Equine Internal Medicine

Lecture /lab name and number

Your lecture/lab Learning Outcomes:

CLO #

1.  Physical Exam

1. -Know how to perform a thorough equine physical examination in a safe way
2. -Identify the locations for intramuscular injection and venipuncture in the horse

3- Identify the specific differences in an equine PE compared to a small animal PE

2

5

2

2. Equine Diagnostics

1-Interpret abnormalities in routine equine laboratory tests

3

2- Differentiate cases of acute versus chronic inflammatory diseases based on laboratory data

3

3- Describe the basic principles of immunodiagnostic testing including selecting the appropriate test and knowing its limitations

3

4- Interpret basic immunodiagnostic and pathogen specific test results in the horse

3

3. Review equine gastro intestinal anatomy and additional diagnostic test options related to equine gastro intestinal disease (colic)

1. Know the clinical anatomy of the equine gastro intestinal tract and identify the locations in the equine gastro intestinal tract that are predisposed to impactions or dislocations
2. Recognize the clinical signs of equine colic

1

2

2

3

3 -Understand when (and which) additional diagnostic tests are indicated in a colic case including fecal exam, urine analysis, rectal palpation, bloodwork, diagnostic imaging, biopsies and absorption tests.

4- Interpret the test results and realize that certain additional tests have potential risks (for the patient and/or clinician)

4.  Fluid Therapy

1. Develop a fluid plan for an individual equine patient based on physical examination findings and bloodwork distinguishing between hypovolemia and dehydration
2. Know the indications for fluid therapy and the limitations of fluid therapy in horses
3. Recognize the differences in equine fluid therapy compared to small animal fluid therapy with regards to fluid administration routes, fluid choice and fluid losses through sweating.

4,5

5

2,3

5.  Equine nutrition

1 Explain the relation of equine nutrition and nutritional related conditions in the horse with regards to the anatomy and function of the equine gastrointestinal tract including enzymatic

digestion (of non-structural

1,2

5

2

carbohydrates, fat and protein in the fore gut), hind gut fermentation (of structural carbohydrates (fiber)) and the vitamin + mineral dynamics.

2. Revise a food label and formulate a correct ration for the individual horse taking performance level, age and nutritional related predisposed conditions into account
3. Understand that acute changes in the equine diet are a major cause of colic

6. Equine Gastro Intestinal Tract: esophageal conditions

1. Identify common pathological conditions of the equine esophagus (including choke and hypomotility) and determine whether they are medical or surgical
2. Provide treatment options for medical conditions involving the equine esophagus including emergencies
3. Provide information as to the prognosis and survival rate of the different conditions that can affect the esophagus

1, 2

4,5

6

7. Equine Gastro Intestinal Tract: stomach conditions

1-Understand the difference in the pathophysiology of Equine Gastric Ulcer Syndrome (EGUS) in adult horses and neonatal foals

1,2

2,3,4

5

2. Recognize the clinical signs of EGUS and know how to diagnose the different forms of EGUS (Equine Squamous Gastric Ulcer Disease: ESGUD + Equine Glandular Gastric Ulcer Disease: EGGUD) including emergency cases
3. Determine the risk factors for the development of EGUS and Identify treatment options for EGUS

8. Equine Gastro Intestinal Tract: small intestinal conditions

1. Explain the pathophysiology of equine inflammatory bowel disease and S-I enteritis.
2. Identify the different forms of equine inflammatory bowel disease based on the utilization of signalment, history, clinical signs, a thorough PE and diagnostic test results
3. Provide a prognosis and formulate a treatment plan for the different forms of inflammatory bowel disease and S-I enteritis
4. Identify pathological obstructive conditions of the equine small intestinal tract and determine whether they are medical or surgical
5. Provide medical treatment options for colic cases involving small intestinal obstruction / strangulation including: nasogastric intubation,

1

2,3

4,5

2,3,4

5

3,4,6

administering medication (dewormers, nsaid’s, antimicrobials, parasympaticolytica, prokinetic medication, fluid, electrolytes….)

