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Wednesday, March 20, 2013

CC #2: Buttercup

Get your answers in by Friday, before I post the answer and if you guess correctly you could be drawn for a (small) prize!

Buttercup is a slightly pudgy bay arab who is being conditioned for endurance. He's boarded at a public stable and often uses the public arena across the street, which is also the location of the local trail head.

He's going across the state line and needs a health certificate in order to do his first spring endurance endurance ride.

Buttercup's coat is shiny and in good condition with no ectoparasites. He pooped during the exam and has well formed poop with a good consistency.

He has a temperature of 103.2*F (elevated), heart rate of 36/min, respiration of 12/min.

Mentation: Quiet, alert, and responsive

Eyes clear, no nasal or ocular discharge.

As the vet, you explain to the client that you are concerned about the elevated temperature. She replies that because it is a hot day, he probably just overheated in the trailer on the way here.

She's upset that you won't issue the health certificate and as she loads Buttercup back into the trailer, he seems to have trouble navigating the step up with his hind legs and then once in the trailer, almost falls down.

What is your top differential diagnosis considering you are located in Illinois and it is February 2013?


  1. Hmmm, I was thinking EEE, until I got the the February part...

  2. Are you in Gurnee, by any chance?

  3. EHV-1 Because it's in the news, elevated temp and neuro signs

  4. ^Late to the party, but I agree that EHV would be on the top of my list of differentials. However, until confirmed, I would not rule out or dismiss less likely candidates like rabies and EPM - while fever is not part of the usual presentation for either, anything that affects the brain can cause fever, and the consequences of missing a rabies diagnosis are potentially disastrous.

    1. Totally agree that rabies is definitely on the DDx list somewhere - always wise to keep it in mind and it can present as pretty much anything. Any of the "encephalitis" diseases are good bets as well.


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