Test 2: 10 lower Flashcards
An owner presents you with a dead 3-day old puppy from a litter of 6. The puppy was seen nursing and seemed “normal” until the night before when the puppy stopped nursing and looked “sleepy.” Gross inspection of the body and oral cavity reveals this lesion. All other puppies are eating and acting normally. Q1a: What is the anatomic location of the lesion?
Hard palate
Briefly describe the lesion you see in the oral cavity.
A large focal cleft that separates the edges of the hard palate.
medical term for cleft palate
Palatoschisis
Briefly describe the exudate within the nares and provide a corresponding morphologic diagnosis
SALTD, DSSCCL
Opaque pale-yellow mucoid exudate- severe acute bilateral mucopurulent rhinitis
describe
SALTD, DSSCCL
The ventral portion of the right cranial lung lobe contains coalescing well- demarcated dark red depressed foci with a single centrally located 1-2cm diameter slightly raised pale tan focus.
morphologic diagnosis.
Severe acute suppurative bronchopneumonia
how does cleft palate lead to suppurative bronchopneumonia
Palatoschisis with oral-nasal communication→ aspiration of ingesta (milk) into the nasal cavity → suppurative rhinitis → extension of aspirated contents into the trachea & lung → suppurative bronchopneumonia
An adult horse develops a unilateral (left sided), malodorous mucopurulent nasal discharge. Percussion over the left maxillary sinuses are dull compared to the right which are resonant. Radiographs reveal a soft tissue (fluid) opacity within the left rostral and caudal maxillary sinuses with lysis of the tooth root apices of the 1st molar (M1). The soft tissue (fluid) opacity limited to the left side taken together with physical exam findings is compatible with a unilateral bacterial sinusitis.
Is the sinusitis a primary or secondary process?
secondary
What radiographic evidence do you have for a secondary process?
M1 tooth root lysis
Based on PE and radiographic evidence, what is the likely cause of the sinusitis in the horse?
Maxillary cheek tooth (M1) infundibular necrosis with pulpitis & tooth root abscess → alveolar bone lysis with bacterial translocation into the sinuses → suppurative sinusitis.
— sinusitis/rhinitis typically manifests as a clear serous (non- malodorous) exudate.
Viral
Streptococcus equi or Strep. zooepidemicus (gram positive cocci
usually bilateral
Dental attrition with malocclusion; “WAVE MOUTH”
pig with wave mouth and gastric impaction. how do they explain each other
Dental attrition with malocclusion–> inadequate mastication–> gastric impaction –> reflux and aspiration–> aspiration pneumonia (anaerobes make it malodorous)
raised, fluid-filled transient lesions resulting from ballooning degeneration and necrosis of epithelium
Vesicle
circumscribed areas of epithelial cell denudation down to the level of (but not through) the basement membrane
erosion
focal defects in the mucosa that extend BELOW the basement membrane
ulcer
oral cavity inflammation
stomatitis
lip inflammation
cheilitis
tongue inflammation
glossitis
gingiva inflammation
gingivitis
teeth, gum, alveolar bone inflammation
periodontitis
esophagus inflammation
esophagitis
The pigs have developed lameness and raised, fluid filled lesions on the snout, lips, tongue and coronary bands that progress to erosions & ulcers. The cow has similar lesions. The horse is unaffected.
Q5a: Given the history, lesions and species affected, what is the most critical disease you want to rule out?
Foot and Mouth Disease
reportable
4 other differential diagnoses for these fluid filled lesions in pigs
Vesicular stomatitis
Swine Vesicular Disease
Vesicular Exanthema of Swine
Senecavirus A (Seneca Valley Virus)
of :
Vesicular stomatitis
Swine Vesicular Disease
Vesicular Exanthema of Swine
Senecavirus A (Seneca Valley Virus)
which can a horse get and is it reportable?
Vesicular stomatitis
yes
Name a common viral disease in cats that causes oral vesicles, erosions and ulcers with hypersalivation and anorexia:
Feline Calicivirus
On examination, the calf is emaciated and has diarrhea containing mucus and flecks of blood. Oral examination reveals hypersalivation with multifocal erosions and ulcers on the tongue and palate.
Provide 3 differential diagnoses for the lesions in the oral cavity
(remember that vesicles can be very transient and rapidly convert to
erosions/ulcers)
- Bovine Viral Diarrhea
- Malignant Catarrhal Fever
- Bluetongue Disease
Given the autopsy findings in the calf and the poor reproductive history of the herd, what is the likely disease?
Bovine Viral Diarrhea (BVD)
1) Epithelial cell necrosis
2) Lymphoid necrosis
3) Teratogenic effects
A 4-year-old Longhorn steer is euthanized for severe unilateral swelling of the mandible with reluctance to eat. You palpate several large (4-6cm diameter) firm to fluctuant subcutaneous nodules expanding the sub-gingival mucosa.
Radiographs reveal multifocal-coalescing lytic foci within the mandible.
Q8a: Based on the lesions presented, provide the common name for the most likely disease
Bovine Lumpy Jaw
Actinomyces bovis
Bovine Lumpy Jaw
is caused by
Actinomyces bovis
lumpy jaw causes what inflammatory process
Pyogranulomatous stomatitis and osteomyelitis
Actinomyces bovis
A hobby farmer with a small herd of beef steers has had 3 animals die acutely. Because he wants to fatten these cattle for market, he has turned them out in a field containing alfalfa. All have pronounced left-sided abdominal distension.
Rumen fluid has a slimy emphysematous appearance.
Given the history & lesions, what disease do you most expect?
