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AAA Companion Animal VMS4005 > Companion Animal Treatment and Procedures II > Flashcards

Companion Animal Treatment and Procedures II Flashcards

1
Q

Heart disease - senior pet

A
  • Medical - Pimobendan, ACE-inhibitors, ARBs, diuretics, anti-arrhythmics, antithrombotics
  • Pace maker
  • Monitoring - medications, BP, repeat echo
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2
Q

Renal disease - senior

A
  • Nutrition
  • Medical - for high BP = ACE-inhibitors, ARBs, anti-hypertensives, electrolytes, fluids
  • Monitor - urinalysis, UPC (urine protein : creatinine), CBC (complete blood count), chem, BP, weight, eye exam
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3
Q

Neuro disease (senior)

A
  • Medical - Selegiline (neuroprotective func)
  • Diet
  • Environmental enrichment
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4
Q

Osteoarthritis

A
  • Multimodal drug therapy - NSAIDs, opioids, amantadine, paracetamol
  • Physio
  • Weight loss
  • Environmental management
  • Anti-NGF monoclonal Ab therapy - nerve growth factor (NGF): dogs = bedinvetmab (Librela, Zoetis); cats = frunevetmab (Solensia, Zoetis)
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5
Q

Neoplasia

A
  • Sx
  • Chemo
  • Radiation
  • Pain management
  • Palliative care
  • Immunotherapy
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6
Q

Chemotherapy drugs

A
  • Cisplatin
  • Carboplatin
  • Doxorubicin
  • Doxorubicin + carboplatin
  • OPLA-Pt - slow release cisplatin
  • Lymphoma - CHOP - cyclophosphamide (cytoxan), doxorubicin (adriamycin), vincristine (oncovin), prednisolone, L-asparaginase
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7
Q

Hyperthyroidism (cat)

A
  • Medical - carbimazole, methimazole, diet
  • Sx - thyroidectomy, can become hypothyroid, check Ca
  • Radioactive iodine
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8
Q

Hypothyroidism (dog)

A
  • Levothyroxine - inc T4
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9
Q

Diabetes mellitus

A
  • Insulin - SC q 12 h (ProZinc)
  • Diet change
  • Exercise
  • Lens Sx
  • Cystitis management
  • Monitor - glucose - curves (over 12 h), fructosamine, urinalysis
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10
Q

Hyperadrenocorticism

A
  • Trilostane, mitotane
  • Monitor ACTH stimulation or pre- and post- trilostane cortisol or dexamthasone stim test
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11
Q

Senior + geriatric screening protocols

A
  • Annual checks (prefer q 6 m)
  • CE - dental + BCS
  • Preventative med - annual vaccs, parasite Tx
  • Screening protocols - haem, biochem, urinalysis
  • T4 + BP in cats
  • Radio/US
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12
Q

Minimum geriatric database (dog)

A
  • PE
  • Haem
  • Biochem + SDMA
  • Urinalysis + UPC (urine protein : creatinine)
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13
Q

Minimum geriatric database (cat)

A
  • PE
  • Haem
  • Biochem + SDMA
  • Urinalysis + UPC (urine protein : creatinine)
  • Total T4
  • BP
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14
Q

Vision (senior)

A
  • Night-lights
  • Stair lifts
  • Lit-up feed areas
  • Don’t rearrange furniture
  • Close pools
  • Pet gates
  • Halo
  • Avoid startling
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15
Q

Hearing (senior)

A
  • Visual cues
  • Scent
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16
Q

Mobility (senior)

A
  • Non-slip flooring (yoga mats)
  • Ramps
  • Non-slip booties
  • Strollers for walks
  • Swimming
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17
Q

Skin health (senior)

A
  • Brushing
  • Bathing
  • Diet
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18
Q

Cognitive problems/restlessness (senior)

A
  • Analgesia
  • Anti-anxiety meds
  • Sedatives
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19
Q

