August - September 2024 Flashcards
How is cryptosporidiosis treated in reptiles?
- Metronidazole
- Fenbendazole
- Sulfa antibiotics
- Penicillin
- There is no effective treatment
Answer: There is no effective treatment
The correct answer is there is no effective treatment. Clinical signs of cryptosporidiosis in reptiles include regurgitation, weight loss, and debilitation. The organism causes thickening of the gastrointestinal mucosa and loss of motility.
Diagnosis is made by acid-fast staining of fresh feces or regurgitated food. Since there is no effective treatment euthanasia is often recommended.
You arrive to a canine breeding kennel to help them with an outbreak of diarrhea that appears to be of the malabsorptive and maldigestive kind. You perform several fecal smears to help find a diagnosis. On several of the smears you notice a protozoal organism swimming around in a “falling leaf” motion when you are at 40x. These organisms also have a ventral concave disc, are pear shaped, binucleate, and are approximately 15 × 8 micrometers. What is the organism?
- Cryptosporidium
- Tritrichomonas foetus
- Isospora
- Giardia
Answer: Giardia
The correct answer is Giardia. Young, immunodeficient, and grouped animals tend to show signs. This question provides a classic description of the motile trophozoite. Remember, the cyst is the infective mode, not the trophozoite.
T. foetus has an undulating membrane which helps you differentiate from Giardia along with 3-5 anterior flagella. Additionally, T. foetus is not commonly found in dogs. When looking for Isospora, you would expect to see them on a fecal flotation in the form of ocysts.
Cryptosporidium would be round and slightly smaller than a red blood cell. Acid-fast or fluorescent antibody stains are performed on direct fecal smears to help find these small organisms.
A dog spayed at what time has the least likelihood of developing malignant mammary tumors?
- After third estrus
- Between first and second estrus
- Between second and third estrus
- Before first estrus
Answer: Before first estrus
The correct answer is before first estrus.
Development of mammary tumors in the dog is hormone dependent. As such, ovariohysterectomy before a heat cycle prevents the hormonal effects on the mammary glands that predispose them to developing tumors. Dogs spayed prior to an estrus are 0.05% times as likely to develop a mammary tumor as an intact dog. That risk rises to 8% and 26% after one and two heats respectively, with no decrease in risk if they are spayed subsequent to a third heat.
A cat arrives at your clinic after being attacked by a raccoon. This cat is unvaccinated. What should you do?
- Vaccinate immediately and quarantine for 45ndays
- Euthanize immediately or quarantine for 4 months. Vaccinate for rabies at time of entry into quarantine
- Euthanize immediately or vaccinate immediately and quarantine for 45 days
- Euthanize immediately or quarantine for 6 months, and vaccinate 1 month before release
- Euthanize immediately
Answer: Euthanize immediately or quarantine for 4 months. Vaccinate for rabies at time of entry into quarantine
Per the 2016 Rabies Guidelines:
Since the cat is unvaccinated, it should either be euthanized and tissue submitted for rabies testing OR immediately vaccinated for rabies and quarantined for 4 months.
The Direct Fluorescent Antibody Test detects viral antigens and should be tested on two locations from the brain (brainstem and cerebellum) and is the test of choice for rabies diagnosis.
If the cat was current on rabies vaccination, the guidelines direct to booster the rabies vaccination immediately and have the owners observe closely indoors for 45 days.
If owners are able to provide proof the cat had been previously vaccinated for rabies, but is overdue: guidelines direct to booster rabies vaccination immediately and keep the cat indoors under owner observation for 45 days.
Which of the following drugs and treatment intervals are appropriate for preventing heartworm disease in dogs?
Milbemycin twice daily
Ivermectin once a month
Milbemycin oxime once daily
Ivermectin once daily
Diethylcarbamazine once monthly
Answer: Ivermectin once a month
The correct answer is ivermectin once monthly.
Diethylcarbamazine (DEC) can be used to prevent heartworm, but is administered once daily.
Milbemycin oxime is another preventative used once monthly.
A 3-month-old pit bull terrier presents with generalized alopecia and crusting of the skin (see image). A deep skin scraping shows the dog has generalized demodicosis.
What should you tell the owners?
- The dog likely has an inherited defect in cellular immunity. The dog should not be bred.
- It is very common for pit bull puppies to get generalized Demodex infections. The puppy should be treated for the infection but the prognosis is good.
- Transmission of the infection was from the bitch to the puppy. The bitch should be treated for Demodex because she is the source of the infection. The puppy does not need to be treated.
- Generalized Demodex infections usually resolve on their own without treatment.
Answer: The dog likely has an inherited defect in cellular immunity. The dog should not be bred.
The correct answer is the dog likely has an inherited defect in cellular immunity. The dog should not be bred. Generalized demodicosis in juveniles and puppies is usually caused by an inherited defect in cell immunity. They should be treated with a mite killing agent like ivermectin, amitraz, or milbemycin, as well as with oral antibiotics for secondary bacterial infections.
Spontaneous remission of the infection can occur, but the prognosis is always guarded. Demodex mites are part of the natural flora of a dog’s skin, so they are normally present all the time. Adult dogs that develop generalized demodicosis are usually immune-suppressed.
Young turkeys on a large new farm are showing stunting, poor feathering, and short thick bowed legs. Histologically they have chondrodysplasia. The most likely cause of this is?
- Selenium deficiency
- Copper deficiency
- Choline deficiency
- Magnesium deficiency
- Vitamin E deficiency
Answer: Choline deficiency
This occurs in both chicks and young turkeys, but turkeys have a particularly high choline requirement. The clinical signs described should lead you to suspect this deficiency.
Which of these breeds of dogs has a congenital ocular anomaly characterized by choroidal hypoplasia, manifested by varying degrees of visual dysfunction with signs of large bizarre choroidal vessels visible on fundic exam as depicted here?
Collie
Toy Poodle
Boston Terrier
German Shepherd Dog
West Highland White Terrier
Answer: Collie
The correct answer is collie. Collie Eye Anomaly is seen in up to 80% of the breed. Some are completely blind and others show no visual deficits.
Other signs include optic disc coloboma, retinal hemorrhage and retinal separation.
Tammy, a veterinary assistant, is having a disagreement with Stella, the practice’s Lead Veterinary Technician. Tammy discusses the issue with the practice owner, Dr. Farooqui. Meanwhile, Stella discusses the issue with the practice’s Office Manager. Dr. Farooqui and the Office Manager each recommend different solutions to the issue. Unfortunately, the conflicting recommendations worsen the disagreement between Tammy and Stella.
Which of the following is the most appropriate way for the practice to address employee disputes in the future?
- Have the practice’s office manager address all problems in a weekly meeting.
- Instruct the staff members to bring all problems to the attention of the practice owner.
- Create a chart outlining the hierarchy of authority for handling problems in the practice.
- Designate a panel of three employees to address problems within the practice.
Answer: Create a chart outlining the hierarchy of authority for handling problems in the practice.
Each staff member should know their relationship to one another in the clinic’s hierarchy of authority.
This information should be written and organized into an easy-to-understand chart. Communication channels should be outlined so that all staff members know who to approach with problems.
Designating a single person to handle all clinic issues is inefficient. While an advisory panel may be helpful in certain circumstances, creating a clear hierarchy of authority in which each staff member knows who to report to is ideal.
Source: The Art of Veterinary Practice Management. Mark Opperman and Sheila Grosdidier. Advanstar Communications, Inc., 2014. Page 83-84.
A 3-year-old male castrated golden retriever presents to your emergency clinic by a good samaritan. He reports finding the dog severely limping and bleeding while he was on a hike. On your examination, the dog has a large bleeding wound on the lateral aspect of the left elbow.
- The dog has a gunshot wound
- The dog was caught in an animal trap
- The dog fell from a significant height
- The dog has a penetrating wound from a sharp object
- The dog was attacked by an animal
The dog is alert with pink mucous membranes and normal vital parameters. He is non-weight bearing lame on the left forelimb. You start the dog on fluids and analgesics and apply a sterile bandage before taking a radiograph of the left elbow which is shown below. How would you interpret the radiograph?
Answer: The dog has a gunshot wound
The metal dense shrapnel and highly comminuted fracture of the distal humerus and proximal radius and ulna are indicative of a gunshot wound. The dog should be assessed for life threatening injuries including penetrating trauma to body cavities and for any evidence of hemorrhage. This fracture probably cannot be stabilized due to the degree of comminution.
Arthrodesis could potentially be attempted but more likely, the dog will require an amputation.
You are examining a 12-year old spayed female Border Collie. You note that her pupillary light reflex is slow and incomplete. Her menace and palpebral responses are normal. You see that the iris-pupil margin is somewhat irregular.
Fundic exam is shown in the image. What is the most likely cause of the slow PLR? Both eyes are similarly affected.
- Uveal neoplasia
- Cranial nerve III deficits
- Progressive retinal atrophy
- Iris atrophy
Answer: Iris atrophy
The correct answer is iris atrophy. This is a normal canine fundus in the picture. Iris atrophy is a normal aging change seen in almost all dogs over 10 years old. It leads to scalloping of the iris margin and sometimes a moth-eaten stroma. It can cause absent or incomplete PLRs, dyscoria, or anisocoria.
Progressive retinal atrophy is less likely, especially with a normal fundic exam. It would be weird to have bilateral CN III deficits. This is not how uveal neoplasia usually manifests.
Which of the following is considered to be a component of addressing maladaptive behavior and animal welfare issues?
- Extra water
- Environmental enrichment
- Treats
- Light cycle changes
- Extra food
Answer: Environmental enrichment
Explanation
Environmental enrichment should be used to curb maladaptive behaviors and welfare issues.
