BCSE FC’s Flashcards
A three-year-old Thoroughbred mare is presented with brown urine, sweating, muscle fasciculations, and stiffness following a strenuous training after a long weekend without exercise.
A serum increase in which would be most supportive of the presumptive diagnosis?
Alkaline phosphatase
Creatine kinase
Sodium and potassium
PCV and TS
Glucose and lactate
Answer: Creatine kinase
Increased serum creatine kinase (CK) and aspartate aminotransferase (AST) are indicative of exertional rhabdomyolysis (a.k.a. “tying up”). These enzymes are released from damaged muscle undergoing myonecrosis.
CK is the most specific for muscle damage. It has a very short half-life and increases within 4 hours of muscle damage, returning to normal in 1-2 days after transient injury.
AST is also found in liver and erythrocytes, so is less specific for muscle (need to look at the rest of the serum biochemistry). It has a longer half-life, takes longer to increase, and takes up to 2 weeks to come back to normal after even transient muscle injury.
Equine myopathies are divided into exertional vs. nonexertional, and sporadic vs. chronic. Exertional sporadic can be due to overexertion/undertraining or dietary/electrolyte imbalance.
DDx for exertional chronic myopathy include:
- Recurrent exertional rhabdomyolysis (Thoroughbreds, Standardbreds, Arabians)
- Polysaccharide storage myopathy type 1 (Quarterhorse-type breeds)
- Polysaccharide storage myopathy type 2 (Warmbloods, drafts,
Arabians, Thoroughbreds)
- Myofibrillar myopathy (Arabians, Warmbloods)
- Malignant hyperthermia (Quarterhorses)
Nonexertional causes of myopathy are myriad, including infectious, inflammatory, toxins/plants, nutritional, and hereditary.
Following intubation, at what pressure should you leak test the endotracheal tube?
95 mm Hg
20 cm H2O
2200 psi
There should be no leak around the tube
Answer: 20 H2O
Following intubation during induction of general anesthesia, leak test the endotracheal tube at 20 cm H2O. This ensures that the cuff is inflated to the appropriate pressure without causing airway damage. Remember that muscles continue to relax with a deeper anesthetic plane and the cuff should be retested at that time.
If the cuff is over-inflated, pressure necrosis or tearing of the trachea can occur. If the cuff is under-inflated, personnel are exposed to waste anesthetic gases, and it may be more difficult to keep the patient anesthetized.
Here is useful information from the American Animal Hospital Association (AAHA) on equipment preparation prior to anesthesia.
What is the main clinical problem caused by neosporosis in cattle?
Abortion
Allergic pneumonitis
Diarrhea
Umbilical infection and joint ill
Proliferative ileitis
Answer: Abortion
In cattle, Neospora caninum is emerging as an important cause of bovine protozoal abortion.
Chemotherapy is effective against some tumors because it targets rapidly dividing cells. Side effects occur because these drugs also attack normal tissues with a high rate of cell turnover.
Which of the following tissues contain rapidly dividing cells under normal circumstances?
Kidney; spleen
Adrenal glands; peripheral nervous system
Bone marrow; gastrointestinal tract
Liver; lungs
Heart; cerebral cortex
The bone marrow, gastrointestinal (Gl) tract, and hair are most susceptible to the effects of chemotherapy due to their high rate of cell turnover. Related side effects include myelosuppression, Gl signs (e.g., nausea, vomiting, diarrhea, anorexia), and poor hair regrowth, respectively.
Chemotherapy is useful in the treatment of systemic (body-wide) cancers such as lymphoma and is also used as an adjunct to surgery/radiation therapy to reduce the risk of metastasis.
Combination (or multi-agent) chemotherapy is advantageous because different drugs kill neoplastic cells by different mechanisms. This reduces the risk of cancer cells becoming resistant to treatment compared to monotherapy (e.g., doxorubicin single agent).
The goal of chemotherapy is to maintain a good-to-excellent quality of life. To achieve this goal consider dosage adjustments, alternate protocols or treatment cessation as needed.
How long is the average gestation period of sheep and goats?
6 months
7 months
4 months
5 months
3 months
Answer: 5 months
6 months
7 months
4 months
5 months
3 months
A five-month-old male intact Pomeranian is presented with a two-week history of tetraparesis and pain. The dog screams when he is picked up and he will not turn his head.
Plain lateral cervical radiographs show occipitoatlantoaxial malformation and agenesis of the dens. The hypoplastic dens has a rounded appearance and C2 is displaced dorsal and caudal to C1.
What is the diagnosis?
Atlantoaxial subluxation
Discospondylitis
Type Il intervertebral disc disease
Cervical spondylomyelopathy
Vertebral fracture
Answer: Atlantoaxial subluxation
This is atlantoaxial (AA) instability/subluxation, a common cause of cervical pain and neurologic deficits in young toy/miniature breed dogs (can see radiographs in the link).
Full radiograph interpretation would show: The cranial aspect of the axis (C2) is displaced dorsally relative to the atlas (C1). There is widening of the space between the dorsal aspect of C1 and C2.
There are open growth plates in this young dog.
Use heavy sedation/anesthesia for correct radiographic positioning. Handle with extreme caution and avoid cervical ventroflexion in anesthetized patients to avoid worsening neurologic deficits due to spinal cord compression.
Tx: Refer dogs over eight months of age with neurologic deficits and/or intractable cervical pain for surgical stabilization. In acute cases Tx by stabilizing the AA joint with a light cervical bandage, strict cage rest, and use analgesics as indicated. Px is good following surgical stabilization.
Can also see a form of occipitoatlantoaxial malformation (OAAM) in Arabian foals and miniature horses.
Which one of the following statements about tail docking in cattle is correct?
Should be performed in all cattle before weaning age
Associated with higher risk of mastitis
Increases the risk of zoonotically transmitted leptospirosis in milk parlor workers
Opposed by North American veterinary medical associations
Significantly reduces stress and pain in cattle
Answer: Opposed by North American Veterinary Medical Associations
Both the American Veterinary Medical Association (AVMA) and the Canadian Veterinary Medical Association (CVMA) oppose routine tail docking in cattle. There is no scientifically based advantage for the cows and it increases fly-associated stress (from face flies, horn flies, etc.).
Tail docking has been touted to decrease the risk of leptospirosis in milkers by preventing a urine-soaked tail from contacting a milker’s skin or face. This has NOT been proven.
For more information, check out the AVMA Welfare Implications of Tail Docking in Cattle.
Consumption of legumes and lush cereal grasses can predispose cattle to which one of these problems?
Rumenal hyperkeratosis
Vagal indigestion
Hypocalcemic paresis
Frothy bloat
Jejunal hemorrhage syndrome
Answer: Frothy bloat
Frothy bloat occurs when normal ruminal gasses produced during fermentation of feed are trapped in a stable foam. The foam is a by-product of digestion of lush legumes and certain cereal grains mixing with ruminal contents.
The foam prevents elimination of gasses from the rumen, so they accumulate and cause ruminal tympany. The resultant increased intraruminal pressure further decreases normal eructation.
Frothy bloat can lead to death by asphyxiation as the bloated rumen prevents normal contraction of the diaphragm during respiration.
Can differentiate from free gas bloat because passage of an ororuminal tube alone does not deflate the rumen.
