Diseases and their Treatment Flashcards
lymphocytic cholangitis
(+/- triaditis)
- Lymphocytic cholangitis is a slowly progressive chronic disease characterised by infiltration of the portal areas of the liver with inflammatory cells, mostly lymphocytes and plasma cells.
- Bile duct hypertrophy and fibrosis are present. However, lymphocytic cholangitis does not progress to biliary cirrhosis.
- Treat with Corticosteroids
Chronic Neutrophilic Cholangitis
- Treat with Antibiotics
- Neutrophilic cholangiohepatitis is characterised by infiltration of large numbers of neutrophils into portal areas of the liver and into the bile ducts.
- It results from ascending bacterial infection from the small intestines.
- Escherichia coli, Staphylococcus spp., Streptococcus spp., Clostridium spp., Bacillus spp., Actinomyces spp., Bacteroides spp and occasionally Salmonella spp. have been isolated.
- Concurrent biliary tract disease are common in cats, especially pancreatitis and inflammatory bowel disease. Other predisposing factors include congenital or acquired abnormalities of the biliary system such as that of anatomic abnormalities of the gall bladder or common bile duct, bile duct obstruction caused by inspissated bile, cholelithiasis and cholecystitis.
Toxoplasmosis
- Treatment usually involves a course of an antibiotic called clindamycin, either alone or in combination with corticosteroids if there is significant inflammation of the eyes or central nervous system
- caused by T. gondii
Leptospirosis
- Penicillin sensitive, afterwards Tetracycline derivatives
- Leptospirosis (also called Lepto for short) can be an acute disaster of severe illness but most dogs survive their acute phase and are not diagnosed until they reach a more chronic stage. For example, the most common manifestation of leptospirosis-related kidney failure is excessive water consumption a week or two after an episode of unexplained fever
- The organism settles in the kidneys and begins to reproduce, leading to further inflammation and then kidney failure in 90 percent of patients (10-20% also have liver failure).
Copper-Storage Hepatopathy in Dogs
- Copper storage hepatopathy is a condition caused by an abnormal accumulation of copper in the animal’s liver, which leads to progressive damage and scarring of the liver (cirrhosis). This condition may be secondary to a primary disease or the result of genetic-based abnormal copper metabolism
- Bedlington terriers, Doberman pinschers, West Highland White terriers, Skye terriers, and Labrador retrievers are dog breeds known to be susceptible to this disease. (+/- immune mediated in dobies)
- Acute liver failure will need to be treated supportively
- Additionally: copper chelaters, zinc, diet changes
Chronic Hepatitis
- Hepatitis, a medical condition used to describe long-term, ongoing inflammation of the liver, is associated with an accumulation of inflammatory cells in the liver and progressive scarring or formation of excessive fibrous tissue in the liver (fibrosis).
- If your dog is severely ill it will need to be hospitalized and given fluid therapy supplemented with B vitamins, potassium and dextrose.
- Medication to increase elimination of fluids from the body will help to decrease fluid build-up in the abdomen, and medications may also be prescribed to treat infection, decrease brain swelling, control seizures, and decrease ammonia production and absorption (from the intestines to the rest of the body). Enemas can be used to empty the colon. Zinc may also be supplemented if necessary.
Feline Infectious Peritonitis
- caused by a type of virus called a coronavirus, which tends to attack the cells of the intestinal wall.
- FIP is fatal in more than 95 percent of cases. In mild cases of the dry form, it may be possible to prolong the survival period, but most cats with the wet form of the disease die within two months of the onset of signs. Fortunately, the disease is very uncommon.
- An intranasal vaccine was developed to prevent FIP in cats, but it has been controversial. Some studies show that it protects against disease, while others show that it offers little benefit.
Glucocorticoid (steroid) Hepatopathy
- Cause: exogenous glucocorticoids, hyperadrenocorticism.
- Signs: asymptomatic, elevation in liver enzymes or very occasionally hepatic failure.
