September - October 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)
- 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.
Which are the most common serovars now thought to play a role in canine leptospirosis?
- Bratislava, canicola, icterohemorrhagiae
- Grippotyphosa, pomona, bratislava
- Pomona, bratislava, icterohemorrhagiae
- icterohemorrhagiae, canicola, grippotyphosa
Answer: Grippotyphosa, pomona, bratislava
Explanation
The correct answer is grippotyphosa, pomona, and bratislava. Icterhemorrhagiae and canicola were the most common serovars isolated in the past. The leptospires penetrate mucous membranes or abraded skin and multiply in the blood stream and spread to organs. The antibody response usually limits the response to the renal tubular epithelial cells. Clinical signs include anorexia, pyrexia, vomiting, dehydration, PU/PD, anuria or oliguria. The standard diagnostic test is the microscopic agglutination test (MAT); be careful when interpreting titers. Remember, leptospirosis is zoonotic.
A 9-year old DSH cat initially presented with a history of decreased appetite and intermittent vomiting. On physical exam the cat is approximately 5% dehydrated. There is no palpable slip noted in the thyroid region. Blood work performed showed a BUN of 44 mg/dL (19-34 mg/dl) and creatinine of 2.4 mg/dL (0.9-2.2 mg/dl). PCV is 55 % (30-45 %). Glucose was 180 mg/dL (60-120 mg/dl). Abdominal radiographs showed a questionable pattern in the area of the duodenum but it was not obstructive. A barium series was then performed and did not show any obvious filling defects or delayed emptying. How should you treat this patient?
- Perform an ultrasound of the urinary tract followed by a nephropyelogram
- Begin patient on amoxicillin/clavulonate
- Recommend an exploratory laparotomy and obtain biopsies
- Admit patient for fluid therapy and supportive care
Answer: Admit patient for fluid therapy and supportive care
Explanation
With the information given, we can be sure that this patient has a mild azotemia which is more than likely pre-renal in origin. With acute renal failure, BUN and creatinine values would be much more increased. There is no indication of an infection and treating blindly with an antibiotic is inappropriate. An exploratory laparotomy would be premature at this time but may be indicated if the patient does not respond to supportive care. It is possible this patient has a mild case of pancreatitis or indigestion. It is best to admit the patient for supportive care and consider performing an abdominal ultrasound.
A turkey producer calls you out to examine his flock. Some of his turkeys have crusty, nodular lesions on the head and neck. When you take a look at these birds, you notice some lesions are coalescing and many are scabbed. There are no other clinical signs in these birds and there has been no mortality. Because of the clinical presentation, the small number of birds affected, and the lack of mortality, you presumptively diagnose fowlpox. What is the best method to stop the spread of disease?
- Depopulate the flock due to the highly contagious nature of the disease
- Vaccinate young birds only, those ‹12 weeks of age
- Do nothing as the virus is self-limiting
- Vaccinate all turkeys except those naturally infected
- Vaccinate all turkeys in the flock including those infected with disease
Answer: Vaccinate all turkeys except those naturally infected
Explanation
Vaccinating all turkeys except those naturally infected is the best method to stop the spread of disease as those infected will have natural immunity after recovery.
Depopulation is not necessary as the disease is not as contagious as some and is not severe.
The virus is self-limiting, but it will spread to other birds. Additionally, there is another form of the disease, the diphtheritic form, with higher morbidity and mortality which will have a more detrimental effect to the flock.
Vaccinating young birds only is not going to stop the spread of disease to adult birds and vaccination of young birds with passive immunity will not develop an appropriate response to vaccination.
Vaccinating turkeys with natural infection is not necessary due to the development of natural immunity.
Which two conditions may be diagnosed by finding a ping on the left side of the cow using simultaneous auscultation and percussion?
- Cecum and torsed abomasum
- Spiral colon and torsed abomasum
- Spiral colon and cecum
- Ruminal tympany and left displaced abomasum
Answer: Ruminal tympany and left displaced abomasum
Explanation
The correct answer is ruminal tympany and left displaced abomasum. Gas in the spiral colon, cecum, and torsion of the abomasum are diagnosed by a ping on the right side.
An 8-year old mixed breed dog presents for polyuria, polydipsia, and polyphagia. Bloodwork and a urinalysis were submitted, but the dog dies the next day due to pulmonary thromboembolism diagnosed at necropsy. What is the bloodwork and urinalysis likely to show?
- Hypercalcemia, hyperphosphatemia, isosthenuria
- Hypocholesterolemia, low BUN, hypoalbuminemia, hyperbilirubinemia, isosthenuria
- Hyperkalemia, hyponatremia, elevated BUN, hyposthenuria
- Hypercholesterolemia, elevated alkaline phosphatase, thrombocytosis, isosthenuria
- Moderate azotemia, elevated amylase, isosthenuria
Answer: Hypercholesterolemia, elevated alkaline phosphatase, thrombocytosis, isosthenuria
Explanation
The correct answer is hypercholesterolemia, elevated alkaline phosphatase, thrombocytosis, isosthenuria. This dog has Cushing’s disease or hyperadrenocorticism. The clinical signs and death from PTE makes this a classic Cushing’s patient. If an ACTH stimulation test were run, the results would be high, consistent with Cushing’s disease.
