September Mock NAVLE Test Flashcards
A 4-year-old female spayed Domestic Shorthaired cat presents for vomiting, lethargy, and anorexia of several weeks’ duration. On physical exam, you note that the cat has lost 2 lbs. since her last visit and now has a body condition score of 3/9. You perform a CBC and serum biochemistry, revealing mild elevations in ALT, SAP, and total bilirubin, as well as hypocalcemia. Concerned about pancreatitis, you recommend a Feline Pancreas-Specific Lipase Immunoreactivity (fPLI) and an abdominal ultrasound. The owner becomes irritated and asks why two tests are required. How do you respond?
- Abdominal ultrasound can be performed alone; it has a higher sensitivity and specificity than the fPLI
- fPLI is useful as a sole test; ultrasound is only recommended for prognostic significance
- A definitive diagnosis of feline pancreatitis requires positive results on both diagnostic tests
- Both tests are low in sensitivity; the only single test that can give a definitive diagnosis is a pancreatic biopsy
Answer: Both tests are low in sensitivity; the only single test that can give a definitive diagnosis is a pancreatic biopsy
Explanation
The subtlety of clinical signs (lethargy, anorexia, weight loss) and its association with other diseases make feline pancreatitis difficult to diagnose before death. Although it is possible to obtain useful information from serological testing and imaging, a pancreatic biopsy, along with biopsies of the liver, intestines, and mesenteric lymph nodes are often required for an accurate diagnosis. While pancreatic biopsy is relatively safe, cats with pancreatitis may not always be stable enough for general anesthesia and surgery. Additionally, surgical biopsy may be prohibitively expensive for some clients. Therefore, combining the results of ultrasound and fPLI provides the highest likelihood of arriving at an accurate diagnosis without the need for abdominal surgery.
A 2-year-old intact male Bluetick Coonhound comes to your mobile vaccine clinic in Georgia for a rabies vaccination.
The dog has never been on flea, tick, or heartworm preventatives. He was dewormed a year ago when he received his vaccinations. While obtaining the patient history, the client comments that when hunting, the dog has much more energy now that he is on a raw diet. You notice that he is accompanied by his wife, who is carrying a one-year-old child and appears to be pregnant. Based upon this little information, from which of the following zoonotic diseases is the family at greatest risk?
- Brucellosis
- Salmonellosis
- Tick-borne encephalitis
- Sarcocystis
- Botulism
Answer: Salmonellosis
Explanation:
The correct answer is salmonellosis. Raw diets are based on uncooked ingredients of animal origin and can include skeletal muscle, offal, bones, and eggs or dairy. Raw diets may be home prepared or commercial products (fresh, frozen, or freeze-dried). The U.S. Food and Drug Administration (FDA) does not recommend feeding raw diets to pets due to the public health risk posed by the handling of contaminated meat and the potential for zoonotic transmission of pathogens from the dog or cat to humans, even when the pet does not show any signs of disease. Bacteria in the juices from raw meat dog food could splash and spread to other foods and surfaces, and dogs could transfer potentially harmful bacteria by licking faces immediately after eating.
Thus, all members of this family are placed at risk for salmonellosis.
It should be noted that in all cases of zoonotic disease, the individuals at greatest risk are the young, the elderly, pregnant, or immunocompromised.
Botulism is incorrect. Clostridium botulinum is a Gram-positive, saprophytic, spore-forming bacterial rod found in soil. Its associated risk is in those dogs who eat carrion (or other contaminated food). However, unlike the potential spread of Salmonella, the family would have to ingest the pre-formed toxin in the infected carrion or other contaminated food. So, even if the dog were to contract C. botulinum, the risk of spread to the family would be low.
Brucellosis is incorrect. Brucellosis is caused by a Gram-negative coccobacillus or rod-shaped bacterium, Brucella canis. Organisms are spread through highly contaminated fluids of infected individuals: vaginal discharge (following abortion), urine, milk of lactating bitches, semen, prostatic fluid, vaginal fluid during estrus, and lochia of parturition. Thus, human cases are rare except in those who have extremely close physical contact with an infected dog. In the case of this family, even if their intact male dog were infected, the risk of transmission to family members would be much lower than their risk of acquiring salmonellosis.