6- Provide information as to the prognosis and survival rate of the different S-I obstructions/ strangulations

9.  Equine large intestinal

1-Identify pathological

2,3

conditions (diarrhea and obstructions/strangulations)

conditions of the equine large intestinal tract including left dorsal

displacement, right dorsal

3,4

2

displacement, left ventral

5

colon impaction, colon torsion, pedunculated

6

lipoma of the small colon,

sand impaction, right dorsal

colitis, salmonellosis,

clostridiosis,

cyathostominosis,

intussusception of ileum in

cecum, cecum impaction

2-Determine whether the

colic caused by one of the

conditions mentioned above

is medical or surgical based

on clinical signs, blood work

results and belly tap results.

3-Know the risk factors for

the different large intestinal

conditions

4-Provide treatment options

for medical and surgical

conditions of the large

intestine mentioned above

5-Provide information as to

the prognosis and survival

rate of the different L-I conditions mentioned above

10. Equine post operative care

1-Recognise post-operative complications including thrombophlebitis, laminitis, peritonitis, post-operative ileus, ventral midline incision infection, colic, fever through throrough monitoring of the patient using repeated physical exams, bloodwork and diagnostic imaging

2,3,4

5

2- Formulate a treatment plan for the post-operative patient including antimicrobial administration, nsaid’s, fluid and diet.

11. Equine Dermatology

1-Explain the etiology and

1

pathophysiology of common equine dermatological

2

conditions including equine sarcoid, melanoma,

3

squamous cell carcinoma,

5

dermatophilosis, dermatophytosis,

6

hyperelastosis cutis, nodular

necrobiosis, papilomatosis,

folliculitis, pastern

dermatitis,

cellulitis/lymphangitis,

abcesses (caused by

streptococcus equi,

Corynebacterium

pseudotuberculosis,

clostridium spp, multi

resistant staphylococcus

aureus), lice, mite and tick

infestations, habronemiasis,

onchocercasis, insect

hypersensitivity, alopecia

areata, burns, decubitus lesions and contact dermatitis.

2. Recognize pathological conditions of the equine skin and determine whether they are medical or surgical
3. Choose appropriate additional diagnostic tests in order to get a final diagnosis in a horse with a skin condition
4. Recommend treatment and management options for the different equine skin conditions
5. Discuss the prognosis of horses suffering from the aforementioned diseases

12. Equine Neurology

1. Explain the etiology and pathophysiology of common equine neurologic diseases including rabies, equine protozoal myeloencephalitis, alpha virus encephalitis, west nile virus, equine herpes myeloencephalitis, leucoencephalomalacia, botulism, tetanus, cervical stenotic myelopathy, temporohyoid osteoarthropathy, rectus capitus avulsion, equine motor neuron disease, equine polyneuropathy and equine grass sickness.
2. Formulate an appropriate diagnostic testing plan and differential list for a horse

1

2,3

2

2,3

5

6

presenting with clinical signs of neurologic disease

3. Perform a thorough neurological exam in the horse including cranial nerve examination, assessment of autonomic function, and a dynamic neurologic exam (gait analysis + assessment of proprioceptive deficits)
4. Diagnose cases of common equine neurologic diseases based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results
5. Develop a therapeutic and management plan for horses with aforementioned diseases
6. Discuss the prognosis of horses suffering from the aforementioned diseases

13. Endotoxemia

1. Integrate knowledge of the pathophysiology of endotoxaemia and drug targets to create treatment plans for horses with endotoxaemia
2. Compare and contrast advantages and disadvantages of drugs used in equine endotoxaemia

1,5

5

5

3-Clarify the clinical signs associated with equine endotoxaemia

14. Equine clinical pharmacology

1. Integrate knowledge on pathophysiology of common equine diseases to create treatment plans
2. Evaluate treatment plans based on the therapeutic concept including Good Veterinary Practice and Antimicrobial Stewardship
3. Compare and contrast advantages and disadvantages of different treatment modalities