***PowerPage: Hyperadrenocorticism (Cushing’s Disease)
You are called to a dairy farm to examine a cow that appeared uncomfortable in the milking parlor earlier in the day. When you arrive at the farm, you learn that no other issues have been noted within the herd and bulk milk tank somatic cell counts have been normal. On your physical exam, you note that the cow has a temperature of 101.6°F, pink/moist mucous membranes, and no abnormalities on thoracic or abdominal auscultation. When you examine the mammary glands, you observe that one quarter is firm and painful upon milking. Milk expressed from the affected quarter is thickened, with fibrinous clots. What treatment do you recommend?
- Intramuscular administration of Penicillin G to the entire herd
- Intramammary infusion of pirlimycin and intramuscular injections of Penicillin G to the entire herd
- Intramuscular administration of Penicillin G to the affected cow
- Strip the affected quarter several times a day
- Intramammary infusion of pirimycin to the affected cow
Answer: Intramammary infusion of pirimycin to the affected cow
Explanation
An intramammary infusion of pirlimycin to the affected cow is the best treatment for mild clinical mastitis. The producer must also follow withdrawal period guidelines to keep the treated cow’s milk out of the food supply for the required amount of time and/or until there are no detectable antibiotics in the milk. The cow is not showing systemic symptoms, which makes systemic antibiotics unnecessary. Treating all cows in the herd is not necessary unless there is a subclinical mastitis problem in the herd, which would be indicated by high somatic cell counts (SCC) in bulk milk tank samples. Stripping the affected quarter several times a day is recommended in any clinical mastitis case, but is unlikely to eliminate this infection without the addition of antibiotics.
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.
What are the most common serum electrolyte abnormalities in a foal with uroperitoneum?
- Hyperkalemia, Hypernatremia, Hypochloremia
- Hyperkalemia, Hypernatremia, Hyperchloremia
- Hyperkalemia, Hyponatremia, Hyperchloremia
- Hyperkalemia, Hyponatremia, Hypochloremia
Answer: Hyperkalemia, Hyponatremia, Hypochloremia
Explanation
This is the most common electrolyte profile in a foal with uroperitoneum. The urine is high in potassium and low in sodium and chloride; thus when uroabdomen occurs, the electrolytes equilibrate between the serum and abdominal fluid.
***PowerLecture: Foal Uroperitoneum
A herd of goats has recently experienced several animals with CNS signs including not herding with the group, appearing blind, and having anorexia and hypermetria. One goat had developed dorsomedial strabismus and teeth grinding; it went on to become comatose and had periodic tonic-clonic convulsions before it died. Postmortem reveals cerebrocortical necrosis (polioencephalomalacia). What treatment should be used on the next animal to appear with these signs?
- Penicillin orally and IV
- Thiamine injections
- Selenium orally
- Phosphorus orally
- Tetracycline IV
Answer: Thiamine injections
Explanation
The disease has many factors, including dietary, that should also be addressed, but the single best treatment is to give thiamine. Convulsions can also be controlled by diazepam or phenobarbital. Thiamine should be diluted and given either SQ or very slowly IV.
***PowerPage: Top 10 Sheep and Goat Diseases
A Paint horse is found to be approximately 7% dehydrated after a several day trail ride. Assuming there are no other ongoing losses and the horse weighs 500kg how many liters of fluid will you need to give this horse over a 24 hour period to correct the deficit and account for maintenance requirements?
- 65L
- 125L
- 40L
- 35L
- 75L
Answer: 65L
Explanation
To determine this answer you must figure out the deficit and calculate the horse’s maintenance needs. The deficit is 35L (deficit x BW). Maintenance needs for a horse is approximately 60ml/kg/day. In this case, 30L.
Adding the deficit and maintenance fluids together yields a total of 65 liters.
A deceased adult Red Tailed Hawk presents to you for necropsy after long standing respiratory disease. You find white plaques on the air sacs and caseous plugs in the distal trachea. What disease do you suspect?
- Candidiasis
- Internal papillomatosis
- Trichomoniasis
- Aspergillosis
Answer: Aspergillosis
Explanation
The correct answer is aspergillosis. This is caused by Aspergillus fumigatus. It is common among raptors, penguins, and waterfowl but not psittacines except under poor husbandry, stress, or immunodeficiency.
Transmission is by inhalation of spores. There may be a history of respiratory signs (acute or chronic). Findings include fungal plaques on the air sacs and thickening of the air sacs. Antemortem diagnosis can be made by transtracheal wash with culture and cytology. Treatment is with antifungals such as amphotericin B or -azole antifungal agents.
Aural hematomas in pigs are often caused by which of the following?
- Ear notching
- Poor nutrition
- Coagulopathies
- Bites inflicted by other pen mates
Answer: Bites inflicted by other pen mates
Explanation
The correct answer is bites inflicted by other pen mates. Aural hematomas in pigs also commonly occur from violent head shaking. Violent head shaking is often associated with foreign debris in the ears and ectoparasites such as mites or lice.
If a mass appears in the lungs on a right lateral radiograph but not on a left lateral radiograph, where is the mass located?
- Mediastinum
- Right lung
- Body wall
- Left lung
Answer: Left lung
Explanation
The correct answer is left lung. On a right lateral radiograph, the right side is down. In this situation, the right lung lobes are compressed and the left lung lobes inflated, accentuating a mass in the left lung. On a left lateral radiograph, the left lobes are compressed and a mass in the left lung can be concealed due to compression of the lung surrounding the mass.
