Canine week 1 Flashcards
You are about to anesthetize a 5-year old mixed breed dog for a laceration repair. It has a history of seizures since it was 2 years of age. Which drug should not be used in the anesthesia protocol as it may promote seizures in this predisposed patient?
Propofol
Diazepam
Pentobarbital
Ketamine
Etomidate
Ketamine
The use of ketamine has been associated with seizures in epileptic dogs. Diazepam, propofol, and pentobarbital are more commonly used to treat acute seizure episodes and should not cause them.
Doxycycline
D-penacillamine
N-acetylcysteine
Ca-EDTA
Ca-EDTA
This dog is showing signs of lead poisoning. Clinical signs are primarily gastrointestinal and neurologic. Animals are usually exposed in old buildings or areas of renovation where they have access to lead paint, old batteries, lead fishing weights, etc. Old food and water dishes can also be a source if lead paint was used. Lead blood levels can be measured; however, they do not necessarily correlate with severity of clinical signs. Toxic blood levels are greater than 0.4 ppm. Bloodwork can show an elevated number of nucleated RBCs without anemia. Basophilic stippling is a classic finding with lead toxicity but not specific. Ca-EDTA is the chelator used to treat lead poisoning. Succimer can also be given orally. D-penacillamine has also been used to chelate lead, copper, iron and mercury. It is used more commonly for copper toxicity. N-acetylcysteine is used for acetaminophen toxicity and hepatotoxicity. Basophilic stippling can sometimes be confused with erythrocytic parasites for which doxycycline may be the treatment of choice.
A dog presents for an acute onset of right hind limb lameness. On physical exam you note the limb to be slightly externally rotated and shorter than the contralateral limb. You suspect a coxofemoral luxation. What is the most likely direction of luxation?
Caudodorsal
Craniodorsal
Ventral
Dorsal
Caudoventral
Craniodorsal
The correct answer is craniodorsal. Interestingly, over 80% of coxofemoral luxations occur in a craniodorsal direction in dogs. The key players in maintaining the femur in its socket are the ligament of the head of the femur, dorsal acetabular rim, and joint capsule. If any two of these are compromised, a luxation will most likely result.
Which is not a common treatment option for dogs with hyperadrenocorticism?
o,p’-DDD (Lysodren or Mitotane)
Adrenalectomy
Pituitary surgery
Ketoconazole
Pituitary surgery Correct Answer
The correct answer is pituitary surgery. Pituitary surgery is the most common mode of treatment in humans with hyperadrenocorticism, but it is rarely performed in dogs. Adrenalectomy is a dangerous surgery, but it is often performed with adrenal tumors causing adrenal dependent hyperadrenocorticism. Lysodren is essentially the insecticide DDT. It is commonly used to treat PDH and causes selective necrosis of the zona fasciculata and zona reticularis. Ketoconazole inhibits production of all steroids and is used as a medical treatment option for functional adrenal tumors
The patient has severe bronchoconstriction and a bronchodilator should be prescribed
The patient has severe pulmonary edema secondary to heart failure and furosemide should be administered
This patient has metastatic lesions throughout the lungs and only palliative treatment can be recommended
The patient has severe aspiration pneumonia and should be started on broad spectrum antibiotics, IV fluids, and oxygen support
This patient has metastatic lesions throughout the lungs and only palliative treatment can be recommended Correct Answer
This dog was not staged prior to surgical removal of the mass and likely had visible metastatic nodules at the time of surgery. The only other potential differential with this radiographic finding would be granulomatous disease which is unlikely given the history.
Which of the tumors listed is considered a “soft tissue sarcoma” due its locally invasive behavior and relatively low metastatic rate for most low and intermediate grade tumors?
Peripheral nerve sheath tumor
Basal cell tumor
Osteosarcoma
Histiocytic sarcoma
Hemangiosarcoma
Mast cell tumor
Peripheral nerve sheath tumor Correct Answer
Soft tissue sarcomas include a group of mesenchymal tumors with similar biologic behavior, namely a locally invasive growth pattern and a metastatic rate of less than 20% for low- and intermediate-grade tumors. High-grade tumors have up to a 50% metastatic rate.
These tumors include peripheral nerve sheath tumors (PNST), hemangiopericytomas (HPC), fibrosarcomas (FSA), liposarcomas, malignant fibrous histiocytomas, myxosarcomas, rhabdomyosarcomas, and leiomyosarcomas.
