Exam 1 Case Scenarios

Question 1

A horse presents for mild colic and anorexia; further history includes: acute onset of dysuria and access to pasture and bailed alfalfa hay

When you run labwork, you notice hypocalcemia and hypomagnesemia

Top Ddx based on the above?

Answer 1

Blister beetle

Question 2

You arrive at a farm to examine a cow with anorexia and diarrhea; Physical exam findings include abdominal discomfort, and bloody, dark diarrhea; you walk the pasture a notice there are several large trees scattered throughout;

To confirm your suspicions, you run bloodwork and also find evidence of acute renal failure; you’re sure it must be?

Answer 2

Quercus spp. (oak toxicity)

Question 3

You examine a horse with the presenting complaint of colic and abdominal pain; the owner also notes the horse has had severe bloody diarrhea & seems to be straining;

Feed exam shows the horse had been consuming castor beans!

Castor beans fall under which broad toxic category?

Answer 3

Toxalbumin

*Their specific toxic principle is Ricin

Question 4

A farmer calls you to tell you several of his goats have started vomiting… as he continues to explain the situation, you form a differential list in your mind. At the top is?

Answer 4

Rhododendron spp. (azalea)

Vomiting goats= azalea

Question 5

You’re on a farm call performing an exam on a cow that is showing respiratory distress and has brown mucous membranes;
You noticed on the way in that the cows have access to Johnson Grass;

What do you suspect and how can you confirm?

Answer 5

Nitrate/nitrite poisoning

Measure levels in PLASMA

Question 6

You just diagnosed a cow with cyanide poisoning secondary to consumption of chokecherry leaves; How will you treat?

Answer 6

Most will die

Sodium nitrate + sodium thiosulfate

Question 7

You are called to a farm to examine a flock of sheep after several have acutely died and the others “aren’t looking good”

When you arrive, you notice the sheep seem very weak, have pale MM, and haven’t been eating. A few are icteric.

Necropsy of the dead sheep reveals they had yellow, friable livers & dark red kidneys;

What would your next step be to confirm your suspicions?

Answer 7

Check feed for copper levels!

These signs fit copper toxicity

Question 8

Profound heamturia and urinary tract neoplasia are typically associated with which toxic plant?

Answer 8

Bracken Fern

*Enzootic hematuria

Question 9

You are called to a farm after several members of the herd have acutely died; postmortem findings include blood in the joint spaces & bleeding within the GI tract;

You examine a few of the other cows on the farm and find that quit a few seem stiff/lame and others have epistaxis

You run a coag panel & find prolonged PT… top differential(s)?
How will you treat?

Answer 9

Sweet clover toxicity

Rodenticide would also be high

Tx= IM or SQ Vitamin K1

Question 10

What are your top 3 toxic differentials for cows that present for acute respiratory distress, expiratory grunts, frothing at the mouth & many have already died?

Answer 10

ABPEE
Perilla Mint
Moldy Sweet potato

Question 11

You are examining a cow the presented for weakness & recumbency; on your analysis you note myoglobinuria

Bloodwork reveals elevated CK & AST

Top differential?

Answer 11

Senna spp. toxicity

Sicklepod
Coffeeweed

Question 12

If used in large amounts in horse bedding, this can lead to limb edema, a stiff gait, and laminitis

Answer 12

Black Walnut

Question 13

You are called to examine a horse that’s anorexic and showing signs of lameness

You examine the horse and find the hooves to be strangely deformed; in addition, there seems to be hair loss involving the mane and tail;

You run bloodwork to confirm your suspicions of?

Answer 13

Selenium toxicosis

Question 14

You are called to do a post-mortem exam on a horse that acutely died last night;
the owners say the horse seemed okay in the morning but by the afternoon he seemed weak, wouldn’t eat, and eventually became recumbent and refused to stand;

On post-mortem you find pulmonary congestion/edema and you also notice the muscles have pale streaks in them, especially on the heart;

You examine the feed and find that it’s labeled for cattle! oh no! Your top ddx?

Answer 14

Ionophore toxicity

Question 15

You know that vomiting goats most likely consumed azaleas, but what other potentially fatal side effect should you be monitoring?

Answer 15

Bradycardia

*<60 give atropine

Question 16

You are called to examine two mares; 1 has recently foaled but isn’t producing milk, the other was due over 2weeks ago but hasn’t yet shown signs of labor

They share a pasture & you’re concerned they’ve been ingesting…..

Answer 16

Endophyte-infected fescue

• agalactia
• prolonged gestation

Question 17

You are examining a group of what the farmer claims are “pre-pubertal gilts” (based on age) but many of them are showing vulvar edema, mammary development, and showing signs of estrus

Early estrus in these pigs could be due to?

Answer 17

Zearalenone infected corn

Question 18

In addition to Lupine, which two other plants can cause crooked calf syndrome?

Answer 18

Poison Hemlock

Tobacco (swine)

Question 19

You are called to examine a horse who is having difficulty eating his food;
When you examine the horse, you notice the facial muscles have increased tone and the tongue is curled & protruding from the mouth;

When you offer the horse food, he seems like he is having trouble with apprehension;

This clinical presentation is typical of?

Answer 19

Centauria toxicity

• Yellow Starthistle
• Russian Knapweed

Question 20

You are called to examine a cow that’s “walking funny”;
When you arrive, you watch the cow from a distance and notice what seems to be a minor head tremor;

When stimulated to walk, the cow has a stiff, spastic gait; the owner reported the cow may have had a seizure this morning; the cows graze on an annual rye grass

Top ddx?

Answer 20

Grassland Staggers

• Perennial or annual rye grass
• Bermuda grass
• Dallis grass

Question 21

A farmer calls you after finding a few cows dead near the creek on his property; he thinks there might be something in the water…

When you arrive, you notice another cow near the creek having convulsions–you euthanize; You examine the area around the creek and notice a tree with serrated leaves and white flowers on stalks; the veins on the leaves terminate between the points on the leaf…thanks to toxicology, you know this plant is __________ ___________.

Would consumption of that plant explain these clinical signs?

Answer 21

Water hemlock

YES!!

Question 22

You have just diagnosed a horse with Sorghum toxicity–the horse was BAR but ataxic in the hindlimbs and dribbling urine; the pasture is filled with this grass

What is the acting toxic principle?

Answer 22

B-cyanoalanine

Question 23

You are called to examine a cow showing tremors; physical exam is difficult to do because the cow is very excitable
You are at least able to get a HR & RR–both elevated
The pupils are also dilated and an oral exam reveals a very dry mouth

These signs all fit with _______stimulation secondary to consumption of?

Answer 23

adrenergic stimulation (due to suppression at muscarinic receptors)

Jimson weed

Question 24

For which 4 toxicities should you be concerned with transmission in the milk

Answer 24

1) Oleander
2) White snakeroot
3) Yew
4) PA (crotalaria & Ragwort)