How much protein should you feed a dog with hepatic insufficiency or hepatic encephalopathy?
- The maximum amount of protein they will tolerate without causing signs of encephalopathy
- The minimum amount of protein they will tolerate without developing hypoproteinemia
- The total quantity of protein is not important as long as they eat predominantly meat proteins rather than dairy proteins
- 1.0 gram protein/kg/day
Answer: The maximum amount of protein they will tolerate without causing signs of encephalopathy
Explanation
Dogs with hepatic insufficiency or hepatic encephalopathy need to have their protein levels restricted to reduce clinical signs associated with liver dysfunction; however, restricting protein intake to the point where hypoproteinemia develops is excessive. If too little protein is fed to these patients, muscle catabolism may occur. Proteins derived from meat sources are more prone to causing encephalopathy than proteins from dairy sources due to the high levels of nucleic acids and other nitrogenous compounds found in meat that are converted to ammonia.
Vitamin E deficiency in chicks results in which problem?
- Nutritional encephalomalacia
- Bleeding diathesis
- Weak bones
- Blindness
Answer: Nutritional encephalomalacia
Explanation
Chicks 15 to 30 days old on a Vitamin E deficient diet show ataxia or paresis, prostration and death. There is ischemic necrosis, demyelinization, and neuronal degeneration of many parts of the brain. Vitamin E deficiency can also cause exudative diathesis and nutritional myopathy in chicks.
You are called to a swine breeding herd that is experiencing some abortions. On arrival you find out that there are 285 sows in the herd and 5 of them aborted overnight. Two days ago 2 other sows aborted. You are suspicious of Porcine reproductive and respiratory syndrome (PRRS). The herd has not used any PRRS vaccines for the past 18 months. All aborted fetuses have been discarded by the time you arrive. What diagnostic workup should you do?
- Only test the 7 aborted sows for PRRS virus via serum PCR
- No testing can be done since the fetuses have been discarded
- Only test the 7 aborted sows for PRRS antibodies via serum ELISA
- Test 30 random sows in the herd for PRRS antibodies via serum ELISA
- Test 30 random sows in the herd for PRRS virus via serum PCR
Answer: Only test the 7 aborted sows for PRRS virus via serum PCR
Explanation
The correct answer is to only test the 7 aborted sows for PRRS virus via serum PCR. PRRS causes abortions shortly after infection and therefore the sows should still be viremic at the time of the abortion. Your testing should be focused on the sick (aborted) animals. Random sampling is used when establishing the herd’s status; in this case you are focused specifically on the status of the aborted animals. Antibody production takes time and therefore is most likely not present in the sows at the time of the abortion.
All the following are true regarding cutaneous feline mast cell tumors EXCEPT which of the following?
- Cutaneous feline mast cell tumors are most commonly found on the trunk and extremities
- Feline mast cell tumors are not graded I, II, and III as they are in canines
- Cutaneous mast cell tumors are the 2nd most common skin tumor in the cat
- Cutaneous feline mast cell tumors rarely metastasize
Answer: Cutaneous feline mast cell tumors are most commonly found on the trunk and extremities
Explanation
Cutaneous feline mast cell tumors are most commonly located on the face and head. They are the second most common skin tumor found in cats, behind basal cell tumors. Feline mast cell tumors of the skin rarely metastasize. Generally speaking, when metastatic mast cell disease is found, it is likely that a visceral source of disease (i.e. splenic mast cell disease) is present. Feline mast cell tumors of the skin are not graded as they are in dogs, but histopathology is relied upon to predict the behavior of the tumor that is removed.
Cryptococcus neoformans is associated with the feces of which animal?
- Cat
- Bat
- Bird
- Snake
- Dog
Answer: Bird
Explanation
The correct answer is bird. Birds, such as pigeons, tend to shed this organism. It can actually survive in pigeon feces for up to 2 years if in the right conditions.
***PowerLecture: Cryptococcus
You are examining a horse for depression and an inability to swallow. Which of these neurologic conditions is LEAST likely seen in horses?
- Lead toxicity
- Botulism
- Pseudorabies
- Rabies
Answer: Pseudorabies
Explanation
The correct answer is pseudorabies. Horses are very rarely affected by pseudorabies. The other diseases listed are more likely to affect horses.
***PowerPage: Top 12 Equine Neurologic Diseases
Which dermatophyte is most commonly associated with ringworm in the llama?
- Trichophyton verrucosum
- Microsporum canis
- Microsporum nanum
- Trichophyton mentagrophytes
Answer: Microsporum nanum
Explanation
The correct answer is Microsporum nanum. M canis commonly affects dogs and cats. T mentagrophytes affects cattle and more commonly, goats. T verrucosum affects goats and more commonly, cattle.
***PowerPage: Top 10 Things to Know for Camelids
A 1 year old female sheep presents to you with a discrete mass on the ventral neck. In cross section, the mass has an “onion-ring” appearance of concentric layers of fibrous tissue separated by inspissated caseous exudate. An aspirate shows many small gram-positive rods both intracellularly and extracellularly. What is the likely etiology?