Dr. Wyatt is the owner of a practice that employs five Licensed Veterinary Technicians. One of the more recent hires, Jennifer, is newly licensed. Jennifer’s ability to work independently and perform technical procedures such as jugular venipuncture or placement of intravenous catheters is lower than that of the other technicians. Dr. Wyatt plans to conduct a formal review of Jennifer’s progress. Which of the following is the most appropriate goal to set for Jennifer at the review meeting?
- Jennifer will improve her success rate of jugular venipuncture to 100% within the next four weeks.
- Jennifer will learn to consistently draw jugular blood samples and place intravenous catheters by the end of the day.
- Jennifer will improve her success rate of intravenous catheter placement to 80% within the next eight weeks.
- Jennifer will refine her technical skills and will improve her ability to work independently.
Answer: Jennifer will improve her success rate of intravenous catheter placement to 80% within the next eight weeks
This is the best option because it meets the SMART objectives for goal-setting: specific, measurable, achievable, realistic and timed. This option states a specific goal (improving intravenous catheter placement), provides a measure of success (increasing the success rate to 80%), and gives a timeline that is both achievable and realistic (8 weeks). Options that do not include a way to measure success and/or do not include a specific timeline are incorrect. Expecting substantial improvement in technical skills in one day is not realistic. Expecting the success rate of a technical skill to improve to 100% is also not realistic.
An 8-month old dwarf rabbit presents to you for the lesions seen in this photograph of the eye. Which of the following therapies is LEAST LIKELY to be helpful in the management of this condition?
- Removal of the lens with phacoemulsification
- Topical steroids
- Corneal debridement and grid keratotomy
- Oral albendazole
Answer: Corneal debridement and grid keratotomy
Explanation:
This is a case of Encephalitozoon cuniculi (E. cuniculi). Encephalitozoon cuniculi is a microsporidian parasite of rabbits that causes neurologic and renal disease. This parasite directly infects the lenses of rabbits and causes phacoclastic cataracts (meaning it can break through the lens capsule) and uveitis. (If you were able to identify this, congratulations; that is truly outstanding!)
If you were not able to identify this as an Encephalitozoon cuniculi infection, it may still have been possible to reason through this question provided that you identified the white cataract and the signs of uveitis in the picture. If you observed those two things, you should realize that lens removal is the treatment for the cataract and steroids for the uveitis. You would then choose between albendazole and grid keratotomy. There is no corneal disease or ulceration in this rabbit’s eye, and that is what corneal debridement and grid keratotomy are used for. So remember on your exam, even if you are not sure exactly what the image is, you can often reason your way through the answer choices to make a good choice.
Leptospirosis is usually observed when livestock come into contact with urine from an infected maintenance host.
Which of the following is the most important maintenance host of L. interrogans serovar Pomona?
- Cattle
- Dogs
- Swine
- Cats
- Rats
Answer: Swine
Explanation
Other maintenance hosts of Pomona include opossums, skunks and racoons. For other serovars, the maintenance hosts are as follows:
Canicola- dogs
Icterohemorrhagiae- rats
Hardjo- cattle
Grippotyphosa-mice, muskrats and squirrels
In canine patients with primary hyperparathyroidism, a chemistry panel would show:
A. Hypocalcemia, hypophosphatemia
B. Hypocalcemia, hyperphosphatemia
C. Hypercalcemia, hypophosphatemia
D. Hypercalcemia, hyperphosphatemia
Answer: Hypercalcemia, Hypophosphatemia
The correct answer is hypercalcemia, hypophosphatemia. Patients with primary hyperparathyroidism would have hypercalcemia and normo to hypophosphatemia due to the law of mass action in which phosphorus decreases as calcium increases and vice versa.
Which of the following is a causative agent of infectious bovine keratoconjunctivitis as shown in this image?
A. Moraxella bovis
B. Thelazia
C. E. coll
D. Histophilus somni
Answer: Moraxella bovis
The correct answer is Moraxella bovis.
Thelazia is the eye worm. Histophilus somni is a cause of many syndromes, but is rarely found in the eye. E. coli is not an ocular pathogen.
A 1.5-year-old spayed female cat presents with a 7-day history of vocalizing, rolling, and allowing a male neutered cat in the household to mount her. The cat has gone through one similar episode 1 month ago. She otherwise has been behaving normally and has no other health problems. You performed an ovariohysterectomy on the cat at 3 months of age. You perform vaginal cytology which shows some cornified epithelial cells but is inconclusive. You measure serum lutenizing hormone of 0.2 ng/ml (normal for an ovariectomized female is >1 ng/ml). Which of the following is the most appropriate course of action?
A. Exploratory laparotomy to remove the ovarian remnant
B. Order MRI of the brain to rule out a pituitary tumor
C. Measure serum estrogen and progesterone levels
D. Measure serum testosterone levels
Answer: Exploratory laparotomy to remove the ovarian remnant.
This is a classic description of ovarian remnant syndrome, which is when a cat goes into estrus after previously having an ovariohysterectomy (OVH).
This can occur anywhere from weeks to years after OVH and typically the clinical signs consistent with estrus are sufficient to conclude that the cat is in estrus and has ovarian tissue present. Additional diagnostic tests that are consistent with ovarian remnant syndrome include:
Serum estrogen >70 pmol/L indicate that the cat has estrogen production from the ovary. The problem with this test is that estrogen measurements may fluctuate and can be unreliable.
Serum progesterone >6 nmol/L after induced ovulation is sufficient to conclude that corpora lutea formed and released progesterone.
Testing for serum LH levels can also help confirm the diagnosis. In intact queens, LH is consistently maintained at basal levels due to negative feedback from ovarian estradiol secretion. After OVH, this control is lost and LH concentrations increase. LH <1 ng/mL is consistent with the presence of an ovary as it is in this case.
Surgery is the treatment of choice. Many practitioners prefer to do surgery during estrus or diestrus when the ovarian tissue is enlarged and easier to locate. Remnants may be bilateral so a complete exploratory laparatomy is necessary. Ovarian tissue is most commonly at the ovarian pedicle but can also be in the mesentery or elsewhere.
You examine the eyes of a 45-year-old Amazon parrot as part of a pre-purchase examination for a valued client.
On retinal examination, you notice a black, somewhat tubular structure extending from the retina into the vitreous. What would you recommend next?
- Treat the bird with ivermectin for suspected ocular nematodiasis
- Discuss photoactive laser treatment for ocular melanoma
- Do nothing since this is a nomal structure
- Treat the bird with itraconazole for suspected ocular mycosis
Answer: Do nothing since this is a nomal structure
This normal anatomic structure is called the
“pecten” and is present in all birds. It is a highly vascularized intraocular organ and is believed to nourish the retina and control the pH of the vitreous body.
The synthesis of which of these clotting factors is dependent on vitamin K?
- Factor V
- Factor VIII
- Factor VI
- Factor IX
- Factor III
Answer: Factor IX
Explanation
The correct answer is factor IX. The vitamin K dependant factors are II, VII, IX, and X. This is important when animals are exposed to a vitamin K antagonist, such as many rodenticides.
Which of the following is not a method to prevent ringtail in rats?
- Increase humidity in the environment
- Provide nesting material in the environment
- Provide a wire-bottom cage for the rat
- Keep environmental temperatures between
- 70-74 degrees Fahrenheit
Answer: Provide a wire-bottom cage for the rat
Explanation
The correct answer is to provide a wire-bottom cage for the rat. Ringtail is an annular constriction of the tail found in weanling rats and rats kept in wire-bottom cages. The condition causes the tail to constrict, undergo dry gangrene, and fall off.
Factors contributing to ringtail include increased environmental temperatures, low humidity, impaired blood supply to the tail, and possibly drafts. The tail stumps usually heal with no complications.
You need to perform emergency splenectomy to remove a mass in the spleen. You want to choose anesthetic agents that do not cause the spleen to enlarge/engorge.
With that in mind, which of the following options is the best combination?
- Xylazine and thiopental
- Acepromazine followed by diazepam and ketamine
- Acepromazine and propofol
- A mixture of thiopental and propofol
- Morphine followed by diazepam and ketamine
Answer: Morphine followed by diazepam and ketamine
Explanation
Acepromazine can cause splenic enlargement and sequestration of red blood cells in the spleen. This is often striking and evident on radiographic or sonographic exams of animals sedated with acepromazine. Thiopental is a thiobarbiturate which induces splenic engorgement; this makes surgical manipulation and removal of the spleen more difficult.
Xylazine, diazepam, ketamine, propofol, and opioids such as morphine do not increase the size of the spleen.
Measuring which of the following physiological parameters can help provide an indication of the welfare of animals when undergoing transitory procedures:
Plasma glucocorticoid and heart rate levels
Brain waves and body condition scoring
Stress hormones and approachability
Heart rate and lameness scoring
Answer: Plasma glucocorticoid and heart rate levels
Explanation
Elevated plasma glucocorticoid levels and heart rate are associated with stress responses and are easily measurable, accurate indicators of welfare.
There are a number of drugs that are used extra label in beef cattle. When working with any food animal, you always have to consider milk and meat withdrawal. What is the meat withdrawal (in days) for xylazine, tolazoline, lidocaine, and meloxicam, respectively?
- 15, 1, 8, 4
- 3, 7, 3, 18
- 4, 8, 4, 15
- 4, 1, 18, 21
- 7, 18, 21, 15
Answer: 4, 8, 4, 15
Explanation
The correct answer is 4, 8, 4, and 15. Remember that xylazine is extremely potent in cattle, taking 10% of the dose that would be given to a horse of equivalent size is sufficient.
Tolazoline is an alpha 2 antagonist. Give the same volume as xylazine.
Lidocaine is commonly used during c-sections in cattle. If a producer is doing a c-section as a salvage procedure, it is important to inform that person that the cow cannot go to slaughter for 4 days.
Visit www.farad.org to search for this type of information.
