Canine Diseases Flashcards
Dog presents with: P/u, P/d, Polyphagia, weight loss +/- vomiting, inappetance, lethargy
Potential DX?
Tests?
Diabetes Mellitus
Serum Chem (K+ and P derangements)
Urinalysis
Fructosamine
Fructosamine tests for?
blood glucose over the previos 2 weeks- rule out stress hyperglycemia
Dog presents with p/u, p/d, p/p, panting and pot belly.
Truncal alopecia; thin skin
DX?
Tests?
Hyperadrenocorticism
Chem: ALP increase; hyper cholesteremia
CBC: Stress leukogram; thrombocytosis
Urinalysis: hyposthenuria, +- protenuria
Urine cortisol: creatinine ratio abnormal
ACTH Stim test: iatrogenic
LDDS: high sensitivity
Endogenous ACTH: differentiate PDH from ADH
HDDS: will suppress 75% of PDH.
Abdominal U/S
PDH- bilateral normal to hypertrophic adrenals
ADH: unilateral enlarged adrenal; contralateral small or non visible.
Stress Lekogram is..
netrophilia, lymphopenia, eosinopenia
Tx: Cushing’s DZ
PDH : Trilostane (enzyme inhibitor to prevent cortisol production)
Lysodren (destroys cortisol secreting portion of adrenals
SX- hypohysectomy; bilateral adrenalectomy
Radiation
ADH
SX: adrenalectomy
trilostane; lysodren
Iatrogenic: oral steroid; decrease dosage over weeks. Do acth stim to see if can stop steroids
middle aged Toy breed dog presents with honking cough that is exacerbated by exercise; ocassional retching; in severe cases cyanosis
potential DX?
diagnostics?
Rx?
Collapsing trachea
thoracic rads (rule out pulmonary edema) fluroscopy endoscopy
short course corticosteroids
cough supressant
weight loss
if refractory: tracheal stent
Dog presents with lethargy, wekness, pallor, tachypnea, icterus, possible organomegaly, hemoglobinuria/ bilirubinemia
possible DX?
IMHA
You suspect IMHA. what diagnostics should you perform? what will be the findings?
CBC- anemia +/- reticulocytosis, sperocytes, polycromasia, anisocytosis
Regenerative anemia expected but takes 3-5 days for bone marrow to respond
Saline Slide Agglutination
Coombs test
Infectious dz testing
Rule out Neoplasia - imaging
Coombs test
tests for antibodies against RBCs
Tx for IMHA
immunosuppressive drugs: prednisone, azathioprine, cycclosporin, mycophenolate
Blood Transfusion
Prevent thromboembolism: asparin; heparin
Dog presents with extreme pain in neck or back. Arched back/ head held down. Ataxia; paraparesis; paraplegia; tetra paresis.
Potential DX?
IVDD
DXics for IVDD
MRI
CT (faster then MRI lower quality)
Myelogram (invasive)
Tx for IVDD
Avoid Steroids!
if only pain no neuro: cage rest; opiates or NSAIDS
Nonambulatory/ unresponsive : surgical decompression
thoracolumbar: hemilaminectomy
Cervical: ventral slot
hansen type 1 IVDD
chondordystrophic breeds
nucleus pulposis extrudes through the annulus
hansen type 2
hypertrophy/ bulging of the annulus
IVDD prognosis
ambulatory: excellent
nonamb w/ deep pain: excellent with sx
nonamb with no deep pain: 50% regain func if sx within 24 hours
Dog presents with cough; evercise intolerance; abdominal distension; harsh lung sounds +/- heart murmur/arrhythmia
DX?
Diagnostics?
Heart Failure
thoracic rads: heart enlargement; dialated pulmonary veins, interstitial/ alveolar lung changes in caudo dorsal lung fields
echo:
left atrial +/- left ventricular enlargement causing pulmonary edema
valvular insuff
right atrial and ventricular dilation
Treatment for acute heart failure
furosemide
O2 therapy
+inotrope and vasodilator: pimobenden
+/- mild sedation to reduce stress
tx chronic heart failure
furosemide
+inotrope and vasodilator: pimobenden
ACE inhibitor
restrict exercise and dietary salt
Dog presents with cough; exercise intolerance ; abdominal distension; weight loss poor body condition
Heartworm
Diagnostics for Heartworm?
