Vet prep Power Pages Canine and Feline Flashcards
Itchy dog less than 1 year is likely what condition? What if it was around 1-3 years old?
<1 year is Food allergy whereas ages 1-3 years is likely Atopy (which is usually seasonal) they look the same as far as distribution of the lesions so beware (paws, face, ears, belly)
Atopy vs flea allergy lesions
Distribution of lesions:
FAD is caudal half of body and lumbosacral region and tail, butt, thighs NECK IN CATS
Atopy is usually paws, face, ears and belly
contact allergy dermatitis usually has these lesions _______
pruritic vesicles and erythematous papules
in cats beware of what two forms of skin reaction patterns?
Miliary dermatitis and eosinophilic (crusted papules diffusely) granuloma complex (4 types)
What are the 4 types of granuloma complex in cats?
indolent ulcer- most commonly seen as ulcerative symmetrical lesion on the upper lip
Eosinophilic granuloma- found in mouth or on body
Eosinophilic plaque- commonly seen as linear plaques on the caudal thighs
Flea allergy dermatitis of cats- caudal dorsal, symmetrical alopecia can be on face and neck
how long does it need to be on flea preventative and resolution of CS to say it was FAD?
2-3 months and be sure them bitches are cleaning because the larva hide from the meds in a cacoon
Why do we test the skin of the allergic animal with atopy?
NOT for a diagnosis persay but rather for a vaccine
normal dogs will also test + so this is not a diagnosis for atopy
Biopsy is the worst thing to do to try to diagnose it
Contact allergy is a type ___ hypersensitivity whereas Atopy is a type _____ hypersensitivity
And Flea allergy dermatitis is types…
Type 4 (cell-mediated) is contact allergy whereas Atopy is type 1 aka IgE mediated type of hypersensitivity; FAD is types 1, 4 and basophil hypersensitives
animal exposed to possible rabies animal and is vax vs unvax
is vax- redose RV ASAP and monitor for any CS for 45 days by owner
if not vax- vax immediately and quarantine for 4 months in dogs and cats and 6 months in ferrets
animal bites human and unknown RV hx
euth and send out for testing (IFA I think)
or if vax, quarantine for 10 days under supervision
Human unvax for RV and exposed
Human immunoglobulin + 4 RV (but if you have good titers then you just need 2 RV)
Poodle with waxing and waning GI signs, increased ALP and hyperkalemia that is PU/PD likely has…
Addison’s Disease
Addison’s disease is a deficiency in ____ and ____
mineralocorticoids (makes aldosterone– hold sodium excrete potassium) and glucocorticoids (makes cortisol)
Tx with oral pred daily or injectable drug monthly and increase dose like 4x for stressed patients
use what to tx Addison crisis?
0.9% NaCl, plus dextrose or sodium bicarb to throw the K+ back into the cells (since hyperkalemic), also give pred and use 60-90mL/kg/hour (shock dose) of IV fluids of 0.9NaCL
Itchy bugs in dogs and cats
Sarcoptes, fleas, dermatophytosis (ringworm), demodex gatoi which is one of the feline demodex mange mites and is contagioussss
What is the key cytokine that activates JAK/STAT and causes pruritus and the release of pro-inflammatory cytokines?
IL-31 is the key mediator cytokine that activates JAK/STAT and causes pruritus and the release of pro-inflamm cytokines
Both Apoquel and Cytopoint affect the same pathway but they act different bc _____ acts higher in the pathway
Cytopoint
MOA of Apoquel
MOA of cytopoint
Apoquel- JAK inhibitor Cytopoint- monoclonal antibody that binds to IL-31 which prevents it from binding/activating JAK/STAT pathway
how does cyclosporin help with itchy p?
calcineurin inhibitor that suppresses cytokine IL-2 which blocks the proliferation of T-cells and reduces inflammation and allergies
$$ so can use with ketoconazole
but beware bc cyclosporin can cause MDR1 interactions, and mess with insulin in diabetic p, hair growth (hirsutism), gingival hyperplasia- reverses when off the drug and can taper to minimize SE
what 3 skin drugs have quick onset of activity (24 hours)? What has a slower one of like a month?
