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Food Animal Medicine > Exam 4- Vaccination, Deworming, Dehorning > Flashcards

Exam 4- Vaccination, Deworming, Dehorning Flashcards

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1
Q

What are the 3 goals of vaccination programs?

A
  • Protect against agents or diseases most likely to be encountered
  • Protect during the period of maximum challenge
  • Do no harm!
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2
Q

What is the appropriate site to administer sub q injections to cattle?

A

Neck triangle bounded by the spinal column, shoulder, and jugular furrow. Can go slightly more caudal than for IM injections.

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3
Q

True or False: A vaccine dose is not determined by weight of an animal

A

True

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4
Q

What is the appropriate site to administer IM injections to cattle?

A

Neck triangle bounded by the spinal column, shoulder, and jugular furrow.

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5
Q

How long after the initial dose should the booster dose be administered?

A

2 weeks is minimum, 4 weeks is better

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6
Q

Why are injection sites and needle sizes important in cattle?

A

Beef Quality Assurance (BQA)

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7
Q

How are “core” vaccines defined?

A

AVMA definition: those “that protect from
diseases that are endemic to a region, those with potential public health significance, required by law, virulent/highly infectious, and/or those posing a risk of severe disease”

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8
Q

What does “window of susceptibility” mean regarding immunity?

A

The ‘window of susceptibility’ occurs when there is no longer sufficient maternal antibody to provide full protection from infectious disease, but where sufficient antibody remains to block the ability of the animal to make its own immune response.

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9
Q

What are the 4 agents that cause scours which we vaccinate for?

A

– Enterotoxigenic E. coli
– Rotavirus
– Coronavirus
– Clostridium perfringens type C

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10
Q

What are the 3 ways to protect calves from scours?

A

1- vaccinate springing heifers and dry cows
2- vaccinate newborns
3- Provide monoclonal antibodies to newborns

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11
Q

What is the timing of calf scours vaccination of springing heifers and dry cows?

A
  • Primer and booster in springing heifers, annual booster thereafter
    – Booster needs to be at least 3 weeks pre-fresh, meaning primer should go 60-75 days
    pre-fresh
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12
Q

What type of vaccine is used to prevent scours and are given to springing heifers and dry cows?

A

Scour Guard® 4KC (killed virus, bacterin-toxoid):
Rotavirus, Coronavirus, K99+ E. coli, Clostridium perfringens type C

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13
Q

What is the timing and route of administration when vaccinating newborn calves against calf scours?

A

Administered orally before the calf nurses

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14
Q

What type of vaccine is used to vaccinate newborn calves against calf scours?

A

Vaccinate newborns (MLV, modified-live)
Calf-Guard®: Rotavirus, Coronavirus

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15
Q

What are 2 non-vaccine options for treatment of newborn calves for the prevention of scours?

A

Provide monoclonal antibodies to newborns
■ First Defense® : K99+ E. coli , Coronavirus antibody
■ Tri-shield First Defense®: Rotavirus, Coronavirus, E. coli antibody

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16
Q

Why is the timing of the primer and booster dose of a killed scours vaccines so critical for a springing heifer?

A

Because you have to time the vaccine booster to coincide with the time colostrum is produced so that the maternal antibodies can be transferred to the calf orally via the colostrum

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17
Q

Why do oral MLV vaccines need to be given before the calf nurses?

A

So that maternal antibodies in colostrum don’t interfere with the vaccine’s ability to elicit an immune response in the calf

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18
Q

What 4 respiratory pathogens do we vaccinate newborn calves against?

A

Viral respiratory disease
– Infectious bovine rhinotracheitis (IBR)
– Bovine respiratory syncytial virus (BRSV)
– Parainfluenza 3 (PI3)

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19
Q

What is an example of a respiratory vaccine used in newborn calves? What does it cover, what type of vaccine is it, what is the route of administration, and what is the timing of dosing?

A

Example: INFORCE™ 3
Bovine Rhinotracheitis, Parainfluenza3-Respiratory Syncytial Virus
Modified Live Virus
For intranasal use only
Typically administered at birth

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20
Q

Why do intranasal vaccines allow for greater flexibility in timing of administration?

A

Mucosal IgA response does not interfere with maternal antibodies

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21
Q

What vaccine is used to prevent septicemia in newborn calves?

