Clinical exams and day 1 skills Flashcards
what are some reasons to vaccinate?
responsible pet ownership maintain healthy pet population reduce deaths reduce zoonosis incidence early detection of clinical conditions encourage client education
why must we wait until MDAs (maternally derived antibodies) have decreased before vaccinating?
will inhibit the development of an immune response in the neonate
what are the types of vaccines?
modified live
killed
recombinant
describe a modified live vaccine
contain virus that has been modified to lose its disease causing ability (attenuation)
describe a killed vaccine
attenuated through a process that results in their death
describe a recombinant vaccine
parts of virus/bacteria genetic sequences that encode immunogenic proteins in animals are isolated
what are the core canine vaccines set by the WSAVA?
distemper
hepatits
parvovirus
what are the core canine vaccines set by the BSAVA?
distemper
hepatitis
parvovirus
leptospirosis
what is the main route of infection of canine distemper virus?
inhalation
what are the clinical signs of canine distemper virus?
respiratory, alimentary, oculo-nasal (2 weeks post infection)
neurological (4 weeks post infection)
hyperkeratosis (3 months post infection)
what is the only treatment available for canine distemper virus?
supportive
what virus causes canine infectious hepatitis?
canine adenovirus 1
what are the main routes of infection of canine infectious hepatitis?
saliva
faeces
what cells does canine infectious hepatitis replicate in? and what does this cause?
hepatocytes
liver failure and jaundice
what is the only treatment for canine infectious hepatitis?
supportive
what are the clinical signs of canine infectious hepatitis?
blue eyes pyrexia lethargy cranial abdominal pain vomiting/diarrhoea
what type of vaccine is canine infectious hepatitis?
live attenuated
what dogs does canine infectious hepatitis mainly occur in?
young (<6 months)
what is the route of infection of canine parvovirus?
faeco-oral
where does canine parvovirus replicate?
rapidly dividing cells (intestinal crypts and bone marrow)
what does intestinal crypt necrosis and villous atrophy lead to?
acute enteritis
what are the clinical signs of canine parvovirus?
lethargy
vomiting
diarrhoea (haemorrhagic)
what type of vaccine is canine parvovirus?
live attenuated
what can be used to diagnose canine parvovirus?
clinical signs
faecal SNAP test
what are the non-core vaccinations of dogs?
leptospirosis parainfluenza kennel cough complex herpes rabies
what group of animals is the herpes vaccinated licensed in?
pregnant bitches
what is the route of infection of leptospirosis?
ingestion of infected urine
rodent bites
what are the clinical signs of leptospirosis?
jaundice, haemorrhagic syndrome, uraemia syndrome, chronic active hepatitis
what are the two options for leptospirosis vaccination?
lepto-2 (active against 2 strains)
lepto-4 (active against 4 strains)
what are the benefits of the lepto-2 vaccine?
can give second dose 2-4 weeks after first so able to socialise puppy earlier
what virus is a key component of kennel cough?
canine parainfluenza
from what age can canine parainfluenza vaccine be given?
8 weeks (another dose 2-4 weeks later)
what are the two main components of kennel cough vaccine?
canine parainfluenza
Bordatella bronchiseptica
what type of vaccine is kennel cough?
live attenuated
what is the operator warning for the kennel cough vaccine?
immunocompromised individuals should avoid any contact with the vaccine or vaccinated dogs
what age are the core canine vaccines delivered?
1st - distemper, hepatitis, parvovirus (DHP) at 6-8 weeks
2nd - DHP at at least 10 weeks (2-4 weeks after 1st)
booster at 1 year then every 3 years
what age are the non-core canine vaccines delivered?
leptospirosis and parainfluenza at 8 weeks and then 2-4 weeks later
kennel cough at 8 weeks then both annually
what are the core feline vaccines?
feline panleukopenia virus (FPV)
feline herpesvirus
feline calicivirus
(herpes and calici is cat flu)
what are non-core feline vaccines?
feline leukaemia virus
rabies
what are the routes of infection of cat flu?
nasal
oral conjunctival
(sharing food bowls)
what are the clinical signs of feline calicivirus?
gingivitis/stomatitis
lingual ulceration
transient limp
what are the clinical signs of feline herpesvirus?
