Small Animal Clinical Case Studies Flashcards
What are the clinical signs of Atopic Dermatitis?
- Erythema
- Excoriations
- Hyperpigmentation
What is the ‘hygiene hypothesis’?
An increase in atopic disorders can lead to lower infections in early childhood transmitted by unhygienic contact with older siblings (Bloomfield et al., 2006)
What are the characteristics of Canine Atopic Dermatitis?
- Known as Atopy
- Pruritic allergic skin condition
- Affects >10% of dogs (Hillier et al., 2001; Lund et al., 1999)
- Genetic predispositions
- IgE response to environmental allergens
What are the diagnostic and treatment routes for atopic dermatitis?
- No definitive diagnostic tests available
- Environmental allergy testing should be performed only in diagnosis cases where CAD is present
What is the Shar Pei problem?
- Suffer from entropion (in-turned eyelids)
- Need to be bred with thinner, flattened skin to avoid welfare impacts
What is cardiomyopathy?
Disease involving primarily and predominantly the heart muscle
What are the 3 broad categories of myocardial disease?
- Cardiac dilation with AV incompetence & congestive heart failure
- Cardiac hypertrophy
- Cardiac constriction
What are the clinical signs of feline hypertrophic cardiomyopathy?
- Inappetence
- Vomiting
- Weight loss
- Sudden death
(Visser, 2018)
What is the average survival time of hypertrophic cardiomyopathy?
92-2153 days (Payne et al., 2013)
What is the most common feline cardiomyopathy observed?
Hypertrophic Cardiomyopathy
How many of the cat population can be affected with hypertrophic cardiomyopathy?
15%
What cats have a genetic predisposition to hypertrophic cardiomyopathy?
Maine Coon- A31P mutation
How can hypertrophic cardiomyopathy be diagnosed?
- Post mortem
- Echocardiography
- Radiography
- Electrocardiography
What are the 2 main hormones which the thyroid releases?
- Triiodothyrodine (T3)
- Thyroxine (T4)
What is the main function of the thyroid?
Regulate metabolism
What is the purpose of calcitonin?
Increases the calcium uptake by bone; produced in response to high blood calcium levels
What factors does the thyroid help with metabolic factors?
- Carbohydrate metabolism
- Fat metabolism
- Basal metabolic rate- weight loss & respiratory system
What is hypothyroidism?
The inability to produce, release or respond to T3 and T4
Does hypothyroidism mean the blood levels are too high or too low?
Too low
What are issues associated with primary hypothyroidism?
- Idiopathic necrosis and atrophy
- Immune mediated lymphocytic thyroiditis
- Cretinism
What are issues associated with secondary hypothyroidism?
- Lack of TSH
- Glucocorticoid therapy
How many clinical cases are secondary hypothyroidism associated with?
5%
What is cretinism?
Congenital failure to T3 & T4 and is rare
How is hypothyroidism diagnosed in the lab through blood analysis?
- Mild non-regenerative anaemia (30%)
- Hypercholesterolaemia and hypertriglyceridaemia (50-75%)
- Mild increased ALT, ALP, CK
How is hypothyroidism diagnosed in the lab through dynamic thyroid function tests?
- ELISA- total T4
- Equilibrium dialysis- Free T4
- TSH response test (expensive)
What therapy routes can be used for hypothyroidism?
- Aim to eliminate signs of hypothyroidism, but prevent signs of hyperthyroidism
- Synthetic T4 in tablet; PO
- Response seen in behaviour; energy levels within 1-2 weeks
- Improvements in skin and coat condition take months to become apparent
What is hyperthyroidism?
Thyroid gland produces and secretes excessive amounts of T3/t4
Why does hyperthyroidism occur?
- Due to development of hyper-functional thyroid nodules
- 98% associated with functional adenoma (uni- or bi-lateral)
What species is hyperthyroidism common in?
Cats >9 years old
How is hyperthyroidism diagnosed in felines?
- Total T4 raised
- Enlarged thyroid may be palpable
- PCV mildly elevated
- Raised ALT, ALP and AST
What drug can be used to treat feline hyperthyroidism?
Cytotoxic drug therapy with methimazole
What are the requirements for using surgical thyroidectomy for treatment of hyperthyroidism?