1,5

5

5

15. Laminitis

1- Describe the pathophysiology of all forms of laminitis

1

2- Recognize the risk factors and clinical signs of laminitis

2

3- Evaluate diagnostic tests utilized in cases of laminitis

3

4- Develop a therapeutic plan for the various presentations of laminitis including pain management

4,5

5- Discuss the prognosis of laminitic horses

6

6- Prepare a plan for laminitis prevention in the at risk horse

5

16. Endocrinology

1- Describe the major hormone imbalances/pathophysiology

that occurs with pituitary

1

pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS)

2- Differentiate between the signalment and clinical signs of PPID and EMS

2

3- Formulate a diagnostic testing plan for horses suspected of having PPID and/or EMS

2

4- Interpret diagnostic testing results for PPID and EMS

3

5- Diagnose cases of hypothyroidism (congenital and acquired), anhidrosis and nutritional secondary hyperparathyroidism based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

1,2,3

6- Develop a therapeutic and management plan for horses with PPID and EMS

5

7- Discuss the prognosis of horses diagnosed with an endocrinopathy

6

17. Hepatobiliary

1- Explain the etiology and pathophysiology of common equine liver diseases

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for suspect liver dysfunction

2

3- Interpret liver specific diagnostic test results

3

4- Diagnose cases of: Theiler’s disease (serum sickness), Tyzzer’s disease, aflatoxicosis, bacterial cholangiohepatitis, cholelithiasis, chronic active hepatitis, hyperlipemia/hepatic lipidosis and pyrrolizidine alkaloid/clover toxicity based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5- Develop a therapeutic and management plan for horses with aforementioned diseases

4,5

6- Discuss the prognosis of horses suffering from liver disease

6

18. Urinary

1-Explain the etiology and pathophysiology of common equine urinary tract diseases

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for suspect urinary tract dysfunction

2

3- Interpret urinalysis results from a horse

3

4- Diagnose cases of: acute renal failure, chronic renal failure, NSAID toxicity,

urolithiasis and incontinence

2,3,4

based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

5- Develop a therapeutic and management plan for horses with aforementioned diseases

4,5

6- Discuss the prognosis of horses suffering from urinary tract disease

6

19. Muscle

1-Explain the etiology and pathophysiology of common equine skeletal muscle diseases

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for a muscle disorder

2

3- Interpret muscle specific diagnostic test results

3

4- Assess cases of: exertional rhabdomyolysis, polysaccharide storage myopathy, recurrent exertional rhabdomyolysis, hyperkalemic periodic paralysis, nutritional myodegeneration, clostridial myositis, and ionophore toxicity based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5- Develop a therapeutic and management plan for horses with aforementioned diseases

4,5

6- Discuss the prognosis of horses suffering from a myopathy

6

20. Hematologic

1-Explain the etiology and pathophysiology of common equine hemolymphatic disorders

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for anemia, a clotting disorder or lymphosarcoma

2

3- Interpret specific diagnostic test results for the aforementioned complaints

3

4- Diagnose cases of: blood loss (acute versus chronic), red maple leaf toxicity, anemia of chronic disease, iron deficiency anemia, moldy sweet clover toxicity, IMTP, DIC, snake envenomation and lymphosarcoma based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5- Develop a therapeutic and management plan for

4,5

horses with aforementioned diseases

6- Discuss the prognosis of horses suffering from the aforementioned diseases

6

21. Infectious Disease

1-Analyze farm biosecurity and your role in management of cases of infectious disease

5

2-Explain the etiology and pathophysiology of common equine infectious diseases including equine infectious anemia, equine piroplasmosis, equine viral arteritis, equine granulocytic erlichiosis, lyme disease, leptospirosis, Corynebacterium pseudotuberculosis (pigeon fever) and vesicular stomatitis virus.

