JVIM

Question 1

List 10 drugs that may increase cyclosporine concentrations

Answer 1

Acetazolamide Flavonoids in grapefruit juice Allopurinol Fluconazole Amiodarone Fluoxetine Azithromycin Ketoconazole Bromocriptine Imapenem Calcium channel blockers Itraconazole Carvedilol Macrolide antibiotics (Erythromycin, clarithromycin) Chloramphenicol Methotrexate Cimetidine Metoclopramide Ciprofloxacin/Enrofloxacin Metronidazole Cisapride Omeprazole Colchicine Sertraline Danazol Tacrolimus Digoxin Tinidazole Estrogens

Question 2

List 10 drugs that may decrease cyclosporine concentrations

Answer 2

Azathioprine Phenobarbital Carbamazepine Phenytoin Clindamycin Rifampin Cyclosphosphamide Sulfadiazine Famotidine Terbinafine Nafcillin Trimethoprim Octreotide

Question 3

What are steroids effect on blood concentrations of cyclosporine?

Answer 3

May increase or decrease

Question 4

Primary route of metabolism and excretion of cyclosporine

Answer 4

Metabolized by P-450 in liver. Excreted in biliary system, minimal renal excretion

Question 5

2014: Prognostic Value of Early Magnetic Resonance Imaging in Dogs after Traumatic Brain Injury: 50 Cases
Findings? What had abnormal MRI?

Answer 5

Sixty-six percent of the dogs had abnormal MRI findings. MRI grade was negatively correlated (P < .001) with MGCS. The possibility of having seizures was associated with higher percentage of intraparenchymal lesions (P = 0.0054) and 10% developed PTE

Question 6

2015: Changes in Systolic Blood Pressure over Time in Healthy Cats and Cats with Chronic Kidney Disease
Findings?

Answer 6

Systolic blood pressure significantly increased with age in all cats (P < .001). Healthy cats were at less risk than cats with CKD to become hypertensive (hazard ratio 0.2, P < .001), with creatinine being an independent risk factor for the development of hypertension.

Question 7

Bland 2014: Characterization of Kidney Injury Molecule-1 in Cats
KIM-1 was found more in AKI or CKD? What part of nephron was it released from?

Answer 7

Kidney injury molecule 1 was expressed in specific segments of the nephron (proximal tubule) and detected in urine of cats at risk of AKI (conditions known to cause AKI), but not with CKD.

Question 8

Borgarelli 2015 Prevalence and Prognostic Importance of Pulmonary Hypertension in Dogs with Myxomatous Mitral Valve Disease
What % of dogs had PH and what factors were predictors of worse outcome?

Answer 8

Evaluated dogs with B2 or C MVD. Over the study period, 39% of dogs developed PH, more common in stage C. In multivariate analysis, presence of tricuspid regurgitation pressure gradient> 55 mmHg and La/Ao ratio >1.7 remained significant predictors of worse outcome in the multivariate analysis.

Question 9

Borgeat 2014: Arterial Thromboembolism in 250 Cats in General Practice: 2004–2012

What were risk factors for death at 24 hours and at 7 days?

Answer 9

61 of cats were euthanized at presentation. 70% of the remaining cats survived >24 hours after presentation.
Those that survived >24hours, 44% survived for at least 7 days.

Hypothermia and management by clinic 2 were independent predictors of 24 hour euthanasia or death.

For cats surviving >24 hours, hypothermia and failure to receive aspirin, clopidogrel, or both were independent predictors of death or euthanasia within 7 days.

For cats that survived > 7 days, MST was 94 days.

Question 10

Bovens 2014 Basal Serum Cortisol Concentration as a Screening Test for Hypoadrenocorticism in Dogs
What cut-off value for cortisol should be used?

Answer 10

Using cut-off of 2ug/dL, those with >2 disease is unlikely; those with <2 should be stim’d

Question 11

Braff 2014 Relationship between Serum Symmetric Dimethylarginine Concentration and Glomerular Filtration Rate in Cats

Answer 11

Increased serum SDMA concentrations were observed in cats with reduced renal function as determined by direct measurement of GFR. (linear relationship GFR to inverse of SDMA). This finding indicates that SDMA could have clinical applications in the diagnosis of CKD in cats.

Question 12

Cagle 2014: Diagnostic Yield of Cytologic Analysis of Pericardial Effusion in Dogs
What % were non-diagnostic
What cut-off of Hct made cytology more useful?