Hemangiosarcoma and osteosarcoma are mesenchymal in origin but are not lumped into this category due to their highly metastatic behavior. Histiocytic sarcoma and mast cell tumors are considered of round cell origin. Basal cell tumors are epithelial in origin.
You are examining an 9-year old spayed female mixed breed dog that became acutely blind after being normal yesterday. Ophthalmic and fundic exams are normal. What is the most likely cause of the dog’s blindness?
Progressive Retinal Atrophy (PRA)
Primary brain tumor
Sudden Acquired Retinal Degeneration Syndrome (SARDS) Correct Answer
Retinal detachment
Sudden Acquired Retinal Degeneration Syndrome (SARDS) Correct Answer
The correct answer is SARDS. SARDS is a condition seen usually in middle-aged obese female spayed dogs. They develop acute blindness and initially have no optic or fundoscopic lesions. In 1-2 months, they will develop retinal vascular attenuation and tapetal hyperreflectivity. A primary brain tumor would be more likely to show progressive signs. Retinal detachment and progressive retinal atrophy would show changes in the retina on fundic exam.
What is the best rabies vaccination protocol for a dog?
Vaccinate at 1.5 months, then every 1-3 years Your Answer
Vaccinate at 3 months and then every 1-3 years
Vaccinate at 3 months, booster one year later, then every 1-3 years
Vaccinate at 6 months, booster at one year, then every year
Vaccinate at 6 months, booster at one year, then every year
Vaccinate at 3 months, booster one year later, then every 1-3 years
The correct answer is vaccinate at 3 months, booster one year later, then every 1-3 years. You should not give a rabies vaccine earlier than three months because you run the risk of having interference with maternal antibodies. The best answer is to vaccinate at 3 months, booster one year later, and then every 1-3 years depending on your local regulations.
Trauma
Lymphoma
Coccidioides immitis infection
Systemic Lupus Erythematosis
Hypertension
Systemic Lupus Erythematosis Correct Answer
The correct answer is systemic lupus erythematosis. SLE causes many signs, but anterior uveitis is not considered one of them. The causes of uveitis include infection (bacterial, viral, fungal, rickettsial), immune mediated (lens-induced uveitis), neoplasia, hypertension, and trauma. Over 50% of the time, the cause is not found and the uveitis is termed idiopathic.
What drug used to treat gastroenteritis can cause feces to darken and look like melena when given orally?
Cimetidine (Tagamet)
Chlorpromazine (Thorazine)
Loperamide (Immodium)
Metronidazole (Flagyl)
Bismuth subsalicylate (Pepto-Bismol)
Bismuth subsalicylate (Pepto-Bismol)
Bismuth=Black
The correct answer is bismuth subsalicylate. Bismuth subsalicylate (Pepto-Bismol) forms bismuth sulfide in the colon, which is a very dark compound that makes feces black and can lead to the misdiagnosis of melena.
You check blood gases on a cat in the intensive care unit with renal disease.
They read as:
PaCO2= 28 (28-34 mmHg)
pH= 7.23 (7.25-7.4)
PaO2=100 (90-100 mmHg)
Base excess= -8 (-5 to +2 mmol/L)
HCO3 = 12 (16-20 mmol/L)
What can you conclude?
The cat has primary metabolic acidosis with compensatory respiratory alkalosis
The cat has primary metabolic alkalosis with compensatory respiratory acidosis
The cat has primary respiratory alkalosis with compensatory metabolic acidosis
The cat has a mixed respiratory and metabolic acidosis
The cat has primary respiratory acidosis with compensatory metabolic alkalosis
The cat has primary metabolic acidosis with compensatory respiratory alkalosis Correct Answer
The correct answer is that the cat has primary metabolic acidosis with compensatory respiratory alkalosis. The low pH tells you the cat is acidemic so the primary disorder must be an acidosis because compensatory mechanisms will never overshoot the primary abnormality. In this case, the negative base excess or low HCO3 tells us there is a metabolic acidosis (renal disease can cause this). The low PaCO2 tells us there is a respiratory alkalosis or hyperventilation. The primary abnormality must be the metabolic acidosis. The respiratory alkalosis can then be interpreted as compensatory.
You are presented with your long-term 13-year old male neutered domestic longhair patient. You are managing it for poorly controlled diabetes mellitus. At home, the cat is markedly polyuric, polydipsic, polyphagic, and has increased in weight from 7.2 kg (15.8 pounds) to 9.0 kg (19.8 pounds) over the last 3 months. The cat is currently receiving 15 units of protamine zinc insulin every 12 hours with meals. On physical exam, the cat is quiet and mentally dull. He has an enlarged head, paws, and liver on abdominal palpation. A blood glucose curve shows values between 400 mg/dL -500 mg/dL (normal range of 60-125mg/dL) on each reading throughout the day. What is the most effective treatment for the uncontrolled diabetes?