In sarcocystosis, the muscles and soft tissues of various intermediate hosts (horses, cattle, sheep, goats, pigs) are invaded by protozoans of the genus Sarcocystis. Even if the dog were to eat infected meat, the risk of transmission to the family would be extremely low unless they, too, ate the infected raw dog food diet.
Tick-borne encephalitis (TBE) is spread through bites of infected Ixodes ticks and is found primarily in Europe and Asia. Humans can also get TBE by eating or drinking unpasteurized dairy products (such as milk and cheese) from infected goats, sheep, or cows. Therefore, there is no risk of TBE being transmitted to members of this family from their dog.
A 4 year old Ayrshire cow presents with a two day history of depression, anorexia, fever, conscious proprioceptive deficits, circling, right sided head tilt, and head-pressing. A neurologic exam identified cranial nerve deficits. Particularly, the right ear is drooping, the right eye appears “dropped”, and she is drooling from the right side of her mouth. What is the most likely diagnosis?
- Mycoplasma bovis
- Listeriosis
- Perennial ryegrass staggers
- Polioencephalomalacia
Answer: Listeriosis
Explanation
Listeria monocytogenes may cause an acute meningoencephalitis with microabscesses in the area of the brainstem and cranial nerve roots. However, there are other clinical forms of listeriosis that may be seen, such as abortion and septicemia of neonates. Usually, only individual animals are affected and not the herd. The animals commonly become infected after consuming spoiled silage. In general, the clinical signs seen are associated with dysfunction of the caudal brain stem, cerebellar peduncles, or spinal cord. Mycoplasma bovis will not result in central nervous system disease, especially in such a short time span (can cause otitis media-interna). Polioencephalomalacia does not result in cranial nerve signs and is caused by a thiamine deficiency.
Ingestion of perennial ryegrass (grows between June and September in northern hemisphere) will cause ataxia and tremors as a result of activating GABA receptors when it is infected with an endophytic fungus.
***PowerLecture: Central Nervous System
- Listeriosis: A sporadic bacterial infection affecting various animals, including ruminants, humans, and birds.
- Listeria monocytogenes: Gram-positive, motile, nonspore-forming coccobacillus, grows at 4°-44°C.
- Transmission: Ingestion of contaminated feed (e.g., spoiled silage), inhalation, fecal-oral route.
- Infection Mechanism: L. monocytogenes enters via ingestion/inhalation, localizes in the brain stem via the trigeminal nerve, causing encephalitis; also localizes in the placenta, leading to abortion.
- Encephalitis: Depression, facial paralysis, circling, head tilt, recumbency, drooping ear, flaccid lip, salivation.
- Abortion: Late-term abortion, stillbirths, neonatal death without prior signs.
- Septicemia: More common in monogastric animals and young ruminants, causes hepatic necrosis.
- Clinical Signs: Asymmetric brain-stem dysfunction, depression.
- Laboratory Tests: Bacterial culture, immunofluorescence assay on brain tissue, placenta, and fetus.
- CSF Analysis: Increased protein concentration, mild pleocytosis.
- Antimicrobials: High doses of penicillin (22,000 U/kg every 12 hours for 1-2 weeks), oxytetracycline (16.5 mg/kg/day IV).
- Supportive Care: Fluids, electrolytes, and possibly dexamethasone (controversial).
- Silage Management: Avoid feeding spoiled silage, improve feed storage.
- Vaccination: Equivocal results, cost vs. benefit questionable.
- Hygiene Measures: Segregate affected animals, proper handling of aborted materials.
- Human Infection: Can cause fatal meningitis, sepsis, skin lesions. Pregnant women and immunocompromised individuals are at higher risk.
For more detailed information, visit the Merck Veterinary Manual.
Which of the following is the best preventative measure for decreasing the incidence of laminitis?
- Avoiding lush pastures
- Frequent shoeing
- Prophylactic NSAIDS
- Strenuous exercise
Answer: Avoiding lush pastures
Explanation
The correct answer is avoiding lush pastures. A major risk factor in the development of laminitis is feeding on lush pastures. Strenuous exercise is also a risk factor in unfit horses.
***PowerLecture: Laminitis
A 6-year old Macaw presents to your emergency clinic with a broken blood feather. What is the best way to stop the hemorrhage?