Answer 12

92.3 were non-diagnostic

If effusion Hct <10%, diagnostic utility increased to 20%

Question 13

Clare 2014 Short- and Long-Term Cure Rates of Short-Duration Trimethoprim-Sulfamethoxazole Treatment in Female Dogs with Uncomplicated Bacterial Cystitis

Answer 13

Dogs treated with TMS 15 mg/kg BID x 3 days or cephalexin 20 mg/kg BID for 10 days.
did not identify a difference in cure rates between short-duration sulfonamide and long-duration beta-lactam treatments in female dogs with uncomplicated cystitis. Long-term cure rates in both treatment groups were low.**(44 vs 20% micro cure rate at 30 days for tms vs cephalexin and 50%/65% clinical cure rate).
In some female dogs, “uncomplicated” bacterial cystitis may be more complicated than previously recognized.

Question 14

Claude 2014 Effects of Maropitant Citrate or Acepromazine on the Incidence of Adverse Events Associated with Hydromorphone Premedication in Dogs

Answer 14

In healthy dogs, maropitant citrate administered before hydromorphone significantly decreases the incidence of vomiting in dogs but does not improve signs of nausea, ptyalism, or increased panting.
Marop 30-45 mins before IM hydro- 0 % vomiting
Control 87% vomiting
Ace 30-45 mins before- 53% vomiting
Marop concurrent with hydro - 27% vomiting

Question 15

2014 Eason Influence of Beta Blockers on Survival in Dogs with Severe Subaortic Stenosis

Answer 15

Beta blocker treatment did not influence survival in dogs with severe SAS in our study, and a higher PG at diagnosis was associated with increased risk of death.

Question 16

Fine 2014: Hemodynamic and Biochemical Alterations in Dogs with Lymphoma after Induction of Chemotherapy

Answer 16

Systolic blood pressure and urine sodium concentration were significantly increased, and bromide dilution space, PCV, urine specific gravity, and urine potassium concentration were significantly decreased compared to controls.
Conclusion and Clinical Importance: Echocardiographic and biochemical abnormalities in dogs with lymphoma appear consistent with volume depletion, and may be the result of systemic hypertension and subsequent pressure natriuresis.

Question 17

Floras 2014: N-Terminal Pro-C-Natriuretic Peptide and Cytokine Kinetics in Dogs with Endotoxemia

What was the difference between LPS treated dogs and placebo dogs on the NT-pro-CNP?

Answer 17

Serum NT-proCNP concentration does not change significantly in response to LPS administration in healthy dog. Some cytokines were significantly different between LPS and placebo group (IL6, IL10, TNFalpha)

Question 18

Furman 2014 A Retrospective Study of 1,098 Blood Samples with Anemia from Adult Cats: Frequency, Classification, and Association with Serum Creatinine Concentration

Were more samples regenerative or non-regen?
Which group had more severe anemia?
How sens/spec were erythrocyte indices for predicting RA?
What % had increased creatinine?

Answer 18

Majority of anemic samples were classified as Non-Regen A (58% vs. 42%) Anemia was more severe in cats with RA.

Erythrocyte indices were not sensitive indicators of RA (ie high MCV and low MCHC to detect regenerative anemia had sensitivity of 20% and specificity of 90%).
Creatinine increased in 52% of anemic samples and 38% of non-anemic samples.

Question 19

2015 Gauthier: Effect of Synthetic Colloid Administration on Coagulation in Healthy Dogs and Dogs with Systemic Inflammation

Answer 19

Tetrastarch bolus administration to dogs with and without systemic inflammation resulted in a transient hypocoagulability characterized by a prolonged activated partial thromboplastin time, decreased clot formation speed and clot strength, and acquired type 1 von Willebrand disease.

Question 20

2014 Hafner : Intensive Intravenous Infusion of Insulin in Diabetic Cats

What was the goal range to maintain BG in intensive group?

Answer 20

90-180 mg/dL

Overall, they found that initial IV infusion of insulin for tight glycemic control in cats with DM decreases insulin requirements during the subsequent 6 months.

Question 21

Hall 2014 Comparison of Serum Concentrations of Symmetric Dimethylarginine and Creatinine as Kidney Function Biomarkers in Cats with Chronic Kidney Disease

Compare sensitivity and specificity between SDMA and creat?

Answer 21

Serum SDMA and creat conc were significantly correlated to GFR.
SDMA became increased before creat in 17/21 cats
SDMA had higher sensitivity (100%) compared with creatinine (17%) but lower specificity (91% vs 100%) and PPV (86% vs. 100%)

Question 22

2015 Hamacher Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Answer 22

Increased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow-up measurement of cTnI concentration provides no additional prognostic information for short-term mortality.

Question 23

Hann 2014: Effect of Duration of Packed Red Blood Cell Storage on Morbidity and Mortality in Dogs After Transfusion: 3,095 cases (2001–2010)
- does duration of storage affect mortality and if so in what group?

