Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CMS - term 2 > Acute Medicine and Surgery > Flashcards

Acute Medicine and Surgery Flashcards

You may prefer our related Brainscape-certified flashcards:
Introductory Sommelier Exam (CMS) flashcards
1
Q

gastric foreign body definition

A

anything ingested that can’t be digested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

examples linear foreign bodies

A

string, yarn, cloth, dental floss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

foreign bodies in cats

A

usually linear
must be removed asap
can cause intestinal perforation and peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

signs gastric foreign body

A

may be asymptomatic
vomiting - acute or persistent
anorexia
depression
abdominal pain
dehydration - sometimes
palpable plicated intestines - somtimes
linear foreign body attached to ventral tongue - cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

gastric foreign body - ddx

A

parvo
gastric neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

diagnostics gastric foreign body

A

radiography - radio-opaque visible, radiolucent needs positive contrast or double contrast
cytological examination of any effusion
endoscopy - gastroduodenoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment - gastric foreign body

A

induce vomiting - apomorphine for dogs, xylazine for cats - only if quite certain can be expelled without harm
correction of acid base
withold food - 12 hours
radiographs immediately before surgery or endoscopy - localise foreign body
perioperative antibiotics
gastrotomy - to inspect whole GIT
don’t pull on linear foreign body unless comes loose easily
endoscopy - to remove foreign body, care of sharp edges
antiemetics if vomiting continues

prognosis good so long as stomach not perforated and foreign body removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

GDV definition

A

gastric dilatation-volvulus
enlargement of stomach and roatation on mesenteric axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

simple dilatation definition

A

stomach engorged but not malpositioned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

dilitation definition

A

organ or structure stretched beyond normal dimensions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

GDV pathophysiology

A

enlargment from gastric outflow obstruction - can’t vomit, eructate or empty pylorus to intestine
enlarged with gas/fluid
stomach rotates, usually clockwise ( from surgeons perspective)
spleen displaced to right ventral abdomen
caudal vena cava and portal veins obstructed - reduced venous return and cardiac output, myocardial ischemia, obstructive shock and inadequate tissue perfusion
affects multiple organs

arryhtmias common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

risk factors GDV

A

exercise after large meals or a lot of water
soy or cereal based dry foods
irish setters fed single feed type
large meals (regardless of number of meals daily)
feeds that are high oil or fat content
anatomic predisposition
gastric ileus
trauma
primary gastric motility disorders
vomiting
stress
male sex
increasing age
low BCS
rapid eating
raised feeding bowl - may promote aerophagia
dry kibble anxious dogs
spending 5 or more hours with owner
egg supplements
equal time in and outdoors
splenectomy (maybe)

military dogs more commonly develop GDV in November, December, Janurary - don’t know why

adding table food to large or giant breed dogs may decrease GDV incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

GDV signallment

A

usually large deep chested breeds - but not exclusively (also see in small dogs and cats)
more common in shar peis than other medium breeds
more common in middle aged and older
intact females higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

GDV signs

A

distending and tympanic abdomen - varying degrees
recumbency
depression
may have pain - arched back
clinical signs of shock - weak peripheral pulses, tachycardia, prolonged CRT, pale mm, dypnoea,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GDV ddx

A

simple dilatation - common in puppies that overeat
small intestine volvulus
diaphragmatic hernia
ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

GDV diagnostics

A

radiograph - differentiate GDV and simple dilatation
free abdominal air - suggests gastric rupture
air within wall of stomach - indicates necrosis

immedaite surgery once stabilised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

GDV treatment

A

stabilise - fluids - isotonic, 7% saline or hetastarch
blood gas analysis
CBC
broad spectrum antibiotics
oxygen therapy if dyspnoea
gastric decompression - tube, care not to perforate oesophagus
once decompressed wash with warm water to prevent recompression
surgery once stabilised even if stomach decompressed - rotation impedes blood flow so can lead to necrosis
surgery in dorsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

GDV surgery aims

A

inspect somtach and spleen
remove damaged or necrotic tissue
decompress stomach
correct malpositioning
adhere stomach to body wall - prevent future malpositioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

enterotomy

A

allows access to entire GIT
provides full thickness biopsies - important for submucosal masses
can examine and sample rest of abdomen at same time
samples taken from lymph nodes, liver and other tissues before gastric or intestinal - cross contamination

simple interrupted to close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

enterotomy - indications

A

masses
foreign body removal
luminal examination
biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

end to end anastomoses

A

recommended for removal of ischemic, necrotic or neoplastic tissue or fungal infected segments of intestine or irreducible intussuceptions

care not to pull sutures too tight but make water tight

simple interrupted recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

coagulopathy - horses - acute haemorrhage

A

not a common cause of haemorrhage but consumptive coagulopathy can be an issue after the haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

signs of haemorrhagic shock

A

tachycardia
tachypnoea
cold extremities
anxiety or depression
pale mm
prolonged CRT
weak arterial pulse
flow murmur
sweating
colic
abdominal distension
decreased MAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

acute haemorrhage - biochem markers

A

hyperlactatemia - impaired oxygenation to tissues
hypoprteinemia
anemia
may have normal PCV and TP - especially in early stages - can stay normal until fluid redistributes (up to 12 hours) TP changes first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

estimating blood loss - acute haemorrhage (horse)

A

total blood volume - 8% body weight

<15% loss - HR normal, CRT normal, BP normal, possible mild anxiety
15-30% - increased HR and RR, mildly prolonged CRT, normal BP, mild anxiety
30-40% - moderate to severely increased HR, increase RR, prolonged CRT, decreased BP, anxiety or depression, cool extremities
>40% - severely increased HR, increased RR, pale mm, severe hypotension, obtunded, cool extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

controlling blood loss - acute haemorrhage

A

ligation - surgical
pressure - pressure bandage, tourniquet, manual pressure
pack sinuses
pro-coagulants - topical, absorbable (for smaller areas), IV formalin (no evidence in support) herbal
stablise clots - anti-thrombolytics - aminocaprioc acid, transexamic acid (morepotent, better evidence) - inhibit fibronolysis and stabilise clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

fluid therapy - acute haemorrhage - horse

A

assess if controlled or not
need coagulation factor replacement

uncontrolled -
persistant hypotension - dangerous
aim to support circulating blood to minimum volume needed for tissue perfusion until controlled
crystalloids indicated if donor blood not immediately available and the case is an emergency
blood products preferred

controlled -
if definitive hemotasis - expand volume with crystalloids, hypotonic saline, or blood
if unstable controlled - replace minimum of estimated blood lost, can give initial bolus
blood products preferred as not diluting RBCs

crystalloids and synthetic colloids can dilute RBSs and clotting factors - increase BP so destabilising clot and increasing bleeding, may also cause hypocoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

blood transfusion indications - acute haemorrhae - horse

A

30% loss
signs of hypovolemic shock
PCV < 20% in acute bleed, <12% in chronic anemia
lactate >4mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

blood transfusion - donors - horse

A

ideally large healthy geldings
good temperament
PCV <35%
TP <6g/dL
ideally negative for Aa and Qa alloantigens

8 equine blood groups, >30 different factors

avoid donor mares that have had foals or horses who have previously had a transfusion
can’t use donkeys - donkey factos

cross match by evaluating haemogluttination - may not need to do this is recipient has not had blood products before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

calculation blood deficit - acute haemorrhage - horse

A

(normal PCV - animal PCV/normal PCV) * blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

reactions to blood transfusion - horse

A

usually in first 15 mins
more common after multiple transfusions

agitation
tremors
urticaria
pruritis
piloerection
colic
nasal oedema
pulmonary oedema
weakness
collapse
tachycardia
tachypnoea
dyspnoea
pyrexia
death

stop if any reaction, use corticosteroids or antihistamine
adrenaline in severe cases

if re-starting do so slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

safety and restraint measures - farm

A

competent human help
crush
calving gate
locking yolk
halter
kick bar
tail jack
hobbles
tie back leg
ppe
cotton wool in ears
down halter
sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

sedation - farm

A

xylazine
detomidine
romifidine
butorphanol

aims - standing, standing with muscle relaxation, recumbent, deep recumbent sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

sedation side effects - farm

A

increased salivation
recumbancy
abortion risk
bloat
regurgitation and inhalation
heat stress

pulmonary oedema risk in sheep

TMPS antibiotics contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

considerations sedation - farm

A

IM - slower onset, longer duration, larger dose

IV - faster, shorter duration, smaller dose

consider epidural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

sacrococcygeal epidural - farm

A

uses -

obstetrics
prolapse
c-section
embryo fertility work
rectal prolapse
epiostomy - cut during parturition to make more space
castration

when - before starting painful procedure around hindquarters

procaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

sacrococcygeal epidural - procedure - farm

A

18gauge 1.5inch needle
5ml procaine

lift tail and bend slightly
palpate 1st or 2nd coccygeal space
clip and sterile prep
needle at 15degrees to vertical

effective within 5-10 mins no motion of tail, no sensation around perineum and no straining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

