Exam 2 Flashcards
Grade the luxation: Patella fixed in luxation, manual reduction is not possible, stifle cannot be fully extended
Grade 4
DOC to tx VPCs?
Lidocaine
The short portion of the tarsal collaterals is taut/relaxed in extention/flexion?
Taut in flexion and extension
Describe the appearance of a leg that has caudoventral hip luxation
Non-weightbearing
Leg is held abducted and flexed
Stifle internally rotated
Affected limb is longer
Tx for tarsus hyperextension?
Coaptation prior to surgery
Partial tarsal arthrodesis at level of injury
Double bladder sign on US = ?
Prostatic cyst
How would you differentiate acute gastric dilation from chronic gastric volvulus based on stomach position?
AGD = normal position
CGV = slight malposition
Indications for medical management of pyometra?
Not systemically ill
Open pyometra
Owner highly motivated and aware of risks
Do mammary tumors affect male and female dogs at the same rate? Male and female cats?
Dogs - female > male
Cats - female = male
If you suspect your patient has legg-perthes but the radiographs are normal, what do you do?
Repeat in 1 month
Signs associated with vaginal neoplasia?
Vulvar mass
Vaginal discharge
Dysuria
Tenesmus
Indications for partial pancreatectomy?
Tumor removal
Biopsy of large lesion
Which canine mammary glands are most commonly affected by neoplasia?
4th and 5th
What procedure is ideal for large, active dogs with hip dysplasia?
THR
When closing the stomach, what is the holding layer?
Submucosa
What is the most common vaginal neoplasia?
Leiomyoma
What makes up the common calcanean tendon?
Gastrocnemius tendons
Combined tendons of the gracillis, semitendinosus, biceps femoris
Superficial digital flexor
The long tarsal collaterals are taut/relaxed when the joint is extended/flexed?
Taut when extended
Indications for a chain mastectomy?
Multiple masses throughout the chain
Tumors in gland 3 with any COM
Solitary masses anywhere with multiple COM
Indications for TPO?
6-8 months old
Distinct “clunk”
Angle of reduction <30 degrees
What is the single most important element of preventing hip dysplasia?
Weight management
What breeds are predisposed to GDV?
Great dane
St. Bernard
Standard poodle
What layers are incised with a Fredet-Ramstedt Pyloromyotomy?
Seromuscular layers
Which ovarian neoplasia can be bilateral?
Adenocarcinoma
What type of female reproductive lesions would you use an episiotomy approach?
Vestibular
Vaginal
As a result of medial malalignment of the quadriceps, what changes occur that relate to MPL?
Medial displacement of tibial tuberosity
Shallow trochlear groove
Hypoplasia of medial condylar ridge
Classify the acquired pyloric stenosis: Muscular hypertrophy
Grade 1
What breed is associated with congenital pyloric stenosis?
Boston terriers
Tx and approach for fibroadenomatous hyperplasia in cats?
OVH/OVE
Flank approach
What sex and breed is associated with mesenteric torsion?
Male GSD
What is the degree of rotation with counterclockwise GDV?
90
Which lobes of the liver is it ok to use the ligature technique for a complete liver lobectomy?
Left lateral
Left medial
Breeds associated with gastric adenocarcinoma?
Rough collie
Staff terrier
Belgian shep
What breeds are most affected by patellar luxation?
Small/toy breeds
What are the cat specific signs of portosystemic shunts?
Ptyalism
Copper colored irises
Aggressive behavior
What factors predispose a dog to GDV?
Underweight
Older
Temperament (mean/fearful)
Male
Intact female
Splenectomy?
What margins should you take when removing an intestinal adenocarcinoma or leiomyosarcoma?
4-8cm
Indication for Billroth II procedure?
When resection of stomach is so proximal to limit end to end anastomosis
What are the early radiographic changes associated with legg-perthes?
Radiopacity of lateral femoral head
Focal bony lysis - “motheaten” or “apple core”
What are the most common intestinal neoplasias in cats?
Lymphosarcoma
Adenocarcinoma
What percentage of CCL injuries also have meniscal injury?
60-70%
What is the most common rectal neoplasia in dogs?
Adenomatous polyp
What breeds are associated with intrahepatic portosystemic shunts?
Labs
Australian shepherds
Old english sheep dogs
What gait is associated with MPL?
Skipping gait
Which part of the CCL is taut in flexion and extension?