Faster onset is Cytopoint, Apoquel, and pred. Slower onset is cyclosporine
Brachycephalic syndrome has one or all of the following characteristics…
Elongated soft palete, stenotic nares (sx-wedge resection), hypoplastic trachea (no tx), everted laryngeal saccules (this one is acquired as a result of increased airway resistence/inflammation and can be easily removed under anesth with allis tissue forceps and traction)
what is the risk with severe brachycephalic syndrome?
laryngeal collapse (toc would be permanent tracheostomy)
what are the possible causes of collapsing trachea? How to diagnose it?
can be result of weak or redundant dorsal tracheal membrane or if cartilaginous rings become hypoplastic or fibrodystrophic; diagnosis based on palpation of trachea causing honking coughing/spasms, can also see flattened trachea on rads or endoscopy showing bronchi collapsing
TX of collapsing trachea-
weight loss, anxiolytics if needed, bronchodilators
Sx-
-mild cases- can do dorsal tracheal membrane plication
-intratracheal stenting - 80% success rate
-external support- not very good option
Definition of DCM
a primary myocardial dz characterized by cardiac enlargement and impaired systolic function (seen in lrg breed dogs and cats without taurine in their diet)
CS of Dilated Cardiomyopathy (DCM)
fainting, ex. intolerance, lethargy, resp. distress from L sided heart failure or ascites from R sided failure
Diagnosis of DCM; Tx of DCM
echo and rads (echo will show systolic cardiac dysfunction bc poor contractility and shortening fraction);
TX is ACE inhibitors and/or Pimobendan (Vetmedin) or beta blocker if more severe like in heart failure (these meds end in olol)
Boxer dogs get what cardiac thing?
Familial arrhythmic cardiomyopathy aka arrhythmogenic right ventricular cardiomyopathy of boxer dogs
causes acute rapid VPC’s, may be asymp, have syncope, or have systolic dysfunction and heart failure (tx like a dog with DCM and give L-carnitine supplement)
What do you use in a boxer dog with syncope?
It likely has Familial arrhythmic cardiomyopathy aka arrhythmogenic right ventricular cardiomyopathy of boxer dogs so tx with sotalol (beta blocker) +/- mexilitine (Class I anti-Arrythmigenic)
What 3 drugs are cytotoxic?
Chlorhexidine and aminoglycosides and tetracyclines
TPLO eliminates what but not what?
tibial thrust but not cranial drawer of the stifle
Tx options for CCL tear?
TPLO, extracapsular repair aka lateral suture (small dogs), or TTA
what is the function of the cranial cruciate ligament?
Prevent cranial drawer,
-patellar translocation, excessive hyperext. and internal rotation
Always do urine culture in diabetic p like 1x/year because…
their urine is usually more dilute since pu/pd even with diabetes controlled and that makes it hard for the UA machine to detect some bacteria so culture will really let u know also if they have sugars leaking into their urine its a perf environment for bacteria to grow
What does this pet have?
PU/PD, polyphagia but losing weight, plantigrade stance (cat) and cataracts (dog)
diabetes mellitus
what is wrong with this patient:
Anorexia, vomiting, weak and has metabolic acidosis that is severe with BG >500mg/dL
Diabetic ketoacidosis (DKA)
A cat is super stressed but you wanna run a BG curve bc you suspect diabetes. what should you do instead?
Run a Fructosamine which will tell you what the BG has been for the past 2 weeks or teach o how to check at home
A dog presents for PU/PD, minor weight loss, elevated liver and cholesterol. What is on your ddx?
Diabetes Mellitus
what is the veterinary oral hypoglycemic drug used to decrease insulin requirements or insulin resistance?
Glipizide (Glucotrol) works similar to metformin in humans
What does a diet need to be in a dog with DM? How about a cat?
Dog- high fiber, low fat
Cat- high protein, low carb
DKA tx
aggressive IV fluids 0.9% with potassium and phosphate supplementation, regular insulin (fast acting as CRI or every 6-8 hrs), Bicarbonate therapy if meta. acidosis is severe or not getting better with IV fluids
Potassium Notes— Insulin causes the intracellular movement of potassium into muscle cells by binding to its receptor on skeletal muscle. About two-thirds of patients will develop hypokalemia in the course of treatment for DKA
Cats with diabetes can come off their insulin unlike dogs after they are regulated and is called “clinical remission” T/F
True!!!
What is the most common cause of pruritus in dogs and in cats?
Flea allergy dermatitis (FAD)
What is the most common flea for dogs and cats?
Ctenocephalides felis
(can carry Bartonella which is cat scratch fever, Dipylidium caninum which is tapeworm, and Yersinia Pestis which is the Plague)
what is the average time for a lifecycle in fleas?
