Module 16 Wk1 Flashcards
(Small Animal Foundation Dentistry)
What should you inspect and palpate on a conscious head exam?
- Facial symmetry
- Masticatory muscles
- Salivary gland/lymph node
- Ptyalism
- Facial swelling
what is Ptyalism? what could it be due too?
It is excessive salivary secretions
Could be due to pain/toxicity/nausea
What is the most probable diagnosis for facial swelling under the eye?
Tooth abscess
What should you be looking for on an oral examiniation?
- occlusion
- soft tissue
- hard tissue
- TMJ
Whats the most common issue with the TMJ?
Arthristis in dogs and trauma in cats
On an unconscious oral exam what should you be examining extraorally?
- Lymph nodes
- Masticatory muscles
What are the 4 masticatory muscles? and there function pookie
- Temporalis - closes mouth
- Masseter - closes mouth
- Digasticus - opens mouth
- Pterygoids - closes mouth
T/F masseter is the biggest muscle in mouth?
false its temporalis
What are the names of the salivary glands that you should examine in an unconscious oral exam?
parotid
zygomatic
sublingual
What is the invasive papillae and where is it loacted?
It is located behind the incisors.
It connects the mouth and nose stright to the brain. So indicates to the dog if something is okay to be eaten or not
What is the caruncula and where is it located?
It is located at the base of the tongue and is where the submandibular salivary gland empties into the mouth and also connects the tongue to the base of the mouth
What is the most common dental disease in cats?
Periodontal disease and tooth resorption
What are SA paediatric patient dental diseases?
Hypo/hyperdontia
malocclusion
cleft lip/cleft palate
feline juvenile gingivitis
enamel defects
What is the normal dentition in dogs?
3142/3143
What can unerruption of a tooth cause?
a cyst
Should you perform surgery on a grade 1 malocclusion?
No, if the animal is not in pain, there is no need.
What is grade 2 malocclusion?
Discrepancy between upper and lower jaws
What does grade 3 malocclusion look like?
It is were the lower jaw is longer than the upper one
What can gingivitis be triggered by?
The eruption of the permanent dentition
What can juvinile gingivitis be assoc with?
Juvenile periodontal disease, is very painful and should be referred.
What systemic diseases may cause enamal defects?
viral infection, distemper and nutritional problems.
What is gingivitis?
The inflammation of the gums but it is reversible
How is periodontitis a step past periodontal disease?
As it involves damage to the bone and the ligament and its irreversible after bone destruction
What is loss of mandibular bone a sign of?
advanced periodontal disease
What is tooth resorption? and what is the most common tooth to be affected?
This is where the tooth is resorbed and mandibular PM3
Discuss tooth resorption type 1 and how it is treated
Tooth resorption type 1 is associated with periodontal disease and is associated with the crown and is a round lesion triggered by inflammation. Type 1 is treated via extraction.
Discuss tooth resorption type 2
Type two is idiopathic (no clue why it happens) -it occurs everywhere around the tooth and is the most commonly diagnosed via x-ray. Type 2 depends on the grade.
What is type 3 tooth resorption?
Type 3 is a combination of type 2 and type 1
T/F a microline fracture in a tooth is abnormal?
False - it is infact normal
what do you want to do when there is an enamal fracture?
x-ray it
what parts of the tooth are involved in an uncomplicated crown fracture?
enamel and dentine
What parts of the tooth are involved in a complicated fracture?
enamel, dentine and pulp
T/F extraction of tooth is needed for a complicated crown root fracture
True
What are structurally important teeth in dogs?
Upper 4th premolar
Canine
Lower fourth premolar
What are structurally importnat teeth in cats
canine
What is stomatitis?
It is an inflammatory condition affecting the mucous membranes of the mouth causing lesions.
How would you treat stomatitis?
You would treat it by extracting the teeth affected by the disease along with medications such as antibiotics and antifungals.
should you refer an animal with stomatitis?
