Diseases of the muzzle
The congenital defect of harelip may be contiguous with a cleft palate.
Severe dermatitis with scab formation, development of fissures, and
sloughing and gangrene of the skin of the muzzle are common lesions in
cattle affected with photosensitive dermatitis, bovine malignant catarrh,
bovine virus diarrhea and rinderpest.
In sheep severe lesions of the muzzle are less common, but occur in
bluetongue and ecthyma.
 Stomatitis
Stomatitis is inflammation of the oral mucosa and includes glossitis
(inflammation of the tongue), palatitis (lampas) (inflammation of the
palate) and gingivitis (inflammation of the mucosa of the gums).
Etiology
Stomatitis may be caused by physical, chemical or infectious agents that's
includes:
Physical agents
1. Trauma while dosing orally with a balling gun.
2. Laceration of the tongue.
3. Foreign body injury.
4. Malocclusion of teeth.
5. Sharp awns or spines on plants.
1
Medicine
4th stage
Lec 4
Dr. Ali Rabee
6. Eating frozen feed and drinking hot water are recorded, but seem
highly improbable.
7. Ulcers of the soft palate of horses may be due to mechanical
trauma.
Chemical agents
1. Irritant drugs, e.g. chloral hydrate.
2. Counterirritants applied to skin, left unprotected and licked by the
animal, including mercury and cantharides compounds.
3. Irritant substances administered by mistake, including acids, alkalis
and phenolic compounds.
4. Manifestation of systemic poisoning, e.g. chronic mercury
poisoning.
5. Lesions associated with uremia syndrome in horses.
Infectious agents
Cattle
1. Oral necrobacillosis associated with Fusobacterium necrophorus.
2. Ulcerative, granulomatous lesions may occur on the gums in cases
of Actinomycosis.
3. Stomatitis with vesicles occurs in foot-and-mouth disease and in
vesicular stomatitis.
2
Medicine
4th stage
Lec 4
Dr. Ali Rabee
4. Erosive, with some secondary ulcerative, stomatitis occurs in
bovine viral diarrhea (mucosal disease), bovine malignant catarrh,
rinderpest.
5. Proliferative lesions occur in popular stomatitis, proliferative
stomatitis.
6. Oral mucosal necrosis in bovine sweating sickness.
Sheep
1. Erosive lesions in bluetongue, rinderpest and peste de petits
ruminants.
2. Vesicular lesions rarely in foot and mouth disease.
3. Granulomatous lesions due to ecthyma.
Horse
1. Cheilitis and gingivitis (inflammatory nodules of the lips and gums
caused by plant awns).
2. Vesicular lesions in vesicular stomatitis.
3. Herpesvirus infections.
4. Lingual abscess associated with Actinobacillus spp.
Clinical findings
1. There is partial or complete anorexia and slow, painful mastication.
2. Chewing movements and smacking of the lips are accompanied by
salivation, either frothy and in small amounts, or profuse and
3
Medicine
4th stage
Lec 4
Dr. Ali Rabee
drooling if the animal does not swallow normally and the saliva
may contain pus or shreds of epithelial tissue.
3. A fetid odor is present on the breath only if bacterial invasion of
the lesion has occurred.
4. Enlargement of local lymph nodes may also occur if bacteria
invade the lesions.
5. An increased desire for water is apparent and the animal resents
manipulation and examination of the mouth.
Treatment
1. Affected animals should be isolated and fed and watered from
separate utensils if an infectious agent is suspected.
2. Specific treatments are described under the headings of the
individual diseases.
3. Nonspecific treatment includes frequent application of a mild
antiseptic collutory such as a 2% solution of copper sulfate, a 2 %
suspension of borax or a 1 % suspension of a sulfonamide in
glycerin.
4. Soft, appetizing food should be offered and feeding by stomach
tube or intravenous alimentation may be resorted to in severe,
prolonged cases.
4
4th stage
Medicine
Lec 4
Dr. Ali Rabee
 Pharyngeal obstruction
Obstruction of the pharynx is accompanied by stertorous respiration,
coughing and difficult swallowing.