Tx: administer an ororuminal antifoaming agent to break up the stable foam. Mineral oil, vegetable oil, or commercial products are all effective. Emergency rumentomy with a trocar is not effective in treating frothy bloat because it does not break down/eliminate the foam.
An 11-month-old Quarter horse filly is presented with a recent history of mild colic, moderate diarrhea, and weight loss coinciding with warmer spring weather.
Physical exam reveals a small amount of ventral abdominal and distal limb edema and mild depression. There is fecal staining on her hind legs and perianal irritation.
Bright red worms are visible in the feces (see image below).
Click on the labwork icon to review the hematology and chemistry results.
What is the top differential diagnosis?
Strongylus vulgaris, Strongylus edentatus
Strongyloides westerii
Spirocerca spp
Cyathostomiasis
Roundworms
Answer: Cyathostomiasis
This yearling has cyathostomiasis. Cyathostomes are small strongyles. Small strongyle eggs are often NOT found on fecal exan in the teces, esp. after dewormin-stage larvae can be easily
Cyathostomes develop in the wall and then lumen of the intestine.
Larvae in the wall of the intestine may undergo hypobiosis (arrested development) and can remain dormant for long periods.
Click here to see encysted hypobiotic cyathostome larvae in the colon of a horse.
Cyathostomes in the lumen of the intestine are easily killed by anthelmintics (avermectins), but hypobiotic larvae in the intestinal wall are much more difficult to eliminate. Moxidectin and double-dose fenbendazole are reportedly (variably) effective against these encysted larvae. A few small strongyles do not cause problems.
Heavy infestations of hypobiotic larvae may cause problems when the encysted larvae leave the gut wall en-masse in late winter and spring (or following appropriate deworming), causing sudden weight loss, colic, and diarrhea, esp. in younger (1-4 years of age) horses.
What organism causes “rabbit syphilis”?
Cheyletiella yasguri
Pasteurella multocida
Francisella tularensis
Treponema paraluis-cuniculi
Encephalitozoon spp
Answer: Cheyletiella yasguri
Treponema paraluis-cuniculi causes rabbit syphilis (treponematosis, vent disease, “rabbit syphilis”).
Think of dry crusty exudates around perineum, vulva, nostrils, eyes. In spite of the name, this is NOT a zoonotic disease.
What does the appearance of toxic neutrophils on a blood
smear indicate?
The animal ingested a toxin
Bacterial toxins are harming the neutrophils
Allergic response
Inflammation is present
The neutrophils are old
Toxic neutrophils indicate inflammation.
Toxic changes are signs of immature neutrophils (NOT due to bacterial or infectious toxins’ effects on the neutrophils).
Inflammatory response leads to accelerated maturation and release of neutrophils from the bone marrow.
The presence of immature neutrophils in peripheral circulation is called a “left shift.”
Toxic change is characterized by: toxic granulation, Dohle bodies, nuclear immature, and cytoplasmic vacuolation and basophilia.
Click here to see an image of a toxic neutrophil.
Hypersegmented nuclei are not seen in toxic neutrophils. As neutrophils age, the nuclei become more segmented, so hypersegmentation is a sign of older cells in circulation.
A surgical needle with a taper point is most useful for suturing •
which tissue?
Fascia
Tendon
Skin
Liver
Periosteum
Answer: Fascia
Taper needles have a pointed end and are typically used for subcutaneous tissues, intestines, and fascia. They avoid cutting surrounding tissues as they pierce.
Cutting needles are used for tough tissues such as skin. A blunt point needle is used on friable tissues such as kidney and liver.
Click here to see a pictorial review of needle point types.
For a good review of surgical basics, instruments, draping and approaches see the University of Saskatchewanâs Basic Surgical Skills course.
What syndrome is characterized by concurrent thrombosis and
spontaneous bleeding?
Systemic inflammatory response syndrome
Disseminated intravascular coagulation
Sepsis
Cardiogenic shock
Multiple organ dysfunction syndrome
Answer: Disaminated intravascular coagulation
Disseminated intravascular coagulation (DIC) is characterized by concurrent thrombosis and spontaneous bleeding. It is a serious— often fatal-complication of septic shock.
Multiple organ dysfunction syndrome (MODS) is characterized by organ damage secondary to microvascular clotting and DIC.
Systemic inflammatory response syndrome (SIRS) is a complicated phenomenon of widespread inflammation secondary to sepsis.
Which one of the following is a recognized cause of bovine respiratory disease complex that can be found in the tonsillar
crypts of healthy cattle?
Mannheimia haemolytica
Clostridium perfringens
Moraxella bovis
Streptococcus bovis
Salmonella dublin
Answer: Mannheimia hemolytica
Mannhemia haemolytica is a normal inhabitat of the tonsillar crypts and is the most frequently isolated bacterium from the lungs of cattle with bovine respiratory disease (BRD) complex.
Stress or viral infection suppresses the hostâs immune system and allows bacterial colonization of the lungs.
Other common bacteria associated with BRD include Pasteurella multocida and Histophilus somni.
Trueperella pyogenes is frequently isolated from pulmonary abscesses.
Overgrowth of Streptococcus bovis in the gastrointestinal tract of cattle is associated with ruminal acidosis.
Salmonella spp generally cause enteric disease in cattle.
Clostridium perfringens causes enterotoxemia in many species.
Moraxella bovis is the cause of infectious bovine keratoconjunctivitis.
A 12-year-old female cat is presented for a firm, ulcerated, 2x2 cm mass in the right middle mammary gland. Thoracic radiographs do not show evidence of metastasis and minimum database of bloodwork is within normal limits. The plan is to perform an unilateral mastectomy. Ligate which arteries during this procedure?
Mesenteric and long internal pudendal
Medial circumflex and external obturator
Internal iliac and right gastroepiploic
Ventral perineal and cranial pancraticoduodenal
Cranial and caudal superficial epigastric
Ligate the cranial and caudal superficial epigastric arteries, the primary blood supply to the mammary glands, during a unilateral mastectomy.
For the caudal chain of glands, ligate the caudal superficial epigastric arteries emerging from the external pudendal artery near the inguinal canal. For the cranial chain, ligate the cranial superficial epigastric artery, arising from the internal pudendal artery. The lateral thoracic artery from the axillary artery also supplies the cranial-most mammary gland.
Cats usually have four pairs of glands while dogs have five.
Mammary gland neoplasia is most common in older intact females; more common in dogs than in cats, but 90% of feline tumors are malignant vs. 45% in dogs.
What is the holding layer when closing the abdomen in dogs
and cats after surgery?
Parietal peritoneum
Transversus abdominis
External rectus sheath
Rectus abdominus
Internal abdominal oblique
Answer: External rectus sheath
The holding layer is the external rectus sheath because it contains connective tissue.
The rectus sheath is composed of the aponeuroses of the three flat abdominal muscles (the external and internal abdominal oblique muscles and the transversus abdominis muscle) as they pass by the rectus abdominus muscle.
The linea alba is the cord formed where the aponeuroses from each side join on the ventral midline. It extends from the pelvis symphysis to the xiphoid cartilage.
Which choice best describes the process of repairing a dirty and traumatized wound by second intention?