Meloxicam is being used more and more. It is longer acting (~ 4 days) than banamine, but banamine only has 4 days of meat withdrawal. If you plan on going into production medicine, it is important to memorize the numbers for these commonly used drugs so that you can inform the producer.
An Atlantic salmon net pen operator calls you with concerns about loss of fish during the seawater phase of rearing. They report that especially during warm temperatures, fish experience high mortality due to Vibriosis. They are currently using florfenicol-medicated feed to treat these outbreaks. The net pen operator is concerned about the consequences of the repeated antibiotic treatments they are administering, and they are looking to you for alternative options for managing Vibriosis. You inform them that
- Net pens are a biosecure environment and should not have Vibriosis.
- Vaccines are excellent for managing Vibriosis.
- Antibiotics are the only option to manage Vibriosis.
- Ampicillin is a superior antibiotic for Vibriosis management.
Answer: Vaccines are excellent for managing Vibriosis
Vibriosis is a common disease of saltwater fish, caused by Gram-negative rods in the Vibrio genus.
Common clinical signs are hemorrhage, inflammation along the ventral and lateral body, ulcers, and petechiae on the fins, vent, and mouth.
Net pens are not a biosecure environment because they are exposed to untreated water with wild fish and other animals that can cause disease in the fish being reared.
Antibiotic medicated feeds may be prescribed by a veterinarian.
Ampicillin is not an FDA-approved antibiotic medicated feed treatment and is illegal to use in these Atlantic salmon. Repeated use of antibiotics may cause resistance, and an excellent alternative to treatment is the prevention of Vibriosis via vaccines, such as Aquavac®.
Vaccines for fish are often given orally via feed or via prolonged immersion in a bath.
What is the most common cause of exocrine pancreatic insufficiency in the dog?
- Pancreatic neoplasia
- Pancreatic infection
- Chronic pancreatitis
- Pancreatic acinar atrophy
Answer: Pancreatic acinar atrophy
The correct answer is pancreatic acinar atrophy.
This is an idiopathic condition where the exocrine cells of the pancreas atrophy with minimal inflammation. Chronic pancreatitis is a much more common cause of EP in cats than dogs. For this reason, dogs with EPI do not usually have concurrent diabetes mellitus because the endocrine cells are spared, whereas cats often do have concurrent DM. Neoplasia and infection are rare causes of EPI.
Employees in your veterinary clinic are discussing measures to prevent disease transmission between employees and between patients. One of them asks you if using Purell hand sanitizer will prevent transmission of most pathogens. You remember reading on the label that Purell is a 65% ethyl alcohol based antiseptic. Which of these agents would be most effectively killed by such a product?
- Influenza virus
- Isospora canis
- Parvovirus
- Bacillus anthracis
Answer: Influenza virus
Hand sanitizing, alcohol based products are effective at killing many types of Gram positive and negative bacteria, including methicillin resistant Staphylococcus aureus (MRSA), tuberculosis, and E. coli. It is also effective against many types of fungi and enveloped viruses such as influenza viruses, HIV, and hepatitis virus (one exception is rabies virus).
They are not effective against non-enveloped viruses (parvovirus), bacterial spores (Anthrax, C. difficile), and protozoan oocysts (Giardia, Isospora, Cryptosporidium).
A 10-year old male castrated Collie presents for what the owner calls heart failure. Which of the following is not a typical sign of right heart failure?
- Exercise intolerance
- Muscle wasting
- Hepatomegaly
- Tachypnea
- Cough
Answer: Cough
Explanation
The correct answer is cough. Coughing is typically a sign of left heart failure that occurs with the development of pulmonary edema and/or bronchial compression from an enlarged left atrium. In right heart failure, tachypnea and dyspnea can develop due to pleural effusion.
Hepatomegaly occurs due to venous congestion from the damming of blood into the liver. Exercise intolerance develops because a decrease in cardiac output causes a decrease in oxygenation of tissues.
Muscle wasting occurs from loss of protein into effusions and from hepatic and Gl malfunction.
Other signs of right heart failure include lethargy, weakness, venous distention, ascites, and peripheral edema.
A 5-month old female cat presents to you for weight loss, chronic diarrhea and steatorrhea. The organism seen in a stained fecal smear is shown in the image below (this is a magnified 40X image, the organism is approximately 15 x 8 um). Which treatment is most appropriate?
- Tylosin
- Penicillin
- Sulfadimethoxin
- Fenbendazole
Answer: Fenbendazole
The organism is Giardia which can be recognized as a trophozoite with two nuclei outlined by adhesive discs. Giardia should be distinguishable from trichomonads which have a single nucleus and an undulating membrane.
The best treatments for Giardia are either fenbendazole or metronidazole.
Which of the following is not a clinical sign of hypovitaminosis A in box turtles?
- Renal disease
- Posterior paresis
- Palpebral edema
- Respiratory disease
- Squamous metaplasia of epithelium
Answer: Posterior paresis
Explanation
The correct answer is posterior paresis.
Hypovitaminosis A most commonly affects box turtles that are fed imbalanced diets of fruit and insects that have little vitamin A. Clinical signs include edema of the eyelids, chronic respiratory disease, renal disease (due to the squamous metaplasia of renal tubules blocking collecting ducts), squamous metaplasia of epithelium, and secondary infections of the eyes, skin, and respiratory system. Treatment includes oral or parenteral vitamin A supplementation.
Which statement about hypertrophic osteopathy (HO), as depicted in the radiograph below, is true?
- HO occurs in association with a thoracic mass
- HO usually starts in the proximal appendages and spreads distally
- HO is characterized by sclerosis of the subchondral bone of long bones
- HO occurs in young, large breed dogs
Answer: HO occurs in association with a thoracic mass
Explanation
The correct answer is HO occurs in association with a thoracic mass.
There is no breed or age predisposition for HO. The disease usually starts at the distal extremities and develops proximally. HO is characterized by periosteal proliferation near joints, not sclerosis of the subchondral bone.
A 5-year old female intact New Zealand White rabbit presents for hematuria, anorexia, and weight loss. What is the most likely differential?
- Pregnancy
- Normal estrous
- Rabbit syphilis
- Porphyrinuria
- Uterine adenocarcinoma
Answer: Uterine adenocarcinoma.
Uterine adenocarcinoma is the most common neoplasia of female rabbits, with up to 80% incidence among intact females of certain species. Because of this, all female rabbits that are not breeders should be spayed. The most common signs of uterine ACA are hematuria, anorexia, depression, dysuria, and milk production.
Pregnancy would be unlikely to cause hematuria. Rabbits are induced ovulators and do not exhibit estrous.
Hematuria must be distinguished from porphyrinuria, which is a normal red or orange pigment in the urine of some rabbits. However, porphyrinuria does not cause anorexia and weight loss.
Rabbit syphilis is a sexually transmitted disease caused by Treponema paraluis cuniculi. It causes perineal lesions but does not cause hematuria.
The relationship among incidence (I), prevalence (P), and duration (D) of disease is best expressed as:
- P=ID
- I=P-D
- P=I-D
- I=PD
Answer: P=ID
The correct formula to use is P = 1 x D. Prevalence can generally be viewed as the product of incidence and disease duration.
Incidence is defined as the number of new cases of a disease in a given period, and prevalence is the number of total cases prevailing (counted) in the given period.
This formula is helpful in a clinical scenario to help evaluate risk. Prevalence can increase (or decrease) in two ways: 1) the number of new cases (incidence) increases (or decreases), and 2) the duration of disease increases (or decreases). If a disease goes untreated, for example, duration would likely increase (compared to treated cases), and prevalence would increase.
Similarly, if the risk of acquiring a disease increased, the prevalence would increase. Note, for example, that if the weekly incidence of a disease were 5 new cases and the duration was 2 weeks per case (on average), generally one would expect the weekly prevalence to be 5 cases/week x 2 weeks = 10.
Ref: Veterinary Epidemiology: Principles and Methods, 1987 pg. 81, Martin, Meek, Willeberg
Which of the following are effects of non-steroidal anti-inflammatory drugs that are non-selective COX inhibitors?
Inhibition of inflammation, destruction of platelets, reduction of fever
Gastrointestinal ulcer formation, destruction of platelets, inhibition of neutrophil function
Reduction of swelling, analgesia, inhibition of neutrophil function
Gastrointestinal ulcer formation, inhibition of
platelet function, analgesia
Answer: Gastrointestinal ulcer formation, inhibition of platelet function, analgesia
Explanation
The correct answer is gastrointestinal ulcer formation, inhibition of platelet function, analgesia. NSAIDs reduce inflammation and pain by blocking the COX-1 and COX-2 pathways. Non-selective COX inhibitor side effects include Gl ulcers, inhibition of platelet function, renal damage, and reduction of fever.
What is the duration of a mare’s estrous cycle?
9-15 days
19-26 days
41-52 days
27-37 days
53-60 days
Answer: 19 -26 days
Explanation
The correct answer is 19-26 days. Estrus in a mare can last 2-10 days but, on average, is 6 days long. The mare is a polyestrous animal from the beginning of spring through summer. The estrous cycle’s duration lasts 19-26 days.
What is the significance of xanthochromia on a CSF tap?
- Evidence of nervous coccidiosis
- Evidence of prior hemorrhage
- Evidence of neoplasia
- Evidence of an infectious process
Answer: Evidence of prior hemorrhage
Explanation
The correct answer is evidence of prior hemorrhage. This is that yellow discoloration that can be seen for at least a week after bleeding in the CSF.
A black discoloration would be diagnostic for melanoma.
Measuring which of the following physiological parameters can help provide an indication of the welfare of animals when undergoing transitory procedures:
Plasma glucocorticoid and heart rate levels
Brain waves and body condition scoring
Stress hormones and approachability
Heart rate and lameness scoring
Answer: Plasma glucocorticoid and heart rate levels
Explanation
Elevated plasma glucocorticoid levels and heart rate are associated with stress responses and are easily measurable, accurate indicators of welfare.