3 MONTHS
What do you do to tx a cat or dog with FAD?
Short term glucocorticoids to dampen the inflammation, flea control, clean house/tx yard, treat secondary infections!!!
Low TLI in dog or cat means…..
EPI
Elbow dysplasia in dogs–
umbrella term for one of the following conditions:
- ununited anconeal process (UAP)
-OCD of humeral condyle
-Fragmentation of the medial coronoid process
-Elbow incongruity
Elbow dysplasia CS/Diagnosis
usually by 4 months to a year of age, will have pain on elbow manipulation and may be bilateral so def check the other leg, take rads in the flexed lateral position
Tx of ununited anconeal process in dogs
NSAIDs, excision of the anconeal process works but could do Lag screw fixation and proximal ulnar ostectomy instead
OCD of the humeral condyle definition
Abn endochondral ossification resulting in thickening of the articular cartilage
OCD of the humeral condyle CS
bilateral 80% of the time, diagnosis with lesion on the MEDIALLLL aspect of the humeral trochlea with subchondral bone defect and surrounding sclerosis with osteophytosis
what is the tx of choice for OCD of the humeral condyle
sx to remove the flap and debride- excellent results, do it with arthroscopy
Medial fragmented coronoid process Diagnosis and TX
rads showing sclerosis of the subchondral bone along the trochlear notch of the ulna and adjacent to the proximal radioulnar articulation near the lateral coronoid process
TX is surgical removal with arthroscopy for removal of the fragment
Elbow incongruity
poor alignment of the elbow jts, predisposes to elbow dysplasia and tx is ulnar osteotomy but may not be super effective
Once fungal spores enter the body from inhalation or a wound, they convert to _____ and spread thru the body.
Yeast
what fungal orgs are most common in southern western US?
Coccidiomycosis aka Valley Fever
What fungal spore is most common in mid US moving east? (Midwest of MS river!!!!)!!!!
Histoplasmosis
What fungal spore is more prevalent eastern and northern US?
Blastomycosis
What fungal orgs is more prevalent in like Cali and some in Washington and colorado?
C. gattii cryptococcosis
Histoplasmosis
Midwest and Mississippi river
soil fungus spread via bat and bird feces- inhaled- dog or cat will have GI signs, resp. signs and nodular skin lesions with swollen joints
Diagnosis- anemia, leukocytosis, thrombocytopenia, nodular interstitial patter, pleural effusion, serum, CSF or urine antigen testing (cannot do fungal culture bc risk to lab workers)
TX- itraconazole and go 1 month past CS
Blastomycosis
hunting dogs!!!
Ohio river and east of MS river, soil fungus- bird and bat feces- inhaled- lots of URI signs and lymphadenopathy with snowstorm chest rads +/- draining tracts in skin showing thick walled budding yeast on cytology, lymphopenia, eosinophilia, mild anemia, monocytosis, hypoalbuminemia, hyperglobulinemia
Can do urinary antigen test or PCR to test
Tx Itraconazole 1-2 months past resolution of CS
Cryptococcus
cats more likely to get it- transmission through in soil via pigeon feces- pacific northwest- resp signs, ocular changes, neuro issues, cutaneous lesions like Roman Nose
Diagnosis- round purple or blue with VERY THICK MUCOID LOOKING CAPSULE short based budding
Tx- Amphotericin B 3x/week, +/- Fluconazole, tx is 2 months past resolution of CS so like 5 months to a year…..
what labwork do we need to pay attn to with a patient on an antifungal like ketoconazole or itraconazole?
Liver values, P450 cytochrome metabolism
Coccidioides immitis aka Valley Fever
Southern western US after heavy rain or earthquake that brings spores to the surface, inhaled- whole body systems affected- diagnosis with culture ZOONOTIC SO BE CAREFUL, will see spherules with double walls and will be full of endospores on cytology of a draining tract- Tx is ketoconazole 2 months past CS and itraconazole tx 6 months to a year can add amphotericin B (beware bc with -azole meds you need to keep an eye on liver values but also Ketoconazole can cause cataracts if used for more than 1 year…)
What classifies hip dysplasia???