Insert a drain and bind the wound closed with bandages
Allow wound to epithelialize and contract to closure
Delayed primary closure
Application of a tissue graft
Suture the wound closed
Answer: Allow wound to epithelialize and contract to closure
Second intention healing is used for dirty, traumatized wounds, where the injury is cleaned and allowed to contract and epithelialize on its own until closed.
This kind of wound closure has risks because new epithelium is easily damaged, and contracted skin can sometimes impede normal movement.
Because of this, many wounds like this are left open to contract and granulate in (3-5 days) and then closed surgically (delayed closure, also called third intention healing).
First intention healing (also called appositional healing or primary. wound closure) means you suture up a fresh, clean wound within
6-8 hours of injury.
Which one of the following patients would most likely benefit from staphylectomy?
Queen with follicular cysts
Sheep with laryngeal chondropathy
Horse with a thrombosed and infected section of the jugular vein
Dog with brachycephalic syndrome
Pygmy goat with a small urolith lodged in the distal urethra
Answer: Dog with brachycephaloc syndrome
A dog with clinical signs due to brachycephalic syndrome would most likely benefit from staphylectomy, or resection of an elongated soft palate.
Short-nosed dogs like bulldogs, Boston terriers, pugs, and boxers are predisposed to brachycephalic syndrome with clinical signs of stertor, exercise intolerance, gagging, coughing, and even cyanosis and collapse.
Anatomic and functional abnormalities present in these dogs include stenotic nares, elongated soft palate, hypoplastic trachea, everted laryngeal saccules, laryngeal collapse, and paralysis of the laryngeal cartilages.
Surgical interventions that can benefit dogs with clinical signs include staphylectomy, removal of everted laryngeal saccules, and correction of stenotic nares.
Permanent tracheostomy may be required in severe cases. Most dogs have concurrent gastrointestinal disease (reflux, esophagitis, hiatal hernias) that must also be addressed. Weight loss is also helpful.
This protuberance is sometimes called a “hunter’s bump.”
What is it, anatomically?
Ischiatic tuberosity
Greater trochanter
Anticlinal vertebrae
Tuber sacrale
Scapular spine
Answer: Tuber sacrale
Hunter’s bumps are prominences of the tuber sacrale that can result from luxation, subluxation, or ligamentous injury of the sacroiliac joint.
Horses with hunter’s bumps can be sound if the injury has completely healed, but lameness can be observed if the injury is recent or has never resolved.
Image courtesy of courtesy of bjornmeansbear.
A dog is presented with numerous small pinpoint hemorrhages on the mucous membranes of the mouth.
What are these hemorrhages called?
Petechiae
Hematomas
Ecchymoses
Epiphora
Suppuration
Answer: Petechiae
Petechiae are small, pinpoint hemorrhages on the skin or mucous membranes. Look for on the gums and ventral abdomen where the hair is thinner and skin changes are more easily seen. Larger hemorrhages (1-2 cm dial.) are called ecchymosis.
Look for petechiation and ecchymosis in patients with a severely decreased platelet count.
Here are some images of a dog with petechiae, a dog with ecchymosis on the gums, and a dog with ecchymosis on the abdomen.
Fluoroscopy is useful to help diagnose which one the following conditions?
Renal dysplasia
Lung lobe torsion
Pericardial effusion
Tracheal collapse
Bile duct obstruction
Answer: Trachea collapse
Fluoroscopy is commonly used to diagnose tracheal collapse.
Fluoroscopy provides a continuous radiographic image, allowing visualization of the changing tracheal diameter during inspiration and expiration.
Click here to see a video of fluoroscopy_performed on a dog with tracheal collapse.
Fluoroscopy is an excellent tool for assessing dynamic processes and moving structures.
Other indications for fluoroscopy include assessment of esophageal motility, myelography, cardiovascular studies, fracture reductions and catheter/stent placement.
Because a continuous x-ray beam is used, radiation exposure is a concern.
Radiographers must follow safety procedures and wear a dosimeter during procedures.
A 12-year-old female spayed domestic shorthair cat is presented with a progressive preference for wet food and drooling.
The cat is sedated and a thorough oral examination and is shown in the image seen below. Note that the cat is lying on its back and the labeled teeth are maxillary.
What problem is indicated by the arrow?
Severe bacterial periodontitis
Enamel hypoplasia and hypomineralization
Unable to determine from this history and image
Tooth resorption
Ameloblastoma
Answer: Tooth resorption
This clinical history and image are consistent with tooth resorption, also known as feline odontoclastic resorptive lesions.
In this image, there is a resorptive lesion on upper premolar 2, indicated by the arrow. With progression, resorption progresses into dentin and extends to the tooth crown where it undermines enamel and ultimately a fracture can occur. Incidentally, there are also fractures of upper premolar 1 and the canine tooth, and plaque on upper premolar 3.
Click here to see an image of very severe tooth resorption.
Tooth resorption is common in cats over four years old, especially those with periodontal disease and excessive tartar. The cause is unknown. Premolars and molars are most commonly affected. Clinical signs vary from none to those seen in this cat, and can also include tooth chattering.
Dx: Full examination under anesthesia. Full mouth dental radiographs are needed - lesions are often quite advanced before becoming clinically apparent.
Tx: Surgical extraction of all affected teeth and root remnants of fractured teeth. The disease is progressive.
Image courtesy of Uwe Gille.
A one-month-old puppy is presented with pale mucous membranes and bloody diarrhea. The puppy is underweight and has a mildly distended abdomen.
Hookworms are suspected. Make what recommendations to the owner?
Infection can only be definitively diagnosed post-mortem
No treatment necessary; condition is self-limiting
Hookworm infection is reportable and dog must be quarantined
Zoonotic; treat with fenbendazole
Owner and entire family should be treated with pyrantel
Answer: Zoonotic, treat with Fenbendazole
Ancylostoma caninum (hookworm) is zoonotic and should be treated with fenbendazole, moxidectin, or pyrantel.
A. caninum is the cause of cutaneous larva migrans in people, so zoonotic potential must be discussed with owners. Hookworm larva can penetrate human skin, then migrate and cause raised, erythematous, pruritic tracts in the skin.
A. caninum can be transmitted in the milk or by fecal-oral route to puppies. Prevent by making sure the bitch is free from hookworms and deworming puppies at 2, 4, 6, and 8 weeks of age.
Hookworm eggs can easily be seen on fecal flotation. Young puppies may have clinical signs prior to patent infections and therefore have negative fecal flotations.
It is not legal nor appropriate to diagnose or recommend therapies for humans. Veterinary clinics should inform clients about zoonotic potential and refer them to their physicians.
What weight measurement is the best one to use to calculate anesthetic drug dosages on an obese patient?
Lean body mass
Ideal weight for breed, sex
Current reading from scale
Estimated weight at 1 year of age
10% below present weight
Answer: Lean body mass
Drug calculations are based on estimated lean body weight for obese animals. Body fat does not contribute to drug volume distribution.
There is an estimated 10-15% increase in fat weight for each increase in body_condition score (BCS). For an animal scored at 9/9, where normal is 5/9, this means an estimated
20-30% increase in body weight.