SNAP test - protein secreted by adult female worm 5 mo post infection
false negatives if: Ag/Ab complex formation
no adult female worms
light parasite load
Microfilaria test: recommended annually
Thoracic Radiographs: enlarged tortuous +/- blunted pulmonary arteries
pulmonary parenchymal disease
right heart heart enlargement
echo: pulmonary artery dilation; right heart dilated; visible heartworms in pulomnary artery; caval syndrome (HW visible in right ventricle and maybe right atrium
Heartworm Treatment
Doxycycline: 30 days prior to aduticide ( reduces wolbacia intracellular bacteria essential for worm survival)
Adulticide: melarsomine dihydrochloride 3 dose protocol im, wait 1 mo then 2 doses given 24 hours apart kils 98% of heartworm
STRICT exercise restriction for 6-8 weeks after last dose
Corticosteroids: tapering antiinflammatory does to control clinical signs of pulmonary thromboembolism; 1-2 mos prior to adulticide if symptomatic or microfilria +
Sx extraction of adult worms indicated with caval syndrome
Heartworm prevention
macrocyclic lactones
prevent new infections; eliminate susceptible alrvae and microfilaria
if microfilaria + pre treat with diphenhydramine and corticosteroids
treat monthly strating 2 mos prior to adulticide
intact middle aged female 3-4 weeks post estrus ; pu/pd; vomiting; anorexia; abdominal pain; enlarged palpable uterus
+/- vulvar discharge
Pyometra
DX:
Abdominal Rads
distended tubular enlarged fluid filled uterus.
Vaginal cytology: degenerative neutrophils +/- phagocytized bacteria
abdominal u/s enlarged fluid filled uterus: rule out pregnancy
Stabilization: IV fluids; broad spectrum AB; analgesics
SX: OVH
RULE OUT IN ANY SYSTEMICALLY ILL FEMALE DOG.
Acute onset of moderate to severe pruitis ; more commonly in the warmer seasons; excessive self grooming and hair loss; especially rear half of body
Flea allergy Dermatitis
DX: hx and PE
visible fleas
flea comb/ dirt
+ response after flea eradication
TX for FAD
corticosteriods tapered- pruritis
topical oral flea adulticide
environmental control
15% of dogs have no evidence of fleas
bunny hoping gate; lameness ; difficulty rising; + ortalani sign
hip dysplasia
rads: shallow acetabulum flattening of femoral head <50% coverage by acetabulum thickened femoral neck morgan line
young medium to giant breed dog, male; acute lameness fever; long bone pain
Panosteitis
rads: multiple long bones have increased medullary opacity
tx: analgesia
young medium to giant breed dog, male; acute lameness fever, swollen and warm distal limb; metaphyseal pain
HOD
double physeal line
tx: analgesia
young medium to giant breed dog, male; acute lameness, fever, joint effusion, decreased range of motion
OCD
CT
Rads
flattening of subchondral bone; joint effusion; image both limbs
sx debridement or medical rx with joint supplements and analgesics
3- 12 mo old small or toy breed dog with pelvic limb lameness
Legge- perthes dz ( avascular necrosis of the femoral heads)
lots of bone opacity at femoral epiphysis; moth eaten appearance of femoral neck and head
surgical femoral head ostectomy or total hip replacement analgesics
prognosis good w/ sx
Treatment for Hip dysplasia
triple pelvic osteotomy; femoral head ostectomy; total hip replacement.
Nsaids; weight loss joint supplements
Which is more accurate method of dxing hip dysplasia?