1

3- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for vasculitis or the aforementioned equine diseases

2

4- Interpret specific diagnostic test results for the aforementioned diseases

3

5- Diagnose cases of common equine infectious diseases based on the presenting complaints, relevant historical

information, physical exam

2,3

findings and diagnostic test results

6- Develop a therapeutic and management plan for horses with aforementioned diseases

5

7- Discuss the prognosis of horses suffering from the aforementioned diseases

6

22. Ophthalmology

1- Develop a plan for a comprehensive ophthalmologic exam in the equine patient including nerve blocks and topical medications

2

2- Explain the etiology and pathophysiology of common equine diseases of the eye

1

3- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for an ophthalmologic condition

2

4- Interpret ophthalmologic diagnostic test results

3

5- Diagnose cases of bacterial and fungal keratitis, equine recurrent uveitis, ocular habrenomiasis, onchocerciasis and common ocular neoplasia including squamous cell carcinoma, sarcoids and melanoma based on the presenting complaints, relevant

historical information,

2,3

physical exam findings and diagnostic test results

6- Develop a therapeutic and management plan for horses with aforementioned diseases

5

7- Discuss the prognosis of horses suffering from the aforementioned diseases

6

23. Cardiology

1-Explain the etiology and pathophysiology of common equine cardiac disorders

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for suspect cardiac disease

2

3- Interpret cardiac specific test results from a horse

3

4- Diagnose cases of: atrial fibrillation, ventricular tachycardia. Ventricular septal defect, tetralogy of fallot, patent ductus arteriosus, degenerative valvular disease, endocarditis, pericarditis and myocardial disease based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5- Develop a therapeutic and management plan for horses with aforementioned diseases

4,5

6- Discuss the prognosis of horses suffering from cardiac disease

6

24. Respiratory
25. Neonatology

1-Explain the etiology and pathophysiology of common equine respiratory disorders

1

2- Formulate an appropriate diagnostic testing plan and differential list for a horse presenting for suspect respiratory disease

2

3- Interpret respiratory specific test results from a horse

3

4- Diagnose cases of: sinusitis, guttural pouch empyema &

mycosis, Rhodococcus equi infection,

bacterial/fungal pneumonia (pleuropneumonia), Equine Herpes Virus-1 & 4, Equine Influenza Virus, Strep. equi infection(“Strangles”), RAO, IAD and EIPH based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5- Develop a preventative, therapeutic and management plan for horses with the aforementioned diseases

4,5

6- Discuss the prognosis of horses suffering from respiratory disease

6

7- Develop a vaccination program to combat common respiratory pathogens

5

1- Differentiate and interpret normal and abnormal physical exam findings in the equine neonate as compared to the adult

1,2

2- Explain the etiology and pathophysiology of common equine neonatal disorders

1

3- Formulate an appropriate diagnostic testing plan and differential list for a foal presenting with weakness, not suckling, seizures, respiratory distress, colic, a distended abdomen, dysuria, diarrhea, enlarged umbilicus or lameness.

2

4- Diagnose cases of: prematurity/dysmaturity, sepsis, failure of passive transfer, HIE (“dummy foal syndrome”), fractured ribs, meconium impaction, SCID & neonatal isoerythrolysis based on the presenting complaints, relevant historical information, physical exam findings and diagnostic test results

2,3,4

5-Develop a preventative, therapeutic and management plan for foals with the aforementioned diseases

5

6- Discuss the prognosis of foals suffering from the aforementioned conditions

6

Course Learning Outcome

SGUSVM Program Learning Outcome

Explain the etiology and pathophysiology for common equine medical diseases for all the major organ systems

PLO 1 Recall, understand, and adequately utilize multidisciplinary knowledge of basic structures and functions of healthy animals.

PLO 2 Analyze homeostasis and disturbances of basic structures and functions of healthy animals.

PLO3 Recall, understand, and adequately utilize knowledge of etiology, pathogenesis and pathology of common infectious, non- infectious, and zoonotic diseases, including biosafety and biosecurity considerations.

PLO 4 Explain the relationship between disease processes and clinical signs.

PLO 7 Evaluate and analyze normal versus abnormal animal behavior.

PLO 8 Apply principles of animal welfare and articulate relevant legislation, including notifiable diseases.

PLO 9 Apply the principles of veterinary public health for the promotion of human and animal health.