Body Condition Score (BCS) is a 9-point scale:
Under Ideal BCS
1 - No discernible body fat; obvious loss of muscle mass
2 - No palpable fat; minimal loss of muscle mass
3 - Tops of lumbar vertebrae visible; obvious waist and abdominal tuck
Ideal BCS
4 - Ribs easily palpable, minimal fat covering; abdominal tuck evident
5 - Ribs palpable without excess fat covering; abdominal tuck when viewed from side
Over Ideal BCS
6 - Ribs palpable with slight excess fat covering; abdominal tuck apparent
7 - Ribs palpable with difficulty; waist absent, abdominal tuck may be present
8 - Ribs not palpable under heavy fat cover; no abdominal tuck, obvious abdominal distension may be present
9 - Massive fat deposits over the thorax, spine and base of tail; obvious abdominal distension.
Which choice correctly lists the order in which gases pass through a typical circular (closed) anesthetic circuit?
Reducing valve, flowmeter, vaporizer, patient, COz canister
Vaporizer, reducing valve, flowmeter, CO2 canister, patient
Reducing valve, vaporizer, patient, CO2 canister, flowmeter
Flowmeter, reducing valve, vaporizer, patient, COz canister
Answer: Reducing valve, flow meter, vaporizer, patient, CO2 canister
Gases flow through a circular/closed anesthetic circuit in the order: Reducing valve, flowmeter, vaporizer, patient, CO2 canister.
Carrier gas exits the high pressure tank through the pressure reducing valve, which maintains a steady gas pressure regardless of the pressure of the tank.
It then flows through the flowmeter, which controls the amount of carrier gas delivered to the patient, then the vaporizer, where anesthetic vapor is produced from the liquid.
Anesthetic vapor carried by the carrier gas exits the vaporizer and flows into the breathing circuit for inhalation.
Exhaled gases pass through a CO2 absorbent canister and are then rebreathed in a circle system, or are eliminated in a non-rebreathing system.
STRATEGY HINT: This is an ORDER question. If you already know that the CO2 canister is LAST in the order, you can narrow your choices down to two, right away. When you see ordering questions, look for things you are pretty sure must go FIRST or LAST, and then work from those choices to fill in between.
Which choice correctly lists the order in which gases pass through a typical circular (closed) anesthetic circuit?
Reducing valve, flowmeter, vaporizer, patient, COz canister
Vaporizer, reducing valve, flowmeter, CO2 canister, patient
Reducing valve, vaporizer, patient, CO2 canister, flowmeter
Flowmeter, reducing valve, vaporizer, patient, COz canister
Answer: Reducing valve, flow meter, vaporizer, patient, CO2 canister
Gases flow through a circular/closed anesthetic circuit in the order: Reducing valve, flowmeter, vaporizer, patient, CO2 canister.
Carrier gas exits the high pressure tank through the pressure reducing valve, which maintains a steady gas pressure regardless of the pressure of the tank.
It then flows through the flowmeter, which controls the amount of carrier gas delivered to the patient, then the vaporizer, where anesthetic vapor is produced from the liquid.
Anesthetic vapor carried by the carrier gas exits the vaporizer and flows into the breathing circuit for inhalation.
Exhaled gases pass through a CO2 absorbent canister and are then rebreathed in a circle system, or are eliminated in a non-rebreathing system.
STRATEGY HINT: This is an ORDER question. If you already know that the CO2 canister is LAST in the order, you can narrow your choices down to two, right away. When you see ordering questions, look for things you are pretty sure must go FIRST or LAST, and then work from those choices to fill in between.
Which choice is the preferred method to identify the contents of a gas cylinder tank?
Evaluate the size of the tank
Look at the pressure gauge
Use the primary color of the tank
Sniff the yoke where the regulator attaches to the cylinder head
Read the tag or label
Answer: Read the tag or label.
The best way to evaluate the contents of a compressed gas tank is to read the tag or label. Relying on tank color can lead to catastrophic accidents if the contents are different than the tank color.
Most gasses are available in various sizes of tanks and the colors can vary by country and/or may become worn off with repeated refills. It is never a good idea to sniff a compressed gas. The pressure gauge will vary with how full the tank is.
Which decongestant and anti-cough medicine is also used in anesthetic induction protocols in horses?
Phenylpropanolamine
Diphenhydramine
Dextromethorphan
Guaifenesin
Acepromazine
Answer: Guaifenisin
Guaifenesin is an anti-tussive (anti-cough) and decongestant medication that also works as a muscle relaxant.
Guaifenesin is often used to provide a smooth anesthetic induction and maintenance in horses. FYl - in horses, butorphanol (Torbugesic®) is a commonly used opiate with analgesic (anti-pain) and anti-tussive properties.
Diphenhydramine is just another name for the antihistamine decongestant Benadryl®, used to treat anaphylaxis (immediate whole-body allergic reaction) in horses and allergies in many species.
Dextromethorphan is a cough suppressant, but it is not used to induce anesthesia. Acepromazine is a sedative, but not a cough suppressant.
Pheny|propanolamine is a decongestant used to increase urethral tone in cases of urinary incontinence in dogs.
Why might atropine or glycopyrrolate be given as a premedication to dogs and cats before inducing anesthesia with ketamine?
Lowers body temperature
Decreases salivation
Increases airway secretions
Helps keep eyes closed
Slows the heart rate
Answer: Decreases salivation.
Use anti-cholinergics (e.g., atropine, glycopyrrolate) as pre-medicants prior to anesthetic induction with ketamine to decrease salivation and airway secretions, and increase heart rate.
Anti-cholinergics do not affect eye opening but they do cause pupil dilation.
Remember that many anesthetic drugs (e.g., opiates, inhalant anesthetics) promote bradycardia (slowed heart rate) and may also decrease respirations.
What is the U.S. Drug Enforcement Agency controlled schedule for the anesthetic drug alfaxalone?
I
III
V
IV
II
Answer: IV
Alfaxalone is a U.S. Drug Enforcement Agency (DEA) schedule IV controlled substance.
Alfaxalone is a neuroactive steroid used in cats and dogs for the induction and maintenance of general anesthesia. It may be administered IV or IM and, similar to propofol, it does not provide any analgesia.
The DEA schedules drugs into one of five categories based on their accepted medical use and the abuse/dependence potential. Schedule I drugs have a high risk for abuse and are the most restricted. Schedule V drugs have the least potential for abuse.
Which class of medication is most effective for the treatment of acute pain in dogs and cats?
Alpha-2 agonists
Benzodiazepines
Phenothiazines
Opioids
Corticosteroids
Answer: Opioids
Use opioids to treat acute pain in many animals, including dogs and cats.
Mu receptor opioid agonists (morphine, oxymorphone, hydromorphone, etc) are the most potent and effective, especially for short-term therapy. Long-term use is limited by side effects such as sedation, dysphoria, and constipation, along with a lack of oral alternatives.
Kappa receptor agonists, such as butorphanol, have fewer adverse side effects but analgesia is weaker and for a shorter duration.
Alpha-2 agonists are good analgesics, but they cause sedation and have significant adverse cardiovascular effects. Benzodiazepines do not provide analgesia when used alone.
The negative endocrine and immune effects of corticosteroids limit their use for pain. Non-steroidal anti-inflammatories are good for mild/moderate acute/chronic pain with close monitoring of renal and gastrointestinal function.
Which choice is a risk of overinflating the endotracheal tube cuff?