Chronic pain - NSAIDs

A
  • Caprofen
  • Meloxicam
  • Robenacoxib
  • Mavacoxib - 1 m half-life
  • 1 w washing out period, can give cats Buprenorphine PO, e.g. during 1 w of ‘wash-out’ period of changing NSAIDs / paracetamol in dogs
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20
Q

Chronic pain - opioids

A
  • Not useful but use when acute on chronic exacerbations
  • Methadone = NMDA (N-methyl-D-aspartate receptors) antagonist, become less responsive to pain
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21
Q

Hyperalgesia

A
  • Amantadine PO = NMDA receptor antagonist
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22
Q

Neuropathic pain

A
  • Gabapentin + pregabalin
  • Suppress glutamate + substance P release, reduces depolarisation of mem dorsal horn
  • Onset > 3 d
  • Capsules
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23
Q

Other chronic pain therapeutics

A
  • Tramadol - norepinephrine + serotonin re-uptake inhibition (less effective in dogs, Amantadine more effective)
  • Paracetamol - analgesic, anti-pyretic (dog)
  • PLT - prednisolone (corticosteroid), cinchophen (NSAID), not advised - shouldn’t mix corticosteroids + NSAIDS
  • Regen medicines - stem cells
  • Intra-articular hyaluronic acid
  • Polysulfated glycosaminoglycans
24
Q

Chronic kidney disease (cat)

A
  • Stable IRIS I - III - meloxicam or robenacoxib + monitor
  • 70% cats w/ CKD also have OA
  • Oro-transmucosal buprenorphine for breakthrough pain (acute flare)
25
Q

Non-pharmacological Tx of chronic pain

A
  • Physiotherapy
  • Hydrotherapy
  • Massage
  • Heat/cold
  • Acupuncture
  • TENS (transcutaneous electrical nerve stimulation)
  • Low level laser therapy
  • Prolotherapy (conc solution of dextrose + local anaesthetic injected into affected ligaments)
26
Q

Dietary chronic pain considerations

A
  • Weight management
  • Glucosamine - cartilage component
  • Chondroitin - cartilage component
  • Green-lipped mussel extract - anti-inflam
  • Fish oils - omega 3 - anti-inflam
27
Q

End of life care

A
  • Tx locations - maximise home care
  • Individual responsibilities - who will provide
  • Client education
  • Environmental modifications - ensure comfort + safety
  • O safety
  • Periodic plan assessments
  • Medication, nutrition, activity review + assessment
28
Q

Ileus (rabbit)

A
  • Identify underlying cause - radio, BG
  • Correct pain, dehydration, shock - fluids, (buprenorphine, methadone, fentanyl)
  • Syringe feed high fibre supplements
  • Encourage movement -
  • Ranitidine (milder cases)/Cisapride - prokinetcs
29
Q

Rabbit nutrition

A
  • Good quality timothy/meadow hay - lower protein, smells + palatable
    (Alfalfa too rich + high Ca)
  • Not dusty
  • Fresh grass + wild meadow plants, fresh herbs - aware of source for disease transmission
  • Mixed leafy green vegetables (not carrots - starchy root veg, speeds up gut flora)
  • 1 egg-cup full of extruded rabbit pellet food (vitamin mineral supplementation) - Excel diet, don’t give museli
  • Treats - anything found in wild e.g. dandelions, dried herbs, fresh grass, fresh herbs
30
Q

D+ (rabbit)

A
  • Gently clip hair before washing -> warm running water -> shampoo
  • IVFT - dehydration
  • Analgesia - opioids
  • Faecal samples
  • Euth - poor Px, a lot of suffering
31
Q

Outdoor housing (rabbit)

A
  • Fox-proof/predators
  • Sheltered - weather protection
  • Space to move - 3 hops
  • Access to grass - natural behaviour, can move around
  • Ventilation
  • Ramp - climbing options
  • Companion
  • E.g. Aviaries, dog kennels, children’s play house, converted sheds
  • Litter tray
  • Insulation in roof space - bubble wrap + vents - stay warm due to VFAs, cannot cope above 24 C - heat stroke = killer
  • Place to hide away from predators
  • Easy to clean
32
Q

