1. Basic Physical Examination of Horses Chapter #5 LACP

2. 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

3. History Coach the client- Individual –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

4. 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

5. 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

7. Visual Observation Observe the animal from a distance Gait Posture Hair coat Behavior Breathing pattern Respiratory noises Body swellings Skin wound Etc.

8. Observation From a Distance Behavior Individual differences Affected by illness/pain Depending on environment, changes throughout the day Eating, drinking Feces, urine

9. 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.

10. 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

13. Attitude Depressed attitude: Pain Weakness Cerebral dysfunction Abnormal behavior: Pain Cerebral dysfunction

14. 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

15. 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

16. 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

17. Equine weight measuring tapes

18. Pull the tape so that is it snug and not tight around the horse’s girth.

19. Read the number that meets the “weight arrow” end of your weight tape, this is the animal’s weight in lbs.

20. Page 487 CVTV

21. The height of a horse is measured from the point of the withers to the ground.

22. Measuring height. A, Proper position for the height/weight tape for measuring height. B, Height is read at the highest point of the withers

23. Physical Examination By systems (skeletol, neuro, etc) Always use the same approach Record your findings Look at “the whole picture”

25. Body temperature Temperature is almost always taken rectally using a standard mercury thermometer or a digital thermometer for large animals Look Familiar? 99-101.5

27. When inserting rectal thermometer, stand facing caudally and maintain contact with the horse

28. Never stand directly in back of the horse’s rear end. Grasp the tail at the base and move it gently to the side

29. Insert the thermometer. 60 seconds consider environmental factors when taking rectal temperatures

30. A, The thermometer has been inserted and secured with the clip to the tail hairs. B, Thermometer secured to hair coat with the clip.

31. 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

32. 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

33. B, Identify the facial artery along the medial aspect of the mandible. C, Press the vascular bundle against the medial aspect of the mandible

34. 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.

35. Coccygeal artery Supplies the tail and is located along the ventral midline of the tail.

36. Dorsal metatarsal artery Is located between the metatarsal 3 and 4 (cannon bone and lateral splint bone) on the hind limp

37. 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.

38. 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

39. 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.

40. 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.

41. 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

42. Landmarks for the lung. Borders of the left lung field for auscultation

43. Lung auscultation The stethoscope is placed in several locations within the lung field to listen to several breaths at each location

44. 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.

45. 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

46. 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.

47. 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

48. Examination of mucous membranes 4 areas:.A, Examination of the gums. B, Examination of the conjunctiva

49. Examination of mucous membranes C, Examination of the mucosa of the nares. D, Examination of the vulva in the female.

50. Mucous membrane color. Normal gum color.

51. 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

52. Neurological Examination Confirm disease Find where More tests usually needed

53. Neurological Examination (cont’d)

54. How you durin?..…...