Vet prep Dog/Cat part 1 Flashcards
1
Q
A 10 year old shih-tzu for collapse, a diagnostic work up shows a mass on the R kidney, which was subsequently removed and biopsied as a renal carcinoma. What can be assoc. with carcinoma?
A
polycythemia which is an erythropoietin secretion causing elevations in Hct as a paraneoplastic syndrome
2
Q
hypercalcemia is assoc. with what tumor most commonly?
A
Adenocarcinomas (like AGASACA) but also lymphomas and others
3
Q
thrombocytopenia can be seen with what two tumors most commonly?
A
Hemangiosarcoma and multiple myeloma
4
Q
What is used for urinary incont. In dogs and is a weak alpha agonist
A
Phenylpropanolamine- it increase urethral sphincter tone and helps prevent incontinence (beware because can cause bone marrow suppression bc basically an estrogen supplement)
5
Q
What are the components of nephrotic syndrome (4 of them)
A
Proteinuria (test with protein: creatinine), hypoproteinemia, hypercholesterolemia, and ascites or edema
6
Q
Why are struvite stones seen with infection (UTI)?
A
Because bacteria are producing urease which alkalize the urine in which struvite stones love to live (dissolve or remove)
7
Q
Monitoring water and urine output:
A
Normal water consumption is 50-60mL/kg/day and polydipsia is defined as more than 100mL/kg/day, polyuria is more than 50mL/kg/day of urine and is best measured with an indwelling urinary catheter and hospitalization
8
Q
Diabetes insipidus
A
when urine cannot be concentrated because there is no ADH secretion (abn vasopressin or abn response to vasopressin)
9
Q
You are looking at a 3 y/o F Mini poodle that apparently has been bumping into things more at home and esp. at night. On fundic exam, you see tapetal hyperreflectivity, and gray vermiform lines on the fundus and retinal vascular attenuation with a pale optic disc. What is the most likely cause of her problem
A
Gray vermiform lines means imbalance of growth between the retina and the outer choroid and sclera (sometimes seen in collie breeds), they disappear after several week
10
Q
What eye condition is seen in dogs with distemper or fungal infections and cats with FIP, FeLV, FIV, Toxoplasmosis and fungal infections??
A
Chorioretinitis
11
Q
What is a potential effect of chronic anterior uveitis in dogs?
A
corneal scarring
12
Q
chronic uveitis can lead to what 3 things in the eye?
A
cataracts, glaucoma, and corneal scarring
13
Q
You are assisting the ophthalmologist with an eye exam during your internship rotation and examining a 5 y/o GSD who has been recently lethargic and seems to be having issues seeing especially at night. On dilated fundic examination, you note gray areas in the fundus and the retina looks blurry. You also note a small area of hemorrhage in the OS and you do an electroretinogram and find impaired cone function, eye test shows the following: stain neg, tonometry 8 OS and 12 OD, and Schirmer tear test shows 20mm < 60 sec. OU. What is the diagnosis?
A
Chorioretinitis- this is aka posterior retinitis and is inflammation of the choroid and retina. Signs of ongoing or acute chorioretinitis in dogs are poorly defined gray spots throughout the fundus, retinal separation, and retinal hemorrhage.
Full labwork and infectious disease testing should be submitted.
14
Q
what is a normal shirmer tear test result?
A
more than 15mm/min
15
Q
a dog presents for a brown, circular mass floating in the anterior chamber of the eye, what is it?
A
Uveal cyst- (ddx from melanoma because it is free-floating and will transilluminate and are spherical to ovoid and smooth unlike melanoma)
16
Q
what is optic disc coloboma?
A
a congenital malformation of the optic disc where there is failure of optic fissure to close embryonically and usually results in a keyhole shaped pupil
17
Q
What is the difference between an incomplete and complete cataract?
A
Both are diffuse changes of the lens but the animals can see through the incomplete cataract
18
Q
Different types of cataracts-
A
An incomplete cataract is not completely opacified and a tapetal reflection can be seen through it. and animal can see through it.
A complete cataract is a completely opacified lens that cannot be seen through and tapetal reflection cannot be appreciated.
A focal cataract is aka an incipient cataract
Degradation of the lens protein after developing a cataract is called resorbing cataract
19
Q
nuclear sclerosis is normal aging changes to the center of the ___ of the eye
A
lens
20
Q
Dogs with what endocrine disorder have an increased incidence of sudden acquired retinal degeneration syndrome (SARDS)
A
Hyperadrenocorticism (Cushing’s disease)
21
Q
what are tx options for glaucoma (primary or secondary) in dogs?
A
Carbonic anhydrase inhibitors (such as dorazolamide) a
Latanoprost (Xalatan) is a prostaglandin analog
22
Q
what drug is C/I with glaucoma?
A
Atropine
23
Q
what is tacrolimus used for?
A
topical immunosuppressant for dry-eye
24
Q
blood in the anterior chamber of the eye with precipitates in the posterior chamber is what disease?
A
Anterior uveitis
25
Hyphema and keratic precipitates are specific signs of what?
Anterior uveitis
26
You examine a dog with bilateral blepharospasm, mucoid ocular discharge and 360-degree corneal vascularization. What test will most likely give you a diagnosis as to the cause?
Schirmer tear test
27
fungal infections such as coccidioides immits infection can cause what ocular change?
