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PVS > Clinical and euthanasia > Flashcards

Clinical and euthanasia Flashcards

1
Q

List the main settings of keeping animals that may present a potential risk for public health

A
  • Home
  • Pet shops
  • Companion animals in pet zoos/open farm
  • Occupational risks
  • Leisure pursuits
  • Farm animal species kept as pets
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2
Q

List significant risks to public/human health from companion animals

A
  • Zoonoses
  • Bite injuries
  • Transmission of specified diseases
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3
Q

List factors that may increase the risk of zoonoses from companion animals

A
  • Population density of humans and pets is increasing
  • Exotic and “novelty” pet species increasing
  • Close contact between pet and human esp. children
  • Companion and wild animals as reservoirs of disease
  • Pet travel and migration of wild animals increasing spread of diseases
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4
Q

Outline the public health significance of dog bites

A
  • Increasing incidence
  • Women bitten more than men
  • Children 20% of cases (face and hands mostly)
  • Adults mainly hands and legs, 10% head/neck
  • Loss of tissue function, disfigurement
  • Occupation risk
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5
Q

Outline ways in which dog bites can be prevented

A
  • Education
  • Appropriate restraint in vet practice
  • Legal enforcement of dogs act 1871
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6
Q

What is the purpose of the Dangerous Dogs act 1991?

A

Protection of people after growing concerns over “status dogs”

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7
Q

Outline the content of the Dangerous Dogs act 1991

A
  • Prohibits certain breeds of dogs
  • Prohibits any dog to be “dangerously out of control” in a public place, or place where it is not allowed
  • Dogs can be seized
  • Owner must be able to prove that dog is not of prohibited type
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8
Q

Outline the contents of the Dangerous Dogs Act Amendment 2014

A
  • Extended definition of out of control to cover all public and private spaces (excl. burglars)
  • Extends to attacks on assistance dogs as well as people
  • Court to take into account the character of owner/keeper and temperament of dog, plus past behaiour
  • Death: 14yr sentence, injury: 5 yr sentence, assistance dog attacked: 3yr sentence
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9
Q

Outline the occurrence of infection following bite injuries

A
  • Severe infections in 20% of reported cases
  • Septicaemia can develop quickly
  • Infection with commensal flora from human skin and/or animal oral cavity
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10
Q

What pathogen is common in cat and dog bites?

A

Pasteurella multocida

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11
Q

What pathogen is common in fish bites?

A

Halomonas vensuta

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12
Q

What pathogen is common in reptile bites?

A

Serratia mercescens

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13
Q

What pathogen is common in rat bites?

A

Streptobacillus moniliformis (rat bite fever)

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14
Q

Describe the pathogen that causes cat scratch disease

A
  • Bartonella henselae
  • Gram -ve
  • Intracellular bacterium
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15
Q

Describe infection with Bartonella henselae

A
  • Transmitted by cat scratch, or flea faeces or saliva of infected cat
  • Transmitted between cats via Ctenophalides felis
  • Usually self-limiting disease in humans, can become chronic./recurrent, frequently unresponsive to antibiotics
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16
Q

Outline the prevention of cat scratch disease

A
  • Eliminate fleas

- Educate owner about risk

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17
Q

Describe the clinical signs of cat scratch disease

A
  • Lymphadenopathy
  • Haemotropic, adheres to RBCs and causes bacillary angiomatosis of lymph nodes (benign tumour-like microvascular proliferation)
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18
Q

Describe the pathogen that causes psittacosis

A
  • Chlamydophila psittaci
  • Gram -ve intracellular bacterium
  • Aka ornithosis, Avian chlamydiosis
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19
Q

Which species are affected by psittacosis?