Loss of articular cartilage, fibrosis, bone remodeling and loss of function
CS and Tx of a dog with hip dysplasia
Bunny hopping gait, ortolani sign, less than 50% of coverage of femoral head, osteophytes present, Morgan Line
Tx- JPS, THR, TPO, FHO and conservative tx
what is a “Morgan Line”
With Hip dysplasia, osteophyte formation at the insertion of the joint capsule
OFA hip-
performed in an effort to screen for hip dysplasia, 7 point grading scale, need to be at least 2 y/o and is SUBJECTIVE
Penn HIp-
Can do as early as 16 weeks BUT best results are at 1 year, distraction index is a good indicator of jt laxity (more objective than OFA hip)
Juvenile Pelvic Symphsiodesis sx
done at 14-20 weeks old, preventative as it allows for more acetabular coverage but still predisp to DJD bc pelvis was cut at the growth plate
Triple pelvic osteotomy (TPO) surgery
3 cuts- pubis, ischium, ilium and placement of the special plate on the ilIum to rotate the pelvis
do at ages 6 months to 12 months
if already has DJD, DO NOT do
Total Hip Replacement (THR)-
placement of prosthetic acetabular femoral component like in humans
super good success rate
can do anytime jt plates are closed, can already have hip dysplasia and DJD
Femoral Head and Neck Ostectomy (FHO)
remove head and neck, may have non painful lameness bc you shortened the leg, great results, salvage procedure in cases of severe hip dysplasia
Osteoarthritis (OA)
progressive, chronic, most common/impt in dogs and horses, steroids C/I… selective inhibition of COX-2 receptors with NSAIDs is the mainstay of medical mgmt
Bone and cartilage changes of OA:
Collagen fibril disruption (basically loss of CT), loss of articular cartilage, sclerosis of subchondral bone, osteophytes and enthesophytes (a bony spur forming at a ligament or tendon insertion into bone) with synovial inflammation
Why are steroids C/I with OA?
Into the joint, steroids inhibit the production of matrix metalloproteinase activators like plasmin and can cause thinning of the cartilage and fibrillation
What does heat stroke lead to in the final stages?
Thromboembolisms, SIRS, renal, neuro and GI dysfunction and eventually DIC with cardiovascular collapse
the temp of heat stroke is about ___ or higher but heat stroke p can present with subnormal or normal temps on presentation…
106 degrees F
what are some causes of heat stroke besides the obvious?
Toxins, eclampsia (placental issue causing hypertension), seizures, upper airway obstruction/lar par
when should cooling efforts be stopped in a dog that is hyperthermic?
When the temp reaches 103 degrees to avoid vasoconstriction
(use room temp water to cool the p and use fanning)
the most common cause of hypercalcemia in cats is…
Idiopathic
what regulates calcium in the body?
Parathyroid hormone (PTH), vitamin D (calcitroil) and calcitonin
what does PTH do?
causes increased Phosphorus and calcium mobilization from the bone and allows Phosphorus to be peed out and calcium to be retained by the kidneys (will cause increased Ca and decreased Phosphorus in the body)
What does calcitriol do?
increases calcium absorption from intestines and results in increased Phosphorus as well
what does calcitonin do?
Reduces calcium levels by inhibiting osteoclastic bone resporption
Signs of hypercalcemia–
pu/pd, anorexia, GI signs, seizures or muscle tremors, arrhythmias, weakness
DDX of hypercalcemia-
HOGS IN YARD
Na:K ratio < 27: 1 is suggestive of what disease?
Addison’s Disease
hypercalcemia and hyperglobulinemia are suggestive of what?
Myeloma or lymphoma
What diuretic can be given to well hydrated p with hypercalcemia to help promote caliuresis (urinating out calcium)?
Furosemide
what do we use to tx hypervitaminosis D causing hypercalcemia?
Bisphosphates or can use calcitonin
what do we use in emergency cases with hypercalcemia?
Sodium bicarbonate
dogs have ____ pancreatitis whereas cats get _____ forms
acute; chronic, subacute
canine pancreatitis is almost always ____ with cause unknown but factors include…..
Sterile; factors include fatty meals, endocrine diseases, inflammation or trauma, drugs (azathioprine, cyclosporine, L-asparaginase, tetracycline)
Diagnostic test of Pancreatitis in dogs and cats-
PLI and U/S but def diagnosis is pancreatic biopsy which is Gold Standard but is like never doneee.
pancreatitis meds-
fluids if needed, pain meds (not T3 or T4 because can cause worsening pancreatitis so use Gabapentin, stay away from NSAIDs bc stomach already upset), H2 blockers, anti-emetics, probiotics and dogs and CATS may need abx bc their pancreatitis is usually not sterile like in dogs, also low fat diet
EPI in dogs and cats
polyphagia, weight loss, young animal
What is the most common cause of EPI in dogs?