YEEE
What is ONF?
Oral nasal fistulae
What can ONF be caused by?
- Periodontal disease
- Malocclusion
- Foreign body
- Neoplasia
- Poorly carried out tooth extraction (especially canine)
What should you do if there is an oral mass?
- Take a pic
- Measure it
- Describe it
T/F in cats 50% of oral masses are benign and 50% malignant?
False - this is true for dogs but in cats its 90% malignant and 10% benign.
You are presented with a WHWT 6y/o MN whi has mesial pocket of 8mm - what you doing?
X-ray
You are presented with a mix breed brachy 2y/o missing its first premolar - what you doing?
x-ray
You are presented with a 10/yo FN lab with recurrent right facial swelling - what could be causing it and what you doing?
Tooth root abscess
Extract the tooth
You are presented with a DSH FN 12y/o who hase advanced tooth reabsorption - what you doing?
x-ray
(equine dentistry)
How can an overjet and overbite be decribed?
‘parrot mouth’ ‘overshot jaw’ ‘over bite’
Does overjet and over bite cause grazing issues?
Rarely
T?F overjet and overbite are not inheritable?
False they are
How might you go about treating an overbite?
Orthodontic treatment with biteplate or wire
What is a mandibular prognathism and how might else it be called?
It is shortened premaxilla or maxilla and can be called ‘sow mouth’ ‘undershor jaw ‘ or ‘underbite’
With a underbite what teeth do you get over growths with?
lower 06 and upper 11 overgrowths
where anatomically do retained deciduous incisors sit and what do they cause to permenant teeth?
They are usually displaced in front of permanent teeth so cause caudal displacement of permanent teeth
When removing lower incisors what nerve block should you use?
Left mental nerve block
When removing upper incisors what nerve block should you use?
infraorbital nerve block
What are supernumerary incisors?
They are additional to the 6 normal adult incisors, they have long reserve crowns
When is incisor trauma common?
In juveniles and following kicks/collisions
When faced with a complacated fracture what question should you ask yourself?
Is the pulp necrotic or still viable
What does endodontic treatment of fractured incisor allow?
The tooth to regrow
T/F Equine odontoclastic tooth resorption and hypercementosis is similar to Feline resorptive lesions?
True except the horse often lays down much more cementum subgingivally
T/F slope or slant mouth are mostly secondary to mild craniofacial abnormalities?
True - wrynose is most common, others have abnormalities of hard palate/facial bones and some have painful unilateral dental disorders.
What is Wry nose and what may it result in?
It is lateral deviation of nose to dysplastic side and may result in nasal occlusion
Up to how many months can Wry nose be surgically corrected?
up to 6months
What are abnormalities seen in canine teeth of horses?
- Displaced
- Incompletely erupted
- Long? – Do not reduce
- Calculus (“tartar”)
- EOTRH / resorptive lesions
How would you deal with calculus on canines?
Break off with forceps
How would you deal with a canine resorption lesion?
Either extract tooth or just leave it in to be fully resorbed
What will lower wolf tooth cause and should they be extracted?
Yes they should be - they are likely to cause a bitting problemo
Describe the procedure for extracting a wolf tooth?
Sedate
Local Anaesthetic
Burgess Punch for Mucosa only
Slowly Elevate all Sides of Tooth
Lever against 06s last
What are the normal occlusal angles and what can the go up to?
10-15 degrees up to 35
What are the different developmental cheek teeth disorders?
- Retained deciduous
- Diastemata
- Rostral positioning
- Displacements
- Supernumerary
- Oligodontia
- Maleruption
What are the different aquired cheek teeth disorders?
- Sharp enamel points
- Periodontal disease
- Fractures
- Tumours
- Periapical infections
What are caps?
the remnants of deciduous teeth
When are caps normally shed?
During eruption of permenant teeth
What can retained caps cause?