Craniomedial
What sling do you use for a craniodorsal hip luxation? For how long?
Ehmer sling 4-14 days
Beak or apple core appearance of pylorus = ?
Congenital pyloric stenosis
Describe the stance of a dog that is in the compensatory stage of hip dysplasia
Rear base-wide
Common age of animals affected by carpal laxity syndrome?
5-27 weeks
Males
Surgical tx for tarsus OCD?
Fragment excision/debridement
Tibiotarsal arthrodesis
When would you do a single layer stomach closure instead of a double later?
Pyloric outflow tract
Reduced gastric volume
Thickened gastric wall
Classify the acquired pyloric stenosis: Mucosal hyperplasia + muscular and submucosal inflammation
Grade 3
What ratio of small intestine diameter to L% height tells you obstruction vs obstruction?
<1.6 = no obstruction
>2 = obstruction
If you are doing a regional mastectomy for a mammary tumor in glands 1 and 2, which glands are you going to remove?
1-3
MST for intestinal leiomyosarcoma?
1y
What are the most common cecal neoplasias?
Leiomyoma
Leiomyosarcoma
Which carpal collateral ligament has a straight and oblique part? Which only has a straight part?
Radial = straight and oblique
Ulnar = straight only
Neutering is recommended for what hip condition?
Legg-perthes
Advantages/Disadvantages of Fredet-ramstedt Pyloromyotomy?
Ad - quick and easy, lumen not opened
Dis - Only for congenital, stenosis may reoccur
When is it indicated to do an emergency gastrostomy for GDV?
If unable to decompress by orogastric tube or trocharization and other surgical treatment must be delayed
What is the most common sign of cystic endometrial hyperplasia?
Failure to conceive
What phase(s) is it easiest to identify an ovarian remnant?
Estrus or diestrus
How does prostaglandin F2a help in the medical management of pyometra?
Makes the smooth muscle contract and expell the fluid
Tx for vaginal edema?
OHE/OE
Tx for small vs large prostatic cysts?
Small/limited attachment = surgical resection
Large/capsular/urethral communication = partial resection and omentalization
Castration with all cysts
Age range for young dogs with hip dysplasia?
5-12 months
T/F: Ovarian neoplasias commonly metastasize
False
What approach and technique would you use for annular vestibulovaginal stenosis that is intrapelvic?
Ventral abdominal + transpelvic approach
Vaginectomy (cervix to urethral opening)
How are glucose and potassium affected with GDV?
Both decreased
Best method to dx pancreatic pseudocyst?
Cytology
Which is more common, primary or secondary peritonitis?
Secondary
What is the most common intestinal malignancy in dogs?
Adenocarcinoma
What is the most common gastric neoplasia?
Adenocarcinoma
What is a poor prognostic indicator with single, congenital shunts?
Ascites (secondary to portal hypertension)
What is a post-op complication of meniscal release?
Long term OA
What antibiotics are best for tx of pyometra?
Ampicillin/enrofloxacin
What makes percutaneous tru-cut biopsy better than FNA w/ cytology in terms of diagnosis?
Histopathologic evaluation is better than cytology
Advantages/disadvantages of Heineke-Mikulicz Pyloroplasty?
Ad - mucosa exposed (biopsy), reoccurrence unlikely
Dis - Lumen opened, not usually effective with acquired stenosis
Surgical tx for recessed vulva?
Episioplasty (aka vulvoplasty)
How mant maniscotibial ligaments are there?
2
Medial and lateral
If you are doing a regional mastectomy for a mammary tumor in glands 4 and 5, which glands are you going to remove?
3-5
Which mammary tumor is surgery not indicated for?
Inflammatory carcinoma
What conditions predispose to pica?
Pancreatic exocrine insufficiency
Hepatic encephalopathy
Iron deficiency
T/F: Restricting water before/after feeding reduces the risk of GDV
False
What is the most common injury to the canine carpus?
Hyperextension (damage to palmar support structures)
What is the male:female of intestinal neoplasia in dogs and cats?
Dogs = 2:1
Cats = 1:2
What is the most common congenital deformity of the stifle?
Patellar luxation
What size margins should you excise when removing a gastric adenocarcinoma?
>5cm
Remove regional LN’s too
Is clockwise or counterclockwise GDV more common?
Clockwise
What lactate levels are associated with gastric necrosis?
