Canine

Question 1

What is the best treatment for Familial dermatomyositis?

Answer 1

Pentoxifylline

Familial dermatomyositis is an idiopathic inflammatory disease of the skin and muscles of young Collies and Shetland Sheepdogs. The mode of inheritance is reported to be autosomal dominant in Collies, but there is some evidence of a role for an unidentified infectious agent in the pathogenesis. A vasculopathy is associated with the early inflammatory stages of the disease in the skin and muscle; in both tissues, the eventual sequela is atrophy. The onset is typically at <6 mo of age, although onset in adulthood has been recorded. Progression of lesions is variable, and individual pups within a litter may be affected mildly to severely. Skin lesions appear in areas of increased trauma and are seen on the face, ear tips, tail tips, and lateral surfaces of the extremities. Skin lesions, which consist of erosion, crusting, and alopecia, are exacerbated by heat and sun exposure. The muscles affected most severely are on the head and extremities. Diagnosis is established by evaluation of littermates and family history, skin biopsy, electromyography, and muscle biopsy, which must be performed early in the course of the disease. There are reports of disease amelioration with dosages of corticosteroids, vitamin E, and omega-3 fatty acids, but severely affected dogs rarely respond satisfactorily to treatment. Pentoxifylline (10 mg/kg, PO, bid) has been helpful in many dogs.

Question 2

An 8-month male intact English bulldog presents after his owner noted bleeding from the penis. He took a look and describes seeing a small mushroom-like mass at the tip of the penis. The owner states that the dog has always been healthy and that the only thing unusual about the situation is that the dog masturbates on his favorite stuffed animal on a daily basis. On your physical exam, you confirm a urethral prolapse. What is the best treatment option?

Answer 2

Urethral prolapse is a relatively rare condition in dogs; however, it is most often seen in young male English bulldogs. Although the etiology is unknown, it is suspected that sexual excitement, masturbation, genitourinary infection, and calculi may play a role. Additionally, a genetic component is likely present, since English bulldogs are over-represented; therefore, concurrent castration is always recommended and thought to decrease the incidence of recurrence.

There are several treatment options for urethral prolapse, including placing a purse string suture, amputation of the prolapsed region, and urethropexy. The urethropexy technique (Kirsch JAAHA 2002) is (although not proven) thought to be associated with the least likelihood of recurrence. Although an amputation of the penis can be performed, this would be excessive for a urethral prolapse and therefore is not recommended due to to urethrostomy-associated complications. Attempting medical management is likely to result in recurrence, so it is generally not recommended.

Question 3

You are presented with a 2-year old spayed female Chow Chow, who became acutely right hind limb lame after jumping out from the back of the owner’s riding lawn mower. You diagnose a craniodorsal luxation of the right coxofemoral joint. Your plan is to perform a closed reduction and place a bandage. What type of bandage best fits this situation?

Answer 3

Ehmer slings prevent weightbearing. Additionally, they aid in maintaining some degree of abduction and internal rotation of the affected limb. In dogs, they are placed and maintained for 7-10 days. Velpeau slings are placed on the front limb to prevent weight-bearing. They are often placed after medial shoulder instability surgery. Spica splints are large padded bandages placed over the affected limb and torso, often in order to immobilize proximal fractures. Schroeder-Thomas splints represent another type of splint that has been used in the past for fracture immobilization.

Question 4

The majority of Cushing’s disease cases in dogs are from primary dysfunction of which organ or tissue?

Answer 4

Pituitary dependent hyperadrenocorticism (increased secretion of ACTH) is far more common than adrenal tumors causing hyperadrenocorticism.

The other answer choices listed are not implicated in the pathogenesis of Cushing’s disease.

Question 5

A 13-year-old, male neutered Labrador retriever patient presents for a quality of life consult. The owner is concerned that his dog has progressively become more painful in the hips. He was diagnosed with hip dysplasia at a young age and the owner elected to treat him conservatively by providing low impact exercise, maintaining a lean body weight, and administering non-steroidal anti-inflammatories as necessary for pain. There are several nutraceuticals available that have been touted as having some benefit in patients with osteoarthritis. Which of the following will result in an increased production of less inflammatory eicosanoids?