- Mycobacterium paratuberculosis
- Escherichia coli
- Mycoplasma mycoides
- Corynebacterium pseudotuberculosis
Answer: Corynebacterium pseudotuberculosis
Explanation
The correct answer is Corynebacterium pseudotuberculosis. This is a classic description of how caseous lymphadenitis presents in sheep. Infection may occur via penetration through superficial skin wounds and sometimes through unbroken skin. The pus contains large numbers of bacteria that can survive for months in the environment and be a source of infection. Typical clinical signs are a slowly growing, non-painful mass at the point of entry or a local lymph node. Treatment is usually not attempted as this tends to be a chronic recurring disease causing economic loss. Carriers can be a source of infection to other animals.
**PowerPage: Top 10 Sheep and Goat Diseases
**PowerLecture: Caseous Lymphadenitis
A beef ranch has suffered 12 acute deaths of 2-4 month old calves in the past six months. The owner of the ranch states that the animals appeared severely weak and depressed just before dying. On some of them, he noticed that they were having trouble breathing and had a frothy nasal discharge.
You perform a necropsy on a calf that died yesterday. Findings included bilaterally symmetric muscular atrophy. The skeletal muscle appears pale and dry in appearance with white streaks running along muscle bundles. You also notice that there are several calves in the ranch which are having trouble rising, and their musculature appears swollen, hard, and painful. What is the most likely diagnosis?
- Clostridial myositis
- Septicemia
- Gossypol toxicity
- Oleander toxicity
- Vitamin E and selenium deficiency
Answer: Vitamin E and selenium deficiency
Explanation
The correct answer is vitamin E and selenium deficiency (white muscle disease). The clinical signs are somewhat compatible with the other answers; however the necropsy results are diagnostic for white muscle disease. There is both a cardiac form, in which animals die acutely, and a skeletal muscle form, in which animals don’t die acutely but show clinical signs. In this particular question, the ranch was suffering from both forms. Remember that oleander and gossypol are both cardiotoxic and can cause acute death. Given the necropsy findings, clostridial myositis would be unlikely. Selenium is essential for glutathione peroxidase, deiodinase, and selenoprotein-P to work. Glutathione peroxidase breaks hydrogen peroxide and lipoperoxide into water or harmless alcohols.
***PowerPage: White Muscle Disease
You are called to examine a flock of sheep in the Western US. Several sheep have recently become ill. One acted lethargic for approximately one week before being found acutely dead in the pasture with frothy nasal discharge. Other animals appear to be less severely affected. They exhibit lethargy and reluctance to move, accompanied by mild facial swelling. Some animals have gone on to develop mucopurulent discharge and act as though their muzzle is painful. When you examine the most severely affected sheep, you observe the presence of mucous membrane hemorrhages, oral ulceration, and a swollen, cyanotic tongue. Several of the sheep are also lame, with visible bruising at the skin/hoof junction. What treatment do you recommend?
- Administer oxytetracycline to the entire herd
- Feed affected sheep moist, softened food
- Vaccinate the affected sheep for heartwater
- Vaccinate the clinically ill sheep for bluetongue
Answer: Feed affected sheep moist, softened food
Explanation
The signs observed in these sheep are consistent with bluetongue, a vector-borne disease of sheep (and some other ruminants) spread by Culicoides spp., biting midges. This disease is present in the Southern and Western regions of the US due to the vector presence. The name bluetongue describes the cyanosis and swelling of the tongue of affected animals. Affected animals also have vasculitis of the hoof coronets causing lameness. The edema seen in affected animals is fairly indicative of this disease. Treatment is supportive in nature, including rest and soft food.
Vaccination may prevent disease but will not have an effect on animals that are already showing clinical signs.
Antibiotics are only necessary if a secondary infection develops and antivirals are not recommended.
Which of the following viruses can cause paralysis and lymphoid tumors in young chickens and is commonly vaccinated against at hatcheries by 18-day in ovo or subcutaneous injection in hatchlings?
- Infectious bursal disease
- Lymphoid leukosis
- Fowl pox
- Marek’s disease
- Newcastle disease
Answer: Marek’s disease
Explanation
Diagnosis is based on enlarged nerves and lymphoid tumors in viscera. Marek’s disease can look very similar to Lymphoid leukosis, which may also cause tumors. Tumors in the bursa of Fabricius are more suggestive of Lymphoid leukosis, and it does not typically cause paralysis like Marek’s disease. Another differentiator is that Lymphoid leukosis is not usually seen in birds less than 14 weeks of age, while Marek’s may be seen in chickens as young as 3 weeks.
What is the physiologic abnormality in animals with tracheal collapse?
- Decreased number of tracheal rings
- Underlying bronchopneumonia
- Weakness of the tracheal rings
- Narrow tracheal lumen
Answer: Weakness of the tracheal rings
Explanation
The correct answer is weakness of the tracheal rings. Tracheal collapse occurs because of hypocellularity and deficient glycoproteins and glycosaminoglycans in the tracheal rings. This leads to decreasing strength and loss of ability to remain firm and eventually collapse.
***PowerPage: Collapsing Trachea
A 4-week old foal is presented to you for evaluation of dysphagia and weakness. During your physical exam, you observe weakness and generalized muscle tremors. Upon further examination, you note weak tongue tone and dilated, non-responsive pupils. What is the most likely cause of these clinical signs?