PennHIP
more accurate for dx at an earlier age than OFA
OCD prevention
avoid excess food, Ca, vit D
stupor stumbling, ataxia, nausea, pu/pd
1-2 hours post Ethylene Glycol toxicity
anorexia, lethargy, pu/pd, vomiting
signs related to renal failure- 24-72 hours post ethylene glycol toxicity
DXic options for suspect EG toxicity
EG blood screening: detects for 30 min to 12 hours after ingestion
Utinalysis: Calcium oxalate crystals 3-18hrs post ing
isosthenuria as renal failur developes
High anion gap metabolic acidosis
osmole gap greater than 20 mOsm/kg strongly correlates with blood EG level
Azotemia, hyperphosphatemia, hypocalemia, hyperglycemia
crystals seen in EG toxicity
calcium oxalate
Tx of EG toxicity
Best window 8-12 hours post ing
decontaminate: emesis; activated charcoal (lots low affinity for EG)
Fomepizole (prevents conversion to toxic metabolites) (oxalic acid)
7% ethanol solution parenterally
fluids; hemodialysis; peritoneal dialysis if oliguria or anuria present
False +s on EG blood test
propylene glycol; glycerol in activated charcoal, semi moist dog foods, inj diazepam
A <8mo old puppy/ unvaccinated adult; vomiting; hemorrhagic diarrhea; lethargy; inappetance
doberman; rotty; pits; GSD; Dachshund
Parvoviral enteritis
DX Parvo Virus
Fecal ELISA
Leukopenia Neutropenia
hypoalbunemia, hypoglycemia, hypokalemia, prerenal azotemia
FECAL: concurrent helminthiasis
TX Parvo
IV Fluid therapy (KCl or dextrose if needed) (Colloid support (heatstarch or albumin)
Broad Spectrum AB bacterialcidal ( ampicillin, cephlasporin, unasyn)
Anti nausea drugs ( metoclopramide, ondansetron, maropitant)
nutritional support
Parvo ELISA considerations
False +s: within 5-15 d of vacc
False -s : if test too early in dz process
Parvo virus properties
resistant non enveloped single stranded DNA virus
CPV-2b most common in US
CPV-2c increasing
Virus attacks intestinal crypt cells, lyphopoietic tissue and bone marrow
disinfection : Parvo virus
CLEAN
then 1:32 bleach solution to kill virus
older, giant/ large breed dog with narrow and deep chest cavity;
abdominal distension; ping
unproductive retching, ptyalism, discomfort, restlessness, collapse
GDV
Radiographic finding of GDV
right lateral abdomen
gas ditended pylorus cranuial to fundus; double bubble; Use DV but NOT VD (aspiration)
CBC/ Chem findings GDV
hemoconcentration; increased lactate
+/- DIC
TX plan for GDV
FLUIDS (1st) Rads Decompression (trochar or orogastric tube) opiods SX - decompression and de rotation Gastropexy
possible gastic resection; splenectomy
post op
Fluids; analgesia, AB
Gastric acid reducers monitor for arrythmias (ventricular) GI pro motility meds
most common arryhmias seen with GDV cases
ventricular
Factors assoc with poor GDV prognosis
Gastric necrosis
preop lactate >6 mmol/ L
Greater than 5 hr time lag from onset to evaluation
mid to large sized middle age dog with weight gain; lethargy; weakness; alopecia (rat tail, symmetrical truncal alopecia) cold intolerance
possible neuro signs
rare- myxedema coma
hypothyroidism
DXic findings Hypothyroid Dog CBC
CBC: Mild non regenerative anemia
DXic findings Hypothyroid Dog Chem
hyperlipidemia (cholesterol and TGs)
T4 findings - hypothyroid dog
total t4- low (may be low normal if Abs present)
Free T4 - measures metabolically available T4- if low confirms hypothyroid - RO euthyroid sick (other dz process)
TSH- normal to increased
Serum thyroglobulin auto antibodies increased in lymphocytic throiditid
RX Dog Hypothyroid
levothyroxin PO
IV T4 for myexdema coma
Cloudy white pupil; decreased vision
cataract
Blood/ Urine glucose; ocular U/s, ERG
tx: sx
assoc with DM
<2 yr old english bulldog; beagle; Shihtzu, cocker
smooth moist reddish pink mass at medial canthus
Cherry eye
tx: sx - only remove if cancerous - risk of keratoconjunctivitis sicca
conjunctival hyperemia; photophobia, blepherospasm
aqueous flare; color change of iris; midrange to miotic pupils
Uveitis
tonometry (IOP)
< 10mmHG
50% idiopathic
what is aqueous flare?
