JAVMA/AJVR Flashcards
Haspeslagh et al (2016) conducted a retrospective review of 230 horses treated for 614 sarcoids at the University of Ghent between 2008 and 2013. What treatment modality was associated with the highest treatment success rate in this population of horses? What factors increased the odds of treatment failure?
Electrosurgical excision resulted in the highest treatment success rate (277/319 [86.8%]).
Odds of treatment failure were significantly greater for intralesional injection of platinum-containing drugs, cryosurgery, and topical acyclovir treatment and for sarcoids in equine with multiple tumours rather than solitary lesions.
Ref: Haspeslagh et al, J Am Vet Med Assoc 2016; 249:311-318.
Describe the technique of percutaneous transabdominal urinary catheter placement described by Chigerwe et al, 2016, for treatment of obstructive urolithiasis in goats, sheep and pot-bellied pigs and list the complications associated with the use of such catheters.
Animals heavily sedated with a benzodiazepine +/- anaesthetised with isoflurane via face mask. The right mid to ventral caudal portion of the abdomen was clipped of hair and prepared aseptically. The urinary bladder was identified ultrasonographically. The entry point for the catheter on the skin was most commonly a caudal ventral position at a location where the distended urinary bladder and skin were in proximity. The skin at the entry point was infiltrated with 20 mg of 2% lidocaine solution, a 3-mm stab skin incision was made with a No. 15 scalpel blade and the PTC was then advanced slowly through the skin incision into the urinary bladder with ultrasonographic guidance. Once urine flow through the PTC was detected, the catheter stylet was removed while the rest of the PTC was simultaneously advanced into the urinary bladder. The PTC was secured to the skin with suture.
Medical management of after PTC placement included administration of analgesics, antimicrobials, and relevant crystalloid fluid to address existing serum analyte abnormalities.
Complications associated with PTC placement included blockage of the catheter by urine sediment, perforation of the cecum, and migration of the catheter out of the urinary bladder.
Ref: Chigerwe et al, J Am Vet Med Assoc 2016; 248(11):1287-1290.
A donkey presents to your hospital for repair of an eyelid laceration. The referring vet was knocked unconscious when attempting to administer an injectable sedative to the donkey after ignoring the owner’s warning that Eeyore was very scared of needles! You ignore the warning too, which results in your poor intern gaining a hoof-shaped bruise on her buttock. You search your memory and a hazy recollection of a paper evaluating the efficacy of a certain oral sedative in donkeys surfaces. Describe the medication you would give to Eeyore to repair his eyelid and what dose you would choose with reference to the literature.
Detomodine hydrochloride oral gel at 40ug/kg PO at least 30 minutes prior to the procedure. The paper assessed a placebo, 20ug/kg and 40ug/kg detomodine HCl PO. Both doses induced sedation and an increased nociceptive mechanical threshold compared to the placebo. Sedation was dose dependant, therefore a higher dose would be appropriate in this donkey which is already excited.
Ref. Lizarraga et al, J Am Vet Med Assoc 2016;249:83-39.
The acute phase proteins serum amyloid A (SAA) and haptoglobin have been investigated as prognostic indicators in acute colic cases in the horse. Outline the findings of Westerman et al, 2016 regarding the usefulness of SAA and haptoglobin as indicators for the need for surgical intervention, development of complications, and hospitalization cost and duration in horses with colic.
Mean SAA concentration was significantly higher in the surgical group, compared with that for both the control and medical groups. Haptoglobin concentration did not differ significantly among groups. Horses with small intestinal lesions had significantly higher SAA concentrations than did control horses. Euthanasia due to a poor prognosis or the development of thrombophlebitis was more likely for horses with an SAA concentration > 5 μg/mL. A weak positive correlation (r = 0.30) was observed between cost of treatment and SAA concentration.
Ref: Westerman et al, J Am Vet Med Assoc 2016; 248:935-940.