- Clostridium tetani
- Guttural pouch mycosis
- Equine protozoal myeloencephalitis
- Clostridium botulinum
Answer: Clostridium botulinum
Explanation
The correct answer is Clostridium botulinum (also known as Shaker Foal Syndrome). Foals (2 weeks-6 months) are susceptible to the toxicoinfectious form of botulism, where they ingest the spores which grow in their intestines and make the toxin. The toxin blocks the release of acetylcholine from the neuromuscular junction, thus resulting in flaccid paresis or paralysis. Adults usually will only show clinical signs if they ingest the preformed toxin. Clinical signs are shaking, flaccid paralysis, drooling, decreased muscle tone, weakness, and dyspnea. The weak tongue tone is considered a cardinal sign. With medical treatment, prognosis is favorable; however prognosis is poor if treatment is not instituted, as many die of respiratory paralysis or pneumonia within days.
***PowerPage: Top 12 Equine Neurologic Diseases
Babesia primarily affects which cells?
- Platelet
- Eosinophil
- Monocyte
- Red blood cells
- Neutrophil
Answer: Red blood cells
Explanation
The correct answer is red blood cells. Babesia causes RBC destruction due to direct damage and immune mediated mechanisms thus resulting in anemia. Interestingly, a thrombocytopenia is common with babesiosis.
Infectious bovine rhinotracheitis ophthalmic lesions are caused by which virus?
- Bovine Herpes virus Ill
- Bovine Herpes virus Il
- Bovine Herpes virus I
- Bovine Lenti virus
Answer: Bovine Herpes Virus I
Explanation
The correct answer is bovine herpes virus I. The virus infects the trigeminal ganglia and becomes latent. When an animal is immunosuppressed, the virus replicates and causes disease. Herpes Il causes bovine ulcerative mammilitis. Herpes Ill is the alcelaphine herpes virus (African malignant catarrhal fever). Lenti virus in cattle causes bovine leukosis.
***PowerPage: Infectious Bovine Rhinotracheitis
Which of the following is correct concerning the esophagus of a horse?
- Entire length is striated muscle
- Cranial 2/3 is striated muscle
- Entire length is smooth muscle
- Cranial 1/3 is smooth muscle
Answer: Cranial 2/3 is striated muscle
Explanation
The correct answer is cranial 2/3 is striated muscle. The remaining caudal third is smooth muscle.
15-25% of diaphragmatic hernias are not diagnosed until several weeks after trauma; therefore, it is important to perform thoracic radiographs in all animals that undergo significant trauma to avoid having an animal later go into respiratory distress and die. How should you treat a diaphragmatic hernia as shown below?
- Fascia lata graft using a simple interrupted pattern
- Mesh graft using porcine small intestinal submucosa
- This hernia is too large and has exceeded the repair limits; the patient should be humanely euthanized
- Simple continuous pattern of an absorbable suture such as polydioxanone
Answer: Simple continuous pattern of an absorbable suture such as polydioxanone
Explanation
Acute, traumatic, diaphragmatic hernias should be repaired primarily without the use of any “substitute” material for the diaphragm to reduce the risk of complications. It is very rare to have insufficient tissue/muscle to close an acute defect to the diaphragm. Using the native diaphragmatic wall decreases the risk of failure because this technique involves tissue with a direct blood supply as opposed to a mesh type material that is foreign to the body.
The 35-day postpartum recumbent dairy cow in this image has normal vital parameters, appetite, and milk production but has mucus and pus draining from her vulva. Speculum exam shows this material exiting the cervix. Rectal exam shows that she has an involuting uterus and normal ovaries. Which of the following treatments should be administered to help treat this condition and have the fewest negative economic effects such as prolonged milk withdrawal?
- Intrauterine chloramphenicol
- Systemic diethylstilbestrol
- Intrauterine penicillin
- Systemic ceftiofur
- Intrauterine metronidazole
Answer: Systemic ceftiofur
Explanation
The diagnosis is endometritis. This is based on the involuting post partum uterus and the normal vital signs (TPR). Intrauterine penicillin (after 30 days) or tetracycline or ceftiofur can be beneficial. The negative impact can be antibiotic residues in milk (up to 80 hours for penicillin and 96 hours for tetracycline in milk) and in tissues (up to 12 days for penicillin), so some prefer to use dilute povidone iodine, or uterine lavage with saline.
Systemic ceftiofur achieves adequate intrauterine levels and is thus the safest and best of the options listed.
Prostaglandins can also be given to “short cycle” the cow which will aid in treating the endometritis. The other drugs listed are not legal for use in the USA, and could cause harmful residues to appear in milk..
The image shows a polled Hereford calf several months of age with constant hypertonia of extensors of the rear limbs when it stands. It also has difficulty getting up. The condition started over a month ago and is worsening gradually. What is the diagnosis?
- Spinal lymphosarcoma
- Weaver syndrome
- Ankylosing spondylitis
- Bilateral ruptured cranial cruciate ligaments
- Spastic paresis
Answer: Spastic paresis
Explanation
Spastic paresis, also known as Elso heel, affects cattle of many breeds (as well as pygmy goats) beginning from three weeks to 1 year of age. It is believed to be caused by a combination of genetic and environmental factors which somehow cause over stimulation of the gamma motor neurons of the spinal cord.
A second disease, inherited periodic spasticity is a genetic disorder (probably single autosomal recessive) of most dairy breeds, and is seen rarely in beef breeds. It first appears at 3 to 7 years of age and gradually worsens, when the animals develop marked muscular spasms of the hip and upper leg muscles.
