NAVLE® Question of the day

MO TU WED TH FR

July 16, 2024

NAVLE

A 22-year-old Thoroughbred mare is presented for bilateral green nasal discharge, retching, coughing, and inappetence noted after feeding this evening.

The owner recently switched the mare to a pelleted diet because of the mare's poor dentition.

Physical exam reveals bilateral green nasal discharge. The mucous membranes are pink and moist with a capillary refill time of 1.5 seconds.

A slight swelling is notable in the proximal-left jugular groove just caudal to the vertical ramus of the mandible.

Based on the most likely diagnosis, what initial therapy would be recommended?

Value	Normal
100.6°F (38.1°C)	99.1–100.8°F (37.3–38.2°C)
HR=40 bpm	28-40 bpm
R=12 brpm	10-14 brpm

A - Ultrasound thorax, perform transtracheal wash for cytology and culture, begin broad-spectrum antimicrobials

B - Pass nasogastric tube; give atropine; lavage the esophagus until the obstruction clears

C - Cautious guttural pouch endoscopy with lavage for Streptococcus equi spp. equi PCR, quarantine horse until results are available

D - Withhold food and water; give sedatives and oxytocin; recheck in 2 hours

E - Administer antimicrobials, refer horse immediately for endoscopy and lavage under general anesthesia