Buccal/oral pain and may delap cheek teeth eruption and cause eruption cyts
What is a possible sequelae of diastema?
Food trapping decending periodonatl disease
In severe cases of diastema what can happen?
- periapical abscessation or
- oro-sinus fistula
What is the treatment protocol for diastema?
- Removal of impacted food
- Filling diastemata with impression material
- Partial or Full widening of diastema
- Reduction of excessive transverse ridges (ETR) opposite diastema
- Dietary modification
What three things are needed when cleaning the diastema with right angles diastema forceps?
- A well sedated horse
- IV anti- imflammatories
- Topical anaesthetics
What kind of substance can cause dramatic improvements in diastemas?
Firm substances between adjacent teeth
What is the downside to using firm substances over putty-like ones between teeth?
May cause severe buccal/Tongue trauma
What is distema widening useful for?
Valve conformation
What type of cheek teeth displacement are more severe?
Developmental
What teeth are usually effected by developmental displacement?
09 and 10s
What teeth are usually effected by acquired displacement?
lower 10s and 11s
What can dental displacements cause?
Overgrowths and peridontal disease
How should you manage dental displacement in horses?
Treat the peridontal disease and remove overgrowths every 6 months if mild and if more severe extract full tooth and deep peridontal disease
What are cinsequences of supernumeracy cheek teeth in horses?
- Malocclusion, overgrowths and periodontal disease result
- Treat Periodontal disease
- Remove overgrowths
- If severe periodontal disease -extract tooth
What is oligodontia?
Absence of normal number of teeth
What other defects can oligodontia be associated with?
defective enamel and ectodermal formation
What does oligodontia result in?
Drifting from adjacent cheek teeth
What is step mouth?
Step Mouth: A horse’s teeth have uneven heights, with one tooth being much taller than the rest, creating a “step.” This happens when a tooth is missing or not worn down properly.
What is wave mouth?
Wave Mouth: A horse’s teeth form a wavy pattern, with some teeth being too tall and others too short. This makes chewing harder for the horse.
What are cingulae?
large vertical ridges on maxillary cheek teeth
What is the involvement of pulp in a simple dental fracture?
NON
What is the pulp involvement of a complicated dental fracture?
The pulp is exposed
What age of horse are fractures involving madibular cheek teeth most common in?
Young horses
T/F Premature removal of fractured teeth is dangerous
true hehe
What are Latrogenic dental fractures?
man made dental fractures
What might latrogenic dental fractures be caused by?
- During attempted tooth removal (extraction or repulsion)
- During dental overgrowth (“hook”) removal
- Use of inappropriate examination equipment (Swale’s gag)
- More likely during procedures on inadequately restrained horses
(Imaging of the GI Tract, Liver and Pancreas)
What are the pros and cons of radiology as a diagnostic tool for GI?
- Pros = widely available. Good to visualise position, changes in size/diameter, gas/mineral opacities
- Cons = loss of serosal detail can hinder interpretation, so multiple views are required. .
What is used in contrast radiology?
Barium/iodine based contrast
What is the most common diagnostic tool used in first opion practices to image GI?
Ultrasound
Where is the liver generally contained?
Within the caudal ribs
What shape is the liver on a lateral view radiograph and how should it appear?
Triangular shaped with sharp margins caudoventrally with an even, soft tissue opacity appearance.
What is falciform fat?
Fat opacity tissue, ventral to liver on lateral views
What presents if there is a true hepatomegaly?
Rounding or “blunting” of the caudal ventral liver margins.
What is hepatomegaly?
An enlarge liver
what is microhepatia
abnormally small liver
Do you get enlarged or small liver with PSS or herniation?
Yes
When ultrasounding a liver what should you look for and see?
- Generally contained within the costal arch, with sharp margins
- Architecture – parenchyma, portal veins (hyperechoic walls), hepatic veins
- Gall bladder
When scanning the liver and its hyperechoic what do you see and what can this indicate?