Answer 5

Consuming a high concentration of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) has been shown to result in the preferential use of these compounds to form eicosanoids. Eicosanoids derive from either omega-3 or omega-6 fatty acids. Omega-6 eicosanoids are generally pro-inflammatory, while omega-3 eicosanoids are less inflammatory. Omega-3 fatty acid supplementation results in a decrease in pro-inflammatory omega-6 eicosanoids; providing potential benefit to patients with osteoarthritis.

Carnitine is thought to potentially aid in weight loss as it is involved in fat metabolism, but there are limited studies demonstrating significant clinical benefit to supplementation at this time.

Glucosamine is a precursor of glycosaminoglycans which is a major constituent of the joint and thought to be of great importance for joint health. Chondroitin is also an important constituent of cartilage and helps provide resistance to compressive force. It is commonly administered in conjunction with glucosamine. The amount of clinical benefit of glucosamine and chondroitin supplementation is not currently well established.

Question 6

A 2-year old Terrier mix presents for an alopecic, raised nodule on its head. The owner describes previous similar lesions that have ulcerated and regressed over time. What is your most likely diagnosis?

Answer 6

The correct answer is cutaneous histiocytoma. Cutaneous histiocytomas in dogs occurs early in life at less than 3 years of age. The lesions are alopecic, raised, nodules that often ulcerate and regress on their own. Treatment is not needed unless the lesions persist. Treatment for persistent lesions is surgery. The other tumor types do not regress, although mast cell tumors may grow and shrink over time.

Question 7

A 1-year old bull dog mix presents for physical exam before breeding. Her physical exam is unremarkable with the exception of the abnormality seen in this image (prolapsed gland of the nictitans). What is the best method of treatment, and would you recommend breeding this bitch?

Answer 7

Prolapsed glands of the third eye lid (“cherry eye”) are congenital defects and will likely be passed on to future generations. Repair is straight forward with prolapsed gland replacement and tacking to periorbital rim (Kaswan anchoring technique) or using the Morgan pocket technique. Surgical removal is NOT recommend as you will remove the tear gland and predispose to iatrogenic keratoconjunctivits sicca.

Question 8

A concerned breeder wants to know the most common cause of dystocia in the bitch. What is your answer?

Answer 8

The correct answer is uterine inertia. Studies show that this the most common cause of dystocia followed by malpresentations, fetal oversize, narrow canal, and malformations.

Question 9

What are the three main goals with articular fractures?

Answer 9

1) Rigid fixation of the fracture fragments; neglecting to do this will result in loose fracture fragments within the joints that will promote osteoarthritis.
2) Anatomic realignment (50% or even 75% is not adequate with articular fractures, in contrast to long bone fractures)
3) 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.

Question 10

Name 3 treatments for hyperkalemia.

Answer 10

Insulin and Glucose
Calcium chloride
Calcium gluconate

Question 11

How many permanent teeth do dogs have?

Answer 11

Dogs also have 42 permanent teeth

Question 12

What is the maximum safe rate for potassium?

Answer 12

The maximum safe rate of potassium infusion is 0.5 mEq/kg/hr. As this dog weighs 12 kg, the maximum is 6 mEq/hr. This is one of those rates that you need to know. Administering potassium more rapidly than this can result in fatal arrhythmias.

Question 13

A 6-month old Chocolate Labrador presents for limping and failure to gain weight. He is housed in an outdoor kennel with other hunting dogs. He is fed a large breed dry puppy food. He received his puppy shots at 8, 12, and 16 weeks old. He is quiet, alert, and responsive. His body condition score is 3/9, with rib exposure and poor fat deposition. His mucous membranes are pale pink, with a capillary refill time of 2 seconds. His heart and lungs auscult normally. No abnormalities are felt on abdominal palpation. He is an intact male, and both testicles are descended. The only abnormalities are the pads of his two front feet and left hind foot (see image) that he chews at frequently. What is diagnostic test of choice?