When considering a dog that is hypoventilating you realize that the dog is in
- Metabolic acidosis
- Respiratory alkalosis
- Metabolic alkalosis
- Respiratory acidosis
Answer: Respiratory acidosis
The correct answer is respiratory acidosis.
There is bound to be some sort of acid-base question on the exam.
This question might look tricky, but it is truly simple. Think about the information you are given; all you know is the dog is hypoventilating. So there is build up of CO2; in effect the dog is in respiratory acidosis. Remember, CO2=Acid. Since you have no other information, there is no way to diagnose a metabolic acidosis or alkalosis.
Some causes of respiratory acidosis include airway obstruction, open pneumothorax or flail chest, neuromuscular disease, abdominal enlargement, pleural space disease, and bicarbonate therapy.
You are working at a small animal clinic performing a cystotomy on a 7 year old male Dalmatian. You glance at your anesthetic monitoring equipment and notice that the oxygen saturation on your pulse oximeter is 90%. Assuming that your equipment is working normally, what does this mean about your patient’s oxygenation status?
- Arterial oxygen pressure is 100 mm Hg, which is normal for this patient
- This oxygen saturation is low for a patient under anesthesia breathing 100% oxygen but would be normal for an animal breathing room air, which is 21% oxygen
- This is concerning because normally, a patient’s oxygen saturation does not exceed 50%
- Arterial oxygen pressure is 60 mm Hg, and oxygen saturation may drop precipitously if it decreases further
- Arterial oxygen pressure is 40 mm Hg and will result in potentially serious tissue hypoxia due to inadequate oxygen delivery
Answer: Arterial oxygen pressure is 60 mm Hg, and oxygen saturation may drop precipitously if it decreases further
When assessing an anesthetized patient with pulse oximetry, it is important to realize several things:
- The shape of the oxygen saturation curve is sigmoid, and until you reach oxygen pressures of < 60 mm Hg, there is very little change in oxygen saturation. Because an anesthetized patient breathing 100% oxygen should have about 500 mm Hg oxygen in the arterial blood, this can drop a long way before a dramatic change to oxygen saturation occurs.
However, the time to intervene is early when you see saturation percentages decrease because it means that your patient is oxygenating very poorly, especially if they are breathing 100% oxygen, and even a relatively small further decline could dramatically reduce their oxygen saturation, resulting in tissue hypoxia and dangerous consequences.
An oxygen saturation of 98-100% corresponds to > 100 mm Hg oxygen in arterial blood
An oxygen saturation of 95% corresponds to 80 mm Hg An oxygen saturation of 90% corresponds to 60 mm Hg An oxygen saturation of 50% corresponds to 30 mm Hg An oxygen saturation of 10% corresponds to 10 mm Hg
By the way, in room air, arterial oxygen pressure should normally be 80-100 mm Hg and oxygen saturation is 95-100%
What is the treatment for proliferative bowel disease in ferrets?
- Nonsteroidal anti-inflammatory drugs
- Antibiotics
- Anthelmintics
- Corticosteroids
- Antiprotozoals
Answer: Antibiotics
Explanation
The correct answer is antibiotics.
Proliferative bowel disease in ferrets is caused by Lawsonia, an intracellular bacterium. The organism is very susceptible to chloramphenicol and has a variable susceptibility to other antibiotics.
Which of the following signs is strictly associated with central vestibular disease?
- Head tilt toward the side of the lesion
- Circling toward the side of the lesion
- Non-positional horizontal nystagmus
- Positional, vertical nystagmus
Answer: Positional, vertical nystagmus.
Explanation
The correct answer is positional, vertical nystagmus. Positional and vertical nystagmus only occur with central vestibular disease.
Circling, head tilt, and horizontal nystagmus all occur with either central or peripheral vestibular disease.
An 8-year old female spayed domestic short hair cat presents for her yearly physical exam. Your oral exam reveals multifocal lesions of absent dental substance on multiple teeth consistent with feline odontoclastic resorption lesions (FORL). Which of the following statements about FORL is true?
- The lesions are usually non-painful
- The lesions can be internal and external, so dental radiographs should be taken to further investigate the extent of the lesions
- The lesions are usually incidental findings that are not clinically significant and do not need to be treated
- FORL is now a rare clinical finding since commercial diets have become more strictly regulated
Answer: The lesions can be internal and external, so dental radiographs should be taken to further investigate the extent of the lesions
The correct answer is the lesions can be internal and external, so dental radiographs should be taken to further investigate the extent of the lesions. FORL lesions are usually very painful and are more common now than before.
Up to 67% of cats presenting for dental care may be affected.
The exact etiology of FORL is not known, but studies have shown an association of FORL and diets low in calcium, magnesium, phosphorus, and potassium. Periodontal disease is also often found in association with FORL.
Treatment should include addressing associated periodontal disease and possibly extraction of teeth affected by deep lesions.
An owner brings in her 4-year old domestic short hair cat for decreased appetite and sneezing. She has very limited funds for diagnostics, but approves a fine needle aspirate of the swelling you noticed over the bridge of the nose. You perform the aspirate and look at the slide under the microscope (see image). What medication should you prescribe for this cat?
- Fluconazole
- Clindamycin
- Fenbendazole
- Chlorambucil
Answer: Fluconazole
Explanation
The cytology from the fine needle aspirate shows cryptococcus.
Cryptococcus is an encapsulated fungus and is treated with anti-fungal medications such as fluconazole or itraconazole.
Clindamycin is used to treat toxoplasma.
Fenbendazole is used to treat intestinal parasites such as hookworms, roundworms, and Giardia.
Chlorambucil is a chemotherapeutic agent often used in treating lymphoma.
A 3-year old male castrated domestic short hair cat presents to you for weight gain, polyuria and polydipsia over the course of 6 months. His previous veterinarian made a diagnosis of diabetes and has tried to control this with insulin but has not been successful. On examination, you detect prognathism, hepatomegaly, and a grade III/VI heart murmur. You suspect that the cat may have an underlying disorder that is contributing to his poorly-controlled diabetes. Which of the following diagnostic tests will be most helpful in confirming your suspicion?
- Abdominal ultrasound
- MRI of the brain
- Serum insulin:glucose ratio
- Serum folate and cobalamin levels
Serum T4 levels
Answer: MRI of the brain
Explanation
This cat has clinical signs most consistent with acromegaly (weight gain, prognathism, organomegaly, and diabetes mellitus that is difficult to control). This condition results from a growth hormone (GH) secreting pituitary tumor. GH or insuline-like growth factor (IGF) assays can be diagnostic but are not offered by many veterinary laboratories. Advanced imaging techniques are the most reliable way to diagnose a pituitary mass in this instance. This cat is not likely to be hyperthyroid due to the history of weight gain. Hyperadrenocorticism as a cause of insulin-resistant diabetes mellitus is less likely given the cat’s other clinical signs; nevertheless, adrenal function testing such as an ACTH stimulation test or dexamethasone suppression test to rule out hyperadrenocorticism should be considered.
A 3 year old male neutered Maltese who was recently adopted from the shelter presents for kennel cough. He is currently on doxycycline. You would also like to send a cough suppressant and write a prescription for hydrocodone. In order to prescribe this medication, what does the law require?
- A current premise license
- A signed written consent form from the owner acknowledging this is a controlled substance
- A list of side effects of this medication provided to the owner
- A current DEA license
Answer: A current DEA license
Hydrocodone is a controlled substance. Controlled substances cannot be prescribed unless the veterinarian holds a current DEA license.
Pharmacists require a DEA number in order to process these prescriptions.
A premise license is held by the owner of the building of the veterinary hospital.
A conversation with the owner of possible side effects of any medications sent with the pet should occur, but a written list is not required by law.
It’s 6:00 PM, and Dr. Freels is running late for his last appointment of the day, which was scheduled for 5:30 PM. Unfortunately, Dr. Freels diagnosed a new case of diabetes mellitus in a canine patient at the 4:30 PM appointment and the education needed for the pet owner to begin insulin today took more than thirty minutes. Dr. Freels often runs late when new diabetes cases are diagnosed because client education required is so specific and takes so much time. Dr. Freels’ lead technician recommends delegating client education for diabetes to the technical staff instead and offering a bonus for technicians who would like to be trained in diabetes education. Which of the following is the most appropriate goal for Dr. Freels to set for the technicians regarding training for diabetes education responsibilities?
- Allow six months for the technicians to increase their understanding of diabetes management and improve their public speaking skills.
- Give the technicians a four-week timeframe to review assigned materials, achieve at least an 80% score on a written examination, and pass an oral examination regarding diabetes education for dog and cat owners.
- Instruct the technicians to read information about diabetes management in dogs and cats with the goal of being able to discuss the information independently with pet owners.
- Tell the technicians to read some textbooks and journal articles regarding diabetes education and be prepared to achieve a 100% score on a written examination within one week.
Answer: Give the technicians a four-week timeframe to review assigned materials, achieve at least an 80% score on a written examination, and pass an oral examination regarding diabetes education for dog and cat owners.
Goals should be set using SMART objectives: specific, measurable, attainable, realistic, and timed. This option has a clearly defined timeline and objective. The 80% score goal is measurable.
Also, a strategy for achieving an outcome is clearly identified. No specific strategy for achieving these changes is identified in the incorrect options. A one-week timeframe to achieve a perfect score is not realistic and therefore not attainable. Options which do not include a specific measure of success are incorrect.
Source: Handbook of Veterinary Communication Skills. Edited by Carol Gray and Jenny Moffett.
Wiley-Blackwell, 2010. Pages 134-136.