chemosis
corneal ulceration
how can cat flu be treated?
supportive
reducing stress
antivirals
what are general clinical signs of cat flu?
rhinitis
nasal discharge
sneeze
what does feline panleucopenia virus attack?
rapidly dividing cells (intestinal epithelium, bone marrow, foetuses)
what is caused by feline panleucopenia attacking intestinal epithelium?
diarrhoea
vomiting
what is caused by feline panleucopenia attacking bone marrow?
panleucopenia
what is caused by feline panleucopenia attacking foetuses?
cerebellar hypoplasia
what is the route of infection of FeLV?
fighting and sharing food bowls (saliva)
what are the clinical signs of FeLV?
reproductive
anaemia
immunosuppression
neoplasia
what are the restart protocols for dog vaccines?
DHPPi require single dose
leptospirosis requires 2nd dose 4 weeks later
what are the requirements of an animal health certificate for travel?
microchipped up to date rabies vaccine supporting documentation (proof of id) tapeworm treatment (certain countries)
how soon after issuing of an AHC does the animal have to travel?
within 10 days
what are the most common vaccines given to horses?
influenza and tetanus
what equine vaccinations are available in the UK?
influenza tetnus herpes strangles rotavirus west nile virus equine viral arteritis
what is the main reason for controlling equine influenza?
the economic impact of outbreaks on the equine industry
describe the morbidity and mortality of equine influenza
high morbidity
low mortality
how many equine influenza vaccines are on the UK market?
3
what equine influenza vaccine contains both clade 1 and 2, hence is the only one to apply with the OiE recommendations?
Proteq-Flu
what vaccine is compulsory for racehorses?
equine influenza
what are the Jockey Club Rules for the influenza vaccine?
horse must have received two primary vaccinations between 21 and 92 days apart
they also require a booster between 150 and 215 days after the second vaccine
how often does a horse need an influenza booster if it is competing under the FEI?
every 6 months
what are the ProteqFlu data sheet dates for vaccine administration?
second jab 4-6 weeks after the first
third jab 5 months after the second
booster every year
what has to be filled in when administering a vaccine to a horse?
their passport
is tetanus treatment effective in horses?
no, very poor prognosis
what age can tetanus vaccine usually be given from in horses?
6 months
what is the primary tetanus vaccination course in horses?
2 vaccines 4-6 weeks apart and third with 12-17 months after the first
how often does a horse need a booster for tetanus?
every 2 years
can pregnant mares be given the tetanus vaccine?
yes, usually 4-6 weeks before foaling (may give passive immunity to foal)
what is used to provide immediate protection to tetanus in horses?
tetanus antitoxins
how long does tetanus antitoxin work for?
about 3 weeks
where does tetanus antitoxin have to be kept?
in a fridge
can tetanus antitoxin and vaccination be given at the same time?
yes, but at a different site
who can implant microchips in horses?
only vets
when are the exceptions for a horse not being accompanied by its passport?
emergency situations
at pasture or stabled
moved on foot
participating in an event requiring horse to leave the venue
at what age must a horse have a passport?
within 6 months of birth or by 31st December of its birth year
what do you do if you want to give a horse bute or flunixin but the passport is present but unsigned?
get owners consent and sign the passport before giving bute/flunixin
what do you do if you want to give a horse bute or flunixin but the passport isn’t present?
can get an emergency treatment for or administer a drug suitable for food producing animals
what horses need to be microchipped?
all (unless they are truly wild)
where is a horses microchip placed?
nuchal ligament
what is the procedure for giving a horse a microchip?
scan to ensure it doesn’t already have one
scan new chip to make sure the numbers are correct
clip and clean the area
insert local anaesthetic
insert microchip
fill out ID form
how do you mark a horse is microchipped on a passport?