Tilduronate has been promoted as a treatment for navicular disease in horses. Which of the following statements reflects the findings of Whitfield et al, 2016 with regards to administration of this drug?
A. Mean peak vertical ground reaction force (pVGRF) and subjective lameness score (SLS) remained unchanged following tiludronate administration at all time points.
B. Mean peak vertical ground reaction force (pVGRF) increased on days 120 and 200 following administration of tiludronate via regional limb perfusion, but SLS remained unchanged.
C. Mean peak vertical ground reaction force (pVGRF) increased on days 120 and 200 following systemic administration of tiludronate via the jugular vein, but SLS remained unchanged.
D. SLS improved on day 120 following both administration of tilduronate via both the systemic and intravenous regional limb perfusion routes.
C. Mean peak vertical ground reaction force (pVGRF) increased on days 120 and 200 following systemic administration of tiludronate via the jugular vein, but SLS remained unchanged.
Ref: Whitfield et al, Am J Vet Res 2016; 77:167-173.
You are presented with a 3 year old SB colt for cryptorchidectomy. The owner insists that the surgery be done laparoscopically as everyone knows laparascopic procedures are better than routine open surgical procedures. You respond by telling her that you are capable of performing the procedure laparascopically, (ref: Cribb et al, 2015):
A. But you advise against it as horses undergoing laparoscopic cryptorchidectomy have increased surgical preparation time, increased surgery and anesthesia times, and more postoperative complications, compared with horses undergoing open cryptorchidectomy.
B. And it will reduce the time taken to remove the testicle, however the rate of post-operative complications is increased compared to open cryptorchidectomy.
C. But prefer the open technique as this is what you have done for the past twenty years.
D. And you recommend this approach compared to an open technique as it is faster, and therefore the rate of post-surgical and anaesthetic complications is lower than when performing open cryptorchidectomy.
A. But you advise against it as horses undergoing laparoscopic cryptorchidectomy have increased surgical preparation time, increased surgery and anesthesia times, and more postoperative complications, compared with horses undergoing open cryptorchidectomy.
Ref: Cribb et al, J Am Vet Med Assoc, 2015; 246:885-892.
Which of the following statements is true regarding horses requiring repeat celiotomy for treatment of colic within 14 days of a first celiotomy (Dunkel et al, 2015)?
A. Horses undergoing small intestinal resection were more likely to survive to discharge than horses which did not require resection and anastomoses.
B. Incisional infection rate was low in horses undergoing repeat celiotomy.
C. Horses taken to surgery for a second time due to wound dehiscence were less likely to survive than horses taken to a second surgery for persistent nasogastric reflux or abdominal bleeding.
D. The most common finding during the first surgery was a small intestinal strangulating lesion and the most common reason for the second surgery was persistent nasogastric reflux.
D. The most common finding during the first surgery was a small intestinal strangulating lesion and the most common reason for the second surgery was persistent nasogastric reflux.
Ref: Dunkel et al, J Am Vet Med Assoc, 2015; 246:540-546.
What is the prognosis for return to racing following colic surgery in Thoroughbred racehorses? For horses that do return to racing following colic surgery are there any differences in performance variables compared to their untreated cohort (Hart et al, 2014)?
In a study of 59 Thoroughbred racehorses undergoing colic surgery at the University of Pennsylvania, 45 (76%) returned to racing. Return to racing was significantly associated with admission heart rate and peripheral lactate concentration. Treated and untreated horses had no difference in total number of quarters raced, number of starts, or earnings after surgery. Treated horses had higher earnings per start, compared with untreated horses.
Ref: Hart et al, J Vet Med Assoc, 2014; 244:205-211.
Which of the following statements is true regarding diagnosing enterolithiasis with digital abdominal radiography (DR) in horses (Kelleher et al, 2014)?