Answer 23

Duration of PRBC storage does not appear to be a major contributing factor to mortality in the overall canine population. However, longer duration of PRBC storage may negatively impact outcome in dogs with immune-mediated hemolytic anemia

Question 24

2015 Kelley: Thromboelastographic Evaluation of Dogs with Acute Liver Disease

Answer 24

The TEG results defined dogs as hypocoagulable (11/21), normocoagulable (8/21), or hypercoagulable (2/21). Increases in LY30 defined 8/21 dogs as hyperfibrinolytic.
Overall, ALD dogs have a range of coagulation abnormalities that trend toward hypocoagulability and hyperfibrinolysis as functional impairment occurs

Question 25

2015 Kidd: Procoagulant Microparticles in Dogs with Immune-Mediated Hemolytic Anemia

Answer 25

Tissue factor and phosphatidylserine microparticle procoagulant activity were increased in some dogs with IMHA. Circulating numbers, however, were not significantly higher.

Question 26

2014 Klainbart Peripheral and Central Venous Blood Glucose Concentrations in Dogs and Cats with Acute Arterial Thromboembolism

What cut off for BG should be used and what was sensitivity and specificity?

Answer 26

Delta glucose cutoffs of 30 mg/dL and 16 mg/dL, in cats and dogs, respectively, corresponded to sensitivity and specificity of 100% and 90% in cats, respectively, and 100% in dogs.

Question 27

2014 Langhorn Cardiac Troponin I and T as Prognostic Markers in Cats with Hypertrophic Cardiomyopathy

• what was significant predictor of death?
• Were any echo variables associated with elevated cTnT or cTnI?

Answer 27

cTnT was a significant predictor of death.

Left ventricular free wall thickness at end-diastole (LVFWd) at admission was correlated with cTnI at admission, however no significant correlations were found between changes in troponin concentrations and left ventricular thickness over time.

Question 28

2014 Langston: Use of Tissue Plasminogen Activator in Catheters Used for Extracorporeal Renal Replacement Therapy

Catheter function improved after alteplase instillation in ____% of treatments.
Median blood flow rate increased by ___% in dialysis session after alteplase.
___% were treated on more than 1 occasion.

Answer 28

Catheter function improved after alteplase instillation in 79% of treatments.
Median blood flow rate increased by 13% in dialysis session after alteplase.
24% were treated on more than 1 occasion.

Question 29

2015 McMichael: Hypercoagulability in Dogs with Blastomycosis

Answer 29

Dogs with blasto had leukocytosis, hyperfribrinogenemia and increased thrombin/anti-thrombin complex compared to controls. They were also hypercoagulable on TEG and had increased in vitro thrombin generation.

Question 30

2014 Mellema: Hypomagnesemia in Brachycephalic Dogs

What was period prevalence of hypomagnesemia in boxers vs. bulldogs? Possible clinical significance?

Answer 30

In the retrospective study, period prevalence of hypomagnesemia was 4.7% in Boxers and 15% in Bulldogs.
Brachycephalic dogs are at risk for arterial hypertension and obstructive sleep apnea, which are both associated with chronic magnesium depletion.

Question 31

2015 Munana: Effect of Chronic Administration of Phenobarbital, or Bromide, on Pharmacokinetics of Levetiracetam in Dogs with Epilepsy

Answer 31

Concurrent administration of PB alone or in combination with bromide increases LEV clearance in epileptic dogs compared to concurrent administration of bromide alone. Dosage increases might be indicated when utilizing LEV as add-on treatment with phenobarbital in dogs.

Question 32

2015 Nabity: Symmetric Dimethylarginine Assay Validation, Stability, and Evaluation as a Marker for the Early Detection of Chronic Kidney Disease in Dogs

SDMA identified, on average,

Answer 32

Although trending improved sCr’s sensitivity, SDMA identified, on average, <20% decrease in GFR, which was earlier than sCr using any comparison method.

Question 33

2014 Parente: Serum Concentrations of Gastrin after Famotidine and Omeprazole Administration to Dogs

Which caused transient increase? when was peak?

How long did it take after stopping meds for gastrin to return to normal?

Answer 33

Omeprazole caused a significant increase in serum gastrin concentration. Famotidine induced a transient increase in serum gastrin that peaked at administration day 3 and declined thereafter. By day 7 after cessation of both drugs, there was no difference in serum gastrin concentrations compared to those before administration

Question 34

2015 Parkinson - Evaluation of the Effect of Orally Administered Acid Suppressants on Intragastric pH in Cats

Famotidine or omeprazole better?
Did formulation of omeprazole matter?

Answer 34

% time that intragastric pH was >3 was highest for omeprazole vs. famotidine vs. placebo.

Omeprazole concentrations in plasma were not different b/n fractionated tablet vs. an oral paste.

Question 35

Steagall- review of buprenorphine

What is ceiling dose for buprenorphine?