bloat types - farm

A

frothy bloat - can’t be eructated - consumption of fermentable legumes

free gass - obstructive, can’t eructate

calves - rumen drinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

treatment bloat - farm

A

stomach tube
NSAID
antacids
electrolytes

recurrent bloat -
local anaesthesia
red devil trochar or rumenotomy

incision paralumbar fossa
screq red devil into the abdominal muscle and rumen
release gas
remove once animal recovered

oozing and slow hole closure common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

indications caesarian - farm

A

legs cross
no room around head/legs
precervical torsion
uterine torsion that won’t move
foetal monster
uncorrectable dystocia
suspected uterine tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

caesarian procedure - farm

A

edipural - 5ml procaine for 600kg cow
clenbuterol IV
nsaid
3-5 days antibiotic - penicillin, amoxycillin, tetracycline

clip left paralumbar fossa
abdominal local same as LDA
incision same as LDA
bring uterus to incision edge
incision on uterus greater curvature
aim to incise over calf distal limb
pull out calf - assistant for resuscitation
check for twins/tears
trim placenta

absorbable suture - utrecht for uterus
close abdomen - as in LDA
2-4ml oxytocin - counteracts clenbuterol

treat calf umbilicus with iodine
10% bw colostrum in first 6 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

caesarian complications - farm

A

infections
dehiscence
seroma
recumbancy/down cow
comorbidities - hypocalcemia
retained placenta
death
peritonitis
abdominal adhesions
reduced future repro performance
metritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

castration - farm

A

calves/lambs/kids - <7 days - rubber ring - no anaesthetic

calves/goats - >2months - any method, local anaesthetic

lambs - >3 months - any method, local

pigs - <7days - any methods, local

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

castration - rubber ring - farm

A

efficient and safe
no anaesthetic needed

complications if incorrectly applied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

open castration - farm

A

various methods
1-3 months old
suckler calves to 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

castration considerations - farm

A

health
housing hygiene
size
handling facilities
analgesia
antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

j shaped incision open castration - farm

A

3-5ml procaine under scrotal skin and into cord
+/- sedation or GA
NSAID

clean skin - hibiscrub
push testes into sac
j shaped incision lateral scrotum through vaginal tunic
separate vascular and non vascular spermatic cord
strip vaginal tunic
twist testicle and pull to break cord
snip off dangling ductus deferens
spray incision with antibiotic spray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

open castration complication - farm

A

haemorrhage - watch for continuous bleeding, monitor, twist or ligate vessles, pack scrotum with wool

may then develop scrotal haematoma or abscess

remnant of spermatic cord recoils into abdomen - intestinal obstructions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

urethral obstruction - farm

A

ruminants, esp goats
adolescent fattening and mature breeding animals
wether goats
texel and scottish blackface sheep

dietary mineral imbalance
concentrate feeding - imbalance calcium:phosphate or magnesium

signs -
off colour
straining to urinate
anuria
down
blood tinged urine
distended abdomen
abdominal fluid thrill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

urethral obstruction diagnostics - farm

A

palpation - uroliths, enlarged or diappeared bladder palpable per rectum, urethral pulsations

complete blood count - increased urea, BUN, creatinine, potassium and muscle enzymes, deacreased sodium, chloride
acidic urine pH

imaging - US shows distended bladder and urethra hypoechoic
radiography - may see stones depending on crystal type
contrast to confirm rupture

abdominocentesis - creatinine in peritoneal fluid 2x more than plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

ddx urethral obstruction - farm

A

cystitis
peritonitis
coccidiosis
peritoneal tumour
ruminal tympany
hydrops
GI obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

urethral obstruction treatment - farm

A

correct fluid and electrolye imbalances

medical -
sedation
analgesia
local anaesthetic
foley catheter to flush out stones
ammonium chloride - decrease urine pH and dissolve stones - calcium carbonate stone bronze and dont dissolve
IV fluids for depressed uremic animals

surgery - usually
perineal urethrostomy - 82% non recurrentce in 12 months
penile amputation
tube cystotomy
drain urine from abdomen
bladder marsupialisation - 67-84% long term success

euthanasia

prognosis good for small number years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

urethral obstruction - other considerations - farm

A

often relapse after medical treatment
prognosis good after surgery but not for so long
males can’t breed after perineal urethrostomy - salvage procedure

evaluate diet
iceberg disease
long time to correct

complications -
UTI
strictures
bladder mucosal prolapse
scalding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

urethral obstruction prevention - farm

A

increase urinary chloride excretion - sodium chloride supplementation

decrease urine pH - ammonium chloride dietary supplement

calcium supplement - unless calcium based uroliths present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

fracture repair - farm

A

NB - small ruminants do well with amputations

NSAIDS to minimise swelling and give analgesia
+/- sedation

bandage
stirrups
padding for cast
fibreglass
hooves inside cast
confine animal
cast for 4-6 weeks
tape for further 2 weeks

closed fractures only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

fractures considerations - farm

A

manage expectations - esp if growth plate involvement or infection
cases over 400kg need specialist case - referral - poorer prognosis
schroader thomas splint for tibia/radial fracture
neonates need regular recasting

euthanasia often most economical option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

ddx - pyrexia of unkown origin - cats

A

FIP
Pancreatitis
cat flu - calicivirus and herpes
parasites
FIV
FeLV
feline panleukopenia
neoplasia
toxins
foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

pyrexia of unkown origin - testing - cat

A

FIV, FeLV, Feline panleukopenia SNAPs
abdominal ultrasound
hemo and biochem - WBCs, serum proteins, pancreatic parameters, renal and liver parameters
biopsy - liver and kidney (FIP virus in non effusive)
FNA enlarged lymph nodes - FIP virus in macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

pathogenesis FIP

A

feco-oral spread (usually multi-cat houses, catteries, shelters)
enteric coronavirus replicates in enterocytes
mutates to live in macrophages
spreads
immunodeficiency, vasculitis, damage to blood vessels
organ damage (various)
signs variable based on organ system adamaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

FIP treatment

A

remdesivir
steroids
supportive therapy - fluids, nutritional support

euthanasia should be considered if no response in 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

ddx pyrexia of unknown origin - dog

A

infection
immune mediated
neoplasia

young, large breed - steroid responsive meningitis
young, small breed - granulomatous encephalomeningtis
sight hounds, collies, shar peis - immune mediated polyarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

common ddx pyrexia of unknown origin - equine

A

pleuropneumonia
strangles
collitis
peritonitis
pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

bacterial pneumonia - equine

A

risk factors -
long distance transport
recent oesophageal obstruction
dysphagia
recent anaesthetic
recent viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

bacterial pneumonia - signs

A

congested mm
cough
nasal discharge

often picked up before obvious signs so history important

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

colitis risk factors - equine

A

parasite management
recent antimicrobials
recent NSAIDs
consuming oak or sand
recent diet change
stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

testing - pyrexia of unknown origin - equine

A

clinical exam
hemo and biochem - inflammation may not show in bloods if erly stages, SAA and fibrinogen useful to guide whether acute or chronic, low WBC and left shift in severe infection
peritoneal fluid - peritonitis, increased WBC and TP indicate intra-abdominal infalmmation, cytology for insight into cause, culture if WBC increased
rectal palpation
US thorax and abdomen
nasopharyngeal swab - combined PCR influenza, strangle and EHV 1 and 4 - negative result doesn’t rule out

bacterial pneumonia - US lungs - pleural effusion and lung parenchyma consolidation, trachel wash and BAL also useful (but more invasive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

tick borne infection - pyrexia of unkwon origin - equine

A

anaplasma and borellia (lyme disease)
neuro sign, abortion, pain, arthritis

NSAIDS - analgesia and reduciton of inflammation and pyrexia
contraindication if suspected colitis, renal disease or severe hypovolemia - run hemo and biochem first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

antimicrobials in pyrexia of unkown origin - equine

A

yes if bacterial pneumonia, even if secondary

if cause unknown -
risk factors for bacterial pneumonia - severe pyrexia, cough, lethargy - then yes
no risk factors - then no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

difference - hyperthermia and pyrexia

A

hyperthermia - increased muscle activity, increased ambient temperature, or increased metabolic rate - heat stroke, stress, medication

pyrexia - hypothalamus resets body thermoregulation point higher - infectious, immune mediated, or neoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

pyrexia of unknown origin - non specific signs - small animal

A

lethargy
depression
anorexia
panting
shivering
collapse
reluctance to move/stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

trial treatment - pyrexia of unkwon origin - small animal

A

only for animals confortable to send home - alert, eating and drinking, not clinically dehydrated

focus on most common causes (cats - FIP, cat flu, infection, dogs - kennel cough, steroid responsive meningitis)