Decreasing the amount of insulin
Increasing the amount of insulin
Surgical exploration of the abdomen
External beam radiation therapy
Iodine 131
External beam radiation therapy
This cat has the signs and symptoms of acromegaly. Acromegaly is caused by excessive growth hormone release from the pars distalis from a tumor in the pituitary gland. Excessive growth hormone causes a defect in the insulin receptors on target cells causing insulin resistant diabetes mellitus. The enlarged head, paws, abdominal organs, and weight gain are due to the anabolic effects of the growth hormone.
The most effective way to treat a pituitary tumor in veterinary medicine is with external beam radiation. Other less effective treatments include high doses of insulin to try and control the diabetes, and somatostatin analogs (octreotide) to try and inhibit the release of growth hormone from the tumor. Surgical excision has been used as a form of treatment in people with pituitary tumors, but this has only been rarely reported in cats. Prior to instituting therapy, pituitary imaging (CT scan +/- MRI) should be performed.
A 3-month old healthy kitten tests positive for FELV (feline leukemia virus) on your in-house ELISA. What do you tell her about her kitten?
If the ELISA is repeated again in 3 months and it is negative, then the kitten is not infected with FELV.
An IFA (Immunofluorescent Antibody Testing) should be submitted. If it is positive as well, the kitten is truly infected with FELV.
An IFA (Immunofluorescent Antibody Testing) should be submitted. If it is negative, then the kitten is not infected with FELV.
The kitten has FELV and is expected to have a shortened life expectancy and is contagious to other cats.
An IFA (Immunofluorescent Antibody Testing) should be submitted. If it is positive as well, the kitten is truly infected with FELV. Correct Answer
FELV is a retrovirus and it is transmitted both horizontally and vertically in the cat. Once a cat is exposed, the virus is propagated through the tissues (from lymphoid tissue which then results in amplification in the spleen, lymph nodes, GALT, intestinal crypt epithelia, and bone marrow). Once the bone marrow is infected, peripheral viremia occurs by infected neutrophils and platelets being released. Finally, excretion of the virus does not occur until 28-56 days after infection, once there is widespread infection of epithelial and glandular tissue which will excrete the virus in saliva and urine.
The ELISA tests for the p27 virus antigen in the serum. The IFA (Immunofluorescent Antibody) tests for p27 antigen in leukocytes and platelets.
Because the virus can be neutralized in some cats before progression/amplification in the body, a positive ELISA may eventually turn negative after a few weeks (in this situation, the IFA will remain consistently negative). If there has been propagation of the virus to the bone marrow then the IFA will be positive.
If you have a positive ELISA test with a negative IFA, it is important to re-test the ELISA again in 3 months to see whether virus neutralization occurred.
Unfortunately, in some cats, an ELISA turning negative 3 months later does not prove that the pet has overcome the infection. Some cats will sequester the virus in their bone marrow resulting in only a positive IFA.
It is a busy day in the clinic and you are down to your last appointment. You are excited to leave for the day and can’t wait to finish this general examination of a 1-year old female cat that was just adopted from the local rescue. The owners would like a general health screen along with information on spaying the cat. On physical exam, you detect a continuous machinery murmur, which is audible on both sides of the chest. Otherwise, the examination was unremarkable, pulses were strong and symmetrical, normal temperature, heart rate, and respiratory rate. The cat was purring making it difficult to hear the murmur but you are certain it is present. You discuss with the owners the likelihood of a patent ductus arteriosus and recommend an echocardiogram to confirm the diagnosis. You also explain to the owners that this condition, although seen in cats, is much more commonly seen in dogs. Assuming the owners will go on to have surgery performed, what muscular landmark allows the surgeon to determine he/she is at the 5th rib space?
Superficial pectoral muscle
Cutaneous trunci muscle
Scalenus muscle
Serratus ventralis muscle
Latissimus dorsi muscle
Scalenus muscle Correct Answer
The correct answer is scalenus m. This applies to both dogs and cats. The 5th rib marks the end of the muscular portion of the scalenus and the beginning of the external abdominal oblique. It is almost impossible to remember all the origins and insertions of muscles; a good tip is to try and at least remember those that provide important surgical landmarks.
