Canine Top 20 Diseases - Part 1 Flashcards

1
Q

what is the classic case presentation of diabetes mellitus?

A

PU/PD/PP + weight loss

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2
Q

what is the classic case presentation of a very ill or DKA patient?

A

vomiting, inappetence, & lethargy

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3
Q

what is the classic case presentation of hyperadrenocorticism?

A

PU/PD/PP/PANTING

pot bellied appearance, truncal alopecia, cutaneous thinning, & calcinosis cutis

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4
Q

what is the classic case presentation of collapsing trachea?

A

toy/small breed middle aged dog with a honking cough that is elicited with increased activity or exercise that ends with the animal retching

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5
Q

what is the classic case presentation of IMHA?

A

patient is icteric, lethargy, weak, increased pallor, variable degrees of organomegaly, & discolored urine from hemoglobinuria or bilirubinuria

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6
Q

what is the classic case presentation of IVDD?

A

PAIN!!! in the neck or back, arched back or head down, ataxia, paraparesis, tetraparesis, or paraplegia

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7
Q

what is the classic case presentation of a severe case of collapsing trachea?

A

cyanosis & exercise intolerance

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8
Q

how is diabetes mellitus diagnosed?

A

chemistry panel - hyperglycemia

fructosamine - elevated levels indicate BG levels over 2 weeks

urinalysis - glucosuria, elevated USG, +/- ketonuria

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9
Q

how is hyperadrenocorticism diagnosed? include expected findings on CBC, chemistry, UA, urine cortisol:creatinine, ACTH stim test, LDDST, endogenous ACTH, HDDST, & abdominal ultrasonography.

A

CBC - stress leukogram (neutrophilia, lymphopenia, eosinopenia) + thrombocytosis

chemistry - elevated ALP & hypercholesterolemia

UA - hyposthenuria +/- proteinuria

urine cortisol:creatinine: if normal, rules out cushings, if abnormal, further testing indicated

ACTH stim: test of choice for iatrogenic cushings (excessive cortisol response)

LDDST: more sensitive for PDH/ADH (no suppression, or loss of suppression at 8 hours)

endogenous ACTH: used to differentiate between PDH & ADH (if low, PDH, if normal to high, ADH)

HDDST: in PDH 75% will suppress & 25% will not but in ADH, there will be no suppression

abdominal ultrasound: in PDH, same size of adrenals or bilateral enlargement, in ADH: one adrenal gland is enlarged & the other is small or not seen

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10
Q

how is collapsing trachea diagnosed?

A

rads - may be hard to see dynamic collapse

fluoroscopy - I would think this is best

endoscopy - requires general anesthesia

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11
Q

how is IMHA diagnosed? include expected findings on CBC, saline agglutination test, coomb’s test, etc.

A

CBC - anemia, +/- reticulocytosis, spherocytes, polychromasia, & anisocytosis, icteric serum on PCV

positive saline agglutination test

positive coomb’s test for antibodies against RBC

infectious disease testing - 4DX test!!!

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12
Q

how is IVDD diagnosed?

A

MRI - safe, fast, & best quality

CT - safe & faster than MRI but lower quality

myelogram - invasive & seizures may occur during recovery

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13
Q

how is a stable diabetes mellitus patient treated?

A

long acting insulin (NPH or vetsulin)

increased fiber in the diet & RX diabetic diet

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14
Q

how is an ill/DKA patient treated?

A

hospitalization with supportive care, regular insulin CRI until controlled, & potassium/phosphorus derangements are corrected

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15
Q

what test can be done to rule out stress hyperglycemia when trying to diagnose diabetes mellitus?

A

fructosamine

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16
Q

T/F: glucosuria can cause an elevated USG in patients with diabetes mellitus

A

true

17
Q

what is the prognosis of diabetes mellitus?

A

good

18
Q

what medical & surgical treatment is used for PDH? what about ADH? what about iatrogenic hyperadrenocorticism?

A

PDH medical - trilostane, inhibits the enzyme key for cortisol synthesis or lysodren

PDH surgical - hypophysectomy or bilateral adrenalectomy (requires lifelong post-op hormonal therapy though)

ADH medical - trilostane or lysodren (may get neoplastic necrosis of the adrenals)

ADH surgical - adrenalectomy

iatrogenic - change to a short acting oral steroid that is gradually decreased over several weeks & do an ACTH stim test to see if steroids can be stopped

19
Q

what are the 3 types of hyperadrenocorticism?

A
  1. PDH, most common
  2. ADH, 25% of cases
  3. iatrogenic hyperadrenocorticism
20
Q

what medical treatment is used for patients with a collapsing trachea? what surgical therapy?

A

medical - short course of steroids, cough suppressant, & weight loss plan if indicated

surgical - tracheal stent placement if patient is refractory to medical treatment (requires referral)

21
Q

what is the prognosis of hyperadrenocorticism?

A

guarded to good

22
Q

what diagnostic test should always been done for a patient with a suspected collapsing trachea? why?

A

thoracic radiographs - rule out pulmonary edema as a cause of the cough

23
Q

what treatment is used for patients with IMHA?

A

immunosuppression!!! prednisone, cyclosporine, azathioprine, or mycophenolate

blood transfusion

prevention of thromboembolism - aspirin or low molecular weight or unfractionated heparin

24
Q

what is the prognosis of IMHA? is it usually regenerative or non-regenerative?

A

guarded

regenerative anemia is expected but bone marrow needs 3-5 days to respond

25
Q

why are steroids falling out of favor for treatment of IVDD? what drug is used instead?

A

numerous adverse effects & poor efficacy

NSAIDS

26
Q

what is the prognosis of IVDD if the patient is ambulatory? what if they are non-ambulatory but deep pain positive? what if they are non-ambulatory & deep pain negative?

A

ambulatory - excellent

non-ambulatory & deep pain positive - guarded without surgery, but excellent with surgery

non-ambulatory & deep pain negative - 50% chance of regaining function if surgery occurs within 24 hours

27
Q

what animals are affected by hansen type I IVDD? what about hansen type II?

A

hansen type I - chondrodystrophic breeds (weenies) where the nucleus pulposus extrudes through the annulus

hansen type II - non-chondrodystrophic breeds (any type of dog) with hypertrophy or bulging of the annulus

28
Q

what surgery is done for IVDD for cervical discs? what about thoracolumbar discs?

A

cervical - ventral slot

thoracolumbar - hemilaminectomy

29
Q

when is medical treatment used for IVDD patients? what is included in treatment?

A

if they are painful only with no neurological signs

strict cage rest & analgesia with opioids or NSAIDS

30
Q

what therapies are looking promising for pituitary tumors causing PDH?

A

stereotactic radiosurgery & radiotherapy