Conditions list revision Flashcards
Describe the aetiology of Chronic renal failure
Persistent loss of kindney function over time commonly seen in geriatric cats
Briefly explain the pathophysiology of CRF
The kidney is unable to filter nitrogenous waste from the blood leading to uraemia
Deterioration in renal function causes pH and electrolyte imbalance (potassium and phosphate)
Describe clinical signs that may be seen in this patient and explain the reason for each sign - CRF
Polyuria
Polydipsia
Weight loss
Oral ulcers
Dehydration
Select TWO diagnostic techniques available for the diagnosis of this condition and describe each technique - CRF
What are the rationales for choosing these techniques? CRF
Urine specific gravity - assess urine concentrating ability, non invasive, quick and simple to perform
Blood biochemisty - simple and quick to perform, elevations can indicate CKD however as there are other causes further tests usually performed in addition to confirm the diagnosis (such as urinalysis to determine USG)
Describe the aetiology of Diabetes Mellitus
TYPE 1; β cells have been destroyed and can no longer synthesise insulin adequately.
TYPE 2 reduced ability to respond to insulin
Briefly explain the pathophysiology of Diabetes Mellitus
Absolute or relative insulin deficiency
Reduced tissue utilisation of glucose
Leads to hyperglycaemia in bloodstream
And low glucose levels in cells
Renal threshold for glucose exceeded»_space; glycosuria
Eventually fats are broken down as cells cant access glucose
This can lead to ketosis
Describe clinical signs that may be seen in this patient and explain the reason for each sign - diabetes mellitus
Polyphagia
Polyuria
Plydipsia
Glycosuria
Select TWO diagnostic techniques available for the diagnosis of this condition and
describe each technique - diabetes mellitus
What are the rationales for choosing these techniques? Diabetes mellitus
Single blood glucose assay – simple and quick to obtain, relatively low cost, provides accurate reading of glucose levels in blood at the time of sampling
Urinalysis – glucose and ketones – non-invasive, easy and cheap to carry out, Detection of ketones highlights if gluconeogenesis is occurring
Describe the aetiology of dialated cardiomyopathy
Thinning of myocardium results in a decreased ability of the heart to generate pressure to pump blood through the vascular system, factors including nutritional, infectious, and genetic predisposition have been implicated, commonly large and giant breeds dogs, sometimes occurs in cats
Briefly explain the pathophysiology of dilated cardiomyopathy
DCM is characterized bydilation of the ventricles with ventricular wall thinning, ventricular and atrial enlargement, and systolic and diastolic dysfunction
Describe THREE clinical signs that may be seen in this patient and explain the reason for each sign - dilated cardiomyopathy
collapse or fainting
decreased appetite
weight loss
swollenbelly
depressed attitude or quiet and not interactive
sudden death
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique
- dilated cardiomyopathy
radiography is accessible in first opinion practice but has limitations when it comes to providing information about the shape and size and function of structures inside the heart. Lung fields can be evaluated at the same time to ascertain if there is concurrent respiratory disease as well as detect pulmonary oedema
Ultrasonography can be carried out on conscious patients most of the time and can provide information regarding the architecture of valves, ventricular muscle thickness and chamber size and function ( but it does require a certain level of operator skill. )
Clinical signs of acquired heart disease may be similar when the disease reaches its terminal stages for all conditions. A cardiac murmur may be present in all 3 conditions although the precise nature of the murmur can vary.
Describe the aetiology of Exocrine pancreatic insuffciency (EPI)
Exocrine pancreatic insufficiency (EPI) isthe inability to produce sufficient pancreatic enzymes needed to digest fats, carbohydrates, and proteins.
Briefly explain the pathophysiology of EPI
Exocrine pancreatic insufficiency is caused by decreased production of digestive enzymes by the pancreas.
Describe clinical signs that may be seen in a dog suffering from EPI
polyphagia, weight loss, and loose stools.
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique
EPI
History and clinical signs (though signs common to many other intestinal problems)
Faecal examination revealing large amounts of undigested fat in faeces
Serum Trypsin-like immunoreactivity – looking for low levels to confirm disease, external lab test, confirms diagnosis
Describe the aetiology of Epilepsy
Neurological condition arising from disruption of forebrain function
Idiopathic epilepsy is the most common- cause unknown but genetic link suspected in a number of breeds including Border Collies, Hungarian Visla and Labradors
Briefly explain the pathophysiology of Epilepsy
Disordered electrical activity of the brain cells – imbalance in excitatory and inhibitory signals
tonic clonic seziures
Partial or generalised
Generalised – dogs
Partial – cats
Three phases
Pre-ictal
Ictal
Post-ictal
Prolonged seizing – status epilepticus (more than 5 mins)
Describe clinical signs that may be seen in this patient and explain the reason for each sign - Epilepsy
Period prior to seizure
Feels uneasy
Altered behaviour pattern
Anxious and restless
Episode of fitting
Collapse and unconsciousness
Action varies animal to animal
Clonic paddling spasms or tonic spasms
Spasms of jaw muscles
Vocalisation
Incontinence
Recovery period
Extreme tiredness
Hunger
Ataxia
Compulsive walking
Dazed
May last several hours
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique.
