2013 questions Flashcards
This 25 year old Quarter Horse is presented for evaluation in July in the northern hemisphere. Which one of the following would be the most likely cause of this horse’s abnormal hair shedding?
A-Pituiatary pars intermedia dysfunction
B-Diabetes mellitus
C-Equine metabolic syndrome
D-Infestation with Psoroptes equi
E- Adrenal dependent hyperadrenocorticism
A-Pituiary pars intermedia dysfunction
This horse has pituitary pars intermedia dysfunction.
This disorder is characterized by degeneration of dopamine producing neurons in the hypothalamus that normally exert an inhibitory action on the pituitary pars intermedia, resulting in functional adenomas in the pars intermedia that produce high levels of adrenocorticotropin hormone.
Clinical signs and laboratory findings include hypertrichosis, poor muscle tone, laminitis, hyperglycemia and insulin resistance, and increased susceptibility to infection.
This 3-year-old horse presents for evaluation of this dry, horny, wart-like mass on the distal forelimb. This horse also has smaller wart-like lesions on its muzzle. The other young horses in the herd have similar lesions.
Which one of the following is the most likely diagnosis?
A - Melanomatosis
B - Pediculosis
C - Papillomatosis
D - Trombiculosis
E - Dermatophilosis
C-Papillomatosis
These are warts, or papillomas, which is related to infection with equine papilloma virus.
Equine papillomatosis occurs most frequently in young horses and are most commonly found on the inner surfaces of the pinna, muzzle, distal limbs, and genitalia.
They are contagious, and since they usually resolve spontaneously, treatment is rarely pursued.
What is the diagnosis?
A - Ketosis
B - Nutritional Muscular Dystrophy
C - Metastatic Calcification
D - Vitamin E Deficiency
E - Vitamin C Deficiency
E-Vitamin C Deficiency
Think scurvy (vitamin C deficiency) when you see hemorrhages SQ in a guinea pig. Look for swollen joints (source of lameness) and a hx of lameness, anorexia, diarrhea, weakness. May be thin with a rough hair coat. See increased vulnerability to opportunistic infections, and sudden death. Follow this link to see the original Merck image of scurvy in a guinea pig
Rx with daily vitamin C 5-10 mg/kg, PO or IM, for 1-2 wk.
AVOID multivitamins! May cause toxicity for overdose of other vitamins. Need minimum 10 mg vitamin C/day (30 mg/day for pregnant sows) in diet.
Metastatic Calcification occurs mostly in MALES
Nutrional Muscular dystrophy and vitamin E deficiency are the same thing- can present like vitamin C deficiency but without diarrhea.
Ketosis is mostly a disease of fat or pregnant animals
During the fall, a 5 year-old standardbred mare from northern California is presented with a 5-day history of depression, partial anorexia and undulating fever between 102-106 F (38.9-41.1 C)..[N=99-101.3 F].
Physical exam reveals mucosal petechiae and icterus. The horse has edematous hindlimbs and appears reluctant to move.
Blood drawn for a complete blood count shows inclusion bodies in the neutrophils.
What is the diagnosis?
A - Equine infectious anemia (EIA)
B - Purpura hemorrhagica
C - Equine ehrlichiosis
D - Equine viral arteritis (EVA)
E - Equine Babesiosis
C-Equine ehrlichiosis
his is one of the 5 classic “anemia / edema “ presentations of horses. (Remember “Big 3 are PEE” Purpura, EIA, EVA; 2 minors are Babesia, ehrlichia (now renamed Anaplasma).
Inclusion bodies in the neutrophils of a California horse with icterus and petechiae and an undulating fever says Equine granulocytic ehrlichiosis (EGE).
Originally classified as Ehrlichia equi, but is NOW called ANAPLASMA phagocytophila due to DNA sequencing studies. EGE is a seasonal necrotizing vasculitis (edema, icterus, petechiae) seen in N. California, suspected to be tick borne.
See dependent edema with Equine viral arteritis (EVA), but also should see respiratory presentation (conjunctivitis/pinkeye, rhinitis) +/- abortions.
Equine infectious anemia(EIA) is rarely seen today because of testing programs, but could present this way. Less likely because 92% cases seen around the Gulf of Mexico states (Texas to Florida), Mississippi river valley AND no inclusion bodies.
Purpura hemorrhagica is a type III Antigen/Antibody/Complement complex disease causing vascultis, petechia, purplish discoloration, usually afebrile, with Hx of recent Strangles (Strep equi equi) or bacterin vaccination.
Equine Babesiosis presents more as a hemolytic anemia: seen in the S. USA, endemic in Southern FLORIDA
Which organism determines the minimum temperature needed to pasteurize milk in the United States?
A - Brucella abortus
B - Mycobacterium bovis
C - Listeria monocytogenes
D - Coxiella burnetii
E - Escherichia coli
D-Coxiella burnetii
Temperature of pasteurization is set by the toughest, most heat-resistant organism, which is Coxiella burnetii, the cause of Q fever. If the temperature is high enough, for long enough to kill Coxiella, it will also kill the other organisms.
Historically, bovine TB, (Mycobacterium bovis) was the organism that prompted pasteurization ordinances.
- Brucella* and Listeria can also be transmitted in milk.
- E. coli* is typically a contaminant from unsanitary milking conditions.
Milk pasteurization standards in the United States are detailed in the Grade A Pasteurized Milk Ordinance. Basically, the higher the temp, the shorter the pasteurization time needed. ie: 90 C (194 F) for 0.5 seconds, or 100 C (212 F) for 0.01 seconds. (see item 16p)
Which pair of neonatal calf diarrheas both have public health/zoonotic significance?
A - Colibacillosis, Rotavirus
B - Salmonella, Coccidiosis
C - Cryptosporidiosis, Salmonella
D - Clostridium perfringens, Coronavirus
E - Colibacillosis, Ostertagiasis
C-Crytosporidiosis, Salmonella
Cryptosporidiosis is caused by a protozoa implicated in drinking water-associated outbreaks of diarrhea in humans; Salmonellae can infect humans from a number of different sources (turtles, chickens, eggs)
E. Coli can cause human disease, but Ostertagia and bovine rotavirus do not. (There IS a human version of rotavirus, however)
C. perfringens can be found in soil and in the normal gut flora and is not contagious.
This is a corneal abscess secondary to infectious keratoconjunctivitis (pinkeye).
What is the most commonly recognized organism that causes pinkeye in cows?
A - Neisseria spp.
B - Colesiota conjunctivae
C - Chlamydophila pecorum
D - Mycoplasma spp
E - Moraxella bovis
E- Moraxella bovis
In cattle, Moraxella bovis is the most commonly recognized cause of infectious keratoconjunctivitis, (“Pinkeye”); Other causes include Mycoplasma spp and Neisseria spp. The severity of infection with Moraxella bovis may increase with infection with IBR or other microbes. Chlamydophila pecorum is the most common cause of pinkeye in sheep.
Five calves are presented with an outbreak of profuse watery diarrhea, all less than 4 days old. The calves are dehydrated and weak.
The night before two other calves died. One had diarrhea, the other did not.
What is the clinical diagnosis?
A - Colibacillosis
B - Coccidiosis
C - Rotavirus
D - Neonatal Salmonella
E - Enterotoxemia
A-Colibacillosis
Colibacillosis is the most likely cause of watery diarrhea and sudden death in multiple calves less than 4 days old. Associated with failure of passive transfer (FPT) and septicemia.
Remember the AGE, SEVERITY and # AFFECTED when looking at calf diarrheas.
The EARLY diarrheas are due to:
Escherichia coli- less than 4 days old, multiple cases.
Rotavirus - 5d-2 wks old, self limiting, multiple calves.
Coronavirus, 4-30d, multiple calves
Enterotoxemia (Clostridium perfringens type C) 2 wks, healthiest, fastest growing calf, hemorrhagic diarrhea, sudden death!
Cryptosporidia, 1-4 wks, diarrhea, tenesmus, emaciation.
LATER diarrheas are:
Neonatal Salmonella-1-2 mos, fever and diarrhea, septicemia, sudden death.
Coccidiosis-older than 21 days and in ALL ages, bloody diarrhea, tenesmus.
What’s wrong with this picture?
A - Left acetabular fracture
B - Sacrococcygeal dysgenesis
C - Megacolon
D - Pelvic fracture
E - Tail root avulsion
B-Sacrococcygeal dysgenesis
This is Sacrococcygeal dysgenesis, an inherited trait in Manx cats. Look for dysgenesis, agenesis of sacrum or other spinal column abnormalities.
May present asymptomatic or with palpable lumbosacral abnormalities and LMN hind limb signs. (Hopping or crouched gait). May see nonprogressive urinary or fecal incontinence, chronic constipation.
Sequelae include recurrent urinary tract infections, megacolon.
NO treatment.
A 3-year old Irish Setter presents with a history of lameness and swelling in the distal forelimb. A radiograph looks like the image below.
What is the presumptive diagnosis?