cloudiness of aqueous humor
Big Blue Eye (buphthalmos)
visual impairment
tortuous episleral vessels
Glaucoma
tonometry (IOP)
> 30mmHG
can be 2dary to uveitis
gonioscopy - visualize reduction of iridocorneal angle
u/s
early referral!
tx contralateral eye with prophylactics
tx for pain even if blind
Tx Uveitis
topical and systemic corticosteriods or NSAIDS (unless 2ndary to protozoal or fungal inf / corneal ulceration)
topical atropine to deacrease pain of iridocyclospasm
find underlying cause and tx
Acute Glaucoma tx
decrease IOP and pain mgmt Top/sys carbonic anhydrase inhibitor Topical beta- adrenergic antagonist or blocker MAnnitol \+/- corticosteroids
Chronic Glaucoma tx
topical prostaglandins; enucleation
Acute/ Chronic may be subclinical
Hx of diet indiscretion
high fat diet
vomiting anorexia
diarrhea abdominal pain,weakness, dehydration
Pancreatitis
Drugs assoc with pancreatitis
Kbr azothioprine L asparginase phenobarbital thiazide diuretics
breed overreprisented with pancreatitis
mini schnauzer
DX Plan Pancreatitis
SNAP canine pancreatic lipase. If positive confirm w/ canine pancreatic lipase immunoreactivity (spec CPLI) test
u/s: abdominal
enlarged hypoechoic pancreas
hyperechoic peripancreatic fat
fluid around pancreas- not useful in dx but aid to rule out other ddxs
4-5x elevation of lipase and amylase are suggestive
Treatment for pancreatitis
aggressive fluid therapy with appropriate additives based on lab work +/- colloid support or plasma pain med (opiod or lidocaine CRI) ante nausea meds (maripotent, odansetron, dolasetron) ultra low fat nutritional support unless intractable vomiting
avoid antibiotics unless necessary
acute onset non productive cough +/- retch
hx of exposure to other dogs (large #s)
Kennel Cough
infectious tracheobronchitis
DX of Kennel Cough
hx and clinical signs strongly suggestive
bacterial culture/ PCRof Bordetella bronchoseptica from nasal or oropharngeal swabs, transtracheal wash or BAL
on thoracic rads can see signs of pnuemonia if severe
Treatment of Kennel Cough
if no secondary pneumonia resolves in 7-10 days
cough supressants if persistent dry cough (hydrocodone, butorphanol)
Bronchopneumonia tx
antibiotics oral iv if severe based on C/s
nebulization w/ sterile saline +/- gentimicin
iv/sq fluid therapy
o2 therapy
Etiology of Kennel Cough
CPIV, CAV-2, CDV
B. Bronchospetica
Mycoplasma
Vaccination for Kennel Cough
CPIV/CAV-2/CDV modified live combo
and or
B. Bronchospetica/ CPIV intranasal combo
reduce inf rate and severity
A dog presents with regugitation, coughing, drooling, weight loss,
+/- weakness , pnuemonia
megaesophagus
weakness due to myasthenia gravis, polyneuropathy or poly myopathy.
DX Megaesophagus
may be idiopathic or secondary to systemic dz
thoracic rad air- filled dialated esophogus
+/- 2ndary aspiration pnuemonia (VD view best)
Tests of underlying conditions of Megaesophogus
Acetylcholine receptor Ab test - Mysenthia gravis
ACTH stim- ADdison dz
Free T4 - hypothyroid
lead levels
EMG/ nerve conduction for polymyopathy or polyneropathy
TX megaesophogus
tx underlying condition and or aspiration pnumonia
upright or meatball feeding
GI motility meds aid in gastric emptying to reduce esophogeal reflux (cisapride)
Gastric acid reducers to decrease acid reflux (PPI : pantazolprole, omeprazole. H2 blockers: famotidine, ranitidine)
Breed predilictions for megaesophogus
GSD, Mini Shnauzer, fox terrier
drugs causing temporary megaesophagus
ketamine, xylazine