Aqueous flare (and uveitis)
28
what does dyscoria mean? what does anisocoria mean?
dyscoria is abn shape of the pupil; anisocoria is different pupil sizes
29
When are changes seen on electroretinogram (ERG) with sudden acquired retinal degeneration syndrome (SARDS) in dogs?
flat lined ERG from day 1 of the condition
30
Chronic superficial keratitis aka _____
AKA PANNUS; a condition seen mainly in GSD and shepherd crosses due to UV light exposure that is believed to cause alterations to the corneal proteins leading to an immune reaction
It is tx with topical steroids and cyclosporine- usually requires lifelong tx
31
You are examining the eyes of a dog with all the signs of Horner’s Syndrome, After instilling topical hydroxyamphetamine, there is no change but then you instill phenylephrine and after 5 minutes, the eye returns o normal. What can you conclude?
Hydroxyamphetamine and phenylephrine stimulate the sympathetic NS and is used to dilate the pupil
(phenylephrine causes a more rapid response)
so this dog has a post-ganglionic lesion
32
What do you do first in a dog that presents to you for a melting corneal ulcer?
swab for cytology and culture (assume it is infected)
33
You are looking at a 9 y/o female spayed dog that became acutely blind after being normal all yesterday, ophthalmic and fundic exams are normal. What is the most likely cause of this dog’s acute blindness?
sudden Acquired Retinal Degeneration Syndrome (SARDS) which is a condition seen in middle-aged dogs that are obese and develop acute blindness and initially have no optic or fundoscopic lesions. In 1-2 months they will develop retinal vascular attenuation (caused by decreased metabolic demand of the degenerating retina) and tapetal hyper reflexivity (indicates retinal thinning and degeneration and is characterized by a shiny tapetal appearance)
34
What is a cause of hypoxemia in a dog
Low FiO2 which is fraction of O2 and is estimation of O2 amount inhaled
35
What is the treatment of choice for a primary lung tumor in the dog?
Excision with very wide margins
36
What is the end-point of warfarin therapy in an animal with a pulmonary thromboembolism?
A prothrombin time of 1.5-2 times normal
PT (extrinsic factor “PET”) is the best test for warfarin toxicity
PTT (intrinsic) and activated clotting time will be unchanged
37
a dog with a bunch of Q-tips up each nostril in ventral recumbency and intubated on anesthesia-- Q asks what is most likely the complication associated with the post-anesthetic recovery of this dog receiving Clotrimazole (which is an anti-fungal like they use for Athlete's foot/Jock itch)
laryngeal inflammation because clotrimazole is instilled in the frontal sinus and nasal cavity following the debridement of a fungal mass (likely Actinobacillus)
38
A 5-month-old English Bulldog has a hard time breathing with stertor and coughing. Which set of abnormalities is most likely present in this patient?
Stertor is noise created within the back of the throat or nose and is low-pitched and sound like nasal congestion or snoring
Seen with tracheal hypoplasia, stenotic nares and elongated soft palate
Young brachycephalic dogs are afflicted with a number of upper airway abn, collectively termed “Brachycephalic airway syndrome” and includes tracheal hypoplasia, stenotic nares, elongated soft palate, everted laryngeal saccules, and laryngeal collapse.
39
From vet prep Canine Brachycephalic Syndrome Notes:
The congenital components are the elongated soft palate, stenotic nares, and hypoplastic trachea and the acquired components (which are a result of increase airway resistance) is everted laryngeal saccules +/- laryngeal edema, collapse, and or redundant (edematous) pharyngeal folds
TX sx stenotic nares- wedge resections of the nasal fold
Tx for laryngeal collapse is permanent tracheostomy (very advanced)
Everted laryngeal saccules can be grabbed with long pair of Allis tissue forceps or hemostats and be removed with traction
40
What is most likely to provide a definitive diagnosis for a dog with chronic nasal discharge that has nasal aspergillosis
Histopathology which will show the fungal hyphae
41
A dog present to your clinic for coughing and a fever a week after hunting and you find a grass awn in the lungs on bronchoscopy and remove it. What bacterial infection is this dog predisposed to?
Actinomyces-- which is a filamentous branching, gram positive bacteria that is a normal inhabitant of the mouth and oropharynx and is commonly associated with a grass awn migration and can migrate from the nasal passages to the GI tract and cause an issue with diagnosis (Megan Watkin's dog for example)
42
What would cause a dog to have nasty greenish yellow nasal discharge bilaterally with a mixed population of lymphocytes and plasma cells when biopsied?
Idiopathic usually, could be Parainfluenza virus-3, canine adenovirus-2, or Bartonella or Chlamydophila
43
What is the difference between stertor and stridor?
stertor is a gurgling/congested noise that is generally associated with the nasal passages whereas stridor is higher pitched and the sound is usually from the larynx or near it
44
In an animal with pleural effusion, what rads will give you the best view of the heart?
ventrodorsal
45
You can an 11 year-old female spayed lab that is presenting in acute respiratory distress after playing fetch on a hot summer day, on initial exam, Lucy is panting heavily and a loud stridor sound is audible. Upon more history taking, the owners tell you that lucy’s bark has changed over the past couple of months. What is the most common complication/side effect of the recommended treatment for lucy’s condition?
Lar par causing aspiration pneumonia
The arytenoid cartilages fail to abduct during inspiration, resulting in upper airway obstruction. These p usually present with acute clinical signs even though the disease is chronic in nature. Surgical arytenoid lateralization (tie-back) is the tx of choice but with the chronically opened airway, aspiration pneumonia can be a common side effect. If sx is not an option, do prednisone to help reduce laryngeal inflammation
46
the ________ ________ muscle opens the arytenoid cartilage which opens the airway and is innervated by the recurrent laryngeal nerve
cricoarytenoideous dorsalis muscle
47
what is a comorbidity of a dog with lar par that we commonly see?
