Vet prep dog/cat part 2 Flashcards
Why should you always be ready to ET tube a p when inducing with propofol?
It causes severe apnea sometimes
How do you take care of anaphylaxis/Type 1 hypersensitivity reaction
anti-histamines, corticosteroids, and epinephrine as needed + fluids and supportive care
What fungal infection is considered contagious and zoonotic?
Beware not to confuse contagious with infectious, Sporotrichosis is the answer and the other choices are coccidioidomycosis, Aspergillosis, Blastomycosis, and Cryptococcosis (which are all infectious but not contagious—they are mainly acquired from the environment and transmission from animal to animal is rare)
do not confuse what two fungus?
DO NOT confuse cryptococcus with cryptosporidium, which IS very contagious and zoonotic—the cow poop one)
what fungus is high risk to vets with handling cats who have wounds?
Sporothrix aka rose gardeners disease
cat bites usually carry what bacteria?
Pasteurella
A dog presents with fever and lymphadenopathy, you do aspirate of the LN and find large, bipolar staining coccibacilli and o mentions the dog was eating a rat a few days ago, what should you be thinking?
Yersinia pestis which is transmitted to dogs and ats via ingestion of rodents or bites from the prey’s fleas, this is the Plague
Dogs usually recover and you may have to lance the “buboes”
Dogs and cats are poor vectors of the Plague thankfully
What anesthetic agent is not to be used in malignant hyperthermia?
Halothane
what is the derangement???
Base excess -8 normal -5 to 0 mmol/L
anion gap 18 (8-25 mmol/L)
pH 7.30 (7.35-7.45)
pCO2= 29 (34-40)
metabolic acidosis, respiratory alkalosis
pyoderma in dogs information
pyoderma is common in dogs because the canine stratum corneum is not the best barrier the bacteria and their skin lack ostial hair plugs in their follicles, which allows bacterial (like staphylococcus pseudointermedius being the most common one) to colonize and make an infection (cocci on cytology)
what is the tx of puppy strangles?
aka juvenile cellulitis tx with prednisone and abx
fever and generalized lymphadenopathy and dogs will be affected around the muzzle, pinnae, eyes and abx and steroids are needed for tx
what do you prescribe to a dog with sneezing, ocular discharge but otherwise healthy, you think it is a viral URI with possible secondary bacterial infection, what do you prescribe?
cephalexin
a dog was given an antibiotic for an URI infection and now presents to you for severe cutaneous ulcerations, and skin biopsy confirms coagulative necrosis of the epidermis with mixed inflammation in the dermis and epidermis, what should you tell the owner?
You are most concerned that a severe and life-threatening cutaneous drug reaction occurred and the dog should be hospitalized for supportive care and testing
The hx and clinical appearance is consistent with toxic epidermal necrolysis which is usually associated with adverse drug reactions and can be life-threatening
Anal gland tumors are usually apocrine gland adenocarcinomas but FNA is need
They are assoc. with hypercalcemia and sub lumbar LN are the most common sites for mets
What dog breed is predisposed to canine familial dermatomyositis?
collies- the disease causes atrophy of the muscles and erosion, crusting, and alopecia od the skin that gets a lot worse with sun or heat exposure and tx is high doses of steroids but usually does not even help, Omega 3 FA, and vitamin E
what do you tell the owners of a collie that was just diagnosed with canine familial dermatomyositis???
the disease is cyclic and will regress on its own, diagnosis is made with skin or muscle biopsies but can hard to get a good sample because it will wax and wane so much and its usually caused by immunosuppression
what method do you NOT use for taking ticks off?
burn off the ticks is not recommended because it can cause the ticks to be agitated and regurgitate their stomach contents
what are the types of eosinophilic granuloma complexes in cats and what do each of the terms mean???
Indolent ulcer: most commonly observed as an ulcerative symmetrical lesion on the upper lip
Eosinophilic granuloma: found in mouth or body
Eosinophilic plaque: commonly observed as linear plaques on caudal thighs.
Flea allergy dermatitis in cats can present with different distributions of clinical signs – caudal dorsal, symmetrical alopecia, or face and neck
Localized demodex in young dogs does not usually need to be tx because it clears up on its own, T/F
True!!!!
Ivermectin is used to treat localized or generalized demodex??
Generalized but Amitraz is the only FDA LABELED DRUG don’t use steroids
Localized is the puppy normal one
GENERALIZED IS THE OLDER IMMUNOCOMPROMISED GENETIC ONE
Information about demodex
use ivermectin to treat generalized forms
Benzoyl peroxide shampoos should be used in demodicosis patients by aiding in follicular flushing but will not directly kill the mites, demodex is a species-specific mite and is not considered zoonotic
Do not treat demodex patients with prednisone because it will cause immunosuppression and lead to worse response to the mites
Demodex= need deep skin scrape because they reside in the hair follicles (deep)
we usually talk about demodex canis but what is the other one that is not nearly as common but may show up on NAVLE??