Steve is a 3-year-old male neutered Siamese cat who presents for a three-day history of not eating or drinking. On physical exam, Steve is QAR with a body weight of 5 kg. He is mildly tachycardic, with a heart rate of 240 bpm, but he is also quite nervous. On physical exam, you note his pulses are strong and synchronous, but his pink mucous membranes are dry, his skin turgor is decreased, his abdomen is “doughy,” and his eyes appear slightly sunken. His body temperature is 102.8°F. You elect to hospitalize Steve and administer 24 hours of intravenous fluids while awaiting the results of his diagnostic tests. What fluid rate do you select?
- 11 ml/hr
- 55 ml/hr
- 17 ml/hr
- 28ml/hr
- 5 ml/hr
Answer: 28ml/hr
Explanation
These exam findings indicate Steve is approximately 8% dehydrated. The goal is to replace his fluid deficit over the next 24 hours, in addition to providing maintenance fluids.
Given that he is 8% dehydrated, Steve’s fluid deficit is calculated as follows: 5 kg x 0.08 = 0.4 kg = 400 ml.
Therefore, Steve needs an additional 400 ml of fluid over the next 24 hours, or 17 ml/hr, for rehydration.
Next, estimate Steve’s maintenance fluid requirement at 55 ml/kg/day: 5 kg x 55 ml/kg/day = 275 ml/day, or 11 ml/hr.
Lastly, add the replacement and maintenance rates together to arrive at your desired fluid rate for the first 24 hours of hospitalization: 17 ml/hr + 11 ml/hr = 28 ml/hr.
An owner brings in her 4-year old domestic short hair cat for decreased appetite and sneezing. She has very limited funds for diagnostics, but approves a fine needle aspirate of the swelling you noticed over the bridge of the nose. You perform the aspirate and look at the slide under the microscope (see image). What medication should you prescribe for this cat?
- Clindamycin
- Fluconazole
- Chlorambucil
- Fenbendazole
Answer: Fluconazole
Explanation
The cytology from the fine needle aspirate shows cryptococcus. Cryptococcus is an encapsulated fungus and is treated with anti-fungal medications such as fluconazole or itraconazole.
Clindamycin is used to treat toxoplasma. Fenbendazole is used to treat intestinal parasites such as hookworms, roundworms, and Giardia. Chlorambucil is a chemotherapeutic agent often used in treating lymphoma.
A 10-year old female spayed greyhound presents with severe dental and periodontal disease (see image). You perform pre-anesthetic bloodwork, which is within normal limits and schedule the dog for a dental cleaning next week. Which of the following can be recommended for short-term use to treat periodontal disease in dogs?
- Enrofloxacin
- Raw hide chews
- Daily periodontal probing
- Daily chlorhexidine rinses
Answer: Daily chlorhexidine rinses
Explanation
Chlorhexidine rinses can be used short-term, such as prior to or immediately after any dental procedure. Daily usage kills off normal bacterial flora in the mouth and will stain teeth over time. Daily chlorhexidine use is sometimes advocated as a long-term treatment of severe periodontal disease, but alternative therapies should be recommended if possible. Raw hide chews, daily teeth brushing, and chew toys all help to reduce plaque and calculus when used regularly.
Enrofloxacin is a not a very good choice for oral infections since it is ineffective against anaerobic bacteria. Beta-lactam antibiotics (especially Clavamox) or clindamycin are better choices for oral infections because of their activity against anaerobes.
You perform thoracocentesis on a dog with pleural effusion. The fluid is an opaque pink color and has a protein content of 2.5 g/dl. There are 3,000 cells/uL. You suspect that it is chyle. What is the test of choice to definitively classify this fluid?
- Differential cell count on the fluid
- Thoracic radiographs
- Triglyceride concentration of the fluid compared to serum
- Glucose concentration of the fluid compared to serum
- Culture and sensitivity of the fluid
Answer: Glucose concentration of the fluid compared to serum
Explanation
The correct answer is triglyceride concentration of the fluid compared to serum. The fluid described is most consistent with a chylous effusion. The best way to definitively classify chyle is finding an elevated triglyceride level compared to serum. If you chose differential cell count, this is also a good answer because most chylous effusions are composed primarily of lymphocytes, unlike other effusions. However, with prolonged loss of lymphocytes, chronic chylous effusions may be composed primarily of neutrophils, which may lead you to believe it is an exudate. Radiographs and culture and sensitivity may be appropriate tests but will not help you classify the fluid. Glucose concentration of the fluid is not useful in this instance. It is sometimes used to diagnose pyothorax as glucose concentrations are typically < 10 mg/dl.
Several young goats under one year of age in a herd of 50 goats have scabby lesions around their mouths and noses, as shown in the photo. They also have low-grade fever and appear reluctant to eat hay, so they are falling behind the group. The owner is concerned because this condition appears to be spreading. You examine three affected kids and find that under the scabs is what appears to be proliferative granulation tissue. You advise the owner that the diagnosis is______
- Pseudocowpox
- Bovine papular stomatitis
- Malignant catarrhal fever
- Foot-and-mouth disease
- Contagious ecthymal
Answer: Contagious ecthyma
Explanation
Also known as orf or soremouth, this parapoxvirus disease is common in lambs and kids. Humans can also be affected. Rarely fatal, it nonetheless can make affected kids or lambs end up smaller than their age mates.
Lesions occasionally also occur on the teats of the dams. The scabs dry up in 2 to 4 weeks and fall off, with the virus overwintering in the scabs on the ground until more susceptible animals appear next year.