Hypothyroidism
48
What is considered predisposed to developing nasal aspergillosis?
Dolichocephalic
49
What do you see on chest rads of a dog with pleural effusion?
pleural fissure lines on the lateral and VD views----
pleural fissure lines are diagnostic for pleural effusion, the fissures are the normal divides between the lung lobes and are not visualized on rads unless there is free fluid in the chest or the pleura is thickened. When there is a large amount of fluid, you may begin to appreciate the loss of detail and it is possible that the lung lobes will collapse as a result of the inability to properly expand in the face of pleural effusion
50
What is a lobar sign and when is it seen?
lobar sign is seen when there is a line of demarcation between the radiopaque (consolidated) lung lobe and the radiolucent (normal) lung lobe. There can be many causes for a lobar sign including hemorrhage, edema, or pus within the lobe.
51
What is an air bronchogram and when is it seen?
Air bronchograms are seen when alveolar edema occurs as the result of fluid accumulating within the alveoli. Alveolar edema will result in a sharp contrast between the fluid in the alveoli on the air in the bronchi.
52
A 5 y/o Rottweiler comes in after being kicked by a horse earlier that morning. PE shows skin wound at the chest, you take chest rads and note 1-2 cm regions of localized consolidation. What do you tell the owners?
Pulmonary contusions are likely and your dog needs to be carefully monitored for the next few days bc it may worsen and cause breathing issues
Pulmonary contusions can cause respiratory issues in a p that seems healthy in 24 hours following the trauma, and then they usually improve over the next 1-2 days
53
Carcinomas are _____ in origin
epithelial
54
Tx for intra vs extra-thoracic tracheal collapse--
For extra-thoracic-If cartilage is normal can plicate the redundant membrane (only for mild cases and not done commonly bc med. Mgmt. works too). Can also do plastic rings around the trachea to support it, Teflon tubing and polypropylene syringe cases used but results are ehhhh
For intra-thoracic- Stent possible but can fracture, may see collapse around the stent anyway, if used correctly there is an 80% success rate
55
What is the TOC for aspergillosis in dogs?
Topical antifungal therapy (Clotrimazole)
!!!!! STEROIDS ARE C/I !!!!
Topical antifungal works better than systemic in this case
Synthetic imidazole has an 80% cure rate with a single application
56
You need to start tx for a dog that has been diagnosed with Valley Fever (coccidioides immits). The fluconazole that you normally use is on backorder and the human version is very expensive. You decide to start ketoconazole in the meantime. What is a potential side effect?
Elevated liver enzymes-- Ketoconazole is hepatotoxic and can cause elevated liver enzymes
57
facial excoriation is a potential side effect with _______
methimazole
58
A 10 y/o retriever presents for progressive onset of exercise intolerance and voice changes. On the PE she is overweight and mm are pink with CRT of less than 2 seconds. Lung sounds are clear bilaterally but there is stridorous breathing on inspiration. Laryngeal paralysis is suspected and a sedated laryngeal examination has been rec. to the o. The o agrees to a routine blood panel, chest rads and laryngeal exam. What meds will help in looking at the laryngeal function
Doxapram (can also use injectable anesthetics like thiopental or propofol but only with Doxapram)
59
What is likely to cause resp. distress and an increase in resp. rate in animals that are victims of smoke inhalation (like smoke from fire not cigarette)?
Carbon monoxide inhalation
60
What is the gold standard test for diagnosing thromboembolism (PTE)?
angiography is gold standard (contrast rads)
61
A previously healthy lactating dog 2 weeks after whelping shows signs of restlessness, whining, fever, muscle spasms and convulsions. What is the most likely a cause?
Eclampsia which is due to reduction in serum-ionized calcium secondary to the demand of producing large amounts of milk. Tx is calcium supplementation
62
During which phases of the estrous cycle does the female dog attract the male dogs?
Proestrus and estrus but she will only stand to be mating in estrus
63
A 13-year-old female Dachshund presents for 2 lumps on her abdomen. Your physical exam reveals that both lumps are 2.5 cm mammary masses in the 5th mammary gland. The associated inguinal LN is prominent. Aspirates of the LN show sheets of epithelial cells on cytology. Both mammary masses are firm and nodular in shape. What do you suspect to be true?
The LN aspirate results are a negative prognostic indictor—you should never find sheets epithelial cells in a LN unless it is infiltrated with metastasis (or unless you aspirated something else on accident, like a salivary gland). Metastasis of a mammary gland tumors in dogs is a negative prognostic indicator
64
A dark red vaginal discharge in a bitch 3 weeks after whelping indicates what process?
Normal response--- dark red vaginal discharge occurs normally for up to 6 weeks after whelping. Subinvolution can cause bleeding for 12-15 weeks post-partum
65
T/F
Dogs spayed prior to an estrus are 0.05% times as likely to develop a mammary tumor as an intact dog, that risk increases to 8% and 26% after one and two heats respectively with no decrease in risk if they are spayed subsequent to a 3rd heat
True!!!
66
Frequently, owners question the value of spaying or neutering a dog. In this case, you have a hesitant owner that has come with her new Bichon at 12 weeks of age. Which is true:
Spaying your dog after the 1st heat cycle will result in approx. 8% likelihood of mammary cance
67
what are the CS of an estrogen secreting Sertoli cell tumors in a dog?