>6
Worse prognosis
Age for dogs and cats with ovarian cyst?
Dogs < 3 years
Cats < 5 years
What % of canine mammary tumors are malignant?
50%
T/F: Repair of vestibulovaginal stenosis also fixes incontinence
False
What is the preferred test for diagnosing gastric adenocarcinoma?
Endoscopy
How does JPS differ from TPO in regards to the acetabulum?
JPS rotates ventrally
TPO rotates dorsally
Grade the luxation: Patella can be manually luxated but spontaneously returns to normal position
Grade 1
Which do you want to do first, OHE or mastectomy and why?
OHE first
Avoid seeding tumor into abdomen
When is diagnostic imaging necessary for cancer?
Thoracic and abdominal tumors
Firm, non-mobile tumors
SQ, IM, and body wall tumors
When is a lumpectomy appropriate?
When there are no COM
What is the gold standard for diagnosis of gastric neoplasia?
Biopsy
What is the most common origin of uterine neoplasia in dogs?
Smooth muscle
When should excisional biopsy be considered?
Treatment would not be altered by tumor type
Re-excision possible without great morbidity
Classify the acquired pyloric stenosis: Muscular and mucosal hypertrophy
Grade 2
What approach and technique would you use for septal vestibulovaginal stenosis?
Episiotomy or endoscopic
Laser ablation or scissor resection with endoscopic
Cytology is good for what types of cancer?
Mast cell tumors
Melanoma
Lymphoma
TVT
Plasma cell
Acute gastric dilation or chronic gastric volvulus: normal position, distended stomach
Acute
Is medial or lateral collateral injury more common?
Medial
What are the 3 forms of liver adenocarcinoma and which has the best prognosis with complete surgical excision?
Massive - best prognosis
Nodular
Diffuse
Grade the luxation: Patella luxates with lateral pressure or on flexion of stifle, remains luxated until reduced manually or when animal extends
Grade 2
Etiology of medial luxating patella?
Medial malalignment of quadriceps (growth)
MST for cecal neoplasia?
7-12m
When would you do a punch liver biopsy?
Superficial lesions that are centrally located
Generalized hepatic disease (easy to do multiply biopsies)
What nutritional contents should be restricted to help prevent hip dysplasia from developing?
Calcium/Vitamin D
Energy
When would you use medical treatment for tarsus OCD?
Older dogs
Established OA
Describe the stance of a dog in the degeneration phase of hip dysplasia
Rear base-narrow
What layers are incised with the Heineke-Mikulicz Pyloroplasty?
All layers
What is the dx of choice to dx canine mammary tumors?
Excisional biopsy
With partial rupture of the common calcanean tendon, what portion is spared?
SDF
What tumors should be removed with wide excision?
Mast cell tumors (high grade)
Sarcomas
Is gastric leiomyosarcoma more common in the cardia or pylorus?
Cardia
What age animals usually get intussuseptions?
<1 year
What breeds and age are associated with legg-perthes?
4-11 months
Minature poodle
Westie
What is the main risk associated with percutaneous tru-cut liver biopsy?
Increased risk of bleeding
What are the main functions of the cranial cruciate ligament?
Prevents:
Cranial tibial thrust
Hyperextension
Internal rotation
Tx for feline mammary tumor?
Chain mastectomy on affected side
Treatment of choice for uterine torsion?
OHE
Do not derotate!
What mammary tumor factors influence MST?
Tumor subtype
Tumor size
Histopathologic characteristics
What is the average age for intestinal carcinoma, lymphosarcoma, and leiomyosarcoma?
Carcinoma and lymphosarcoma = 10y in dogs and cats
Leoimyosarcoma = 11y in dogs
What is the best modality to diagnose congenital pyloric stenosis?
US
What is the gait associated with hip dysplasia?
Hip sway
Do you more often need surgical repair with caudoventral or craniodorsal hip luxation?
Craniodorsal
T/F: Osteotomy will eliminate tibial thrust and cranial drawer
False
Only eliminates tibial thrust
What can you give to help deal with reperfusion injury from GDV?
Acetylcysteine
Vitamin C, E, selenium
Deferoxamine
Lidocaine
What are the complications of a Billroth II procedure?
Alkaline gastritis (bile and pancreatic secretions enter stomach)
“Blind loop” syndrome (gastric contents move orally)
Marginal ulceration
What complication is associated with TPLO?