The scalenus lies ventral to the origin of the cervical and thoracic parts of the serratus ventralis. It attaches to the first few ribs and the transverse processes of the cervical vertebrae and inserts on the 5th rib.
The serratus ventralis is fan-shaped and originates on the transverse processes of the last five cervical vertebrae and the first seven or eight ribs. It inserts on the scapula.
The superficial pectoral muscle originates on first two sternebrae and usually part of the third. It goes on to insert on the whole crest of the greater tubercle of the humerus.
The latissimus dorsi covers most of the dorsal and some of the lateral thoracic wall. Its origin is at the spinous processes of the lumbar and last 7 or 8 thoracic vertebrae. It inserts on the teres major tuberosity of the humerus and teres major tendon.
The cutaneous trunci muscle is a thin sheet of muscle that covers most of the dorsal, lateral, and ventral walls of the thorax and abdomen. This muscle is responsible for twitching the skin and is innervated by the lateral thoracic nerve.
Collagenolytic granuloma
Eosinophilic ulcer
Eosinophilic plaque
Miliary dermatitis
Collagenolytic granuloma Correct Answer
The image and description are most consistent with a collagenolytic granuloma. Feline eosinophilic granuloma complex consists of 3 separate clinical syndromes:
1) The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the nose, chin (as in this case), oral cavity, or caudal thighs. The lesions are typically raised and ulcerative or nodular as seen here.
2) The eosinophilic plaque occurs most frequently on the abdomen and medial thighs but can appear other places. They appear as single or multiple, raised, red, often ulcerated lesions of varying size (0.5-7 cm). They frequently have a cobblestone appearance and unlike eosinophilic ulcers, these are often pruritic. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy.
3) The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the upper lip and may be unilateral or bilateral. They often have a characteristic central area of yellow to pink tissue with a slightly raised circumferential edge
The underlying cause of eosinophilic ulcers and collagenolytic granulomas are unknown, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested.
Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems. Some cases respond to antibiotic therapy but most require glucocorticoid therapy.
Measure triglycerides on the effusion as compared to peripheral blood
Total protein of effusion greater than 6.0 mg/dL
Cytology of effusion showing no bacteria
Spin down the fluid to see if it will separate; if it won’t separate, it is chyle
Glucose on fluid less than 20 mg/dL
Measure triglycerides on the effusion as compared to peripheral blood
Chyle has a high triglyceride content and if the effusion has a higher triglyceride value than the concurrent peripheral blood sample, this is most diagnostic.
Other than pyothorax, cytology of effusions do not typically show bacteria. This does not aid in the diagnosis but may help to rule out pyothorax.
Protein content of the effusion is not helpful due to the interference of the refractive index by the high lipid content of the fluid.
A 2-year-old male neutered domestic short hair cat presents for acutely being anorexic, lethargic, and not passing any stool. The owner reports that the cat was playing with dental floss 2 days ago and may have swallowed it. On physical exam, the cat is depressed, febrile with a temperature of 104.3 F/ 40.2 C, and resists abdominal palpation. On oral exam, you see that one end of the dental floss is attached to the base of the ventral side of the tongue. Abdominal radiographs show clumped intestines, loss of serosal detail, and an irregular gas pattern in the abdomen. What should you recommend to the owner?
Release the dental floss and allow it to pass through the intestinal tract on its own
Induction of emesis with xylazine
Induction of emesis with apomorphine
Exploratory laparotomy with linear foreign body removal
Endoscopy for linear foreign body removal
Exploratory laparotomy with linear foreign body removal Correct Answer
A 12-year-old female spayed Siamese cat presents for weight loss and progressive vomiting of 2 months duration. On physical exam, the intestines feel diffusely thickened and the cat has a body condition score of 2/9. Blood work shows a low albumin of 1.9 g/dL (normal 2.4-3.9 g/dL), and normal kidney and thyroid values. Abdominal ultrasound confirms the diffusely thickened intestines. There are also several mildly prominent and hypoechoic mesenteric lymph nodes. You suspect the cat has cancer. What is the most appropriate treatment for the type of cancer you suspect in this patient?
Radiation therapy
Cyclophosphamide, vincristine, doxorubicin, and prednisone
Chlorambucil and prednisolone
Surgical resection
Carboplatin
Chlorambucil and prednisolone
The cat most likely has small cell or low-grade intestinal lymphoma based on the history and clinical findings. This is considered an indolent or slowly progressive form of lymphoma and can be effectively treated with chlorambucil and prednisolone. This form of lymphoma is sometimes thought to develop from the progression of inflammatory bowel disease in cats. Chlorambucil is an oral alkylating agent that is usually well tolerated with few side effects. Many cats can live several years with this form of lymphoma and this treatment.