Loss of clarity of portal vessels. Steroid hepatopathy (cushings, medication-related), Chronic hepatitis, Fatty liver, Fibrosis
When scanning the liver and its hypoechoic, what do you see and what can this indicate?
Increased contract with portal vessels. acute inflammation, oedema, lymphoma, congestion
What are vascular liver abnormalities?
Venous congestion with RSHF and PSS
What animal is gall bladder sludge found on a US most important in, cats or dogs?
Cats as it indicates cholestasis or cholangitis
What can cause loss of serosal detail on an US?
- decreased fat
- Increased soft tissue opacity in/around mesentery
- Free fluid
- Peritonitis
- Carcinomatosis
How long should you starve a patient for before a stomach ultrasound?
4hrs
Describe a normal stomach us?
Cart-wheel appearence, often small and incidental amount of gas present that block visualistation of part of the gastric wall.
What might be gastric lesions?
- ulcers
- masses
- outflow obstruction
What is the normal diameter of the canine SI on radiograph?
1 x height of L5 vertebral body
What is the normal diameter of the feline SI on radiograph?
12mm
Why cant we reliably assess Gi thickness on radiographs?
Due to the fluid/soft tissue content being the same opacity as the intestinal walls. The presence of said contents might give the impression that the walls are thickened when in reality they just contain normal fluid content.
When there is a SI mechanical obstruction what would be seen?
Single or few dilated or thickened loops – compare with L5 (dogs); cats <12 mm wide
Why might the illeus dilation be functional?
Peritonitis, GDV, Dysautonomia
what do intestinal tumours look like on a radiograph?
Diffuse to mild thickening of intestinal diameter
What is the gravel sign and what does it indicate
Collection of mineralised material immediately above partial, chronic GI obstruction and indicates chronic partial obstruction
Where shoud you place the ltrasound probe to scan the duodenum?
On the right flank
Where should you place the ultrasound probe to vie the jejunum?
mid abdomen
Where can you locate the ileo-colic junction with your ultrasound probe?
right to mid abdoemn, medial to the right kidney
what is Intussusception?
Where a segment of the intestine slides or “telescopes” into an adjacent part of the intestine. This causes obstruction of the bowel, cutting off blood supply to the affected part and leading to swelling, inflammation, and, potentially, tissue death.
What indicates GI tract neoplasia on ultrasound?
Loss of wall layers
Markedly thickened walls
Irregular lumen
Lack of peristalsis
Focal vs Generalised
Continuity with adjacent GI tract
What is corrugation of intestines?
“Scalloping” of the muscularis layer due to inflammation.
How much should the colon typically measure on US?
2-3mm
(GI Nematodes of cats and dogs)
What are the three main ascarids in cats and dogs?
Toxocara canis, toxocara cati and toxocara leonina
What are the routes of infection of T.canis?
Orally (direct) - L3 in egg
Transplacental
Transmammary
Paratenic host
What is the out come of infection of T.Canis when the dog is less than 3 months?
The adult worms develop in the small intestines resulting in adult worms producing eggs
What is the outcome of infection of T.Canis in dogs 3-6months?
The larvae tend to arrest in tissues, so there are no adults.
What are clinical signs a pup has been infected with T.Canis?
Pot bellied pups failing to thrive
How should you treat T.Canis?
The principle is to prevent environmental contamination with eggs. Should start treatment before parasite lays eggs and treat bitch at the same time.
What is the PPP for T.Canis?
16 days
What season has the highest prevalence of T.Canis in the fox population?
Spring
What is the PPP of T.Cati?
8 weeks
Is there any trnasplacental infection with T.Cati?
No
What route of infection is most important with T.Cati?
Transmammary
What appearance does the T.Cati have?
Arrowheaded
T/F you can identify between T.Cati and T.Canis eggs?
NO false you cannot
What is the PPP of T.Leonina?