- Epilepsy
History and clinical signs are very important and accompanied by a physical and neurological exam may lead the VS to diagnosis
Blood testing may be carried out to rule out other causes – infection, toxicity, glucose, uraemia
MRI and/or CT – advanced imaging may help to visualise lesions in the CNS, requires GA.sedation
CSF tap – usually performed under sedation/GA and evaluated for presence of inflammatory cells etc., external lab or referral
Describe the aetiology of Feline leukaemia virus (FeLV)
Retrovirus from the oncornavirus (cancer causing) group
Incubation period: Months to years
Transmission- Excreted in saliva or transplancental
Direct - grooming, bites
The primary differential diagnosis for FeLV is FIV
Briefly explain the pathophysiology FeLV
Transmission - Direct contact with infected feline through saliva, body fluids, urine and faeces
Virus replicates in the lymphoid tissue and enters lymphocytes and monocytes
Transported around the body where it then eventually enters the bone marrow
In some cats, persistent infection with the virus can lead to immune suppression, neoplasia or anaemia
Outcome is variable – depends on many factors, including cats immune response
Describe clinical signs that may be seen in this patient and explain the reason for each sign - FeLV
Immunosuppression
Recurrent infections
Anaemia
Tumour development eg lymphoma, leukaemias
Lethargy
Diarrhoea
Guarded diagnosis, most die within 3-4yrs of diagnosis
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique - FeLV
SNAP ELISA for serum antigen, patient side rapid result, in a healthy patient any positive test should be repeated in 12 weeks! (may rid themselves of virus)
PCR – isolation of viral genetic material to confirm where the ELISA result is questionable, sent to external lab
Virus isolation – not commonly done gets sent to external lab
Describe the aetiology of Feline Upper Respiratory Disease (FURD)
Aetiology: Can be caused by a number of agents:
Feline Herpesvirus type 1 (FHV-1)
Feline Calicivirus (FCV)
Bordetella bronchiseptica
Chlamydophila felis
Briefly explain the pathophysiology of FURD
Transmission -
Transmission:
Direct contact with an infected animal
Inhalation/aerosol – spread by sneezing
Indirect contact with contaminated fomites
FHV-1 persists for approx. 18 hours in the environment. FCV 1 persist for a week
Most FHV-1 patients become carriers, with intermittent shedding after stressful episodes (1-10 days)
Some cats become FCV carriers (most stop within a year) and excrete the virus continually via oro-nasal secretions
Replicates in the tissues of the upper respiratory tract and ocular systems -> epithelial necrosis
Irritation to the pharynx, larynx and trachea
Rare signs: reproductive and dermatological signs
Secondary bacterial infections common as result of damage
Describe clinical signs that may be seen in this patient and explain the reason for each sign FURD
Anorexia
Pyrexia
Depression
Sneezing
Conjunctivitis
Hypersalivation
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique
FURD
Often based on history (unvaccinated) and clinical signs
Swab taken from oropharyngeal area to isolate causative agents (may be negative in carrier cats)
Describe the aetiology of Gastric Dilatation and Volvulus (GDV)
Not completely understood
Large breed dogs, deep chested dogs commonly effected.
Great Danes, Weimaraner’s, St Bernard and English Setters .
Some increased incidence if relatives have had GDV.
Fed once daily or history of recent large meal.
Exercise immediately before or after feeding. (Possible associated with dry food)
Briefly explain the pathophysiology of GDV
Stomach dilates and rotates into a twisted position where upon gas cannot escape.
Distension of the stomach fills the abdominal cavity putting pressure on the caudal vena cava and disrupting venous return to the heart.
Pressure on diaphragm may compromise breathing leading to poor ventilation and damage to body tissues.
Necrosis of gastric wall/splenic tissue can occur due to distruptioon of blood supply to these areas
Describe clinical signs that may be seen in this patient and explain the reason for each sign GDV
Restlessness
Retching
Anterior abdominal swelling*
Dyspnoea
Collapse
Shock
Death
*note that in very large breeds swelling of the stomach may not be obvious as the stomach lies under the ribs
Select TWO diagnostic techniques available for the diagnosis of this condition and
Describe each technique & Explain the rationale for the selection of that technique GDV
Based on presenting signs and a high index of suspicion in large deep chested dogs
History and clincial signs
Tympany of abdomen
X-rays to confirm existance of bloat and may be suggestive of torsion
Nature and extent confirmed at surgery
Describe the aetiology of Hyperthyroidism
Functional thyroid tumour
Usually benign adenomatous hyperplasia (rarely cancerous) of the thyroid gland
May affect one or both lobes (also ectopic tissue)
Inciting cause theorised but unknown
Briefly explain the pathophysiology of Hyperthiroidsm
Affected gland overproduces thyroxine
This leads to a hypermetabolic state
As thyroxine affects a number of body tissues there are a wide range of clinical signs seen
Complications such as hypertension and hypertrophic cardiomyopathy may occur
Describe clinical signs that may be seen in this patient and explain the reason for each sign - Hyperthyroidism
Polyphagia
Weight loss
Hyperactive/aggressive or restless
Tachycardia
Vomiting and diarrhoea
Poor coat/unkempt
Polydipsia
Select TWO diagnostic techniques available for the diagnosis of this condition and
describe each technique & Explain the rationale for the selection of that technique.
- Hyperthyriodism
History and clinical signs including physical examination which may confirm a goitre
Blood test – high T4 levels confirm diagnosis, can be done in practice
Scintigraphy – imaging using radioisotopes, referral required, can help identify ectopic thyroid tissue too
Evaluation of cardiac function eg. Ultrasound is recommended in case of concurrent HCM
Describe the aetiology of Hyperadrenocorticism
Also termed Cushing’s Syndrome/Disease
Increased blood cortisol levels
Middle-aged to older dogs, rare in cats
Aetiology;
Caused by either
Pituitary tumour – increased production of ACTH (most common)
Adrenal tumour – direct increase of cortisol
Both lead to increased serum cortisol
Briefly explain the pathophysiology of Hyperadrenocorticism
Overactive tissue in pituitary or adrenal gland leads to increased production of cortisol
High levels of cortisol lead to hyperglycaemia and inhibit ADH – leading to PUPD
High cortisol also causes protein catabolism leading to muscle wasting and poor wound healing
Cortisol affects hair growth and distribution of fat