Cyclophosphamide, vincristine, doxorubicin, and prednisone are the drugs in a CHOP chemotherapy protocol used to treat dogs and cats (and people) with high grade or large cell lymphoma, which more commonly manifests as a large focal mass rather than diffusely thickened intestines.
Surgery and radiation therapy are not good treatment options due to the diffuse nature of the cancer.
Carboplatin is not known to be an effective chemo agent for low-grade lymphoma in cats.
Your client is pregnant and is worried about acquiring toxoplasmosis from her cat. What do you advise?
Toxoplasmosis titer should be performed on the owner by a human physician. A positive titer indicates antibodies to the organism that will prevent infection in the first trimester. A negative titer indicates she should remove her cats from her environment.
Submit toxoplasmosis titers from the cat. A positive cat infected with toxoplasmosis can shed multiple times in its lifetime and pose a zoonotic risk.
Submit toxoplasmosis titers from the cat. A IgG titer of 1:64 or greater suggests recent or active infection that could pose a danger.
Have a housemate empty the litter box daily as a simple precaution to prevent infection as it takes 1-3 days for passed oocysts in the stool to sporulate into an infective form.
Have a housemate empty the litter box daily as a simple precaution to prevent infection as it takes 1-3 days for passed oocysts in the stool to sporulate into an infective form.
Toxoplasmosis gondii is a protozoal organism. The cat is the definitive host; the entire life cycle of the organism can be completed within this host. Most cats become infected when they consume an exposed rodent with bradyzoites encysted in their tissues. Only recently infected cats generally shed oocysts in their stool, and cats typically only shed these oocysts for 1-2 weeks. Most cats will only have one shedding episode in their lifetime.
A IgM (not IgG) titer of 1:64 or greater suggests recent or active infection and that cat is at risk of shedding oocysts in their stools. Oocysts are not infective until they sporulate. This process takes > 24 hours, so emptying the litter box daily is advised, preferably by someone who is not pregnant.
If an owner has owned cats for a long while, it is possible that they may have previously been exposed and therefore have mounted an immune response to the organism. If so, it may be advisable to test for Toxoplasma antibody titers in the owner. A sufficient antibody titer will mean the client is protected from infection during the first trimester.
Ivermectin
Hydrocortisone cream
Lyme sulfur dip
This is an environmental contaminant and does not require treatment
Lyme sulfur dip
This is an image of the dermatophyte microsporum canis; one of several organisms that cause ringworm. Approximately 90% of cats affected with a dermatophyte will have microsporum canis. The clinical signs can vary tremendously, however the classic “ringworm” lesion appears as a central/circular region of alopecia with a ring of edema or crusting.
Lyme sulfur dips are very effective at treating dermatophyte infections. You will likely have to do several treatments and also consider systemic therapy. Other topical treatments include miconazole shampoo and enilconazole (currently not available in the United States).
In cats and dogs ivermectin has been used as a microfiliaricide, ecto- and endo-parasiticide.
Hydrocortisone cream will not have any effect on dermatophytes and its sole use would potentially predispose the patient to additional secondary complications.
What is the most frequently observed side effect associated with acepromazine use in horses?
Paraphimosis
Arrhythmias
Hypotension
Seizures
Hypotension Correct Answer
The correct answer is hypotension. Acepromazine will reliably cause hypotension. Acepromazine may cause paraphimosis in male horses, but this is not very common. However, because of this, many veterinarians will not use acepromazine on stallions. Acepromazine actually has anti-arrhythmogenic properties. Acepromazine does reduce the seizure threshold, but seizures are not as common as hypotension
A 4-year old Arabian mare is shipped from the United Arab Emirates to New York where you examine the horse. You note that the horse has a mucopurulent discharge from the nares and has labored breathing and cough. Heart rate is 24 bpm, respiratory rate is 40 breaths per minute and temperature is 104.9 F (40.5 C). You make a smear of the discharge and see large numbers of extracellular straight Gram-negative rods with rounded ends. Which diagnostic test is most likely to confirm your clinical suspicion?