A

Live culture for Salmonella Dublin

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22
Q

What are the 4 diseases that we vaccinate 4-8 month old calves against?

A
  1. Respiratory disease
  2. Leptospirosis
  3. Clostridial diseases
  4. Brucellosis
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23
Q

What type of respiratory vaccine is used in 4-8 month old calves?

A

5-way MLV: BVD I, BVD II, BRSV, IBR and PI3

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24
Q

How long do maternal antibodies interfere with vaccination of calves? How does this impact vaccination schedules?

A

Maternal antibodies may interfere up to 6 months
Re-vaccination after 6 months is recommended

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25
Q

What are the clinical signs of Leptospirosis in calves? What are the clinical signs of Leptospirosis in adult cattle?

A

In calves: septicemia - fever, hemolytic anemia, hemoglobinuria, jaundice.
In breeding age heifers and adults - reproductive failure, abortion.

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26
Q

What is the host-adapted serovar of Leptospirosis for cattle?

A

Serovar Hardjo-bovis

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27
Q

What are 2 types of Leptospirosis vaccines available for use in cattle? How is it recommended to use them?

A

5-way
and
Monovalent: serovar Hardjo-bovis

Current recommendation: vaccine protocols should include use of both multivalent and
monovalent products

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28
Q

What are the 8 Clostridial pathogens that we can use Clostridium bacterin-toxoids to protect against in calves?

A

C. perfringens C
C. perfringens D
C. chauvoei
C. hemolyticum
C. novyi
C. septicum
C. sordelli
C. tetani

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29
Q

Which cattle do we vaccinate against Brucella abortus?

A

Female cattle only, 4-12 months of age

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30
Q

What are the special requirements for vaccination of cattle against Brucella abortus? Why is this?

A

Must be administered by an accredited veterinarian, officially reported, and animal permanently identified. Animal will appear positive on serotesting after vaccination.

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31
Q

What is the standard of care during banding of cattle, vaccination-wise?

A

Tetanus vaccination should be standard of care when cattle are being banded for
castration

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32
Q

What are the 2 biggest causes of morbidity and morality in pre-weaned calves?

A

Pre-weaned calf scours and respiratory disease are major causes of morbidity
and mortality on dairy farms

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33
Q

What types of farms should consider vaccinating pre-weaned calves for scours and respiratory disease?

A

Viral scours and respiratory vaccines should be strongly considered on all farms

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34
Q

What component of bacteria cause endotoxemia? Gr + or Gr - ? What are 2 important examples of these types of bacteria?

A

LPS (lipopolysaccharide), Gram negative bacteria share a common
set of LPS core antigens in their outer membranes, E. coli, Salmonella enterica

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35
Q

What is a core antigen vaccine and what does it do?

A

Core antigen vaccines help prevent
endotoxemia caused by a multitude of
gram-negative agents
– Mastitis caused by E. coli (J-Vac®)
– Salmonellosis caused by Salmonella typhimurium (Endovac-Dairy®)

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36
Q

What is the dosing schedule for core antigen vaccines in springing heifers?

A

Primer and booster required for springing
heifers, followed by annual re-vaccination

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37
Q

What is a Siderophore receptor porin vaccine and what does it protect against? What age of cattle is it used in and what is the dosing schedule?

A

SRP is an additional Salmonella vaccine containing siderophore receptor porin which is involved in iron transport into bacteria.
■ Effective at reducing fecal shedding of Salmonella Newport and controlling
disease caused by different serotypes of Salmonella
■ Can be administered to cattle > 6 months of age
■ Primer and booster required

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38
Q

In adult cattle, what vaccines should be considered for annual re-vaccination?

A

In adult cattle consider annual re-vaccination with:
– 5-way MLV respiratory vaccine
– 7 or 8-way clostridial vaccine
– SRP

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39
Q

What vaccines should be considered for cows at dry off?

A

At dry-off
– Gram-negative core antigen vaccine
– Calf scours vaccine

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40
Q

What components are necessary to elicit an appropriate immune response, other than the vaccine itself?

A

Immune response requires low stress, good
nutrition and health

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41
Q

What are the major dairy cattle diseases for which there are commercially
available vaccines?