Iatrogenic angular limb deformity
What is the most common source of infection for secondary septic peritonitis
GIT
How would you differentiate BPH from prostatitis on US?
BPH = homogenous enlargement
Prostatitis = heterogenous enlargement
What age is it appropriate to do a JPS in a dog with hip dysplasia?
<20 weeks
What conditions must be satisfied in order to do medical treatment for metritis?
Valuable breeding animal
Good response to initial therapy
No devitalized tissue/retained placenta or fetus
What forceps do you want to use on tissue you plan to preserve?
Doyen forceps
Gold standard for diagnosing septic peritonitis?
Cytology of abdominal fluid
What complication is associated with TTA?
Iatrogenic patellar luxation
How are the collateral ligaments different in the tarsus and carpus?
Carpus = only span one joint
Tarsus = long portion spans entire tarsus, short portion in two parts
Which type of surgery acts as a prosthetic capital ligament for coxofemoral luxation?
Toggle pin/rod
MST for cats and dogs with intestinal adenocarcinoma?
Cats = 2y
Dogs = 10m
Tx for atresia ani?
Bougienage
Analplasty
Rectal pullthrough
What bacteria are usually associated with septic secondary peritonitis?
E. coli
Bacteroides
T/F: In regards to CCL disease, synovitis is present in the contralateral stifle joint
True
Most common feline mammary tumor?
Adenocarcinoma
What does it mean if you see cranial drawer/tibial thrust in a puppy ≤6 months old?
Normal finding
Are vaginal neoplasias usually benign or malignant?
Benign
Tx for grade 3 acquired pyloric stenosis?
Billroth 1
T/F: With counterclockwise GDV, the greater omentum covers the stomach
False
With clockwise rotation
What breeds are predisposed to tarsal hyperextension?
Middle-aged Shelties/Collies
What approach and technique would you use for annular vestibulovaginal stenosis that is caudal to the pelvis?
Dorsal approach
Vaginal resection and anastomosis
What layers of the stomach and small intestines are affected by pythiosis?
Submucosa
Muscularis
T/F: Castration increases the risk of prostatic neoplasia
True
What % of feline mammary tumors are malignant?
85-90%
What large intestinal procedure do you want to use prophylactic antibiotics for?
Subtotal colectomy
T/F: Glucocorticoids are great to use when treating GDV
False
Never give!!!!!
What is the most common cause of multiple acquired portosystemic shunts?
Portal hypertension
What is the most common neoplasm in the intact female dog?
Mammary tumor
How many meniscofemoral ligaments are there?
1
Lateral only
What is the most common grade of acquired pyloric stenosis?
Grade 2
Age of dogs with cecal inversion?
<4y
What nerve can be affected by the lateral suture technique?
Peroneal
What type of arrhythmia is most common post-op GDV and what causes it?
VPCs
Caused by reperfusion
What is the most common type of meniscal tear?
Bucket handle
What organs are most affected by vasoconstriction caused by GDV?
Liver and kidney
What muscles may me atrophied with hip dysplasia?
Quads
Biceps femoris
95% of deaths following GDV occur how long post-op?
Within 4 days
How long can uterine prolapse happen after parturition of final fetus?
Up to 48 hours
Signalment for splenic torsion?
Large and giant breed dogs
Males > females
Not reported in cats
With GDV, how does the pylorus rotate?
Cranial ventrally from righ to left
Which part of the CCL is taut in extension only?
Caudolateral
Which radiographic view is best to diagnose GDV? Which view should you never take?
Right lateral is best
Never take VD
What liver neoplasia is most common in dogs and cats?
Dogs = hepatocellular
Cats = cholangiocellular
What diets decrease the risk for GDV and why?
Egg or fish
Easy to digest protein
Why can you no longer get pyometra after an OHE or OE?
The ovary is the progesterone source so since its not there anymore, pyometra cant develop
Describe the lameness associated with OCD of the tarsus?
Worsens after rest
How does the age range differ between gastric leiomyosarcoma and gastric leiomyoma?
Sarcoma = 7 years
Leiomyoma = >15 years
Where does gastric adenocarcinoma metastasize to?
Regional lymph nodes
Liver
When would you use the guillotine technique for liver biopsy?
Lesions at the periphery of the lobes
Diffuse liver disease
Which arteries supply the greater curvature of the stomach? Lesser curvature?