Viral culture of a guttural pouch wash
PCR of the exudate for Rhodococcus equi virulence associated plasmid
Biopsy of the mandibular lymph node
Mallein test PCR of the exudate for SeM protein of Streptococcus equi subsp. equi
Mallein test Correct Answer (KILL THEM HIGHLY ZOONOTIC WORLD HEALTH POTENTIAL)
The horse’s history of arrival from the United Arab Emirates along with the clinical and cytologic findings are consistent with the nasal form of glanders.
Glanders is a bacterial disease caused by Burkholderia mallei (previously known as Pseudomonas mallei). It is thought to be endemic in regions of the Middle East, Asia, Africa, and South America. Glanders can cause disease in donkeys, mules, and small ruminants. Glanders is primarily a concern in horses because they can be chronic or occult carriers that intermittently shed this deadly and potential zoonotic pathogen.
Burkholderia mallei causes 3 different forms of disease; nasal glanders, pulmonary glanders, and cutaneous glanders (also referred to as Farcy).
The nasal form presents with high fever, loss of appetite and labored breathing with cough. Viscous mucopurulent discharge or crusting may be present around the nares. There may be ulceration of the upper respiratory passages that resolve in the form of star-shaped cicatrices (“stellate scars”). Regional lymph nodes may be enlarged and indurated and may rupture or adhere to deeper tissues.
The pulmonary form often develops over several months, beginning as a fever with dyspnea and cough. Lung lesions commence as light colored nodules surrounded by hemorrhage or as diffuse pneumonia. The nodules may become caseous or calcified and discharge contents to the upper respiratory tract. Nodules may also be found in other organs.
The cutaneous form develops over several months, beginning with cough and dyspnea as well. Eventually, nodules develop in subcutaneous tissue along the course of the lymphatics of the legs, costal areas, and ventrum. They can rupture and excrete infectious purulent exudate. Infected lymphatics may form thickened cord-like lesions that sometimes coalesce into a string of beads appearance known as “farcy pipes”. Nodular lesions of other organs may also be found.
Burkholderia mallei can be identified in smears made from fresh lesions as mainly extracellular straight Gram-negative rods with rounded ends. Several diagnostic tests exist including PCR, ELISA, and Western Blot but the two that you actually need to know about because they are used in international trade are complement fixation (CF) serology and the mallein test. The mallein test is considered the most reliable, sensitive, and specific test; it involves injection of mallein purified protein derivative intradermally into the lower eyelid. The test is read at 24 and 48 hours and a positive reaction is characterized by edematous swelling or purulent discharge.
Horses should not be treated; local authorities should be notified if a case is suspect and if disease is confirmed, horses must be humanely destroyed and affected carcasses should be burned and buried.
One of your clients recently purchased a horse that she plans to add to her stable. She is concerned about potential exposure of the horse to Streptococcus equi subsp. equi. Which of the following is the most sensitive test for detecting carriers of the disease?
Nasopharyngeal culture on Columbia CNA (colistin, nalidixic acid) agar with 5% sheep or horse blood
Guttural pouch culture Columbia CNA (colistin, nalidixic acid) agar with 5% sheep or horse blood
PCR of a guttural pouch wash for the S. equi M protein (SeM) gene
Serology for antibodies to S. equi M protein (SeM)
PCR of a guttural pouch wash for the S. equi M protein (SeM) gene Correct Answer
Testing for Streptococcus equi subsp. equi can be complex. The 3 major tests are PCR, serology, and culture. PCR and serology both detect SeM which is an important virulence factor for the bacteria. Culture is best performed on Columbia CNA agar with 5% sheep or horse blood.
While there are pros and cons to each test, the key to answering this question correctly is focusing on the issues of sensitivity and detecting carriers.
PCR is approximately 3 times more sensitive than culture. In general, sampling the guttural pouch is a better way to detect carriers than the nasopharynx because it is where most carriers harbor the organism.
Serology is the best test for assessing exposure but is not a good tool for detecting carriers. This is because antibodies may be elevated after an infection has been cleared or even after vaccination. It may also be falsely negative if an exposure was recent.
To summarize the best uses of culture, PCR and serology:
Culture is the gold standard for diagnosing a horse with an infection.
PCR is best for detecting asymptomatic carriers, establishing infection status prior to or following transport, and to determine the success of elimination of S. equi from the guttural pouch. PCR cannot distinguish live DNA from dead DNA and may have false positives after a cleared infection. Using PCR in combination with culture may be helpful in such an instance.
Serology is best for determining exposure and the need for vaccination as well as for supporting diagnoses of S equi associated purpura hemorrhagica or of bastard strangles.