Are SC and buccal routes consistent in providing adequate noiciception?

What is onset of analgesia?

Does epidural or systemic buprenorphine change MAC of isoflurane in cats?

Answer 35

0.04 mg/kg

At clinical dosages, the SC route of administration does not appear to provide adequate antinociception and analgesia whereas the buccal route has produced inconsistent results

30-45 minutes after IV or IM injection.

No

Question 36

Swann 2015: Systematic Review of Prognostic Factors for Mortality in Dogs with Immune-mediated Hemolytic Anemia

Answer 36

On systematic review, all studies had major flaws. 15 variables were identified as prognostic with only 2 variables identified by more than 1 study (bilirubin and BUN).

Question 37

Tolbert 2015: Efficacy of Intravenous Administration of Combined Acid Suppressants in Healthy Dogs

Answer 37

These results suggest that short-term combination treatment with famotidine and pantoprazole is not superior to pantoprazole alone for increasing intragastric pH in dogs. (q 12 pantoprazole).

Question 38

Ueda 2015: Incidence, Severity and Prognosis Associated with Hyponatremia in Dogs and Cats

Incidence?
Assoc with mortality?
Better or worse than hypernatremia?
Community or hospital acquired?

Answer 38

Incidence- 25.5% in dogs and 49.4% in cats
Magnitude of nyponatremia was linearly associated with a higher case fatality rate.
Hyponatremia was associated with lower case fatality rate than hypernatremia.
Majority had community-acquired hyponatremia, with <10% having hospital acquired hyponatremia.

Question 39

Ueda 2015: Incidence, Severity and Prognosis Associated with Hypernatremia in Dogs and Cats

Incidence?
Assoc with mortality?
Better or worse than hyponatremia?
Community or hospital acquired?

Answer 39

Incidence - 5.7% dogs and 8% cats.

Magnitude of hypernatremia was linearly associated with higher case fatality rate and was higher than those with hyponatremia.

50% dogs and 38.5% cats had community acquired hypernatremia, remainder hospital-acquired.

Question 40

2014 Unterer: Endoscopically Visualized Lesions, Histologic Findings, and Bacterial Invasion in the Gastrointestinal Mucosa of Dogs with Acute Hemorrhagic Diarrhea Syndrome

• where were lesions noted.
• what bacteria was commonly found

Answer 40

Acute mucosal lesions were only found in the intestines, not in the stomach. Clostridium spp., identified as Clostridium perfringens in 6/9 cases, were detected on the small intestinal mucosa in all dogs with HGE, either by culture or immunohistopathology. In the control group, C. perfringens could only be cultured in one of 11 dogs.

Question 41

Sutalo 2015: The Effect of Orally Administered Ranitidine and Once-Daily or Twice Daily Orally Administered Omeprazole on Intragastric pH in Cats

Answer 41

Twice-daily omeprazole treatment significantly increased intragastric pH, whereas pH after once-daily omeprazole and ranitidine treatments did not differ from that of placebo-treated cats.

Question 42

2015 Viitanen: Co-infections with Respiratory Viruses in Dogs with Bacterial Pneumonia

• what was most common co-infection ?
• differences in clinical variables?

Answer 42

CPIV was detected in 7/20 and CRCoV in 1/20 dogs with BP. Respiratory viruses were not detected in dogs with tracheobronchitis caused by bordetella bronchiseptica. There were no significant differences in clinical variables between BP dogs with and without a viral co-infection.

Question 43

201 Wallisch: Incidence, Timing, and Risk Factors of Azathioprine Hepatotoxicosis in Dogs

• When were liver changes seen?
• What breed was over-represented
• what CBC changes were seen and when?

Answer 43

Hepatotoxicosis (as defined by a >2-fold increase in serum ALT) was observed in 5 of 34 dogs (15%) within a median onset of 14 days.

German shepherds were significantly over-represented (3 of 5 dogs with hepatotoxicosis)

Thrombocytopenia or neutropenia were seen in 4 of 48 dogs with CBC follow-up (8% of dogs), but occurred significantly later in treatment (median onset, 53 days

Question 44

2014 Wesselowski: Discrepancies in Identification of Left Atrial Enlargement Using Left Atrial Volume versus Left Atrial-to-Aortic Root Ratio in Dogs

• What was a better marker than La/Ao for left atrial enlargement?
• Was this better in mildly or severely affected dogs?

Answer 44

LA Vol/BW identified LAE in 12 cases in which LA : Ao was normal.

This study shows evidence of diagnostic disagreement between LA : Ao and LA Vol/BW for assessment of LAE. LA Vol/BW may be superior to LA : Ao for identification of mild LAE.