A

Rotavirus, Coronavirus, E. coli, Clostridia, Salmonella, BVD I, BVD II, BRSV, IBR, PI3, Siderophore, Bovine Rhinotracheitis, Brucellosis

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42
Q

Explain the three ways to confer protection against calf scours

A

1- Vaccinate springing heifers and dry cows with killed virus/bacterin-toxoid vaccine Scour Guard® 4KC against Rotavirus, Coronavirus, K99+ E. coli, Clostridium perfringens type C
2- Vaccinate newborns (modified-live)
Calf-Guard®: Rotavirus, Coronavirus administered orally before the calf nurses
3- Provide monoclonal antibodies to newborns like First Defense® (K99+ E. coli , Coronavirus antibody) or Tri-shield First Defense® (Rotavirus, Coronavirus, E. coli antibody)

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43
Q

What are the risk factors and clinical signs of coccidiosis?

A

Risk factors: high egg burden in the environment, young, nonimmune, stressed (hutches to group pens), co-infection with respiratory viruses, multiple ages housed together, poor sanitation/high fecal contamination in environment.
Clinical signs: Profuse diarrhea (+/- blood), poor condition, reduced weight gain

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44
Q

What is the infective stage of coccidia? Where are they found?

A

Sporulated oocysts, fecal contaminated environment

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45
Q

What are the clinical signs of ostertagiasis?

A

Ill thrift, poor growth, anorexia, diarrhea, hypoproteinemia

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46
Q

What is the difference between types 1 & 2 Ostertagiasis?

A

Type I is gradual ingestion of L3 larvae and development over ~ 3 weeks. Type II is larvae from a previous season that were in hypobiotic state becoming active all at once and causing severe clinical disease.

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47
Q

What are the 3 most important internal parasites (general categories) of dairy cattle in WI?

A

– Lungworm (Dictyocaulus viviparus)
– Coccidiosis
– “HOT” complex GI nematodes (Hemonchus, Ostertagia, Strongyles)

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48
Q

What are the 3 most important external parasites (general categories) of dairy cattle in WI?

A

– Mange (mites)
– Lice
– Ringworm

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49
Q

What organism causes verminous pneumonia in cattle?

A

Lungworms aka Dictyocaulus viviparous

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50
Q

What are the clinical signs of verminous pneumonia? Related issues?

A

Clinical disease characterized by bronchitis and pneumonia
– Parasite induced hypersensitivity
– Secondary bacterial infection

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51
Q

Which populations of cattle are most affected by verminous pneumonia?

A

Pastured calves in first grazing season

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52
Q

How is verminous pneumonia diagnosed and treated?

A

■ Diagnosed via modified Baermann technique
■ Treat with anthelmintics
– Macrocyclic Lactones/Benzimidazoles
– May require antibiotics and antihistamines

53
Q

What organisms cause coccidiosis in cattle? What specific cells do they affect to cause pathology?

A

Eimeria bovis, E. zuernii, Destroy large intestinal enterocytes

54
Q

What population of cattle are most severely affected with coccidiosis and when?

A

Young, nonimmune animals that ingest large numbers of sporulated oocysts from heavily contaminated environments
■ Most common when calves moved from hutches to group pens

55
Q

What are the clinical signs of calf coccidiosis?

A

Profuse diarrhea (+/- blood), poor condition, reduced weight gain
Nervous coccidiosis: muscle tremors, hyperesthesia, nystagmus, seizures
- Pathophysiology poorly understood, mortality rate high

56
Q

What management practices can lower risk of exposure/exposure levels of calves to coccidiosis?

A

Reduce Exposure
■ Limit overcrowding
■ Proper manure disposal
■ Avoid housing multiple age groups
together
■ Sanitize environment between
sequential groups of calves
■ Limit eating off ground
■ Routine cleaning of water troughs

57
Q

What management practices can lower susceptibility of calves to coccidiosis?

A

Reduce Susceptibility
■ Limit number of stressors around
time of weaning
■ Strive for low prevalence of
comorbidities (i.e. BRD)
■ Coccidiostat prophylaxis
– Effective drug
– Appropriate dose delivered to
all animals

58
Q

What are some commonly-used drugs to treat coccidiosis? What is their general mechanism of action? How are they generally delivered?

A

Commonly used drugs
– Amprolium (Corid®)
*Thiamine antagonist
– Decoquinate (Deccox®)
– Lasalocid (Bovatec®)
*Ionophore
– Monensin (Rumensin®)
*Ionophore
– Sulfamethazine (Sustain®)
– Sulfadimethoxine (Albon ®)
Drugs most often administered
in the feed or water

59
Q

Overdose of amprolium can
lead to which neurologic
disease of ruminants?