- Diagnosis: history of glucocorticoid use, signs, histopathology.
- Prognosis: very good; reversible on removal of excess steroid.
Dental:
Immune Compromised Patients and Acute Facial Swelling that is associated with dental disease
- Useful AB’s: Co-amoxycillin-clavulanic acid and Clindamycin
- NOTE: AB’s are not indicated in 95% of dental cases
Confrimed Contagious Equine Metritis
Treatment: 2% chlorohexidine for 5 days
CEM leads to Cervicitis in many cases and usually occurs concurrently with endometritis or vaginitis
Confirmed Pseudomonas Aeruginosa
- Treatment: 1% silver nitrate or enrofloxacin (broad spectrum AB) for 10 day
Confirmed Klebsiella Pnuemoniae
Treatment: 1% hypochlorite solution followed by gentamycin for 7 days
Pustules, Vesicles and “Pox lesions” on penile shaft and vulvar
- does not permanently affect fertility
- depigmentation of pigmented skin of the vulva occurs with healing of the lesions
- EHV-3!
mare having trouble with milk letdown due to either:
- pain in abdomen
- premature foaling
- being a maiden mare
- dysgalactia - oxytocin (standard 1-2ml should do the trick), prolactin stimulation
- analgesia - flunixin (don’t want her to run away every time foal tries to suckle)
- flunixin is good as it has a short acting effect, nice anti-endotoxic effect
- ACP can encourage prolactin secretion (handy also when you have an anxious mare)
- Need to assess colic pain and that they are passing droppings as well
Retained Fetal Membranes in the Mare
(Treatment after 4+ hours)
Endometrial Haemorrhage in a Mare Post Foaling
Broad Ligament Hemorrhage in Mare Post- Foaling
- Mare has aborted a fetus
- The stud shows lack of apparent separation of young and older mares
- there is no evidence the mare has had an abortion due to twinning
- ASSUME IT IS EHV 1 (4) UNTIL PROVEN OTHERWISE
- isolate everyone
- unbelievably contagious - blood born pathogen
- PME: get PCR on the placenta and aborted fetus, vaccinations, look for lesions on the liver of the aborted foal
breeding stallion or colt:
- snotty nose
- swelling of distal limbs, conjuctiva, scrotum
- fever and lethargy
- some abortions seen in mares it was in contact with prior
- RUN SEROLOGY FOR EVA
- males are the source of the disease (can be transferred in frozen or chilled semen)
- very virulent
- There is a vaccination you can use for seroconversion after proving the male is seronegative only with an Ab titre
Breeding Mare Presenting with
Note: males with this are usually asymptomatic
- need to have negative test shown before rebreeding them after CEM!
- In the stallion: need to get their bacterial floar back to normal (like a probiotic treatment)
Mare/Foal
Symptoms include high fever, anemia (due to the breakdownof red blood cells), weakness, swelling of the lower abdomen and legs, weak pulse, and irregular heartbeat. The horse may die suddenly. Subacute: A slower, less severe progression of the disease.
- tranported semen must be accompanied by an EIA negative test even though it is not transferred typically by semen
- any seropositive individuals will be euthanased
- No vaccination, no cure
Cat presenting with murmur
suspected HCM (doing work up)
Asymptomatic
Normal LA on US/Echo
- no treatment
- many of these cats manage fine!
- Possibly atenolol for Left Ventricular Outflow Tract Obstruction - but need to discuss with the owner
Cat with suspected HCM
Asymptomatic
LA enlargement on US/Echo
- Clopidigrel - to reduce risk of aortic thromboembolism!
Cat with HCM
Presenting in CHF
- Furosemide (to effect) - may give some to take home if they become stable
- Clopidogrel
- Spironolactone (aldosterone inhibitor for RAAS system)
- ACE inhibitor
HCM cat presenting with poor systolic function
- Pimobendan
- BUT:
- not licensed for use in cats
- do not give to cats with LVOTO
- peri-anal adenoma and perianal carcinomas tend to be more cutaneous than subQ –> these 2 occur more in the glands of the skin
- Also : peri-anal adenomas tend to be in entire male dogs (androgen dependent)
- STS= soft tissue sarcoma
- not likely for another tumor like MCT or STS to be occurring in that region but not out of the question!