There is also Demodex injai which causes greasy seborrhea especially on the face and dorsal trunci and terriers and shih tzus may be predisposed, some dogs may be pruritic and the mite is slender when compared with demodex canis and still needs a deep skin scrape
demodex is a ____ skin scrape and sarcoptes scabei is a _____ skin scrape
Demodex is DEEP and scabies is SUPERFICIAL
What is discoid lupus erythematosus?
is an autoimmune condition that can result in ulcerative nasal dermatitis and loss of cobblestone appearance
There is low risk of transfer of Staphylococcus pseudointermedius from animals to humans since staphylococcus is host-adapted to dogs
It can be transmitted to humans that are immunocompromised but its not very common
Staph aureus HOWEVER IS a risk to humans, since it is host adapted to humans
A 3- month old bully presents with generalized alopecia and crusting of the skin, a deep skin scraping shows the dog has generalized demodicosis. What do you tell the owner?
The dog likely has an inherited defect in cellular immunity and should not be bred
what usually causes generalized demodicosis in juveniles and pups is usually caused by inherited defect in what? how do you tx???
cell immunity; tx with mite killing agents and oral abx for the secondary bacterial infection(s)
What is the tx for generalized demodex that IS FDA APPROVED
amitraz (Mitaban)
Ivermectin and milbemycin can also be used to tx this but only if Mitaban is not carried in your hospital but they are NOT FDA approved for it
Acral lick granuloma
usually solitary, about 50% of them will be diagnosed as idiopathic or psychogenic but other underlying disease must be ruled out and most lesions are deep bacterial infections and tx should include systemic abx based on deep culture sample
the lesions will not resolve without topical abx tx
dermatomyositis lesions and tx
start as papules and vesicles and eventually rupture, muscles of the face will be atrophied and the muscle (which is directly over the ramus) usually this condition will wax and wane and prognosis varies
tx is immunosuppressive doses of steroids and Pentoxifylline (which is used to improve blood flow) and cyclosporine
Seen most commonly in collies
more than ____ Malassezia yeast is abnormal in ear cytology
5 yeast per HPF
what is proper tx for yeast in ears?
tx include Tresaderm (thiabendazole, neomycin, and dexamethasone), Mometamax (mometasone, gentamicin, clotrimazole), and Otomax (gentamicin, betamethasone valerate, and clotrimazole), you will not send home triple antibiotic ointment (neomycin, bacitracin, and polymyxin B) because it is an anti-biotic WITHOUT any anti-fungals
what is the most common SE with ivermectin?
Neurological toxicity, will be reversed after stopping the medication
Malassezia infection of the claws usually produces a red to brown discoloration of the nails closer to the nail bed
symmetrical lupoid onychodystrophy results in splitting and breaking of the nails with deformation of the nails
A 10 year old boxer presents with a mass on her neck and the mass was diagnosed as MCT based on FNA, she was screened for mets and did not have any found, the mass was removed by non-clean margins resulted on histopathology and it came back high grade (grade 3). What do you tell the owner?
Start tyrosine kinase inhibitor chemotherapy drug (Palladia)
MCT are highly responsive to radiation therapy
how to treat some furunculosis/folliculitis on the chin of a dog?
clean the area with benzyl peroxide shampoo or gel
Same w chin acne on cats— can use Stridex pads
what is a skin auto-immune disease that requires immunosuppressive therapy and tx is steroids and maybe some other immunosuppressants
Pemphigus vulgaris
what is the most common dermal malignancy in dogs
MCT
what is the TOC of MCT???
excision with 2-3 cm lateral margins and 1 fascial plane deep is needed and TOC if mets is not already present is sx but if mets present, need radiation and/or chemo too
Also RX predisone because it is cytotoxic to mast cells, give H1 blocker like Benadryl aka diphenhydramine (not IV tho), and H2 blocker like famotidine or ranitidine, do NOT use morphine drugs when in sx or after sx because they can cause more histamine release!!!!
What is an FDA-approved tx for cancer in dogs???
Toceranib phosphate (Palladia) since 2009
It is an inhibitor of a membrane-bound signaling molecule called a receptor tyrosine kinase and they are blocked by Palladia
If you are suspicious of methicillin resistance with a skin infection, use ___________
clindamycin; Could also use TMS UNLESSS the Q specified it was a Doberman because TMS in Dobermans can cause anemia, thrombocytopenia, arthritis, and renal toxicity due to a type 3 hypersensitivity in their breed with this abx
Chloramphenicol could be used but best to reach for clindamycin first
what drug can cause anemia and thrombocytopenia in Dobermans?
TMS
Continue skin abx for ___ days after resolution of CS
7-21 days after resolution of CS because deep pyodermas involve tissues deeper than the epidermis or even dermis/subcutis so the surface may be healed but the deeper layers may still need abx
Always continue abx for 7- 21 days after resolution of CS
what to do for deep pyodermas–
Deep infections can require up to 12 weeks of abx in some cases whereas superficial infections need 3-4 weeks of abx for reference
For deep pyoderma- keep on abx til 2 weeks past resolution of CS and 1 week past for superficial skin lesions
What breed is predisposed to acanthosis nigricans?
Dachshund
what is acanthosis nigrcans
It is characterized by hyperpigmentation of the axillary and groin areas and can spread to other parts of the body and these areas are predisposed to other issues like bacterial or yeast infections and/or seborrhea
The mode of inheritance is autosomal recessive or polygenic inheritance
You are called to a house call to see a 3 y/o lab showing red, ulcerative, thickened areas around both eyes (periocular edema) and facial pruritus and has been a recurrent problem for 4 months now and the o says the episodes happen when the dog stays indoors.