***PowerPage: Top 10 Sheep and Goat Diseases
On the morning of a beautiful summer day, a five-year old, male German Pointer played unattended in the backyard garden. During the following 24 hours the right side of the dog’s face became swollen as seen in the image below. The dog developed urticaria and became lethargic, unable to walk and vomited several times. Which of the following are the best treatment options for the likely condition?
- Induce vomiting, administer activated charcoal, intravenous fluids
- Antihistamines, corticosteroids, and epinephrine
- Furosemide, oxygen, and nitroglycerin
- Drain the swelling, administer antibiotics
- Diazepam, methocarbamol, and non-steroidal anti-inflammatories
Answer: Antihistamines, corticosteroids, and epinephrine
Explanation
The dog has angioedema +/- anaphylaxis, likely caused by an insect bite or sting. A snake bite should also be ruled out by trying to visualize the bite or questioning the owners. This is a type I hypersensitivity reaction and is treated by removing the offending agent if possible and providing supportive care with anthistamines, corticosteroids, and epinephrine as needed
Below is a lateral thoracic radiograph of the caudodorsal lung field of a 4-month old foal with clinical evidence of weight loss, fever, and tachypnea. What is the best diagnosis based on the clinical signs and radiograph?
- Pulmonary abscesses
- Pulmonary aneurism
- Congestive heart failure
- Pulmonary carcinoma
- Rhinopneumonitis pneumonia
Answer: Pulmonary abscesses
Explanation
The two horizontal lines represent fluid or pus capped by gas within cavitary lesions. In foals, this occurs most frequently with Rhodococcus equi pneumonia.
***PowerPage: Rhodococcus equi
Several 6 month-old calves have died on a large ranch, and you have performed a post-mortem exam and diagnosed blackleg (see image). The owner, who has never vaccinated his calves, would like your recommendations for prevention.
- Vaccinate all animals starting at one year of age and annually thereafter, using killed vaccine containing several common Clostridial organisms
- Vaccinate all calves at 4 to 6 months of age with killed vaccine containing Clostridium septicum and several other common Clostridial organisms.
- Give penicillin whenever handling the calves, as this eliminates the Clostridium chauvoei spores from tissues
- Give Clostridial antiserum to all calves at the time they are handled for branding and castration
- Give Fusobacterium necrophorum vaccine to to all calves starting at 4 to 6 months of age
Answer: Vaccinate all calves at 4 to 6 months of age with killed vaccine containing Clostridium septicum and several other common Clostridial organisms.
Explanation
Blackleg is caused by Clostridium chauvoei, but can also be seen with Cl. septicum or Cl. sordellii (often called malignant edema). Vaccines containing up to 8 different Clostridia are often used. Calves under one year old are most susceptible. On high-risk farms it may be necessary to start vaccination at a younger age or also vaccinate cows to maintain high colostral levels of antibody, and/or to give a booster (second) dose 4 to 8 weeks following the initial dose to calves. Annual revaccination of at least yearlings is also recommended.
A 10 year old female spayed Dachshund presents for further evaluation of progressive lameness in the hind. The owner notes that she has begun intermittently scuffing her hind limbs, has somewhat of a weak or drunken gait in the hind as she walks, and is having trouble rising. Given the answer choices below, what is the best treatment?
- Total hip replacement bilaterally
- Prolonged antibiotic therapy with clindamycin
- Femoral head ostectomy
- Dorsal laminectomy
Answer: Dorsal laminectomy
Explanation
This patient’s clinical signs are consistent with neurological deficits. Although you do not have all of the information necessary to reach a definitive diagnosis, you should have been able to deduce that this patient probably needs a dorsal laminectomy to relieve disc compression.
In order to definitively diagnose the condition you would want to proceed with a complete exam, basic bloodwork, and a CT or MRI of the lumbosacral region. Although this patient does exhibit evidence of hip dysplasia radiographically, the clinical signs are not characteristic of a dog with pain secondary to hip dysplasia.
There is no indication of osteomyelitis on these radiographs and the clinical signs are not necessarily suggestive of osteomyelitis.
It is important not to skip ahead to image interpretation without carefully reading the question. Doing so in this case would likely lead you to select the incorrect answer.
Radiographs provided by Adrien Hespel, DVM, MS, DACVR and University of Tennessee College of Veterinary Medicine
You are presented with a 10-day old Holstein dairy calf weighing 40 Kg that is cold (Temperature is 97 degrees F, 36.1 degrees C) and nonresponsive. Her eyes appear sunken as in the photo. In addition to placing the calf on a warming pad, what is the best treatment?
- 1 liter of subcutaneous fluids containing glucose, sodium, bicarbonate, chloride and lesser amounts of potassium
- Gentamicin intravenously at the label dosage
- 4 liters of intravenous fluids containing glucose, sodium, bicarbonate, chloride and lesser amounts of potassium
- 4 liters fluid containing equal amounts of sodium and chloride
Answer: 4 liters of intravenous fluids containing glucose, sodium, bicarbonate, chloride and lesser amounts of potassium
Explanation
The calf is in metabolic acidosis (base deficit of about 15) and needs sodium containing fluids IV that contain bicarbonate or other base. 4 liters intravenously is a more appropriate fluid volume for a dehydrated 10-day old calf, calculated as 10% Of the 40 kg body weight. The sunken eye, as seen in the photo, is an important indicator of marked dehydration.