Increased Sp02
Tracheal necrosis
Cyanosis
Difficulty maintaining anesthetic depth
Aspiration pneumonia
Answer: Tracheal necrosis
Overinflation of an endotracheal tube cuff can cause tracheal necrosis due to pressure of the cuff on the mucosal lining of the trachea. Risk increases the longer the tube is in place.
Overinflation also increases incidence of tracheal tear if the tube is manipulated in this state. Respiratory distress would be expected secondary to tracheal necrosis/tearing.
As the airway itself is patent and protected while the tube is in place, blood gas levels and anesthesia delivery should not be affected by cuff overinflation.
Kelli Johnsen CVT, VTS (ECC) provides information on preventing tracheal trauma secondary to endotracheal intubation.
A cardiac arrhythmia is ausculted during a preoperative examination in a three-year-old Thoroughbred gelding.
The heart rate is 32 beats/minute [N=28-42] and the rhythm is regularly irregular. A representative ECG strip is shown below. - Lead I, Base Apex, 25 mm/sec
What rhythm is this?
Idiopathic bradycardia
2nd degree AV block
Atrial fibrillation
Sinus arrest
Answer: 2nd degree AV block
This is 2nd degree atrioventricular (AV)_block.
2nd degree AV block is more common in horses at rest, when the heart rate is low, as it is associated with increased vagal (parasympathetic) tone. When sympathetic tone increases, as with exercise, excitement, pain, etc., the heart rate increases and AV block disappears.
2nd degree AV block can be diagnosed without an ECG. The rhythm is regularly irregular, the pause is equal to 2X the normal interval between contractions, the 4th heart sound (S4) is audible during the pause, and the irregularity disappears when the HR increases.
Click this link to see this ECG with legend.
Check out this Joint ACVIM/ECEIM Consensus Statement on Recommendations for Management of Equine Athletes with Cardiovascular Abnormalities.
Refs: Wilson Clin Vet Advisor: The Horse, pp 55-8, Bassert, Beal and Samples, McCurnin’s Clinical Textbook for Veterinary Technicians, 9th ed. pp. 867-68 and Anesthesia &
Analgesia for Vet Techs, 4th ed. pp. 20-1, 147-9.
A five-year-old male neutered German Shepherd is presented with an acute onset of severe abdominal distension and non-productive retching.
Physical exam reveals pale mucous membranes, tachycardia, weak peripheral pulses, and abdominal tympany.
Abdominal radiographs confirm gastric dilation/volvulus (GDV).
You select a tube for orogastric decompression while the IV catheters are being placed for emergency fluid therapy.
What is the best way to measure to determine the correct length of the orogastric tube to mark it before intubation?
Nares to point of shoulder
Vertical ramus of mandible to the first lumbar vertebra
From the point of the nose to the xiphoid
Length of the dog’s thoracic limb from elbow to metacarpal pad
This is unnecessary, only one length of tube exists
Answer: From the point of the nose to the xiphoid.
The tube for gastric decompression should be the same as the length from the point of the nose to the xiphoid. Measure the tube and mark it with tape. A tube too long can cause damage and too short will be ineffective.
Gastric decompression is typically performed under sedation at the same time as IV fluid resuscitation in dogs with gastric dilation/volvulus (GDV) prior to surgical correction via
midline laparotomy.
After placing a mouth gag, pass the tube through the mouth and into the esophagus. Keep the head slightly ventroflexed to facilitate passage into the esophagus instead of the trachea. Confirm proper passage in the esophagus via at least one of these methods: palpate two firm tubes in the neck, patient is not coughing, see the tube in the neck, have an assistant blow a small amount of air into the tube while ausculting it in the stomach with a stethoscope, or negative pressure when light suction is applied to the end of the tube.
Caution must be used to avoid perforating the esophagus, as it can be difficult to get through the potentially twisted cardiac sphincter into the stomach. If passage of the tube is unsuccessful, it may be necessary to use percutaneous needle gastric decompression.
GDV is an acute enlargement and rotation of the stomach, mostly seen in large- and giant-breed dogs. The enlarged stomach compresses the caudal vena cava, leading to hypovolemia; pushes on the diaphragm, causing respiratory dysfunction; and puts pressure on Gl contents, leading to bacterial translocation and endotoxemia. Even with immediate medical and surgical therapy, the mortality rate is 20â45%.
An unvaccinated three-month-old shelter kitten is presented that tests positive for feline immunodeficiency virus by rapid immunoassay (ELISA).
What is the best next step?
Perform a repeat ELISA test in 3 months
Perform a Southern blot test to confirm diagnosis
Monitor CBC for leukopenia
Rule out co-infection with feline coronavirus
Test for toxoplasmosis
Answer: Perform a repeat ELISA test in 3 months
A positive ELISA for feline immunodeficiency virus (FIV) in a kitten <6 months of age means the cat has antibodies to FIV; repeat an FIV ELISA when the cat is >6 months because maternal antibodies (Ab) have waned by this age.
If the cat is still positive, and not vaccinated, consider a confirmatory test such as a Western blot. An ELISA cannot distinguish between a natural FIV infection, circulating maternal antibody, or vaccination-related antibodies, so false positives may occur.
Unfortunately, there is no commercially available test to distinguish between vaccine-induced and infection-induced Ab. After vaccination, both Western blot and ELISA testing are falsely positive.
https://www.merckvetmanual.com/immune-system/immunologic-diseases/secondary-immunodeficiencies-in-animals#Feline-Immunodeficiency-Virus_v3277196
Feline Immunodeficiency Virus in Animals
Feline immunodeficiency virus (FIV) has been identified in domestic and wild felids. The infection is endemic in cats throughout the world. The virus is shed in the saliva, and biting is the principal mode of transmission. As a result, free-roaming, male, and aged cats are at the greatest risk of infection. A transient fever, lymphadenopathy, and neutropenia follow infection. Most cats initially recover and appear to be clinically normal for many months or years before progressive immunodeficiency leads to secondary infections and deaths.
The virus targets lymphocytes, leading to a gradual loss of CD4+ helper T cells, which results in a loss of cell-mediatec immunity. Cats with acquired immunodeficiency induced by FIV then develop chronic secondary and opportunistic infections of the respiratory, Gl (including mouth), and urinary tracts, as well as the skin. FIV-infected cats have a higher than expected incidence of FeLV-negative lymphomas, usually of the B-cell type, and myeloproliferative disorders (neoplasia and dysplasias).
Which statement regarding feline Mycoplasma haemominutum infection is most accurate?
Unlikely to cause anemia
Frequently infects bone marrow
Commonly causes hepatomegaly and pulmonary edema
Associated with abortion and fading kitten syndrome
Eliminated with 14 d oral doxycycline
Answer: Unlikely to cause anemia.
Feline Mycoplasma haemominutum is typically a subclinical infection, and it is unlikely to cause anemia. It is the most common hemotropic mycoplasma identified in cats; diagnose with PCR testing.
Remember, in an anemic cat a positive PCR for M. haemominutum is unlikely to be the cause. Continue assessment for other causes of anemia (e.g., M. haemofelis infection,
retroivral infection, Gl blood loss).
Other mycoplasmas can cause acute disease. M. haemofelis is the most pathogenic of the feline hemotropic mycoplasmas and typically causes a regenerative, hemolytic anemia.
Coinfection with M. haemominutum or M. turicensis is possible. Diagnose these with PCR.