Indoor housing - safe zone considerations (rabbit)

A
  • Wire storage cubes (joing w/ zip ties)
  • Protected spaces
  • Playpen
  • Garden wire fencing panels
  • Aware of electrical cables
  • Vit D - sunlight on skin - some disease processes related to lack of vit D - dentistry, no access to natural light, get outside once a week in secure grazing pen/get UV sunlight lamp
33
Q

E. cuniculi (rabbit)

A
  • Fenbendazole + Tx of companion rabbit (28 d course)
  • Improve hygiene to limit reinfection
  • Serology + Tx of incoming animals + repeat serology to ensure Ab levels not rising
  • NSAIDs given - monitor kidneys - fluids to aid kidney func
  • Anti-fungals
  • Px = guarded - parasite killed by Tx but damage caused is irreversible
34
Q

Vaccination (rabbit)

A
  • Myxomatosis (Nobivac RHD Myxo Plus) - > 5 w/o
  • Not absolute protection
  • RVHD - rabbit viral haemorrhagic disease 1 & 2 protection
  • 3 w onset of immunity
35
Q

Anaesthesia drugs (rabbit)

A
  • Pre-med sedation/analgesia = medetomidine (better analgesia properties than ACP/dexmedetomidine/midazolam (muscle relaxants not commonly used in GP) + buprenorphine/methadone depending on analgesia) (+ ACP if wanter longer sedation for e.g. Fx). Nitrous oxide - analgesia
  • Induction = alfaxalone 2 mg/kg, slow boluses
  • IV triple combo (when alfaxalone not clinically appropriate) - 1st to provide sed: Buprenorphine 0.03 - 0.05 mg/kg, medetomidine 0.03 - 1 mg/kg, ketamine 3 - 5 mg/kg
    (Propofol metabolised too fast, difficult to maintain adequate + stable place of anaesthesia for intubation)
36
Q

Airway management - v-gel (rabbit)

A
  • Wash/clear mouth
  • Sx plane of anaesthesia
  • Desensitise the larynx
  • Insert into pharynx to seal over the larynx
  • Check position after insertion (airway patency)
  • Check w/ otoscope/endoscope/capnograph
37
Q

Acquired dental disease (rabbit)

A
  • Long-term analgesia to stable early (maybe late) dental disease; stabilises retrograde reserve growth
  • Meloxicam = highly palatable
  • Gastric side effects reported
38
Q

Analgesia (rabbit)

A
  • Meloxicam
  • May need for months/years
  • NSAID adverse effects
39
Q

Dental examination (rabbit)

A
  • Restrain in towel
  • Use otoscope to retract ST - look at incisors
  • Palpate mandible - back from point of mandible - any abnormal eruptions of teeth/new bone/pain swelling, tear duct swelling/epiphora?
  • Look for gingivitis - root disease + inflamed gum around
  • Inc saliva + uncomfortable mouth, something going on
  • Radio
40
Q

Incisor malocclusion Sx (rabbit)

A
  • 1). Trim teeth q 2 - 6 w using side cutting burr or diamond disc, expensive long-term
  • Don’t clip incisors, low speed to accurately cut
  • 2). Incisor reshaping - alter occlusal angle to change occlusal forces on dental crowns, 40% success, possible w/o anaesthetic
  • 3). Incisor extraction - regrow of teeth, make hook out of a needle to retrieve retained pulp, risk of infection, bone Fx + root Fx, small, slim-shaped luxators needed
41
Q

E.cuniculi Tx plan (rabbit)

A
  • Tx eases symptoms but does not reverse damage already done by parasite
  • Aimed and reducing bodies inflammatory response to the parasite
  • Fenbendazole (20mg/kg PO SID) for 28 d to kill the parasite
  • Meloxicam (0.5mg/kg BID SC or PO). Consider lowering dose when blood results come back indicating kidney damage
  • Short-acting steroids to reduce inflammation without using NSAID? CARE
  • Euthanasia if severe signs that do not respond to treatment within a week.
  • Isolate the rabbit and disinfect environment (use F10)
42
Q