Question 45

2015 Wong: Antimicrobial Susceptibility Patterns in Urinary Tract Infections in Dogs (2010–2013)

• most common bugs?
• susceptibility patterns?
• what antibiotics administered within previous 30 days were associated with resistance?

Answer 45

Most common- E. coli, then Staph and enterococcus.

In vitro susceptibility among all isolates varied for commonly prescribed antimicrobials (amoxicillin [59%], amoxicillin/clavulanic acid [76%], cephalexin [66%], enrofloxacin [74%] and trimethoprim-sulfamethoxazole [86%]). For all antimicrobials tested (except aminoglycosides), in vitro susceptibility was higher in uncomplicated versus complicated infections (P < .05). Uncomplicated infection isolate susceptibility rates remained ≤90% for PO administered antimicrobials. Administration of amoxicillin, doxycycline, and enrofloxacin, but not amoxicillin/clavulanic acid in the previous 30 days was associated with resistance to that antimicrobial.

Question 46

2015 Cortellini: Neutrophil Gelatinase-Associated Lipocalin in Dogs With Sepsis Undergoing Emergency Laparotomy: A Prospective Case–Control Study

• NGAL on sepsis vs. control?
• influence on survival?

Answer 46

Serum NGAL and UNCR (urinary NGAL normalized to creatinine) were significantly higher in study dogs across all time points compared with controls. Urinary NGAL normalized to creatinine in the study group was not significantly different between survivors (n = 12) and nonsurvivors (n = 3). Dogs that received hydroxyethyl starch had significantly higher UNCR across all time points than those that did not.

Question 47

2015 Foy: Evaluation of Iron Deficiency Using Reticulocyte Indices in Dogs Enrolled in a Blood Donor Program

Answer 47

PCV,HCT,retic lower in donor dogs. Serum iron and ferritin were similar between groups but total iron binding capacity was higher in the control group.

The findings in dogs donating ≥6 times annually suggest the presence of iron-deficient erythropoiesis in this population.

Question 48

2015 Geddes: Relationship between Plasma Fibroblast Growth Factor-23 Concentration and Survival Time in Cats with Chronic Kidney Disease
- what factors negatively associated with survival?

Answer 48

Creatinine, FGF-23, UPC, and age.

PCV positively associated with survival.

In multivariable logistic regression, independent predictors of CKD progression included logFGF-23 and age.

Question 49

What is function of FGF-23
where is it secreted
what stimulates secretion

Answer 49

Secreted by osteocytes and osteoblasts in response to hyperphosphatemia and increased plasma calcitriol concentrations.
acts in the kidney to inhibit calcitriol production by reducing mRNA expression of the vitamin D synthesis enzyme (25-hydroxyvitamin D-1a-hydroxylase) and to increase phosphaturia by down-regulating sodium-phosphorus type II co-transporters (NaPi-IIa and NaPi-IIc) in the proximal tubules.
Also acts in parathyroid gland to decrease PTH production and secretion.

Question 50

Goggs 2015: Predicting Outcome in dogs with Primary Immune-Mediated Hemolytic Anemia: Results of a Multicenter Case Registry

• What factors were independently associated with survival
• What scores created for IMHA were associated with survival.
• What did the author’s model include and how accurate was it for predicting outcome at discharge.

Answer 50

BUN, Creatinine, bilirubin concentration and ASA classification are independently associated with outcome in dogs with IMHA.

CHAOS was associated with death in hospital and within 30 days. Tokyo was not associated with either.

A model containing SIRS-classification, ASA classification, ALT, bilirubin, urea, and crt predicting outcome at discharge was accurate in 82 of cases.

Question 51

Gookin 2015: Association of Gallbladder Mucocele Histologic Diagnosis with Selected Drug Use in Dogs: A Matched Case-Control Study

• what drugs were associated and what was different about shelties?

Answer 51

Thyroxine, treatment for cushings disease, or products containing imidacloprid.

When only evaluating shelties, shelties with GBM were 9.3 times as likely to have had imidacloprid.

Question 52

Guieu 2015: Serial Evaluation of Abdominal Fluid and Serum Amino-terminal pro-C-type Natriuretic Peptide in Dogs with Septic Peritonitis

In septic dogs, abdominal fluid NT-proCNP were higher/lower/same as concurrent serum concentrations and higher/lower/the same as control?

Answer 52

In dogs with SP, admission abdominal fluid NT-proCNP concentrations were lower than the concurrent serum concentrations (P = 0.031), and lower than control canine abdominal fluid concentrations (P = 0.015

Question 53

Osuga 2015: Vitamin D Status in Different Stages of Disease Severity in Dogs with Chronic Valvular Heart Disease

Answer 53

Vit D conc were significantly lower in stage B2, and C/D vs. B1. Not different between B2 and C/D.

Negative correlations b/n Vit D conc and LA/AO, LVEDD.