M with a circle round it pointing to where it was inserted
what are the general rules for identification on a horse passport?
description in black ink in capitals whorls marked as X white marks outlined in red and hatched food colour is marked flesh marks drawn as solid red prophets thumb mark is a black triangle acquired marks are drawn as a black arrow narrative must match the sketch
what are the stages of a farm animal clinical exam?
take history background knowledge of farm/client full clinical exam on animal look at environment sampling for testing
what are the three approaches to reaching a diagnosis in farm clinical examination?
blunderbuss
algorithmic
pattern matching
what is the blunderbuss approach to clinical examination?
examine the animal from top to toe
take lots of tests to rule out different diagnosis
fit the tests into a model or database to get a diagnosis
what are the disadvantages of the blunderbuss approach?
not very methodical
expensive
time consuming
(shouldn’t use this approach)
describe the algorithmic approach to reaching a diagnosis
flow chart approach using and, or, not and if
what are the advantages to the algorithmic approach for diagnosis?
simple
can train farmers to use
(still to simple for us to use)
what is the best method to use to reach a diagnosis on farm?
hypotheticodeductive model (generation and testing of hypothesis)
define sensitivity
proportion of true positives detected
define specificity
proportion of true negatives detected
define positive predictive values
probability a test positive result is truly positive
define negative predictive value
probability a test negative result is truly negative
what is the first step of a farm animal clinical exam?
restrain the patient and exam from a distance
when examining a cow from a distance what are you looking for?
coat quality and cleanliness lameness (mobility) BCS demeanour lesions
what do you examine at the tail end of a cow?
temperature
vaginal discharge
MM colour
where do you listen to the rumen of a cow?
left hand side
behind the last rib and under the transverse process
what is the withers test on a cow for?
check for cranial abdominal pain, should dip down twice if none is present
what is the turnover rate of the rumen?
3 every 2 minutes
what are the three most relevant questions to ask during an equine clinical exam?
what is the horse used for?
how old is it?
how is it kept?
why is finding out what the horses is used for an important part of a clinical exam?
problems - common issues for its work
future expectations - what condition does this horse need to return to
timescale for resolving the issue
drugs/treatment options
why is asking how the horse is kept an important question?
problems are sometimes associated with management
rule out diagnosis
problems often associate with changes in routine
can influence treatment
what two things must be done when examining a colic?
ensure safety
decide if it is medical or surgical
when examining a coughing horse, what is the main thing that must be established?
is the cause allergic or infectious
what are the three main questions to answer when examining a lame horse?
is it actually lame?
which leg is lame?
where on the leg is the problem?
when examining a horse described as off-colour what are the three differentials you want to rule out?
colic
neurological
pyrexia
what is a very good simple test to determine how ill a horse actually is?
food test - offer them food, if it doesn’t eat it chances are it is fairly ill
when examining a horse with weight loss, what two factors need to be decided?
is the problem pathological or management
is the horse ill or healthy
what is triage?
the skill to sort multiple cases into order of priority
what are some examples of emergency presentations that need immediate assessment?
distended abdomen with non-productive retching (dog) breathing difficulties seizures lasting >5 minutes major trauma major bleeding (pulsatile flow) male cat unable to urinate dystocia (stuck pup/kit) toxin ingestions within the last 2 hours
what is the first step of triage?
get a capsule history
what should be found out in a capsule history?
presenting signs current medications onset/duration consent to stabilise patient (can be easier to separate owner and patient)
what must be done as soon as the patients have been sorted into order of priority?
explain to owners what is happening!!
what acronym can be used to quickly assess a patient?
ABCD
alert, breathing, circulation, disability
acute failure of which systems will lead to rapid death?
CV
respiratory
neurological
what should be examined when assessing the cardiovascular system?
HR and rhythm pulse quality and rate MM CRT auscultation
what should be examined when assessing the respiratory system?
respiratory rate respiratory effort pattern (dyspnoea, mouth breathing, paradoxical) noise (without stethoscope) auscultation
what should be done if a cat is mouth breathing?
give immediate oxygen
what is the main thing assessed during an emergency neurological exam?
the animals mentation
what is the scale of mentation?
alert and responsive quiet dull obtunded comatosed seizuring
what are the three main aims of stabilisation?
prevent current issue getting worse
find a cause of the problem
welfare (analgesia!!)
when presented with an unconscious patient, what are the differentials that you should try to rule out?
hypoglycaemia (check glucose) severe shock (CV signs) seizuring (medicate) toxins heatstroke arrest
what are the first two things to do with patients in respiratory distress?
reduce stress
give oxygen
an animal comes in with an external haemorrhaging wound, what should you do?
put gloves on direct pressure on wound with swabs don't remove base layer of swabs (add more if needed) analgesia support CV system
what was BARTA formed for?
to set out protocols to make rescues more efficient and safer for vets and rescue workers
what does BARTA stand for?