PLO 10 Recall, understand, and adequately utilize knowledge of animal nutrition for common domestic animals under a variety of husbandry conditions.

PLO 11 Understand and apply basic principles of research and recognize the contribution of research to all aspects of veterinary medicine.

Utilize presenting complaints, history, physical exam findings, and clinical signs to create differential lists and to select appropriate diagnostic tests in the equine patient

PLO 1 Recall, understand, and adequately utilize multidisciplinary knowledge of basic structures and functions of healthy animals.

PLO 2 Analyze homeostasis and disturbances of basic structures and functions of healthy animals.

PLO3 Recall, understand, and adequately utilize knowledge of etiology, pathogenesis and pathology of common infectious, non- infectious, and zoonotic diseases, including biosafety and biosecurity considerations.

PLO 4 Explain the relationship between disease processes and clinical signs.

PLO 6 Apply multidisciplinary scientific knowledge to clinical situations and understand evidence-based veterinary medicine.

PLO 7 Evaluate and analyze normal versus abnormal animal behavior.

PLO 8 Apply principles of animal welfare and articulate relevant legislation, including notifiable diseases.

PLO 10 Recall, understand, and adequately utilize knowledge of animal nutrition for common domestic animals under a variety of husbandry conditions.

PLO 11 Understand and apply basic principles of research and recognize the contribution of research to all aspects of veterinary medicine.

Interpret diagnostic test results in the equine patient

PLO 1 Recall, understand, and adequately utilize multidisciplinary knowledge of basic structures and functions of healthy animals.

PLO 2 Analyze homeostasis and disturbances of basic structures and functions of healthy animals.

PLO3 Recall, understand, and adequately utilize knowledge of etiology, pathogenesis and pathology of common infectious, non- infectious, and zoonotic diseases, including biosafety and biosecurity considerations.

PLO 6 Apply multidisciplinary scientific knowledge to clinical situations and understand evidence-based veterinary medicine.

Evaluate emergency cases and develop a plan for resolution of these issues

PLO3 Recall, understand, and adequately utilize knowledge of etiology, pathogenesis and pathology of common infectious, non- infectious, and zoonotic diseases, including biosafety and biosecurity considerations.

PLO 4 Explain the relationship between disease processes and clinical signs.

PLO 5 Recall, understand, and adequately utilize knowledge of and apply principles of therapeutic agents and their application, including relevant legislation and guidelines on the use of medicines.

PLO 6 Apply multidisciplinary scientific knowledge to clinical situations and understand evidence-based veterinary medicine.

PLO 7 Evaluate and analyze normal versus abnormal animal behavior.

Formulate an appropriate treatment regimen for the equine patient including fluid therapy and preventative care.

PLO 5 Recall, understand, and adequately utilize knowledge of and apply principles of therapeutic agents and their application, including relevant legislation and guidelines on the use of medicines.

PLO 6 Apply multidisciplinary scientific knowledge to clinical situations and understand evidence-based veterinary medicine.

PLO 8 Apply principles of animal welfare and articulate relevant legislation, including notifiable diseases.

PLO 9 Apply the principles of veterinary public health for the promotion of human and animal health.

PLO 10 Recall, understand, and adequately utilize knowledge of animal nutrition for common domestic animals under a variety of husbandry conditions.

Wk

Date / Hour

Lecture topic

Modality/Location

Faculty

0

January 10th

9:30-10:20

Course Intro/Physical exam review

Online zoom

Werners-Butler

January 11th

9:30-10:20

G-I Anatomy review and Dx

Online zoom

Werners-Butler

January 12th

10:30-11:20

Diagnostics

Sis Hall + Zoom

Wise

1

January 17th

9:30-10:20

Equine nutrition review

Online zoom

Werners-Butler

January 18th 11:30-

12:20

Equine Esophagus disorders

Online zoom

Werners-Butler

January 20th

9:30-10:20

Equine Stomach disorders

Online zoom

Werners-Butler

2

January 24th

10:30-11:20

Inflammatory Bowel Dz + enteritis

Online zoom

Werners-Butler

January 25th

10:30-11:20

Applied G-I related fluid therapy

Online zoom

Werners-Butler

January 26th

10:30-11:20

G-I cases 1

Online zoom

Werners-Butler

January 27th

10:30-11:20

Small Intestinal disorders

Online zoom

Werners-Butler

3

January 31st

9:30-10:20

Large intestinal obstruction

Sis Hall + Zoom

Werners-Butler

February 1st

10:30-11:20

Diarrhea (acute / chronic)