Doxycycline is effective at reducing bacteremia in cats w/ anemia due to mycoplasmal infection; however, no antimicrobial Tx eliminates the infection. Do not use antimicrobials in cats that are PCR positive without clinical signs of anemia.
https://www.merckvetmanual.com/circulatory-system/blood-parasites/hemotropic-mycoplasma-infections-in-animals
Why are laboratories advised not to culture Histoplasmosis capsulatum?
It is expensive and time-consuming
Contamination with bacterial species is common
Inhalation is hazardous to laboratory staff
The test cross-reacts with other fungi such as Blastomyces
PCR is the most sensitive means of attaining a diagnosis
Answer: Inhalation is hazardous to laboratory staff
Do not perform culture of Histoplasma capsulatum because inhaling the fungus is hazardous to the laboratory staff. Mycelial growth of the organism occurs at room temperature,
and any inhaled microconidia are infectious.
The fungus produces yeast in body tissues, a form that is not transmissible between animals.
While contamination of culture media with bacteria is of concern, labs have developed a variety of methods to reduce this occurrence. There is no PCR test available.
Definitive diagnosis relies on cytology or histopathology to demonstrate organisms in tissue. Alternatively, you can submit urine, serum, or CSF for antigen testing with a quantitative ELISA.
There is risk of cross-reactivity of the fungal ELISA test with other fungal antigens, most notably Blastomyces.
https://www.merckvetmanual.com/generalized-conditions/fungal-infections/histoplasmosis-in-animals
What is a primary function of the avian heterophil?
Link fibrin to contain infection
Release histiocytic granules
Make immunoglobulins
Produce mucus
Phagocytosis
Answer: Phagocytosis
•The heterophil is the avian version of a neutrophil and one of its primary functions is phagocytosis.
They are the first cell to respond to infectious/inflammatory disease and they are characterized by a multilobed nucleus and intracytoplasmic granules.
Similar to other species, look for increased heterophil counts with infection/inflammation and stress.
Heterophils in Pet Birds - Comprehensive Veterinary Information
Definition:
• Heterophils: Equivalent to mammalian neutrophils, primarily responsible for phagocytosis and bactericidal activity.
Characteristics:
• Structure: Contain lysosomal enzymes, visible granules.
• Function: First responders to infection/inflammation, forming caseous material rather than liquid pus.
Clinical Relevance:
• Heterophilia: Indicates infection or stress response.
• Heteropenia: Often associated with overwhelming infection or viral disease.
Pathophysiology:
• Infectious Response: Heterophils migrate to infection sites, ingest pathogens, and form granulomas with macrophages.
Assessment:
• Blood Smear: Identifies heterophil presence and morphology.
• Complete Blood Count (CBC): Monitors heterophil levels in response to disease.
A dog presents for emergency triage after being hit by a car. Venous blood gas reveals a low PCO2.
Which of the following could explain this value?
High spinal cord injury
Upper airway obstruction
Traumatic brain injury
Pulmonary contusions
Hypoventilation
Answer: Pulmonary contusion
Pulmonary contusions can cause a low venous PCO2 because these hypoxemic patients hyperventilate. Remember, CO2 is more diffusible than 02 so increased ventilation results in decreased PCO2 even if hypoxemia is the trigger.
Other causes of hyperventilation include pain and anxiety. PCO2 also decreases as a compensatory mechanism with primary metabolic acidosis. Respiratory compensation for acute metabolic disturbances can happen within 15 minutes, but metabolic compensation for respiratory disturbances takes 24 hours.
Always look at the pH first to determine if acidemia or alkalemia is present and then assess PCO2 and HCO3 to diagnose a primary respiratory vs. metabolic disturbance.
Here is an excellent summary of acid-base disturbances from the Cornell University eClinPath website.
https://www.merckvetmanual.com/emergency-medicine-and-critical-care/specific-diagnostics-and-therapy/trauma-in-emergency-medicine-in-small-animals?autoredirectid=20423
https://eclinpath.com/chemistry/acid-base/types-of-disturbances/
Pulmonary Contusions in Small Animals - Comprehensive Veterinary Information
Definition:
• Pulmonary Contusions: Bruising of the lung tissue caused by trauma, leading to alveolar hemorrhage and edema.
Pathophysiology:
• Injury Mechanism: Blunt trauma causes alveolar capillary damage, resulting in bleeding and fluid leakage into the alveoli.
• Physiological Impact: Impairs gas exchange, leading to hypoxemia (low blood oxygen levels) and increased work of breathing.
Clinical Signs:
• Respiratory Distress: Labored breathing, crackles or rales on auscultation.
• Hypoxemia: Low arterial oxygen levels, cyanosis.
• Blood Gases:
• Hypoxemia: PaO2 < 80 mmHg.
• Hypercapnia: Elevated PaCO2 if ventilation is severely compromised.
• Acidosis: Respiratory or mixed acidosis due to impaired gas exchange and tissue hypoxia.
Assessment:
• Diagnostic Imaging: Radiographs may show patchy infiltrates 12-24 hours post-injury.
• Blood Gas Analysis: Identifies hypoxemia, hypercapnia, and acidosis.
Treatment:
• Oxygen Therapy: Supplemental oxygen to maintain adequate oxygenation.
• Mechanical Ventilation: Positive-pressure ventilation for severe cases with significant respiratory compromise.
• Fluid Management: Judicious use to avoid exacerbating pulmonary edema.
A 12-year-old Warmblood mare is presented with a history of aggressive, stallion-like behavior and prolonged estrous cycles. Abdominal palpation per rectum reveals that the left ovary is enlarged and firm.
The right ovary is difficult to definitively identify. The enlarged left ovary is removed via laparoscopy and is shown below.
Which one of the following hormones is frequently elevated in the serum of mares affected by this condition?
Inhibin
Follicle stimulating hormone
Estrogen
Gonadotropin releasing hormone
Progesterone
Answer: Inhibin
This is a granulosa cell tumor (GCT). Serum inhibin levels are increased in ~90% of mares with GCTs and serum testosterone is elevated in 50-60% of affected mares.
Ball et al showed that anti-Müllerian hormone is increased in 98% of affected mares. Progesterone is not typically elevated but is often measured.
Dx: You may see classic behavior changes of aggressive, stallion-like behavior and prolonged estrous cycles or alternatively, anestrus. Look for characteristic findings on ovarian palpation/ultrasound per rectum, and bloodwork as discussed above.
Ultrasound findings should not be confused with anovulatory hemorrhagic follicles. GCT are common slow growing tumors that do not typically spread.
The affected ovary becomes large and firm and typically has a cystic, honey-combed appearance. The inhibin produced by the GCT makes the contralateral ovary small and inactive.
Rx: Surgical removal (via laparoscopy; ventral midline or flank laparotomy; or transvaginally). The remaining ovary will cycle again normally but it may take 6-12 months.
Refs: Brinsko, Blanchard et al., “Manual of Equine Reproduction”, 3rd ed., Ball et al., “Determination of serum anti-Müllerian hormone concentrations for the diagnosis of granulosa-cell tumours in mares,” Equine Vet J. 2013 Mar;45(2):199-203,. Image courtesy of Kalidoskopika.
https://www.merckvetmanual.com/behavior/normal-social-behavior-and-behavioral-problems-of-domestic-animals/behavioral-problems-of-horses
Hemoglobin concentration is roughly what percentage of packed cell volume (PCV) in most domestic animals?