Primary (Frothy) Bloat/ Primary Rumen Tympany
What is the likely cause of rumen tympany/ bloat?
primary- foamy bloat
Excessive alfalfa forage in diet → proteins
stabilize foam and promote microbial production of stable slime that blocks the cardia and prevents eructation
The same farmer calls you back several weeks later because other steers have developed lameness and another steer has died. You find sole ulcers (consistent with bovine laminitis). The rumen of the dead steer is filled with fluid and contains multifocal ulcers. The liver contains multifocal soft tan foci (abscesses). The
farmer is no longer feeding alfalfa BUT he’s added CORN
what disease?
Rumen acidosis
what causes Rumen acidosis?
Rumen acidosis and ulcerative rumenitis. High CHO diet → Fermentation to VFA’s → Initial drop in pH → Death to normal microflora (protozoa and Gram negative anaerobic bacteria) → Microflora shift to acid loving/producing gram positive bacteria (Strep. bovis & Lactobacillus)→ Further drop in pH → Chemical damage to the epithelium → Rumen erosions/ulcers →Opportunistic infection by opportunistic bacteria/fungi → Invasion through wall into portal blood vessels → bacterial/fungal emboli → Liver abscesses
You examine a 3-year-old dairy cow for anorexia and reduced milk production. PE reveals marked left abdominal distension without auscutable or palpable rumen contractions. There is submandibular and presternal swelling with jugular vein distension & jugular pulses. Auscultation of the heart reveals tachycardia with muffled but turbulent sounds (like a washing machine). These are the findings from the abdominal and thoracic ultrasound exam.
what disease
Bovine Hardware Disease
Traumatic reticuloperitonitis/reticulopericarditis
what prognosis do you give the farmer/ what treatments (if any) do you recommend for Traumatic reticuloperitonitis/reticulopericarditis aka bovine hardware disease
Although the farmer could try broad-spectrum antimicrobials, the prognosis is poor given the abundance of fibrin and fluid within the pericardial cavity and thickening of the pericardium. The presence of dependent edema in the head/neck and the pulsating jugular distension indicated right-sided cardiac insufficiency.
hardware disease with lesions on the pericardial sac leads to
Cardiac tamponade and/or restrictive pericarditis
describe lesions on the epicardial surface and peritoneum after hardware disease
effusive
Severe subacute diffuse fibrinous peritonitis and pericarditis
A 2-year-old German Shepherd has chronic regurgitation. A barium contrast radiograph shows esophageal dilation proximal to a severe narrowing of the contrast dye. Four months ago he had a corncob extracted from his esophagus via endoscopy.
Given the history, what does the focal narrowing likely signify.
stricture
What is the most likely pathogenesis of the narrowing & proximal dilation beginning with the initial corn cob ingestion?
Physical esophageal obstruction → pressure necrosis of wall → mucosal ulcer → inflammation & healing w/ fibrosis → stricture → proximal dilation
What disease of the respiratory system is this dog at risk of acquiring with a esophagus stricture?
Aspiration pneumonia
List the 4 components of the gastric mucosal barrier
- Mucus secretions
- Bicarbonate secretions
- Rapid cell turnover (replacement of surface epithelium)
- Adequate blood flow
List the steps in the pathogenesis of NSAID-associated gastric ulcers
— cause gastric ulcers in DOGS
NSAIDS, stress, direct trauma to epithelium (foreign bodies), GDV,,
gastric adenocarcinoma (OLD dogs), mast cell tumors producing excess circulating histamine, IBD, Clostridium perfringens (HGE- cause ulcer and hemorrhage)
— cause gastric ulcers in CATTLE
Dietary change (excess CHO), stress, concurrent disease, abomasal displacement/volvulus, lymphosarcoma (BLV infection), BVD virus, Clostridium perfringens abomasitis
— cause gastric ulcers in horses
NSAIDS, stress, irregular feeding intervals, transportation, high grain
diets, squamous cell carcinoma (older horses)
— cause gastric ulcers in pigs
Helicobacter, small feed particles, genotype, gender, season, stress/concurrent disease
You identify these lesions in the abomasum of a calf submitted for autopsy due to acute death. The owner reported the calf was a greedy eater but suddenly bloated and died. 14a) Describe the lesions
The mucosa is mottled pink with dark red to dark brown-black foci. The mucosa is expanded by multifocal emphysematous bubbles.
Provide an appropriate morphologic diagnosis
Severe diffuse hemorrhagic emphysematous abomasitis
what caused this
Clostridium perfringens
emphysematous abomasitis is similar to — in a —
Dogs- Hemorrhagic Gastroenteritis
What is the likely cause of the mucous membrane pallor
anemia from Haemonchus contortus nematodes (abomasal Haemonchosis)
What is the reason for the dependent edema and diarrhea from a Haemonchus infestation?
Due to capillary leakage of protein into the abomasum, Haemonchus causes severe hypoproteinemia → low intravascular oncotic pressure → dependent edema. The increased protein (albumin) liberated into the gi tract → osmotic drawl of fluid into the intestines → diarrhea (a preview for next lectures!)
What are the 3 predominant inflammatory cell infiltrates in canine, feline and equine IBD?
- Lymphocytes 2. Plasma cells 3. Eosinophils
primary vs secondary bloat
primary- frothy from abrupt dietary change
secondary- free gas- from failure to burb (eructation)- esophageal obstruction or rumen stasis)
what are things that can cause secondary bloat?
Free Gas bloat
Due to FAILURE OF ERUCTATION
(ie, Esophageal Obstruction or Rumen Stasis)
explain primary bloat mechanism
sudden high carb diet will decrease saliva
saliva usually inhibits foam production
proteins in forage will stabilize foam, high carb will cause change in microflora, also produce more slimy foam
stable slime blocks the cardia causing rumen distension
what is the bloat line
Blanching of the distal esophagus (bloat line) with passive congestion of the proximal esophagus