A clinic sees two different patients named “Sadie” on the same day. Blood is drawn for both patients, and samples are sent to an external reference laboratory. Sadie A’s results support a diagnosis of diabetes mellitus. However, those results do not fit with Sadie A’s history. Sadie B does have signs of diabetes mellitus, but her results are normal. After discussion with the clients, you arrange for both dogs to have their blood drawn again. When the new results arrive, it is obvious that the tubes for the original samples were mislabeled. What is the most appropriate step to avoid another labeling error at the clinic in the future?
- Create a written standard operating procedure for submission of laboratory samples.
- Talk privately with the assistant who mislabeled the original laboratory samples.
- Hold a staff meeting to discuss the procedure for submission of laboratory samples.
- Take disciplinary action against the assistant who mislabeled the original laboratory samples.
Answer: Create a written standard operating procedure for submission of laboratory samples.
Creating a written standard operating procedure (SOP) for submission of laboratory samples is the best option for prevention of future labeling errors.
Written SOPs are the best way to ensure that team members adhere to established procedures for frequently occurring processes. Talking privately with the assistant who mislabeled the tubes and/or taking disciplinary action against that team member may be appropriate options, however this will not reduce the chances of a future labeling mistake by another team member. Holding a staff meeting to discuss proper procedures is important, however this will not reduce the chances of a future labeling mistake by new employees or anyone not in attendance at the meeting.
Source: Handbook of Veterinary Communication Skills. Edited by Carol Gray and Jenny Moffett.
Wiley-Blackwell, 2010. Pages 136-138.
In a well-leveraged practice, which of the following jobs should be performed by a veterinarian?
- Restrain a patient for a rectal exam
- Induction and monitoring of anesthesia for a splenectomy
- Prescribing medications to a patient with roundworms
- Taking a thoracic radiograph
- Perform a complete blood count
Answer: Prescribing medications to a patient with roundworms
In a well-run practice, veterinarians should be performing the tasks that they alone are qualified to do, namely to make a diagnosis and prognosis, prescribe drugs, and perform surgery.
Technical tasks should be performed by technicians including surgical assisting, laboratory procedures, radiography, anesthesia, patient treatment and nursing, and client education.
Veterinary assistants have no AVMA-accredited training programs and act as support for veterinarians and technicians, for tasks that do not require the higher level of training or expertise.
These generally include patient handling and restraint and assisting with various radiographic, laboratory, and pharmaceutical tasks. It is critical that they have documented skill and safety training for any technical tasks that they perform.
What is the approximate daily water requirement for a rabbit?
- 120 ml/kg
- 240 ml/kg
- 60 ml/kg
- 15 ml/kg
- 30 ml/kg
Answer: 120ml/kg
Explanation
The correct answer is 120 ml/kg day. This is considerably higher than a dog or cat.
Two 9-year old female spayed Labrador retrievers presented for their next chemotherapy treatments. Both were diagnosed with multicentric lymphoma and have been receiving the CHOP protocol. One received doxorubicin (Adriamycin) and one received vincristine (Oncovin) today. Your technician informs you that both unfortunately had extravasations occur and wants to know what she should do. Which drug is a worse vesicant and what should be done to the injection site?
- Vincristine. Cold compress to contain the spread of drug
- Doxorubicin. Cold compress to contain the spread of drug
- Doxorubicin. Warm compress to disperse the drug
- Vincristine. Warm compress to disperse the drug
Answer: Doxorubicin. Cold compress to contain the spread of drug
Explanation
Intravenous chemotherapy drugs can cause severe tissue necrosis (doxorubicin) or irritation (vincristine) if extravasation occurs. Treatment for both should begin immediately. In both cases, the catheter should be left in place and as much of the drug should be aspirated as possible.
Treatment for doxorubicin extravasation involves cold compressing the site to promote vasoconstriction, however perivascular necrosis may still occur and may progress days to weeks later. In severe cases involving doxorubicin, debridement or limb amputation may be needed.
Vincristine extravasation should be treated with warm compresses to disperse the drug and enhance systemic absorption.
Extravasation should be prevented through patient restraint training, use of catheters that have been placed on the first stick, and careful monitoring during administration. The peripheral veins should be avoided for blood draws if possible on all patients receiving chemotherapy.
You receive a message from a koi owner who has been experiencing moderate mortality in their pond this summer. You arrive at midday and perform water quality testing, the results of which are provided (see image).
They report that many fish have severe skin lesions that are red and raised with deep ulcers exposing the underlying muscle. New fish were added to the pond this past fall. The owner was hesitant to call you at first, because they were worried they might need to depopulate their pond. You call them back and inform them that:
- The prognosis is good with antibiotic treatment.
- The prognosis is grave and depopulation will be required.
- The prognosis is excellent with no treatment required.
- The prognosis is guarded and depopulation is recommended.
- The prognosis is excellent with salt treatment.
Answer: The prognosis is good with antibiotic treatment.
The top differential diagnosis for this case is
“Furunculosis” caused by Aeromonas salmonicida.
The classic clinical sign is large, swollen skin lesions mistakenly referred to as “furuncles” (since fish don’t have hair). Other clinical signs include hemorrhage, kidney and vent swelling, and ulcers.
For food fish, furunculosis may be treated with oxytetracycline, sulfadimethoxine and
ormetoprim, and florenicol medicated feeds via a Veterinary Feed Directive. In a koi pond, you may use injectable antibiotics if the population is small.
If left untreated, furunculosis may lead to serious mortality.
Koi herpesvirus (Cyprinid herpesvirus Type 3) is not a top differential because mortality at this temperature would be extremely high, approaching 80-100% if new fish had been introduced several months ago. Clinical signs of KHV include gill necrosis and enophthalmia. The clinical signs in this case are also not indicative of Spring Viremia of Carp. Spring Viremia of Carp would present with extremely high mortality and internal ecchymotic hemorrhages. SVC also usually presents at a lower temperature (50-64°F).
A quarantine protocol and improved biosecurity measures may be helpful to discuss with the owner since they introduced new fish recently.
Dr. Macintyre is the owner of a practice that is due for state inspection soon. Part of the inspection will involve a detailed review of the practices safety protocols. Dr. Macintyre downloaded a checklist from the state website that outlines the preparations which should be made prior to the inspection. He delegates the task of ensuring compliance with the guidelines to the office manager. As the inspection date approaches, Dr. Macintyre notices that several important items on the checklist have not been completed. Which of the following is the best approach to ensure that the tasks are completed appropriately?
- Take no action and wait for the office manager to complete the assigned tasks.
- Remove the office manager from the project and reassign the tasks to another team member.
- Complete the tasks independently and formally discipline the office manager.
- Schedule a meeting with the office manager to review the project timeline.
answer: Schedule a meeting with the office manager to review the project timeline.
Following delegation of a task, defining a project timeline is recommended. Performance should be tracked throughout the project. Avoid undermining the delegated responsibility. Delegation of tasks does not mean abdication of responsibility.
Regular check-ins should be scheduled with the employee who is in charge of the delegated tasks.
Completing tasks that have been delegated to another team member, or delegating those tasks to a new team member, undermines that team member’s responsibilities and authority.
Source: The Art of Veterinary Practice Management. Mark Opperman and Sheila
Grosdidier. Advanstar Communications, Inc., 2014. Page 104-105.
A7-year old female spayed English Springer Spaniel presents for difficulty breathing and lethargy. Physical exam shows pale mucous membranes and increased respiratory effort. You collect blood for a complete blood count and a chemistry panel and you place a drop of blood with a drop of saline on a glass slide. After swirling the sample around, you can grossly see what is shown in the picture. What’s your diagnosis?
- Hemolysis
- Vitamin K antagonist toxicity
- Immune mediated hemolytic anemia
- Rouleaux formations
- Evan’s syndrome
Answer: Immune mediated hemolytic anemia
The image shows a positive slide agglutination test. The dark patches in the sample are caused by antibodies attached to the surface of the erythrocytes cross linking the cells together causing these clumps. This is highly suggestive of an immune mediated reaction to antigen on the individual’s red blood cells.
Rouleaux formations are red blood cells stacked together as a result of their natural discoid shape and large surface area causing them to have an affinity for each other. They typically resemble a stack of coins or cookies.
Evan’s syndrome is an autoimmune condition characterized by an immune attack on erythrocytes, platelets, and occasionally leukocytes as well. You would not be able to diagnose this on a slide agglutination test alone.
Vitamin K antagonist toxicity with rodenticide causes a coagulopathy but should not cause hemagglutination.
What is the primary mode of transmission of West Nile Virus (WNV) between birds?
Via feces
Via placenta
Via mosquitoes
Via Cnemidocoptes mites
Via saliva
Answer: Via mosquitoes
Mosquito vectors are the primary mode of transmission for WNV between birds and other hosts (horses, humans). There are infrequent documented cases of the disease being spread by feces or saliva. No mites have been documented to transmit the disease. Birds do not have a placenta.
West Nile Viral Infection in Equids: NAVLE Study Guide
Definitions and Causative Agents
• West Nile Virus (WNV): A Flavivirus transmitted by mosquitoes, causing encephalitis in equids. Horses are considered “dead-end” hosts, as they do not spread the virus further.
Pathogenesis
• Virus Structure: The virus has an RNA genome that encodes structural proteins (C-prM-E) and nonstructural proteins (NS1-NS5). • Transmission Cycle: WNV is maintained in a bird-mosquito cycle. Horses become infected through mosquito bites, developing subclinical or clinical neurological disease.
Clinical Signs
• Symptoms: Ataxia, limb weakness, recumbency, muscle fasciculations, hyperesthesia, and cranial nerve deficits like facial nerve paralysis. Severe cases may lead to tetraplegia and death. • Fatality Rate: Ranges from 22% to 44% in clinical cases.
Diagnosis
• Tests: Real-time RT-PCR to detect viral RNA, ELISA for detecting IgM antibodies, and post-mortem immunohistochemistry in nervous tissues. • Considerations: WNV viremia is short, making early detection challenging. IgM antibodies indicate recent infection, whereas IgG antibodies may persist from vaccination or past exposure.