Estrogen secretion Sertoli cell tumors are quite common in cryptorchid testes and cause CS of truncal alopecia, hyperpigmentation, bone marrow dyscrasia (close to the earlier stage of leukemia and is where WBC grow uncontrollably), aplastic anemia, gynecomastia and urinating in a female position
68
What is the neoplasm seen in dogs that can be cured in 90% or more of cases with chemotherapy alone?
transmissible venereal tumors can be cured with chemo alone in 90% of cases
69
Dogs in estrus should have what cytology findings of vaginal cytology?
cellular cytology with more than 90% cornified epithelial cells
70
There is a female dog who is intact and is not receptive to males but has a very enlarged vulva, what is happening?
she is likely in proestrus and is normal, vulvar swelling and edema do occur with rising estrogen levels in proestrus
71
What phase of the estrus cycle does pyometra usually occur in the dog?
diestrus, progesterone is the predominant hormone and it promotes endometrial growth, suppresses myometrial activity, and inhibits leukocyte response to infection (all of this predisposes the dog to develop pyometra)
72
In what days of gestation can you see fetal skeletons on rads?
43 days of gestation, the fetal skeletons ossify at 42-45 days in the dog and 35-39 days in the cat. In the dog, the mineralized fetuses can be seen around 42-46 days. The scapula, humerus, and the femur can be made out around 46-51 days and the ribs can be seen at 52-59 days. Their teeth and digits can be seen at 58-63 days
73
If you suspect prostatitis in a patient use what drug???
Enrofloxacin
74
What is frequently associated with testosterone-dependence and is therefore found mostly in dogs that are intact males?
Perianal adenoma- will shrink and resolve after neutering
75
what tx can be used for OPEN pyometra but still OHE recommended?
Prostaglandins (and always use abx with pyometras)
76
A dog FS dog presents for leaking urine while sleeping and rads shows a normal sized bladder. What do you prescribe
Phenylpropanolamine which is a sympathomimetic that results in increased sphincter tone and thus eliminates incontinence (can lead to bone marrow suppression so beware-estrogen like tx)
77
What is the most common presentation for a patient with idiopathic epilepsy?
A dog that is 3 y/o lab and has recently begun having generalized tonic-clonic seizures approximately once a week and most frequently at night when resting and otherwise behaves WNL between seizures.
78
Idiopathic elipsey refers to what?
a specific condition and should not be applied to a p with seizurs from an unknown cause, most dogs with it will being having them between 1-5 years of age
79
where do seizures originate?
from the cerebral cortex and thalamus in the prosencephalon
80
What is a generalize seizure? What is tonic-clonic and absence seizures?
entire brain is involved with complete loss of consciousness
Tonic-clonic “Gran mal”- complete seizure, large amounts of motor activity with big movements, tonic is extension and clonic is flexion
Absence – petite mal seizure- no movements at all
81
what is a focal aka partial seizure?
only part of the brain is involved
82
simple vs. complex seizures:
simple -consciousness is NOT impaired with slight small motor activity like twitching a leg or part of the face
Complex – some loss of consciousness with focal motor activity like in simple
83
A combo of all of the different types of seizures discussed is called a _____ seizure
Jacksonian seizure
84
what does it mean by "pre-ictal" and "post-ictal"
Pre-ictal- this is a period of abn behavior before a seizure (like 30 mins before a seizure)
Ictal- seizure itself, most seizures last <2 mins but not all
Post-ictal phase- period of abn behavior after a seizure (can last from one hour to a couple of days), can include abn neuro findings bc brain still needs time to recover
85
More than 2 seizures within 24 hours is called...
cluster seizures
86
status epilepticus
a single seizure lasting more than 5 mins or repeated seizure without complete recovery in between events
The brain does not have time to recover between events and one seizure usually leads to more
87
ER Seizure drugs:
Benzodiazepines- enhances GABA-- Valium, Midazolam
Barbiturates: Enhance GABA--Phenobarbitol, thiopental, pentobarbital
Others-- Keppra, propofol, isoflurane
88
what are the maintenance meds used for seizure control?
Phenobarbital, potassium bromide, oral benzodiazepines and others including Zonasmide, Keppra, Topimax, and Gabapentin
89
Phenobarbital
works at GABA, metabolized in the liver and SE include sedation, ataxia, pu/pd/pp, Increased liver enzymes (esp. Alk phosph so do not over-interpret on routine labwork) blood dyscrasias
90
Potassium Bromide
works at GABA due to Bromide and excreted via kidneys and SE includes pu/pd/pp, sedation, ataxia, MAY BE linked to pancreatitis in dogs but not proven, but it is proven that cats will get reactive pneumonitis (like asthma) in all cats
91
Oral benzodiazepines
generally short half life and is not the best idea, also p can develop tolerance and can cause liver failure in cats
92
A 6 y/o cocker spaniel with a chronic hx of ear infections presents for circling to the left, with a left head tilt and both rotary and horizontal nystagmus with the fast phase to the right. There is no other neuro deficits and is on ear meds for a previous ear infection, what med was probably used causing this vestibular disease?
Chlorhexidine- ototoxic and causes peripheral vestibular disease; other cytotoxic meds include aminoglycosides
93
You have an 8 y/o MN Boxer presenting for drooping face, o said it was acute and the owner noticed it when they woke up this morning and appears to be unilateral. You are performing a cranial nerve exam to try and determine where the lesion is located. What is true about cranial nerve VII (facial nerve) in a dog?