What do you do next and what are the next steps???
perform a conjunctival swab and aspirate of the edematous parts of the eye and it reveals lots of eosinophils, suspect hypersensitivity
(edema is a common sign of type 1 hypersensitivity reaction or allergy. The intermittent nature of the episodes suggests some type of allergic reaction, most likely infrequent contact with a potent allergen to which the dog has become sensitized)
A 3-year old spayed lab presents with pruritus, the owner reports that over the past year and a half she has been licking and scratching her ventrum, paws, ears, and face, mostly in the summer. The dog is on flea control. What is likely the most successful tx for the most likely PRIMARY UNDERLYING ETIOLOGY of the dog’s pruritus?
Hyposensitization injections based on intradermal skin test results
Based on the signalment and history and PE, you should be most suspicious of atopic dermatitis (atopy)
Tx pyoderma with what abx?
Cephalexin and chlorhexidine shampoos for 8 weeks (2 weeks past resolution of CS)
Incidental pinnal alopecia can be seen in some dog breeds like what breeds???
Dachunds, American or Portuguese water dogs, spaniels, chi, Italian greyhounds, whippets, boston terriers, mini poodles, and weims
A 3 y/o wire fox terrier presents for pruritis, crusted papules, alopecia, erythema and excoriations distributed mainly around the caudal half of her body. The changes are fairly bilaterally symmetric and are most prominent at the dorsal lumbosacral region, tail base, perineum and medial thighs. Which of the following interventions will be most successful at treating the most likely PRIMARY UNDERLYING ETIOLOGY of the dog’s pruritus?
Topical administration of imidacloprid and permethrin
Based on the signalment, hx, PE you should be most suspicious of flea allergy dermatitis (FAD) which can occur with rapid onset and lesions as described
What will you see on IMHA p?
spherocytes, autoagglutination, positive Coomb’s test, regenerative anemia (will also see regenerative anemia with Heinz bodies) also do R N A test I learned about at hillside (reactive nuclear antibodies)
What is IMHA/what causes it??? TX for it???
IMHA is when RBC are coated with immunoglobulins and are then engulfed by macrophages. AS a result the RBC will lose a portion of its cell membrane but not Hgb. With the loss of part of the cell membrane, spherocytes appear smaller (without volume loss), no central pallor, and stain deep red
Can cause an increased risk for thromboembolism in patients so beware of that
Tx with azathioprine and prednisone commonly
what are the SE of azathioprine (which is an immunosuppressive drug)
SE of Azathioprine is hepatotoxic, can cause acute pancreatitis, GI upset an bone marrow suppression (with GI upset being the most commonly reported) Cats are more sensitive to the drug because of a deficiency in thiopurine methyltransferase which is the enzyme that is used to metabolize azathioprine so it should be used with heavy caution, if at all, in cats
What does hypochromic microcytic anemia mean???
means the RBC are less red and smaller (means iron deficiency)
what type of anemia will a IMHA p have? What is the breed that is over represented?
IMHA poster child is the cocker spaniel and presents with normocytic normochromic regenerative anemia with autoagglutination and spherocytes with CS as pale mm, lethargy, depressed, inappetence, mildly tachycardic, anemia with spherocytes and CBC/WBC WNL
TX with packed red blood cell transfusion, prednisone, and cyclosporine
What anesthetic do you choose that do not cause the spleen to engorge/enlarged while doing a splenectomy?
Morphine followed by diazepam and ketamine (Xylazine, diazepam, ketamine, propofol, and opioids do not cause the spleen to change size)
The mean circulating lifespan of a neutrophil in a dog is _____ hours
5-9 hours
what is the neutrophil lifespan in cattle? Horses?
Cattle is 16 hours and horses is 10-11 days
what is the RBC lifespan in dogs? What about horses? Pigs? Sheep?
dogs- 110 days
cows- 70 days
horses- 145 days
pigs- 86 days
sheep- 150 days
SMILED stress leukogram means what?
Segmented neutrophils and monocytes increased, lymphocytes and eosinophils decreased
what does chronic lymphocytic leukemia look like?
Small, mature lymphocytes with lymphadenopathy and prominent spleen, high reticulocytes, lymphocytes, and bone marrow aspirates showing 40% small lymphocytes and another mass aspirate showing 90% small lymphocytes
Canine thrombopathia information:
Autosomal recessive trait in Basset Hounds where platelets fail to aggregate and secrete their granules in response to normal stimuli which causes increased risk of bleeding spontaneously
Platelet numbers and coag. Panels will be normal (it is an issue with platelet function not number)
The Q was a basset hound with epistaxis from both nostrils with ecchymoses hemorrhages on the skin in his abdominal region but PE otherwise WNL, and coag WNL and not anemic
There is a basset hound with epistaxis from both nostrils with ecchymoses hemorrhages on the skin in his abdominal region but PE otherwise WNL, and coag WNL and not anemic, what do you suspect?
canine thrombocytopathia which is an autosomal recessive trait usually seen in Basset hounds (platelet numbers and coag. Panels will be normal (it is an issue with platelet function not number)
What do you administer a Doberman that has mild chest contusions and elevated BMBT?