11 weeks
How can T.Leonina be distinguished between T.Canis?
Based of shell as it has a smooth shell
What are the 4 main hookworms in cats and dogs
Anycylostoma caninum -dog
A. braziliense -dog and cat
A. tubaeforme -cat
Uncinaria stencephala -dog, cat and fox (in UK)
Describe what a hookworm looks like?
1-3cm, stout, hooked head
Does a Anycylostoma caninum hookworm have aa direct or indirect life cycle?
Direct
What what of infection is important for Anycylostoma caninum hookworms in pups?
Transmammary as bitch can infect three consecutive litters
Can Anycylostoma caninum hookeworm larvae arrest?
Yes, larvae that migrate via the lungs can arrest as L3 in skeletal muscle and can emergy from arrest years after infection when immune-compromised or stressed.
T/F Anycylostoma caninum hookworms are blood suckers?
True the hookworm head is buried i the mucosa and actively ingests blood and other tissues.
Anycylostoma caninum Hookworms degrade heamoglobin, how?
They produce lytic factors, anticoagulants and various proteases
Describe the pathogenesis of a Anycylostoma caninum hookworm
Hookworm disease is a simple haemorrhage
What are clinical signs of a young animal infected by Anycylostoma caninum hookworms? and how might you treat the symptoms?
Severe acute haemorrhagic anaemia (maybe bloody diarrhoea)
- Transfusion/ iron supplements may be required
What are clinical signs of a older animal infected by Anycylostoma caninum hookworms?
- Chronic haemorrhagic anaemia
- Respiratory signs due to larval damage
- Multiple infections -HS skin reaction -dermatitis
what are the two sources of infection of Anycylostoma caninum hookworms?
Transmammary
percutaneous/Oral from enviro
How can you control the spread of hookworms?
Wormed every three months
high dose for pregnant bitch
Clean, dry bedding
Is there still transmammary infection in Uncinaria Stenocephala hookworms?
no its an oral infection
(Anthelmintics – factors influencing use in companion animals)
What is the mechinism of action of benzimidazoles?
Binds helminth tubulin and prevents microtubules formation- interferes with helminth metabolism, prevents formation of mitotic spindle
Tubules absent 6-24 hours
Starves parasite- affects microtubules which affects glucose uptake
Why does benimidazoles not effect mammalian cells?
The difference in structure of tubulin between mammalian and helminths
What is the pharmacokenetics of Benzimidazoles
Core structure is 1,2-diaminobenzene which has Limited solubility
What kind of administration do Benzimidazoles use?
Oral admin only
What are Benzimidazoles distribuation like?
Limited abdorption from GIT
Plasma levels typically less than 1% oral dose
What can improve the efficacy of benzimidazoles?
If gut transit time is slowed
How are Benzimidazoles metabolised?
Reduction, oxidation then in ruminants cyclization
What is the mechanism of action of macrocytic lactones?
stimulate glutamate-gated chloride channels in invertebrate nerve and muscle cells
Chloride influx causes hyperpolarisation of the post synaptic cells
Interferes with neurotransmission
Results in flaccid paralysis which allows them to be expelled in the faeces
Describe the pharmacokenetics of macrocytic lactones
Large lipophillic compounds that have long half life, long period of efficacy
Whats the best route for ivermectin?
SC
What does ivermectin bind too?
Binds to albumin and lipoproteins
Does ivermectin have a fast or slow elimination?
slow
Is selamectin absorbed slow or fast after administration?
Rapidly
What formulations does mibemycin oxime come in?
chewable tablets for cats and dogs
What is the mechanism of action for Tetrahydropyrimidines?
They stimulate nicotinic acetylcholine receptors and have higher affinity for the parasitic ones so paralyses worm
Describe the pharmacokinetics of tetrahydropyrimidines
Not well absorbed from GIT so very effective against GI luminal parasites.