33% of PCV
10% of PCV
50% of PCV
25% of PCV
Answer: 33% PCV
Normal hemoglobin concentration (Hb, g/dl) is about one-third (33%) of the packed cell volume (PCV) in normal dogs, cats, horses, cows, sheep, goats, and pigs.
So, in a cat with a PCV of 30%, the Hb will be roughly 10 g/dl.
And in a dog with a PCV of 45%, the Hb will be roughly 15 g/dl.
Remember, Hb is a protein in erythrocytes that helps to transport oxygen.
Follow this link to see Small and large Animal reference values
One exception to the 33% rule is South American camelids, whose hemoglobin is 40%-45% of the PCV, presumably an adaptation to high altitude, lower oxygen environments.
https://eclinpath.com/hematology/tests/hemoglobin/
What time of year is dermatophytosis in cattle most likely to occur?
Summer
Non-seasonal
Spring
Winter
Autumn
Answer: Winter
Dermatophytosis (ringworm) most likely occurs in cattle that have been stabled for the winter. It is most commonly seen in calves as periocular lesions although it can become generalized.
Trichophyton verrucosum is the most common cause of ringworm in cattle.
The lesions are typically scaling areas of alopecia with gray crust formation and often ring-shaped; non-pruritic.
Tx is not usually required as cattle often spontaneously recover. There are no approved antifungal agents in cattle. Antifungals approved in other animals or humans could be used if a meat and milk withdrawal time can be determined.
Image courtesy, Dr. Lisle George
https://www.merckvetmanual.com/integumentary-system/dermatophytosis/dermatophytosis-in-cattle
A six-year-old female spayed Golden retriever is presented for a two-week history of head shaking. The dog appears otherwise normal.
On examination there is ceruminous debris in both ear canals with mild erythema. The dog is well-behaved but dislikes aural evaluation. The tympanic membrane is intact bilaterally.
An image from an ear cytology from the right ear is shown below. Both ear cytologies are similar.
What is the most appropriate treatment?
Ear cleaning and topical miconazole
Intramuscular methylprednisolone acetate
Weekly amitraz dip
Subcutaneous cefovecin
Oral enrofloxacin
Answer: Ear cleaning and topical miconazole
Treat this case of Malassezia spp. otitits externa with regular ear cleaning and a topical antifungal agent such as ketoconazole.
Perform an otoscopic exam on all patients presenting for ear disease. It is essential to assess the integrity of the tympanic membrane prior to determining the best Tx option.
Malassezia pachydermatis is most commonly implicated. It is a commensal yeast, however, disruption of the normal skin barrier (e.g., due to hypersensitivity, conformation, or endocrine disease) can result in overgrowth.
Malassezia spp. infections are often highly pruritic and head shaking is common in dogs with otitis.
Which choice describes excessive growth of granulation tissue around a healing wound?
Proud flesh
Villonodular synovitis
Hygroma
Suspensory desmitis
Ulceroproliferative faucitis
Answer: Proud flesh
Proud flesh is excessive growth of cauliflower-like granulation tissue around a healing wound. Especially common with lower-leg wounds in horses.
A hygroma is inflammation of an acquired bursa that develops where normally there is no bursa due to trauma to the dorsum of the carpus.
Villonodular synovitis is an inflammation of the synovial membrane of the dorsoproximal aspect of the forelimb fetlock joints.
Ulceroproliferative faucitis is a progressively worsening gingivitis and stomatitis in cats. The glossopalatine arches (fauces) often have severely ulcerated, friable, inflamed, and proliferative lesions. Click here to see a cat with ulceroproliferative faucitis.
CGPT: Chronic Proliferative Synovitis in Horses
CGPT: Oral Inflammatory and Ulcerative Disease in Small Animals
A five-month-old male Saint Bernard dog is presented with lameness of the right forelimb.
If there is a problem visible in this radiograph, what is it?
Osteochondritis dissecans (OCD)
There is no abnormality
Esophageal placement of endotracheal tube
Cervical vertebral dislocation
Salter Il physeal fracture
Answer: Osteochondritis dissecans (OCD)
There is an osteochondritis dissecans (OCD) lesion on the caudal aspect of the humeral head. Think of OCD with shoulder lameness in a young (4 - 10 mo), male (3x more likely than female), fast-growing, large breed dog.
Click here to see the affected area circled on the caudal humeral head.
Although OCD lameness may present on only one side, always perform radiographs of the contralateral limb. Click here to see the normal left shoulder (bottom), same dog,
compared to the right (top).
In dogs, the joints most commonly affected by OCD include:
• Shoulder: caudal humeral head
• Elbow: medial humeral condyle
• Hock (tarsocrural joint): medial or lateral trochlear ridges of talus
• Stifle (knee): lateral or medial femoral condyle
Osteochondrosis is abnormal endochondral ossification that disrupts the normal transition of cartilage to bone. These cartilage cells thicken and weaken with normal joint use, causing damage to the cartilage; including cracks, fissures, and flap formation (then called OCD). Joint incongruity and debris leads to synovitis and ultimately arthritis.
A five-month-old male Saint Bernard dog is presented with lameness of the right forelimb.
If there is a problem visible in this radiograph, what is it?
Osteochondritis dissecans (OCD)
There is no abnormality
Esophageal placement of endotracheal tube
Cervical vertebral dislocation
Salter Il physeal fracture
Answer: Osteochondritis dissecans (OCD)
There is an osteochondritis dissecans (OCD) lesion on the caudal aspect of the humeral head. Think of OCD with shoulder lameness in a young (4 - 10 mo), male (3x more likely than female), fast-growing, large breed dog.
Click here to see the affected area circled on the caudal humeral head.
Although OCD lameness may present on only one side, always perform radiographs of the contralateral limb. Click here to see the normal left shoulder (bottom), same dog,
compared to the right (top).
In dogs, the joints most commonly affected by OCD include:
• Shoulder: caudal humeral head
• Elbow: medial humeral condyle
• Hock (tarsocrural joint): medial or lateral trochlear ridges of talus
• Stifle (knee): lateral or medial femoral condyle
Osteochondrosis is abnormal endochondral ossification that disrupts the normal transition of cartilage to bone. These cartilage cells thicken and weaken with normal joint use, causing damage to the cartilage; including cracks, fissures, and flap formation (then called OCD). Joint incongruity and debris leads to synovitis and ultimately arthritis.
What is the most likely process involving the first digit of this cat’s right front paw?
Nutritional
Immune-mediated
Degenerative
Neoplastic
Traumatic
Answer: Neoplastic
The process is highly likely to be neoplastic. There is severe lysis of all of the bones of the first digit of the right manus, with nearly complete destruction of the metacarpal bone and proximal phalynx.
There is severe regional soft tissue swelling over the medial aspect of the right manus as well. The second metacarpal bone has thinning and irregularity of the cortex.
There is a transverse fracture in the mid diaphysis of the third metacarpal bone, the margins of the fractures are irregular and there is a moderate irregular periosteal proliferation present circumferentially around the fracture.
CGPT: Bone Tumors in Dogs and Cats
What abnormalities are seen in the circled area of the canine lateral thoracic radiograph shown below?