- Pull the feather
- Thermally cauterize the area
- Bandage the wing, incorporating the feather
- Apply gentle pressure to the bleeding area of the feather for 2-5 minutes
Answer: Pull the feather
Explanation
Blood feathers, also called “pin feathers,” are new feathers that are starting to grow and need a large blood supply. They will bleed if broken. A blood feather starts out with a waxy keratin sheath and, when mature, the blood supply will recede, and the waxy sheath will be removed by the bird. Blood feathers can be broken or may accidentally be cut when the wings are trimmed.
Pulling the blood feather is the most appropriate treatment. The bleeding can be temporarily stopped with other means (thermal or chemical cautery), but the feather can easily be re-injured or the clot dislodged due to the slippery keratin of the feather.
Removing the feather is best done using a forceps or hemostat. The feather should be gripped close to the skin and pulled steadily and firmly in the direction the feather is growing. Pulling out a feather will cause pain, so be sure you hold the bird firmly, but carefully. If it is a wing feather, support and immobilize the wing to keep it steady during the procedure. Do not jerk on or twist the feather.
If bleeding occurs from the follicle after the feather has been removed, continue to apply pressure to the area for several minutes and monitor the bird for at least an hour.
Approximately how long does it take for spermatogonia to mature to sperm in the stallion?
- 60days
- 5 days
- 14 days
- 30 days
Answer: 60 days
Explanation
The correct answer is 60 days. For this reason, a stallion with poor quality semen should be re-evaluated in 2 months before making a final judgment.
A 4-month old male intact Great Dane presents for lethargy and reluctance to stand. He is non-weight bearing on his left forelimb. You localize pain and swelling to the distal radius and ulna and take the following radiograph. What do you tell the owner about recovery and prognosis?
- Prognosis is guarded. Recovery includes antibiotics and joint lavage.
- Prognosis is poor. Amputation is recommended and there is a high rate of metastasis to the lungs. Survival time is less than 1 year even with chemotherapy.
- Prognosis is usually good but angular limb deformity is a possible complication. Recovery relies on supportive care and can take days to weeks. Most dogs with this disease will have 1 or 2 episodes and recover.
- Prognosis is good but angular limb deformity is a possible complication as the physis is involved. Coaptation is recommended and healing should occur rapidly as he is still young.
Answer: Prognosis is usually good but angular limb deformity is a possible complication. Recovery relies on supportive care and can take days to weeks. Most dogs with this disease will have 1 or 2 episodes and recover.
Explanation
Hypertrophic osteodystrophy (HOD) is a disease of large, rapidly growing dogs. The distal metaphyses of the forelimbs are more commonly affected and can be swollen. Radiographic findings include metaphyseal flaring and the classic “double physeal line.” Treatment is supportive with anti-inflammatories or steroids, pain medications, and activity restriction.
Septic arthritis can cause lameness, joint pain and swelling. Radiographs can show bone destruction and osteolysis with chronic disease as well as irregularities in the joint space. Osteosarcoma causes bony lysis and proliferation at the metaphyseal region of long bones. These are commonly in the distal radius/ulna, proximal humerus, proximal tibia, and distal femur (“away from the elbow and towards the knee”). Age does not rule out this disease as it has been diagnosed in animals as young as 6 months.
A 1.5-year old Quarter Horse gelding is presented to you for symmetric ataxia, weakness, and spasticity of all limbs, but worse in the hind limbs. When walking, the horse frequently drags his toes and the hind limbs frequently interfere with one another. Based on the signalment, history and physical examination findings, which of the following is the most likely cause of these clinical signs?
- Botulism
- Equine Protozoal Myeloencephalitis (EPM)
- Cauda Equina Syndrome
- Equine Motor Neuron Disease (EMND) Your A
- Equine Degenerative Myeloencephalopathy (EDM)
Answer: Equine Degenerative Myeloencephalopathy (EDM)
Explanation
The horse in this question has clinical signs most consistent with EDM; cervical vertebral malformation (wobblers) is also a possibility, but was not provided as an answer. The cause of EDM is unknown, but this disease typically affects young horses (< 2-3 years of age; but older horses can develop disease). Clinical signs are a result of diffuse neuronal fiber degeneration of various portions of the central nervous system. This disease has been associated with low serum vitamin E concentrations, suggesting that oxidative damage may play a role in the development of disease.