Pancreatic acinar atrophy
what is the most common cause of EPI in cats?
Chronic pancreatitis
pica means…
eating things out of the normal like soil, mulch, bark, etc.
Dog or cat with small bowel diarrhea with yellow to gray feces and polyphagia weight weight loss and pica= what diagnosis most likely?
Exocrine Pancreatic Insufficiency aka EPI
what does it mean if TLI or PLI is low?
EPI
what is the TOC for EPI?
Exogenous pancreatic enzyme supplementation
can also do cobalamin (vit B), vit K and Vit E supplements orally with highly digestible low fiber diet
osteosarcoma forms at the ____ site of bones and is away from the elbow in toward the knee in big dogs but is usually where in smaller dogs (less common)?
Where do primary bone tumors form? What about secondary?
metaphyseal; axial skeleton (jaw, scapula, ribs, pelvis, spine) in smaller dogs but this is not common
mandible has the best prognosis of any other osteosarcoma site with 1 year survival with sx alone
Primary bone tumors go to metaphysis but SECONDARY goes to the diaphysis!!!
what is the TOC for osteosarcoma?
Amputation of the limb which is the most effective way to get rid of pain and is palliative but 90% of dogs still develop mets (chemo can extend MST to 10-12 months)
where does osteosarcoma like to spread when it mets?
LUNGS, but can also go to LN and other bones
Does osteosarc cross jt lines into other bones?
nopeee
pulmonary mets will be visible in ___% of osteosarcoma cases at time of diagnosis but will still develop later on in most cases
10%
what on lab work of a lame dog will tell you it may be osteosarcoma?
elevated ALP (Alkaline phosphatase) on chem panel- associated with worse prognosis
Osteosarc but mets in the lungs and sx not an option tx-
Chemo and radiation and put the p on Bisphosphates bc they are osteoclast inhibitors and will help palliate pain in p where sx is not an option
Osteosarcoma MST
amputation alone 4-6 months but with chemotherapy 10-12 months
if presence of mets then 1-3 months
What is the most common malignant oral tumor in dogs? What are the overrep breeds?
Oral melanoma
Breeds overrepresented are chows, goldens, poodles, and cocker spaniels
___ of oral melanoma tumors are amelanotic so they do not have any melanin pigment
1/3
What % of oral melanomas are metastatic?
up to 80% and they frequently met to the LN and then the lungs
oral melanomas are the most common but what are the other sites for melanoma to develop?
Cutaneous (usually benign on dogs), nail beds (1/2 are malignant and 1/2 are benign)
how is the oral melanoma vax used?
Xenogeneic human DNA vaccine made from tyrosine which is a protein found in melanocytes and melanoma cells that allows the immune system to recognize it and form antibodies against it used to tx oral melanoma AFTER it has developed, and will NOT prevent the disease from developing like a normal vax
Oral melanomas less than ___ cm have MST of __ months
<2 cm have MST of 17 months
oral melanoma tumors more than 2 cm have MST of how long?
5.5 months
dogs with the tumor more caudal in the mouth obvs have poorer prognosis than if it was more rostral
TOC of oral melanoma
wide sx excision +/- rad and chemo
What are the most common dermal malignancy in dogs?
Mast cell tumors
what breeds are predisposed to MCT?
Boxers, Pugs, Boston Terriers, and other brachycephalic breeds (usually lesser grade MCT tho)
MCT release what substances when they degranulate? What can this cause?
Histamine, heparin, proteases, and cytokines that can cause GI ulcers/bleeding, poor wound healing, anaphylaxis (hypotension, vasodilation and collapse etc.)
What is the grading system used for MCT in the US?
The Patnaik system which evaluates the cell differentiation, mitotic figures, and invasiveness in surrounding tissues and predicts likelihood of recurrence and mets (1 is least aggressive and 3 is most aggressive)
Sx for MCT
excision with 2-3 cm lateral margins and 1 fascial plane deep and is TOC (radiation needed if you do not get good margins)
if mets present, then the TOC is chemotherapy
Supportive care for MCT
Glucocorticoids (cytotoxic to mast cells and reduces inflammation from the tumor), H1 blocker like diphenhydramine (Benadryl– NEVER give IV), H2 blocker like famotidine or ranitidine or cimetidine
what is the first FDA approved drug for tx of canine cancer in the US?