A - Osteosarcoma
B - Osteomyelitis
C - Panosteititis
D - Osteochondrosis
E - Hypertrophic osteodystrophy
A-osteosarcoma
This is a classic image of Osteosarcoma, a COMMON, aggressive bone tumor typically found in the appendicular skeleton, especially distal radius.
90% have microscopic metastases to lungs by time of Dx, (but less than 10% will have visible thoracic metastasis at time of diagnosis).
Usually, does not cross joint (unlike osteomyelitis, which usually DOES cross joint). Look for soft tissue swelling, periosteal proliferation, sunburst periosteal reaction (33%), possible pathologic fractures.
What are the two main causes of pregnancy toxemia in guinea pig sows?
A - Anemia and hyperkalemia
B - Ketosis and hypertension
C - Hypocalcemia and anemia
D - Hyperlipidemia and hyperglycemia
E - Hypocalcemia and thrombocytopenia
B-ketosis & hypertension
The two types of pregnancy toxemia in guinea pigs are-
- Ketosis secondary to a negative energy balance and
- Ischemia due to the uterine compression of the vascular supply of the uterus, GI tract, or kidneys resulting in hypertension.
Clinical signs of pregnancy ketosis are ketone breath, lethargy, incoordination, dyspnea, paralysis, and death. Treatment of pregnancy-related hypertension may require an emergency cesarean section.
Which of the following hays is highest in calcium?
A - Orchard grass hay
B - Barley hay
C - Oat hay
D - Alfalfa hay
E - Bermuda grass hay
D-Alfalfa Hay
Compared to other types of hays, alfalfa tends to be higher in calcium, protein, and energy.
An aged intact female potbellied pig presents for evaluation of abdominal distension. A large mass contiguous with the uterine wall is discovered with ultrasound exam of the abdomen.
Which of the following choices is the most likely cause of this finding?
A - Endometrial hyperplasia
B - Uterine leiomyoma
C - Uterine lymphosarcoma
D - Endometritis
E - Uterine adenocarcinoma
B- Uterine Leiomyoma
The most likely cause of a large uterine mass in an intact female potbellied pig is a uterine leiomyoma. These tumors do not typically metastasize so a cure may be achieved by surgical removal of the uterus.
Follow this link to see more on leiomyomas and other connective tissue tumors
A sandhill crane from a local zoo dies after a period of chronic weight loss and weakness. Nodular lesions are discovered in the liver and spleen.
Which one of the following choices is the most likely diagnosis?
A - Tuberculosis
B - Spirochetosis
C - Histomoniasis
D - Fowl cholera
E - Lymphoid leukosis
A-Tuberculosis
Tuberculosisdue to Mycobacterium avium is the most common cause of these findings. M. avium is challenging to control in zoos and poultry flocks, because treatment may not be effective. A 3-month quarantine of all new additions to the aviary is strongly recommended.
Histomoniasiscan produce caseous lesions similar to that of tuberculosis, but usually only involves the ceca and liver of galliform birds, especially turkeys and chickens. Histomoniasis is also known as blackhead.
A poultry operation has been having problems with sick birds and many have died over the past few months.
A few showed torticollis before death. Some of the currently ill fowl have swollen joints, wattles, and footpads.
One of the broilers with swollen wattles is sacrificed. There is caseous, suppurative material inside the wattle and necrotic lung lesions.
Which one of the following agents is likely involved?
A - Salmonella gallinarum
B - Paramyxovirus
C - Fowlpox
D - Pasteurella multocida
E - Marek’s disease virus
D-Pasteurella multocida
Pasteurella multocida is the causative agent of Fowl Cholera. Older chickens are more vulnerable than are younger chickens.
The description above is of chronic fowl cholera. In acute fowl cholera, there are usually no clinical signs before a large number of birds die.
Classic lesions of Marek’s diseaseare enlarged sciatic nerves and lymphoid tumors. It is a highly contagious disease, but may be subclinical in many cases.
This 25 year old Quarter Horse mare is presented for evaluation in July in the northern hemisphere. She is diagnosed with pituitary pars intermedia dysfunction.
Which one of the following medications would be most likely to be beneficial to this mare?
A - Pentoxifylline
B - Isoxsuprine
C - Glucocorticoids
D - Pergolide
E - Methimazole
D-Pergolide
Pergolide is the treatment of choice for pituitary pars intermedia dysfunction (PPID).
PPID is characterized by degeneration of dopamine producing neurons in the hypothalamus that normally exert an inhibitory action on the pituitary pars intermedia, resulting in functional adenomas in the pars intermedia that produce high levels of adrenocorticotropin hormone.
Clinical signs and laboratory findings include hypertrichosis, poor muscle tone, laminitis, hyperglycemia and insulin resistance, and increased susceptibility to infection.
Diagnosis is commonly made by documenting increases in plasma adrenocorticotropin hormone levels in affected animals.
This 3 year old horse is presented for evaluation of these non-pruritic, non-painful face lesions. Most of the other young horses in the herd are also affected, and many of these horses also have lesions in the girth area.
Which one of the following diagnostic tests would be most likely to identify the cause of the lesions?
A - Fungal culture of hair and skin scales
B - Determination of serum antibody response to a regional panel of fungal pathogens
C - Biopsy
D - Testing for antinuclear antibodies in serum
E - Bacterial culture of hair and skin scales
Fungal culture of hair and skin scales.
This horse has dermatophytosis, or ringworm, typically caused by infection with Trichophyton equinum or Trichophyton metagrophytes.
Lesions can start as papular urticaria, but then progress to one or more, usually round, patches of alopecia, scaling, and crusting.
Culture confirms the diagnosis, and the recommended treatment is topical anti-fungal shampoos, although the disease is usually self-limiting.
The disease is highly contagious among susceptible animals and is also potentially zoonotic.
What is wrong with this picture?
A - Posterior synechiae
B - Orbital cellulitis
C - Anterior lens luxation
D - Nuclear sclerosis
E - Cataract
This is Anterior lens luxation. Follow this link to see another lens displacement image- note the aphakic crescent to right side (area of pupil without lens)
Look for an opaque (cloudy, milky) lens behind pupil with cataracts. In contrast, Nuclear sclerosis looks like this.
Orbital cellulitis presents in large and hunting breeds of dogs with acute pain on opening mouth, eyelid swelling, unilateral prolapse of nictitating membrane, eye protrusion, conjunctivitis. Dog’s face looks swollen with inflamed, red eyes , (aka: “Devil dog”)
An 8-year old German shepherd is presented with a 1-month history of cough, labored breathing and lethargy. He has fainted a few times after exertion.
Upon physical exam pallor and a slow capillary refill time is noted. The dog has jugular distension, diminished, quiet heart sounds, ascites and weak, variable femoral pulses.
T=102.0 F (38.9 C)..[N=99.5-102.5 F]
HR=140 bpm………..[N=80-120]
RR=24 brpm………..[N=15-34]
A thoracic radiograph reveals the following.
What is the clinical diagnosis?
A - Cor pulmonale
B - Peritoneopericardial hernia
C - Dilated cardiomyopathy
D - Congestive heart failure (left)
E - Pericardial effusion
This is the clinical picture of Pericardial effusion. Note the spherical “Balloon heart”. Follow this link to see a DV view of Pericardial effusion. RX of choice is pericardiocentesis.
Ascites, distended jugulars suggests RIGHT congestive heart failure (CHF), more than left CHF (pulmonary edema, crackles, wheezes, cough).
Cor pulmonale is just another name for right CHF due to pulmonary hypertension.
Dilated cardiomyopathy (DCM) should be on your DDX. More likely to hear systolic murmur, arrhytmias, less likely to be muffled heart sounds. ECHOCARDIOGRAPHY resolves DDX between pericardial effusion, DCM and Peritoneopericardial hernia.
What kind of organism causes equine granulocytic ehrlichiosis?
A - Chlamydia
B - Spirochete
C - Protozoa
D - Anaplasma
E - Ehrlichia
D-anaplasma
This is a tricky question to help you remember that two diseases FORMERLY classified as ehrlichia have now been re-classified. The causative organism of Equine granulocytic ehrlichiosis (EGE)was originally classified as Ehrlichia equi, but is now called ANAPLASMA phagocytophila due to DNA sequencing studies.
Do not confuse EGE, a necrotizing vasculitis in HORSE with BOVINE anaplasmosis, primarily an anemia, with icterus, fever.
Another name change occurred with the causative organism ofPotomac Horse Fever (PHF), from Ehrlichia risticii to NEOrickettsia risticii. PHF presents as a febrile colitis/diarrhea, with laminitis 3-5 d after diarrhea in horses of all ages: A big rule out is salmonella (think septicemia/fever+ diarrhea).
Which one of the following disorders can develop secondary to Spirocerca lupi infection?
A - Mammary adenocarcinoma
B - Tracheal sarcoma
C - Hyperparathyroidism
D - Diverticulitis
E - Hypertrophic osteopathy
E - Hypertrophic osteopathy
Hypertrophic osteopathy can occur secondary to infection with the ‘esophageal worm’, Spirocerca lupi.