Answer 13

Hookworms (Ancylostoma and Uncinaria) are intestinal parasites that suck blood and can cause anemia, enteritis, coughing during larval migration, and dermatitis. Any young dog that is failing to thrive and/or has pale mucous membranes should be tested for intestinal parasites. Hookworm dermatitis, also called Ancylostomiasis is typically seen in conditions with poor sanitation and/or in kennels.

Hookworms can be transmitted in utero, during nursing, or via 3rd stage larva penetrating the skin. The most commonly affected skin areas are the pads and interdigital spaces of the feet, but can include any surface that contacts the ground. The larva migrate through the dog’s tissues before arriving in the intestines. They cause significant anemia, failure to thrive, or sudden death in young dogs. In mild cases, deworming protocols are often enough; with severe cases blood transfusions and parenteral treatments are often necessary.

Skin scraping and impression smears of the affected skin areas are typically unrewarding for isolating parasites. A PCV/TP would show signs of anemia, but not the underlying etiology. Complete blood cell count and chemistry will often show anemia that is regenerative and an eosinophilia. Radiographs would be unrewarding in this case. A biopsy may show migrating larva if biopsied soon after trauma, however this is not a diagnostic test routinely used.

Question 14

Ohio river valley

Answer 14

Histo

Question 15

Is canine hypothyroidism caused by immune mediated lymphocytic thyroiditis?

Answer 15

YES

Question 16

What is the most commonly recognized cause of pulmonary thromboembolism in small animals?

Answer 16

Although all of these are associated with PTE, dirofilaria or heartworm is the most commonly recognized cause.

Question 17

In what species do glucocorticoids cause increased serum ALP?

Answer 17

The correct answer is dog. Only the dog synthesizes a corticosteroid induced isoenzyme of ALP.

Question 18

What is the causative agent of Rocky Mountain Spotted Fever?

Answer 18

Rickettsia rickettsii.

Question 19

A 10-year old intact Siberian Husky presents with a history of regurgitation and exercise intolerance. On physical examination, you note the patient is thin. Blood work is unremarkable other than a stress leukogram and a slightly decreased albumin. What is the next diagnostic test you wish to recommend?

Answer 19

The correct answer is chest radiographs. Based on the clinical signs of regurgitation and exercise intolerance, you should be considering a thymoma. These tumors arise in the cranial mediastinum and are associated with causing myasthenia gravis and megaesophagus as paraneoplastic syndromes. If a cranial mediastinal mass is present, your top two differentials should be thymoma or lymphoma.

As long as thymomas are well encapsulated, the prognosis is relatively good, and surgery via a median sternotomy should be recommended.

An abdominal ultrasound would be reasonable but not the next best choice as a diagnostic test. There are no examination findings that would indicate the necessity of a brain MRI. A type 2M antibody test is a test to rule out masticatory muscle myositis. A prescapular lymph node aspirate will likely be low-yield given the presentation and the fact that there was no enlargement indicated on physical examination.

Question 20

A 5-week old male German Shepherd Dog presents for regurgitation that started when it was weaned off its mother’s milk. What is a congenital defect that would explain this occurrence?

Answer 20

The correct answer is persistent right aortic arch. This vascular ring anomaly is an inherited defect that causes a constricting obstruction of the esophagus at the level of the heart base. There is a breed predilection for German Shepherd Dogs and Irish Setters. Clinical signs of regurgitation usually manifest as the puppy is weaned off of milk and onto solid foods. PDAs, pulmonic stenosis, and diaphragmatic hernias of the small intestines should not cause regurgitation; however, vomiting may be a clinical sign if there is an obstruction associated with the diaphragmatic hernia of the small intestine.

Question 21

Which of these is considered a hepatic enzyme induced by cholestasis in the dog?

Answer 21

The correct answer is gamma-glutamyl transferase (GGT). The hepatic leakage enzymes are AST and ALT, meaning that damage to hepatocytes causes leakage of these enzymes and subsequent elevations of serum levels. ALP and GGT are hepatic enzymes produced by the bile duct epithelium that have increased synthesis when there is cholestasis. Bilirubin is a product of the liver and is not an enzyme. Creatinine is a product produced by muscle, usually used to evaluate renal function and GFR.