A

Polioencephalomalacia (PEM) that causes neurological signs like blindness, head pressing, seizures, and disorientation.

60
Q

What is the primary organ
affected by monensin
toxicosis?

A

Cardiovascular system, particularly the heart muscle

61
Q

What are clinical signs associated with Ostertagiasis?

A

Ill thrift, poor growth, anorexia, diarrhea, hypoproteinemia

62
Q

What is the infective stage of parasitic nematodes that cause verminous pneumonia and ostertagiasis?

A

L3

63
Q

How are type I and type II ostertagiasis different re: worm development?

A

– Type I Ostertagiasis: Rapid acquisition of L3 that complete development to the adult stage within 3 weeks
– Type II Ostertagiasis: Synchronous
development and maturation of inhibited larvae.

64
Q

Which type of ostertagiasis is most clinically severe? Why?

A

Type II is more severe. Large numbers of larvae are active at one time b/c they are synchronized after a hypobiotic state. In type I larvae are more gradually acquired from the environment and develop asynchronously.

65
Q

What ages of cattle do ostertagiasis types I and II generally affect?

A

Type I Ostertagiasis: young cattle (up to ~18 months) during their first grazing season. Type II Ostertagiasis: Older animals (2-4 years), seen months after first grazing season.

66
Q

What is the classic necropsy finding in ostertagiasis cases in cattle?

A

Abomasum: Moroccan leather (bumpy)

67
Q

What are the 4 components of multimodal parasite control in herds?

A

Diagnostics, Treatment, Refugia, Management

68
Q

What test can be used to diagnose herd problems with parasites? What is the goal for parasite treatment?

A

Fecal egg count reduction test
Recheck in 14 days after treatment
Goal > 95% reduction in fecal egg count

69
Q

What are 2 classes of drugs used to treat GI parasites in cattle? What are their general mechanisms of action and how are they different?

A

Macrocyclic lactones
■ Cause nerve paralysis of both internal and external parasites
■ Longer persistent activity
Benzimidazoles
■ Interfere with microtubules of the parasite, depleting energy supply
■ “Purge” internal parasites, short acting

70
Q

What are 2 classes of drugs used to treat GI parasites in cattle? What are some examples of these drugs and how are they administered?

A

Macrocyclic lactones
■ Injectable and pour-on products available
– Ivermectin (Ivomec®)
– Moxidectin (Cydectin®)
– Eprinomectin (Longrange®, Eprinex®
Benzimidazoles
■ Oral administration
– Fenbendazole (Safe-Guard®, Panacur®)

71
Q

What is refugia?

A

Creating a population of parasites that are in refuge from the dewormer- are not resistant

72
Q

What are 3 practices in establishing refugia?

A

■ Selectively choose not to deworm a percentage (~10%) of the herd,
reducing drug-resistant selection pressure
■ Do not deworm all animals when parasite loads are low
■ After deworming, do not immediately move cattle to a clean pasture
– Can lead to contamination of new pasture with resistant parasites

73
Q

What pasture management practices can help control GI parasites?

A

■ Avoid overgrazing
– Most parasites are in bottom 2 inches of pasture
■ Pasture rotation
– Avoid grazing same pasture in fall of one year and spring of next

74
Q

What are the clinical signs of chorioptic mange in cattle? Where is chorioptic mange commonly seen?

A

TAILHEAD & LEGS erythematous, Crusted papular lesions
* Intense pruritis with secondary bacterial skin infection
* Commonly seen in show cattle bedded on straw- Grooming supplies and halters are excellent fomites

75
Q

How is chorioptic mange treated in cattle?

A

Treat with topical or injectable insecticides (ivermectin, cydectin)

76
Q

What are clinical signs of lice infestation in cattle? In what conditions is this usually seen?

A

Lice
■ Biting louse
– Bovicola bovis
■ Sucking louse
– Haematospinus sp.
■ More common in winter
■ Group housed animals
■ Pruritus, alopecia
■ Neck and tailhead affected first

77
Q

What organism causes ringworm in cattle? How is it treated?