Desmopressin acetate which is a vasopressin and results in release of von Willebrand factor to help the p with clotting since it has elevated BMBT it likely has von Willebrand disease
Cryoprecipitate from random donors is no longer an optimal choice because of the risk of transfusion-associated viral infections
What is a common finding on CBC of a dog with a ruptured splenic hemangiosarcoma?
Schistocytes which are fragmented RBC that are mechanically broke up due to irregular vessels and fibrin strains
Would also have thrombocytopenia, anemia, and leukocytosis
Low MCV, MCH, MCHC and hct with normal reticulocyte is most likely
Iron deficiency
this describes a microcytic, hypochromic, non-regenerative anemia which is consistent with chronic iron deficiency
What should you do if Doxorubicin is outside of the vein at the site of injection causing extravasations to occur?
Cold compress to contain the spread of the drug since it can cause severe tissue necrosis where debridement and maybe amputation will be needed
For Vincristine, however, you can warm compress it to disperse the drug and enhance systemic absorption because it is just irritating but should not cause severe tissue necrosis
The most common time for anastomosis failure is 3-5 days post op why???
due to the degradation of fibrin at the site prior to deposition of enough collagen, do an andromonoecies if you are afraid there is leakage at the sx site and septic peritonitis likely
What of the following is the most likely diagnosis for a cough in a 2-month old puppy?
Toxocara canis (roundworm) infection
How to feed megaesophagus patient
They should be fed high calorie diets and fed upright (Bailey Chair) at a 45-90 degree angle from the floor, they should stay in that position for 10-15 minutes after eating and they should be fed in meatballs if possible (fed high-calorie low volumes)
rads of the GI tract without serosal detail tells you what??
ascites
what type of gastropexy may cause subsequent surgeries to have an inadvertent incision into the stomach if the animal requires another surgery in life?
Incorporating gastropexy
This technique is easy and rapid to perform and involves making an incision through the seromuscular layer of the stomach and then suturing it to the lineal aba as you are closing your incision
What causes cutaneous larval migrans in humans?
ancylostoma which is hookworms that come in contact with unprotected skin and the infective larvae penetrate the epidermis and migrate aimlessly because they cannot penetrate the basement membrane of the skin so they are just right under the skin, usually self-limiting in humans
Ancylostoma brazilinese
What zoonotic parasite is best known to affect the eyes of children?
Roundworm (toxocara canis)
what worm is the most common cause of visceral larval migrans in humans with fecal-oral transmission, children are the ones most infected bc they play in sandboxes where cats may poop, puppies may also acquire the disease transplacental
Toxocara canis aka the roundworm
what do we expect with pancreatitis on U/S
Hypoechoic pancreas with hyperechoic surrounding mesentery (pancreas is hypoechoic due to edema and mesentery is hyperechoic because focal peritonitis/reactive)
How much protein should you feed a dog with hepatic insufficient or hepatic encephalopathy?
The max amount of proteins they will tolerate without causing signs of encephalopathy
Dogs with hepatic insufficiency or hepatic encephalopathy need to have their protein levels restricted to reduce CS of liver dysfunction, however, restricting protein intake to the point where hypoproteinemia is not good so if too little protein is fed, muscle catabolism will occur
An obese 5 month old Maltese presents for having mucous diarrhea, and you see on a fecal stain “gull-shaped” gram negative rods. What is most likely your diagnosis?
Campylobacteriosis– It is a gram negative motile thin S-shaped (gull-shaped) rod that can be in pairs or chains
You arrive to a canine breeding kennel with an outbreak of diarrhea that is malabsorptive and maldigestive kind. You do some fecal smears and find protozoal organisms swimming around in a “falling leaf” motion when you are at 40X. These organisms also have a ventral concave disc, one pear-shaped, and are approximately 15 x 8 micrometers, what is the organism?
Giardiai
What is usually found in cats and has an undulating membrane with a long anterior flagella
Tritrichomonas foetus
Measurements of liver function
ALT and ALP are leakage enzymes and can indicate ongoing damage to the liver or cholestasis but do not tell you anything about liver function
Other tests of liver function besides BUN is cholesterol, glucose, bilirubin, albumin and bile acids
What is the most important and specific medical therapy for exocrine pancreatic insufficiency?
Enzyme supplementation
Perianal fistula
GSD with hematochezia, tail chasing, tenesmus, malodorous mucopurulent discharge from around his anus and multiple ulcerations around the perineum
On rectal examination- reduced anal tone and mucosal thickening
Tx with immunosuppressants (like cyclosporine) since this is an immune-mediated condition
When measuring B12 (Cobalamin) and Folate levels in a dog with suspected SIBO, what finding is most supportive of this diagnosis?
decreased cobalamin (vitamin B12) and Increased folate
what is the TOC for Giardia infection?
Fenbendazole or metronidazole (but choose fenbendazole if that is the only option)
What is the best method to find Giardia canis trophozoites (remember from HVH)
Direct smear
Oral surgery in conjunction with another elective surgery in an otherwise health dog is usually not recommended for which of the following reasons?
Oral surgeries cause significant bacteremia, which may be an endogenous source of wound infection
What is the most common cause of exocrine pancreatic insufficiency in the dog?