Question 22

Which are the most common serovars now thought to play a role in canine leptospirosis?

Answer 22

The correct answer is grippotyphosa, pomona, and bratislava. Icterhemorrhagiae and canicola were the most common serovars isolated in the past. The leptospires penetrate mucous membranes or abraded skin and multiply in the blood stream and spread to organs. The antibody response usually limits the response to the renal tubular epithelial cells. Clinical signs include anorexia, pyrexia, vomiting, dehydration, PU/PD, anuria or oliguria. The standard diagnostic test is the microscopic agglutination test (MAT); be careful when interpreting titers. Remember, leptospirosis is zoonotic.

Question 23

What are the CHEM parameters for Addison’s?

Answer 23

The classic laboratory finding for an Addisonian includes hyponatremia, hyperkalemia, azotemia, anemia, acidosis, hypoglycemia, and of course a low resting cortisol level or low ACTH stimulation test result.

Question 24

Why are supraventricular tachycardias considered less clinically important than ventricular tachycardias in the dog?

Answer 24

Supraventricular tachycardias may progress to atrial fibrillation and cause progressive left ventricular dysfunction, whereas ventricular tachycardias may lead to ventricular fibrillation and death

Question 25

What is a possible post-operative sequela of surgical excision of an insulinoma in dogs?

Answer 25

Post-operative complications for insulinoma removal may include acute pancreatitis, transient diabetes mellitus, and recurring hypoglycemia (indicative of metastasis). The other options listed are not documented to occur as a result of removing part of the pancreas.

Question 26

In a dog, which of the following is not a cause of bradycardia?

Answer 26

The correct answer is hypotension. With hypotension you will see an increase in heart rate as the body tries to make up for the lack of blood volume and pressure. Hypertension could cause bradycardia. Hypothermia, hyperkalemia, A-V conduction blocks, and high vagal tone will all lead to bradycardia.

Question 27

In chronic renal failure patients, what is the body’s compensatory mechanism to deal with rising phosphorus concentrations?

Answer 27

The correct answer is secondary hyperparathyroidism. In chronic renal failure, phosphorus concentrations increase due to decreased glomerular filtration and decreased activity of the renal tubules. In response, the body upregulates parathyroid hormone which causes a decrease in phosphorus reabsorption in the kidneys, allowing the phosphorus concentrations to return to normal early on in the disease.

Question 28

A male dog is undergoing exploratory surgery for a suspected extrahepatic portosystemic shunt. What are the only veins that should be entering the vena cava between the hepatic veins and renal veins?

Answer 28

The correct answer is the phrenicoabdominal veins. The left circumflex iliac vein and testicular vein are both caudal to the renal veins. The caudal pancreaticoduodenal vein eventually becomes the gastroduodenal vein, which empties into the portal vein. Any vessels other than the phrenicoabdominal veins would be considered anomalous and could be your extrahepatic shunt.

Question 29

Bedlington Terriers are predisposed to developing which of the following?

Answer 29

The correct answer is copper toxicosis. Copper toxicosis occurs as a result of an autosomal recessive gene that is commonly carried by Bedlington Terriers. Those afflicted with the disease accumulate copper in their livers and will show signs of liver insufficiency and failure.

Question 30

A dog presents to your clinic for coughing and fever a week after going hunting. You work the dog up, perform bronchoscopy and remove a plant awn from the lungs. What bacterial infection is this dog predisposed to?

Answer 30

The correct answer is Actinomyces. This is a filamentous, branching, gram positive bacteria that is a normal inhabitant of the mouth and oropharynx. It is commonly associated with grass awn migration. These are usually contaminated in the oropharynx and then migrate through the body from the respiratory or GI tracts. Many times it takes months to years to make a diagnosis. Nocardia is a ubiquitous soil saprophyte found everywhere and is usually introduced via the respiratory tract.