Papillomavirus is believed to play a role in the pathogenesis.
Metastasis is common with advanced lesions
They usually regress spontaneously without treatment Your Answer
Surgical excision is nearly always curative
Papillomavirus is believed to play a role in the pathogenesis. Correct Answer
Sarcoids are one of the most common tumors in horses. They are considered non-metastatic tumors in virtually all cases. For this reason, small lesions are sometimes treated with benign neglect, but they are not expected to regress. More advanced lesions or tumors in certain sites do need to be treated more aggressively. Unfortunately, no single treatment is universally effective. Recurrence rates after surgical excision are approximately 50%. Although there is still controversy surrounding this issue, either bovine papillomavirus or an equine variant is thought by many to play a role in development of these tumors.
Equine infectious anemia (EIA) infection
Endotoxemia/septicemia (toxic changes within cell)
Streptococcus equi infection
Heinz body anemia
Anaplasma phagocytophilum infection
Anaplasma phagocytophilum infection
Based on the clinical signs (fever, lethargy, tachycardia and limb edema), CBC results (leukopenia, neutropenia, thrombocytopenia) and microscopic observation of a morula within the neutrophil, the correct answer and diagnosis is Anaplasma phagocytophilum infection. Diagnosis can be supported via PCR assays.
Anaplasmosis (formerly Ehrlichi equi) infects primarily neutrophils and form inclusion bodies which consists of one or more coccobacillary organisms within these cells, known as morula. The complete pathogenesis of this disease is not fully elucidated but the organism is spread via tick bites. Other clinical signs that may be associated with this disease include petechiation, icterus and ataxia. The drug of choice for this disease is…(think about it for a second)…you got it…oxytetracycline.
Guttural pouch mycosis
Ethmoid hematoma
Nasal adenocarcinoma
Exercise induced pulmonary hemorrhage
Ethmoid hematoma
The most likely cause of the epistaxis based on the radiographs is ethmoid hematoma. These lesions are angiomatous masses that originate from the mucosal lining of the ethmoid conchae or walls of the maxillary or frontal sinus. Guttural pouch mycosis also can result in epistaxis but typically has no radiographic changes. Although horses can get tumors in the nasal passages, this is relatively rare. Exercise-induced pulmonary hemorrhage also can result in epistaxis, but the blood originates from the lungs. In the radiograph provided, notice the smooth, well-defined soft tissue mass in the sinus region of this horse. No osseous changes or fluid lines are apparent in this radiograph. In this particular case (ethmoid hematoma), the soft tissue mass is actually dorsal to the ethmoid turbinates (ethmoids are normal appearance in this case). Upon surgical removal, a definitive diagnosis of ethmoid hematoma was confirmed.
Constipation
Ataxia
Regurgitation
Anhydrosis
Constipation Correct Answer
The correct answer is constipation. Lethal white foals have aganglionosis of the intestines which leads to hypomotility, megacolon, constipation, colic, and death.
Apply heavy cotton wraps from the foot to the hip, confine calf in sling
Put calf in small water bath so that he is barely weight-bearing for 24 hours a day for 6 weeks
Apply fiberglass cast from foot to stifle
Apply full-length fiberglass cast and Thomas splint
Apply Thomas splint from foot to hip
Apply full-length fiberglass cast and Thomas splint Correct Answer
A calf this age will tolerate a cast and splint well and the bones tend to heal rapidly, usually in 6 to 10 weeks (even this ugly tibial fracture). The cast must be changed every two to three weeks as the calf is growing rapidly at this stage. The cast can reach from the bottom of the foot up to the stifle. The Thomas splint goes from the pelvis to the foot and minimizes stifle movement.
Raise heifers in the foothills and put pregnant heifers in the hills only when 6 months or more pregnant
Vaccinate heifers against Chlamydia psittaci
Put ear tags on all heifers to keep ticks off before putting the heifers in the foothills
Provide hay periodically so that heifers do not eat oak
Feed tetracycline to pregnant heifers for 9 months
Raise heifers in the foothills and put pregnant heifers in the hills only when 6 months or more pregnant
After decades of research, a novel deltaproteobacterium was identified as the causative agent of EBA in 2005. The disease is transmitted by a ground-dwelling soft tick, Ornithodoros coriaceus. Abortion occurs more than 3 to 4 months after exposure, so keeping pregnant heifers out of the foothills until they are 6 months pregnant means they calve before fetal lesions occur. Raising heifers in the foothills until breeding provides premunition immunity, since there is no vaccine as of 2013. Also, the rancher should keep these heifers that abort, as they will now be immune to EBA. Tick control is very difficult on cattle running in the hills, but the ticks do not inhabit irrigated pastures (they live in the dry ground duff of needles and leaves), so bred heifers can be kept in irrigated pastures for months 1-6 of pregnancy. Feeding tetracycline for 9 months is not practical.