Treatment
• Supportive Care: Includes anti-inflammatory drugs, fluids, and measures to reduce stimuli (e.g., padded stalls). • Experimental Therapies: Use of WNV antibodies and antiviral drugs like ribavirin and interferon, though no proven efficacy in horses.
Prevention
• Vaccination: Several vaccines are available, including inactivated virus vaccines and recombinant vaccines using canarypox vectors. Annual boosters are recommended. • Mosquito Control: Essential to reduce exposure; involves minimizing outdoor activity during peak mosquito times and using repellents.
Pathology
• Histopathological Findings: Mild to severe polioencephalomyelitis, with lesions primarily in the brainstem and spinal cord. Neuronophagia and perivascular infiltrates are common.
Prognosis
• Outcome: Varies; many horses recover, but some have residual neurological deficits.
lonized serum calcium levels are influenced by three regulatory hormones. Of the following, which are the correct three?
- Thyroid hormone, 25-hydroxycholecalciferol D3, and calcitonin
- Parathyroid hormone (PTH), calcitonin, and 1,25-dihydroxycholecalciferol D3
- Parathyroid hormone (PTH), Vitamin D3, and calcitriol
- Thyroxine, calcitonin, and parathyroid hormone (PTH)
- Vitamin D3, somatotropin and parathyroid hormone (PTH)
Answer: Parathyroid hormone (PTH), calcitonin, and 1,25-dihydroxycholecalciferol D3
Explanation
PTH comes from parathyroid chief cells in response to hypocalcemia. Calcitonin is from thyroid parafollicular glands in response to hypercalcemia. 1,25-dihydroxycholecalciferol D3 is of renal origin and sometimes called calcitriol.
Ionized serum calcium levels are regulated by three key hormones: Parathyroid hormone (PTH), calcitonin, and 1,25-dihydroxycholecalciferol D3 (calcitriol). PTH is secreted by parathyroid chief cells in response to low calcium levels, calcitonin by thyroid parafollicular cells in response to high calcium, and 1,25-dihydroxycholecalciferol D3 is produced by the kidneys.
Highly pathogenic avian influenza (HPAI) has become endemic in some domestic ducks in Asia. Wild ducks and geese can move the virus, often without showing clinical illness. What is the human health concern?
- The HPAl can transfer genes from pig or human influenza strains, which allow the avian flu to become infectious to humans
- Some human genotypes are inherently susceptible to the avian influenza strains and, thus, a portion of the population could die from exposure to the HPAI
- The HPAl can spontaneously mutate or rearrange and become highly pathogenic for humans as well as birds
- The avian influenza strains are not pathogenic to humans, but the porcine (pig) strains are.
- Humans exposed to live pigs carrying pig flu in a market could start a major pandemic
Answer: The HPAl can transfer genes from pig or human influenza strains, which allow the avian flu to become infectious to humans
Explanation
While the highly pathogenic avian influenza strains can kill domestic ducks and poultry, they do not normally cause major public health issues unless they acquire the genes that allow them to attach to human respiratory mucosa and become pathogenic for humans. This is how a worldwide influenza pandemic could occur.
Which of the following is an appropriate objective in the repair of an articular fracture in a dog?
- 6-8 weeks of strict post-operative rest
- Early return to function
- Avoid rigid fixation of the fracture
- 50% or greater alignment
Answer: Early return to function
Explanation
The correct answer is early return to function. With articular fractures, the 3 major goals of the clinician are:
Rigid fixation of the fracture fragments; neglecting to do this will result in loose fracture fragments within the joints that will promote osteoarthritis.
Anatomic realignment (50% or even 75% is not adequate with articular fractures, in contrast to long bone fractures).
Early return to function. With long bone fractures, extended rest is recommended to promote stability and healing of the bone. The opposite is true in articular fractures where prolonged rest after repair will promote fibrosis, causing decreased range of motion in the joint.
An obese, sedentary, female Bichon Frise of 5 months of age walks into your clinic as a result of having mucus-laden diarrhea of one-week duration. You perform a gram stain of the feces and visualize “gull-shaped” gram-negative rods. What is the most likely diagnosis?
- Salmonellosis
- Cryptosporidium
- Campylobacteriosis
- Clostridioides difficile
Answer: Campylobacteriosis
Explanation
The correct answer is Campylobacteriosis. This is a gram negative motile, thin, S-shaped or gull-shaped rod. It can occur singly, in pairs, or in chains. C. jejuni is most commonly isolated. You can also isolate this organism with fresh fecal swabs streaked onto Campylobacter blood agar plates, which grows in an oxygen-reduced atmosphere in 3-4 days. Salmonella is a gram-negative bacillus. C. difficile is a gram-positive rod.
Cryptosporidium is a coccidian parasite. Fun Fact:
Kids with puppies are 16 times more likely to acquire Campylobacteriosis.
A 13-year old spayed female Miniature Poodle presents with two mobile, soft, well-circumscribed, subcutaneous sternal masses, 3 cm and 6 cm in diameter, respectively. The owner had noticed one mass three months previously. Fine needle aspiration of both masses is performed and smears are prepared. A representative field of both specimens is illustrated below (Wright’s 20X). What is your diagnosis?
- Mesenchymal neoplasia (sarcoma)
- Fungal granuloma
- Mast cell tumor
- Lipoma
Answer: Lipoma.
The cells depicted are well-differentiated adipocytes. These cells are large, appear in aggregates or sometimes singly, and contain fat that stains negatively with Wright’s, such that the cytoplasm appears clear. The cells possess a small, round or ovoid, pyknotic nucleus that may be compressed and located in the periphery of the cell. This benign tumor is a lipoma, which is common in dogs. If the mass hinders the animal, it may be removed surgically. Infiltrative lipomas, and their malignant counterpart, liposarcomas, are less common.
When sampling for cytology, frequently the first indication that a lipoma has been aspirated is the clear, oily appearance of the material ejected from the aspiration needle onto the slide. Care must be taken while staining to ensure that the material does not wash off the slide, as fat does not adhere readily to the glass surface.
Note: Gentle heat fixing of greasy material to a slide may be of benefit in keeping adipose cells adherent to slides during staining. This can be accomplished by holding a slide over a Bunsen burner or lighter or gentle heating on a heating tray/bar for a few seconds so that the side opposite to that containing the cellular material is slowly warmed. The slide must be left to cool completely before staining. Slides coated with poly-l-lysine, which are used for Papanicolaou staining and/or increased adherence of tissue sections to slides, are also helpful in promoting cellular adherence and eliminating loss of cells during staining.
Sometimes, local fat will be aspirated and cannot be reliably differentiated from the adipose cells of a lipoma. If there is any doubt as to the presence of a discrete mass, surgical removal with histological evaluation is recommended.
A three-year-old female goat presents in poor body condition, slightly depressed, and febrile. The goat is mildly pruritic. The skin shows mild to moderate erythema and alopecia and marked hyperkeratosis and crusting on all four extremities, as shown in the image below. Skin scrapings are negative for mites. A cytology taken from the underside of a crust shows parallel stacks or rows of cocci (“railroad tracks”) between keratinocytes, also shown below. Which one of the following choices is the most likely diagnosis?
- Dermatophytosis
- Pyoderma
- Streptococcus infection
- Dermatophilosis
- Malassezia dermatitis
Answer: Dermatophilosis
Dermatophilosis is a crusting dermatitis caused by the filamentous bacteria Dermatophilus congolensis, seen in all ruminants and horses. Also called “lumpy wool” or “rain scald/rot.”
Infection is seen most often in younger or systemically ill/immunocompromised animals. Many are housed in areas with poor hygiene or without shelter. Excessive moisture, rainy conditions, skin damage, and concurrent illness that results in immunosuppression are predisposing factors.
Loss of the protective sebaceous film layer seen on healthy skin is thought to be an important factor in the pathogenesis.
Carrier animals and fomites such as grooming tools are also important as this can be contagious in at-risk animals.
Thick crusts, which usually contain the organism, look like the end of a paint brush when removed from the animal and are a typical finding. On cytology (impression smear of a crust) the “railroad track” appearance of the gram-positive cocci is classic for dermatophilosis.
The infection self-resolves after a few weeks in most animals without treatment. Can use topical and systemic antimicrobials in persistent cases.
Link: Dermatophiolosis (“Rain Rot”) in Horses
https://www.merckvetmanual.com/horse-owners/skin-disorders-of-horses/dermatophilosis-rain-rot-in-horses?autoredirectid=22723
A 12-year old intact male Boston terrier presents with a history of straining to defecate over the past 2 months. On physical examination, a bulge is immediately noted in the right perineal region (see image). A rectal exam is also consistent with a perineal hernia. When discussing complications associated with repair of a perineal hernia which of the following is NOT a concern?
- Infection
- Failure of repair
- Femoral nerve paralysis
- Fecal incontinence
Answer: Femoral Nerve Paralysis
Explanation
Femoral nerve paralysis is not a reported complication.
The surgical region is not near the femoral nerve.
Incontinence can occur if over 50% of the external anal sphincter is damaged. Infection is a very common complication due to the region in which the surgery is being performed. Failure of repair is also a complication due to the weak nature of the muscles being used to repair the defect.
A 5-year old cow presents with skin lesions confined to the nonpigmented areas (see image). The affected skin is dry and raised at the periphery. The skin of the teats appears dry. Which of the following could result in this presentation?
• Ingestion of Pteridum aquilinum (bracken fern)
• Ingestion of moldy feed containing aflatoxins
• Ingestion of lupine
- Ingestion of Quercus spp.
Answer: Ingestion of moldy feed containing aflatoxins
Explanation
This is a case of photosensitization based on the skin lesions confined to the nonpigmented areas.