Question 31

What is the most common site of the bone for metastatic bone tumors to occur in dogs?

Answer 31

The correct answer is diaphysis. Metastatic bone tumors usually occur in the diaphysis, most likely because this is where the blood supply comes in. This is in contrast to primary bone tumors which usually occur at the metaphysis, likely because this is where most cell division occurs.

Question 32

A clinician calls you about a heifer he examined and mentions that he heard a murmur over what he thought was the aortic region. Over which intercostal space would an aortic valve murmur be heard best?

Answer 32

The correct answer is the left 4th intercostal space. We at VetPrep always think of our left-handed ex-girlfriend PAM. That stands for Pulmonic, Aortic and Mitral and then you just work your way from the 3rd intercostal space (pulmonic) to the 5th intercostal space (mitral). So the point of maximal intensity for an aortic murmur will be on the 4th intercostal space. Keep in mind that this is all on the left side. On the right side the only valve you can appreciate is the tricuspid valve which is audible best between the 3rd and 4th intercostal space.

Question 33

What is the most common primary intraocular tumor in dogs and cats?

Answer 33

The correct answer is melanoma. Melanoma is the most common primary intraocular tumor, while lymphoma is the most common secondary intraocular tumor. Ciliary body adenomas and hemangiosarcoma are much less common.

Question 34

A 6-month old Cocker Spaniel is presented to you with the owner complaining of a history of regurgitation after eating. She describes that the dog will repeatedly attempt to swallow and bring up food and will sometimes cough or sneeze concurrently. You perform thoracic radiographs which are normal. What is the most likely diagnosis?

Answer 34

The correct answer is cricopharyngeal dysphagia. This is a congenital disorder characterized by in-coordination of the swallowing reflex leading to the signs described. Megaesophagus could also cause regurgitation but should not cause the repeated swallowing and would probably be identifiable on radiographs in most cases. Pancreatitis often causes vomiting in dogs but not usually regurgitation unless there is secondary esophagitis. Ascarid infection also could cause vomiting if sufficiently severe.

Question 35

What are Bernese Mountain Dogs predisposed to?

Answer 35

Bernese Mountain Dogs are commonly affected with hip dysplasia, elbow dysplasia, malignant histiocytosis, osteosarcoma, as well as other neoplasms.

Question 36

What is the most common dermatophyte infecting the dog?

Answer 36

The correct answer is Microsporum canis. Microsporum gypseum is the second most common, and T. mentagrophytes is third most common in dogs.

Question 37

What liver lobes surround the gall bladder in the dog?

Answer 37

The correct answer is quadrate lobe and right medial lobe. This is the type of question that comes directly from an anatomy book.

Question 38

What is the causative agent of bacillary hemoglobinuria, also known as redwater?

Answer 38

The causative agent is Clostridium hemolyticum. Clostridium hemolyticum has recently been renamed to Clostridium novyi Type D. Pasteurella multocida and Mannheimia hemolytica are associated with pneumonia. Anaplasma marginale causes extravascular hemolysis and you don’t get hemoglobinuria. Bacillary hemoglobinuria is an acute and highly fatal disease, with disease occurring within 15 hours of exposure.

Question 39

A 10-year old male Labrador retriever presents to you with complaints of tenesmus and a swelling near his anus (see image). On examination, there is a fluctuant swelling lateral to the anus, and on rectal exam, there is a lateral deviation of the rectum. What is the most likely diagnosis?

Answer 39

The correct answer is perineal hernia. Adult intact male dogs (and cats) are at increased risk of perineal hernias. The deviation of the rectum on rectal palpation is how the diagnosis is usually made. The cause is often not identified, but it frequently occurs as a sequela to chronic tenesmus.

Question 40

What is the most common intranasal tumor in the dog and cat?

Answer 40

The correct answer is Dog: Adenocarcinoma, Cat: Lymphosarcoma. The key word in the question is intranasal. Cats get many squamous cell carcinomas of the nasal planum, especially white cats in the sun, but lymphoma is the most common intranasal tumor of cats.