A
  • Psittacines and columbiformes mainly

- Also ducks, turkeys, chickens and >450 other bird species

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20
Q

Describe psittacosis in psittacines

A
  • Often chronically infected
  • Asymptomatic until stressed
  • Shed intermittently throughout life
  • Source of infection for humans and other birds
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21
Q

Describe the clinical signs of psittacosis in birds

A
  • Nasal/ocular discharge
  • Yellow-green diarrhoea
  • Respiratory distress
  • Acute infection in young ducks characterised by ataxia, diarrhoea, purulent ocular and nasal discharge
  • Chronic cases show emaciation and chronic respiratory involvement
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22
Q

Outline the public health significance of psittacosis

A
  • Zoonotic to humans
  • Inhalation of contaminated faeces and dust, mouth-to-beak contact, bird bites
  • Occupational hazard in poorly-ventilated abattoirs in particular
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23
Q

Outline the clinical manifestation of psittacosis in humans

A
  • Flu-like illness, pneumonia

- Fatalities and person-person transmission rare

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24
Q

What groups are at particular risk of psittacosis?

A
  • Vets
  • Poultry processing workers
  • Bird keepers
  • Young, elderly, immunocompromised, pregnant women
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25
Q

Outline the prevention of psittacosis

A
  • Eradication in birds not possible
  • No vaccine
  • Can be reduced with antibiotics but is resistant and intracellular (difficult)
  • PPE when processing ducks and turkeys
  • Regular clear out of faeces from pet birds, good ventilation
  • Rehome or cull vulnerable birds
  • Where suspected, quarantine and treat all birds in consignment with oxytet
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26
Q

Is psittacosis reportable?

A

Yes, report to the CCDC in Cambridgeshire

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27
Q

Describe the agent that causes rabbit fever (tularaemia)

A
  • Francisella tularensis
  • Gram -ve bacterium
  • Type A in USA, Type B everywhere else
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28
Q

What are the reservoirs of tularaemia?

A
  • Rodents
  • Other small mammals
  • Rabbits in particular
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29
Q

What are the possible routes of transmission of tularaemia?

A
  • Aerosol
  • Ectoparasites
  • Bites, scratches, wounds, open sores
  • Consumption of contaminated food/water
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30
Q

Describe the typical symptoms of tularaemia in humans

A
  • Fever
  • Diarrhoea
  • Vomiting
  • Ulcers
  • Haemorrhage
  • Pneumonia
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31
Q

Compare the susceptibility of dogs and cats to tularaemia

A
  • Cats more susceptible

- Dogs relatively resistant

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32
Q

Outline the prevention and treatment of tularaemia

A
  • Vaccines available for humans but not animals
  • Antibiotics including aminoglycosides, fluoroquinolones
  • Ectoparasite control in endemic areas important
  • Prevent consumption of contaminated water
  • Educate “at risk” groups
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33
Q

What are some at risk groups for tularaemia?

A
  • Outdoor workers
  • Vets
  • Walkers
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34
Q

Describe the pathogen that causes ringworm

A
  • Dermatophytosis
  • Microsporum in cats
  • Trichophyton in horses
  • Fungal
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35
Q

What are the common reservoirs of ringworm?

A
  • Dog
  • Cat
  • Horses
  • Rabbits
  • Rodents
  • Cattle
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36
Q

Outline the control and treatment of ringworm

A
  • Generally self limiting
  • Common zoonosis
  • Systemic or topical antifungal agents used e.g. itraconazole, chlorhexidine washes also effective in severe cases
  • Decontamination of environment and equipment
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37
Q

Describe the pathogen that causes bordetellosis (kennel cough)

A
  • Bordetella bronchiseptica
  • Gram -ve
  • Strict anaerobe
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38
Q

Describe bordetellosis in humans

A
  • Purtussis-like disease

- Whooping-style cough

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39
Q

Outline the prevention and treatment of bordetellosis

A
  • Prevention with vaccine (but can be ineffective and short-lived)
  • Treatment usually supportive
  • In severe cases may treat with tetracyclines
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40
Q

What is the consequence of bordetellosis in the presence of other pathogens?