Tyrosine Kinase Inhibitor Palladia
Laryngeal paralysis is usually idiopathic in older dogs and can result in dyspnea and death and can be unilateral or bilateral..T/F
Trueeee!!!
What are the CS of lar par?
Voice changes, inspiratory stridor (high pitched wheeze sound), dyspnea and at risk for aspiration pneumonia
what muscle is responsible for the abduction of the arytenoid cartilage that opens the airway?
Cricoarytenoideus dorsalis muscle
What nerve innervates the cricoarytenoideus dorsalis muscle?
Recurrent laryngeal nerve
What is def diagnosis of lar par?
Laryngeal examination under light anesthesia using Doxapram to stimulate respiration and visualize arytenoid function
TOC for lar par, what are the risks? what if the p has lar par and megaesophagus?
Tie back sx AKA cricoarytenoid lateralization sx; risk of aspiration pneumonia; if the p is at an extreme risk for aspiration pneumonia like it also has megaesophagus then do permanent tracheostomy
A dog presents to you for weight gain, alopecia, pyoderma, and skin changes. What is the disease?
Hypothyroidism
How do we diagnose hypothyroidism?
Baseline T4 but confirm with cTSH and free T4 by equilibrium
What is the tx for hypothyroidism?
Synthetic thyroid hormone (levothyroxine) orally daily
What is the most common cause of hypothyroidism?
lymphocytic thyroiditis
why is hypothyroidism sometimes missed?
Euthyroid sick syndrome which is where the hypothalamus-pituitary stimulation of the thyroid is dampened because of illness
what hormones does the thyroid gland synthesize?
Thyroid hormone thyroxine (T4) and triiodothyronine (T3)
CS of hypothyroidism
lethargy, weight gain, alopecia, pyoderma, hyperkeratosis, seborrhea, hyperpigmentation, bradycardia, weak pulses
What will you see on cbc chem with hypothyroidism in dogs?
Mild non-regenerative anemia and hypercholesterolemia
Serum T4 level will be low (but make sure you confirm with cTSH or free T4 by equilibrium before tx)– hypothyroid dogs have increased cTSH and low free T4)
What will the labwork be that slam dunks hypothyroidism on cTSH and free T4?
Increased cTSH and low free T4; hypothyroid dogs should have low T4 even after TSH stimulation
What does this patient have: Bradycardia with severe dehydration but USG low, Na:K ratio <27, episode started when patient was stressed
Hypoadrenocorticism aka Addison’s Disease
what is the test of diagnosis for addisons?
ACTH stim test (suspected if baseline cortisol <2)
what is the tx for addisons?
Rapid infusion of 0.9% NaCl as shock dose (60-90ml/kg) and tx hyperkalemia with dextrose or sodium bicarbonate, steroids
Addisons disease is the deficiency of ____ and ____ and most commonly occurs because of what?
it is usually a deficiency in mineralocorticoids (makes aldosterone) and glucocorticoids (makes cortisol) and most commonly occurs from the idiopathic adrenocortical atrophy
Mineralocorticoids produce aldosterone which does what??
allows the body to retain sodium and excrete potassium
What is the sex predilection for addisons?
70% of females get it
What does hyperkalemia look like on ECG?
Tall tented T waves and diminished to absent P waves with prolonged P-R interval and wide QRS complex
what might you see along with addisons in terms of other anatomy?
Small adrenal glands, megaesophagus, micro cardia
post ACTH stim test below ____ ug/dL is consistent with Addisons disease
What steroid will not interfere with this test?
<2 ug/dL; only dexamethasone will not interfere with this test
longterm tx for Addisons disease:
Glucocorticoid- prednisone tapered but give 2-4x maintenance dose at times of stress or can
Mineralocorticoid- fludrocortisone daily or injectable DOCP every 3-4 weeks (Percorten I think)
Cushings occurs in ___ and ___ (species)
dogs and horses
A dog presents for pu/pd, panting, polyphagia, pendulous belly and pyoderma with thin skin?
Cushings disease
most cases of cushings are what and how are they tx?
Most cases are pituitary-dependent (PDH) and are treated medically with Lysodren or Trilostane
what is seen in horses with cushings?
Hirsutism which is abnormal long wavy coat
What will you see on labwork with cushings disease?
stress leukogram (SMILED), elevated ALP (alkaline phosphatase), hyposthenuria (USG less than 1.010)