Question 41

The majority of Cushing’s disease cases in dogs are from primary dysfunction of which organ or tissue?

Answer 41

Pituitary dependent hyperadrenocorticism (increased secretion of ACTH) is far more common than adrenal tumors causing hyperadrenocorticism.

The other answer choices listed are not implicated in the pathogenesis of Cushing’s disease.

Question 42

What is the most appropriate medical treatment for transitional cell carcinoma at the trigone of the bladder, as depicted in the photo?

Answer 42

Transitional cell carcinoma of the bladder in dogs can be palliatively managed with non-steroidal anti-inflammatory drugs such as piroxicam. Progression-free interval and survival can be extended with the addition of chemotherapy. The most commonly used agents are carboplatin, cisplatin, and mitoxantrone. Although cisplatin is effective against TCC, it has increased nephrotoxicity with piroxicam and is less commonly used these days in the author’s experience. Secondary infections can be treated with appropriate antibiotics.

Question 43

What is the ideal incision site for a foreign body gastrotomy?

Answer 43

The correct answer is halfway between the greater and lesser curvature. At this site, you avoid any major bleeding and retain good blood supply from both sides to help with the healing of your incision. Cutting along the greater and lesser curvature is not recommended due to the need to avoid blood vessels. Cutting along the pylorus has a risk of disturbing the sphincter and causing the formation of a pyloric stricture. Additionally, this does not provide a good view inside the stomach.

Question 44

A 9 year-old male neutered American Eskimo presents for progressive hair loss along his sides. The areas of alopecia are smooth with no crusts or scales, and he is not pruritic. You performed an ACTH stimulation test and did an adrenal sex profile, both of which were normal: thyroid tests were also normal. The owners declined a skin biopsy. You suspect Alopecia X in this patient. The owner would like to know if there is an over-the-counter medication that may potentially help with hair regrowth. You suggest that she could try which of the following supplements?

Answer 44

It is unknown what exactly causes Alopecia X, but it has been shown to be genetic. Nordic breeds and Pomeranians are most commonly affected. Alopecia X causes an arrest of the hair cycle. Melatonin may help some pets with this condition.
Husky dogs can get zinc responsive dermatosis, which would be treated with zinc. Milk thistle is used as a supplement for dogs with liver disease. Hypovitaminosis A is more common in birds fed a seed-only diet and can cause lesions in the eyes and mouth and may cause respiratory symptoms.

Question 45

What is seen in human lyme disease but not in dogs?

Answer 45

The correct answer is erythema migrans. Apparently, this is only seen in humans. The other choices are observed with Lyme disease.

Question 46

A 6-year old female spayed English Pointer presents for lethargy and weight gain. The owner notes that the dog is eating and drinking a normal amount, but the dog is still gaining weight. A physical exam reveals weak pelvic limbs, facial nerve paralysis, a symmetrically patchy haircoat, and seborrhea. Lab work reveals a normocytic, normochromic anemia with a PCV of 29% (35-57%), lipemic serum, and cholesterol of 1090 mg/dl (135-278 mg/dl). What is the most likely diagnosis?

Answer 46

The correct answer is hypothyroidism. The clinical signs, physical exam findings, and lab work abnormalities are classical for hypothyroidism. Other common abnormalities seen with hypothyroidism include pyoderma, neuromuscular signs (ataxia, knuckling, vestibular signs, etc), markedly elevated triglycerides, and a mild normocytic, normochromic anemia. Hyperthyroidism rarely occurs in dogs. You would expect to see polyuria, polydipsia, and polyphagia with hyperadrenocorticism.

Question 47

A 3-year old German Short Hair Pointer presents for vomiting, lethargy, and diarrhea. A fecal exam reveals the eggs of Nanophyetus salmincola, the salmon poisoning fluke. What treatment should be administered to treat the symptoms of the dog?

Answer 47

The correct answer is tetracycline antibiotics. The causative agent for the dog’s clinical signs is Neorickettsia helminthoeca. Treatment of choice for this rickettsial agent is tetracycline antibiotics. The fluke itself is not responsible for the clinical signs, but may be treated effectively with Praziquantel.