A

Dermatophytosis (Ringworm)
■ Trichophyton verrucosum
■ Trichophyton mentagrophytes
–Disease is self-limiting

78
Q

Define the term “disbudding”

A

Disbudding: Removal of the horn bud in young animals before bud attaches to the skull by destruction or excision of the germinal epithelium

79
Q

Define the term “dehorning”

A

Dehorning: Removal of the horn after it has attached to the skull

80
Q

Define the term “scur”

A

loose/moveable horn remnant
- consequence of incomplete dehorning/disbudding

81
Q

Define the term “polled”

A

Polled: animal born without horns

82
Q

What type of trait is the polled gene? Will a heterozygote have horns?

A

Autosomal dominant gene (P). Pp = heterozygous polled, animal will not have horns

83
Q

Why aren’t there polled goats?

A

In goats, intersex gene linked to the polled gene à infertility

84
Q

What is the germinal epithelium of ruminants and why is it important to dehorning?

A

Tissue with horn-forming ability. Must be fully removed to prevent horn growth.

85
Q

What is the most important reason we dehorn cattle?

A
  1. SAFETY!!!
    * People, animals, and property
86
Q

What are three slightly less important reasons to dehorn cattle?

A
  1. Facilitates handling, transport
  2. Decrease carcass losses from bruising
  3. Fractured horns pose significant
    health risk
87
Q

At what age is it possible to disbud an animal?

A

Birth to 8 weeks

88
Q

What are possible health risks of a horn fracture/dehorning an adult cow?

A
  • Hemorrhage
  • Sinusitis
  • Osteomyelitis
89
Q

What bone does the horn bud attach to?

A

Frontal bone

90
Q

What does the cornual diverticulum communicate with in the bovine skull?

A

Frontal sinus

91
Q

At what age does the cornual diverticulum extend into the horn?

A

~ 6 months

92
Q

What nerve innervates the horn? What nerve does it branch off of?

A

Cornual nerve innervates the skin of the horn/horn bud
* Branch of the zygomaticotemporal division of the maxillary nerve

93
Q

What is the landmark does the cornual nerve run along in the bovine skull?

A

Temporal fossa

94
Q

Regardless of technique used what are the 3 requirements for dehorning/disbudding procedures?

A

1) Restraint
2) Local nerve block
3) Systemic analgesia

95
Q

What are two methods of restraint for dehorning/disbudding procedures?

A
  • Physical: Headlocks, head catch, rope halter
  • Chemical: Xylazine
96
Q

What are the common drugs used for analgesia for dehorning/disbudding procedures? How are they administered? Are these drugs labeled for this use?

A
  • Flunixin meglumine (IV only)
  • Meloxicam (oral)
    No medications labelled for alleviating pain associated with dehorning in cattle &
    goats, off-label use
97
Q

What drug is used for local blocks for dehorning/disbudding procedures?

A

Lidocaine

98
Q

Why should you use sedation for dehorning/disbudding procedures?

A
  • Improves restraint
  • Facilitates nerve block
  • Provides some analgesia
    Less stressful for everyone
99
Q

What drugs and dosages are used for sedation in bovines for dehorning/disbudding procedures? ROM?

A

Xylazine:
0.1 mg/kg IM (takes 5-10 min for effect)
0.05 mg/kg IV

100
Q

What drugs and dosages are used for sedation in caprines for dehorning/disbudding procedures? ROM?

A

Xylazine
* Kids (Disbudding)
0.05 mg/kg IM or 0.025 mg/kg IV
* Larger goats
0.2 mg/kg IV
May be combined with 2 mg/kg Ketamine IV

101
Q

What is the reversal agent for dehorning/disbudding procedures? What ratio are they used in wrt sedation drug?

A

Tolazoline (Reversal)
1-2 mg/kg IV or 1:10 agonist/antagonist ratio

102
Q

When would you use a reversal agent after disbudding/dehorning?

A

With young animals in cold weather at risk of hypothermia

103
Q

How long does lidocaine take for full effect? Duration of action?

A

Takes 2-5 minutes for full effect, duration ~ 90 minutes

104
Q

What is the toxic dose of lidocaine in adult animals?

A

Adults: 10 mg/kg

105
Q

What is the toxic dose of lidocaine in young animals?

A

Kids, lambs, calves: 5 mg/kg

106
Q

Using 2 % (20 mg/ml) lidocaine, in a 10 kg kid, what is the maximum safe dose in mls?