Primary photosensitization can occur when photodynamic agents are absorbed from the G.. tract such as Hypericum perforatum (St. John’s wort), Fagopyrum esculentum (buckwheat), Ammi majus (bishop’s weed), and Cymopterus watsonii (spring parsley). Secondary (hepatogenous) photosensitization occurs when the liver’s excretion of phylloerythrin is impaired due to liver damage.
Phylloerythrin is derived from the breakdown of chlorophyll by rumen microbes. The best answer in this question is aflatoxins because they are known to cause liver damage.
Bracken fern toxicity causes acute hemorrhagic syndrome in cattle. Lupine toxicity primarily causes birth defects. Quercus (oak) toxicity causes Gl and renal dysfunction.
A 5-year old cow presents with skin lesions confined to the nonpigmented areas (see image). The affected skin is dry and raised at the periphery. The skin of the teats appears dry. Which of the following could result in this presentation?
• Ingestion of Pteridum aquilinum (bracken fern)
• Ingestion of moldy feed containing aflatoxins
• Ingestion of lupine
- Ingestion of Quercus spp.
Answer: Ingestion of moldy feed containing aflatoxins
Explanation
This is a case of photosensitization based on the skin lesions confined to the nonpigmented areas.
Primary photosensitization can occur when photodynamic agents are absorbed from the G.. tract such as Hypericum perforatum (St. John’s wort), Fagopyrum esculentum (buckwheat), Ammi majus (bishop’s weed), and Cymopterus watsonii (spring parsley). Secondary (hepatogenous) photosensitization occurs when the liver’s excretion of phylloerythrin is impaired due to liver damage.
Phylloerythrin is derived from the breakdown of chlorophyll by rumen microbes. The best answer in this question is aflatoxins because they are known to cause liver damage.
Bracken fern toxicity causes acute hemorrhagic syndrome in cattle. Lupine toxicity primarily causes birth defects. Quercus (oak) toxicity causes Gl and renal dysfunction.
A 12-year-old female spayed Labrador Retriever dog is presented for dental cleaning. After she is induced under general anesthesia, her pulse oximetry drops below normal at 91%. Thoracic radiographs show the following changes (see images below). What is the most clinically significant finding evident on thoracic radiographs from this dog?
- Spondylosis deformans is present
- Osteochondritis dissecans is evident in the left shoulder
- There is a gastric foreign body
- Left cranial lung lobe has alveolar infiltrates
- Heart is globoid is appearance
Answer: Left cranial lung lobe has alveolar infiltrates
This dog has pneumonia of the left cranial lung lobe. There are diffuse alveolar infiltrates within the left cranial lung lobe with air bronchograms.
You should cancel the anesthetized procedure and wake up the patient because she is oxygenating poorly. Recheck radiographs are recommended once she is awake to rule out any component of atelectasis due to recumbency and sedation.
There is an incidental gastric foreign body (rounded metal opacity within the stomach that is in close association with additional irregular metal opacity).
The dog does have spondylosis deformans, which is a very common and incidental radiographic finding in older dogs.
Although these changes are present, they are not the most clinically important findings on these radiographs.
You examine a 6 year old horse for head tilt to the left (left ear is lower, see image). The owner first observed it 2 days ago and it has since worsened. On PE, T=102F (38.9 C), and pulse and respiratory rate are normal. Other CNS signs include mild facial paralysis, mild ataxia, and nystagmus that does not change with head position. What is the most likely diagnosis?
- Cerebellar abiotrophy
- Leukoencephalomalacia
- Vestibular disease
- Nigropallidal encephalomalacia
- Locoweed poisoning
Answer: Vestibular disease
Explanation
These signs are compatible with mild infectious vestibular disease caused by bacterial otitis media/interna. Other possible causes of vestibular disease are guttural pouch mycosis, polyneuritis equi, viral labyrinthitis, and traumatic skull fractures.
The procedure performed on the patient’s right hip is a triple pelvic osteotomy. On the patient’s left hip a total hip replacement has been performed. Which one of the following statements is true?
- Triple pelvic osteotomies will eliminate progression of arthritis
- Triple pelvic osteotomies should only be performed in dogs free of radiographic signs of degenerative joint disease
- The most common complication associated with total hip replacements is caudoventral luxation
- Total hip replacements should only be done in dogs that are over 2 years of age
Answer: Triple pelvic osteotomies should only be performed in dogs free of radiographic signs of degenerative joint disease
Explanation
Triple pelvic osteotomies (TPO) are designed to increase the dorsal coverage of the femoral head.
If there are degenerative changes at the time of surgery then the likelihood of achieving good results with the procedure is diminished. This is why this surgery is typically performed in dogs that are 6mo - lyr of age. TPOs will not eliminate the progression of arthritis; however, it is believed that the degree of arthritis will be less and that many patients are clinically sound despite having radiographic evidence of arthritis.
Total hip replacements (THR) can be performed as soon as the physes in the region have finished their growth. THRs have been performed in dogs as young as 1 year of age and sometimes even younger. A caudoventral luxation can occasionally occur with a total hip replacement; however, craniodorsal luxations are a much more common.
You examine a very ill 4-year old Holstein dairy cow on a large commercial dairy. She freshened one week ago and was producing well, until she was found down and unwilling to rise this morning when you were called. T=103F or 39.4 C, HR=90, and R=35. The scleral vessels are dark are enlarged, her rumen is fairly empty and the motility is poor, and she appears too weak to rise. Rectal exam reveals an involuting uterus which can be retracted, discharging a brownish red mucoid non-odorous lochia through the vagina. The left rear quarter of her udder is swollen, hot, painful, and discolored (see image), and contains a serum-like secretion with clumps of fibrin in it. What is your diagnosis?
- Coliform mastitis
- Grain overload
- Displaced abomasum
- Metritis
- Hypocalcemia (milk fever)
Answer: Coliform mastitis
Explanation
This is a case of severe acute coliform mastitis, and the absorbed endotoxin (LPS) is causing many of the systemic signs observed. The cow needs to be aggressively treated with IV fluids, NSAIDS, and supportive nursing. The gland should be frequently milked out. The use of both intramammary and systemic antimicrobial drugs to which most coliforms are susceptible is still controversial, but is often done in cows in a severe state of illness as in this case. While this cow may have secondary hypocalcemia, treatment with calcium needs to be approached cautiously, as endotoxic animals have very sensitive myocardium and arrest may occur if calcium is given IV. If given, preferred routes of calcium administration would be subcutaneous or oral.
Definition:
Coliform mastitis is a form of mastitis in dairy cattle caused by gram-negative, lactose-fermenting bacteria, primarily Escherichia coli, Klebsiella spp., and Enterobacter spp.
Pathophysiology:
- Invasion: Bacteria enter through the teat canal, proliferate in the mammary gland, and release endotoxins.
- Immune Response: Endotoxins trigger an acute inflammatory response, characterized by neutrophil influx and cytokine release.
- Systemic Effects: Severe cases can lead to systemic toxemia, including fever, shock, and even death.
Causes:
- Environmental Factors: Contaminated bedding, water, and equipment; poor milking hygiene; and trauma to the teats.
- Specific Pathogens: E. coli and Klebsiella are common environmental pathogens associated with coliform mastitis.
Symptoms:
- Local: Swollen, firm udder, with watery, bloody, or pus-laden milk.
- Systemic: Fever, anorexia, dehydration, and in severe cases, shock.
Clinical Changes:
- Milk Changes: Reduced milk yield, abnormal milk appearance (watery or containing clots).
- Udder Changes: Swelling, heat, and pain in the affected quarter(s).
Assessment:
- Clinical Signs: Observation of milk and udder condition, systemic symptoms.
- Laboratory Tests: Somatic cell count (SCC) in milk, bacterial culture to identify the causative agent.
Treatment:
- Antibiotics: Systemic and intramammary antibiotics, ideally chosen based on sensitivity testing.
- Cephalosporins: Commonly used due to efficacy against gram-negative bacteria.
- Aminoglycosides and Fluoroquinolones: Used for severe cases but require careful monitoring for residues in milk.
- Supportive Care: Fluid therapy to manage dehydration and shock, anti-inflammatory drugs to reduce fever and pain.
Prevention:
- Hygiene: Proper milking procedures, clean and dry bedding, regular equipment maintenance.
- Teat Care: Use of post-milking teat dips to reduce bacterial colonization.
- Vaccination: Some vaccines are available for prevention against E. coli and Klebsiella spp.
Prognosis:
- Severity: Varies based on the extent of infection and timeliness of treatment.
- Outcomes: Potential for chronic infections, reduced milk production, and, in severe cases, death or culling.
Epidemiology:
- Incidence: Higher in herds with poor environmental management; outbreaks can occur in warmer climates or with improper bedding materials.
- Zoonotic Risk: Although rare, some coliform bacteria can be zoonotic, posing a risk to humans.
Key Points:
- Early Detection: Critical for effective treatment; regular monitoring of SCC and milk quality is essential.
- Veterinary Involvement: Regular herd health assessments and consultations for mastitis management and antibiotic stewardship.
For more detailed information, visit the Merck Veterinary Manual.
A 10-yr old, 825 gram, male, Moluccan cockatoo named “Ira” is presented to your clinic with a complaint of feather loss on the distal end of the right wing. A feather cyst had been removed from this area three months earlier. Physical examination reveals a thickened, yellow, friable skin lesion on the dorsal aspect of the right metacarpus. You make a contact smear of the area and cytology reveals macrophagic inflammation with multi-nucleated giant cells and cholesterol clefts as seen in the image below. What condition is this most compatible with?