Question 48

The genetic disorder bovine leukocyte adhesion deficiency (BLAD) appeared in Holstein dairy cattle some years ago. If it is like most animal genetic disorders, which of the following modes of inheritance is it likely to be?

Answer 48

Bovine leukocyte adhesion deficiency (BLAD) in Holsteins is an autosomal recessive congenital disease. The most common inheritance pattern of genetic disease in cattle is a simple recessive trait. The defective calf receives a recessive gene from its sire and dam. An autosomal recessive disorder means two copies of an abnormal gene must be present for the disease or trait to occur.

Question 49

Familial Shar Pei

Answer 49

Familial Shar Pei Fever (FSF) is characterized by high fever and unilateral or bilateral tarsal swelling as seen in the photo. This swelling affects tissues around the joint, rather than within the tarsus itself. FSF may be a distinct entity from amyoloidosis but animals with FSF are predisposed to amyoloidosis, resulting in proteinuria. Panosteitis is not associated with FSF.

Question 50

What is the most common dermatophyte infecting the dog?

Answer 50

The correct answer is Microsporum canis. Microsporum gypseum is the second most common, and T. mentagrophytes is third most common in dogs.

Question 51

What is the physiologic abnormality in animals with tracheal collapse?

Answer 51

The correct answer is weakness of the tracheal rings. Tracheal collapse occurs because of hypocellularity and deficient glycoproteins and glycosaminoglycans in the tracheal rings. This leads to decreasing strength and loss of ability to remain firm and eventually collapse.

Question 52

What is the best method of dealing with her Addison’s disease given that she is going to have surgery?

Answer 52

Patients with Addison’s disease have hypoadrenocorticism. This means that the patient is not producing an adequate amount of glucocorticoids. During times of stress Addisonian patients require additional amounts of glucocorticoids or else they are at risk of going into a crisis. The exact amount of additional glucocorticoid to administer is not known but it is generally accepted that patients should receive 2-10 times a physiologic dose of prednisone. The physiologic dose of prednisone is considered by many to be 0.1 mg/kg/day but there is some variation depending on the source. Therefore the best answer is to give a dose of dexamethasone that is approximately 5 times the physiologic dose of prednisone followed by twice the regular dose of prednisone the following day.

Question 53

A 5-year old intact male Pomeranian presents for slowly progressing alopecia of the trunk that is sparing the head and limbs. Skin cytology revealed no infectious organisms or inflammatory cells. CBC and chemistry panel were unremarkable. You explain to the owner that you are most concerned about an endocrinopathy and would like to pursue further endocrine testing. Thyroid panel and ACTH stimulation test are both within reference range. Given the history, what is the best treatment option?

Answer 53

Based on the history and ruling out other endocrinopathies this patient likely has hair cycle arrest (Alopecia X). The pathogenesis of this disease is not known. This condition is common in Pomeranians, Chow Chows, Alaskan Malamutes, Toy Poodles, and Samoyeds. The most common clinical signs are truncal alopecia and hyperpigmentation. The treatment of choice (if the dog is intact) is to neuter; however, it is not uncommon to see a relapse in clinical signs 1-2 years after neutering. Melatonin may help new hair to grow if a relapse occurs. Trilostane, mitotane, and growth hormone supplementation have been tried with varying success. Levothyroxine is a thyroid supplement and would not be indicated.

Question 54

A 6-month old Labrador Retriever presents for failure to thrive and stranguria. Abdominal ultrasound shows a small liver and stones in the urinary bladder. Abdominal radiographs show no visible stones. How can this be explained?

Answer 54

The correct answer is the dog has urate stones. The dog is described as having a portosystemic shunt which is often accompanied by urate stones in the bladder. Urate stones (and cysteine stones) are radiolucent, so they can’t be detected by radiography. Remember “I can’t C U”: (“C” is for cysteine, and “U” is for urate).

Question 55

What is the ideal incision site for a foreign body gastrotomy?