Greater = Right/left gastroepiploic
Lesser = Right/left gastric
What is the best place to take a biopsy of the pancreas from?
Right distal limb (diffuse disease)
Which technique is most commonly used for complete or partial liver lobectomy?
TA stapler
What breeds are associated with extrahepatic portosystemic shunts?
Yorkies
Shih Tzus
Maltese
Mini poodle
Mini schnauzer
Pugs
What is the most common post-op complication of GDV surgery?
Shock
What factors increase the complication rate of the lateral suture technique?
Higher body weight
Younger age
What is an alternative two layer closure technique?
Simple continuous in submucosa, cushing pattern in seromuscular layers
or
Simple continuous in serosa/muscularis/submucosa, cushing pattern in seromuscular layers
What sling is indicated post reduction of a caudoventral hip luxation? Which is contraindicated?
Hobbles for 10-14 days
Dont use Ehmer sling
What is the gold standard for diagnosing portosystemic shunts?
CT angiography
What is the surgical management for a hyperextension injury?
Arthrodesis
How long prior to surgery should a patient with portosystemic shunt be medically managed?
At least 2 weeks
What is the most common tumor of the perianal area?
Perianal adenoma
Tx for grade 1 acquired pyloric stenosis?
Transverse pyloroplasty
Tx for calcanean rupture? Suture type?
3-loop pulley > locking loop
Monofilament nonabsorbable suture
Describe the appearance of inflammatory mammary carcinoma
Edema, erythema
Firm
Pain
CS mimic mastitis
What is the advantage of doing a Roux-en-Y anastomosis over a Billroth II?
Avoids alkaline reflux gastritis and decreases liklihood of blind loop syndrome
How large should your biopsy be when doing a transverse wedge biopsy?
<20-25% of circumference
What is an early radiographic finding of hip dysplasia?
Morgan’s line
What is the traditional two layer closure for the stomach?
Cushing pattern oversewn with lembert
If the antebrachiocarpal joint is abnormal, would you do a partial carpal arthrodesis or a pancarpal arthrodesis?
Pancarpal arthrodesis
What is the most common developmental anomaly of the external male genitalia?
Hypospadia (incomplete formation of the penile urethra)
Treatment of choice for pancreatic abscess?
Debridement > resection
What type of female reproductive lesions would you use a ventral approach for?
Intrapelvic
Abdominal
How long postpartum can metritis occur?
12 hours to 1 week
MST with inflammatory carcinoma?
< 1 month
What is the most common cause of primary peritonitis?
FIP
What finding on palpation is the hallmark for hip dysplasia?
Pain on extension
What technique for partial liver lobectomy results in the greatest blood loss?
Parenchymal fracture and ligation (ligating or cauterizing individual vessels)
Grade the luxation: Patella is luxated most of the time, patella can be manually reduced but reluxated spontaneously
Grade 3
Tx for grade 2 acquired pyloric stenosis?
Y-U Pyloroplasty
Hallmark for diagnosis of septic peritonitis using cytology?
Intracellular bacteria
Acute gastric dilation or chronic gastric volvulus: slight malposition, vomiting, eructation, gastropexy
Chronic
What can you cause if you fail to adequately ligate the bile duct or fail to recognize and ligate small hepatic ducts entering the cystic duct?
Bile peritonitis
Tx for legg-perthes?
FHO
THR
What breed do you commonly see OCD of the tarsus?
Rottweilers
What is the initial tx for GDV?
Fluids
Decompression
Pain management
Describe the appearance of a leg that is affected with craniodorsal hip luxation
Leg held in relaxed extension
Stifle externally rotated
Affected leg is shorter
What breeds are associated with acquired pyloric stenosis?
Lhasa Apso
Shih Tzu
Tx for BPH?
Castration
What signs will you see with proximal vs distal intussuseption?
Proximal = vomiting
Distal = tenesmus
Which ovarian medical issue needs to be referred?
Ovarian remnant
What makes up the medical management of portosystemic shunts?
Lactulose
Low protein diet
Antibiotics (metronidazole, neomycin, ampicillin)
What are the most common type of portosystemic shunts?
Congenital extrahepatic
What do you also have to remove if there is a mammary tumor in gland 5?
Superficial inguinal LN
Kiwi sign on US = ?
Biliary mucocele