Sis Hall + Zoom

Werners-Butler

February 2nd

10:30-11:20

Biosecurity concepts

Sis Hall + Zoom

Werners-Butler

February 3rd

10:30-11:20

G-I cases 2

Sis Hall + Zoom

Werners-Butler

4

February 8th

10:30-11:20

Clin Pharm

Sis Hall + Zoom

Werners

February 10th

9:30-10:20

Clin Pharm

Sis Hall + Zoom

Werners

5

February 14th

10:30-11:20

Endotoxemia

Sis Hall + Zoom

Werners

February 15th

10:30-11:20

Laminitis

Sis Hall + Zoom

Werners-Butler

February 17th

9:30-10:20

Endocrine

Sis Hall + Zoom

Werners-Butler

February 18th

9:30-10:20

Infectious Diseases

Sis Hall + Zoom

Werners-Butler

6

February 21st

9:30-10:20

Infectious diseases

Sis Hall + Zoom

Werners-Butler

February 22nd

9:30-10:20

Dermatology

Sis Hall + Zoom

Werners-Butler

February 24th

10:30-11:20

Dermatology cases

Sis Hall + Zoom

Werners-Butler

8

March 7th

12:00-

1:30pm

MIDTERM EXAM

March 8th

11:30-12:20

Neurology

Sis Hall + Zoom

Werners-Butler

March 9th

8:30-9:20

Neurology

Sis Hall + Zoom

Werners-Butler

March 10th

9:30-10:20

Neurology

Sis Hall + Zoom

Werners-Butler

9

March

14th  10:30-

11:20

Neuro cases**

Sis Hall + Zoom**

Werners-Butler

March 15th

9.30-10.20

Ophthalmology

Sis Hall + Zoom

Werners-Butler

March

16th                        10.30-

11.20

Hemolymphatic

Zoom

Wise

March

17th                      10.30-

11.20

Hemolymphatic

Zoom

Wise

March

18th  11:30-

12:20

Cardiology

Zoom

Wise

10

March 21st

10.30-11.20

Muscle

Zoom

Wise

March

22nd 11.30-

12.20

Muscle

Zoom

Wise

March

24th                        11.30-

12.20

Liver

Zoom

Wise

11

March

28th  10:30-

11:20

Liver

Zoom

Wise

March 29th

10:30-11:20

Urinary

Zoom

Wise

March

31st                     10:30-

11:20

Urinary

Zoom

Wise

April

1st  11:30-

12:20

Respiratory

TopHat Lesson

Wise

12

April 4th

10:30-11:20

Respiratory

TopHat Lesson

Wise

April 5th 10:30-11:20

Clin Pharm approach to different system disorders

Sis Hall + Zoom**

Werners

April 6th

10:30-11:20

Respiratory Review

Sis Hall + Zoom

Wise

13

April 11th

10:30-11:20

Neonatology

Sis Hall + Zoom

Wise

April 12th

10:30-11:20

Neonatology

Sis Hall + Zoom

Wise

April 13th

9:30-10:20

Neonatology

Sis Hall + Zoom

Wise

14

April 19th

10:30-12:20

Final preparation Q&A

Sis Hall + Zoom **

CWB /NW/AW

15

April 27th

12:00-

2.00pm

FINAL EXAM

(Comprehensive)

>89.5%

A

84.5-89.4

B+

79.5-84.4

B

74.5-79.4

C+

69.5-74.4

C

64.5-69.4

D+

59.5-64.4

D

<59.4

F