Answer 55

The correct answer is halfway between the greater and lesser curvature. At this site, you avoid any major bleeding and retain good blood supply from both sides to help with the healing of your incision. Cutting along the greater and lesser curvature is not recommended due to the need to avoid blood vessels. Cutting along the pylorus has a risk of disturbing the sphincter and causing the formation of a pyloric stricture. Additionally, this does not provide a good view inside the stomach.

Question 56

What virus is a voice change associated with?

Answer 56

Rabies

Question 57

A 7-year old female Standard Poodle presents to you for acute onset of vomiting and weakness after the owners returned from vacation. On physical exam, you estimate that the dog is 7% dehydrated, has a respiratory rate of 36 breaths per minute, heart rate of 44 beats per minute and temperature of 99 degrees F. You quickly attach ECG leads and expect to see which of the following abnormalities?

Answer 57

Based on the history and the physical exam findings of dehydration and bradycardia, you should be concerned about hypoadrenocorticism. Hypoadrenocorticism patients are typically hyperkalemic. ECG abnormalities with hyperkalemia include wide, flat, or absent P waves, widened QRS complexes, tall spiking T waves, and bradycardia.

Question 58

What substance is responsible for the wrinkled appearance of Shar Peis?

Answer 58

Excess amounts of the dermal ground substance component mucin is responsible for the wrinkled appearance of Shar-Peis.

Question 59

You diagnose a dog with a large ventricular septal defect with advanced sequelae to the abnormality. Which of the following is the most likely radiographic appearance of this dog’s thorax?

Answer 59

The correct answer is left atrial and left ventricular enlargement with pulmonary hyperperfusion. In dogs with a VSD, the shunt occurs during systole when both ventricles are contracting so blood is shunted from the left ventricle almost directly into the pulmonary artery. The right ventricle acts as a conduit between the left ventricle and pulmonary artery and is less commonly affected by the shunted blood. The excess blood flow is found in the pulmonary vasculature, left atrium, and left ventricle, thus enlarging these structures.

Question 60

A 3-year old German Short Hair Pointer presents for vomiting, lethargy, and diarrhea. A fecal exam reveals the eggs of Nanophyetus salmincola, the salmon poisoning fluke. What treatment should be administered to treat the symptoms of the dog?

Answer 60

The correct answer is tetracycline antibiotics. The causative agent for the dog’s clinical signs is Neorickettsia helminthoeca. Treatment of choice for this rickettsial agent is tetracycline antibiotics. The fluke itself is not responsible for the clinical signs, but may be treated effectively with Praziquantel.

Question 61

What disease often occurs secondary to exocrine pancreatic insufficiency in dogs?

Answer 61

The correct answer is small intestinal bacterial overgrowth (SIBO). This occurs because of the loss of antibacterial factors from pancreatic fluid as well as altered intestinal motility and decreased immunity from malnutrition. Concurrent SIBO can often exacerbate clinical signs and complicate therapy for EPI. The other choices listed are not sequela to EPI.

Question 62

A 1-year-old male neutered Chihuahua presents for a 3 month history of intermittent limping and non-weight bearing on the left hind limb. On physical exam, it is difficult to determine the source of pain as the patient seems to try to bite on any manipulation of the left hind limb. The patient was sedated and these radiographs were obtained. What is your diagnosis and treatment?

Answer 62

Based on the breed and age of the patient, avascular necrosis of the femoral head should immediately be the top differential. This condition is also known as Legg-Calves-Perthes disease and results in a collapse or fragmentation of the femoral epiphysis (as seen on the radiographs) because of a disruption in blood flow. The cause of blood flow interruption is unknown. The condition occurs in young small-breed dogs prior to closure of the capital femoral physis. The condition can be seen bilaterally in 10-17% of patients. Dogs are usually 6-7 months of age when they first start showing clinical signs but the age may range from 3-13 months. Treatment with a femoral head and neck ostectomy (FHO) generally yields excellent results. Alternatively, if owners demand perfect biomechanics, a total hip replacement may be considered, but most veterinarians tend to recommend an FHO.