- Next Diagnostic Step: FNA the Mass
- bc if it is an abscess of the anal sac than it may be readily flushed out and treated with AB’s
- but if it is a tumor, we obviously need to know
- Cytology: shows monomorphic epithelial type cells (acinar formation = glandular)
- likely ANAL SAC ADENOCARCINOMA
- next step would likely be to do CT/abdominal US and chest Rx to check for metastasis due to possible LN involvement - should do staging prior to removing mass
- ASAC’s have a 50-80% chance of being metastatic at the time of diagnosis
- Sx and RT therapy likely ideal in this case (there was a primary tumor, LN involvement, but not any distant spread we can detect at the given time) - but both the promary tumor and LN’s need to be addressed!
- release of parathyroid hormone related peptide
- paraneoplastic hypercalcemia - about 25% are affected! (that have anal sac carcinomas)
- best to check ionised calcium in these patients! - if they do it, they tend to be PU/PD
- horse (also affects ruminants and sometimes humans)
- lower limbs affected
- painful and pruritic
- lives in a very moist area
- during winter (rain season)
- some irritation, chewing, foot stamping
- Mud rash/greasy heel/ pastern folliculitis
- when these cases get chronic, they lead to scarring and secondary lameness
- Dermatophilosis (branching actinomycete) - for horse –> causing Mud Fever/Rain Scald
- causes Fleece Rot in Sheep
- FInd taking a hair pluck and doing a DIffQuik stain
- horse, younger
- Hyperkeratotoic, alopecic plaques found on concave aspect of the pinnae and near mouth
- not super bothered
- papillomavirus Infection - Aural Plaques
- Often just observation as treatment - they can get head shy if you give unnecessary Tx
ring - like, possibly pruritic lesions on horse skin
Dermatophytosis
Trichophyton equinum var equinum
also could be: T. metagrophytes (rats) , M. equinum, M.gypseum (soil)
Dx: often off clinical suspicion as fungal cultures take a while
Tx: topical or will often resolve
- white skin, next to dark pigmented skin
- suspicion of the horse having ongoing liver disease
- Photosensitisation!
- secondary to liver disease due to phylloerythrin build up
- primary cause: could be digestion of plants - St. Johns Wort
- UV+ unpigemented skin+ photodynamic agent
horse
- eryhtema, crusting and oozing localized only to the white areas (unpigmented skin)
- very painful!
- Leucocytoclastic vasculitis
- looks like vasculitis but is more localized to non-pigmented areas!
- Tx: Immunosuppressive (GC’s)
chorioptic mange on the scrotum of a ram, which due to increased blood flow and hence temperature could lead to subfertility of the ram.
correct diagnosis is dermatophilosis in a cow.
- Note the raised clumps of hair containing waxy exudate.
- The hair can be plucked, attached to crusts which are dried exudate, rather than skin sloughs.
- Contagious pustular dermatitis (orf). Goats are susceptible to CPD. This is probably the most common site of infection in sheep and goats – the lips.
Hugely contagious and infectious!
- This is a bit extreme (below pic), but can get these lesions and straberry foot rot
- Only really treat if the lesions are leading to secondary infections
- Don’t vaccinate uninfected farms!
- Virus does not stay in the host between seasons, it stays in the soil
- A well fed lamb will not show clinical signs of ORF unlike a weak lamb
- If you keep them healthy enough, ORF can have a minimal effect on the farm
Female Labrador
Bleach hair coat with patches all over
Ruled out self trauma
Potential causes:
- Cushings
- Hypothyroidism
- Breed: hypothyroid may be a bit more possible, need to have both on differentials though
- Hyperadrenocorticism - causes low T4 levels, so may need to look into this first for diagnosis
Greyhound
3 abnormalities other than hair loss:
Pot belly - not really pendulous, but as a greyhound, should have an abdominal tuck. Swollen abdomen!