British Animal Rescue and Trauma care Association
what is the role of the vet in large animal rescue situations?
triage (injury assessment)
restraint (physical/chemical)
euthanasia
welfare advise
what are the priorities when being called to a large animal rescue?
create a safe workplace place head restraint assess if animal is worth rescuing provide chemical restraint contact owner provide analgesia do not release animal until there is a safe place for them
what are common chemical restraints for horses?
alpha 2 agonists - xylazine, detomidine, romifidine
what are some ways of euthanasia?
lethal injection
shooting
aortic severance per rectum
what are some examples of reasons you may be struck off?
causing serious harm to animals or public
sexual offences
offences involving violence or loss of human life
evidence of a harmful deep-seated personality problem
dishonesty (false certification)
what are the four main hazards for vets when certifying?
negligence
criminal offence
professional misconduct
loss of OV status
what do the 10 principles of certification ensure vets are/do?
caution
clarity
certainty
challenge
what are the 10 principles of certification?
vets should only certify matters which are within their own knowledge/can be ascertained to them personally/are subject to supporting evidence from an authorised vet
vets should not issue a certificate that may raise conflict of interests
should only sign certificates written in a language they understand
vet should not certify that there has been compliance with the law of another country
vets should only sign original certificates
ensure the certification doesn’t contain deletions or alterations
certificates should be written in simple terms which are easy to understand
certification should be clear and concise with a unique identifier
certificates should not uses words with multiple interpretations
certificates should identify the subject being certified
what does SOAP stand for?
Subjective
Objective
Assessment
Plan
what are some things looked at on a subjective exam?
BCS, behaviour, demeanour, gait
when assessing the head of a small animal, what is looked for in the objective exam?
posture of head/neck
symmetry
discharge
when assessing the eye of a small animal, what is looked for in the objective exam?
abnormalities uni/bilateral
size/symmetry
position
discharge
what are some common issues concerning the eyes of small animals?
ectropian entropian cataract protrusion ulcers
when assessing the nose of a small animal, what is looked for in the objective exam?
discharge
airflow
swelling, depigmentation, symmetry
pain
when assessing the mouth of a small animal, what is looked for in the objective exam?
symmetry
MM - colour, moisture, masses
CRT
oral trauma, neoplasia, ulcers
when assessing the teeth of a small animal, what is looked for in the objective exam?
tartar
periodontal disease
fractures
when assessing the ears of a small animal, what is looked for in the objective exam?
pinna - haematoma, hyperplastic change, neoplasia
discharge - purulent, ceruminous, parasites, haemorrhagic
when assessing the neck of a small animal, what is looked for in the objective exam?
palpate larynx
palpate trachea
palpate thyroid gland
jugular veins
where are the common lymph nodes that can be palpated?
prescapular
submandicular
popliteal
when assessing the abdomen of a small animal, what is looked for in the objective exam?
organomegaly
fat
ascites (fluid thrill)
distension (pyo/pregnancy or GD/GDV)
what organs can be palpated in the abdomen of dogs?
liver (under costal arch) stomach and spleen (left cranial) kidney (mid abdomen) small intestine - gas/fluid filled colon bladder - size, shape, turgidity
when assessing the skin of a small animal, what is looked for in the objective exam?
masses
external parasites
alopecia
lesions - pustules, nodules, vesicles, scales, crusting
when assessing the respiratory system of a small animal, what is looked for in the objective exam?
respiratory rate/effort/rhythm
chest auscultation
tracheal auscultation
what is the normal RR of a cat?
20-40bpm
what is the normal RR of a dog?
10-20bpm
what is the normal HR of a dog?
70-140bpm
what is the normal HR of a cat?
145-200bpm
what rip spaces is the heart listen to in on dogs/cats?
3, 4, 5 on the left
4/5 on the right
when assessing the pulse of a small animal, what is looked for in the objective exam?
quality
symmetry
synchronous
(femoral and peripheral)
what is the normal temperature range for a cat?
38-39.5
what is the normal temperature range for a dog?
37.5-39.2
when rectally examining a dog, what is looked for in the objective exam?
pelvic canal prostate masses perineal region anal sacs