NSAIDs - correct dehydration first
fluids
antibiotics - esp in cats with suspected cat bite that can’t be found - amoxyclav, in dogs most causes are viral
steroids - if signs suggest steroid responsive meningitis, confirm not bacterial first because steroids will make that worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

diagnostics - pyrexia of unknown origin - small animal

A

H & B
SNAPs - FeLV, FIV, Parvo
urinalysis
radiograph
abdominal US
fecal analysis

immune - saline auto agglutination - IMHA
cytology - FNA of masses of biopsy, CSF tap for meningitis, bone marrow aspiration for panleukopenia

outdoor cats - toxo IgG, tick borne disease PCRs, bartonella pCR
cats with anemia - anemia panel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

pyrexia of unkown origin - cat bite abscess

A

lethargy
anorexia
pyrexia
focal swelling
draining abscess

treat -
drain pus
analgesia - NSAIDs, opioids if dehydrated
antibiotics - if pyrexic or systemically unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

pyrexia of unknown origin - FIP

A

immune mediated
young or old
multi cat environment
recent stress common trigger

anorexia
lethargy
pyrexia
weight loss
pale or jaundiced mm
wet form - effusion
dry form - harder to recognise, various organ problems but most common ocular and CNS

non regn anemia, lymphopenia, IMHA
proteinaceous effusion
hyperglobulinemia adnd high bilirubin without other liver changes
staining of coronavirus infected macrophages (lymph node FNA)

steroids to moderate immune response
remdesivir
euthanasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

pyrexia of unknown origin - toxoplasma gondii (cats

A

usually no signs
self limiting intermittent diarrhoea (20% of cases)
more likely in hunters

acute - pyrexia, danorexia, CNS signs, multifocal inflammation

detect in tissue biopsy or cytology samples - immunohistochemistry (tricky as not knwoing what tissue involved)

elimination difficult
predisposed to future episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

pyrexia of unknown origin - heat stroke

A

actually hyperthermia
high environmental temp or physical activity in hot weather

panting
hypersalivation
cyanotic mm
stifness
collapse - severe - dic

increased risk - brachys and dogs that run around like mental cases (greyhounds, spaniels)

treat - active cooling (cool water not cold), fluid, oxygen (esp brachys), if seizures then diazepam (seizures –> muscle contraction –> worsened hyperthermia), check for renal and hepatic damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

pyrexia of unknown origin - steroid responsive meningitis

A

most common canine meningitis
young dogs

pyrexia
neck pain with no other neuro deficits
beagles, boxers, bernese mountain dogs

diagnosis -
signallment and exam
left shift leukocytosis
c reactive protein
CSF cytology - pliocytosis and nondegenerated neutrophils in early stages, lymphcytes and macropahfes in later stages

treat -
prednisolone - moderate to severe
NSAIDs - very mild cases
azathiopine - in combination with preds, lowers dose of pred needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

pyrexia of unknown origin - immune mediated polyarthritis

A

primary - idiopathic
secondary - to another inflammatory condition depositing immune complexes in joints

reluctance to walk
lameness
swollen painful joints
altered gait
pyrexia
inappetance
vomiting
diarrhoea

baseline tests to establish primary condition
arthroscopy to diagnose

treat -
preds with or without azathiopine
culture - main ddx is septic arthritis - steroids will make that worse so get this back first
opioid analgesia while waiting for results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

challenges for mother - c-section anaesthesia

A

physiological anemia - increase in blood volume but no increase in RBCs
increased oxygen demand
decreased functional residual capacity of lungs (pressure on diaphragm) and increased alveolar ventilation (panting) - rapid reuptake and offloading of anaesthetic gases
enlarged and full abdomen - can’t breathe well on their backs
poor venous return - compressed vena cava
increased prgesterone and increased blood brain barrier permeability - quicker sedation
delayed gastric emptying, decreased oesophageal sphincter tone, lower gastric pH - greater regurgitation risk
electrolyte disturbances
exhaustion and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

challenges for puppies - c-section anaesthesia

A

viability - hypoxia, hypercapnia, acidosis, effect of drugs
respiratory depression - usually caused by hypoxia
hypoxia - biggest issue - placental separation, impaired maternal ventilation, impaired maternal blood pressure
hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

situational challenges - c-section anaesthesia

A

often emergency - late night, limited help, limited time
financial and emotional pressure
limited experience - both owner and vet
lack of clinical evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

drug challenges - c-section anaesthesia

A

basically no licensed drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

initial stabilisation - c-section anaesthesia - emergency

A

fluids
check electrolytes, TP and PCV
premed - reduce dose of induction agents needed
pre-oxygenate
pre-clip if appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

initial stabilisation - c-section anaesthesia - elective

A

treat as normal
IV canula
pre med
pre oxygenate
prepare equipment and drugs and personnel
pre-clip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

drug choice - c-section anaesthesia

A

short acting
antagonisable
local anaesthetics and blocks if familiar with them - if not may take too long
minimum effective doses but don’t underdose - distress will cause restriction of arteries to placenta
fluids and oxygen support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

pre med - c-section anaesthesia

A

reduces stress - improves uterine blood flow
reduces induction and maintenance agents needed - reduced negative cv effects and foetal drug exposure
care with locals - can cross placenta and ionise so can’t cross back

full mu agonists - sedation and anaesthesia, minimum cv effects, maternal bradycardia potential but treatable, foetal hr not affected because not under autonomic control

short acting fentanyl an option if want to be quick

ACP - avoided generally - prolonged sedation and hypothermia in mother - no increased mortality so can use if needed

alpha-2s - xylazine associated with increased mortality

benzos - not advised - floppy infant syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

induction - c-section anaesthesia

A

avoided inhaled - IV better - common to see struggling to breathe

propofol - maternal 3x higher than foetal after 1 bolus - not associated with poorer outcomes

alfax - some evidence may be better

ketamine - more profound foetal depression, intensive resuscitation often needed, also usually with benzos so not advised

regurg a problem - head raised, secure airway quickly - sellicks manouver (pressure on crichoid while tubing)

pre-oxygenate to avoid apnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

maintenance - c-section anaesthesia

A

iso or sevo in oxygen

IPPV

avoid nitrous oxide

only use neuromuscular blocking agents if familiar with use - need IPPV because won’t be able to breathe

epidural - good if familiar, if not increased time, decreased epidural space because of engorged sinuses, lidocaine

extradural opioids - good, minimal systemic effects

tilt mother to left - pressure off vena cava, reduce supine hypotension syndrome - effective in patients up to 20kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

analgesia - c-section anaesthesia

A

pain –> sympathetic stimulation –> sudden reduction in uterina blood flow –> hypoxia –> puppy mortality
welfare
inadequate analgesia associated with decreased milk production

NSAIDS - useful in dam, often given after puppies removed, negligible transfer in milk
opioids - excellent analgesia, can accumulate but can be antagonised through IV injection to umbilical vein (naloxone or butorphanol to antagonise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

neonatal resuscitation - c-section anaesthesia

A

agpar scoring - HR, RR, reflexes, mobility, suckling and vocalisation - guide to puppy distress

considerations -
warmth
vigorous body rubbing
suction and removal of membranes
oxygen - if suspect hypoxia give oxygen
GV26 acupuncture point on head - used as respiratory stimulant

avoid doxopram - increased myocardial oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

small intestine identifying features - dog

A

duodenum - cranial RHS abdomen

jejunum -
longest
all over abdomen in mesentery

ileum -
shortest
looks like ileum except from artery running along border at 180 degrees from mesentery attachment
most common site for foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

ddx vomiting dog

A

foreign body
dietary indiscretion
bacterial - e coli, salmonella, campylobacter, mycotoxins
gastric ulcers
NSAIDs
parasites
parasites
kidney disease
liver disease
gastritis
pancreatitis
neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

vomiting vs regurgitation

A

if food is partially digested - vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

vomiting diagnostics - dog

A

pancreatitis SNAP
endoscopy
fecal analysis
radiograph - VD and both laterals, contrast to show radiolucent bodies and timing of passage through
abdominal ultrasound
bloods - renal, hepatic, pancreatic, neutrophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

exam - vomiting

A

assess for shock - hypovolemic and distributive most common - HR, pulse, pale mm in hypovolemic, congested in distributive or septic, RR and resp effort, sometimes bradycardia in cats

hypothermia or pyrexia may be seen if infection

cardiac - vomiting, abdominal distension, ascites

hepatic and pancreatic - vomiting, diarrhoea, pain, and distension

urogenital - vomiting and pain

splenic - pain and distension

endocrine - vomiting and diarrhoea

MSK - eg IVDD - may present as abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

vomiting - diagnostics - dog

A

radiographs - plain and contrast - opacities, gas build up, foreign bodies, GDV

abdominal US - AFAST for trauma, survery for general look, good for effusion, stricture due to neoplasia, detect free fluid for sample

peritoneal fluid tap - us guided, type of fluid, cytology

bloods - rule out other causes of GI signs (renal, hepatic, cardiac), corrections before surgeries, metabolic alkalosis in upper GI, WBC changes in infectious disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

stabilisation - vomiting dog

A

fluids - dehydration, account for ongoing losses
correct shock
correct electrolytes

antiemetics -
if suspected dietary indiscretion or infection
not if suspect obstruction - hide signs
maropitant
ondansetron
metoclopramide

gastroprotectants -
H2 receptor agonists - ranitidine, famotidine
omeprazole - proton pump inhibitor
sucralfate - binds to ulcer sites and creates barrier

antimicrobials -
not indicated in mild cases
amoxyclav - perioperative if surgery on GIT
metronidazole - giardia or clostridium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

signs - oesophageal obstruction - dog

A

choking/gagging or coughing a bit
regurg a while after food (chronic)
increased salivation
lethargy
dyspnoea