Etiology
1- Foreign bodies
These include bones, corn cobs and pieces of wire. While horses are
considered discriminating eaters in comparison to cattle, they will
occasionally pick up pieces of metal while eating.
2- Tissue swellings
Cattle
 Retropharyngeal
lymphadenopathy
or
abscess
due
to
tuberculosis, actinobacillosis or bovine viral leukosis.
 Fibrous or mucoid polyps.
Horses
 Retropharyngeal
lymph
node
hyperplasia
and
granulomas.
 Retropharyngeal abscess and cellulitis.
 Retropharyngeal lymphadenitis caused by strangles.
 Pharyngeal cysts.
5
lymphoid
Medicine
4th stage
Lec 4
Dr. Ali Rabee
Clinical findings
1. There is difficulty in swallowing and animals may be hungry
enough to eat but, when they attempt to swallow, cannot do so and
the food is coughed up through the mouth but drinking is usually
managed successfully.
2. An obvious sign is a snoring inspiration, often loud enough to be
heard some yards away, the inspiration is prolonged and
accompanied by marked abdominal effort.
3. When the disease runs a long course, emaciation usually follows.
4. When there is metallic foreign bodies in the oral cavity or pharynx,
the clinical findings include purulent nasal discharge, dysphagia,
halitosis, changes in phonation, laceration of the tongue and
stertorous breathing.
Treatment
1. Removal of a foreign body may be accomplished through the
mouth.
2. Treatment of actinobacillary lymphadenitis with iodides is usually
successful and some reduction in size often occurs in tuberculous
enlargement of the glands but complete recovery is unlikely to
occur.
3. Parenteral treatment of strangles abscesses with penicillin may
effect a cure.
6
Medicine
4th stage
Lec 4
Dr. Ali Rabee
4. Surgical treatment has been highly successful in cases caused by
medial retropharyngeal abscess.
 Pharyngeal paralysis
Pharyngeal paralysis is manifested by inability to swallow and an absence
of signs of pain and respiratory obstruction.
Etiology
Pharyngeal paralysis occurs sporadically, due to peripheral nerve injury,
and in some encephalitides with central lesions.
Peripheral nerve injury:
 Guttural pouch infections in horses.
 Trauma to the throat region.
Secondary to specific diseases:
 Rabies and other encephalitides.
 Botulism.
 African horse sickness.
 A series of unexplained fatal cases in horses.
Clinical finding
1. The animal is usually hungry but, on prehension of food or water,
attempts at swallowing are followed by dropping of the food from
the mouth, coughing and the expulsion of food or regurgitation
through the nostrils.
7
Medicine
4th stage
Lec 4
Dr. Ali Rabee
2. Salivation occurs constantly and swallowing cannot be stimulated
by external compression of the pharynx.
3. There is rapid loss of condition and dehydration.
4. Pneumonia may follow aspiration of food material into the lungs
and produces loud gurgling sounds on auscultation.
5. The animals are normal except that regurgitated boluses are
dropped from the mouth, usually in the form of flattened disks of
fibrous food material.
6. Affected animals m ay lose weight and complete pharyngeal
paralysis is usually permanent and fatal.
Treatment
1. Treatment is unlikely to have any effect.
2. The local application of heat may be attempted.
3. Feeding by nasal tube or intravenous alimentation may be tried if
disappearance of the paralysis seems probable.
 Esophagitis
Inflammation of the esophagus.
Etiology
1. Primary esophagitis caused by the ingestion of chemical or
physical irritants is usually accompanied by stomatitis and
pharyngitis.
8
Medicine
4th stage
Lec 4
Dr. Ali Rabee
2. Laceration of the mucosa by a foreign body or complications of
nasogastric intubation may occur.
3. The administration of sustained release anthelmintic boluses to
young calves that are not large enough for the size of the bolus
used may cause esophageal injury and perforation.
4. Death of Hypoderma lineatum larvae in the sub-mucosa of the
esophagus of cattle may cause acute local inflammation and
subsequent gangrene.
5. Inflammation of the esophagus occurs commonly in many specific
diseases, particularly those that cause stomatitis.
Clinical findings
1. In the acute injury of the esophagus, there is salivation and
attempts to swallow, which cause severe pain, particularly in
horses.