Pancreatic acinar atrophy
When performing an enterotomy in a dog it is best to cut where?
On the antimesenteric border
Do for all species, decreases the risk of cutting blood vessels
What is the best tx for Taenia in dogs?
Praziquantel
What of the following is most likely to infect and cause dermatitis in a child walking barefoot?
Ancylostoma caninum which is the dog hookworm and can infect humans via penetration of the skin and cause dermatitis via cutaneous migration of the parasite
Not to be confused with toxocara which is a roundworm that cause visceral larval migrans in humans
A 6-month old dog presents for regurg after eating and will repeatedly attempt to swallow and bring up food and will sometimes cough at the same time or sneeze. Radiographs are normal, what is likely the diagnosis?
Cricopharyngeal dysphagia which is a congenital disorder by incoordination of the swallowing reflex to the signs described
A male dog presented for sx to remove a foreign body. What muscle should the surgeon incorporate into the closure of the abdominal incision?
Preputialis muscle which is usually cut when making a midline incision in male dogs
The BARF diet is a raw meat and bone diet and can cause salmonella in dogs and cats
usually shows as bloody diarrhea, anemia, lethargy, weak and depressed usually
What is true about the care in a post-operative dog that had a parathyroid adenoma removed?
The patient’s serum calcium should be monitored daily for about a week to check for the development of HYPOcalcemiaaaa
A 7 y/o FS Golden retriever reports for suspected Addison’s and has bloody diarrhea and inappetence and is dehydrated. What should your next step be?
Start aggressive IV fluids and run a chemistry panel
She is likely in hypovolemic shock so push IV fluids
Chemistry panel will show hyponatremia, hyperkalemia, and elevated BUN
How should you handle Addison’s disease in a patient going to surgery?
Give a dose of dexamethasone SP that is approximately 5 times the physiologic dose of prednisone before surgery followed by the regular dose of prednisone the following day
What is the primary goal in the initial treatment of a DKA dog?
Correction of acidosis, electrolyte abn, and hyperosmolality
Give bicarbonate fluids, potassium and phosphorus supplements if needed, and correct the hyperosmolality FIRST thennn use regular insulin to get the glucose back down
You diagnose a dog with diabetes insipidus and put it on desmopressin (DDAVP) to try and see if the pu/pd will resolve. What do you tell the owner as to why they will not see resolution of pu/pd in the patient for 1-2 days?
It may take up to 3 days to overcome medullary washout from being polyuric and polydipsic (it may take about 3 days for the medullary sodium concentrations and concentrating mechanisms overall to be back to normal)
What is usually increased in cushing’s dogs?
Serum cholesterol; BUN will be low, ALT will be increased, serum cholesterol will be high in 90% of cases as well
Suspect insulin resistence if your patient is above ____ mg/kg of their insulin and not well regulated
1mg/kg
What is the best diagnostic test to differentiate pituitary dependent hyperadrenocorticism from adrenal dependent hyperadrenocorticism in dogs?
High-dose dexamethasone suppression test which will suppress cortisol secretion in like 75% of PDH patients 3-6 hours post dex administration. Cortisol secretion does not become suppressed with de administration with adrenal dependent hyperadrenocorticism. If cortisol secretion is suppressed with the HDDST, PDH is diagnosed
Low dose dex suppression test will suppress cortisol in like 65% of pituitary dependent hyperadrenocorticism patients
A 6 year old dog presents for lethargy and weight gain and is eating and drinking normally but is gaining weight, also had weak HL and facial nerve paralysis with a patchy haircoat and seborrhea. Lab work shows normocytic. Normochromic anemia with PCV of 29% and lipemic serum, elevated cholesterol, what is most likely the diagnosis?
Hypothyroidism
how to tx feline asthma?
SQ or IM terbutaline with supplemental oxygen
Terbutaline is a beta-2 agonist that allows bronchial smooth muscle relaxation and along with oxygen
what is the radiographic findings of feline asthma?
diffuse bronchial pattern consisting of airway thickening “tracks and doughnuts”
What is the most appropriate way to initially manage a cat with pyothorax from a cat bite wound from several weeks ago after thoracocentesis?
Place a thoracostomy tube, lavage three times daily with LRS, appropriate systemic antibiotic for six weeks
Lavage 2-4 times a day for 1 hour with an isotonic fluid should be performed, and abx should be given for a minimum of 4-6 weeks and if there is no improvement within 3-4 days, sx should be performed to find a cause of the pyothorax
what will you see on echo of a dog or cat with heartworms?
“double lined echogenicity”
what is the tx of HW in cats?
Cats do not tolerate melarsomine well so tx is HW prevention and bronchodilators with corticosteroids and wait til the worms die after like 2-3 years….
Prevention of HW in dogs and in cats oral vs. topical:
Oral- ivermectin (Heartgard) and Milbemycin (Sentinel)
Topical- Selamectin (Revolution) and Moxidectin and imidacloprid (Advantage multi)
A 1 year old male neutered Newfoundland presents for a PE and you find grade 3/6 murmur (systolic) at the right heart base, thoracic rads show mild left-sided cardiomegaly with left atrial enlargement and segmental enlargement of the ascending aorta. What is an appropriate tx for this patient?