99
Q

sequelae - oesophageal obstruction - dog

A

aspiration pneumonia
perforation
mediastinitis
pleuritis
pneumothorax

100
Q

diagnosis - oesophageal obstruction - dog

A

radiograph - preferred - may need contrast, check lungs for aspiration pneumonia
oesophagoscopy - can also sometimes use to remove objects

101
Q

treatment - oesophageal obstruction - dog

A

endoscopic removal
surgical removal - move to stomach first if possible - gastrtomy - or thoracostomy and end to end anastomoses
medical treatment after removal - sucralfate, anti inflammatories, gastroprotectants, antimicrobials if indicated, soft diet
feeding tube if severe damage - should enter GIT after point of damage

102
Q

GDV signs

A

non-productive retching
abdominal distension
lethargy and collapse - later stages
dyspnoea and/or tachypnoea
tympanic anterior abdomen
tachycardia
dysrhythmia
weak pulses
pale mm
prolonged CRT

103
Q

GDV - sequelae

A

arrythmia
endotoxemia - compromised mucosal barrier
gastric necrosis - peritonitis and septic shock
electrolyte and acid base disruptions
DIC - end stage - euthanise

104
Q

GDV - diagnosis

A

radiograph - looks like 2 compartments

105
Q

GDV - treatment

A

gastric decompression - orogastric tube or through outside
manage shock
manage dysrhythmias

surgery -
partial resection of necrotic stomach and spleen
correct position
adhere stomach to abdominal wall

post op -
monitor electrolytes, acid base and ECG - 24-48 hours - hypokalemia common
fluids
analgesia - opioids
small soft low fat meals - asap after surgery
anti emetic
omeprazole
antibiotics if evidence of infection of lots of leakage into abdomen

106
Q

GDV - prevention

A

frequent smaller meals
avoid stress during feeding
don’t use elevated feed bowl
avoid breeding from dogs who have had one
prophylactic gastropexy - tack stomach to abdominal wall

107
Q

signs - gastric and intestinal foreign bodies

A

total obstruction - vomit everything up including water
almost always present as emergency
young animals known to scavenge - esp golden retrievers

acute gastric - no signs maybe vomiting, dehydration, hypovolemic shock, quick progression

chronic gastric - intermittent vomiting, weight loss, may be asymptomatic or incidental finding

proximal SI - vomiting, dehydration, shock

distal SI - more intermittent and chronic

108
Q

sequelae - gastric and intestinal foerign bodies

A

perforation –> septic shock
DIC - compromised intestinal barrier

109
Q

diagnosis - gastric and intestinal foreign bodies

A

palpation abdomen
check under tongue - linear foreign bodies, esp cats
radiograph - with or without contrast
gastroduodenoscopy - if gastric or proximal GI, can sometimes remove object
bloods

110
Q

treatment - gastric and intestinal foreign body

A

induce vomiting - only if object small enough
move to stomach - easier surgery
fluid
correction of acid base
analgesia - opioids, risk of ulceration with NSAIDs
antibiotics - if sepsis - amoxyclav or cephalosporins
endoscopic removal
gastrotomy
enterotomy
ex lap - check whole GIT in case multiples

milk object to area of healthy tissue
end-to-end anastomoses

111
Q

post op care - gastric and intestinal foreign bodies

A

monitor
electrolyte imbalances
low fat diet 12-24 hours post op
antiemetic if needed
omeprazole if suspect ulceration

112
Q

presentation - intussuception

A

rarely acute
young
quiet
inappetence
often in recovery from parvo or parasitic enteritis
older animals - associated with neoplasia
varying signs based on site and severity

acute - bloody diarrhoea, vomiting, abdominal pain, mass on abdominal palpation
chronic - intermittent diarrhoea, depression, lethargy, emaciation

113
Q

diagnosis - intussusception

A

radiograph - better with contrast
us - best
bloods
fecal analysis - parasitic cause

114
Q

treatment - intussuception

A

treat underlying condition
stabilise - fluids etc
surgery - manual reduction or end-to-end anastomoses
enteroenteropexy - pexy one bit of SI to another
if mass, resection and anastomoses, also if manual reduction not working or dead tissue

115
Q

presentation - mesenteric volvulus/torsion

A

collapse
swollen abdomen
blood from anus
sudden onset
rare - rapidly fatal - once sick usually necrotic intestines

116
Q

ddx acute hemorrhagic diarrhoea syndrome

A

parvo
clostridial endotoxicosis
coagulopathy
intussusception
foreign body leading to intestinal trauma - rare

117
Q

presentation - acute hemorrhagic diarrhoea syndrome

A

haemorrhagic diarrhoea - raspberry jam consistency
anorexia
lethargy

usually self limiting with supportive care - fluids, bland diet, adsorbants

test for parvo

118
Q

testing - acute hemorrhagic diarrhoea syndrome

A

bloods - decreased PCV, inflammatory leukogram (increased PCV in parvo), low protein, low potassium, renal azotemia
fecal analysis
SNAP for parvo
CPLI for pancreatitis
imaging - for pancreatitis or neoplasia

diagnosis of exclusion

119
Q

treatment - acute hemorrhagic diarrhoea syndrome

A

supportive - fluid, antibiotics if sepsis
low fat easy digestible diet in early stages
protectants and adsorbants

parvo treatment -
barrier nursing
antiemetics
gastroprotectants
tube feeding
blood transfusion if very sick
virbagen omega - licensed antiviral
monoclonal antibodies

120
Q

horse GI - indications for referral

A

presistent pain after analgesia
progressive abdominal distension
tachycardia <60bpm
hypovolemia signs
absence of borborygmi
abnormal rectal findings
gastric reflux >4L

121
Q

horse GI - prior to referral

A

plan transport
if inconclusive whether surgical or moedical avoid flunixin
decompress stomach with NG tube
analgesia
rug and bandage limbs - might go down in box

122
Q

CHF pathophysiology

A

increased cardiac filling pressure –> venous congestion –> extravasation of fluids

pleural effusion

pulmonary oedema - left sided
ascites, peripheral oedema - usually right sided

123
Q

CHF signs

A

tachypnoea/dyspnoea
reduced exercise tolerance
reduced appetite
lethargy
weight loss
abdominal distension

124
Q

CHF tests

A

Essential -
TFAST/POCUS - fluid, left atrium size

bonus -
BP
biochem
xray - if stable

125
Q

CHF sedation

A

methadone or butorphanol - if thromboembolism butorphanol not enough

126
Q

Furosemide CHF

A

Either every 4 hours, based on CRI or based on resp rate
monitor mentation - if stressed may artificially rase resp rate
care not to dose too much - kidney injury

diuretic

127
Q

CHF thoracocentesis

A

required to fix significant pleural effusion
day 1 skill
can US guide
quickly reduces resp effort
if inspiratory dyspnoea - can usually assume pleural effusion without needing US

128
Q

CHF pimobendan

A

management of chronic heart disease
utility in emergencies less clear
improves cardiac output and systolic function - not usually the main issue in an emergency
care if suspected obstruction - cats, or dogs with aortic stenosis

expensive

129
Q

CHF radiographs

A

gold standard confirmation
only use once stable to sedate and restrain
after thoracic US, thoracocentesis and diuretics

assessment for concurrent disease

130
Q

pericardial effusion signs

A

muffled heart sounds - main thing
ascites - right sided heart failure
weak pulses
paradoxical pulses
collapse

lethargy
weakness
exercise intolerance

131
Q

pericardial effusion diagnosis

A

echo/TFAST - check for effusion and right atrium collapse (tamponade)
tamponade - main sign need pericardiocentesis
check for masses on US - usually hemangiosarcoma or heart base masses
radiographs - US quicker, do first

132
Q

pericardial effusion - treatment

A

pericardiocentesis - only treatment if tamponade
IV fluid boluses - support cardiac filling to stabilise

DO NOT GIVE FUROSEMIDE - makes mild effusion severe, can be fatal

133
Q

Aortic thromboembolism presentation

A

complication associated with severe heart disease - blood clots thrown off from left atrium

cats
usually caudal aorta - hindlimb paresis
less commonly forelimb, sometimes just one forelimb
pain - vocalising - distressing
absent femoral pulses
cold paws
cyanosis

134
Q

aortic thromboembolism management

A

euthanasia should be considered
if after 72 hours unlikely to further deteriorate
prognosis poor - esp if hypothermia, low HR, multiple limbs affected, absent motor function
long recovery, usually permanent deficits, risk of recurrence

pain relief - methadone, butorphanol not enough, NSAIDs risk kidney injury
furosemide if concurretn heart disease
clopridogrel - anticoagulent - possibly better than aspiring for reducing recurrence
aspirin - anticoagulent - can be used with clopridogrel
rivaroxaban - anticoagulent - newer, expensive

clot breaking drugs
tissue plasminogen activator - risk of reperfusion issue from toxins released from clot
low molecular weight heparin - slower effect - owners can inject at home

135
Q

diagnostic ECG - lead positions

A

red - right fore
yellow - left fore
green - (left) fore

136
Q

diagnostic ECG - considerations

A

electrical interference from other devices
is it tachy or brady
is the HR appropriate for the situation - emergency, stress, pain
regular ror irregular
pulses - weak in shock, same time as heart beats, pulse per beat
P for every QRS?
QRS for every P?
normal QRS? - tall and narrow normal, wide and bizarre not