This parasite affects the esophagus, aorta, and thoracic vertebrae. Infection develops by ingestion of the intermediate host, the dung beetle, or other paratenic hosts such as birds, hedgehogs, lizards, mice, or rabbits.
Spirocercosis can also cause esophageal neoplasia or spondylitis of the thoracic vertebrae.
Which three nerve blocks will correctly isolate the majority of equine lamenesses?
A - Suspensory ligament infiltration, Coffin, Proximal metacarpal
B - Low 4-point, Fetlock, Peroneal
C - Heel, High 4-point, Proximal metacarpal
D - Palmar digital, Abaxial sesamoid, Low palmar
E - Median/Ulnar, Low volar, Navicular bursa
D - Palmar digital, Abaxial sesamoid, Low palmar
90% of all lameness is in the HOOF. That means the three LOWEST nerve block will help you isolate most lamenesses.
These 3 are:
1). HEEL block (also called palmar digital (PD), used to help Dx navicular syndrome )
2) . PASTERN block (also known as the foot block, abaxial sesamoid nerve block (ASNB))- Can use to make a horse with acute laminitis comfortable)
3) . FETLOCK block (Also called Low palmar, Volar or Low 4-point block).
If horse is still lame after these 3 blocks (heel, pastern, fetlock), continue up limb with metacarpal/high 4-point, then prox. metacarpal blocks next.
A guinea pig is presented for seizure-like activity. On closer observation the guinea pig is not having a seizure but is actually severely pruritic. It also has hyperkeratosis and generalized alopecia.
Which one of the following choices is the most likely diagnosis?
A - Follicular ovarian cysts
B - Trixacarus caviae
C - Klossiella cobayae
D - Copper deficiency
E - Scurvy
B - Trixacarus caviae
Trixacarus caviae causes the most severe dermatitis of all guinea pig ectoparasites. Ivermectin treatment is usually successful but is used off label.
Scurvy(hypovitaminosis C) can occur in guinea pigs as they rely on dietary intake of vitamin C.
Clinical signs include diarrhea, joint pain, alopecia, petechiae, weight loss, hypertriglyceridemia, hypercholesterolemia, and skeletal muscle hemorrhage.
A 9-year old neutered male cat is presented, he is an indoor/outdoor cat who has recently been losing weight. He doesn’t run around like he used to and wheezes now when he does move around. His owner relates that he hasn’t had much of an appetite the last few weeks and is vomiting every day or so lately.
On physical exam it is noted that the cat is thin, with mild dehydration and somewhat dark mucous membranes but a normal capillary refill time. On auscultation inspiratory wheezes and somewhat irregular, muffled heart sounds are heard.
T=103.1 F (39.5 C)…..[N=100-103.1 F]
HR=124 bpm…………..[N=100-140]
RR=30 brpm…………..[N=16-40]
A lateral chest radiograph looks like the image below.
What is likely to have caused this illness?
A - Feline mediastinal lymphosarcoma
B - Lung lobe torsion
C - Pleural effusion
D - Hit by a car
E - Hypertrophic cardiomyopathy
D- Hit by a car
This is a diaphragmatic hernia (see loops of bowel with gas density overlapping lung fields).
Almost always secondary to trauma, esp. in pets HIT BY CARS. May present acutely after accident (shock, pale, tachypnea, tachycardia, dyspnea), or may show up with NO Hx of trauma and nonspecific GI, respiratory signs. May hear gut sounds in chest, muffled heart sounds. Can be congenital (think Weimaraner, Cocker), asymptomatic and go undiagnosed until middle age!!
In cattle, associated with traumatic reticuloperitonitis (Hardware Disease).
Look for FLOATING LUNGSwith pleural effusion.
With Hypertrophic cardiomyopathy (HCM) may have more severe cardiac sign, may see classic “Valentine” heart on DV rads.
Lung tumors, likeFeline mediastinal lymphosarcomamay obscure what should be dark, air-filled lung fields, but you still will not see loops of bowel in there. Follow this link to see a primary lung tumor. Note the contrast with multiple metastatic tumors in the lung.
Which reportable condition can affect cattle, but mainly causes disease in sheep?
A - Vesicular stomatitis
B - Anthrax
C - Malignant Catarrhal fever
D - Rinderpest
E - Bluetongue
E-bluetongue
Bluetongueis almost exclusively a sheep disease, (but cattle and deer can get it).
Rinderpestmainly affects cattle and is reported to be eliminated as of October 2010 by the the United Nation’s Global Rinderpest Eradication Program. Because it is a classic severe and reportable vesicular disease, vets will likely need to keep rinderpest on their mental DDX list for years to come.
Pseudorabies is basically a pig pathogen. Can affect cows, but horses (and humans) are resistant
Vesicular Stomatitis(VS) can occur in horses, pigs, cows. Remember the big 8 vesicular diseases: BVD, IBR, BPS, MCF, Bluetongue, VS, FMD, Rinderpest)
How long is a practice required to maintain client medical records?
A - Decades
B - Years
C - Months
D - Never
E - Weeks
B-years
The exact amount of time you must preserve medical records varies by state and provincial law, but it is measured in YEARS, usually 4-6 years or so.
The number of years is typically based on the statue of limitations in your state or province for bringing certain claims against veterinarians.
In the state of Michigan for example, claims include general professional malpractice (2 years), negligence (3 years), property damage (3 years) and breach of contract (6 years).
See the AVMA’s Principles of Veterinary Medical Ethics (2008 revision), form the last word on vet ethics. Section VIII covers medical records handling.
A 3-year old Quarter horse/Appaloosa cross mare is presented on emergency because she collapsed in the last 30 minutes.
The mare is recumbent and weak, with respiratory stridor, muscle fasiculations, sweating, prolapse of the third eyelid and her lips pulled back spasmodically, like a grin.
T=100.2 F (37.9 C)..[N=99-101.3 F]
HR=24 bpm………….[N=28-40]
RR=16 brpm…………[N=10-14]
The horse is hydrated and has had no recent history of colic. During the examination, she improves markedly and within 60 minutes stands and appears almost normal again with no treatment.
What is the clinical diagnosis?
A - Hyperkalemic periodic paralysis
B - Myasthenia gravis
C - Epilepsy
D - Equine degenerative myelopathy
E - Grass staggers
A - Hyperkalemic periodic paralysis
This is likely to be Hyperkalemic periodic paralysis (HyPP), an autosomal dominant trait found in ~ 4% of Quarter horses.
Heterozygotes often have periodic episodes 15-90 min: prolapse 3rd eyelid, muscle fasiculations, collapse. 25% cases traced back to one stallion named “Impressive”.
Onset of signs unpredictable, and many triggers: diets high in POTASSIUM (>1.1%, ie: alfalfa hay, molasses, electrolyte supplements, kelp-based supplements). Fasting, anesthesia, heavy sedation, trailer rides, and stress can precipitate clinical signs.
Grass staggers think “goose-stepping” (overstepping) from ergot on grass. EDM think ataxia in foals 6-8 mos. Epilepsy poorly documented in horses. Myasth. Gravis basically a dog disease.
A 3-month old calf is presented for necropsy. The calf collapsed and suddenly died this morning after she escaped and was chased around the back pasture for 45 minutes by her owner.
Among other things, endocardial plaques in the left ventricle of this calf’s heart are discovered.
What advice should be given the farmer?
A - Search the calf barn for sources of lead
B - Check the mother for bovine leukosis by AGID
C - Take all the calves off ionophore-containing feed
D - Treat the other calves with vitamin E/Selenium
E - Start the other calves on Ceftiofur (Naxcel ®)
D - Treat the other calves with vitamin E/Selenium
Treat the other calves with vitamin E/Selenium. Think of white muscle disease when you see SUDDEN DEATH and endocardial PLAQUES in a young calf, lamb or kid with a history of recent VIGOROUS EXERCISE. Follow this link to a Merck image of pale ventricular myocardium.
Typically seen in young, fast-growing animals (ie: calves 2 weeks-6 mos) Clinical signs may include dyspnea (due to myocardial disease), stiff gait, arched back, weakness, recumbent but BAR (bright, alert, responsive).
Sudden death may resemble enterotoxemia, should see acute bloody diarrhea, convulsions, opisthotonos in first days of life with enterotoxemia.
A cow is presented on emergency with urea/non-protein nitrogen toxicity.
What is the treatment of choice?
A - IV Fluids with MgSO4, Na thiosulfate PO
B - Atropine, Protopam chloride IV q 4-6 hours
C - Rumenotomy
D - Relieve bloat, drench with 2-8 liters sodium bicarbonate
E - Rumenal infusion 2-8 liters vinegar,3-10 gallons cold water
E - Rumenal infusion 2-8 liters vinegar,3-10 gallons cold water
Treat Urea/non-protein nitrogen (NPN) toxicity with a rumenal infusion 2-8 liters 5% acetic acid (vinegar) and 3-10 gallons of cold water. The vinegar decreases rumenal pH which slows absorption of un-ionized ammonia. Repeat Q 6 hours up to 48 hours. Best results if animal is still ambulatory.