Fasciola hepatica
Mycobacterium paratuberculosis
Clostridium chauvei
Fusobacterium necrophorum
Fusobacterium necrophorum
The image shows widespread severe liver abscesses caused by Fusobacterium necrophorum. Fusobacterium necrophorum is a gram-negative, obligate anaerobic bacterium that is a component of normal rumen microflora. In this case, the metritis caused bacteremic spread of the organism which can go to the liver and release local toxins leading to damage and potential abscess formation. Typical Fusobacterium lesions are yellow and spherical with irregular outlines. A diagnosis could be confirmed in this case by culture of the uterine contents and liver. Affected livers are condemned at slaughter. Adhesions to surrounding organs or the diaphragm may require carcass trimming. Liver abscess can also lead to disease associated with thrombosis of the vena cava.
The utility of prophylactic antibiotic therapy in large animal practice is unclear and this practice is often questioned with respect to cost, food safety (milk and meat withdrawal periods), and selection for antibiotic resistance in certain bacterial species. However, in this particular case, prophylactic antibiotics after replacement of the uterine prolapse may have prevented/cleared the uterine infection and/or prevented the bacteremia seeding the liver with fatal consequences.
Fasciola hepatica is the liver fluke of cattle. While Fasciola can cause liver lesions, the lesions typically appear more as tracks and/or hemorrhage. Animals with fasciolosis typically present with abdominal pain or jaundice acutely. Chronically, animals become anemic or anorectic.
Clostridium chauvei is the cause of blackleg in cattle and sheep and causes lameness and fever.
Mycobacterium paratuberculosis is the cause of Johne’s Disease which results in chronic wasting.
Oleander toxicity
Pyrrolizidine alkaloid toxicosis
Gossypol toxicity
Black disease
Mycotoxicosis
Pyrrolizidine alkaloid toxicosis Correct Answer
PAs inhibit mitosis of hepatocytes, so they cannot multiply. As they age, they become large (megalocytes) and when they die they are replaced by fibrous tissue. Bile ducts proliferate as a nonspecific response to hepatic damage. You then look at some of the older alfalfa bales he was feeding to these calves and find loads of Senecio vulgaris, a PA containing plant.
Aflatoxins (a mycotoxin) from Aspergillus and other fungi can cause liver lesions that are similar, but most pathologists think that finding megalocytes is diagnostic for PA toxicity.
Guarded (20-40% chance of survival and recovery)
Fair (50-70% chance of survival and recovery)
Excellent (>95% chance of survival and recovery)
Grave (<10% chance of survival and recovery)
Good (80-90% chance of survival and recovery)
Grave (<10% chance of survival and recovery) Correct Answer
This calf has an abomasal perforation and acute septic peritonitis based on the description. The prognosis is grave, even with prompt veterinary attention. The calf’s signs of dehydration, weakness, and expiratory grunt are additional poor prognostic indicators. Very few animals recover from diffuse peritonitis and those that do will have massive abdominal adhesions. Acute abomasal perforation through a single 1-2 cm ulcer occurs sporadically in young (2-4 month old) beef calves and the cause is unknown.
A neutrophilic pleocytosis
A normal CSF
A lymphocytic pleocytosis
A mononuclear pleocytosi
A mononuclear pleocytosi
The correct answer is a mononuclear pleocytosis. CSF tap is most important for distinguishing Listeriosis from thromboembolic meningoencephalitis (TEME), in which you will see a neutrophilic pleocytosis on CSF cytologic examination. Remember with Listeria, you will often observe CNS signs, an increased number of monocytes and macrophages. Also remember that Listeria is usually contracted from ingesting silage that has been stored at a pH > 5.0
Locoweed
Lupine
Oleander
Yew
Skunk cabbage
YEW
Both Japanese yew (Taxus cuspidata) and English yew (T. baccata) contain alkaloids called taxines that are highly toxic and depress myocardial conduction by blocking sodium movement through membranes. Collapse and sudden death are commonly seen when this plant is ingested, often when clippings are consumed by livestock. Oleander causes similar clinical scenarios.