To treat metabolic acidosis caused by loss of sodium containing fluids you need to give more sodium than chloride, so sodium bicarbonate is the fluid of choice. Neonates such as this one tend to develop severe metabolic acidosis as they dehydrate due to absorption of acids from the gut and due to loss of renal compensatory mechanisms due to poor renal perfusion. The calf is also likely to be hypoglycemic, so adding glucose is essential. As you rehydrate and bring up blood glucose, the serum potassium will be driven back into cells and needs to be replaced with some potassium in the fluids.
***PowerLecture: Calf Diarrhea Part 2
A farmer brings a cow to you with the complaint that the cow is losing weight and not appearing to eat well. On physical exam you find that the tongue is hard and swollen, as shown in the image. How would you treat this cow?
- Euthanasia, and notify the state officials
- Sodium iodide
- Banamine
- Penicillin
- Ceftiofur
Answer: Sodium iodide
Explanation
The tongue is the area most frequently infected with woody or wooden tongue, although other soft tissues can be infected. The infection is introduced by breaks in the mucosa, allowing the normal rumen inhabitant, Actinobacillus Lignieresii, to invade and cause painful granulomas. The disease can often be successfully treated with IV sodium iodide; although certain other systemic antibiotics including tetracyclines can be used. The sodium iodide is given intravenously once and repeated again in 7-10 days. It is given at a concentration ranging from 5-20%.
Ceftiofur cannot be used extra label.
A 25-month old female rat presents to you for weakness. On exam, you note generalized ataxia, most pronounced in both forelimbs. There is mild left sided exophthalmia and you note the rat pressing its head against the side of its cage. The owner is not interested in diagnostic tests or treatment and feels the rat’s quality of life is poor but you are both very interested in finding out the cause of the rat’s signs. You perform a gross necropsy and see the abnormality shown in the image below. What is this condition?
- Cerebellar abiotrophy
- Hydrocephalus
- Glioblastoma multiforme
- Bacterial meningitis
- Cerebellar hypoplasia
- Pituitary adenoma
Answer: Pituitary adenoma
Explanation
Pituitary tumors are most common in older female rats and can produce clinical signs from mechanical growth (as described in this question) or related to hormonal disturbances (such as lactation, decreased fertility, PU/PD).
This is a macroadenoma which is usually defined as > 10 mm in diameter. Treatment options are usually limited to steroids to temporarily decrease swelling associated with the tumor and nursing care.
A 3-year old Jersey heifer is not doing well and is euthanized with a post-mortem performed in the field. Below is an image of her heart, with the right atrium and right ventricle opened. What is your diagnosis?
- Tricuspid valve endocarditis
- No significant findings
- Cardiac neoplasia
- Ventricular septal defect
- Tricuspid valve dysplasia
Answer: Tricuspid valve endocarditis
Explanation
The correct answer is tricuspid valve endocarditis. Hemorrhagic and white masses are seen on all leaflets of the tricuspid valve which makes endocarditis the most likely diagnosis in a young heifer. Neoplasia is unlikely on the valve and at this age; tricuspid valve dysplasia would be seen as short, thick chordae but no masses; a VSD would be seen as a hole between the right and left ventricle which is not apparent here.
You examine a cow with pruritic leg lesions consisting of papules, erythema, scaling, crusting, and alopecia (see image). Several animals in the herd have these same lesions. What should you do to make the diagnosis?
- Skin scraping to identify chorioptic mites
- biopsy to look for Hypoderma bovis infestation
- Take swabs and submit for culture for Corynebacterium pseudotuberculosis infection
- take swabs for PCR to rule out Pseudocowpox
- trap insects at sunset to check for Culicoides hypersensitivity
Answer: Skin scraping to identify chorioptic mites
Explanation
Chorioptes bovis (see image) is found in cattle, and it is a reportable disease. Treatment with ivermectin is usually effective. C. equi, C. ovis and C. capre are found respectively in horses, sheep and goats where they cause mange. Identifying the mite, along with lesion distribution, will determine which mange mite is responsible.
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?
- Melatonin
- Zinc
- Milk thistle
- Vitamin A
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.
A 4-year old cat presents dehydrated, febrile, and jaundiced with a PCV of 16%. The labwork indicates markedly regenerative anemia with an elevated bilirubin. A slide agglutination test is positive. The photomicrograph from the CBC blood smear is below: What is the infectious organism and how is it best treated?
- Bartonella- doxycycline and prednisolone
- Mycoplasma haemofelis- doxycyline and prednisolone
- Bartonella- enrofloxacin
- Mycoplasma felis- enrofloxacin and prednisolone
- Mycoplasma haemofelis- enrofloxacin
Answer: Mycoplasma haemofelis- doxycyline and prednisolone
Explanation
This organism is called Mycoplasma haemofelis (formerly called Hemobartonella).
Bartonella is a different bacterium that is spread via fleas. It is implicated in Cat Scratch Disease.
Mycoplasma felis is a bacterium involved in respiratory infections and is usually considered a co-infection or opportunist in pulmonary disease.
Both doxycyline and enrofloxacin (Baytril) can be effective at treating Mycoplasma haemofelis; however, in severe cases such as this where there is rampant red blood cell destruction via the immune system (as evidenced by positive slide agglutination test), the addition of immunosuppressive doses of steroids can be life-saving.