It is often impossible to treat these cases before they die because of rapid progression to death. If possible, Rx with IV fluids. If necessary, relieve bloat.
Urea/NPN toxicity is related to ammoniated feed toxicity which causes so-called “Bovine bonkers”. Manage ammoniated feed toxicity by removing the ammoniated feed and treating severe cases with anticonvulsants like diazepam, pentobarbital.
A bovine diet that is low in thiamine or high in sulfur can cause ____________.
A - Parturient paresis
B - Polioencephalomalacia
C - Downer cows
D - Pseudorabies
E - Pregnancy toxemia
B - Polioencephalomalacia
The two most common causes of polioencephalomalacia(PEM) are low thiamine (due to thiaminase activity from plants like bracken fern or low thiamine diets) and high sulfur in the diet (which can come from a high molasses-urea diet, corn or sugar cane byproducts, water, or other plants, including alfalfa, Canada thistle (Cirsium arvense), kochia, (Kocchia scoparia), and lambsquarter (Chenopodium spp).
A 2-year old heifer is presented who died the night before.
She was stunted compared to her herdmates, and had a 3-week history of poor appetite, unthriftiness, diarrhea.
Necropsy reveals that the abomasum is edematous and covered in small umbilicated nodules 1-2 mm in diameter (cobblestone or “Moroccan leather” appearance).
Several other younger cows in this Spring-calving herd look unthrifty and have diarrhea too.
What is the plan of action?
A - Deworm cows post-calving, calves by midsummer, all stock in fall
B - Treat affected heifers with Ivermectin, repeat in 6 months
C - Treat affected heifers with Albendazole
D - Treat herd with Amprolium, repeat q 5 weeks
E - Cull the sick cows, Keep horses off same pasture 3 months
A - Deworm cows post-calving, calves by midsummer, all stock in fall
Treatment includes deworming cows post-calving, calves by midsummer, all stock in fall. An abomasum with a cobblestone or “Moroccan leather” appearance is pathognomonic for Ostertagia, one of the three stomach worms of cattle. Follow this link to see a Merck image of Ostertagia in an abomasum. These worms remain dormant in the gastric glands of the abomasum, emerging in the spring.
Rx is based on regular deworming of whole herd (2-4 times/year). Ivermectin or high dose Albendazole/Fenbendazole, given repeatedly can help treat the dormant (“hypobiotic”) Ostertagia in the gastric glands.
Amprolium is your treatment of choices for calves and cows with Coccidiosis.
Refs: Pasquini’s Guide to Bovine Clinics, 4th ed. pp. 21, 55 and the Merck Veterinary Manual online edition.
Pyrrolizidine alkaloid toxicity is caused by chronic ingestion of which one of the following plants?
A - Lupinus spp (lupine)
B - Astragalus spp (locoweed)
C - Nerium spp (oleander)
D - Senecio spp (ragwort)
E - Persea spp (avocado)
D - Senecio spp (ragwort)
Common plants containing pyrrolizidine alkaloids (PA) are: Senecio vulgaris, S. jacobea, Amsinckia intermedius, Heliotropium europaeum, Crotolaria spectabilis.
Although generally not palatable, livestock will eat these plants when baled in hay or on pasture when forage is scarce. Chronic ingestion allows accumulation of toxic levels of PA, resulting in hepatic fibrosis.
Poisoning is most common in horses and cattle, sheep and goats are more resistant to toxic effects.
Persea spp(avocado leaves) contain persin. Signs of toxicity are: noninfectious mastitis, abrupt cessation of milkflow, heart failure.
Neriumspp (oleander) contain cardiac glycosides. Signs of toxicity are: sudden death, weakness, diarrhea, cardiac arrhythmias.
Lupinusspp (lupine) contain alkaloids. Signs of toxicity are: birth defects (ingestion at 40-70 days in cattle), abortion, tremors, incoordination, head pressing, seizures.
Astragalusand Oxytropisspp (locoweed) contain alkaloids (swainsonine). Signs of toxicity are: excitability, incoordination, difficulty eating, exaggerated mouth movements, depression.
Follow this link to a Merck table with images of Poisonous RANGE plants. Follow this link to a Merck table with images of Poisonous HOUSE plants
Refs: Knight and Walter’s A Guide to Plant Poisoning, 1st ed, pp. 144-6, 155-9, Pasquini’s Guide to Bovine Clinics 4th ed., p. 233, Forero, Livestock-Poison Plants of CA, U of CA, Davis, ANR, pp. 7, 23, and the Merck Veterinary Manual online edition.
Which one of the following choices includes the cardinal sign of trigeminal neuritis?
A - Paralyzed eyelid, ear or lip on one or both sides of the face
B - Dysphagia, dysphonia and stridor
C - Masseter muscle pain associated with chewing
D - Circling and head tilt toward side of lesion, no other signs
E - Inability to close the mouth
E - Inability to close the mouth
Idiopathic trigeminal neuritis, cranial nerve 5, (CN 5) is characterized by acute onset of flaccid jaw paralysis. Affected animals cannot close their mouth and have difficulty eating and drinking. Seen occasionally in dogs, rare in cats. Cause is unknown.
Idiopathic facial nerve paralysis, cranial nerve 7, (CN 7) results in the inability to move the eyelid, lip, or ear and dryness of the eyes and mouth.
Masticatory myositis is characterized by pain on opening the mouth and swelling of the muscles of mastication (acute) or atrophy of the temporalis and masseter muscles with the inability to open the mouth due to fibrosis (chronic).
Dysphagia, dyphonia, and stridor are most often associated with dysfunction of the vagus nerve, cranial nerve 10 (CN 10).
Circling and head tilt toward the side of the lesion with no other signs is a common presentation of vestibulocochlear nerve, cranial nerve 8 (CN 8) lesions. Concurrent CN 7 paralysis and Horner’s syndrome (ptosis, miosis, enophthalmis) may be present with middle- and inner-ear infections.
Refs: Chrisman’s Neurology for the Small Animal Practitioner, 2003 p.159, Cote’s Clin Vet Advisor-Dog and Cat 1st ed., pp. 374-5, 687, 1105-6, Pasquini’s Guide to Small Animal Clinics 3rd ed., p. 562-3, 590, and the Merck Veterinary Manual online edition.
An adopted adult cat from a shelter with an unknown vaccination history tests positive for feline leukemia virus (FeLV) infection by IFA.
What should the owner be told?
A - Need a Western blot test to confirm diagnosis
B - Strong chance of lifelong FeLV infection
C - Need an ELISA test in 12 weeks to confirm diagnosis
D - Possible transient FeLV infection
E - Cat may be vaccinated for FeLV
B - Strong chance of lifelong FeLV infection
97% of cats positive for feline leukemia virus (FeLV) by IFA remain persistently infected and viremic for life.
The FeLV ELISA is more seNsitivethan the IFA (fewer false Negs, so trust a NEG test more), so it is a better general screening test with which to start. Click here for a diagram.
The FeLV IFA is more sPecific than the ELISA, (fewer false Pos, so trust a POS test more) so it is a better confirmatory test for any cats with a positive FeLV ELISA. Click here for a diagram.
THREE things to remember about FeLV and vaccinations:
- FeLV ELISA and IFA tests measure ANTIGEN, not antibody, so FeLV vaccination does NOT interfere with testing.
- Vaccinate FeLV-positive cats yearly against respiratory, enteric viruses with inactivated vaccines.
- FeLV vaccination for FeLV-negative cats has been associated with sarcomas. Vaccinate LOW on the LEFT hind.
Refs: Blackwell’s 5-Min. Vet Consult Canine-Feline, 4th ed. pp. 490-1, Cote, Clin Vet Advisor-Dog and Cat, 1st ed. pp. 380-2 and the Merck Veterinary Manual online edition.
How long after the first rabies vaccination is a dog, cat or ferret considered to be immunized and protected against rabies?
A - Same day
B - After 7 days
C - After 24 hours
D - After 14 days
E - After 28 days
E. after 28 days
After 28 days. According to the Compendium for Rabies Control, a peak rabies virus antibody titer is reached 28 days after initial vaccination and immediately after booster vaccination.
Here are some thoughts on rabies:
When in doubt, it is never wrong to check with your local health department.
Basically all potential rabies exposures boil down to 2 questions:
1. Who is involved?
Animal-Animal exposure (less alarm bells)
Animal bites/exposes human (more alarm bells)
- Was animal vaccinated/up to date on vaccination?
Up to date on vaccs (less alarm bells, shorter observation)
Vaccinated, but not up to date (Handle on case-by-case basis)
Un-vaccinated pet (more alarm bells, euthanize or long observation period)
Wild animal, esp. bats, raccoon, skunk (euthanize, send head to state lab)
When dealing with rabies questions, ask yourself if this seems like a HIGH-risk exposure (ie: wild raccoon bites a child)
or a LOWER risk exposure (ie: Up-to-date vaccinated dog messes with woodchuck but no bite wounds on dog).