Indicates VIt D status is associated with degree of cardiac remodeling, and begins to decrease before onset of heart failure in dogs.

Question 54

2015 Tidholm: Diagnostic Value of Selected Echocardiographic Variables to Identify Pulmonary Hypertension in Dogs with Myxomatous Mitral Valve Disease

Answer 54

In dogs with MMVD, the presence of PH might be suspected with the combination of decreased PA AT/DT, increased RVIDDn and LA/Ao, and a small or great LVIDDn

Question 55

Aguiar 2016: Complications of Percutaneous Endoscopic Gastrostomy in Dogs and Cats Receiving Corticosteroid Treatment

Answer 55

The general prevalence of complications was found to be similar between groups, but in the steroid group, 43% of the cases developed a major severity complication compared with 18% of the control group

Question 56

Bijsmans 2016: Factors Influencing the Relationship Between the Dose of Amlodipine Required for Blood Pressure Control and Change in Blood Pressure in Hypertensive Cats

Answer 56

Cats with higher blood pressure at diagnosis might require a greater dose of amlodipine to control their blood pressure adequately. Differences in amlodipine pharmacokinetics between cats do not seem to play a role in the antihypertensive response.

Question 57

Boswood 2016: Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study—A Randomized Clinical Trial

Answer 57

Administration of pimobendan to dogs with MMVD and echocardiographic and radiographic evidence of cardiomegaly results in prolongation of preclinical period and is safe and well tolerated. Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit.

Question 58

Canone 2016: Quantitative PCR and Cytology of Bronchoalveolar Lavage Fluid in Dogs with Bordetella bronchiseptica Infection

Answer 58

The BALF culture and qPCR detected B. bronchiseptica in 14/24 and 18/18 dogs, respectively. Coccobacilli were found adhering to ciliated epithelial cells in 20 of the 21 BALF cytologic preparations where epithelial cells were found, and 2/3 BBF cytologic preparations.

Conclusion and Clinical Importance: Quantitative PCR detection of B. bronchiseptica in BALF appears to be a useful diagnostic tool. Cytologic examination of BALF or BBF, when positive, allows a rapid and reliable diagnosis

Question 59

Finch 2016: Risk Factors for Development of Chronic Kidney Disease in Cats

Answer 59

Our study suggests independent associations between both vaccination frequency and severity of dental disease and development of CKD

Question 60

Freeman 2016: Evaluation of Weight Loss Over Time in Cats with Chronic Kidney Disease

Answer 60

Cats lost a median of 8.9% of body weight in the 12 months before diagnosis, but weight loss was already present 3 years before diagnosis and accelerated after diagnosis of CKD

Cats <4.2 kg at the time of diagnosis had significantly shorter survival time compared to cats ≥ 4.2 kg at diagnosis

Weight loss can be detected in cats before diagnosis of CKD, accelerates after diagnosis, and is associated with shorter survival. Tracking body weight may help clinicians in earlier diagnosis of CKD.

Question 61

Garofalo 2016: Comparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs

Answer 61

pulse contour analysis cardiac output has poor agreement with pulmonary artery thermodilution cardiac output.

Vasodilation worsens agreement.

Therefore has limited clinical application.

Question 62

Ghys 2016: Evaluation of Cystatin C for the Detection of Chronic Kidney Disease in Cats

Answer 62

Sensitivity and specificity were 22 and 100% for sCysC and 83 and 93% for sCr. Serum CysC could not distinguish healthy from CKD cats, nor normal from borderline or low GFR, in contrast with sCr.

Urinary CysC could not be detected in all CKD cats.

Question 63

Gorman 2016: Serum Beta Hydroxybutyrate Concentrations in Cats with Chronic Kidney Disease, Hyperthyroidism, or Hepatic Lipidosis

Answer 63

Beta hydroxybutyrate was above the reference interval (<0.11 mmol/L) in 6/28 cats (21%) with CKD, 7/34 cats (20%) with HT, and 11/15 cats (73%) with HL, significantly exceeding the expected 2.5% above the reference interval for healthy cats.

None of 11 cats with increased serum BHB concentration having urine dipstick analysis performed within 24 h of sampling for BHB were ketonuric

Question 64

Hall 2016: Serum Concentrations of Symmetric Dimethylarginine and Creatinine in Dogs with Naturally Occurring Chronic Kidney Disease

Answer 64

Serum SDMA increased before serum Cr in 17 of 19 dogs.