A
  • Synergy

- In particular with Mycoplasma and canine respiratory coronavirus

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41
Q

Outline the public heath risk of Helicobacter pylori

A
  • Causes GI disease, ulcers, stomach cancer in huamns
  • High prevalence in humans (esp. older)
  • Significance of zoonotic link unclear (some found in cat faeces, saliva and dental plaques but may be reverse zoonosis i.e. from humans to cats)
42
Q

Outline the public health significance of Campylobacter

A
  • Frequently found in cats and dogs
  • C. jejuni shed by dogs over 1 yr old, C. upsaliensis present in all ages
  • Zoonotic link unlcear
  • C. upsaliensis occasionally causes infections in humans but may be that humasn and animals are exposed to common source e.g. chicken
43
Q

Name the canine hookworks

A
  • Uncinaria stenocephala

- Ancylostoma caninum

44
Q

Outline the public health risk of Uncinaria stenocephala

A
  • Endemic in UK
  • 30% of dogs infected, 70-90% of foxes
  • Mild dermatological signs in humans
45
Q

Outline the public health risk of Ancylostoma caninum

A
  • Mostly tropical and subtropical
  • Cutaneous larva migrans
  • possible spread to UK due to climate change and pet travel
46
Q

Outline the prevention methods of canine hookworm

A
  • Humans: personal hygiene, limit possible contact of larvae to skin esp. abroad (beach towel, footwear)
  • Animals: house in conditions which prevent build up of infective large (dry, well maintained)
  • Dogs: routine de-worming with pyrantel
47
Q

Outline the public health risk of Salmonella

A
  • Food-borne infection risk greater than that from companion animals
  • Dogs and cats can shed in faeces/saliva
  • All reptiles/amphibians presumed to carry Salmonella
48
Q

Outline the control of salmonellosis

A
  • Antibiotic treatment not recommended (resistance) so difficult to eradicate
  • Hygiene measures e.g. wash hands after handling, do not use kitchen for washing, disposal of bedding
49
Q

Outline reptile associated salmonellosis

A
  • 27% of salmonella cases in <5yo children linked to reptiles
  • ASPHA and PHE ensure screening of frozen mice imported as feed
  • 50% of mice +ve for Salmonella
  • Source of contamination from reptile feed to human food
50
Q

Describe the pathogen that causes Lyme disease

A
  • Borrelia burgdorferi

- Gram -ve spirochaete bacteria

51
Q

What animals act as reservoirs of Lyme disease?

A
  • Deer
  • Wild mammals
  • Birds
  • Rodents
52
Q

What is the significance of rodents in Lyme disease?

A

Ticks need rodents in the first stage of their life cycle and ticks are the source of Lyme disease transmission

53
Q

Describe Lyme disease in humans

A
  • Variable incubation time (4-32 days), up to 8 weeks to develop antibodies, may have no recollection of tick bite
  • Early disease characteristic - expanding “bulls eye” skin rash (erythema migrans)
54
Q

Describe Lyme disease in dogs

A
  • Sudden lameness (2-5 months after tick bite)
  • Severe pain, swollen joints, depression, lethargy, kidney failures, seizures
  • Chronic form of disease rarer in dogs cf humans
55
Q

Outline the control of Lyme disease in dogs

A
  • Vaccine available (efficacy disputed)
  • Doxycycline effective when used within 4 weeks
  • DEET repellent and prompt removal of ticks
56
Q

Outline the public health significance of Lyme disease

A
  • Most significant vector borne infection in UK/Northern Europe
  • Prompt antibiotic admin important otherwise end up with debilitating condition
  • Suitable clothing as well as DEET and prompt removal of ticks can help prevention in humans
57
Q

Describe the characteristics of type 1 decision making

A
  • Instant
  • No analysis
  • Intuitive
  • Use past experience
  • Quicker, cheaper
  • Orone to error
58
Q

When would it be appropriate to use type 1 decision making in a clinical scenario?