For high risk lean towards euthanasia/testing or long quarantine. For low risk lean towards short observation period (10 days) and a rabies booster.
Refs: The SINGLE BEST REF on rabies is the Compendium for Rabies Prevention and Control, 2011; Nov 4, 2011 / 60(RR06);1-14.
For info on post-exposure prophylaxis for people see: Human Rabies Prevention-US, 2008 ACIP Reccs: May 23, 2008 / 57(RR03);1-26,28 and, as always, the Merck Veterinary Manual online edition.
A poultry operation has been having problems with sick birds and many have died over the past few months.
A few showed torticollis before death. Some of the currently ill fowl have swollen joints, wattles, and footpads.
One of the broilers with swollen wattles is sacrificed. There is caseous, suppurative material inside the wattle and necrotic lung lesions.
Which one of the following agents is likely involved?
A - Salmonella gallinarum
B - Paramyxovirus
C - Fowlpox
D - Pasteurella multocida
E - Marek’s disease virus
D - Pasteurella multocida
Pasteurella multocida is the causative agent of Fowl Cholera. Older chickens are more vulnerable than are younger chickens.
The description above is of chronic fowl cholera. In acute fowl cholera, there are usually no clinical signs before a large number of birds die.
Classic lesions of Marek’s diseaseare enlarged sciatic nerves and lymphoid tumors. It is a highly contagious disease, but may be subclinical in many cases.
Refs:The Merck Veterinary Manual online edition. Image courtesy, The Poultry Site.
A nine-year-old Irish setter presents for vomiting. The owner states that the dog does not really retch, but just spits up food soon after eating. The dog is normal otherwise. Thoracic radiographs are taken.
Based on the lateral radiograph below, which one of the following choices would be useful to determine a definitive diagnosis for this case?
A - Test for acetylcholine receptor antibodies
B - Cardiac echocardiography and doppler flow
C - Endrophonium challenge test
D - Pass a stomach tube and prep for emergency laparotomy
E - Ultrasonography of abdomen
Test for acetylcholine receptor antibodies, to ruleout myasthenia gravis, which is a frequent finding in older dogs with acquired megaesophagus, outlined in the image below.
Edrophonium (Tensilon) can be given as a clinical test for myasthenia gravis. However, since this dog is not weak it would not be useful.
Megaesophagus can be idiopathic or secondary to several disorders. Other causes include megaesophagus are heavy metal toxicity, polymyositis, lupus, and possibly hypothyroidism.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 709-11, Merck Vet Manual 10th ed. online, Dilation of the Esophagus in Small Animals, Image courtesy, Dr Kalumet and Wikimedia Commons.
A farmer has a few 8-12 week old pigs with weight loss, diarrhea, and a few with expiratory dyspnea.
Several pigs with similar symptoms have died recently. Mucous membranes are pale, and inguinal lymph nodes are enlarged.
Which one of the following viruses is the most likely causative agent?
A - Parvovirus
B - Manangle virus
C - Circovirus
D - Herpesvirus
E - Paramyxovirus
Circovirus, a nonenveloped DNA virus was first described in Canada in 1991 and causes Postweaning multisystemic wasting syndrome (PMWS).
The virus is also associated with porcine dermatitis and nephropathy syndrome caused by necrotizing vasculitis, which is more prominent in the skin, renal pelvis, mesentery, and spleen.
Refs: Handbook of Pig Medicine, Jackson & Cockcroft, pp. 188-190, Merck Vet Manual 10th ed. online, Images courtesy, The Pig Site.
A group of chickens presents with facial edema, green diarrhea, neurologic signs (ataxia, paralysis, torticollis) and respiratory distress. Morbidity and mortality are high.
Necropsy of a few birds shows edema and hemorrhage in the proventriculus and conjunctiva. Clinical signs and lesions are shown in the images below.
Preliminary results of virus isolation shows positive hemagglutination. Which one of the following choices is the most likely diagnosis?
A - Newcastle disease
B - Aflacatoxicosis
C - Avian pneumovirus
D - Infectious bronchitis
E - Fowl cholera
A-Newcastle disease
The symptoms above are compatible with the viscerotropic velogenic strain of Newcastle Disease.
Hemorrhage and edema in the proventriculus is a very common post mortem finding. Also, multifocal necrosis and hemorrhage of the intestinal mucosa at lymphoid foci (eg cecal tonsils) is almost pathognomomic.
Infectious bronchitis predominantly has respiratory symptoms and is negative onhemagglutination.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases Newcastle Diseaseand the Merck Vet Manual 10th ed. online. Images courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
A farm has ducklings that are weak, ataxic, or paralyzed with limbs spread out to the sides.
Necropsy shows white streaking in the musculature in many of the ducklings and a hemorrhagic cerebellum in one. Images are shown below.
Which one of the following choices is the most likely diagnosis?
A - Avian encephalomyelitis
B - Fusarium toxicosis
C - White Castle disease
D - Vitamin E deficiency
E - X-linked muscular dystrophy
D-vitamin E deficiency
Vitamin E deficiencycauses 3 syndromes in birds: 1) encephalomalacia, 2) exudative diathesis, and 3) muscular dystrophy.
With exudative diathesis to occur, the diet is deficient in both vitamin E and selenium. With muscular dystrophy, the diet is deficient in both vitamin E and sulfur amino acids.
Avian encephalomyelitishas no gross necropsy lesions. It is caused by a picornavirus that is shed primarily in the feces.
Refs: Vitamin E and Selenium Deficiency, Cornell University College of Veterinary Medicine Atlas of Avian Diseases and the Merck Vet Manual 10th ed. online. Images courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
A 7-year old male German shepherd presents with a history of weakness in the hind limbs, urinary incontinence and recent obsessive chewing around his tail area. Dorsiflexion of the tail over the back and extension of the hind limbs elicits a painful response.
There is moderate hindlimb ataxia. He does not withdraw each hind leg when a toe is pinched, but bears weight on the hindlimbs. Patellar reflexes are normal.
What is the clinical diagnosis?
A - Wobbler syndrome
B - Cauda equina syndrome
C - Hip dysplasia
D - Diskospondylitis
E - Radiculoneuritis
B- cauda equina syndrome
This is a common presentation of Cauda equina syndrome. Look for PAIN in the lumbosacral area (elicited by tail raise, hindlimb extension), LMN hindlimbs, especially Sciatic nerve damage at L7-S1 (lack withdrawal), +/- urinary/fecal incontinence, +/- SELF-MUTILATION of tail, perineum, pelvic limb.
Lesion due to compression of cauda equina at L7-S1 (lumbosacral stenosis). Can be congenital (abn development dorsal arch L7-S1, small dogs, Border Collies) or acquired (degenerative changes, big dogs, especially German Shepard, Rottweiler, Boxer).
Wobbler syndromeis a cervical spinal cord disease (also called cervical vertebral instability/ caudal cervical spondylomyelopathy). In adult form it is an intervertebral disc disease, usually seen at C5-C6 or C6-C7 in Dobies> 5 yrs, Great Danes> 2 years.
Diskospondylitisis a good second choice on your DDX of a large middle aged dog presenting with lumbosacral pain. Due to bacterial/fungal infection of intervertebral disk and adjacent vertebral bodies. Look for systemic signs like fever (1/3 of patients), weight loss, anorexia. Follow this linkto see a Merck image of diskospondylitis.
Refs: De Lahunta, Vet Neuroanatomy and Clin Neurology, 2nd ed. p. 74, Pasquini’s, Tschauner’s Guide to Small Animal Clinics, vol 1, 2nd ed. pp. 529, 533, and the Merck Veterinary Manual online edition.
Which one of the following organisms causes “chronic respiratory disease” in chickens and “infectious sinusitis” in turkeys?
A - Pasteurella multocida
B - Ornithobacterium rhinotracheale
C - Chlamydophila psittaci
D - Avibacterium gallinarum
E - Mycoplasma gallisepticum
E- Mycoplasma gallisepticum
Mycoplasma gallisepticum causes these diseases. It is the most pathogenic avian mycoplasma.
Morbidity is high and mortality low in chickens. Symptoms include respiratory distress, sneezing, nasal discharge, and frothiness about the eyes.
Refs: Mycoplasma gallisepticum, Cornell University College of Veterinary Medicine Atlas of Avian Diseases and the Merck Vet Manual 10th edition online. Image courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
A chicken farm has some chickens with para- or monoparesis for several weeks.
On close examination of the affected chickens, the irises are light colored and the pupils are misshapen.
Necropsy of one of the affected birds shows diffuse thickening of the lumbar plexus on one side.
Some of the birds have recovered without intervention. Which one of the following choices is the most likely diagnosis?
A - Marek’s disease
B - Infectious laryngotracheitis
C - Chlamydiosis
D - Infectious encephalomyelitis
E - Newcastle disease
A- Marek’s Disease
Marek’s disease usually causes a lymphoproliferative syndrome. Infiltrates develop in peripheral nerves, irises, feather follicles, and other organs.