137
Q

ventricular tachycardia ECG

A

short R-R - premature ventricular complex
no P
wide QRS
4 or more VPCs at fast rate - >160-180bpm

if slow rate - not emergency
emergency - will be showing signs - eg collapsed

138
Q

causes ventricular tachycardia

A

cardiac disease - basically always primary cardiac in cats, mostly in dogs, but sometimes none cardiac

neoplasia - splenic, hepatic
GDV
SIRS/sepsis
toxins
anemia
trauma

139
Q

ventricular tachycardia treatment

A

lidocaine - bolus then CRI - care with cats, can get neurotoxicity easily, always be a bit careful anyway as any animal can get neuro signs
majority will respond to some degree to lidocaine

continuous ECG monitoring
check electrolytes - hypokalemia reduces lidocaine efficacy - could be addisons or blocked cat
sotalol - coming off lidocaine, longer term oral meds
refractory cases - referral - amiodarone or electrical cardioversion

140
Q

emergency bradycardia

A

3rd degree atrial ventricular block

or high grade 2nd degree

141
Q

3rd degree AV block ECG

A

no communication between atria and ventricles

P waves but QRS not associated
QRS wide and bizarre, not premature

142
Q

sick sinus syndrome presentation

A

old dogs
westies and schnauzers
not an emergency
pauses in rhythm on ECG

143
Q

persistent atrial standstill presentation

A

rare
usually springer spaniels

looks similar on ECG to 3rd degree block but no P waves

144
Q

3rd degree block management

A

check potassium - could be addisons or blocked cat
treat underlying disease and electrolytes
chronotropics - terbutaline - sick sinus might respond, otherwise usually doesn’t

referral - pacemaker

if escape beat rate 50-60bpm - bad - but probably not middle of the night surgery emergency
if rate 30-40 - more urgent, usually present collapsed - still probably not the best idea to do OOH pacemaker

145
Q

Small animal neuro diagnostics

A

CSF analysis
imaging - radiographs, myelopgraphy, CT, MRI, US, scintigraphy
electrodiagnosticss

neuro clinical exam important - localisation, ddx, decision re further tests

146
Q

CSF analysis indications - small animal

A

suspected inflammatory disease - meningitis, meningo-myelitis, meningo-encephalitis,
before myelography
if multifocal signs

147
Q

CSF analysis

A

establish if infectious (viral, bacterial, protozoal), or non-infectious (steroid response meningitis-arteritis, meningitis of unknown origin)
cell count and basic protein analysis in house
cytology and full protein analysis, PCR and other tests at lab

sites - cisternia magna, lumbar

148
Q

CSF analysis - contraindications

A

raised intercranial pressure
conformation - chiari like malformation/syringomyelia, occipital dysplasia
coagulopathy

149
Q

neuro diagnostics - radiography

A

needs sedation or anaesthesia
careful positioning - don’t want to make it worse eg if spinal

indications -
fracture or sublux
infectious cause
neoplasia
congenital abnormalities
look at apine

150
Q

neuro diagnostics - myelography

A

radiograph with non-ionic contrast agent - injected at cisterna magna or lumbar L5/6/7
lateral, VD and oblique

localise lesions

complications - potential for neuro deterioration, seizures, cardio-resp depression

151
Q

neuro diagnostics - CT

A

see soft tissue and bone windows
nonionic iodinated contrast

indications -
trauma - spinal (more accurate than radiographs), acute head trauma (broken bone and haemorrhage), chest and abdomen evaluation
middle/inner ear assessment - tympanic bullae
IVDD
spinal malformations
surgical planning
if metal in body so can’t MRI

152
Q

neuro diagnostics - MRI

A

best soft tissue detail
need anaesthesia, but have to leave machine outside because metal
longer than CT and more expensive

planes - sagittal, dorsal, transverse

IV paramagnetic agent - gadolinium

indications -
gold standard - shows brain, spinal cord and peripheral nerves

CT+MRI - best for most detail for surgical planning

153
Q

equine - acute MSK emergency - initial assessment and first aid

A

ideally don’t move but may need to - owner might have anyway, lighting, floor
give owner instructions on haemorrhage control - pressure, multi layer bandage, esp if arterial bleed
remove foreign object if sticking out a lot and putting foot down will cause more damage, if below level of shoe can leave in

CV and neuro exam
sedate - alpha 2, safety consideration if distressed horse
history - known trauma, onset, exercise, when last normal, other horse, management factors (stabled?)
sigalment
coaptation - wrapping for support - sometimes not always
pre plan transport and call referral to see what they want done

immediate euthananasia if large bone fracture in an adult horse

154
Q

equine - acute MSK emergency - further assessment

A

fuller history - shoeing, lameness history, medication - ongoing or just given for this
exam - posture, swelling, asymmetry, wounds, deformity
determine affected limbs
assess degree of lameness
clean limbs - better visualisation and better for wounds
palpation - welling, effusion, wounds, digital pulses, foreign bodies (esp easy to miss in frog sulci - pick out and clean), hoof testers, pain on flexion/extension, press all muscle groups (proximal to distal), range of motions (limited, abnormal or painful), crepitus (may be palpable or audible)

155
Q

equine - acute MSK emergency - common causes

A

subsolar abscess - very common, pus in foot

laminitis
ceullulitis
synovial sepsis
fracture
tendonitis
tendon laceration or rupture
myopathy

156
Q

equine - acute MSK emergency - diagnostics

A

radiograph - fracture, sublux, wound assessment (see if bony injury involvement, especially before anaesthetising)
US - see course of wound track, tendons and ligaments, pelvic fractures, foreign bodies or gas indicated their presence
synoviocentesis - synovial sepsis
MRI - penetrating foot injuries, further assessment dital limb injuries
scintigraphy - pelvic or stress fracture
serum biochem/urinalysis - myopathy or rhabdo

157
Q

equine - subsolar abscess - signs

A

severe lameness
heat
focal pain around coronary band
increased pulse amplitude
pain on hoof testers

158
Q

equine - subsolar abscess - causes

A

bruising
conformatino
penetrating wound
white line
laminitis
keratoma

in recurrent - address underlying issue

159
Q

equine - subsolar abscess - treatment

A

nerve blocks - may be contraindicated if non weight bearing
remove shoe
tetanus prophylaxis
antiseptic
bandaging
analgesia
draining - poultice

160
Q

equine - periarticullar cellulitis - treatment

A

broad spectrum antibiotics
NSAIDs
Steroids
Cryotherapy
Physio
Bandaging

161
Q

equine - wound and synovial sepsis exam

A

general exam
haemorrhage - quantify, measure venous blood lactate to gauge hypovolemia
check if multiple injuries
careful attention to anatomical location
feel (digital exploration) - gloves, decomtaminate wound first, look if foreign bodies, bone fragments, feel for tendon tissue (tendon sheath sepsis)
xray - bone damage, esp kick injuries, or if planning anaesthesia
Ultrasound

162
Q

equine - wound and synovial sepsis - complicating factors

A

fracture - changes approach, esp if anaesthetising, impact on cost
sepsis
tendon or ligament damage
vascular damage
thoracic perforation
abdominal penetration

163
Q

equine - wound and synovial sepsis - synovial sepsis signs

A

draining tracts with pus
acute onset or progressive severe lameness
if draining - variable lameness - not as much pressure build up
in foals may spread from distinct wound site in blood
heat and pain

164
Q

Horse GI - indications for referral

A

persistant pain after analgesia
progressive abdominal distension
tachycardia <60bpm
signs of hypovolemia
absence or borborygmi
abnormal rectal findings
gastric reflux >4litres

165
Q

Horse GI - FLASH ultrasound

A

fast localised abdominal sonography of the horse

gastric window - ventral to lung tip (10-15th intercostal space) left hand side - see splenic vein and ocassional small intestine loops, usually can’t see gastric contents

splenorenal region - LHS slightly more caudal than gastric - left kidney, liver and spleen - nephrosplenic entrapment, masses, displacements

duodenal window - RHS, 14-17th intercostal space - descending duodenum, duodenal distension

ventrum - small intestine, bladder - strangulation, entrapment, lipomas, masses, distension, thickened SI walls, free peritoneal fluid, hemoabdomen

colon and caecum - wall thickness (colitis, enteritis, sometimes volvulus) - normal thickness 3-4mm

166
Q

Horse GI exam - rectal exam quadrant system

A

left dorsal - caudal edge of spleen, nephrosplenic ligament, nephrosplenic space, caudal pole left kidney, aorta, root of mesentery

right dorsal and ventral - duodenum not often palpable unless distended or displaced, caecum, inguinal ring

left ventral - pelvic flexure, left dorsal colon, small colon (fecal balls inside), inguinal ring, bladder, reproductive tract

167
Q

Horse GI - indications for surgery

A

uncontrollable or severe pain
poor response to flunixin or detomidine
more than 4L gastric reflux
distended SI
distended and displaced large colon
distension that can’t be medically relieved
palpable mass or foreign body found during a rectal exam
absent intestinal noice on auscultation
peritoneal fluid analysis showing increased TP, RBCs or degenerate neutrophils

not indicated if depressed or lack of pain, if pyrexic (more often associated with medical colics), if neutrophilia or neutropenia, progressive intestinal sounds on auscultation