EMND is typically associated with muscle tremors, shifting of weight while standing, muscle atrophy and recumbency. Botulism is associated with generalized muscle weakness. Cauda equina syndrome causes analgesia of the perineum. EPM can cause a range of clinical signs, but is typically with asymmetric neurologic deficits.
***PowerPage: Top 12 Equine Neurologic Diseas
A 3-year old female intact Doberman presents to your clinic for a routine spay. The owner states she has not recently been in heat and has been healthy her entire life. Aside from a thorough physical examination and routine blood work, what additional diagnostic test should be performed prior to surgery?
- Abdominal ultrasound
- Chest radiographs
- Buccal mucosal bleeding test
- Activated clotting time
Answer: Buccal mucosal bleeding test
Explanation
Doberman Pinschers are predisposed to having von Willebrand’s Disease (vWD). Specifically, Dobermans have increased incidence of have Type 1 WD. In this type, there is a reduced presence of functional von Willebrand factor. This factor is crucial in initial clot formation and attracts platelets and allows them to bind to exposed subendothelium after injury. A buccal mucosal bleeding test should result in a clot in less than 4 minutes in normal dogs. An abnormal result warrants further investigation to confirm the presence of vWD in order to take the appropriate measures prior to surgery.
Chest radiographs are not necessary prior to anesthetizing this patient for an elective procedure unless there are physical examination findings which indicate radiographs of the chest. An abdominal ultrasound is a potentially good choice if there is concern that the uterus is enlarged or the animal is pregnant; however, there is no history presented that would make you believe that is the case, and it is impractical to perform an abdominal ultrasound for a routine procedure unless there is a clear indication. The activated clotting test evaluates the intrinsic and common coagulation pathways, and there is no concern with dysfunction in these.
A Thoroughbred mare is due to foal in three weeks. Based on previous blood testing, the mare is known to be Aa-blood type. The sire of the foal is known to be Aa+ blood type, based on previous testing. Therefore, a screening test for Aa blood type antibodies is performed on the mare. When the results of this screening test are received, the mare is positive for Aa antibodies. What steps should be taken to minimize the risk of illness in this foal?
- Allow the foal to nurse at birth, but store blood from the sire on ice if needed for a blood transfusion for the foal.
- Muzzle the foal at birth and feed colostrum and milk from an Aa- mare for 48-72 hours until the dam’s milk tests negative for antibodies.
- Place the foal on a nurse mare at birth, supplement colostrum, and keep the foal on the nurse mare until weaning.
- At birth, give an injection of dexamethasone and allow the foal to nurse, but store blood from the dam on ice if needed for a blood transfusion for the foal.
Answer: Muzzle the foal at birth and feed colostrum and milk from an Aa- mare for 48-72 hours until the dam’s milk tests negative for antibodies.
Explanation
To prevent neonatal isoerythrolysis, the foal should be muzzled at birth and given oral colostrum and milk from a mare that is negative for Aa antibodies for 48 to 72 hours. If the foal is born with his father’s blood type (Aa+), drinking the dams colostrum will allow Aa antibodies to cross into the foal’s blood stream and lyse his red blood cells, causing anemia and jaundice. After approximately 48 hours, the foal’s gut is no longer permeable to large proteins so he may then safely nurse on his dam. With best practices, the dam’s milk is tested prior to allowing the toal to resume nursing.
Nurse mares are not a good source of colostrum and the foal only needs an alternative colostrum/milk source for the first few days.
Blood from the dam would be unsuitable for transfusion because it contains Aa antibodies.
Blood from the sire would be acceptable because it does not contain Aa antibodies, however, all efforts should be made to avoid the need for a transfusion.
Which of the following are listed on a balance sheet of a practice?
- Sources and uses of cash over a period of time
- Income and expenses over a period of time
- Salary of each employee of the company
- Asset, liability, and owner(s) equity
Answer: Asset, liability, and owner(s) equity
Explanation
A balance sheet is a report on the financial condition of the practice. It lists practice assets, liabilities and owner(s) equity at a specific point in time. It does not track income or cash flow over a period but is more of a snapshot of the company’s condition.