It can also be subclinical and still cause decreased growth rates and a drop in egg production. Vaccination has a greater than 90% efficacy.
Newcastle disease can cause neurologic symptoms, but usually they are in conjunction with, or following, respiratory symptoms.
Refs:Marek’s Disease Cornell University College of Veterinary Medicine Atlas of Avian Diseases, and the Merck Vet Manual 10th ed. online. Images courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
Which one of the following organisms causes infectious coryza in chickens?
A - Ornithobacterium rhinotracheale
B - Pasteurella multocida
C - Chlamydophila psittaci
D - Avibacterium gallinarum
E - Mycoplasma gallisepticum
D- Avibacterium gallinarum
Avibacterium gallinarum. Infectious Coryza causes acute respiratory disease and primarily affects chickens. The severe form is most often seen in young adults.
Clinical signs include nasal discharge, sneezing, swelling of the infraorbital sinuses, facial edema with eyelids so swollen they cannot open, swollen wattles, and conjunctivitis.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases Infectious Coryza, and the Merck Vet Manual 10th ed. online. Image courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
A chicken farm has nearly all of its chickens sick with coughing, dyspnea, gasping, nasal discharge, conjunctivitis, blood-stained beaks, and hemorrhagic mucoid expectorations.
Mortality is about 15%. Necropsy shows most of the lesions in the trachea with mucus accumulation, diphtheritic mucoid or hemorrhagic casts, and necrosis.
Which one of the following choices is the most likely diagnosis?
A - Fowl cholera
B - Infectious laryngotracheitis
C - Fowl pox
D - Infectious bronchitis
E - Ornithobacterium rhinotracheale
B-infectious laryngotracheitis
The hemorrhagic expectorations are highly suspicious of Infectious Laryngotracheitis.
This disease is highly contagious and recovered birds become carriers and are the most important vector. During an outbreak, adults should be immediately vaccinated.
Infectious bronchitislesions are generally not hemorrhagic and mortality is not as high.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases Infectious Laryngotracheitis; Merck Vet Manual 10th ed. online. Images courtesy, Cornell University College of Veterinary Medicine.
Which one of the following choices is the organism that causes fowl cholera?
A - Ornithobacterium rhinotracheale
B - Avibacterium gallinarum
C - Pasteurella multocida
D - Mycoplasma gallisepticum
E - Chlamydophila psittaci
C-Pasteurella multocida
Fowl Cholerais a highly contagious disease caused by P multocida. Acutely, there may be fever, ruffled feathers, anorexia, and cyanosis of the comb and wattles.
The chronic form of Fowl Cholera is characterized by localized infections of the wattles, sinuses, foot pads, sternal bursa and joints.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases, and the Merck Vet Manual 10th ed. online; Image courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
Which one of the following choices is the best treatment for infection with Chlamydophila psittaci?
A - Doxycycline
B - Enrofloxacin
C - Ceftazidime
D - Ciprofloxacin
E - Amikacin
A-Doxycycline
Doxycycline.
Chlamydophila psittacicauses clinical disease in hundreds of bird species. Clinical signs vary from asymptomatic to diarrhea and respiratory symptoms.
Chlamydiosisis a REPORTABLE disease and poses a significant public health concern for humans.
Refs: Merck Vet Manual 10th ed. online; Image courtesy Atlas of Avian Diseases, Cornell University College of Veterinary Medicine.
A group of chickens presents with scabby, proliferative, and ulcerative lesions on the comb, wattles, eyelids, feet, and legs. Mortality is low.
Which one of the following choices is the most likely diagnosis?
A - Fowl cholera
B - Avian pox
C - Infectious coryza
D - Fowl plague
E - Marek’s disease
B Avian Pox
Avian pox, also known as Fowlpox. This disease is not contagious to humans.
There are two forms of the disease - 1) cutaneous or dry pox has low mortality, with proliferative lesions on comb, wattles, etc, and 2) diphtheritic or wet pox that causes yellow canker lesions on mucous membranes, tongue, esophagus, or trachea.
Fowl cholera causes swellings and abscesses in the comb and wattles, but also affects the respiratory tract. The mortality can be high.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases, Avian Pox, and the Merck Vet Manual 10th ed. online; Image courtesy of Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
Which one of the following diseases causes hock sitting, ataxia, and paralysis in chicks 1-2 weeks of age and blue opacity of the lens in those that survive the acute phase of the disease? The disease can affect chickens, pheasants, quail, and turkeys.
A - Infectious laryngotracheitis
B - Avian encephalomyelitis
C - Fowl cholera
D - Mycoplasma gallisepticum
E - Avian metapneumonia
B. Avian Encephalomyelitis
Avian Encephalomyelitis, also called epidemic tremor, is the most likely diagnosis. This disease has about 60% morbidity and 25% mortality.
Other differentials would include vitamin E deficiency, thiamine deficiency, Newcastle disease, and Marek’s disease, however, these do not typically cause cataracts.
M gallisepticum typically causes a chronic respiratory disease in chickens and infectious sinusitis in turkeys.
Refs: Cornell University College of Veterinary Medicine Atlas of Avian Diseases: Avian Encephalomyelitis and the Merck Vet Manual 10th ed. online; Images courtesy Cornell University College of Veterinary Medicine Atlas of Avian Diseases.
The 12-year-old spayed female cat shown below is presented with a history of weakness for the past 2 days. She has neck ventroflexion and a stiff, stilted gait.
Which one of the following is in the top of the differential list?
A - Hyperkalemic periodic paralysis
B - Caudal occipital malformation
C - Hypokalemic myopathy
D - Cervical vertebral malformation
E - Bilateral otitis media/interna
Hypokalemic myopathy.
The posture is classic for hypokalemiaand other neuromyopathies (e.g., myasthenia gravis, organophosphate intoxication) in cats.
Hyperkalemic periodic paralysis has not been reported in cats.
Refs: Dewey, A Practical Guide to Canine and Feline Neurology, 2 nd ed. pp. 497-500 and the Merck Veterinary Manual online edition. Image courtesy of Dr. Shirley Scott.
This radiographic image shows osteoarthritis of the lower hock joints of a horse.
What is the common name for this problem?
A - Bone spavin
B - Ringbone
C - Splints
D - Tarsal hydrarthrosis
E - Osselets
A-Bone spavin
This is bone spavin, the number one hock problem (tarsus) in horses, an osteoarthritis of the lower hock joints, usually affecting the distal intertarsal and tarsometatarsal articulations. Etiology not clear (several theories)-seen most in Standardbreds, Quarter Horses. If horse is lame, tends to drag toe.
Tarsal hydrarthrosis (bog spavin) is a chronic synovitis of the tibiotarsal joint- look for swelling and distention of the joint capsule.
Follow this link to see a photo of bog spavin (lateral swelling, left tarsus).
Refs: Pasquini & Spurgeon’s Anatomy Dom An 11th ed. pp. 100-1, 645b and the Merck Veterinary Manual online edition.
What is the proper name for this parasite of pigs?
A - Dioctophyma renale
B - Stephanurus dentatus
C - Capillaria plica
D - Gnathostoma spinigerum
E - Trichinella spiralis
B-Stephanurus dentatus
This is Stephanurus dentatus, the swine kidney worm.
Found worldwide, particularly in tropical and subtropical areas. Seen in the U.S. as a parasite of pigs raised outside in the southeastern and southcentral states.
Click hereto see these large worms (2-4.5 cm long) encysted in pairs along the ureters from the kidney to the bladder (courtesy of the UPenn CAL site).
Refs: The Merck Veterinary Manual online edition.
A 7 day old Tb filly is anesthetized with isoflurane in oxygen for a cerebrospinal fluid tap when an irregular heart beat is heard on the doppler. The heart rate is approximately 90 beats per minute. A recording of the electrocardiogram is printed as shown in the image below.
Which one of the following choices correctly identifies this arrhythmia?
A - Atrial flutter
B - Paroxysmal ventricular tachycardia
C - Ventricular escape beats
D - Premature atrial contractions
E - Premature ventricular contractions
E-Premature ventricular contractions
Three premature ventricular contractions are present on this ECG strip.
Usual characteristics of PVCs - No p wave present that is associated with the QRS wave, the QRS is wider than normal and bizarre in shape compared to normal, often the QRS is oriented opposite to that of the sinus beats.
The orientation of the QRS is the same (both negative) in both the normal and ectopic beats in this case. Don’t be fooled by the presence of the small waveform just before the PVC, these are the T waves from the prior beat.
Cardiac arrhythmias that occur under anesthesia can be caused by hypercarbia, hypoxemia, hypotension, hypothermia, anesthetic drugs, sympathetic stimulation, electrolyte disturbances, and myocardial disease.
This foal had just been induced with isoflurane, was likely hypoventilating, and a little deeper than necessary. The isoflurane was decreased, she was put on a ventilator - the PVCs disappeared and did not return.
Refs: Muir and Hubbell’s Equine Anesthesia, 2nd ed. pp. 85-88, Grimm, Tranquilli, and Lamont’s Essentials of Anes and Analgesia in SA, 2nd ed. p. 230. ECG image courtesy of Dr JG Adams.