168
Q

Horse GI - large intestine displacement

A

medical treatment - withhold food, pain management
may need surgery
if very distended with gas then risk of rupture during surgery when handled - can decompress with needle centesis

169
Q

Horse GI - causes post-op colic

A

within 48 hours -
incisional/surgical pain
ischemic bowel
reperfusion injury
leakage at anastomosis
post-op ileus
recurrent displacement

2-7 days -
obstruction at an anastomosis
impaction
ulceration
infection

7+ days -
adhesions
recurrence

170
Q

Horse GI - common surgical complications

A

incision infection - encourage drainage by removing some suture, topical lavage, antibiotics, abdominal banage to reduce risk of hernia

herniation - importance depends on size of hernia and intended use of horse - hernia belt or bandage, box rest. can do surgery 3-6 months after the colic surgery if needed

thrombo phlebitis - common if have endotoxemia and can progress to septic thrombophlebitis - remove catheter if still on, antibiotics if septic, topical treatment, monitor with ultrasound (will show cording of jugular vein

171
Q

pyo - predisposing factors

A

age
conctraceptice/abortion medications
previous pyos

172
Q

pyo - diagnostics

A

ultrasound - fluid filled uterus

bloods - increased PCV and TP (dehydration), raised albumin, raised globulin, pre renal azotemia, leukocytosis or leukopenia, anemia

cytology - degenerative neutrophils, bacteria

culture and sensitivity - needed it doing medical treatment route

173
Q

pyo - treatment

A

stabilise - fluids, antibiotics

surgery - spay

medical management - only if open and not too severe - antibiotics, fluids, alizin (relaxes cervix), prostaglandin (luteolysis and contractions)
galistop - caberglione - dopamine agonist, opens cervix

174
Q

orchitis - tests

A

ultrasound - testes - infected more heterogenous, can see discrete mass if neoplasia, torsion can be shown with doppler blood flow

bloods - increased WBCs, inneoplasia may see paraneoplastic hypercalcemia

FNA - cytology - neutrophils, bacteria, culture and sensitivity

serology/PCR - available for pasteurella multocida - commensal to resp tract so needs sterile sample from inside testicle in case licking

175
Q

orchitis - treatment

A

antibiotics - TMPS, baytil but not first line

NSAIDs - meloxicam

cold compress
probiotics for GI signs
castration - risk of abscessation in acute inflammation

176
Q

Foot and mouth signs - cattle

A

pyrexia
anorexia
shivering
reduced milk
smacking lips
grinding teeth
drooling
lameness
vesicles - oral mm, tears, between toes, coronary bands

death in calves - myocarditis -tiger stripe pattern on heart at pm

177
Q

foot and mouth signs - sheep/goats

A

often asymptomatic
may have lesions only at one site
stopped milk
vesicles
abortions

death of lambs - myocarditis

178
Q

foot and mouth signs - pigs

A

pyrexia
foot lesions
lameness
vesicles - snout, dry lesions on tongue, pressure points on limbs
detached claw horn - esp if housed on concrete

death of piglets up to 14 weeks old - myocarditis

179
Q

incubation by species - foot and mouth

A

sheep - 1-12 days
cattle - 2-14 days
pigs - 2+ days

important to know for tracking

180
Q

transmission - foot and mouth

A

inhalation - direct contact or aerosol over distance (esp pigs)
fomites
ingestion of contaminated feed - mostly pigs
ingestion of infected milk
AI with infected semen

181
Q

ddx foot and mouth

A

clinically indistinguishable -
swine vesicular disease
vesicular stomatitis
vesicular exanthema of swine
seneca valley virus

others -
rinderpest
BVD and mucosal disease
IBR
MCF
Bluetongue
epizootic haemorhagic disease
bovine mammilitis
bovine papular stomatitis
trauma or chemical burn

182
Q

feline lower urinary tract disease

A

usually in bladder or urethra
usually feline idiopathic cystitis - stress or lack of stimulation
sometimes UTI or neoplasia
obstruction is usually from accumulation of mucus creating a plug but occassionally blocked by uroliths or urethral stricture

183
Q

urethral obstruction - presentation

A

usually males
straining to urinate
large taut bladder - small on palpation if ruptured
may pass small drops of urine around block or from bladder overflow
often hyperkalemia - post renal AKI

184
Q

causes of urethral obstruction

A

cats - crystalline mucus plugs
dogs - uroliths

prostatic disease - hypertrophy, neoplasia inflammation, abscess
neoplasia
upper motor neurone bladder
stricture
reflex dysynergia

185
Q

blocked cat - presentation

A

common, emergency
males
indoor and overweight most at risk
often associated with a stressor

post renal AKI –> intrinsic AKI
signs at <72 hours

repeat attempts to urinate
pollakuria
dysuria
sometimes able to pass small amount
pain - yowling, licking at perneal area
progression - vomiting, lethargy, collapse

large taut bladder - unless rupture

severe - bradycardia, hyperkalemia

186
Q

blocked cat - diagnostics

A

bloods -
azotemia - post renal AKI
hyperkalemia - educed potassium secretion

ultrasound -
point of care
small amount of fluid around bladder normal
lots of fluid - rupture
sediment and uroliths
thickened bladder wall
taut bladder
detached inner membrane of bladder - pseudomembranous cystitis, severe inflammation causes detachment

radiograph -
lateral abdominal
if will tolerate without sedation
include perineum

do not sedate until hyperkalemia corrected

187
Q

blocked cat - treatment

A

fluid - lactated ringers - correct dehydration and hypotension

analgesia - methadone, sometimes pass urine when pain gone

treat hyperkalemia - fluids and glucose then insulin, then calcium gluconate

cystocentesis - to decompress (Care, risk of rupture)

sedation - once hyperkalemia sorted

unblocking and placing of urinary catheter

hospitalisation to monitor

188
Q

ddx - foal neonatal colic

A

enterocolitis - most common
meconium impaction
transient medical colic - unknown cause, responds to analgesia
ruptured bladder/uroperitoneum
intestinal impaction - volvulus, impaction, intussuception
overfeeding
lactose intolerence - can develop after enterocolitis
gastric or duodenal ulcers
hernia - inguinal, scotal or umbilical
congenital - atresia ani or atresia coli - colon ends in blind sac or no natural perforation at anal sphincter

189
Q

meconium impaction - foal colic

A

first few hours after birth
failure to pass meconium

abdominal pain
flapping tail
lying on back
restless
straining to defecate
gas distension around blockage

US or radiography to see fecal balls

treat - enema, analgesia, fluids, laxatives
surgery if no response to medical treatment

ddx - ruptured bladder

190
Q

ruptured bladder/uroperitoneum - foal colic

A

more often colts
1-3 days after birth, later if tear happens after birth (ususlly in recumbent foals)
usually still urinate but smaller amounts

depression
abdominal distension - increasing
dysuria/stranguria
pain
severe - acute colic, tachycardia, tachyppnoea, collapse, arrythmia
neuro - seizures, spasticity

diagnosis -
Ultrasound - free fluid
fluid analysis - 2x serum creatinine
bloods - hyperkalemia, hyponatremia, hypochloremia, may have increased serum BUN and creatinine but sometimes normal

treatment -
abdominal drainage
correct electrolytes - esp hyperkalemia - saline and glucose
surgery once potassium corrected

refer

191
Q

hernitation - foal colic

A

inguinal or umbilical
inguinal common in males and can often be manually reduced
if no distress gradually reduce daily until stays in
if associated colic or very large then surgery

192
Q

gastric ulceration - foal colic

A

abdominal pain
bruxism
ptyalism
dorsal recumbent
diarrhoea - in foals but not adults

can start from 2 days

deep ulcers can perforate –> death

diagnosis - gastroscopy

treatment - omeprazole +/- sucralfate

193
Q

patent urachus - foal colic

A

should close at birth when umbilicus ruptures
cause unknown
seems to happen as secondary issue in ill neonates

may resolve with supportive care - routine disinfection, antimicrobials, umbilical dips multiple times a day

refer for surgical resection if septic

194
Q

omphalitis/omphalphlebitis - foal colic

A

infection or inflammation of umbilical structures
contamination of cord with bacteria
external may appear normal if limited to intenal structures

Ultrasound - examine size of inner parts - should be 18mm reducing to 15mm 7 days later for stump, umbilical vein 10mm-7mm at 7 days, umbilical arteries 13mm-10mm at 7 days

treatment - antibiotics (not very effective if inside parts affected), surgical removal

may present with other complaints - swollen joints, other infection - disseminates bacteria around the body

195
Q

pregnancy toxemia - small animals

A

rare in dogs
common in rabbits and guinea pigs

risk factors - obesity, large litters - less space for stomach in pregnancy

treat -
fluids and dextrose
oral glucose
syringe feeding high carb food
emergency c section - only saves babies

treatment rarely successfuol, prevention better

prevention -
don’t breed if obese
monitor fetal size and number
avoid stress
increase carbs in risk periods with care for weight gain
encourage gentle exercise during pregnancy