A branch of the facial nerve is responsible for taste in the rostral 2/3 of the tongue
94
You are examining the eyes of a dog and see that he has positive menace response and dazzle reflex and is visual but lacks a palpebral reflex, where does he have a lesion?
Dazzle is when the eyes shut in response to a bright light
CN V
The trigeminal nerve is CN V and is the largest CN
It provides sensory innervation to the face and is divided into three main branches-- the ophthalmic, maxillary, and mandibular nerves.
CN V to open eyelids and CN VII to close eyelids
95
A 3 y/o MN Doberman presented for weakness and difficultly walking, your PE showed ataxia in all limbs and he has conscious proprioception in all libs. He has a stiff gait stilted in all limbs and all spinal reflexes are hyper-reflexive with all limbs also having increased muscle tone. Where is the anatomic localization of this lesion?
C1-C5 localization
96
How would you evaluate whether or not the mandibular branch of cranial nerve V (the trigeminal nerve) is functionally intact in a dog?
Looking for symmetry and tone of the muscles of mastication
The mandibular branch of CN V carries sensory and motor function to the muscle of mastication
97
Which breed and differential diagnosis are most commonly associated with canine degenerative myelopathy?
GSD with hip dysplasia
98
What is canine degenerative myelopathy?
it is a progressive, degenerative spinal cord disease that occurs commonly in GSD between the ages of 5-9 and causes random axonal degeneration in all spinal cord segments but is usually most severe in the thoracic cord. It is caused by defect in SOD-1 gene and is often is confused with hip dysplasia
99
IVDD and o does not want to do sx?
TOC is strict cage rest for a full 8 weeks
((Steroids, analgesics and/or muscle relaxants are also useful but STRICT cage rest is the most important ))
100
A 5 y/o MN Corgi presents for acute paralysis of its pelvic limbs, the owners note that the dog was fine in the morning but in the evening became paralyzed in the HL after he jumped off the bed. The dog has hyper-reflexive spinal reflexes and no motor function or deep pain in the HL. CBC and chem and US show WNL and survey spinal rads show a narrowed disc space between T11-T12. What is the next appropriate step for this p?
Contrast myelogram and decompression sx
101
Rabies diagnostic test is direct fluorescent antibody test, will also see Negri bodies on microscopic exam BUT THAT IS NOT THE ANSWER THEY WANT THEY WANT DFA bc Negri bodies are only seen 50% of the time
DFA is rapid and sensitive
102
What is the prognosis for a dog with spinal trauma that has no deep pain for more than 24 hours?
poor with sx repair bc lack of deep pain with the spinal cord trauma is poor prognostic indicator and even with sx, there is less than 5% chance return to function
103
What is the TOC for head trauma p with increased intracranial pressure?
Mannitol which is a hyperosmotic diuretic and decreases cerebral edema by establishing an osmotic gradient between the plasma and cells
104
Hansen type ___ disc disease usually involves chondrodystrophic (wiener dogs, shih tzu’s, corgis, etc.) breeds and is usually acute, painful and should be considered an ER
type 1
105
Sometimes radiographic contrast in myelograms can cause seizures, what do you do if that happens??
if this happens give a rescue dose of 0.5mg/kg Diazepam IV immediately, can also use midazolam
106
Facial contraction with a smirk= Tetanus, know that tx involves wound debridement, sedation, abx and giving a tetanus antitoxin can cause anaphylaxis
antitoxin would prevent further toxin binding but does not affect the already bound toxin so it helps decrease the progression of CS without reversing what is already present
107
T/F Tick paralysis starts with HL weakness progressing to ataxia in the FL as well and flaccid paralysis, p recover fast after tick is removed
True!!!
108
A poodle presents for L sided head tilt, ventral strabismus on the L, R horizontal nystagmus, the dog is obtunded with conscious proprioception deficits in both R limbs and has R sided facial paralysis. Where is the lesion??
Central NS on the Right
109
You are doing a PE on a dogs and he has dazzle but no palpebral, where is the lesion?
CN V
110
A dog presents with head trauma and is obtunded but the rest of the PE is WNL, what is the first thing you should try to do to minimize intracranial pressure?
maintain HIGH PaO2 and LOW PaCO2
111
A dog is presenting for megaesophagus, what is the tx for the most likely disease the dog is presenting for?
They are looking for you to know that the dog is likely experiencing Myasthenia Gravis, so you need to tx with Cholinesterase inhibitors. MG is caused by antibody-mediated (Type two hypersens) destruction of acetylcholine receptors. Cholinesterase inhibitors decrease the break down of acetylcholine and make more acetylcholine available to bind to the remaining acetylcholine receptors
112
Intramuscular injections into the caudal aspect of the thigh muscles are most often associated with damage to which major nerve in the dog?