Atenolol-The dog described has subaortic stenosis and beta blockers (atenolol) are good because they reduce myocardial oxygen demand and lessen the frequency of ventricular arrhythmias, and provide cardiac muscle protection.
What does Atenolol do?
aka beta blocker; they reduce myocardial oxygen demand and lessen the frequency of ventricular arrhythmias, and provide cardiac muscle protection
Concentric vs eccentric hypertrophy
Concentric hypertrophy is more associated with chronic pressure overload like hypertension or aortic stenosis and is fat like HCM
Eccentric is like with DCM and is involved with volume overload (induced by increased filling pressure of the left ventricle aka diastolic overload and occurs with regurg patients like aortic or mitral regurgitation)
Eccentric cardiomyopathy
eccentric is like with DCM and is involved with volume overload (induced by increased filling pressure of the left ventricle aka diastolic overload and occurs with regurg patients like aortic or mitral regurgitation)
concentric cardiomyopathy
Concentric hypertrophy is more associated with chronic pressure overload like hypertension or aortic stenosis and is fat like HCM
mitral regurg in dogs eventually leads to….
where is the mitral valve? where is the tricuspid valve?
eccentric (thin walls big heart) hypertrophy of the left atrium and the left ventricle
where is the mitral valve- between LA and LV
Where is the tricuspid valve– Between RA and RV
What describes the process of blood flowing from the L ventricle to the left atrium due to a defect in the valve?
Mitral regurgitation
A 6 month old GSD presents for castration but has a 4/6 left systolic murmur that is heard best over the apex of the heart. Thoracic radiographs reveal a moderately enlarged left atrium. What is most likely the diagnosis?
Mitral valve dysplasia
which is a congenital anomaly of the mitral valve where the valve leaflets may be thickened, fibrosed, etc. The chordae tendinae or the papillary muscles attaching to the mitral valve may be irregular as well
mitral valve dysplasia occurs moreso in ____ breed dogs and involves anomaly of the mitral valve and have a _____ ___ murmur
larger breed dogs; left systolic murmur
what results in an enlarged right heart and the murmur will be heard on the right side of the dog
Tricuspid dysplasia
what results in concentric hypertrophy of the left heart and the murmur will be best heart on the left side
Aortic stenosis
what is true about venous pressure?
it is the direct measurement of blood pressure in the cranial vena cava
what are predisposed breeds to PRAA?
Great Danes and GSD
tell how the PRAA forms and what form is most common???
In cases of PRAA, the right aortic arch develops into the aorta and the esophagus
4th PRAA is the most common
A cat presents for difficulty breathing and x-rays showed pleural fluid and you removed 200mL of serosanguinous fluid and are now concerned about the possibility of FIP. What test could you run that has the highest positive predictive value (PPV)?
Immunofluorescence staining for coronavirus in the macrophage of the effusion fluid
what is the best test to R/O FIP in cats because if its high NPV???
Rivalta test
explain the different tests for FIP in cats—
SO HIGHEST PPV IS IMMUNOFLUORESCENCE STAINING FOR CORONAVIRUS IN THE MACROPHAGE OF THE EFFUSIVE FLUID AND HIGHEST NPV IS RIVALTA TEST
a halo sign in a cytology of a cat with sneezing and anorexia and has a swelling on the bridge of her nose means what diagnosis and what tx plan?
Cryptococcus (HALO SIGN) and is encapsulated fungus; tx with fluconazole or itraconazole
where does aspiration pneumonia like to present on rads???
alveolar pattern in the right cranial and middle lung lobes most commonly
FIP is from a mutated feline enteric _____ and usually affects cats __ months- ___ years old
coronavirus; usually affects cats 6 months- 2 years
what is the tx for FIP (poor prognosis though)
cyclophosphamide (Cytoxan) and corticosteroids but prob will not do well anyway (black market drug)
You do a thoracocentesis on a cat with pleural effusion. The fluid has a hazy gold color and a protein content with 7g/dL and 7,000 cell/uL. These cells are primarily non-degenerative neutrophils with lesser numbers of other white blood cells and mesothelial cells. What is the most appropriate interpretation of these findings?
FIP
What is NOT a feature of feline herpes virus infection?
lip ulcerations (its a feature of calicivirus NOT herpesvirus)
what are the characteristics of herpesvirus in cats?
dendritic ulcers, responses to lysine supplementation, symblepharon, and facial dermatitis
Symblepharon is a pathologic condition where the bulbar and palpebral conjunctiva form an abnormal adhesion to one another
what is a common virus in cats that can cause upper respiratory symptoms as well as oral ulcerations and stomatitis?
Feline calicivirus (can also cause lameness in some rarer cases too)
what is the treat for toxoplasmosis in cats
Clindamycin
clindamycin and sucralfate is also the tx for Calicivirus in cats
what do you suspect in a cat that presents to you for dyspnea and on PE, the cat is febrile and you identify pleural effusion and get a sample of it, the fluid has a protein of 9g/dL and is thick and the cellularity is low and the predominate cell type is neutrophils. What is your primary differential?
FIP
a cat presents for decreased appetite, upper respiratory symptoms, severe gingivitis, and stomatitis with multiple lingual ulcerations. what do you think is the diagnosis and what is the tx?