Renal azotaemia (rabbit)

A

Fluids:
- Place IV catheter (marginal ear vein)
- Maintenance rate: 4ml/kg/hr - Estimate hydration and calculate accordingly

43
Q

Gut stasis (rabbit)

A

Analgesia
- NSAID (Meloxicam 0.5mg/kg BID oral or SC)
- Tramadol (11mg/kg orally TID)
- Buprenorphine (0.01-0.05 mg/kg SC or IM q4-8 hours)
- Maropitant (2mg/kg SC SID)

Prokinetics
- Cisapride (prokinetic action on both small and large intestine)
- OR metoclopramide (stomach and small intestine only) AND ranitidine (gastric, small and large
intestine but less effective than cisapride)
- Exercise

Other
- Syringe feed q 4 h until eating normally and passing normal droppings (10 mL/kg per feed)
- Probiotic (Critical Care feed has this in already)

Prevention
- Spores are primarily passed on in the urine of infected rabbits.
- Any new rabbits entering a home with other rabbits should undergo quarantine and serology testing and/or a treatment period (28 days fenbendazole).
- Spores can be killed by routine disinfectants (bleach or F10).

44
Q

Calcium carbonate deposits in bladder (sludgy bladder) (rabbit)

A

Analgesia options
- NSAID (Meloxicam 0.5mg/kg BID oral or SC)
- Tramadol (11mg/kg orally TID)
- Buprenorphine (0.01-0.05 mg/kg SC or IM q4-8 hours)
- Maropitant (2mg/kg SC SID)

  • Fully express bladder, first expression often needs sedation because the sludge is very thick/viscous. Sometimes you need to catheterise to flush and dilute the sediment.
  • Hospitalise with IV fluids + repeat bladder expressions. By shaking up the mineral content and ensuring that the bladder is being completely emptied each time you will be slowly removing more and more sediment each time. If leave rabbit to urinate on his own the sediment will settle + the bladder will only partially empty leaving the sediment behind to build up/concentrate again
  • Make diet changes immediately
  • Secondary infections are likely, due to overflow/dribbling, urine staining, bladder lining irritation and urine retention.
  • TMPS is appropriate first-line treatment without culture and sensitivity.
  • Sulfatrim licenced for use in rabbits
  • Cystocentesis not recommended and a sterile free-flow sample is impossible (usually collected from the floor with a syringe).
  • For this reason if you ever perform a cystotomy ensure you do not forget to collect a sterile urine sample from within the bladder for culture and sensitivity
  • Only perform cystotmy Sx unless you see clear urolith/rabbit blocked/unable to express bladder under sedation
45
Q

Sludgy bladder diet changes (rabbit)

A
  • No alfalfa hay - high in Ca content - substitute w/ another type of hay
  • Reduce amount of Ca + oxalate in diet - don’t completely eliminate
  • No mineral block
  • VetCare Plus urinary diet instead of pellets
  • Inc exercise to lose weight + encourage freq urination/shake-up sediment
  • Fresh water in bowel + water bottle to encourage inc water intake
46
Q

High in calcium + oxalate

A
  • Spinach
  • Kale
  • Celery
  • Parsley
  • Strawberries
47
Q

Low in calcium + oxalate

A
  • Celery
  • Cauliflower
  • Broccoli
  • Carrots
  • Brussels sprouts
48
Q

Pasteurella multocida infection -> pneumonia, resp tract Tx (rabbit)

A
  • AB based on culture and sensitivity - sulfatrim (TMPS) = first-line, penicillin ijection (norocillin), last option = enrofloxacin (Baytril)
  • Bronchodilator - Terbutaline (Bricanyl)
  • Mucolytic in food – bromhexine (Bisolvin)
  • Nebulisation - saline, F10 (1:250), bromhexine
  • NSAIDs – Meloxicam (0.5 mg/kg BID)
49
Q

Pasteurella multocida infection - eye treatment (rabbit)