- Pre-operative stabilisation
- If bilateral, need to preserve at least 1 parathyroid gland
- Monitor post-op Ca2+ levels if bilateral (hypoparathyroidism)
What are the requirements for using radioiodine for treatment of hyperthyroidism?
- Selectively taken up by adenomatous tissue
- Safe and effective
- Necessary to hospitalise for 1-3 weeks and deal with radioactive waste
What is hyperadrenocorticism also known as?
Cushings disease
How is cushings disease characterised?
An overproduction of glucocorticoids
What is cushings disease split between?
- Pituitary dependent (85%)
- Adrenal dependant (15%)
How is the pituitary dependent in cushings disease?
- Causes adenomatous enlargement of the pituitary gland
- Excessive ACTH production
How is the adrenal dependent in cushings disease?
- Functional adenomas/adenocarcinomnas of the adrenal gland
Why is cushings disease iatrogenic?
Causes chronic excessive exogenous steroid administration
What are the clinical features of cushions disease?
- Polyuria
- Bilateral alopecia
- Dehydration
- Fat pads
- Depression
- Polydipsia
What are the laboratory findings of cushings disease?
- Eoisinopaenia, lymphyopaenia, neutrophilia- stress
- Raised cholesterol, glucose and liver enzymes
- Urea usually low
- T4 often low
What does pituitary cushings involve?
The small amount of suppression in cortisol production
What screening tests can be performed for cushions disease?
- ACTH stimulation test
- Low dose dexamethasone suppression test (LDDS)
What does adrenal cushings involve?
No reduction in cortisol production
What is the treatment for cushings disease?
- Adrenalectomy if adrenal tumour
- Mitotane kills adrenal cortex cells: daily dosage to control and maintain on weekly dose
- Care not to overdo medication or patient will develop Addisons
For using LDDS as a diagnosis method, what time are the blood samples required to be taken?
3 blood samples:
1. 1 before dexamethasone administration
2. 1 4 hours after administration
3. 1 8 hours after administration
What is hypoadrenocorticism also known as?
Addisions disease
How are animals affected with addisons disease?
Autoimmune or iatrogenic
What dogs does addisions disease mostly affect?
Young to middle-aged female dogs
What are the clinical signs of addisons disease?
- Illness
- Lethargy
- Weakness
- Anorexia
Is Addisions disease chronic or accute?
Chronic
What are the laboratory findings of addisons disease?
- Hyponatraemia (low sodium)
- Hyperkalaemia (high potassium)
- ACTH stimulation test shows no response to ACTH
What are the treatment routes for addisons disease?
- Chronic condition
- Fludrocortisone acetate (Florinef)
- Table salt on food
What increases the risk for feline leukaemia virus?
Being an:
- Outdoor cat
- Unneutered male
- Young cats
- Cats with other diseases
How is feline leukaemia spread?
Prolonged, repeated exposure to infected i.e. saliva and urine
What is the clinical indications of feline leukaemia virus?
- Mild fever and lethargy
- Damage to WBC
- Anemia
- Lymphosarcomas
How can feline leukaemia be diagnosed?
- ELISA
- PCR
What are disease management strategies for feline leukaemia?
- Vaccination
- Secondary infections treated promptly
- Supportive therapy and nursing care
- Indoor cat
What is Canine infectious tracheobronchitis known as?
Kennel cough
What are the multifactoral etiological causes of kennel cough?
- Bordatella bronchiseptica (Bb) combined with Pseudomonas sp., E. coli and Klebsiella pneumonia
- Canine parainfluenza virus
- Canine adenovirus 1 and 2
- Canine distemper virus
What are the clinical signs of kennel cough?
- Inflammation of the upper airways
- Harsh, dry hacking cough
- Body temperature and WBC normal
- Fever
- Depression and anorexia
How is kennel cough diagnosed?
- History and clinical signs
- Elimination of other causes of coughing
- Thoracic radiographs
What is the treatment route of kennel cough?
- Hygiene and environment
- No hospitalisation
- Cough suppressants
- Antibiotics
What prevention methods can take place to stop kennel cough?
- Vaccination with modified-live virus i.e parainfluenza and CAV-2
- Intranasal vaccination for B bronchiseptica