Thinned skin - can see subcutaneous vessels. Redness seen is actually a lot of the vascular network seen through the skin. Redness on elbow - may be thin skin over point
Muscle loss (atrophy) - packed with blue muscle normally
- greyhound with cushings
- would definitely want to check (elderly, immunosuppressed dog) –> check for demodecosis!
- secondary cause possible of primary reason for hair loss
Female hormones
- Sertoli cell tumor
- Common testicular tumor
- Feminsation
- Discolored Hair Coat
- looks just like Cushings
- is NOT systemically ill
ALOPECIA X
Thin and discolored hair color
Bad dorsal hair coat
Same as in poodle, can see in malamutes
Looks like an endocrine disease
Pluck - this is a telogen phase growth defect
Looks identical to cushings
This is called ALOPECIA X
HAPPENS WHETHER THEY ARE ENTIRE OR NOT
sometimes can see bunches of hair growth where you take biopsies or have wounds - inflammation of the area near the inactive hair follicles causes them to enter a growth phase
some may use microneedling to get the hair coat to get it to grow back, but nothing is really wrong other than cosmetically so is it truly ethical?
Coat color - linked alopecia –> Color Dilution Alopecia
Most commonly affected breeds: fawn/blue dobermans (more rare now!)
Only the dark hair is gone - Blonde hairs are present but darker hairs are not
Melanin clumping disease
Complex
Not producing melanosomes that are transported to the keratinized hair shafts, they just all clump together
Clumps cause the hair shaft to break off - when the melanin clumps reach a certain threshold, it is not compatible with a strong structural hair shaft
Can come to the surface of the skin but mechanical forces on the outside cause it to break off
Recurrent flank alopecia - symmetrical alopecia
Well demarcated
Often develops and resolves (or partly) and then develops again - cyclical feature
In successive cycles becomes larger and more permanent
Don’t understand this disease but just described what is seen
Other breeds predisposed: Airdale Terriers (also predisposed to hypothyroidism - diff. Dx), Bulldog and boxers are particularly susceptible, crosses of these breeds, Ridgebacks
but there is nothing systemically wrong with these dogs!
Not systemically affected
there is a degree of hair cycle arrest but then also a degree of miniturized hair follicles (pic) - then when hair growth kicks in again and new and fully functional hair follicle comes in
If you take a hair plcuk you should only be taking telogen hairs from the affected area, but if you are in the phase right before the active hair growth phase, then you will see these active hair follicles emerging from under the dormant ones
Follicular Dystrophies/Dysplasias
Hair cycling happens - hair follciles are mishapen and unable to produce ordinary fully formed, functional hair shafts
Hair shaft is deformed and fragile
Poor quality, dry breakable hair shafts
Irish Water Spaniel - with a patch of alopecia on its back
HAIR PLUCKS - see funky/wonky hair shafts
Curly coat Retrievers, Chesapeake Bay retrievers- particular predisposition for dreadlock type hair coat dogs
Hair follicles unable to produce proper hair shafts
Cycling may be reduced as well because at one point they may just not be able to form properly
no Tx you can do really! - once affected the dog will remain affected
-end up getting a lot of follicles unable to produce hair shaft with proper diameter and structurally intact hair shafts
its just in those areas as well! - there will be normal hair growth on other regions of the coat
Pattern Alopecia
Fine short hair coat breeds - Staffordshire Terriers, Whippets, shrot coat chihuahuas, greyhounds
see more in caudal thighs and the ventrum
Really fine short hair growth
Caudal thighs, ventrum
Probably genetic variant of having a short hair coat
no Tx really (cosmetic) - But important to just rule out other causes for this
not really a loss of hair shafts - just a bunch of mini hair shafts