A profit and loss statement is the document which reports on income and expenses over a period of time. A cash flow statement is the document which reports on sources and uses of cash over a period of time.
***PowerPage: Reading a Balance Sheet
In autumn, a 3-year old Texel ram presents with swelling and edema of the face (see image). There is no hemorrhage or apparent gas pockets. The ram is dull and depressed with a rectal temperature of 106 F (41.1 C). The mucous membranes are congested and submandibular lymph nodes cannot be palpated due to edema. This is the only ram clinically affected. What treatment or management recommendation is most appropriate?
- Treat affected ram with sodium iodide
- Treat all sheep in herd with oxytetracycline
- Treat the affected ram with penicillin
- Eliminate scabrous feeds
- Cull the affected ram and treat the other sheep in the herd with penicillin
Answer: Treat the affected ram with penicillin
Explanation
The most likely condition to consider based on the image and presentation is bighead (caused by Clostridium novyi, C. sordelli, or rarely C. chauvoei). Bluetongue is less likely based on one sheep being affected. Treatment with penicillin is usually effective.
Culling or treating all animals is unnecessary as Clostridium is found in the soil and feces of healthy animals.
Bighead is caused when the organism enters through wounds obtained during head butting activities. The disease can be fatal if untreated. The key to reducing the incidence of this disease is management to reduce head wounds and vaccination with multivalent clostridial toxoids.
In autumn, a 3-year old Texel ram presents with swelling and edema of the face (see image). There is no hemorrhage or apparent gas pockets. The ram is dull and depressed with a rectal temperature of 106 F (41.1 C). The mucous membranes are congested and submandibular lymph nodes cannot be palpated due to edema. This is the only ram clinically affected. What treatment or management recommendation is most appropriate?
- Treat affected ram with sodium iodide
- Treat all sheep in herd with oxytetracycline
- Treat the affected ram with penicillin
- Eliminate scabrous feeds
- Cull the affected ram and treat the other sheep in the herd with penicillin
Answer: Treat the affected ram with penicillin
Explanation
The most likely condition to consider based on the image and presentation is bighead (caused by Clostridium novyi, C. sordelli, or rarely C. chauvoei). Bluetongue is less likely based on one sheep being affected. Treatment with penicillin is usually effective.
Culling or treating all animals is unnecessary as Clostridium is found in the soil and feces of healthy animals.
Bighead is caused when the organism enters through wounds obtained during head butting activities. The disease can be fatal if untreated. The key to reducing the incidence of this disease is management to reduce head wounds and vaccination with multivalent clostridial toxoids.
The owner of an equine breeding facility reports that they have had a problem with mares foaling weeks past their due date. One foal, born unattended, could not break out of the amniotic sac and suffocated. The owners have been present for subsequent births and have repeatedly had to help the foals break out of the fetal membranes. Another foal had to be pulled when the placenta prematurely separated from the uterus and presented as a “red bag.” The owner saved this placenta for you to examine. You note that it is red and thickened. After further questioning, the owner also reports that when the mares do foal, most are agalactic and have no colostrum. What is the first step that you recommend to the owner of these horses?
- Test all of the farm’s breeding stallions for equine viral arteritis
- Apply a pesticide to trees on the property to eliminate caterpillars
- Vaccinate all horses on the farm for equine herpesvirus
- Move the mares to a dry lot two months before parturition and feed high-quality legume hay
Answer: Move the mares to a dry lot two months before parturition and feed high-quality legume hay
Explanation
This is a case of fescue toxicosis. Mares grazing on fescue grass can ingest an endophyte, Acremonium coenophialum. This endophyte causes increased gestation length, increased risk of stillborn foals, agalactia, retained placenta, and an increased thickness to the placenta. Clinical signs are more severe in the southeastern US, but can also be seen in the north after a mild winter. Removing the mares from fescue 60 days prior to parturition results in normal foaling and milk production. Mares that must remain on fescue pasture may be treated with domperidone 20 days prior to foaling
Eastern Tent Caterpillars are the cause of Mare Reproductive Loss Syndrome, which results in early and late term abortions due to bacterial placentitis. When horses ingest the caterpillars, their spiky hairs (setae) penetrate the lining of the intestine and enter the blood supply with bacteria, causing potential fetal infection.