Question 65

Hezzell 2016: Differentiation of Cardiac from Noncardiac Pleural Effusions in Cats using Second-Generation Quantitative and Point-of-Care NT-proBNP Measurements

Answer 65

Measurement of NT-proBNP using a quantitative ELISA(cardiopet) in plasma and pleural fluid or POC test (SNAP bnp) in plasma, but not pleural fluid, distinguishes cardiac from noncardiac causes of pleural effusion in cats

Question 66

2016 Hokamp: Correlation of Urine and Serum Biomarkers with Renal Damage and Survival in Dogs with Naturally Occurring Proteinuric Chronic Kidney Disease

• what was correlated with glomerular damage?
• what was correlated with tubulointerstitial damage?
• in multivariate analysis, which biomarkers were significantly associated with survival time?

Answer 66

Fractional excretions of immunogloblin M (IgM_FE) and immunoglobulin G (IgG_FE) correlated most strongly with glomerular damage based on light microscopy

Creatinine correlated most strongly with tubulointerstitial damage.

in a multivariate analysis, SCr, IgM_FE, and glomerular damage based on transmission electron microscopy (TEM) were the only biomarkers significantly associated with survival time

Question 67

Hurrell 2016: Beta-hydroxybutyrate Concentrations in Dogs with Acute Pancreatitis and Without Diabetes Mellitus

Answer 67

BHB in dogs with AP > sick dogs without AP > control

Question 68

Jung 2016: Atrial Fibrillation as a Prognostic Indicator in Medium to LargeSized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure

Compare survival of AF/ no AF, adequate rate control vs. not, and treatment strategies

Answer 68

AF increased risk of cardiac death when compared to dogs without AF. (AF -142 days, no AF 234 days)

MST significantly prolonged for dogs with AF whose rates were adequately controlled (<160) vs. dogs that did not respond to medications (171 days vs. 61 days).

Combination treatment of digoxicn+diltiazem significantly decreased median HR to 144 and significantly prolonged MST (d+d 130 days vs. dilt 3 days) when compared to diltiazem alone

Question 69

Kabatchnick 2016: Hypothermia in Uremic Dogs and Cats

Answer 69

prevalence of hypothermia was 38% in azotemic cats and 20.5% in azotemic dogs

Statistically significant differences in temperature between uremic and non-uremic dogs and cats.

Body temperature increases when uremia is corrected with dialysis.

Question 70

Kelly 2016: Effect of Fenoldopam Continuous Infusion on Glomerular Filtration Rate and Fractional Excretion of Sodium in Healthy Dogs

Answer 70

Caused significantly increased GFR and fractional excretion of sodium compared to D5W infusion in healthy dogs.
No adverse effects seen.
Dose: 0.8 ug/kg/min for 5 hours

Question 71

Lewis 2016: Clinical and Diagnostic Imaging Features of Brain Herniation in Dogs and Cats

Answer 71

More severe caudal transtentorial herniation based on “TTX” - transtentorial line to rostroventral aspect of cerebellum is associated with a worse short-term outcome.
CLinical signs of herniation were commonly absent.

Question 72

Lynch 2016: Hospital-acquired Anemia in Critically Ill Dogs and Cats: A Multi-Institutional Study

How many blood samples were significant for developing anemia?

Dogs or cats more likely to develop anemia and what was significance for survival?

Surgical or medical patients more likely to develop anemia?

Answer 72

Admission anemia prevalence- 32%, overall during hospitalization - 56.
pcv decreased significantly during hospitalization for both dogs and cats.

Patients that developed anemia had significantly more blood samples obtained (7 vs 5).

Cats more likely to develop anemia than dogs. But anemic dogs significantly less likely to survive to discharge.

Surgical were more likely to develop anemia vs. medical patients.

Question 73

Manning 2016: Intermittent At-Home Suctioning of Esophageal Content for Prevention of Recurrent Aspiration Pneumonia in 4 Dogs with Megaesophagus

Answer 73

Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog

After intiation of esophageal suctioning, dogs survived for median of 13.5 months, during which 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes but aspiration pneumonia was thought to be contributing factor in their death.

Question 74

Martinelli 2016: Preliminary Investigation of Cardiovascular–Renal Disorders in Dogs with Chronic Mitral Valve Disease

Answer 74

Prevelence of CKD and anemia in dogs with MVD was significantly higher than general population.

Dogs being treated for heart failure had significantly higher prevalence of CKD than dogs not requiring treatment.

Significant correlation b/n IRIS stage and ACVIM class.

Severe heart disease, severe renal disease, furosemide administration and advanced age at diagnosis of heart disease was associated with a shorter survival time.

CVRD decrease survival time compared to MVD alone but anemia does not play central role in worsening heart function.