196
Q

ovarian cysts - small animal

A

guinea pigs
serous or follicular cysts

serous - usually incidental finding unless large enough to impact other organs - treat by pericutaneous drainage or spay

follicular - hormone producing, lead to pruritic alopecia - treat with short acting GnRH agonist or spay

197
Q

uterine tumour - small animal

A

common in rabbits and hedgehogs
uterine adenocarcinoma
surgery treatment if no mets

198
Q

hyperoestrogenism - small animal

A

ferrets if not brought out of oestrus
persistent high oestrogen –> panleukopenia

treat -
spay - risk of cushings
deslorelin impant
mating with vasectomised hob

prevention better

supportive care -
blood transfusion at PCV <15% - no blood types
steroids
iron dextran for RBC production
antibiotics for secondary infections

199
Q

mammary tumours - small animal

A

rats
lots of mammary tissue
fibroadenoma
ulceration, necrosis, and infection from trauma to surface
surgical removal
abergoline post surgery to prevent recurrance - ongoing, expensive
selorelin implant to reduce recurrence

200
Q

testicular trauma - small animal

A

rabbits
entire males in groups

surgical repair
analgesia
antibiotics

try and keep short so not away from group too long

prevent - castration and appropriate housing - enough resources, places to hide

201
Q

bird repro emergencies

A

dystocia
chronic egg laying
salpingitis
yolk coelomitis
penile prolapse - ducks

202
Q

cat - dyspnoea - feline asthma - diagnostics and treatment

A

bloods - eosinophils - allergic disease
BAL - eosinophils
radiographs - lung pattern

oxygen mask or tent - care with tent, can get hot which makes dyspnoea worse
nebuliser - humidify
bronchodilators
IV catheter - butorphanol and steroids
sedative - ketamine + midazolam or butorphanol - minimal CV effects

203
Q

dyspnoea - small animal ddx

A

aspiration pneumonia
heart disease
asthma
BOAS
drug reaction
lungworm
toxin
pneumonia
pulmonary oedema
nasal polyps
neoplasia
trauma

204
Q

dyspnoea - respiratory noises - small animal

A

upper airway - increased inspiratory effort - loud breathing, stertor, stridor

lower airway - increased expiratory effort - wheezes

parenchymal - increased inrpiratory and expiratory effort - crackles

pleural space - short and shallow, increased effort - dull sounds, location depending on area of issue

205
Q

pleural effusion types - small animal

A

transudate -
clear
low SG
low protein
low nucleated cells

modified transudate -
slightly cloudy
mid SG
mid protein
mid cells

exudate -
cloudy, turbid or serosanguinous
high protein
high sg
high cells

chyle -
could white/cream
high protein
high sg
mostly lymphocytes
high triglycerides and cholesterol - higher than plasma level

206
Q

small animal lower respiratory disease - signallment - age and breed

A

puppies - infectious
<2 yo - angiostrongyles
older - laryngeal paralysis, chronic bronchitis, neoplasia

toys and minis - tracheal collapse
westies and border terriers - IPF

207
Q

orthopneoa meaning

A

dyspnoea in any position other than standing or sitting up - usually bilateral pulmonary oedema

208
Q

trepopnoea meaning

A

dyspnoea only in one lateral recumbancy - unilateral lung or pleural disease, or unilateral airway obstruction

209
Q

thoracic exam - auscultation and percussion - small animal

A

palpation - masses, pain

auscultation -
crackles - some kind of fluid
moist crackles - CHF, most prominant on inspiration
dry crackles - eg IPF
wheezes - more chronic - narrowing of airway

percussion -
pleural effusion - dull below level of fluid
diaphragmatic hernia - may be increased sound

210
Q

small animal lower airway respiratory disease - diagnostics

A

bloods -
NTproBNP - cardiac vs non cardiac
cardiac troponin
esoinophils, neutrophils, blood gas evaluation, anemia

imaging -
radiographs - thoracic, 2 views, only nce stable enough - fluid, free gas, lung patterns
CT - more useful than xray for upper resp, but difficult if conscious and more expensive

tracheal wash/BAL -
tracheal wash - when suspected large airway disease and in patients where there is concern about anaesthetising - can be done conscious
BAL - diffuse airway disease, may be able to culture and PCR

bronchoscopy -
from specific site - mucosal inspection, airway collapse, foreign body removal
relatively safe and allows sample collection

thoracocentesis -
fluid analysis, cytology

211
Q

small animal lower respiratory disease - treatments

A

inhaled medications -
steroids, bronchodilators, nebulisers
bet2 agonists - salbutamol - fast onset, duration over 3 hours, cleared renally
steroids - fluicasone propionate slow absorption but long lasting
inhibition of mast cell degranulation - cromolyn sodium - not much evidence

oral -
steroids, NSAIDS, antileukotrienes, bronchodilators, antibiotics, anthelmintics, mucolytics (NAC)

benefits inhaled - good for managing chronic disease, minimal systemic absorption, faster onset than oral

disadvantages inhaled - expensive, owner compliance and capability, time consuming

212
Q

small animal - causes of difficulty breathing

A

Obstruction – cyanotic, cough, resp noise, foreign body, nasal pathology (neoplasia, polyps, granuloma, BOAS), tracheal or bronchial collapse

Loss of thoracic capacity – fluid (blood, pus, chyle, transudates), trauma, CHF, neoplasia, cardiomegaly, abdominal abnormalities (ascites, mass), FIP

Parenchymal disease – tissue damage, increased inspiratory and expiratory effort, may or may not be cough, might cough blood , westies with IPF for long time, aspiration pneumonia (chemical aspiration, large volumes of fluid eg in drowning, gastric contents), pulmonary parenchymal oedema – from increased hydrostatic or decreased osmotic pressure, concurrent DIC, impaired lymphatic drainage from tumour or mass – fluid accumulation in interstitial tissue – cardiogenic or non-cardiogenic, main difference is type of fluid, low protein in cardiogenic, non-cardiogenic from severe lung damage increasing permeability

Non-CRS disease – endocrine, physiological

213
Q

small animal - causes pulmonary parenchymal disease

A

Aspiration pneumonia

Pulmonary oedema – cardiac or non-cardiac

Drowning

Eosinophilic lung disease

Idiopathic pulmonary fibrosis – westie lung

Pulmonary parasites

Pulmonary neoplasia – primary or mets

Infectious pneumonias

Pulmonary hemorrhage

Lung lobe torsion

Pulmonary thromboemboli

Congenital airway diseases

Bullous pulmonary diseases

Lipid pneumonias

Smoke inhalation

Paraquat poisoning

214
Q

small animal - aspiration pneumonia

A

common
care in recumbant patients
outcome dependant what inhaled and how much

potential secondary infection due to damage

signs - cough, harsh or reduced lung sounds, tachypnoea, pyrexia

need oxygen

alveolar infiltrate on xray
BAL - confirm diagnosis and culture

antibiotics
treat underlying cause
antacid if frequent occurence - vomit inhalation
metacloprimide - improve motility and increase lower oesophageal sphincter tone

215
Q

pulmonary radiograph patterns

A

interstitial - donut and track
alveolar - air bronchographs - lung acini filled with fluid, pus, blood, oedema - fluffy looking density
vascular
focal
nodular - neoplasia or granulomatous disease

symmetrical or asymmetrical
lobe
cranial/caudal

216
Q

pulmonary oedema - small animal

A

caused by various conditions - cardiogenic vs non cardiogenic - establish which by type of frluid
cardiogenic - low protein, result of lung damage increasing vascular permeability

changes in pressure balance or impaired drainage –> fluid accumulation in interstitium and ultimately in alveoli

ventilation perfusion mismatch –> hypoxia

signs -
cough
froth from mouth
crackles
interstitial xray pattern - unstructured and often caudodorsal

treat - oxygen and butophanol for sedation
diuretics less effective in noncardiogenic

217
Q

physical lung injury - small animal

A

thoracic trauma - eg from RTA

pain
lag between injury and lung patterns on xray

treat - oxygen and analgesia

218
Q

drowning - small animal

A

signs - cough, might be unconscious

immediate consequences from hypoxia
alveoli filled with fluid
can progress and become more acute later- acute resp distress can appear after appeared previously stable

lactic acidosis and hypercapnia

oxygen and drainage of fluid, no evidence for antibiotics or steroids

219
Q

eosinophilic lung disease - small animal

A

common in dogs
young adult most common
predisposed breeds - husky, malamutes, rotties

acute or chronic presentation
weight loss in hcronic

pulmonary infiltrate with eosinophils –> eosinophilic pneumonitis

usually interstitial lung pattern but can be alveolar
may see peripheral eosinophilia in bloods
BAL to diagnose - eosinophils
excessive mucus or mucopurulence on bronchoscopy
20% airway eosinophils normal, if above this then abnormal

causes - parasites, neoplasia, fungal

treat - steroids - immunomodulation, outcome good and quick unless other organs involved