Sciatic
113
What is a myelogram??
is a positive-contrast rad study where contrast like iohexol or iopamidol is injected into the subarachnoid space where CSF accumulates
114
Phenobarb levels need to be checked and do labwork for assessment of what and why??
of liver function because it is metabolized by the liver
115
What branch of the cranial nerve V (trigeminal nerve) is responsible for motor function of the mouth
Mandibular branch
116
what does the manidbular branch do?
supplies innervation to the muscles of mastication
117
What tumor is considered a “soft tissue sarcoma” for its locally invasive behavior and relatively low metastatic rate for most low and intermediate grade tumors?
peripheral nerve sheath tumor
118
soft tissue sarcomas inormation
a group of mesenchymal tumors with a similar biologic behavior, namely a locally invasive growth pattern and a metastatic rate of less than 20% (but 50% with high grade), these tumors include peripheral nerve sheath tumors, hemangiopericytomas, fibrosarcoma’s, liposarcomas, malignant histiocytomas, myxosarcomas, rhabdomyosarcomas (skeletal muscle), and leiomyosarcomas (smooth muscle)
Tx is aimed at sx with wide margins
Local recurrence is common if wide margins are not used in sx
Chemo would be rec. if mets present, use doxorubicin most commonly
Check lungs for mets and external tumor is usually “tip of the iceberg” so rads or MRI is useful for sx planning
119
A 4 y/o Dobie presents with slowly progressive ataxia and paresis of all four limbs with hyper-reflexive spinal reflexes in all limbs and delayed conscious proprioception in all four limbs with neck pain on ventroflexion. What is most likely the diagnosis?
cervical spondylopathy which usually manifests as sporadic ataxia and paresis of all limbs and UMN of all limbs
120
cushings reflex causes...
bradycardia and hypertension
121
what is tx of MG??
TOC is pyridostigmine which is an acetylcholinesterase inhibitor
Would also do steroids and sucralfate
122
A lot of muscle atrophy on the R side of the masseter and temporalis muscles is likely what?
right trigeminal nerve neuropathy
123
what is masticatory muscle myositis?
an autoimmune disorder that chronically leads to atrophy of the same muscle groups are trigeminal nerve neuropathy but signs will be bilateral and not unilateral
124
what is wobbler's syndrome? Aka cervical spondylomyopathy
Two engine gait that gets better with anti-inflammatory dose of steroid
AKA CERVICAL SPONDYLOMYOPATHY
125
Patient with a mass in the mediastinum of rads and dog with CS consistent with thymoma (progressive tetraparesis, weakly ambulatory with support)
suspected secondary to MG- tensilon (edrophonimum) is a rapidly anticholuinesterase drug that reverses signs of MG within minutes in most dogs
Answer was do a Tensilon test
126
What is the most likely SE of Kbr (potassium bromide) in epileptic dogs?
Sedation
127
What breed and ddx is most commonly assoc. with canine degenerative myelopathy?
GSD with hip dysplasia
128
A dog presents with acute onset of ptosis, drooping of the lip, and drooping of the cheek on the left side. What is likely the nerve that has been damaged?
CN 7 (facial nerve responsible for facial muscles and sensation in the ear and lacrimation)
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You want to anesthetize a dog that has a history of seizures since it was 2 years of age, what drug should not be used in the anesthetic protocol as it may promote seizures in this predisposed patient?
ketamine
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What drug has been associated with seizures in epileptic dogs?
ketamine
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Dog with left head tilt that has paradoxical vestibular disease has right cerebellum lesion localization
Vestibular disease can be peripheral or central, central vestibular disease can be classic in appearance or paradoxical. Peripheral vestibular disease is due to a lesion in the inner ear or vestibular portion of CN 8. Classic central vestibular disease is due to a lesion in the brainstem or cerebellum. Signs with peripheral and classic central vestibular disease includes head tilt, falling, and circling to the same side as the lesion with nystagmus with fast phase on the opposite side
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___ tells LMN what to do and LMN lives in the ____
UMN (which live in the brain) tell the LMN what to do which lives in the spinal cord
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What is HOD?
-usually in larger breed dogs that are young, it causes lameness and can recur, tx is analgesia and supportive care, radiographically, you will see line of lucency where bone has been destroyed, typically parallel to the growth plates of the affected bones “double physeal line”
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what is immune mediated polyarthritis?
Has erosive and non-erosive forms, non-erosive forms have lack of radiographic evidence of cartilage or subchondral bone destruction, the erosive form is rare and is thought to account for less than 1% cases of IMPA
Non-erosive can be from systemic infections, inflamm, or neoplasia or drugs or vaccine rxns but is most commonly idiopathic
CS are anorexia, wt loss, lethargy, and lymphadenopathy, but some does have no CS --Walking on egg shells also
Diagnosis with synovial fluid analysis- fluid with IMPA will be thin, turbid, increased numbers of proteins and cells and esp. nondegenerative neutrophils
TX is immunosuppressive TX --About 80% of the p will respond to this tx
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A GSD presents for lameness that is getting a lot worse, fever, and reluctant to stand/walk. Based on the most likely diagnosis what is the prognosis?
assuming it is panosteitis (confirmed with rads showing intramedullary densities within the bone diaphysis) it is self limiting and prognosis is excellent
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Panosteitis affects what bones? what is the toc?
Affects long bones (will see intramedullary densities within the diaphysis) and TOC is NISAIDs, and limiting activity and it will resolve on its own in weeks to months
It affects the ENDOSTEUM OF BONES
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What is the difference between HOD and Panosteitis
HOD is somewhat similar to panosteitis (pano) in that it affects the growing leg bones of large- or giant-breed puppies. However, pano usually affects only one leg at a time, and is thought of as “growing pains.” HOD can affect more than one leg at the same time, and is more painful than panosteitis. In addition, unlike pano, HOD can permanently damage the growth plates
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Elbow dysplasia is a global term for several congenital conditions which can occur. These include ....
ununited anconeal process, osteochondrosis of the humeral condyle, elbow incongruity, and a fragmented medial coronoid process
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Craniomandibular osteopathy (CMO)
seen in young dogs and is exemplified in this radiograph, terrier breeds have it most commonly but it can be seen in any breed. The disease is usually self-limiting and typically regresses by 1 year old and is thought to be a form of hypertrophic osteodystrophy (HOD) of that occurs in the mandible but can also occur in the tympanic bulla, temporal bones, and TMJ. Tx is supportive care and NSAIDs (like HOD) and prognosis depends on p can open and close its mouth, and rad signs will go away with time
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The what is usually also damaged in p with CCL ruptures because it is closely assoc. with the medial collateral lig which prevents the meniscus from moving all around within the joint
medial meniscus is usually damaged in p with CCL ruptures ***There is less than a 7% incidence that there will be a medial meniscal injury after a TPLO procedure
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What is an appropriate objective in the repair of an articular fx in a dog?