Question 75

Martinez 2016: Plasma Vasoprotective Eicosanoid Concentrations in Healthy Greyhounds and Non-Greyhound Dogs

Answer 75

Plasma eicosanoid profile in Greyhounds was consistent with activation of metabolic pathways known to promote vascular dysfunction and might contribute to higher blood pressures and albuminuria

Question 76

Mazzotta 2016: Red Blood Cell Distribution Width, Hematology, and Serum Biochemistry in Dogs with Echocardiographically Estimated Precapillary and Postcapillary Pulmonary Arterial Hypertension

Answer 76

Only dogs with severe PH had significantly increased RDW compared to dogs without PH.

BUN, HCT, Age, and WBC# significantly associated with RDW.

Conclusion: Underlying pathophysiologic processes associated with PH instead of severeity of PH are likely responsible for increased RDW in dogs with PH

Question 77

Palm 2016 Urinary Neutrophil Gelatinase-associated Lipocalin as a Marker for Identification of Acute Kidney Injury and Recovery in Dogs with Gentamicin-induced Nephrotoxicity

Answer 77

Acute kidney injury was diagnosed significantly earlier based on a 7-fold increase in UNCR (urine NGAL to creatinine ratio) compared to a > 50% increase in serum creatinine concentration

During recovery, the initial decrease in UNCR preceded the decrease in serum creatinine concentration by a median of 2 days.

Question 78

Peters 2016: Cytological Findings of 140 Bile Samples from Dogs and Cats and Associated Clinical Pathological Data

Answer 78

Infectious agents in 30% canine samples and 22% feline samples
Inflammation in 5% of canine samples and 19% of feline samples.
Presence of microorganism more often detected on cytology than culture.
Most common isolates- e coli and enterococcus.

Only increased cPLI was significantly associated with presence of microorganisms, inflammatory cells or both in bile.

Question 79

Piccione 2016: Tick-Borne Relapsing Fever in Dogs

What bugs cause it?
What tick transmits it?
What bloodwork finding is common?
How do you treat?

Answer 79

tick borne relapsing fever caused by borrelia turicatae and borrelia hermsii.

Transmitted by ornithodoros spp. ticks.

In the 5 dogs described, all had fevers and spirochetes seen in blood, all were thrombocytopenic.

Treat with tetracycline

Question 80

Swann 2016 Demographic Characteristics, Survival and Prognostic Factors for Mortality in Cats with Primary Immune-Mediated Hemolytic Anemia

• sex, age or breed disposition?
• what were negative prognostic indicators?
• what were positive prognostic indicators?

Answer 80

No sex or breed predisposition was identified for the development of primary IMHA in comparison to the control cats, but cats in the age range 2.1–5.9 years were predisposed.

Higher total bilirubin concentration and age were significant negative prognostic factors

higher lymphocyte numbers and serum globulin concentration were positive prognostic factors in a multivariable model.

Question 81

Tamborini 2016 Bacterial Cholangitis, Cholecystitis, or both in Dogs

Most frequent isolates? Frequency of complications and association with mortality?

Answer 81

Most frequent isolates were e. coli, enterococcus and clostridium. High antimicrobial resistance.

Biliary tract rupture in 1/3 of cases, with 50% mortality rate.

Question 82

Thomason 2016: The Effects of Cyclosporine and Aspirin on Platelet Function in Normal Dogs

Answer 82

Low-dose aspirin inhibits cyclosporine-induced thromboxane synthesis, and concurrent use of these medications does not alter the antiplatelet effects of aspirin.

Question 83

Tjostheim 2016: Effects of Toceranib Phosphate on Systolic Blood Pressure and Proteinuria in Dogs

Answer 83

Systolic BP significantly higher in previously normotensive dogs afer initiation of treatment with toceranib phosphate compared to baseline. 37% of treated dogs developed SBP ≥ 160 mmHg.

Base-line prevelance of hypertension and proteinuria was not different from controls.

Question 84

What is MOA of toceranib phosphate?

Answer 84

Tyrosine kinase inhibitor- inhibits the VEGF pathway. VEGF plays a key role in tumor neoangiogenesis.

Question 85

White 2016: Subclinical Bacteriuria in Older Cats and its Association with Survival

Answer 85

The prevalence of SB varied between 10 and 13%, and incident infections were uncommon. Female cats were 21 times more likely to have a positive urine culture than were male cats

Question 86

Williams 2016: Serum Cystatin C Concentrations in Cats with Hyperthyroidism and Chronic Kidney Disease

Answer 86

serum CysC not reliable in hyperthyroid cats.

SCysC in nonhyperthyroid cats with azotemic CKD and healthy older cats not significantly different.

Question 87

Yuki 2016: Clinical Utility of Diagnostic Laboratory Tests in Dogs with Acute Pancreatitis: A Retrospective Investigation in a Primary Care Hospital

Answer 87

Measurement of FDC lip activity appears useful for diagnosing AP. High ALT activity might be associated with prolonged duration of hospitalization, and CRP might be useful as a biomarker for monitoring recovery from AP.