A
  • Pattern recognition

- Symptomatic treatment

59
Q

Describe the characteristics of type 2 decision making

A
  • Slower
  • Analytical
  • Conscious
  • Serial/rational
  • Multiple pieces of evidence
  • More accurate
  • May be costly
  • Slower
60
Q

When would it be appropriate to use type 2 decision making in a clinical scenario?

A
  • Gathering of evidence
  • Where a definitive diagnosis is required
  • Where there is time to establish the full clinical picture (i.e. not emergency scenario)
61
Q

What is meant by shared decision making?

A

Communication between vet and client in order to come to a fully informed decision that both parties are happy with

62
Q

What is meant by Evidence Based Veterinary Medicine?

A

Use of best relevant evidence in conjunction with clinical expertise to make the best possible decision about a veterinary patient

63
Q

What may affect test results?

A
  • Prevalence of the disease in the population tested
  • Incorrect labelling
  • Incorrect calibration of machines
  • Storage of samples or test reagents
  • Experience/skill of person carrying out test
  • Recording of results
64
Q

What is meant by paternalism with regards to clinical decision making?

A

Where the vet makes the decision

65
Q

What is meant by autonomy with regards to clinical decision making?

A

Where the client makes the decision

66
Q

What is meant by anchoring bias?

A

Latching onto the first/one thing we hear in conversation

67
Q

What is meant by availability heuristic bias?

A

Overestimation of the important of the evidence available

68
Q

What is meant by choice supportive bias?

A

Decisions made remain “good” even where there are issues

69
Q

What is meant by recency bias?

A

Last decision influences next decision

70
Q

What is meant by confirmation bias?

A

Exploration/hearing of information that confirms preconceptions

71
Q

Outline some of the laws set out for euthanasia

A
  • Is not an act of veterinary surgery but must be human
  • Not obliged to kill healthy animal
  • RSPCA inspectors can use pentobarbitone to euthanase wild animals
  • AWA 2006: welfare of animal is first priority
  • Need owner consent unless delay would adversely affect animal’s welfare
72
Q

Outline some reasons for euthanasia

A
  • Welfare
  • Chronic disease
  • Acute disease
  • Convenience
73
Q

What is the definition of euthanasia?

A

Killing to relieve suffering, welfare reasons

74
Q

Compare euthanasia and killing

A
  • Euthanasia is for welfare reasons

- Killing is for non-welfare reasons e.g. food production, fur production, lab animals

75
Q

What is culling?

A

Killing of wild, food, feral and zoo animals (not for welfare reasons)

76
Q

What are the requirements for informed consent for euthanasia?

A
  • In small animal practice often have a form
  • Not always the case in large animal, ideally witness to this consent
  • Owner must be >16yrs
  • Over the telephone consent need a witness and consent form countersigns
77
Q

Outline the guidelines for the euthanasia of dangerous dogs

A
  • Need to request destruction order from court
  • Unless the dog is a genuine threat to human safety
  • Various legislation involved
78
Q

Outline the guidelines for euthanasia in equine sports

A
  • May need to act without owner consent, trainer second best under BHA rules
  • Record circumstances
  • Confirmation from another vet ideal
  • Ensure adequate insurance of self
  • Ensure identification of correct animal
79
Q

Outline the legislation regarding wildlife casualties

A
  • Legislation differs depending on species
  • Contact DEFRA, local Animal Health Office, English Nature for advice
  • Regional differences
  • Wildlife and Countryside Act 1981 states suffering animal can be taken for treatment, if treatment not possible then may be killed
  • AWA 2006 also covers wild animals
  • RSPCA inspector cannot give consent for euthanasia
80
Q

What should the method of euthanasia lead to in all cases?

A
  • Rapid unconsciousness
  • Cardiac and/or respiratory arrest
  • Loss of brain function
  • Should be painless
  • Minimal stress and anciety
81
Q

What are the different methods of euthanasia broadly?