- Cutaneous xanthomatosis
- Bacterial dermatitis
- Cutaneous gout
- Avian poxvirus
- Cutaneous lymphoma
Answer: Cutaneous xanthomatosis
Explanation
Cutaneous xanthomatosis is a unique condition of birds caused by excessive accumulation of lipids in the skin. It is a macrophagic inflammatory response, with multinucleated giant cells and cholesterol crystals observed cytologically. A xanthoma is a benign growth and is most prevalent in cockatiels, budgies and cockatoos. They are typically non-aggressive, but at times can become locally invasive causing irritation and self-mutilation of the site. The etiology is unknown but a high fat diet and inactivity may contribute.
Gout is a build-up of uric acid, and typically causes swollen painful joints. Bacterial dermatitis is usually associated with a heterophilic or mixed inflammation. Poxvirus lesions have clusters of squamous epithelial cells with eosinophilic cytoplasmic vacuoles. Cutaneous lymphoma yields highly cellular samples of immature lymphocytes.
A foal presents for colic caused by the organism shown in the image below (microscopic image from 40X, organism is approximately 100 um). By which of these mechanisms is colic occurring?
- Immune mediated hypersensitivity
- Enterolith formation
- Intestinal impaction
- Larval migration
- Thrombosis of the mesenteric artery
Answer: Intestinal impaction
Explanation
This is an image of a Parascaris equorum egg. It is almost spherical in shape with a brown color and contains a single-celled zygote.
In foals, a significant ascarid burden with Parascaris equorum can lead to intestinal impaction and associated colic. Thrombosis of the mesenteric artery occurs with Strongylus vulgaris infestations.
Immune mediated hypersensitivities may occur in adult horses with Parascaris equorum infestations but is unlikely to be a significant cause of the morbidity seen in foals. Larval migration can occur with Parascaris equorum but typically will affect the lungs or liver and this stage of the parasite does not lead to colic. Enteroliths are not caused by gastrointestinal parasitism.
A foal presents for colic caused by the organism shown in the image below (microscopic image from 40X, organism is approximately 100 um). By which of these mechanisms is colic occurring?
- Immune mediated hypersensitivity
- Enterolith formation
- Intestinal impaction
- Larval migration
- Thrombosis of the mesenteric artery
Answer: Intestinal impaction
Explanation
This is an image of a Parascaris equorum egg. It is almost spherical in shape with a brown color and contains a single-celled zygote.
In foals, a significant ascarid burden with Parascaris equorum can lead to intestinal impaction and associated colic. Thrombosis of the mesenteric artery occurs with Strongylus vulgaris infestations.
Immune mediated hypersensitivities may occur in adult horses with Parascaris equorum infestations but is unlikely to be a significant cause of the morbidity seen in foals. Larval migration can occur with Parascaris equorum but typically will affect the lungs or liver and this stage of the parasite does not lead to colic. Enteroliths are not caused by gastrointestinal parasitism.
The goose shown in the image below was found weak on the shore of a local pond where oil had been dumped. The goose was covered in oil, dehydrated and weak but responsive. Which of the following is an important acute clinical effect of oil on affected birds?
- Disruption of function of the plumage
- Lead toxicity
- Nephrotoxicity
- Contact dermatitis
- Hepatotoxicity
Answer: Disruption of function of the plumage
Explanation
Feathers serve a critical waterproofing and insulatory function which is disrupted by oil and can rapidly result in hypothermia. Other concerns for oiled birds include Gl irritation from ingestion of oil during preening, hemolytic anemia, and pneumonia due to inhalation of oil.
Treatments include heat, supportive care, and activated charcoal. Once stabilized, frequent high pressure, warm, mild detergent baths and clean warm water rinses until water beads freely off of the feathers is important. Birds should be placed in warm air flow until dry and they should be maintained on self-skimming ponds for several days after washing to ensure full waterproofing.
A rancher has just found a big 2 month-old calf dead in the field and asks you to perform a post-mortem to determine the cause of death. He is worried about a contagious disease in his herd. You find the lungs are edematous and there is mild bronchopneumonia, but this lesion (see image) is found in the heart. Which diagnosis best fits?
- Tetralogy of Fallot
- Bacterial endocarditis
- Ventricular septal defect
- Pulmonary stenosis
- Patent ductus arteriosus
Answer: Ventricular septal defect
Explanation
Congenital ventricular septal defect is one of the most commonly encountered congenital cardiac defects in cattle. It may be a relatively benign of cause death, depending on size. If the rancher sees several calves with this defect, he should discontinue using the bull responsible.
Which of the following is a causative agent of infectious bovine keratoconjunctivitis as shown in this image?
- Thelazia
- E. coli
- Histophilus somni
- Moraxella bovis
Answer: Moraxella bovis
Explanation
The correct answer is Moraxella bovis. Thelazia is the eye worm. Histophilus somni is a cause of many syndromes, but is rarely found in the eye. E. coli is not an ocular pathogen.
***PowerPage: Infectious Bovine Keratoconjunctivitis (Pinkeye)
A 6-year old male neutered domestic short hair cat presents with the chin lesion shown in the photo (see image). The lesion is unilateral and nodular with ulceration. What is the most accurate description of this lesion?
- Miliary dermatitis
- Eosinophilic plaque
- Collagenolytic granuloma
- Eosinophilic ulcer
Answer: Collagenolytic granuloma
Explanation
The image and description are most consistent with a collagenolytic granuloma. Feline eosinophilic granuloma complex consists of 3 separate clinical syndromes:
1) The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the nose, chin (as in this case), oral cavity, or caudal thighs. The lesions are typically raised and ulcerative or nodular as seen here.
2) The eosinophilic plaque occurs most frequently on the abdomen and medial thighs but can appear other places. They appear as single or multiple, raised, red, often ulcerated lesions of varying size (0.5-7 cm). They frequently have a cobblestone appearance and unlike eosinophilic ulcers, these are often pruritic. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy.
3) The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the upper lip and may be unilateral or bilateral. They often have a characteristic central area of yellow to pink tissue with a slightly raised circumferential edge
The underlying cause of eosinophilic ulcers and collagenolytic granulomas are unknown, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested.
Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems. Some cases respond to antibiotic therapy but most require glucocorticoid therapy.
A 3-month old dog presents for acute lameness, and you diagnose a fracture based on the radiograph below. You contact a surgeon to repair the fracture and explain to him that the dog has what type of fracture?
- Type Ill Salter-Harris fracture of the distal femur
- Long oblique femoral fracture
- Type V Salter-Harris fracture of the distal femur
- Type I Salter-Haris fracture of the distal femur l
- Type IV Salter-Harris fracture of the distal femur
Answer: Type I Salter-Haris fracture of the distal femur l
Explanation
Physeal fractures are commonly described in Salter-Harris nomenclature. In this system, a type I is a fracture through the physis, a type Il is fracture partway through the physis extending up into the metaphysis, a type Ill is a fracture partway through the physis extending down into the epiphysis, a type IV is a fracture through the metaphysis, physis, and epiphysis, and a type V is a crush injury to the physis
A 4-year-old spayed female German Shepherd is seen for aggressive chewing and licking at her back legs. After the matted coat is shaved and removed you see the lesions affecting her skin, most severe on her left leg (see image). You diagnose a deep pyoderma. She is started on a limited ingredient diet, chlorhexidine shampoo, and you need to send oral antibiotics. Which of the following treatments would be appropriate?
- Amoxicillin for 4 weeks
- Trimethoprim-sulfa for 8 weeks
- Clindamycin for 4 weeks
- Cephalexin for 8 weeks
Answer: Cephalexin for 8 weeks
Explanation
Deep pyodermas involve tissues deeper than the epidermis, including the dermis and even subcutis. The skin may heal on the surface before the deeper infection is resolved; making clinical cure difficult to assess. In general, deep infections can require 6-8 weeks of antibiotic treatment (and even 12 weeks for severe cases) for resolution.
Deep pyoderma can be secondary to allergies, skin fold anomalies, endocrine disorders, immune mediated skin diseases, bacterial and/or fungal skin infections, or migrating foreign bodies. Determining the underlying etiology will help with resolution and minimize chances of treatment failure and re-occurrence.
Diagnostics should include skin scraping and impressions, culturing for bacteria and fungi, biopsy, and blood work. Treatments typically include antimicrobials that have demonstrated effectiveness, antifungals if needed, and frequent topical treatments with chlorhexidine shampoo and removal of the dead tissue and debris.
Incidentally, the German Shepherds are predisposed to severe deep pyodermas that can be difficult to treat.
Discussing this with your client will help give them realistic expectations for treatment. German Shepherds are at a higher risk of developing dry eye from Trimethoprim-sulfa; therefore, it is not recommended for this condition due to the length of time required to treat a deep pyoderma.
This 3-year old female Budgerigar presents on emergency for a 3-day history of being fluffed at the bottom of the cage with a decreased appetite. The owners noticed red tissue protruding from the vent today. Her diet is seed only with a cuttle bone, and she is housed with a male. She has no previous medical history, but did lay a clutch of eggs last year. They appeared normal to the owner. What is a common predisposing factor for this condition in seed-eating birds?
- Calcium excess
- Vitamin A deficiency
- Hypercholesterolemia
- Calcium deficiency
Answer: Calcium deficiency
Explanation
With seeds as a primary diet, many reproductively active females do not maintain adequate calcium levels to be able to lay eggs normally. This leads to weakened contractions of the reproductive tract and an inability to pass eggs through the oviduct. Initial therapy should consist of fluid support and calcium prior to attempt to reduce the prolapse.
While vitamin A deficiency is often present in seed-eating birds, the clinical syndromes associated with this are more commonly squamous metaplasia affecting the oral mucosa, respiratory and renal systems.
Hypercholesterolemia is often associated with seed-diets, but does not generally result in egg-binding or prolapse, as reproductively active birds will normally have elevated levels of cholesterol for egg production.
Excessive amounts of oral calcium are generally not absorbed by the gastrointestinal tract and are excreted, making it difficult to over-supplement with oral calcium.