Early return to functioning
With articular fx, 3 major goals are:
Rigid fixation of the fracture fragments, anatomic realignment >75%, and early return to function
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What is the tx of hyperextension of the carpus in a dog?
carpal arthrodesis
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bunny hopping gait in large breed dogs is most commonly seen with....
with hip dysplasia
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What are the parts of an inguinal hernia?
external and internal abdominal oblique, external and internal inguinal ring, rectus abdominis, and inguinal ligament
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what usually is associated with a CHEST MASS and there is no age predisposition and the disease usually starts at the distal extremities and develops proximally. It is characterized by periosteal proliferation near the joints
HO
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If you suspect septic joint, do cytology and then do a culture- septic joint will have what?
septic joint will have neutrophils and bacteria whereas IMPA will not have the bacteria
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what is gold standard diagnosis of osteosarcoma (OSA)?
Biopsy of the affected bony lesion
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Where are the most likely regions of traumatic hernia in dog that jumped out of a truck
Flank and prepubic region
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An owner comes to you and their dog has L HL lameness and you detect pain on extension of the hip as well, but is more severe on the left and the owners do not have funds for surgical correction but ask what can be done to make the dog more comfortable, what do you do?
Bloodwork to make sure kidney and liver functions are good before starting NSAIDs (Carprofen)
i. This dog has classic signs of OA and not osteosarcoma likely because more than one limb is affected, NSAIDs are the mainstay of medial management for dogs with OA which can have an effect on kidney and liver because of their excretion by these organs so need to assess them before starting on NSAID
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benefits of omega-3 rather than omega-6's:
omega-3 FA results in increased production of *eicondanoids* that are less inflammatory and has been shown to be preferred to help with OA rather than Omega-6 FA
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For a 2 y/o lab with right FL lameness and radial valgus in the right antebrachium, what tx do you recommend?
Corrective osteotomy
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What you do to tx a hiatal hernia?
Esophagopexy in conjunction with a left sided gastropexy which will prevent the esophagus from herniating back into the thoracic cavity
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What is not an option for a femoral fracture?
Type 2 ex fix because the medial aspect of the femur cannot be approached for a type 2 ex fix due to bone being directly adjacent to the trunk of the p, but you could place a type 1 ex fix on the lateral aspect of the femur for fx fixation
154
If you have a medially luxating patella, what do you need to do?
Transpose the tibial tuberosity laterally in order to line up the patellar tendon with the rest of the stifle in an effort to reduce the likelihood of patellar luxation
The 2 most impt procedures that reduce the incidence of recurrence are lateral transposition of the tibial tuberosity and modifying the trochlear groove of the femur
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Total hip replacements
Can be done as soon as the physes in that region stopped growing and have been done in dogs as early as 1 y/o and sometimes even younger
Craniodorsal luxations are more common than other
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what does suppurative nonspecific inflammation mean??
non-degenerative neutrophils
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what does granulomatous mean?
mostly mononuclear cells (lymphocytes, macrophages, plasma cells)
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what does pyogranulomatous mean?
mixed neutrophils and mononuclear cells
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A dog ate a lot of chocolate, what is the first sign you may see in this dog with chocolate toxicosis?
Cardiac tachyarrhythmias
Toxic principal in chocolate is methylxanthines (spec. theobromine and caffeine) which cause CNS excitement, tachycardia, and vasoconstriction. Signs include v/d, hyperactivity, pu/pd, tachycardia, cardiac arrhythmias, seizures, and death
It may also cause pupil dilation (mydriasis)
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In large doses, epinephrine causes what?
Increase in total peripheral resistance, increase cardiac contractility and bronchodilation
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How to definitively diagnose canine distemper?
Immunofluorescent assay (IFA) on affected epithelium
CS include diarrhea, increased respiratory effort, seizures
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What type of sx would nitrous oxide be C/I for anesthetic protocol??
GI sx because it would move into the intestines since they are a closed gas space, it is also C/I with pulmonary bullae present
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A client brings in a dog that recently ingested rodenticide that has the active ingredient of cholecalciferol. The dog is apparently healthy rn, but what would happen if you did nothing?
Development of organ mineralization because Cholecalciferol (Vit D3) acts by converting into calcitriol and increases Ca and phosp levels leading to mineralization of the organs, esp. the kidneys
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what is used as a treatment/chelator for lead poisoning?
Calcium-EDTA
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What drug is known to cause a significant release of histamine?