A 5 year old quarterhorse is presented with a depigmented hyperkeratotic plaques localized to the concave aspect of both ears.
What message should be communicated to the owner?
A - Typically secondary to underlying immunosuppression
B - Surgical removal is curative
C - Need to check the pasture for photosensitizing plants
D - Lesions usually persist for life
E - Do not breed this horse
D-Lesions usually persist for life
Equine aural plaques(papillary acanthoma, ear papilloma) typically persist for life.
Equine aural plaques are caused by a papillomavirus and thought to be transmitted through mechanical transmission by biting Black flies (Simulium spp.)
There is no specific treatment. Prevention includes application of fly repellent and stabling the horse during the Black fly’s feeding times (dusk and dawn).
Refs: Pasquini’s Guide to Eq Clin, 3rd ed. pp. 292 and the Merck Vet Manual online.
This calf was aborted at 7.5 months pregnancy in early fall. The dam was a primiparous beef animal housed on pasture in Northern California.
Necropsy revealed multiple petechial hemorrhages on the palate and scleral mucus membranes of the fetus, and marked lymphadenopathy. The calf was not decomposed; the cow retained the placenta.
Which one of the following choices is the most likely diagnosis of the abortion in this case?
A - Foothill abortion agent
B - Leptospira pomona
C - Pine needles
D - Brucella abortus
E - Neospora caninun
A-Foothill abortion agent
This is a typical case of foothill abortion, also called Epizootic Bovine Abortion. The condition is common in the coastal and Sierra Nevada foothills, and throughout much of the western United States. It is the most common cause of abortion in California beef cattle.
The etiologic agent has not been identified with certainty. Research suggests that it is a delta protobacteria with DNA homology to bacteria of the vibrio genus. Pregnant cattle exposed to thymic tissues from aborted fetuses can be protected from abortion by feeding tetracycline through the early stages of pregnancy.
The agent is transmitted by the soft shelled Pajahuello tick (Ornithodorus coriaceus). The disease occurs predominantly in heifers. Infection develops during the first trimester of pregnancy while abortions occur later around the 5th to 9th month.
Exposed cattle develop immunity, but it is not known how long protection lasts. However, abortion does not often recur in these animals. The presence of petechial hemorrhages and lymphadenopathy in a late-term aborted fetus is suggestive of foothill abortion.
Neospora is another common abortifacient of beef cattle, but does not produce lymhadenopathy or petechiae in the fetus. Leptospirosis, brucellosis, and pine needles also do not produce the same pathologic lesions as the foothill agent.
Ref: Pasquini’s Guide to Bovine Clinics 4th ed., p. 123, Divers and Peek, Rebhun’s Diseases of Dairy Cattle, 2nd ed., pp. 430 -1,
Image courtesy Dr. Lisle George copyright 2012 and the Merck Veterinary Manual online edition.
A registered Hereford cow on pasture gave birth to this calf with a very short, curly, frosted-looking pale coat and normal-appearing skin. By two weeks of age, some of the hair is falling out. Which one of the following choices is the most likely explanation for its’ appearance?
A - Normal appearance until 21 days of age
B - Baldy calf syndrome
C - Zinc deficiency
D - Ichthyosis
E - Congenital hypotrichosis
E-Congenital hypotrichosis
This calf has congenital hypotrichosis of Herefords, an autosomal recessive genetic problem.
Hereditary hypotrichosis can be differentiated from the other disease choices because the dermis of the calf is normal in appearance.
Baldy calf disease is an inherited problem of Holsteins. The calves may lose hair, have thickened skin and metabolic illnesses.
Refs: Smith, Large Animal Internal Medicine, 3rd ed., p. 1849 and the Merck Veterinary Manual online edition, Images courtesy Dr. Lisle George copyright 20112.
This 3 year old Charolais bull weighing 2100 lbs was found at pasture walking in circles. He has been fed silage enriched with 5% dried chicken litter in addition to the winter pasture.
T = 104.6°F (40.3°C)..[N=101.5-103.5 F]
Pulse rate = 46 beats per minute….[N=55-80bpm]
Resp. rate = 21 per minute….[N=10-30 brpm]
He is depressed, anorectic and drooling, with a head tilt to right. The right ear and eyelid both droop. The bull is ataxic with predominantly right sided proprioceptive deficits.
A sample of cerebrospinal fluid (CSF) taken at the lumbosacral space has normal color, no turbidity but has an increased mononuclear cell count and an elevated protein concentration.
Which one of the following choices is the most likely diagnosis?
A - Otitis media/interna
B - Nervous coccidiosis
C - Rabies
D - Thromboembolic meningoencephalitis
E - Listeriosis
E- Listeriosis
Listeriosisis most likely in this bull. Infection with Listeria monocytogenes usually presents with MULTIFOCAL brainstem signs as seen by dysfunction of multiple cranial nerves, most often V, VII-X, and XII.
Circling is thought to be more than just CN VIII damage because of the intensity associated - affected animals will sometimes continuously circle till they collapse. This suggests that other areas of the brain such as the basal ganglia and the descending reticular formation are also affected.
Thromboembolic meningoencephalitis (TEME) causes brainstem and cerebellar signs but the CSF would be neutrophilic and xanthochromic. The xanthrochromia is due to vasculitis/thrombosis in the CNS. TEME is more common in feedlot calves; respiratory disease, septicemia, and joint disease may also be seen.
Animals with otitis media/interna are alert and responsive, and have signs of vestibular dysfunction, but are not paretic.
The bull could have rabies, but the multifocal nature of this bull’s problem and the localization of lesions to the brainstem favor a diagnosis of listeriosis.
Patients with nervous coccidiosis are usually centrally blind, and have cerebral rather than brainstem signs. It is most often seen in calves soon after the development of diarrhea.
Refs: Pasquini’s Guide to Bovine Clinics 4th ed., p 141-4, 150, Divers and Peek, Rebhun’s Diseases of Dairy Cattle, pp. 512-8, 520, 530, 551-3, and the Merck Veterinary Manual online edition. Image courtesy Dr. Lisle George copyright 2012
This 11-year-old spayed female cat is presented with generalized weakness and unable to lift her head.
The owners have noticed her at the water bowl more often and she seems to be urinating more in the last month.
Which blood chemistry test would be most likely to diagnose cause of her weakness?
A - Bicarbonate
B - Calcium
C - Sodium
D - Chloride
E - Potassium
E-Potassium
Potassium. This is a classic presentation of a cat with hypokalemic myopathy which is often due to potassium loss from renal disease.
Other causes of generalized weakness and neck ventroflexion include polymyositis, organophosphate toxicity, myasthenia gravis.
Refs: Curtis Dewey, A Practical Guide to Canine and Feline Neurology, 2nd ed. pp. 458-9 and the Merck Veterinary Manual online edition. Image courtesy Dr. Shirley Scott.
The sheep seen in the images below presents with listlessness, reluctance to move, and a crusty muzzle. On examination, there is a wide reddened area just proximal to the coronary bands.
Which one of the following choices is the most likely diagnosis?
A - Sheeppox
B - Fuzzy wool disease
C - Caprine arthritis/encephalitis
D - Vesicular stomatitis
E - Bluetongue
E-Bluetongue
Bluetongueis an infectious, noncontagious viral disease of ruminants. Some affected sheep will have swollen, cyanotic tongues. It is transmitted via bites from the vector - Culicoides spp biting midges.
Sheeppoxcan cause crusty, scabby lesions on the nose, but not lameness or the changes at the coronary band.
Refs: Merck Vet Manual 10th ed. online. Images courtesy Dr Jerry J Callis, Dr Brian WJ Mahy and the CDC.
A zebra recently imported from Zimbabwe to a London zoo died after a being ill for about 2 weeks. He was febrile and very depressed, with dyspnea and respiratory distress in the last 24 hours.
Other signs included hyperemia of the conjunctiva and edema all over the head and neck, especially the eyelids and the supraorbital fossae. Necropsy reveals a clear pericardial effusion, froth in the upper airways, and heavy distended lungs.
Which one of the following choices is the most likely diagnosis?
A - Equine viral arteritis
B - Equine influenza
C - African Horse Sickness
D - Piroplasmosis
E - Equine infectious anemia
C-African Horse Sickness
African Horse Sickness (AHS) presents with fever, respiratory signs, and edema. Those with respiratory signs die within about a week; death occurs after 1-2 weeks in the “cardiac” form of the disease.
Caused by an orbivirus, AHS is transmitted via bites of infected Culicoides spp. most often during warm, humid, seasons.
AHS is very lethal, especially in naive populations where mortality approaches 90%. No specific treatment is effective, but attenuated-live virus vaccines are available that are protective.
Edema is a prominent clinical sign, especially of the head and neck. Pulmonary edema and hydropericardium are a common necropsy findings.
The disease is endemic in southern Egypt and occurs sporadically in many parts of Africa. AHS has never occurred in the United States and is a REPORTABLE disease.