Equine herpesvirus (EHV) can cause late term abortion, however there are no placental lesions and agalactia is not present.
Equine viral arteritis (EVA) causes late term abortions and like EHV, placental lesions are not present.
A 9 year-old male neutered American Eskimo presents for progressive hair loss along his sides. The areas of alopecia are smooth with no crusts or scales, and he is not pruritic. You performed an ACTH stimulation test and did an adrenal sex profile, both of which were normal: thyroid tests were also normal. The owners declined a skin biopsy. You suspect Alopecia X in this patient. The owner would like to know if there is an over-the-counter medication that may potentially help with hair regrowth. You suggest that she could try which of the following supplements?
- Zinc
- Vitamin A
- Melatonin
- Milk thistle
Answer: Melatonin
Explanation
It is unknown what exactly causes Alopecia X, but it has been shown to be genetic. Nordic breeds and Pomeranians are most commonly affected. Alopecia X causes an arrest of the hair cycle. Melatonin may help some pets with this condition.
Husky dogs can get zinc responsive dermatosis, which would be treated with zinc. Milk thistle is used as a supplement for dogs with liver disease. Hypovitaminosis A is more common in birds fed a seed-only diet and can cause lesions in the eyes and mouth and may cause respiratory symptoms.
What is the most common ocular tumor in cattle?
- Adenoma
- Melanoma
- Lymphoma
- Squamous cell carcinoma
Answer: Squamous cell Carcinoma
Explanation
The correct answer is squamous cell carcinoma. It occurs most in cattle which lack pigment in the lids and in older beef cattle (particularly Herefords).
A 4-year-old female Bernese mountain dog presents for lethargy and urinary accidents for 2 days. The owner reports she has been drinking more and urinating frequently. She has also vomited several times. Her temperature is 103.2 F (39.6 C), heart rate is 85 bpm, and she is panting. She has a purulent vaginal discharge, which you collect a sample of for cytology (shown below). Abdominal ultrasound shows a thickened and cystic endometrium with anechoic fluid inside the uterus. A complete blood count and chemistry panel are within normal limits except for an increased segmented neutrophil count of 23,000 cells/uL (normal is 4950-12,000/uL). The owner tells you that she does not wish to have the dog spayed. Which of the following would be most useful in the medical management of this problem?
- Prostaglandin F2-alpha
- Prednisone
- Estradiol
- Haloperidol
- Tamoxifen
Answer: Prostaglandin F2-alpha
Explanation
Although ovariohysterectomy is the treatment of choice for dogs with pyometra because it is curative and preventative for recurrence, medical management of pyometra can be considered in dogs of appropriate breeding age that are reproductively valuable and free of life threatening complications including septicemia, endotoxemia, or organ dysfunction. Options include prostaglandins to induce regression of corpora lutea, which relaxes the cervix and stimulates myometrial contractions, promoting expulsion of the uterine contents.
Additional options include dopamine agonists (such as cabergoline and bromocriptine), which act to inhibit prolactin production from the pituitary gland. Patients should be monitored frequently during and after medical management of pyometra and should improve within 2-4 days. Successfully treated bitches should be bred during their next cycle after treatment.
Tamoxifen is an estrogen antagonist and has been associated with causing pyometra in dogs but is not an effective treatment. Haloperidol is a dopamine antagonist. Prednisone is contraindicated for pyometra.
Which of the following is not a viral cause of abortion in cattle?
- Bovine viral diarrhea
- Bovine papular stomatitis
- Infectious bovine rhinotracheitis
- Akabane virus
Answer: Bovine papular stomatitis
Explanation
The correct answer is bovine papular stomatitis. The other ones are viral causes of abortion.
You are asked to examine some feeder pigs that have stopped eating yesterday. The group is lying down and seems lethargic. They have fevers of 105-106F (40.6 - 41.1 C), firm dry feces, and the skin has rhomboid-shaped red blotches scattered on it. What treatment should be recommended?
- Metronidazole
- Streptomycin
- Chloramphenicol
- Penicillin
- Gentamicin
Answer: Penicillin
Explanation
Erysipelas is susceptible to penicillins, as well as tetracyclines (usually), lincomycin and tylosin. Chloramphenicol and nitroimidazoles (including metronidazole) are not approved for food animal use.