Morphine- do NOT USE IN P WITH MCT
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DO NOT EXCEED ___/kg/hr of Potassium in fluids
0.5mEq
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Salmon poisoning disease- Neorickettsia helminthoeca which is vectored by intestinal fluke, Nanophyetus salmincola and dogs get it by eating salmonid fish infected with the cercaria of the fluke which harbor the rickettsia. What is the TX?
with tetracycline abx for CS and the fluke itself is not responsible for CS but can be tx with Praziquantel
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Hypersensitivities--->
Type 1- IgE immune mediated
Type 2- cytotoxic IgM IgG atibody-dependent ex neonatal isoerythro. In horses with stallion Qa positive and mare Qa negative and foal ingesting mare’s colostrum and like MG
Type 3- immune complex mediated reaction
Type 4 -a delayed hypersensitivity and is cell-mediated
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what is the most common heart base masses?
Chemodectoma and HSA (hemangiosarcoma)
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MG with megaesophagus and mediastinal mass is likely...
thymoma
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Does Myasthenia gravis usually resolve after removal or a thymoma?
yessss
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What are the most common serovars that play a role in canine leptospirosis?
Grippotyphosa, Pomona, and Bratislava
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What is the most likely common vector for lyme disease?
Ixodes pacificus
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Rocky mtn spotted fever= ______ ticks
Dermacentor ticks
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Amblyomma Americanum (lone star tick) may transmit ___ _____ and Anaplasma
Ehrlichiosis EWINGII
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what tick is known to transmit Ehrlichia canis, what about ewingii???
Rhipicephalus sanguineus tick; lone star tick (Ambylomma americanum)
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Bartonella information--
Bartonella henselae is the bacteria causing cat-scratch disease and humans will get fever, malaise, weight loss and lymphadenopathy, cats show no CS but dogs show the CS listed but they can also get endocarditis (usually southern ticks or fleas carry it to cats and cats spread it without any CS)
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what is an anti-cholinergic drug that is a pre-med and intra-op for increasing HR and it causes decreased tear secretion, salivary secretion, and GI tone/motility
Atropine
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What anesthetic agent is C/I in malignant hyperthermia?
Halothane which can cause hyper-metabolic reactions in skeletal muscle causing muscle rigidity, increased body temp and O2 consumption (mostly in swine)
180
best tx of pythium
Amputation/sx with antifungal tx long term (mainstay is sx- like an amputation if limb is affected)what virus in dogs causes enamel hypoplasia of the canine teeth
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What virus in dogs may have caused enamel hypoplasia of the canine teeth? What drug in younger years of the dog could have also done this?
Distemper virus; tetracyclines
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What can be best viewed under dark field microscopy?
Leptospira, it is a negative organism that stains poorly and grows slowly
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What is the major potential s/e of chemotherapeutic drug Adriamycin in dog?
cardiotoxicity
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List the chremodrugs and their common S/E
Vincristine can cause ileus
L-asparaginase can cause anaphylaxis
Cisplatin can cause horrible lung issues
Cyclophosphamide can cause cystitis
Adriamycin cardiotoxic
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the main S/E of antivenom is
Anaphylaxis but can have serum sickness delayed at 1-2 weeks from antivenom
BETTER THAN VENOM which is coagulopathic, and/or neurotoxic and causes firm swelling where injected, pain, thrombocytopenia, and prolonged PT and PTT (both being severely elevated)
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What would you expect in hypervitamtosis D?
High calcium and high phosphorus
Side note- PTH causes high Calcium but normal phosphorus because it also enhances renal phosphorus excretion
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what do you tell an owner that has a dog where U/S show a tumor invading the vena cava, what do you tell the owner?
invasion of the vena cava is not necessarily associated with an increased mortality rate and surgery should still be considered
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what can you premed a patient with that has a tumor in the vena cava causing hypertension to increase the likelihood of survival?
phenoxybenzamine (also used to tx hypertension from pheocytochroma)
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Patient is in shock and ascites glucose is 100 and lactate is 2.8.; What do you tell the owners?
surgical exploratory ER-- septic abdomen is an ER and requires surgical intervention
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sepsis is suspected if the glucose in the ascites is at least ____ mg/dL less than peripheral blood and a blood lactate of more than ____ means suspicion of septic abdomen as well as presence of intracellular bacteria
20mg/dL; lactate of 2
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what other signs tell you there might be septic abdomen other than lactate over 2 and glucose in the ascites being at least 20mg/dL less than peripheral blood???
hypotension, bradycardia, and hypothermia
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doxycycline can cause esophageal strictures in cats and dogs and can cause what in puppies?
tetracyclines (so doxy too) can cause enamel hypoplasia in puppies
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what do you do in a cat that is hypothermic and is in shock?
administer 1/4 of the 60mg/kg dose of crystalloids along with aggressive temperature support
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cats vs dogs in shock
cats in shock will be hypothermic with bradycardia, and hypotension and DOGS are the OPPOSITE
But dogs will present that way with sepsis
195
What anesthetic gas has the fastest onset of action in the dog?
Desflurane- the it is not very soluble therefore it has a faster onset of action
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In order from fastest to slowest anesthetic inhalants, how does it go???
Desflurane, Nitrous oxide, isoflurane, halothane, diethyl ether, methoxyflurane
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who is not a good candidate for thiopental and why not??
sighthounds bc they have low fat and thiopental is an ultra-short acting barbiturate and recovery depends on re-distribution to tissues including fat
198
what drug can you not use in MCT patients because why?
cannot use morphine in MCT patients because of histamine release
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Signs of ongoing or acute chorioretinitis
poorly defined gray spots throughout the fundus, retinal separation, and retinal hemorrhage
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Lens removal is strongly rec. with several conditions but which is a condition where it needs to be removed immediately?
anterior lens luxation