Bronchial pattern, pleural effusion
Miliary pattern, hypoinflation
Nodular pattern, pulmonary bulla
Vascular pattern, pleural fissure lines
Interstitial pattern, air bronchograms
Answer: Interstitial pattern, air bronchograms
The circled area of the canine lateral thoracic radiographs shows a diffuse interstitial lung pattern and air bronchograms.
An interstitial lung_pattern is characterized by decreased visualization of the cardiac and diaphragmatic silhouettes and pulmonary vessels. Pulmonary nodules are also considered an interstitial lung patttern.
Air bronchograms are the hallmark of an alveolar pattern. They occur when tiny alveolar air spaces are infiltrated with inflammatory fluid, hemorrhage, or neoplasia. The soft-tissue opacity of fluid/cells within alveoli highlights the air within larger airways (i.e., bronchi). Click here to see air bronchograms on a DV view of a canine thorax.
Which one of the following is frequently diagnosed concurrently with umbilical hernia in young calves?
Answer: Infection of umbilical structures.
Infection of umbilical structures, called omphalitis, is a common comorbidity with umbilical hernia in calves (and foals).
Umbilical hernias are a common finding in neonatal calves, and they are frequently associated with umbilical abscessation.
Easily reducible umbilical masses are typically uninfected while infected masses may be difficult to reduce and accompanied by other clinical signs such as heat in the area, drainage, fever, inappetance, and ill thrift.
Uncomplicated, easily reducible hernias are more common in Holsteins and may be heritable.
It is possible to have infected umbilical remnants while the exterior umbilical structures appear completely normal. May need to use deep palpation, ultrasound, and/or bloodwork to rule out these more hidden infections.
Surgical repair with resection of infected structures is the treatment of choice for umbilical hernias in calves and foals.
Link: Hernias in Animals
https://www.merckvetmanual.com/digestive-system/congenital-and-inherited-anomalies-involving-the-digestive-system/hernias-in-animals?autoredirectid=20413
Link: Umbilical masses / hernias in calves
[link] https://www.acvs.org/large-animal/umbilical-masses-hernias-in-calves/
Umbilical Masses/Hernias in Calves Comprehensive Overview
Definitions and Etiology
• Umbilical Hernias: Protrusion of abdominal contents through the umbilical ring, the most common congenital defect in calves.
• Etiology: Defects in the closure of the abdominal wall at birth; can be hereditary or due to infection.
Clinical Signs
• Simple Hernias: Reducible bulge at the umbilicus, calves appear normal otherwise.
• Infected Hernias: Fever, inappetence, poor growth rates, frequent urination, urination through the umbilicus.
Diagnostic Methods
• Physical Examination: Palpation to assess reducibility and presence of infection.
• Ultrasonography: Determines infection extent and content of the hernia.
• Laboratory Tests: White blood cell counts, bacterial culture from fluid collections.
Treatment and Mechanism of Action
• Surgical Repair: Preferred treatment, involves removing the hernia sac and any infected tissue.
• Simple Hernias: Repair under sedation or general anesthesia.
• Infected Hernias: Drain abscesses, extensive removal if infection reaches the bladder.
• Post-Surgical Care: Antibiotics, NSAIDs (with caution), gradual reintroduction to feed, confinement to reduce tension on the surgical site.
Prognosis
• Simple Hernias: Generally favorable with proper surgical intervention.
• Complicated/Infected Hernias: Higher risk of complications such as peritonitis, poorer prognosis.
Key Points for Veterinary Professionals
• Comprehensive Diagnosis: Includes physical examination, ultrasonography, and laboratory tests.
• Timely Surgical Intervention: Essential to prevent complications and ensure recovery.
• Post-Operative Care: Critical for successful healing and minimizing recurrence.
A flock of sheep has been grazing on Sorghum halepense (Johnson grass), Tetradymia spp. (horsebrush), and Artemisia nova (black sage).
Many of the exposed animals have edema, especially in their heads. This lamb has edema around the eyes, and the ears are hyperkeratinized.
What is the photosensitizing agent responsible for this condition?
Tetradymia spp.
Phylloerythrin
Artemisia nova
Bile acids
Chlorophyll
Answer: Phylloerythrin.
Phylloerythin is a photosensitizing agent derived from microbial breakdown of chlorophyll in the GI tract.
If the liver is damaged, then phylloerythin builds up in the plasma. This phylloerythin absorbs and releases light energy in the skin, causing SECONDARY photosensitization.
This is the most common type of livestock photosensitization. So, when sheep eat hepatotoxic Tetradymia spp. and Artemisia nova, the compromised liver allows toxic photosensitizing phylloerythrin to build up.
PRIMARY photosensitization occurs in the absence of hepatic disease when a photodynamic agent is ingested/injected/absorbed. Hypericum perforatum (St. John’s wort) is an example of a plant that causes primary photosensitization.
Tetracycline is a medication that can cause primary photosensitization.
Congenital inherited photosensitization is seen in some breeds of cattle and sheep.
[link] (https://www.merckvetmanual.com/integumentary-system/photosensitization/overview-of-photosensitization-in-animals?autoredirectid=23401#Primary-Photosensitization-(Type-I)_v3281714)
Which one of the following canine urine sediment findings is most commonly seen within six hours after ethylene glycol ingestion?
Calcium carbonate crystals (dumbbells or balls with spokes)
Ammonium biurate crystals (yellow-brown thornapples)
Calcium oxalate monohydrate (6-sided prisms/spindles)
Bilirubin crystals (yellow-amber antlers)
Urate crystals (Amorphous)
Answer: Calcium oxalate monohydrate.
Expect to see calcium oxalate monohydrate (6-sided prisms/spindles or “picket fences”) crystals, which can appear as early as three hours post-ingestion in cats and six hours in dogs.
Click here to see an image of “picket fence” calcium oxalate monohydrate crystals (image on right) on Cornell’s eClinPath website.
Bilirubin crystals can actually be seen in normal dogs (though they are NOT normal in other animals).
An unweaned two-month-old calf is presented for necropsy.
The calf collapsed and suddenly died after she escaped and was chased around the back pasture for 45 minutes by her owner.
Among other things, white myocardial and endocardial streaking in the left ventricle of this calf’s heart are evident.
What advice should be given the farmer?
Search the calf barn for sources of lead
Check the mother for bovine leukosis by AGID
Put all the calves on ionophore-containing feed
Start the other calves on ceftiofur (Naxcel®)
Administer vitamin E/selenium to all calves
Answer: Administer Vitamin E / Selenium to all calves.
Treat the other calves with vitamin E/selenium.
Think of white muscle disease when you see sudden death and endocardial plaques in a young calf, lamb, or kid with a history of recent vigorous exercise.
Follow this link to a Merck image of pale ventricular myocardium.
Typically seen in young, fast-growing animals (ie: calves 2 weeks-6 mos).
Clinical signs may include dyspnea (due to myocardial disease), stiff gait, arched back, weakness, recumbent but BAR (bright, alert, responsive).
Sudden death may resemble enterotoxemia, but would usually see acute bloody diarrhea, convulsions, opisthotonos in first days of life with enterotoxemia.
lonophores are cardiotoxic, so they should be removed until a diagnosis is confirmed.
CGPT: Nutritional Myopathies in Ruminants and Pigs - Comprehensive Study Guide