***PowerLecture: Multisystemic Diseases
A 4-day old foal presents to you for abdominal distension and depression. The owners describe the foal as having frequent attempts to urinate with only small amounts voided. On physical exam, the foal’s heart rate is 180 beats per minute and respiratory rate is 60 breaths per minute. What is the most likely cause of the foal’s clinical signs?
- Uroperitoneum
- Hemoabdomen
- Right-sided congestive heart failure
- Meconium impaction
- Septic peritonitis
Answer: Uroperitoneum
Explanation
The correct answer is uroperitoneum. With the foal’s history of pollakiuria combined with abdominal distension, tachycardia, tachypnea, and depression, you should suspect uroperitoneum. The most common cause of uroperitoneum is a ruptured urinary bladder from large amounts of pressure on the urinary bladder that often occurs during parturition. Treatment involves surgical repair.
***PowerLecture: Foal Uroperitoneum:
An out-of-town buyer calls your office to schedule a pre-purchase exam for a horse. The buyer is purchasing the horse from one of your largest clients, a well-known and reputable warmblood breeding and training facility. The client is unable to attend the pre-purchase exam. However, she would like for you to email your exam findings and all medical records to her veterinarian, who happens to be a former classmate and good friend of yours. Do you take this appointment?
- Yes, because veterinarians are considered free from conflict of interest
- No, because the seller must be present for a pre-purchase exam
- Yes, because you have a good relationship with the buyer’s veterinarian
- No, because you have a conflict of interest
Answer: No, because you have a conflict of interest
Explanation
Conflict of interest is obvious in this case and referral to another veterinarian who does not treat the sellers’ horses should be advised. The seller does not need to be present for a pre-purchase exam, however, it should be encouraged. If the owner cannot attend, a video of the exam should be taken. While veterinarians are considered one of the most reputable of all the medical professions, we should not put ourselves in a situation that may have legal repercussions. Although you have a good relationship with the out-of-town vet, avoiding a situation like this may be better for your long-term working relationship.
You are out to examine cattle at a beef ranch and the rancher mentions that there has been investigation regarding a possible E. coli 0157:H7 outbreak at a nearby herd. He wants to know what sign(s) infected cows would be most likely to display. What is the best answer?
- No symptoms
- Hematochezia
- Dehydration
- Inappropriate mating behavior
- Seizures
- Weight loss
Answer: No symptoms
Explanation
E. coli O157:7 is a concern because of its zoonotic potential and not because of pathology seen in cattle as infected animals are typically asymptomatic. The bacteria are spread through fecal-oral transmission, most commonly by contamination of food or water supplies. Recent outbreaks in North America have involved contamination of foods (vegetables such as spinach and lettuce). The major sign seen in humans is hemorrhagic colitis.
You examine a very ill 4-year old Holstein dairy cow on a large commercial dairy. She freshened one week ago and was producing well, until she was found down and unwilling to rise this morning when you were called. T=103F or 39.4 C, HR=90, and RR=35. The scleral vessels are dark are enlarged, her rumen is fairly empty and the motility is poor, and she appears too weak to rise. Rectal exam reveals an involuting uterus which can be retracted, discharging a brownish red mucoid non-odorous lochia through the vagina. The left rear quarter of her udder is swollen, hot, painful, and discolored (see image), and contains a serum-like secretion with clumps of fibrin in it. What is your diagnosis?
- Hypocalcemia (milk fever)
- Coliform mastitis
- Grain overload
- Displaced abomasum
- Metritis
Answer: Coliform mastitis
Explanation
This is a case of severe acute coliform mastitis, and the absorbed endotoxin (LPS) is causing many of the systemic signs observed. The cow needs to be aggressively treated with IV fluids, NSAIDS, and supportive nursing. The gland should be frequently milked out. The use of both intramammary and systemic antimicrobial drugs to which most coliforms are susceptible is still controversial, but is often done in cows in a severe state of illness as in this case. While this cow may have secondary hypocalcemia, treatment with calcium needs to be approached cautiously, as endotoxic animals have very sensitive myocardium and arrest may occur if calcium is given IV. If given, preferred routes of calcium administration would be subcutaneous or oral.