Diagnosis is calicivirus and tx is clindamycin and sucralfate
feline asthma aka…
allergic bronchitis
What medications is C/I in cats with chronic feline bronchial disease (feline asthma)?
Atropine, because it thickens its bronchial secretions and encourages mucous plugging of the airway, beta blockers are also C/I in cats with this condition
Also probably also avoid potassium bromide because it also causes feline asthma like symptoms in cats and is used to help tx seizures
what is a bronchodilator used to tx feline asthma? what else is used to help tx feline asthma?
Theophylline; steroids are also used as well as Doxycycline can be used to tx suspected Mycoplasma infections
a cat presents to you dyspneic and obtunded after falling from a tree and on PE, the p is painful on manipulation of the jaw and you auscultate decreased lung sounds dorsally. What do you do next?
Thoracocentesis
What are you thinking for a diagnosis in a cat that presents to you for upper respiratory signs and ulcerative and edematous lesions
calicivirus
you confirmed chylous pleural effusion in a cat and the owner wants to discuss tx options with you. The underlying cause cannot be found and the supportive care if failing. The cat is on a low fat diet and gets intermittent thoracocentesis PRN, what tx would be the best option for the next step in finally resolving the effusion?
Ligations of the thoracic duct and pericardiectomy
A cat with a cryptococcus infection and liver failure should not be treated with ketoconazole for which of the following reasons?
It is hepatotoxic and causes vomiting and diarrhea in cats
a cat presents to you for a history of unilateral mucopurulent nasal discharge and a proliferative soft tissue mass over the bridge of the nose. On PE, you note aqueous flare as well as the abnormalities listed above. Lung sounds are normal, what is the most likely diagnosis?
Cryptococcosis
what is the most common sign of cryptococcosis???
mucopurulent discharge and a proliferation on the nose “roman nose”, may also have ocular and CNS involvement and can look like uveitis in cats
what is the best diagnosis for cryptococcosis?
small yeasts with large capsules in the CSF tap
What is most likely to relieve dyspnea in a cat with feline bronchial disease (feline asthma)?
Beta-2 agonist
what is the feline lungworm called? how is it tx?
Aelurostrongylus abstrusus and ivermectin +/- fenbendazole
Why is toxoplasmosis gondii a public health concern?
Infants may be infected in utero and later show chorioretinitis along with mental retardation
what is cat scratch fever? what are the CS? how are they infected and what is the tx?
Cat scratch disease (Bartonella henselae) results in fever and lymphadenopathy and cats will usually not show any CS of it, fleas are implicated in disease transmission because the bacteria is in their poop so cats with infected flea dander on their paws can scratch and infect people and they can be bacteremia for it and carry it in their salvia and bite someone
What tx do you do for a cat with Dirofliaria immits microfilaria seen on a blood smear?
Steroids and HeartGard
what ocular change does taurine deficiency cause?
central retinal degeneration (will see horizontal band that is in the fundic view)
Acetaminophen toxicity in cats CS and tx
CS: malaise, vomiting, dehydration, edema, depressed, pale mm and CRT prolonged with tachycardia, tachypnea, low hct, ALT and ALP evelated, brown urine
Toxic to the liver and RBC and can cause heptaic necrosis, methemoglobiemia, methemohglobinuria, anemia, hypoxemia, and death
Treatment N-acetylcysteine administration and IV fluids, can do emesis if caught early enough
what do you tell an o who is afraid her FIP + cat will give it to her other cats at home?
FIP IS NOT contagious, it is caused by the mutation of feline enteric coronavirus and is most common in young and immunosuppressed cats and the majority of cats have been exposed to FIP already
cats not eating regular cat food are at risk for what heart abnormality and why?
DCM because def in taurine
a cat presents to you for lethargy, anorexia, having a tick on it, scleral hemorrhage, hepatomegaly. What is likely the diagnosis? What is the tx?
This cat likely has Cytauxzoon felis from mostly the lone star tick (Amblyomma americanum) but can also be from Dermacentor the American Dog Tick but not common; this is a protozoal organism after a tick bite and TOC is none besides supportive care
What does Doxorubicin do in cats?
Causes renal toxicity
what does 5-fluorouracil cause?
in cats it causes neurotoxicity and should not be used in cats EVER
what is the classic lesion seen in cats with FIP?
pyogranulomatous vasculitis
What cell is least likely to be infected by FIV?
Platelets
Cytotoxic T cells (CD8 + cells), T helper cells (CD4+ cells), macrophages, and B-cells are all affected
what can you use to reverse apha-2-agonist Xylazine?
Yohimbine
Hyperthyroid cats can get _____ secondary
HCM
There is a stray cat brought in that is febrile, lethargic, and has severe mandibular lymphadenopathy with a draining tract under its chin. It has a lot of fleas, his breathing is tachypneic. What do you do first?
Wear protection and quarantine the animal and call the state vet, this looks like bacteria Yersinia pestis “Plague”. It’s a bipolar gram negative bacterium that looks like a safety-pin and can see on gram stain but def dx is culture. BUT THE ANSWER IS QUARANTINE AND CALL STATE VET FIRST (these are all options on NAVLE so do not get tripped up)
Very zoonotic, needs abx ASAP
A client’s cat was in the basement and screamed and is now recumbent and vocalizing and rigid with muscle spasms. What could have happened?
