Companion Animal Pathology II Flashcards
Senior pet - descriptors
- Fraility - dec functional reserve, decline in physiological + cog performance, vulnerable to disease, more susceptible to drug effects (+ polypharmacy)
- Immunosenescence - immune dysfunc, remodelling of lymphoid tissues, susceptible to infections, autoimmune disease + neoplasia
- Inflammaging - chronic inflam
Senior pet diseases
- CVS
- Chronic renal disease
- Cognitive dysfunc
- Osteoarthritis
- Immune problems
- Neoplasia
- Thyroid problems
- Diabetes mellitus
- Cushing’s
- Vision + hearing changes
- Dental disease
- Multiple organ involvement
Heart disease
- Inc vascular + myocardial stiffness -> difficult to maintain BP
- Myocardial fibrosis in muscle
- Valvular degen - small dogs
- Reduced adrenergic response
Heart diseases - dog
- Myxomatous valve disease - small breeds
- Dilated cardiomyopathy - large breeds
- Pericardial disease
- Arrhythmia
- Systemic hypertension
Heart diseases - cat
- Hypertrophic cardiomyopathy
- Systemic hypertension
Heart disease Dx
- CS - lethargy, syncope, cough, exercise intolerance, inc resp rate
- PE - heart murmur, arrhythmia, pulse deficit, weak pulses, retinal bleeds (cats)
- Dx - Radio, ECG, echocardiogram, NT-proBNP, cardiac troponins, BP, holter monitor, resting resp rate
Renal system (senior)
- Common in older cats
- Reduced GFR, glomerulosclerosis, interstitial fibrosis
- CS - lethargy, anorexia, weight loss, V+, PUPD, incontinence
- Dx - cachexia, oral ulcers, abdo kidney palp, low USG, proteinuria, anaemia, hypertension + retinal changes, uraemia + elevated SDMA, electrolyte imbalance, radio, US
Neuro disease (senior)
- Canine + Feline cognitive dysfunc
- 14 - 25% dogs > 8 y/o
- Similar to Alzheimer’s disease beta amyloid plaques/senile plaques
- Chronic pain-related anxiety - pain management
- Early detection + Tx -> inc QoL
- Dx = DISHAA - disorientation, social interaction, sleep-wake cycle, housetraining, activity, anxiety
MSK (senior)
- Easily Dx in dogs, but cats hide pain
- Cats rarely have crepitus on joint manipulation
- > 60% cats have evidence of arthritis in one or more joints
Osteoarthritis
- CS - lameness, pain, inactivity, reluctance to jump, dec mentation, reduced grooming in cats, getting ‘slow’
- Dx - PE, radio, CT
Immune disease - senior
- Immunosenescence - reduced immune response - need to maintain vacc
- Auto-immune disease - IMHA, IMTP
- Neoplasia
Neoplasia (dog)
- Lymphoma (multicentric)
- MCT
- Haemangiosarcoma (spleen)
- Osteosarcoma
- Anal sac adenocarcinoma
- Melanoma
- Transitional cell carcinoma
- Soft tissue sarcoma
- Melanoma
Neoplasia (cat)
- Lymphoma (GIT)
- SCC
- Soft tissue sarcoma
- Injection site sarcoma
Neoplasia
- CS - weight loss, anorexia, V+, D+, dyspnoea, coughing, limping, PUPD, palpable + visible masses, pain, behaviour changes, haematuria
- Dx = PE, CBC, serum chem, urinalysis, radio, US, FNA, cyto, biopsy, special staining, tumour markers, CT, MRI
Hyperthyroidism
- Cats more common
- CS - weight loss, hyperactive, aggressive, tachypnoea, tachycardia, poor coat, V+, D+, polyphagia, PUPD, lethargic
- Dx - screening - total T4 + free T4
Hypothyroidism
- Dogs more common
- CS - weight gain, lethargy, ‘sad’ expression, mental dullness, alopecia + coat changes, bradycardia, inappetence, anaemia
- Dx - PE, CBC, biochem, TT4, TSH
Diabetes mellitus
- CS - PUPD, polyphagia, weight loss, blindness, DKA (diabetic ketoacidosis), neuropathy
- Dx - blood glucose, fructosamine (long-term glucose), urinalysis + culture, US
Hyperadrenocorticism
- Cushing’s disease - can start in middle age