2. In some cases, attempts at swallowing are followed by
regurgitation and coughing, pain, retching activities and vigorous
contractions of the cervical and abdominal muscles.
3. Marked drooling of saliva, grinding of the teeth, coughing and
profuse nasal discharge are common.
4. Regurgitation may occur and the regurgitus contains mucus and
some fresh blood.
9
Medicine
4th stage
Lec 4
Dr. Ali Rabee
5. If perforation has occurred, there is local pain and swelling and
often crepitus.
Treatment
1. Feed should be withheld for 2-3 days and fluid and electrolyte
therapy may be necessary for several days.
2. Parenteral antimicrobials are indicated, especially if laceration or
perforation has occurred.
3. Reintroduction to feed should be monitored carefully and all feed
should be moistened to avoid the possible accumulation of dry feed
in the esophagus, which may not be fully functional.
 Esophageal obstruction
Esophageal obstruction may be acute or chronic.
Etiology
Obstruction may be intra-luminal by swallowed material or extraluminal due to pressure on the esophagus by surrounding organs or
tissues. Esophageal paralysis may also result in obstruction.
Intraluminal obstructions
1. Solid obstructions, especially in cattle, by turnips, potatoes,
peaches, apples, oranges, etc.
2. The most common type of esophageal obstruction in horses is
simple obstruction due to impaction of ingesta.
10
Medicine
4th stage
Lec 4
Dr. Ali Rabee
3. Foreign bodies in horses include pieces of wood, antimicrobial
boluses and fragments of nasogastric tubes.
4. A trichobezoar caused esophageal obstruction in a cow; it may
have been regurgitated rather than ingested because of the lack of
teeth marks on the trichobezoar.
Extra-luminal obstructions
1. Tuberculous or neoplastic lymph nodes in the mediastinum or at
the base of lung.
2. Cervical or mediastinal abscess
3. Persistent right aortic arch.
4. Thymoma.
Clinical findings
Acute obstruction or choke
Cattle
1. The obstruction is usually in the cervical esophagus just above the
larynx or at the thoracic inlet. Obstructions may also occur at the
base of the heart or the cardia.
2. The animal suddenly stops eating and shows anxiety and
restlessness. There are forceful attempts to swallow and
regurgitate,
salivation,
coughing
movements.
11
and
continuous
chewing
Medicine
4th stage
Lec 4
Dr. Ali Rabee
3. If obstruction is complete, bloating occurs rapidly and adds to the
animal's discomfort, ruminal movements are continuous and
forceful and there may be a systolic murmur audible on
auscultation of the heart.
4. There is inability to swallow, salivation and continued bloat.
Horse
1. In the horse with esophageal obstruction due to feed, the
obstruction may occur at any level of the esophagus from the upper
cervical region all the way to the thoracic portion.
2. The ingestion of large quantities of grain or pelleted feed can cause
obstruction over a long portion of the esophagus.
3. The clinical findings vary with the location, nature, extent and
duration of the obstruction. Typically the major clinical finding is
dysphagia with nasal reflux of saliva, feed and water.
4. Affected horses will usually not attempt further eating but will
drink and attempt to swallow water.
5. Horses with acute esophageal obstruction are commonly difficult
to handle because they are panicky and make forceful attempts to
swallow or retch.
6. In some horses it may be difficult to pass a nasogastric tube
because they resist the procedure, passage of a nasogastric tube is
12
Medicine
4th stage
Lec 4
Dr. Ali Rabee
necessary to make the diagnosis and to assess the level of the
obstruction.
7. Persistent obstruction may occur in the horse and death may occur
in either species from subsequent aspiration pneumonia or, when
the obstruction persists, from dehydration.
Treatment
1. Conservative approach.
2. Sedation.
 Acepromazine 0.05 mg/kg BW intravenously.
 Xylazine 0.5-1.0 mg/kg BW intravenously.
 Detomidine 0.01-0.02 mg/kg BW intravenously.
 Romifidine 0.04-0.12 mg/kg intravenously.
3. Pass a stomach tube and allow object to move into stomach,
endoscope or by Manual removal through oral cavity in cattle or by
Surgical removal of foreign bodies.
13