A
  • Chloramphenicol eye drops
  • Flush nasolacrimal tract (repeated)
  • Instil chloramphenicol eye drops into nasolacrimal tract after flushing
50
Q

Possibly dangerous AB in rabbits (hind-gut fermenters)
PLACE

A
  • Penicillin
  • Lincosamides - clindamycin
  • Aminoglycosides (possibly)
  • Cephalosporins
  • Erythromycin
51
Q

Safe AB in rabbits (hind-gut fermenters)
“Medications For Treating Small Mammals” MFTSM

A
  • Metronidazole
  • Fluroquinolones (except pradodloxacin)
  • Tetracyclines
  • Sulfonamides
  • Macrolides (except erythromycin)
52
Q

Dental disease

A
  • As long as crowns of teeth health + no spurs growing into cheeks - give pain relief, Tx = medically = meloxicam 3 m, not Sx
  • Long-term - tooth removal not as effective - manage pain of entire mouth
53
Q

Rabbit spur

A
  • Classic rabbit spur
  • Towards tongue + cheek
  • Spikes -> cause damage + pain
  • Swelling of ST
  • Blood
  • A lot of saliva
  • Uncomfortable
  • Sick animal, anaesthetise - sedative job, crank . mouth open to get light, retract ST, look at every single tooth in detail
  • Correct fluids first if not eating + drinking, check glucose levels if low, syringe feed
54
Q

Older rabbit malocclusion

A
  • As age, tooth growth slows
  • Mandibular tooth + molar tooth growing slowly not resisting growth of tooth
  • Teeth of all diff heights - seen on otoscope
  • Would have to burr once monthly, hard for older rabbits
  • If no pain/other CS, leave
  • If pain/swelling/tear - give analgesia - then re-assess
55
Q

Exocrine pancreatic insufficiency (EPI)

A
  • Nutrition - maintenance/light diets BID, avoid high/low-fat + high-fibre diets
  • Pancreatic enzymes - only if given w/ food
  • Supplement cobalamin (B12) - PO in dogs; inject in cats
  • Pre/probiotics
  • AB - patients unresponsive to enzyme therapy, SI dysbiosis - Tylosin 6 w (25 mg/kg PO q 12 h)
  • Antacids omeprazole (0.6 mg/kg PO q 12 h)
56
Q

Flea anaemia (kitten)

A
  • Remove fleas from kitten – comb
  • Treat with ectoparasiticide – fipronil SPRAY (Frontline – Merial Animal Health), licensed for use in kitten from 2 days of age
  • In extreme cases of flea anaemia, may require a blood transfusion.
  • NB if blood loss is slow, lower PCVs will be tolerated in contrast to sudden drops in RBC O2
    carrying capacity (haemorrhage, IMHA etc) if the PCV falls below 10 - 15%
  • Nutritional support weaning from 4 - 6 w/o
  • Careful warming and address other nursing needs
  • Consider endoparasite treatment
  • Treat the environment and all other pets
  • Care with repeat blood testing in anaemia infants, total blood volume of 400g kitten could be 30 mL
  • Once stable recommend infectious screening FIV/FelV minimum
57
Q

Feline hepatic lipidosis

A
  • Restore fluid balance if dehydrated + restore electrolytes
  • Enteral support
  • Multivitamin supplements may improve survival in severely affected cats
  • Enteral feeding usually required – high calorie, high protein RC Recovery Liquid
  • Feeding tube RER = 30(BW) + 70
  • Give 25% first day, then 50% then 100%
  • If not eaten for >1 week at risk of refeeding syndrome - Insulin release on feeding shifts electrolytes into cells – monitor K+ etc
  • Nasooesophageal/gastric tubes until stable – then GA and oesophagostomy tube
  • Multivitamin supplements (esp B12) may improve survival in severely ffected cats
  • Cautiously offer food PO daily to assess interest
  • Treat any underlying disease (DM, pancreatitis, neoplasia, systemic illness)
  • Treat coagulopathies – Vit K

AAA Companion Animal VMS4005 (17 decks)

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