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Suiting up with Smoky

After you and the nurse have suited up and desensitised Smoky to your appearances, the nurse restrains Smoky while you perform a cursory physical examination. Her heart rate and respiratory rate are within normal limits but she is mildly pyrexic with a rectal temperature of 38.9°C. The horse appears to have a dull demeanour. There are no cranial nerve deficits. You are able to lead Smoky for a few steps and find that she is indeed ataxic and appears weak in all limbs. You also note that there are intermittent muscle fasciculations over Smoky’s body.

Provided below are videos of (1) a horse with ataxia and (2) a horse with muscle fasciculations, to demonstrate the type of neurological abnormalities exhibited by Smoky. Please note that the human in video 1 is not wearing PPE as the horse in the video was confirmed to have a non-infectious aetiology.

Video 1: Ataxia involving all limbs

Video 2: Muscle fasciculations

Reflection

Considering the outcomes of the examination, what are the most likely differential diagnoses for Smoky? Are any of these zoonotic, exotic or notifiable?