Black widow spider bite-they make a toxin that binds to calcium channels and increases membrane permeability and enhances depolarization. Ascending motor paralysis and destructions of the peripheral nerve endings occur and a single bite can kill a small animals. CS occur immediately
Cat with FIP- spread of the corona virus and it mutates, how is the corona virus spread?
fecal-oral transmission
What sedation can you give a cat that will actually increase their appetite?
Diazepam
what is the reversal agent for benzodiazepines?
Flumazenil
Diazepam can cause what in cats?
Can cause hepatic necrosis in cats with repeated dosing
what do we think about propofol in cats?
rapidly distributed and cleared in dogs and cats which allows for smoother recovery but constant re-dosing can cause accumulation of Heinz Body anemia and signs of illness
what is the transmission for FIP?
fecal to oral transmission
You see a cat with hair loss and diagnose Demodex gatoi, what is true?
It is contagious to tother cats and is short and stubby and lives superficial and causes itching to cats that are affected
what is the demodex in cats that is long and slender and lives in the hair follicles?
Demodex cati (do a SUPERFICIAL SKIN SCRAPE IN CATS unlike in dogs)
you see a cat with multifocal non-pruritic alopecia and scaling, skin scrapes have no significant findings and you suspect ringworm and do a fungal culture using Dermatophyte test medium (DTM) culture plate. The culture plate turns red in one week, what is the next step?
DTM has phenol red which turns red under alkaline conditions and dermatophytes produce alkaline metabolites so they will turn the medium red (positive result), it is important to check the culture plate under the microscope daily to make sure the red color was not artifact from protein sources
cat bites abscess are predominated by aerobes or anaerobes?
Anaerobes (so allow for continued draining for 3-5 days with penrose drain which is passive draining and O2 to the site and abx are unneccessary until proven otherwise)
an 8 year old cat presents with a single 2 cm skin mass on the top of its head and is well-circumcised, hairless and dome-shaped with it being freely moveable from the underlying fascia and has been there for months and is slowly growing, what is it most likely?
Basal cell tumor – most common skin tumor in cats and present in this appearance and they are almost always benign, usually on the head, shoulders, and neck
Papilloma information–
benign tumors caused by infection of epithelial cells by species specific pallimovrisues, can be from indirect or direct contact and incubation period is 1-2 months and young dogs are more commonly affected
CS- most regress in 3 months and can be there for one year (remember like that one white shep at Greenbriar veterinary hospital)
Basal cell tumors–
Basal epithelial cell in origin, most are benign but can be malignant, common in cats but not in dogs Basal epithelial cell in origin, most are benign but can be malignant, common in cats but not in dogs and they are common in older cats and are usually always benign even when there is high mitotic count and malignant features in biopsy so do not get confused by this
A 6-year-old female spayed cat presents for a well-circumscribed raised yellow, pink linear lesion on the caudal thigh. What is most likely the diagnosis?
Eosinophilic granuloma
Young ____ cats (less than 4 years old) can get _____ subtypes of MCT which will spontaneously regress
Siamese; histiocytic
A examine a 1 year old cat with pruritus, your PE shows a generalized miliary dermatitis and dark brown flecks in the fur. What finding(s) are most consistent with the most likely diagnosis?
likely fleas, you will see anemia, peripheral eosinophilia, and possible tapeworm infestation
You see an DSH cat that presents for chronic skin lesions. The lesions consist of draining nodules and erythematous plaques and the pred and abx the previous vet RX were working but the lesions never fully got better. You do a cytology and see numerous cigar-shaped organisms in the macrophages and the owner says she pulled out a splinter from the right front paw before the lesions started. What is the diagnosis and treatment for this disease?
sporotrichosis is caused by Sporothrix schenckii, it’s a cigar-shaped fungal organism that is associated with rose thorns so it is called “rose growers/garderners disease”
Tx is antifungals
What prolongs the duration of lidocaine?
Epinephrine
What is the tx of ringworm in cats?
Lyme sulfur dip or antifungal shampoo with miconazole and can do oral antifungals like itraconazole or fluconazole which are most effective with the Least side effects
The best tx is combo of topicals and oral
what is a skin infection that occurs around the nails?
Paronychia pronounced “para-niki-a”
What drug can you NOT use with pemphigus foliaceus patient?
Itraconazole- can make it worse
Ampicillin- can make it worse
DO tx with triamcinolone, pred, or clorambucil (immunosuppressives)
A 3 year-old MN DSH presents for crusting and pruritus around the face, neck, and ears. What should be least likely on your list of differential diagnosis (ddx)???
Eosinophilic granuloma– usually are linear lesions (granulomas) which are pink to yellow in color and do not crust nor are pruritic
Hyperthyroidism in cats
The most common endocrinopathy in cats
Accelerated metabolic rate, hyperactivity, vocalizing, polyphagia, tachycardia, may be pu/pd, and may have some GI signs
Can lead to HCM
TX- thyroid excision, radioactive iodine tx, anti-thyroid drugs like Methimazole and LOW iodine RX diets
what is it called when there is a defect in the type 1 collagen production and it is hereditary and results in abnormal type 1 collagen which makes the skin very stretchy/pliable, thin and susceptible to trauma?
Ehlers-Danlos disease of cats