- CS - PUPD, polyphagia, pot belly alopecia, panting, weakness, seizures, lose muscle mass on lower limbs
- Dx - screening tests + confirmatory tests - ACTH stim test, low dose dexamethasone test, US, MRI
Vision + hearing changes (senior)
- Vision - not all, dec vision, hardening of lens - loss of focus
- Hearing - common in older, progressive loss
Dental disease (senior)
- Inc risk - periodontal disese + oral neoplasia
- Loss bone density -> pathological bone Fx
- Effects on general systemic health - periodontitis -> chronic inflam disease process
- Bacteria enter bloodstream - can enter heart valves -> valvular endocarditis
- Radiograph recommended
- Care w/ anaesthesia - but less of a risk than heart disease
QoL - objectives
- Pain management
- Management of clinical signs
- Hygiene - maintain urine + faeces sanitation, access to elimination sites
- Nutrition - diet + BCS
- Mobility
- Safety - avoid self-trauma, from others, dec hazards
- Environmental needs - bedding, temp, ventilation, space, peace
- Family engagement, isolation avoidance, other pet interaction
- Mental stimulation
- Preservation of dignity - soiling, manage incontinence, hygiene, grooming
- Stress reduction
- Preserve pet’s household role
- Maintain will to live - monitor behaviour
Maladaptive chronic pain
- Persists beyond expected course of acute disease, not associated w/ healing, no clear endpoint
- Associated w/ recurrent/long-standing disease conditions, can exist w/o a cause -> serves little to no biological purpose
- Osteoarthritis
- Cancer
- Periodontal disease
- Persistent Sx pain
- Episodes of acute pain
- AKA pathological pain
- Peripheral + central sensitisation -> permanent changes in CNS structure + func
Chronic pain behaviours general
- Lameness/altered gait
- Reduced mobility
- Reduced activity - seem lazy, tired, lethargic
- Hesitant on stairs, slippery floors/uneven surfaces
- Reduced sociability - people + animals
- Inc anxiety
- Aggression
- Grumpiness
Chronic pain behaviour evaluation (cat)
- General mobility - ease of movement, fluidity of movement
- Ability to perform activities of daily living - playing, hunting, jumping, using litter box
- Eating, drinking
- Grooming e.g. scratching
- Resting, observing, relaxing - how well activities enjoyed by cat
- Social activities - people + other pets
- Temperament
Chronic pain behaviour evaluation (dog)
- Vitality + mobility
- Mood + demeanour
- Levels of distress - vocalisation + response to other dogs + humans
- Indicators of pain - comfort levels, stiffness, lameness, orthopaedic exam
- Imprint of pain on somatic structures - myofascial exam, muscle strain patterns
Pain recognition
- Pain score scale
- Behaviour
- Pain recognition tool/device
- Questionnaire
Unresolved/chronic pain in cancer patients
- Direct cancer pain
- Neuroimmune interactions
- Dx procedures
- Metastatic disease
- Concurrent painful conditions e.g. OA
- Poorer response to chemo/radiotherapy
- Earlier death
Osteoarthritis
- Inflammation
Cancer pain
- Inflammation - caused by tumour invasion
- Tissue distortion - caused directly by tumour invasion
- Nerve injury -> neuropathic pain
- Visceral obstruction
- Ischaemia
Examples of severe to excruciating pain
- CNS infarction/tumours
- Meningitis
- Bone cancer
- Aortic saddle thrombosis
- Limb amputation
- Ear canal ablation
Examples of moderate to severe pain
- Immune-mediated arthritis
- Glaucoma
- Uveitis
- Pleuritis
- Mastitis
- Oral cancer
Examples of moderate pain
- ST injuries
- Urethral obstruction
- OVH
- Cystitis
- Dx arthroscopy + laparoscopy
- Oseoarthritis