A
  • Hypoxia
  • Pharmacological
  • Physical
82
Q

Outline euthanasia via hypoxia

A
  • Slaughter
  • Indirect or direct
  • Inhalation: CO, CO2, nitrogen
  • Unconsciousness: electrical stunning, non-penetrating captive bolt, CO2
  • Killing: exsanguination, electrocution, potassium chloride injection
83
Q

What are the injectable agents that can be used for euthanasia?

A
  • Sodium pentobarbital

- Potassium chloride

84
Q

Outline the use of sodium pentobarbital for euthanasia

A
  • Rapid onset
  • Pentobarbitone or somulose (secobarbital/quinalbarbitone and cinchocaine hydrochloride)
  • Often brightly coloured solutions
  • IV admin
  • Non-selective CNS depression
  • Method of choice for SA, many exotics and some horses if not entering food chain
  • Persists for long periods in carcass
85
Q

Outline the mechanism of action of sodium pentobarbital

A
  • Non-selective CNS depression

- Affects synaptic transmission by enhancing GABA-mediated inhibition

86
Q

What are the effects of sodium pentobarbital’s action on the cerebral cortex?

A

In cerebral cortex leads to unconsciousness and anaesthesia

87
Q

What are the effects of sodium pentobarbital’s action on the respiratory centre?

A

Leads to apnoea and subsequent cardiac arrest

88
Q

Outline the use of potassium chloride

A
  • Cardiotoxic
  • Used for euthanasia of livestock/wildlife species where carcasses may be consumed
  • Reduces toxicosis for predators/scavengres
89
Q

What is a disadvantage of potassium chloride euthanasia?

A

Injection is painful and must be used only after induction of unconsciousness e.g. non-penetrating captive bolt or general anaesthesia

90
Q

How is potassium chloride administered?

A
  • IV

- Intracardiac

91
Q

Which inhalational agents can be used for euthanasia?

A
  • Sevoflurane
  • Isoflurane
  • Carbon dioxide
  • Nitrogen
  • Carbon monoxide
92
Q

What is the mode of action of inhalational agents in euthanasia?

A

Induce CNS depression and hypoxaemia

93
Q

Compare the use of sevoflurane and isoflurane in euthanasia

A
  • Sevoflurane is non-irritant
  • Isoflurane has pungent odour and may cause animal to hold breath, leading to delayed onset of unconsciousness and more drug required
94
Q

Outline the use of common inhalational anaesthetic agents in euthanasia

A
  • Usually small exotics and wildlife <5kg
  • Use vapours (liquid phases are irritant)
  • Closed receptacle containing gauze/cotton wool soaked with anaesthetic agent
  • Induction box
95
Q

Outline the use of carbon dioxide for euthanasia

A
  • Is an anaesthetic agent
  • Laboratory animals, food production animals e.g. pigs
  • No longer recommended (caustic)
96
Q

Outline the use of nitrogen for euthanasia

A
  • Induces hypoxaemia

- Used mainly in food production, e.g. poultry

97
Q

Outline the use of carbon monoxide for euthanasia

A
  • Induces hypoxaemia
  • Laboratory animals mainly
  • Used in some shelters for aggressive animals
98
Q

What is commonly used for the euthanasia of fish?

A

Tricaine methane sulfonate (TMS or MS222)

99
Q

Describe the use of TMS or MS222 for the euthanasia of fish

A
  • powder made into solution and buffered with sodium bicarbonate to pH 7.0-7.5
  • May or may not premedicate with medetomidine
  • Fish pale with sedation
  • Leave fish in solution for at least 10 mins after cessation of opercular movement
  • Not appropriate for fish intended for consumption
100
Q

What is tricaine methane sulfonate and what is its mechanism of action?

A
  • Benzoic acid derivative
  • Causes CNS depression
  • Used in the euthanasia of fish

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