Other differentials include anaplasmosis, piroplasmosis, equine viral arteritis, and Equine infectious anemia
Refs: Blackwell’s 5 Minute Consult: Equine 2nd ed., p. 41, and the Merck Vet Manual 10th edition online, Image courtesy, Dr Jerry J Callis, Dr Brian WJ Mahy and the CDC.
A fourteen-year-old cat presents with a protruded nictitating membrane and miotic pupil on the right. There is an absent right palpebral reflex and a right head tilt. The physical, ophthalmologic, and neurological exams are normal.
Where is the lesion?
A - Right brachial plexus
B - Left cavernous sinus
C - Right medulla oblongata
D - Left brachial plexus
E - Right middle/inner ear
E-Right middle/inner ear
A lesion of the right middle/inner ear could cause ipsilateral Horner’s syndrome (miosis, ptosis, enophthalmos), facial nerve paralysis, and vestibulopathy.
Otitis Media and Interna is the most common cause of disease in this area, but neoplasia can also occur in the middle/inner ear.
A brachial plexus avulsion can also cause an ipsilateral Horner’s syndrome, but not facial nerve paralysis or vestibulopathy.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 543-5 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
What are potential complications to surgical thyroidectomy in a hyperthyroid cat?
A - Laryngeal paralysis
B - May miss ectopic thyroid tissue
C - Horner’s syndrome
D - All of these
E - Hypocalcemia
D- All of these
A unilateral thyroidectomy could allow for recurrent Hyperthyroidism, by way of hyperplasia or adenoma, of the contralateral thyroid gland.
The cat should be treated medically for several weeks before surgery.
Refs: Cote, Clin Vet Advisor 2nd ed. pp 562-5 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School
A 12-year-old neutered male mixed-breed cat presents with weight loss, polyphagia, polydipsia, polyuria, and unkempt haircoat. The cat is thin and has tachycardia.
Which one of the following tests is most likely to confirm the presumptive diagnosis?
A - Urinalysis
B - Abdominal ultrasonography
C - Serum T4
D - Fecal examination
E - Abdominal radiographs
C-Serum T4. The signalment and clinical signs are highly compatible with hyperthyroidism.
Canned food diet, ectoparasiticide exposure, and mixed breed origin are probable risk factors for Hyperthyroidism.
The three treatment options are antithyroid medication, radioactive iodine therapy, and surgical thyroidectomy.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 562-5 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
The following cytology is from a bronchoalveolar lavage in a dog.
Which one of the following choices is the most likely diagnosis?
A - Fungal bronchopneumonia
B - Bacterial contamination
C - Eosinophilic pneumonitis
D - Bacterial bronchopneumonia
E - Actinomyces pneumonia
Simonsiella are bacteria that normally inhabit the pharynx and have a large, ladder-like appearance. Their presence indicates contamination from the oropharynx.
Bacteria, if present within neutrophils or macrophages, would be a significant finding.
Refs: Cote, Clin Vet Advisor 2nd ed. pp 160-2 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
A five-year-old mixed breed presents with acute swelling of the left pinna that is determined to be an aural hematoma.
Which one of the following choices is the best treatment?
A - Pinnectomy
B - None of these
C - Incisional drainage
D - Bulla osteotomy
E - Fine-needle aspiration
C-Incisional drainage
This is an aural hematoma, a commonly seen condition in practice. Following incisional drainage, mattress sutures are applied to prevent deformation and the ear is bandaged to the head.
It is important to determine the underlying cause of aural hematomas with a thorough aural exam, cytology, thyroid profile, food trial, or allergy skin testing.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 120-2 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
A fourteen-year-old neutered male Lab presents with a sudden onset of a left head tilt and horizontal nystagmus with the fast phase to the right.
He is barely ambulatory with ataxia but has normal conscious proprioception and normal stride length. The rest of his physical and neurologic exam is normal.
Which one of the following choices is the most likely location of the lesion?
A - Left peripheral vestibular
B - Right cerebrum
C - Left cerebrum
D - Right brainstem
E - Right rostral cerebellar peduncle
A-Left peripheral vestibular
Peripheral vestibular disease in a geriatric dog has a high likelihood of being idiopathic geriatric vestibular syndrome – a self-limiting syndrome.
Otitis Media and Interna or hypothyroidism would be other possibilities.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 1170-1 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
A five-year-old Boxer dog presents for routine vaccinations. The owner points out a small, smooth mass on the right ear.
Fine needle aspiration cytology is shown below. Which one of the following choices is the most likely diagnosis?
A - Pyogranulomatous inflammation
B - Bacterial inflammation
C - Transmissible venereal tumor
D - Lymphoma
E - Mast cell tumor
E-Mast cell tumor
This cytology slide shows mast cells full of purple histamine granules, suggesting a mast cell tumor. Follow this link to see another slide of mast cell cytology.
Grossly, appearances are highly variable and mast cell tumors can be mistaken for skin tags or lipomas.
Skin and subcutaneous masses should always be examined cytologically. These tumors can range from low grade to highly aggressive with local recurrence or lymph node metastasis.
Transmissible venereal tumors are often papillary or nodular in appearance. Cytologically they are a round cell tumor with large, central nucleoli.
Refs: Cote, Clin Vet Advisor 2nd ed. pp 701-3 and the Merck Veterinary Manual online edition. Images courtesy, Nottingham Veterinary School and Wikimedia commons.
A twelve-year-old female spayed miniature schnauzer presents with a history of seizure-like episodes.
Physical exam reveals an irregular heart beat. CBC and panel are unremarkable except for a mild triglyceridemia. ECG is shown below.
Which one of the following choices is the most likely diagnosis?
A - Sick sinus syndrome
B - First degree AV block
C - Ventricular tachycardia
D - Atrial fibrillation
E - All of these
The “seizure-like” episodes, after questioning the owner further, were actually syncopal episodes. Syncope lacks muscle activity and post-ictal behavior.
Older female Miniature Schnauzers tend to be overrepresented with sick sinus syndrome.
The ECG here shows sinus arrest with bradycardia and tachycardia.
First degree AV block is characterized by an increased PR interval.
Second degree AV block consists of occasional P waves not followed by QRS complexes.
Refs: Cote, Clin Vet Advisor 2nd ed. pp.1022-4 and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
Which one of the following choices is the most likely finding consistent with myocardial hypoxia in the ECG below?
A - Increased T amplitude
B - Alternating bradycardia and tachycardia
C - Variable complex intervals
D - ST segment depression
E - Narrow QRS complex
D-ST segment depression or elevation is consistent with myocardial hypoxia.
Tall T waves are commonly normal in cats and dogs, however, if the onset of tall waves is noted during ECG monitoring over time it could indicate hypoxia or movement artifact.
Alternating bradycardia and tachycardia is seen with sick sinus syndrome(SSS). In SSS, the sinoatrial node is unable to generate an impulse. Older female miniature schnauzers are predisposed. Look for signs of fainting, weakness, confusion. Rx is a pacemaker.
Refs: Cote, Clin Vet Advisor 2nd ed. web only and the Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School.
A 12-year-old male Labrador retriever is presented with a one-year history of cough and stridor.
Which one of the following choices can be ascertained from the thoracic radiographs?
A - Emphysema
B - Megaesophagus
C - Cranial mediastinal mass
D - Hypoinflation of lungs
E - Severe heartworm disease
Within the thorax, there is poor inflation with the diaphragm remaining in a relatively vertical position and contacting the entire caudal border of the heart. There is increased opacity throughout the lungs, with a bronchointerstitial pattern.
The cranial mediastinum is uniformly widened on the d/v projections with no evidence of a mass on the lateral projection. The heart and vessels appear normal.
The pulmonary changes are probably due to hypoinflation secondary to upper airway obstruction, however, additional airway or parenchymal disease cannot be ruled out. In this case, the dog had bilateral laryngeal paralysis.
Emphysemacan be either alveolar or interstitial. Pekingese can have congenital lobar emphysema due to poor development of bronchiolar cartilage resulting in air trapping during expiration.
Refs: Thrall, Textbook of Veterinary Diagnostic Radiology 6th ed. pp. 608-31 and the Merck Veterinary Manual online edition., Radiographic interpretation and images courtesy, Dr A. Zwingenberger and Veterinary Radiology.
A 3-year-old neutered male Lhasa Apso was presented with a one month duration of left pelvic limb lameness and depression.
Based on the radiographs, where is the problem located?
A - Right Sacrum
B - L6-7
C - Left ilium
D - Left stifle
E - Right femoral head
C-Left ilium
There is a mixed lytic and productive bone lesion on the wing of the left ilium, extending to the cranial acetabulum. The femoral head is not involved.
The lesion is seen best on the v/d projection.The differentials would include neoplasia or osteomyelitis.
The diagnosis in this case is osteomyelitis secondary to coccidiomycosis.
Refs: Cote Clin Vet Advisor 2nd ed. pp. 800-1 and the Merck Veterinary Manual online edition. Images courtesy, Dr A Zwingenberger and Veterinary Radiology.