A

10 kg kid x 5 mg/kg = 50 mg/20 = 2.5 mL 2% Lidcocaine

107
Q

Using 2 % (20 mg/ml) lidocaine, in a 50 kg calf, what is the maximum safe dose in mls?

A

50 kg calf x 5 mg/kg = 250 mg/20 = 12.5 mL 2% Lidocaine

108
Q

What is the landmark for placement of a cornual nerve block in a bovine?

A

halfway between lateral
canthus of the eye and horn bud, in the depression of the temporal fossa

109
Q

When should you use a ring block in addition to a cornual block for dehorning/disbudding cattle?

A

Any animal older than 2 months

110
Q

What 2 nerves innervate the horns of goats? Where are they found?

A

1- Cornual branch of zygomaticotemporal nerve- Halfway between lateral canthus of the eye and lateral horn base.
2- Cornual branch of infratrochlear nerve-Halfway between medial canthus of the
eye and medial horn base

111
Q

What is the best block for disbudding a goat kid?

A

Ring block (lidocaine volume is low)

112
Q

What is the best block for disbudding a calf?

A

Cornual nerve block

113
Q

Why do we use systemic analgesia for disbudding/dehorning procedures?

A

Used to provide pain relief during the perioperative period

114
Q

What are the differences between using Flunixin meglumine and Meloxicam for disbudding procedures?

A

Flunixin meglumine (1.1 – 2.2 mg/kg IV q24 hours) with 4-day meat withdrawal.

Meloxicam (1 mg/kg PO once)
Inexpensive, Oral, Longer duration of effect (up to 48 hours) with 21-day meat withdrawal.

115
Q

What is the most common method of disbudding used on dairies?

A

Hot Iron (thermal) Disbudding

116
Q

At what age can chemical disbudding be performed?

A

Only within the first 1-2 days of life

117
Q

What are some disadvantages to chemical disbudding? Advantages?

A

Disadvantages: Calf needs to be housed individually and kept out of the rain!
Paste gets onto other parts of the body causing chemical burns, blindness, scur formation more likely
Advantages: Easy to perform, perceived low-stress to the animal (not really true)

118
Q

What are some disadvantages to thermal disbudding? Advantages?

A

Excessive heat or pressure can damage underlying bone or even brain (i.e. heat meningitis in kids), more painful than caustic paste.
More reliable form of dehorning.

119
Q

Describe the process of disbudding a calf using a thermal device

A

1) Locate the horn bud and clip hair
2) Apply the appropriately sized device over the horn bud
3) Apply pressure and rotate back and forth for 5-7 seconds, will need to repeat until copper ring surrounds bud or there is complete separation
- Butane dehorners will quickly cut through the skin, once there is complete separation bud can be popped off

120
Q

What are the 2 methods to dehorn an adult bovine or remove a scur?

A

Cut dehorning, cosmetic dehorning

121
Q

What are some risks/disadvantages associated with cut dehorning?

A
  • More painful than chemical or hot-iron disbudding
  • Hemorrhage
  • Blood contamination of equipment poses risk for spread of disease (BLV, BVDV, Anaplasmosis)
  • Results in entry of the frontal sinus
  • Usually causes set-backs in overall health and performance of animal in the short-term
122
Q

What are some safety practices that are important to minimize complications of cut dehorning?

A

Hemorrhage
-Pull, ligate, or cauterize arteries
-Cotton or gauze, leave on until it falls off
-Padding gives clot a matrix to form on
Wound or bone infection, sinusitis
-Clean and disinfect instruments
-Fly control!
Skull Fracture
-Keep blades sharp

123
Q

What are 2 instruments that may be used for cut dehorning?

A

1- Barnes (Scoop, Gouge) Dehorner
2- Obstetrics (Gigli) Wire

124
Q

What are the indications for use of cosmetic dehorning?

A

Advantages/Indications:
* Primary closure
* Less scarring
* Shorter healing time
* Lessens fly burden
* Cosmetic
* Poll shaping

125
Q

What causes scur formation?

A

Incomplete excision of the germinal epithelium of the horn

126
Q

What is best practice for management of horns in bovines?

A

Use of polled genetics or disbudding before 8 weeks

127
Q

What additional preventative measures are needed for dehorning adult cattle?

A

Prolonged NSAIDs, +/- Antibiotics, Tetanus toxoid vaccine

128
Q
A

Food Animal Medicine (6 decks)

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