A. Sensitivity of DR for diagnosis of enterolithiasis in horses is high (84%) but specificity is low (61%).
B. Sensitivity of DR is higher for diagnosis of large colon enteroliths than small colon enteroliths.
C. Specificity of DR for diagnosis of enterolithiasis in horses is high (96%) but sensitivity is low (58%).
D. Sensitivity of DR is higher for diagnosis of small colon enteroliths than large colon enteroliths.
B. Sensitivity of DR is higher for diagnosis of large colon enteroliths than small colon enteroliths.
Ref: Kelleher et al, J Am Vet Med Assoc, 2014; 245:126-129.
Are plasma cardiac troponin I (CTnI) concentrations altered by colic in horses? If so, what do elevated CTnI concentrations indicate in these cases? (Seco Diaz et al, 2014).
In horses in which CTnI concentrations were measured on admission and 12 and 24 hours post-colic surgery/admission for medical colic cases, and a 24 hours ECG halter monitor trace was performed, abnormal cTnI concentrations at admission were significantly correlated with surgical treatment, development of ventricular arrhythmias and outcome. Horses with an abnormal cTnI concentration at admission were 2.4 times as likely to have surgical treatment, 3.86 times as likely to have ventricular arrhythmias, and 4.17 times as likely to have a negative outcome.
Ref: Seco Diaz et al, J Am Vet Med Assoc, 214; 245:118-125.
An appaloosa gelding is referred to you for excision of the third eyelid of his right eye following diagnosis of a squamous cell carcinoma. You perform the surgery and warn the owner to continue to observe the eye in years to come as the rate and average timeline of recurrence for third eyelid squamous cell carcinomas following third eyelid excision are (Scherrer et al, 2014): A. 20%, 2.3 years. B. 39%, 4.5 years. C. 42%, 1.9 years. D. 17%, 3.7 years.
A.20%, 2.3 years.
Ref: Scherrer et al, JAVMA 2014; 245:812-815.
Discuss the effect of limb positioning on the radiographic appearance of the distal and proximal interphalangeal joint spaces of the forelimbs of horses during evaluation of dorsopalmar radiographs as determined by Contino et al, 2014.
In horses in which dorsopalmar radiographs were taken with the limb standing square or abducted 5 or 10 degrees from midline, forelimb position significantly affected the mediolateral joint balance of the interphalangeal joints. As the extent of limb abduction increased, the medial aspect of the proximal and distal interphalangeal joints became narrower, compared with the corresponding lateral aspect of those joints. For both the distal and proximal interphalangeal joints, the mediolateral joint balance differed significantly among all limb positions. Thus, it is crucial that the forelimbs of horses be squarely positioned when dorsopalmar radiographs are obtained for accurate evaluation of interphalangeal joint space and balance.
Ref: Contino et al, JAVMA 2014; 244:1186-1190.
You are called out to evaluate a lame horse. You suspect the horse has an injury of the distal interphalageal (DIP) joint. You do not have an ultrasound machine with you, so are relying on manual palpation to detect joint effusion. Which of the following statements is true regarding your likelihood of detecting joint effusion on palpation (Olive et al, 2014)?
A. You and the intern who is travelling with you are highly likely to make the same assessment of the degree of joint effusion.
B. Sensitivity is low for low volume (1ml) effusion (57%).
C. Sensitivity is low for moderate volume (4ml) effusion (63%).
D. Sensitivity is high for low volume (2ml) effusion (92%).
B. Sensitivity is low for low volume (1ml) effusion (57%).
Ref: Olive et al, J Am Vet Med Assoc, 2014; 75:34-40.
Which of the following statements regarding cutaneous neoplasia in the North American equine population is true (Schaffer et al, 2013)?
A. Arabians are more likely to have cutaneous lymphoma than other breeds.
B. Thoroughbreds are more likely to have benign masses than other breeds.
C. Appaloosas are more likely to have tumours related to UV radiation than other breeds.
D. There is no breed predisposition towards type of cutaneous tumour in horses.
C. Appaloosas are more likely to have tumours related to UV radiation than other breeds.
Ref: Schaffer et al, J Am Vet Med Assoc, 2013; 242:99-104.