Poor tissue penetration though so poor efficacy against larval stages in tissue
Duration of exposure is important and should give with feed
What is the mechanism of action of praziquantel?
Tetanic contraction of parasite musculature
Describe the pharmacokinetics of praziquantel
Rapidly absorbed and widely distributed
What is the first pass metabolism of praziquantel?
70%
What is the mechanism of action of cyclooctadepsipeptides?
They inhibit acetylcholine-elicited muscle contraction which ultimately causes paralysis/death of parasites
Describe the pharmacokinetics of Cyclooctadesipeptides
Extensively distributed as very lipid soluble.
(Pathology of bacterial infections and inflammatory conditions in the GI system)
What is the Function of the GI system?
Transit, digest and absorption of nutrients, electrolytes and fluids
Prevents entry of pathogens and toxins
Immune regulation
What are the 5 cell types found in the intestine?
- Goblet cells
- M cells
- Enterocytes
-Paneath cells - neuroendocrine cells
What are the functions of the 5 different cells?
- Goblet cells - mucus layer production
- M cells - microorganism, particles and macromolecules
- Enterocytes - absorption
-Paneath cells - Antimicrobial protein/peptides - neuroendocrine cells - regulate intestinal motility, secreetions, visceral sensations and appetite
Describe the mechanism of diarrhoea induced via bacterial toxins?
There is a net increase in electrolytes and water into the lumen and passing through the small intestine to the colon
What are other factors stimulating secretory diarrhoea?
- Prostaglandins and other arachidonic acid-derived inflammatory mediators
- Histamine, kinins, cytokines
What 3 things may increase multiplication of bacteria?
- Increased entry of bacteria
- Abnormalities of intestithe nal loop
- Reduced clearance of bacteria
What can bacterial overgrowth lead to?
- Bile salt deconjunction leading to deficiency in bile salts
- Toxins which cause intestinal epithelial cell injury
- Consumption of nutrients
What do all three things caused by bacterial overgrowth cause?
Malabsorption
What are consequences of diarrhoea?
- Dehydration
- Electrolyte depletion and imbalance
- Metabolic acidosis
What are causal agents of gastroenteritis and diarrhoea in domestic animals?
- viruses
- bacteria
- Fungi/yeast
- Parasites
- Non-infectious causes like NSAIDs
What are issues that interfere with diagnosis of diarrhoea?
- Causal agents can be transiently present
- Causal agents produce lesions such as villus atrophy easily obscured by autolysis
How can you overcome these obsticules interfering with diagnosis?
- Evaluate one or more untreated animals reprentative of the herd problems. Preferably in the eary phase of the disease.
What are effects of bacterial virulance factors
- Production of bacterial toxins that kill phagocytes
- Synthesis of bacterial proteins that prevent phagocytosis by blocking the interaction of opsonins with phagosomes
- Bacterial capsule block contact with the microbe which prevents phagocytosis
- Inhibition of phagolysosome fusion prevents microbial killing
- Facilitate escape of the microbe into the cytoplasm before the microbe is killed in the phagolysosomes
- Production of bacterial antioxidants that block killing in phagolysosomes
What are adhesins?
They attach to receptor on cell membranes or on substances such as mucus, mucins or extracellular matrix (ECM) proteins. They also facilitite entry into cell by endocytosis/Phagocytosis.
What are invasins?
Spread into and through cells mem. cells or tissues via ligand-receptor interactions, cell dysfunction and lysis, or breakdown of ECM.
What are endotoxins?
Stimulate macrophage and endothelial cells to secrete proinflammatory cytokines and nitric oxide causing cell dysfunction and lysis.
What are exotocins?
They inhibit biochemical pathways within in a cell
What are hyaluronidases?
They breakdown hyaluronic acid in ECM of mucosa, skin, CT, and nervous tissue.
What do collangenases break down?
Break down collagen fibers of ECM, especially in muscle tissue.