220
Q

interstitial pulmonary fibrosis (westie lung) - small animal

A

mostly westies, sometimes staffies
middle aged to older
version in cats

insidious onset - progressive chronic breakdown
may cough but not always
excercise intolerance
cyanosis
increased inspiratory effort
crepitus

thoracic CT - shows a pathognomonic - ground glass look, can also gauge severity
interstitial alveolar pattern on xray
pulmonary hypertension
generalised cardiomegaly with right side emphasis

2 types - fibrotic and inflammatory
cats - fibrotic type
dogs - mixed

no cure
symptomatic treatment with steroids
poor prognosis once fibrotic changes

prevention - avoid smoke, harness instead of collar lead, bronchodilators, antifibrotics, antibiotics for secondary infection

221
Q

lungworm (angiostrongylus vasorum) - small animal - signs

A

anemia
sybcut hematoma
internal hemorrhage
prolonged bleeding from wounds or sugery
prolonged appt coagulation profiles

neuro signs in cats - depression, aeizure, pruritis, spinal pain, vision loss (from migration of the nematode or secondary hemorrhage in brain due to coagulopathy)

222
Q

lungworm (angiostrongylus vasorum) - small animal - diagnosis

A

BAL - larvae, PCR
SNAP - in house ELISA, good sensitivity but diagnosis should be made in conjunction with exam etc
modified baemann fecal floatation - pooled sample
radiograph - interstitial and alveolar pattern, diffuse, more caudodorsal

223
Q

lungworm (angiostrongylus vasorum) - small animal - management

A

advocate, milbemax etc
fenbendizole - weekly - good for acute management phase but unlicensed

supportive - bronchodilators, cage rest, oxygen therapy

224
Q

feline asthma - signs and presentation

A

chronic lower airway disease
cough - chronic coughing most common sign to come in for, may be confused for retching or vomiting
dyspnoea - can be severe, more expiratory than inspiratory
exercise intolerance
lethargy
barrel chested appearance - trapped air because of mucous plugs

could be focal sounds - mucous plugs obstructing airways

225
Q

feline asthma - diagnosis

A

bloods - increased eosinophils
bronchoscopy with BAL - eosinophils, culture for secondary infection
xray - flattened diaphragm, bronchial pattern usually but can be mixed, may be focal opacities in severe cases with mucus plugs

226
Q

feline asthma - management

A

stress reduction
humidified oxygen
steroids
bronchodilators
adrenaline in very severe cases

ongoing salbutamol, ventalin, or fluicasone inhalers - no systemic effects, long term control of inflammation
keep away from dusty places
avoid over warm environment
access to outdoors
remove known allergens

227
Q

pulmonary thromboembolism - cats

A

few signs on radiograph
acute onset dyspnoea
open mouth breathing/panting/shallow breathing

caused by hypercoagulative state - following trauma, sugrery, sepsis, DIC, cushings, steroids, hypothyroidism, IMHA, glomerularnephritis, or pulmonary hypertension

risk factors -
hyperthermia/heat stroke
obersity
excitement/fear/stress
parturition/false pregnancy/eclampsia
anemia/abnormal hemoglobin
CNS disease
endocrine disease
neuromuscular disease

228
Q

pregnancy toxemia - small animal

A

rare in dogs
common in rabbits and guinea pigs

risk factors -
obesity
large litters

last 2 weeks gestation or first 2 weeks post partum

treat -
fluids and dextrose
additional oral glucose
supportive feeding - high carb
emergency c section - usually only saves babies
prevention better - treatment rarely successful

prevention -
don’t breed from obese animals
monitor foetal size and number
avoid stress in risk periods
increase carbs in risk times but care for weight gain
encourage gentle exercise in pregnancy

229
Q

ovarian cysts - small animal

A

mainly guinea pigs
serous or follicular

serous -
usually incidental finding unless big enough to impact other organs - pain and GI stasis
not responsive to hormones
treat with oericutaneous drainage or spay

follicular -
hormone producing
non pruritic alopecia
hormone treatment - short acting GnRH agonist
spay to cure

230
Q

uterine tumours - small animal

A

common in rabbits and hedgehogs
uterine adenocarcinoma in rabbits
just lots of tumours in hedgehogs

if no mets - surgery to cure

231
Q

hyperoestrogenism - small animal

A

ferrets - when not brought our of oestrus

persistant high oestrogen –> panleukopenia

prevent -
surgical spay - risk of cushings
deslorelin implant
mating with vasectomised hob

treatment -
rarely successful - prevention key
supportive care for panleukopenia - blood transfusion at PCV <15% (no blood types), steroids, iron dextran to help RBC production, antibiotics for secondary infections

232
Q

mammary tumours - small animal

A

rats - lots of mammary tissue
fibroadenoma
both sexes

surgical removal as early as poss better - if it grows can get trauma to surface –> ulceration, necrosis, infection
cabergoline post surgery - may reduce recurrence - ongoing treatment and expensive

233
Q

testicular trauma - small animals

A

entire male groups
rabbits

can see evisceration

treat -
surgical repair
castration
analgesia - high risk of self trauma
antibiotics

keep procedure short as poss so not away from group too long
castrate all animals in group in one day - all smell weird at once

prevention -
castration
housing - enough of all resources, places to hide away

234
Q

common repro emergencies - birds

A

dystocia
chronic egg laying
salpingitis
yolk coelomitis
penile prolapse - ducks

235
Q

dystocia - birds

A

common
indicative of underlying issue - usually husbandry related (hypocalcemia) but maybe salpingitis or conditions that narrow the canal

wide based stance
slight distension

diagnosis -
conscious radiograph

treatment -
warm dark quiet environment
anaesthetic and manual removal if not responding or if distressed
removal - warm water, ky gelly, break down adhesions with finger, make sure get all of shell bits
analgesia - butorphanol
post op antibiosis - TMPS, amoxyclav, doxycycline
identify underlying cause and make recommendations - calcium supplements, UV provision

oxytocin not effective in birds

236
Q

chronic egg laying - birds

A

cockatiels and ex laying hens

–> calcium and protein depletion –> bone resorption, fractures, immunosuppression, secondary infections

management -
conservative - decrease day length to max 12 hours, removing nest boxes, dummy eggs, behaviour modification, diet modification (pellets instead of seed - gradual change)
hormonal - deslorelin impant, cabergoline (inhibitis prolactin but variable efficacy and daily oral meds hard in birds)

237
Q

ssalpingitis - birds

A

ex battery hens

inflammation of oviduct
septic or non septic

can lead to -
abnormal or lash eggs
dystocia
impacted oviduct
yolk coelomitis

signs -
egg drop
abnormal eggs
weight loss
anorexia

diagnosis -
signallment - ex battery hen
mass or fluid on coelomic palpation
US - fluid around oviduct
xray - mass
cloacal endoscopy - hard to get in
cytology and culture or coecal discharge

treat -
meloxican
antibiotics if septic - amoxyclav or culture and sebnsitivity
supportive care - fluids, nutrition, warm environment
deslorelin - prevent further ovulations

euthanasia if very sick

prevent further ovulations once treated - deslorelin and controlled photoperiod

238
Q

yolk coelomitis - birds

A

sterile coelomitis - egg into coelom then bursts
septic coelomitis - secondary infection or multiple eggs in coelom

signs -
lethargy
anorexia
coelomic swelling
respiratory compromise

diagnosis -
signalment - ex battery hen
fluid on palpation
fluid on US
coelomic tap - therapeutic as well as diagnostic
cytology and culture of coelomic fluid for secondary infections

treatment -
abdomincentesis - relieve pressure on air sacs
anti inflammatories
antibiotics
supportive care
prophylactic antifungals and broad spectrum antibiotics optional

treat once and euthanise if recurs or deslorelin and photo period control to prevent future egg laying

239
Q

reptiles - common repro emergencies

A

preovulatory ovarian stasis
dystocia
cloacal prolapse

240
Q

pre-ovulatory ovarian stasis - reptiles

A

older female tortoises
or any female with wrong husbandry or kept without a male

usually asymptomatic until get coelomitis

diagnosis -
bloods
US - lots of follicles of same size with mixed echogenicity

treat -
conservative - if no signs - husbandry (temp, UVB, nutrition, nesting sites), may help to provide a mate but can also lead to dystocia
medical - always given before surgical, usually dehydrated - fluids, meloxicam, opioids
surgery

241
Q

dystocia - reptiles

A

mostly tortoises but sometimes lizards and snakes
often chronic - may not need urgent intervention

treat -
medical - usually, commonly non obstructive - temp, husbandry, UVB, diet, nesting sites, mate, hydration (bathing), oral calcium
if not getting results - oxytocin and injectible calcium
if can palpate egg sedate for removal - digital manipulation or break egg up, may be able to milk it down in snakes
if can’t palpate - surgical removal

242
Q

cloacal prolapse - reptiles

A

relatively common

differentiate which tissue is prolapsed before treatment - narrows down underlying cause
always is an underlying cause

treat -
conservative - only in uncomplicated cases, fresh prolapse with minimal tissue damage - fluid, reduce inflammation (osmotic dressing and NSAIDs if not dehydrated), push back in gently with lots of gel, stay sutures
treat underlying cause
if complicated - necrosis - surgery - depending on tissue type determines what procedure done, end-to-end anastomosis, resection, or removal or amputation

243
Q
A

CMS - term 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions