VetPrep Flashcards
What tumor type is a cat predisposed to developing at vaccination sites?
Fibrosarcoma
Several beef cows present with a history of decreased appetite and excessive salivation. On physical exam, their tongues are firm on palpation, nodular, and painful
a) what is your top DDX
b) What is your recommendation to the owner?:
1 - Begin therapy with an aminoglycoside
2 - Change feed and treat
3 - Isolate animals at once
4 - Isolate affected animals and submit one of them for necropsy
a) actinobacillosis
b) 2 - change feed and treat
explanation: The correct answer is to change feed and begin treatment of the animals affected with woody tongue, as the response is often good. Sodium iodide and antibiotics are effective. Given the presentation and clinical signs these animals have probably begun to ingest very rough and stemmed (scabrous) feed items which have injured their mouths. Upon injury, the normal inhabitant Actinobacillus lignieresii invades the soft tissues and causes the characteristic woody tongue granulomatous inflammation. These animals don’t have rabies, and there is no need to cull them. Change feed before additional animals are affected. Do not use aminoglycosides as they have an extremely long withdrawal period.
A 13-year old spayed female Miniature Poodle presents with two mobile, soft, well-circumscribed, subcutaneous sternal masses, 3 cm and 6 cm in diameter, respectively. The owner had noticed one mass three months previously. Fine needle aspiration of both masses is performed and smears are prepared. A representative field of both specimens is illustrated below (Wright’s 20X). What is your diagnosis?
- a) Mesenchymal neoplasia (sarcoma)
- b) Fungal granuloma
- c) Lipoma
- d) Mast cell tumor
c) lipoma
Explanation: The cells depicted are well-differentiated adipocytes. These cells are large, appear in aggregates or sometimes singly, and contain fat that stains negatively with Wright’s, such that the cytoplasm appears clear. The cells possess a small, round or ovoid, pyknotic nucleus that may be compressed and located in the periphery of the cell. This benign tumor is a lipoma, which is common in dogs. If the mass hinders the animal, it may be removed surgically. Infiltrative lipomas, and their malignant counterpart, liposarcomas, are less common.
When sampling for cytology, frequently the first indication that a lipoma has been aspirated is the clear, oily appearance of the material ejected from the aspiration needle onto the slide. Care must be taken while staining to ensure that the material does not wash off the slide, as fat does not adhere readily to the glass surface.
Note: Gentle heat fixing of greasy material to a slide may be of benefit in keeping adipose cells adherent to slides during staining. This can be accomplished by holding a slide over a Bunsen burner or lighter or gentle heating on a heating tray/bar for a few seconds so that the side opposite to that containing the cellular material is slowly warmed. The slide must be left to cool completely before staining. Slides coated with poly-l-lysine, which are used for Papanicolaou staining and/or increased adherence of tissue sections to slides, are also helpful in promoting cellular adherence and eliminating loss of cells during staining.
Sometimes, local fat will be aspirated and cannot be reliably differentiated from the adipose cells of a lipoma. If there is any doubt as to the presence of a discrete mass, surgical removal with histological evaluation is recommended.
A 5-year old indoor/outdoor male neutered short hair presents for a wound on the chest. The owner noticed a hole in the skin and thought he had a ruptured abscess. On close examination of the wound, you notice a larva inside the hole. Which organism is most likely under the skin?
- a) Ctenocephalides
- b) Culicoides
- c) Cuterebra
- d) Ancylostoma
c) cuterebra
Cuterebra is a fly that lays its eggs on soil or plants. The eggs stick to the animal’s fur when they come into contact. The eggs hatch, and the larvae either penetrate the skin, are ingested when the animal grooms, or they enter the animal’s body through a natural opening, such as the nose.
I_n most cases, the larvae migrate to areas just under the skin on the head, neck, or trunk_ of the animal. In dogs, cats, and ferrets, who are not the usual hosts of this parasite, the larvae may also migrate to the brain, eye, eyelids, or throat.
As the larva grows under the skin, it produces a nodule or swelling. A small opening develops in the skin, through which it breathes. A small amount of drainage may occur around this breathing hole.
The treatment is to incise the skin if needed to remove the larva. You have to make sure to remove the larva in whole and not crush it. If it is damaged or crushed, it can cause an anaphylactic reaction.
Ctenocephalides is a flea, Ancylostoma is the hookworm, and Culicoides are tiny gnats that most often bother horses and livestock.
What is a common side effect of xylazine administration in cats?
- a) Anuria
- b) Vomiting
- c) Seizures
- d) Polycythemia
- e) Miosis
b) Vomitting
Xylazine frequently causes vomiting in cats. In fact, veterinarians use Xylazine when they wish to induce emesis in cats. It can also cause decreased PCV, mydriasis, and diuresis.
Once infected, for what period of time is canine parvovirus usually shed?
- a) 5-6 months
- b) 1-2 months
- c) 2-3 months
- d) 7-10 days
d) 7-10 days
The correct answer is 7-10 days. Canine parvovirus mainly affects puppies and young dogs less than a year of age. Transmission of the virus is through contact with infected feces and fomites such as hands, toys, the dog’s hair coat. The virus is very resilient in the environment and is resistant to many types of disinfectants. It replicates in the crypt epithelium of the gut and causes epithelial necrosis and hemorrhagic diarrhea. The virus can also affect the heart of young puppies, causing myocarditis. This occurs less commonly now since most bitches are immunized against the virus, which allows for maternal antibodies to protect young puppies from this form of the disease.
You go to a ranch to evaluate the sudden death of a bull. There is black, bloody discharge from all orifices. There is incomplete rigor mortis despite being dead for a day. What is your most likely diagnosis?
- a) Grass staggers (hypomagnésémie, tétanie d’herbage)
- b) tetanus
- c) anthrax
- d) botulism
- e) Moldy sweet clover toxicity
c) Anthrax
Anthrax is caused by Bacillus anthracis. The black blood from the orifices, incomplete rigor mortis, and acute death is very characteristic of the disease in cattle. Lesions occur in the reticuloendothelial system and vasculature. Do not perform a necropsy on the animal as you would potentially release spores into the environment. You should notify the authorities if you suspect the disease.
Coat color and sun exposure likely predisposed this cat to developing the tumor seen in the photo.
- a) Basal cell tumor
- b) Squamous cell carcinoma
- c) Mast cell tumor
- d) Melanoma
White cats or cats with areas of white fur on the face or ears are predisposed to developing squamous cell carcinoma from UV light. These lesions are usually ulcerative and appear around the nose, ears, or eyelids.
What is the main mode of transmission for feline leukemia virus?
- a) Shedding of virus via feces
- b) Shedding of virus via saliva
- c) Aerosol transmission
- d) Fomite transmission
b) Shedding of virus via saliva
The main mode of transmission is via saliva. It requires prolonged, close contact. Cats may shed the virus for months to years. Transmission may also occur through reuse of instruments and blood. Virus is shed in saliva, tears, urine, and feces.
A 6-year old intact male domestic short haired cat presents with acute onset exophthalmos of the right eye in the past 2 days. He is painful on palpation around his eye and head. The eye can be retropulsed some, but there is resistance present. He has not been eating in the past day and has a rectal temperature of 103.4F (39.7 C). What is the most likely diagnosis?
- a) Glaucoma
- b) Anterior uveitis
- c) Orbital neoplasia
- d) Retrobulbar abscess
d) Retrobulbar abscess
Acute, painful exophthalmos is usually due to retrobulbar abscessation. These lesions are usually painful and may be swollen. These animals are frequently systemically ill with fever and leukocytosis. Causes of retrobulbar abscesses include penetrating wounds, foreign bodies, spread from dental or sinus infection, and hematogenous spread. Glaucoma does not cause exophthalmos, although, chronically it can cause buphthalmos which may appear similar. Anterior uveitis also does not cause exophthalmos.
You are working with a farmer who is having trouble with calves between the age of 2 weeks and 6 months. They are alert, but weak, dyspneic and die suddenly. On necropsy they have pale cardiac and skeletal muscles. What is the farmer’s problem?
- a) Sorghum toxicity
- b) Copper deficiency
- c) Selenium deficiency
- d) Lightning strike
c) Selenium deficiency
The pale muscle and clinical signs are classic for vitamin E and selenium deficiency. This is important to remember! Other things that should be on your differential list for this case include cardiotoxic plants.
A 5-month old female cat presents to you for weight loss, chronic diarrhea and steatorrhea. The organism seen in a stained fecal smear is shown in the image below (this is a magnified 40X image, the organism is approximately 15 x 8 um). Which treatment is most appropriate
- a) Sulfadimethoxine
- b) Tylosin
- c) Penicillin
- d) Fenbendazole
d) Fenbendazole
The organism is Giardia which can be recognized as a trophozoite with two nuclei outlined by adhesive discs. Giardia should be distinguishable from trichomonads which have a single nucleus and an undulating membrane.
The best treatments for Giardia are either fenbendazole or metronidazole.
A 10-year old female spayed Siamese cat presents for a new lump the owner found a month ago. She was spayed last year before she was adopted from the shelter. The owner states that the lump has grown over the last month, and it doesn’t seem to bother the cat. On exam, the 2 cm lump is located on the left 2nd mammary gland, and no other lumps are noted. The lump is freely moveable, and chest radiographs are clear. What is the chance that this tumor is malignant?
- a) 50%
- b) 85%
- c) 5%
- d) 20%
b) 85%
70-90% of all feline mammary tumors are malignant.
Spaying a cat before 6 months of age reduces the risk for mammary tumors by 7 fold.
The statistics for dogs is a 50:50 chance of malignancy for a single mammary mass.
An 8-week old Abyssinian cat recently obtained from a cattery presents to you for an examination and the owner reports that the cat has had diarrhea. On fecal float, you find multiple structures like the one shown in the photo (see image). What should you treat the cat with?
- a) Praziquantel (Droncit)
- b) Metronidazole (Flagyl)
- c) Sulfadimethoxine (Albon)
- d) Pyrantel (Strongid)
- e) Selamectin (Revolution)
- f) Amoxicillin and clavulanate (Clavamox)
c) Sulfadimethoxine
This is an image of Isospora from a cat. Isospora are parasitic coccidia that can cause diarrhea as this cat is showing. Treatment for coccidia is usually with sulfonamides such as sulfadimethoxine or trimethoprim sulfa.
For the other drugs listed:
Droncit- Primarily for cestodes (tapeworms)
Revolution- For fleas, heartworms, hookworms, roundworms, and ear mites
Strongid- Primarily for roundworms and hookworms
Clavamox- A broad spectrum antibacterial
Metronidazole- Primarily for anaerobes, also used for giardia
A 12-year old male neutered domestic short hair cat presents for ongoing evaluation of diabetes mellitus. The cat was diagnosed 6 months ago and has continued to be markedly polyuric, polydipsic, polyphagic, and has been gaining weight. The cat is currently receiving 10 units of glargine insulin every 12 hours. On physical exam, the cat weighs 15 pounds (6.8 kg) and has an enlarged head, abdomen, and paws. What imaging modality would be most appropriate to try and prove what you suspect is causing the uncontrolled diabetes and weight gain in this cat?
a) Ultrasound of the neck
- a) Ultrasound of the neck
- b) Ultrasound of the abdomen
- c) MRI of the head
- d) Radiographs of the thorax
- e) CT of the abdomen
C) MRI of the head
This cat has the signs and symptoms of acromegaly. Acromegaly is caused by excessive growth hormone release from the pars distalis from a tumor in the pituitary gland. Excessive growth hormone causes a defect in the insulin receptors on target cells causing insulin resistant diabetes mellitus. The enlarged head, paws, abdomen, and weight gain despite uncontrolled diabetes is due to the anabolic effects of the growth hormone.
Treatment for this condition includes radiation therapy to the pituitary tumor, high doses of insulin to try and control the diabetes, and somatostatin* analogs (octreotide) to try and inhibit the release of growth hormone from the tumor. Surgical excision has been used as a form of treatment in people with pituitary tumors, but this has only been rarely reported in cats.
note (wiki): About 98% of cases of acromegaly are due to the overproduction of growth hormone by a benign tumor of the pituitary gland called an adenoma.[16] These tumors produce excessive growth hormone and compress surrounding brain tissues as they grow larger. In some cases, they may compress the optic nerves.
* Somatostatin = Growth Hormone Inhibiting Hormone, GHIH
A 36 hour foal born from a multiparous mare presents for weakness, decreased appetite, and tachycardia. On physical exam, you examine the sclera as seen in the photo. Based on the signalment and findings, what is a likely cause?
- a) Congenital iron toxicity
- b) Neonatal Isoerythrolysis
- c) Immune mediated thrombocytopenia
- d) Failure of passive transfer
B) Neonatal Isoerythrolysis
Neonatal Isoerythrolysis (NI) would be a possible cause of the icterus noted in the sclera. NI is common in multiparous mares and usually affects foals between 24-72 hours of age. NI results in hemolysis, hyperbilirubinemia, and icterus. A low packed cell volume would further support NI.
NI develops because the newborn foal expresses alloantigens on its red blood cells inherited from the sire that the mare does not have. If the mare becomes sensitized to the sire’s specific antigen, maternal antibodies are produced and absorbed by the foal soon after birth. This subsequently results in lysis of the red blood cells.
You examine a very ill 4-year old Holstein dairy cow on a large commercial dairy. She freshened one week ago and was producing well, until she was found down and unwilling to rise this morning when you were called. T=103F or 39.4 C, HR=90, and RR=35. The scleral vessels are dark are enlarged, her rumen is fairly empty and the motility is poor, and she appears too weak to rise. Rectal exam reveals an involuting uterus which can be retracted, discharging a brownish red mucoid non-odorous lochia through the vagina. The left rear quarter of her udder is swollen, hot, painful, and discolored (see image), and contains a serum-like secretion with clumps of fibrin in it. What is your diagnosis?
- a) Hypocalcemia (milk fever)
- b) Coliform mastitis
- c) Displaced abomasum
- d) Grain overload
- e) Metritis
B) Coliform mastitis
This is a case of severe acute coliform mastitis, and the absorbed endotoxin (LPS) is causing many of the systemic signs observed. The cow needs to be aggressively treated with IV fluids, NSAIDS, and supportive nursing. The gland should be frequently milked out. The use of both intramammary and systemic antimicrobial drugs to which most coliforms are susceptible is still controversial, but is often done in cows in a severe state of illness as in this case. While this cow may have secondary hypocalcemia, treatment with calcium needs to be approached cautiously, as endotoxic animals have very sensitive myocardium and arrest may occur if calcium is given IV. If given, preferred routes of calcium administration would be subcutaneous or oral.
A 2-year old female spayed Dachshund presents for further evaluation as a result of a mass on the pinna noted by the owner. On physical exam, the only abnormality noted was this mass. Cytology is consistent with a histiocytoma. Which of the following is the most reasonable treatment option?
- a) Benign Neglect
- b) Radical surgical excision
- c) Cryotherapy
- d) chemotherapy using lomustine
- e) Radiation therapy
A
Histiocytomas are typically benign and will often present as a small, raised mass that may or may not be ulcerated. Fortunately, these masses usually regress on their own, and surgical or medical intervention is typically not necessary.
A 4-year old female ferret presents with a history of an enlarged vulva and truncal alopecia. What is the most likely diagnosis?
- a) Adrenal tumor
- b) Hypothyroidism
- c) Sertoli cell tumor
- d) Insulinoma
A
The correct answer is adrenal tumor. These tumors are very common in middle-aged ferrets and usually secrete estradiol. Common clinical signs are hair loss, enlarged vulva, pruritus, and behavior changes. Diagnosis is made by clinical signs, ultrasound, and measurement of serum estradiol levels. Treatment is adrenalectomy.
What is the primary mode of transmission of West Nile Virus (WNV) between birds?
- a) Via Cnemidocoptes mites
- b) Via mosquitoes
- c) Via feces
- d) Via placenta
- e) Via saliva
B
Mosquito vectors are the primary mode of transmission for WNV between birds and other hosts (horses, humans). There are infrequent documented cases of the disease being spread by feces or saliva. No mites have been documented to transmit the disease. Birds do not have a placenta.
A 7-year old female spayed English Springer Spaniel presents for difficulty breathing and lethargy. Physical exam shows pale mucous membranes and increased respiratory effort. You collect blood for a complete blood count and a chemistry panel and you place a drop of blood with a drop of saline on a glass slide. After swirling the sample around, you can grossly see what is shown in the picture. What’s your diagnosis?
- a) Hemolysis
- b) Immune mediated hemolytic anemia
- c) Evan’s syndrome
- d) Vitamin K antagonist toxicity
- e) Rouleaux formations
B) Immune Mediated Hemolytic Anemia
The image shows a positive slide agglutination test. The dark patches in the sample are caused by antibodies attached to the surface of the erythrocytes cross linking the cells together causing these clumps. This is highly suggestive of an immune mediated reaction to antigen on the individual’s red blood cells.
Rouleaux formations are red blood cells stacked together as a result of their natural discoid shape and large surface area causing them to have an affinity for each other. They typically resemble a stack of coins or cookies.
Evan’s syndrome is an autoimmune condition characterized by an immune attack on erythrocytes, platelets, and occasionally leukocytes as well. You w_ould not be able to diagnose this on a slide agglutination test alone_.
Vitamin K antagonist toxicity with rodenticide causes a coagulopathy but should not cause hemagglutination.
A 6-month old Chocolate Labrador presents for limping and failure to gain weight. He is housed in an outdoor kennel with other hunting dogs. He is fed a large breed dry puppy food. He received his puppy shots at 8, 12, and 16 weeks old. He is quiet, alert, and responsive. His body condition score is 3/9, with rib exposure and poor fat deposition. His mucous membranes are pale pink, with a capillary refill time of 2 seconds. His heart and lungs auscult normally. No abnormalities are felt on abdominal palpation. He is an intact male, and both testicles are descended. The only abnormalities are the pads of his two front feet and left hind foot (see image) that he chews at frequently. What is diagnostic test of choice?
- A) Skin scraping
- B) Biopsy
- C) Radiograph
- D) CBC and chemistry panel
- E) fecal float
E) Fecal Float
Hookworms (Ancylostoma and Uncinaria) are intestinal parasites that suck blood and can cause anemia, enteritis, coughing during larval migration, and dermatitis. Any young dog that is failing to thrive and/or has pale mucous membranes should be tested for intestinal parasites. Hookworm dermatitis, also called Ancylostomiasis is typically seen in conditions with poor sanitation and/or in kennels.
Hookworms can be transmitted in utero, during nursing, or via 3rd stage larva penetrating the skin. The most commonly affected skin areas are the pads and interdigital spaces of the feet, but can include any surface that contacts the ground. The larva migrate through the dog’s tissues before arriving in the intestines. They cause significant anemia, failure to thrive, or sudden death in young dogs. In mild cases, deworming protocols are often enough; with severe cases blood transfusions and parenteral treatments are often necessary.
Skin scraping and impression smears of the affected skin areas are typically unrewarding for isolating parasites. A PCV/TP would show signs of anemia, but not the underlying etiology. Complete blood cell count and chemistry will often show anemia that is regenerative and an eosinophilia. Radiographs would be unrewarding in this case. A biopsy may show migrating larva if biopsied soon after trauma, however this is not a diagnostic test routinely used.
A 2-year old mare presents to you several weeks after recovering from a mild upper respiratory infection. She now presents with edema and sloughing of the legs (see image), chest and abdomen as well as mucosal petechial hemorrhages. She is sore and reluctant to move. Biopsy of the skin lesion is consistent with aseptic necrotizing vasculitis. What is the most likely diagnosis?
- a) Type I Hypersensitivity
- b) Bastard Strangles
- c) Purpura hemorrhagica
- d) Idiopathic thrombocytopenia
C) Purpura hemorrhagica
This is the clinical and histologic appearance of purpura hemorrhagica. It is a type-III hypersensitivity which is when antigen-antibody complexes accumulate, leading to disease.
Purpura hemorrhagica most commonly occurs 2-4 weeks after exposure to certain infectious agents or vaccines. This condition is most commonly seen subsequent to infection with Streptococcus equi subsp. equi or vaccination against it but it can also be associated with other pathogens, particularly respiratory pathogens including other streptococcal species and equine influenza.
Regardless of the cause, purpura hemorrhagica results from accumulation of antigen-antibody complexes that deposit on blood vessel walls and activate a strong immune response (vasculitis). The leaky blood vessels lead to hemorrhage and edema.
Bastard strangles refers to the condition when Streptococcus equi subsp. equi creates abscesses in unusual sites (other than the lymph nodes draining the throat) such as abdominal or lung lymph nodes.
Cantharidin toxicity (also known as blister beetle toxicity) leads to mucosal irritation and results in colic and cystitis. It can also lead to hypocalcemia.
Primary immune-mediated thrombocytopenia (sometimes called idiopathic thrombocytopenia) can be seen in horses but is not consistent with the necrotizing vasculitis described in the case.
Type I hypersensitivity reactions are immediate reactions (such as urticaria) invoked by an antigen or allergen.
A 2-year old nonlactating dairy cow in California has a sudden onset of head tilt and drooling. The owner also reports that she appears less active and less interested in feed than normal, and today is circling in one direction in the pen. You examine her and find T=105F (40.6 C), HR=96, and RR=32. There is ptosis, drooped ear, and weakness of the lips on the affected side. You take a lumbosacral spinal tap (see photo), and submit the CSF to your lab. The results show elevated protein and WBCs, with the cell type being mainly monocytes. The lab reports seeing some gram positive bacteria in the monocytes of the CSF. Based on these findings what is the best treatment for this condition?
- A) Enrofloxacin
- B) Penicillin
- C) Metronidazole
- D) Metoclopramide
- E) Chloramphenicol
B) Penicillin
The diagnosis is Listeriosis. Listeria monocytogenes can effectively be treated in the early stages of the disease with penicillin, ampicillin, or tetracycline. Intramuscular procaine penicillin for example has a withdrawal of 10 days for slaughter (meat) and 48 hours for milk if the animal is lactating. Other choices of approved antimicrobials would also likely be effective since L. monocytogenes is susceptible to most antimicrobials. For a list of approved animal drugs see www.farad.org/vetgram. FARAD is the United States Food Animal Residue Avoidance Databank which gives withdrawal information as well as a list of prohibited drugs. The other drugs listed as choices here are prohibited and cannot be legally used in food animals in the USA.
A dog presents to your clinic with tenesmus and swelling near the anus as seen in the image. On examination, there is a fluctuant swelling lateral to the anus, and on rectal exam, you note lateral dilatation of the rectum. Which of the following is the most common signalment for dogs presenting with this problem?
- A) They are younger intact females
- B) They are younger intact males
- C) They are older intact females
- D) They are older intact males
- E) There is no age or sex predilection
D) They are older intact males
This is a case of a perineal hernia. Older intact male dogs are most commonly affected.
Overrepresented breeds include Boxers, Collies, Kelpies, Pekingese, and Boston terriers. The hernia results from a weakened pelvic diaphragm. It is thought that there may be a hormonal component which results in weakening with time.
Wiki:
Perineal hernia is a hernia involving the perineum (pelvic floor). The hernia may contain fluid, fat, any part of the intestine, the rectum, or the bladder.
Dogs with benign prostatic hyperplasia have been found to have increased relaxin levels and suspected subsequent weakening of the pelvic diaphragm
In cats, perineal hernias are seen most commonly following perineal urethrostomy surgery or secondary to megacolon.
A pregnant mare was brought out to your barn for observation in anticipation of parturition. After several hours of restless behavior, several gallons of allantoic fluid rush out from the vulva. Which of the following would you expect to happen next for a normal parturition?
- A) The thin, white, glistening amniotic membrane emerges from the vulva
- B) The red, velvety, chorioallantoic membrane emerges from the vulva
- C) The placenta is expelled from the vulva
- D) The hind legs of the foal emerge from the vulva
A) The thin, white, glistening amniotic membrane emerges from the vulva
This case description is consistent with stage I of labor in the horse. The first stage of foaling typically lasts 30 minutes to 4 hours. During this stage, mares act restless and may exhibit signs similar to colic such as flank watching, pawing, and constantly getting up and down. When the placenta ruptures (“water breaks”), there may be several gallons of allantoic fluid that come out. Usually, within about 5 minutes, the second stage of labor begins and the foals feet and nose appear at the vulva, covered in the white, thin, glistening amnion. If a red, velvety, membrane is seen, this is the chorioallantois which indicates premature placental separation which can impair oxygen delivery to the fetus and can result in death of the foal. Usually, the muzzle will emerge from the amnion by the time the foal’s hips pass through the pelvis but if not, the amnion can be gently broken and removed. Usually, the umbilical cord breaks naturally when the mare stands or foal begins to rise. Then, within 30 minutes to 3 hours after foaling, the placenta should be expelled.
A 2-year old male neutered cat presents to you depressed, hypersalivating, and ataxic with muscle tremors. The owner reports that a pyrethrin-based spot-on formulation for flea control belonging to their Golden Retriever was accidentally applied on the cat earlier today. Which of the following drugs will you use to treat the cat’s clinical signs?
- A) Methocarbamol
- B) Amoxicillin
- C) Acepromazine
- D) 2-PAM
- E) Atropine
A) Methocarbamol
Pyrethrins alter the activity of the sodium ion channels of nerves, which prolongs the period of sodium conductance. This increases the length of depolarization resulting in repetitive nerve firing. Cats are particularly sensitive to pyrethrin-containing products and can develop clinical signs within hours after administration. Affected animals should be bathed to remove remaining product. Minor clinical signs such as hypersalivation and ear twitching are usually self-limiting and do not require treatment. Control of marked tremors or seizures can be achieved with methocarbamol (Robaxin).
Your client is pregnant and is worried about acquiring toxoplasmosis from her cat. What do you advise?
- A) Have a housemate empty the litter box daily as a simple precaution to prevent infection as it takes 1-3 days for passed oocysts in the stool to sporulate into an infective form.
- B) Toxoplasmosis titer should be performed on the owner by a human physician. A positive titer indicates antibodies to the organism that will prevent infection in the first trimester. A negative titer indicates she should remove her cats from her environment.
- C) Submit toxoplasmosis titers from the cat. A IgG titer of 1:64 or greater suggests recent or active infection that could pose a danger.
- D) Submit toxoplasmosis titers from the cat. A positive cat infected with toxoplasmosis can shed multiple times in its lifetime and pose a zoonotic risk.
A
Toxoplasmosis gondii is a protozoal organism. The cat is the definitive host; the entire life cycle of the organism can be completed within this host. Most cats become infected when they consume an exposed rodent with bradyzoites encysted in their tissues. Only recently infected cats generally shed oocysts in their stool, and cats typically only shed these oocysts for 1-2 weeks. Most cats will only have one shedding episode in their lifetime.
A IgM (not IgG) titer of 1:64 or greater suggests recent or active infection and that cat is at risk of shedding oocysts in their stools. Oocysts are not infective until they sporulate. This process takes > 24 hours, so emptying the litter box daily is advised, preferably by someone who is not pregnant.
If an owner has owned cats for a long while, it is possible that they may have previously been exposed and therefore have mounted an immune response to the organism. If so, it may be advisable to test for Toxoplasma antibody titers in the owner. A sufficient antibody titer will mean the client is protected from infection during the first trimester.
What is the potential udder fate of goats infected with caprine arthritis encephalomyelitis virus?
- A) Gangrene
- B) The udder is not affected
- C) Hardbag
- D) Bluebag
C
CAEV is a retrovirus and when it affects the udder it will cause fibrosis and result in a firm udder with agalactia. Treatment is ineffective and the goat should be culled. The disease is usually subclinical but can cause arthritis in adults and encephalitis in kids.
A 4-year old male Manx cat presents to you because the owners found an empty, opened pill vial in the bathroom and the cat vomited. On physical exam, you note ptyalism and facial edema. The cat’s mucous membranes are pale and slightly icteric. You perform a blood smear and detect Heinz bodies in erythrocytes. The cat’s packed cell volume (PCV) is 26% (30-45%). The owners provide you a list of the medications in the medicine cabinet which are acetaminophen (Tylenol), finasteride (Propecia), enalapril (Vasotec), and omeprazole (Prilosec). What treatments should you institute for this cat?
- A) Activated charcoal and whole blood transfusion
- B) Prednisone and amoxicillin
- C) Acetylcysteine and S-adenosylmethionine
- D) Emesis and methylene blue
C) Acetylcysteine and S-adenosylmethionine
Acetaminophen toxicity in cats usually occurs when owners administer the drug, unaware of its significant potential toxicity in cats. In this case, the cat’s clinical signs are most consistent with acetaminophen toxicity based on the Heinz body anemia that is present. Cats can die from oxidative damage and methemoglobinemia within 1-2 days of ingestion. It may also be associated with hepatotoxicity in cats, although this is seen more frequently in dogs.
Recall that cats are particularly sensitive to acetaminophen because they have decreased glucuronyl transferase activity which conjugates acetaminophen to glucuronic acid for excretion. As a result, 50-60 mg (a single tablet) may be fatal for a 4-5 kg cat.
Treatment should consist of toxin removal if possible by inducing emesis in some cases. As the cat in this case is already vomiting, this may not be necessary. Activated charcoal is controversial and should only be given if ingestion occurred within hours and should be administered very carefully in cats due to the risk of aspiration.
The specific antidote is acetylcysteine which binds to some of the reactive metabolites of acetaminophen and increases the availability and synthesis of glutathione. Other treatments may include S-Adenosylmethionine (SAMe) which has hepatoprotective and antioxidant properties. Cimetidine can be given to inhibit the p450 oxidase in the liver and limit formation of toxic metabolites. Ascorbic acid can also be used as an adjunct treatment to bind toxic metabolites. In cats with signs of hypoxemia from severe hemolytic anemia (PCV <20%), a transfusion and further supportive care may be warranted.
A client calls and says her cat was chewing on her lily plant two days ago and is now acting very sick. You tell her to bring the cat in immediately so that you can perform which of the following?
- a) ALT, AST, GGT, and total bilirubin levels
- b) Induce emesis and administer activated charcoal
- c) BUN and creatinine levels
- d) Abdominal radiographs to diagnose intestinal obstruction
C) BUN and creatinine levels
Lily plant toxicosis is extremely serious and can cause rapid and fatal acute renal failure in cats. If ingestion is suspected, decontamination and aggressive fluid therapy, and monitoring of renal values are recommended immediately.
In this case, since 2 days have passed, inducing emesis and administering activated charcoal would not be helpful. What you can do is check renal values (BUN and creatinine) and treat for acute renal failure.
Ruling out an intestinal obstruction in a cat with this history is reasonable but not the best of the choices given.
Web: Lilies in the “true lily” and “daylily” families are very dangerous for cats. The entire lily plant is toxic: the stem, leaves, flowers, pollen, and even the water in a vase. Eating just a small amount of a leaf or flower petal, licking a few pollen grains off its fur while grooming, or drinking the water from the vase can cause your cat to develop fatal kidney failure in less than 3 days. The toxin, which only affects cats, has not been identified. Dogs that eat lilies may have minor stomach upset but they don’t develop kidney failure.
A 3-year old, indoor-only, male castrated Maine Coon cat is presented to you for acute-onset of hindlimb pain and paresis. Physical examination reveals a grade III left parasternal heart murmur and minimal movement in the hind legs. Femoral pulses are bilaterally absent, and the hindlimb toes are cold to the touch. The cat is tachypenic, but lung sounds are normal. What is the most likely diagnosis?
- A) Chlorpyrifos toxicity
- B) Tetanus
- C) T3-L3 intervertebral disc disease
- D) Lymphoma of the spinal cord
- E) Thrombus at the aortic bifurcation (saddle thrombus)
E) Thrombus at the aortic bifurcation (saddle thrombus)
Maine Coon cats are predisposed to development of hypertrophic cardiomyopathy at a young age. Consequently, left atrial enlargement predisposes to atrial thrombus formation, and these clots frequently lodge in the arterial supply to the hindlimbs. The trifurcation is where the aorta divides into the two external iliac arteries and the common origin of the internal iliac arteries. Classic findings due to a clot at the aortic trifurcation include posterior paresis/paralysis, hindlimb pain, cyanotic nailbeds, absent femoral pulses, and a firm leg musculature. Other signs of cardiac disease/failure (murmur or pulmonary edema) are often but not always evident at presentation.
Neither cord lesions, tetanus, nor toxicities should cause the vascular compromise evident on this cat’s physical exam.
A 4 year old mare has bilateral swelling and drainage of the mandibular lymph nodes. Rectal temperature is 101.8F (38.8 C). Which of the following is the most appropriate plan for this horse?
- A) Culture the discharge for bacteria
- B) Administer corticosteroids
- C) Administer penicillin
- D) Inform the state veterinarian
A) Culture the discharge for bacteria
The correct answer is to culture the discharge for bacteria. The most likely diagnosis for this horse is equine strangles. Strangles most commonly affects younger horses (<5 years of age), but can cause disease in any age horse. The etiologic agent of this disease is S_treptococcus equi subsp. equi_. The diagnostic test of choice to confirm this is bacterial culture. While awaiting culture results, the horse should be separated from any other horses, as strangles is highly contagious to other horses. Antibiotic therapy is controversial and thought to lengthen the course of disease rather than shorten it when given at this stage; also, it may possibly interfere with the natural immunity acquired from natural infection. S. equi infection is not reportable in all states (or countries), and so it may not need to be reported universally.
A 10 year male castrated German Shepherd dog presents for an acute onset of ptosis, drooping of the lip, and drooping of the cheek all on the left side. What nerve has been damaged?
CN VII.
This is the facial nerve which is responsible for motor of the facial muscles as well as sensation in the ear and lacrimation. CN V is mostly responsible for sensation (and motion/tone of the mastication muscles: masseter and temporal muscles). CN III is the oculomotor nerve and serves in movement of the eye. CN VI is also involved in movement of the eye.
Rappel:
-
NCVII : symétrie faciale (oreilles, ouvertures palpébrales*, narines, lèvres, vibrisses). ,
- * aussi testé avec réflexe palpébraux (NCV) et réponse à la menace (NCII)
- NCV: sensation au visage (réflexes palpébraux + stimulation du septum nasal) et muscles de la mastication (masséter, temporal)
If a mass appears in the lungs on a right lateral radiograph but not on a left lateral radiograph, where is the mass located?
a) Right lung
b) Left lung
c) mediastinum
d) body wall
b) Left lung
The correct answer is left lung. On a right lateral radiograph, the right side is down. In this situation, the right lung lobes are compressed and the left lung lobes inflated, accentuating a mass in the left lung. On a left lateral radiograph, the left lobes are compressed and a mass in the left lung can be concealed due to compression of the lung surrounding the mass.
A 1-year old female spayed Doberman Pinscher has presented after being hit by a car. Initial chest radiographs show mild contusions, and the patient appears to be otherwise stable. A right mid-shaft long oblique femoral fracture has been identified. Routine pre-operative blood work is unremarkable. A buccal mucosal bleeding test (BMBT) is elevated at 6 minutes. What will you administer prior to surgery?
- a) Vitamin K
- b) Whole blood transfusion
- c) 1,25 dihydrocholecalciferol
- d) Desmopressin acetate
d) Desmopressin acetate
The correct answer is desmopressin acetate (DDAVP). Administration of desmopressin results in release of von Willebrand factor, which will help this patient with clotting. Given this dog’s breed and elevated BMBT there is a very strong likelihood she is afflicted with von Willebrand’s disease. In Dobermans this results in an inability to form a clot. This can be life threatening if the dog is taken to surgery.
A whole blood transfusion does not provide an adequate source of von Willebrand factor but may be necessary if the patient’s bleeding cannot be controlled despite appropriate pre-operative measures. 1,25 dihydrocholecalciferol is the active form of vitamin D which aids intestinal resorption of calcium. The BMBT does not assess factors 2, 7, 9, or 10 and therefore vitamin K is not indicated.
moi: test de saignement = hémostase primaire (formation du clou plaquettaire, impliquant facteur de VwB) et non pas secondaire (coagulation/consolidation du clou)
The goose shown in the image below was found weak on the shore of a local pond where oil had been dumped. The goose was covered in oil, dehydrated and weak but responsive. Which of the following is an important acute clinical effect of oil on affected birds?
- a) Disruption of function of the plumage
- b) Nephrotoxicity
- c) Hepatotoxicity
- d) Lead toxicity
a) Disruption of function of plumage
Feathers serve a critical waterproofing and insulatory function which is disrupted by oil and can rapidly result in hypothermia. Other concerns for oiled birds include GI irritation from ingestion of oil during preening, hemolytic anemia, and pneumonia due to inhalation of oil.
Treatments include heat, supportive care, and activated charcoal. Once stabilized, frequent high pressure, warm, mild detergent baths and clean warm water rinses until water beads freely off of the feathers is important. Birds should be placed in warm air flow until dry and they should be maintained on self-skimming ponds for several days after washing to ensure full waterproofing.
Oral administration of which of these drugs has been implicated as a cause of esophageal strictures in cats?
- a) Potassium bromide
- b) Doxycycline
- c) Diazepam
- d) Azithromycin
b) Doxycycline
There is also evidence that clindamycin can cause stricture formation. For this reason, it is recommended that after pilling a cat with doxycycline, it is followed with a small volume (5-10 mls) of water.
Which infectious agent causes the clinical presentation of pigs most similar to Haemophilus parasuis (Glasser’s disease)?
- a) Streptococcus suis
- b) Fusobacterium necrophorum
- c) Mycoplasma hyosynoviae
- d) Erysipelothrix rhusiopathiae
a) Streptococcus suis.
Streptococcus suis and H. parasuis both cause polyarthritis, polyserositis, fever, and pneumonia in young piglets up to several weeks of age. Both can cause fibrinopurulent inflammation as well as meningitis and convulsions.
Erysipelas and M. hyosynoviae typically occur in grower and finisher pigs and do not result in pneumonia. Diamond-shaped skin lesions (thus the name “diamond skin disease”) are pathognomonic for Erysipelas. Fusobacterium necrophorum causes lameness via footrot or laminitis.
You are called one hot summer day to see a group of horses in New Mexico which are slobbering and not eating their hay. Three out of 20 horses seem to be visibly affected. On physical exam of the first one, you find fever of 104 F (40 C) and obvious oral ulcers as shown in the image, mainly on the tongue. What is your tentative diagnosis?
- a) Glanders
- b) Foot-and-Mouth disease (FMD)
- c) Bovine papular stomatitis
- d) Vesicular stomatitis
- e) African Horse Sickness
d. Vesicular stomitis
VS affects horses, cattle and pigs with similar clinical signs. It is a viral disease of high morbidity and low mortality that appears about every 7 to 10 years in the Southwestern United States. Yearly outbreaks occur in southern Mexico and northern South America. Black flies and midges appear to be the vectors. Affected premises should be quarantined.
In January you examine a group of dairy calves which range in age from 2 to 7 months, with a complaint of hair loss and pruritus. The calves are thin and mucous membranes are pale. One has developed bronchopneumonia, and is also febrile and depressed. You do a skin scraping and find the parasite shown in the image, which your technician identifies as Solenopotes sp. The CBC shows the calves to be severely anemic. What treatment recommendation should you now make to the dairy owner?
- a) Vaccinate all calves against Mannheimia hemolytica
- b) Treat all calves for lice
- c) Treat all calves with hematinics
- d) Treat all calves for mange
- e) Treat all calves with long acting tetracycline
b) Treat all calves for lice
This is a blood sucking genus of louse, and c_an cause severe anemia_. The anemic calves become thin and m_ore susceptible to diseases like pneumonia_. You can tell this is a louse and not a tick or a mite because lice are insects with 6 legs and ticks and mites are arachnids with 8 legs.
The three genera of blood sucking cattle lice are Solenopotes, Linognathus, and Hematopinus.
An 8-week old Abyssinian cat recently obtained from a cattery presents to you for an examination and the owner reports that the cat has had diarrhea. On fecal float, you find multiple structures like the one shown in the photo (see image). What should you treat the cat with?
- a) Sulfadimethoxine (Albon)
- b) Amoxicillin and clavulanate (Clavamox)
- c) Praziquantel (Droncit)
- d) Selamectin (Revolution)
- e) Pyrantel (Strongid)
- f) Metronidazole (Flagyl)
a) Sulfadimethoxine (Albon)
This is an image of Isospora from a cat. Isospora are parasitic coccidia that can cause diarrhea as this cat is showing. Treatment for coccidia is usually with sulfonamides such as sulfadimethoxine or trimethoprim sulfa.
For the other drugs listed:
Droncit- Primarily for cestodes (tapeworms)
Revolution- For fleas, heartworms, hookworms, roundworms, and ear mites
Strongid- Primarily for roundworms and hookworms
Clavamox- A broad spectrum antibacterial
Metronidazole- Primarily for anaerobes, also used for giardia
You see an 8-month old kitten with the effusive form of feline infectious peritonitis and perform euthanasia. The kitten was having severe diarrhea around the house when it became ill. The owner has a 2 year old cat at home and wants to know what this cat’s prognosis is since it has been exposed to the sick kitten. Currently this cat is clinically healthy. What do you tell her?
- a) Perform a PCR on the cat’s feces to see if the virus is being shed
- b) Her other cat may develop symptoms within the next two weeks because FIP is highly contagious
- c) Feline infectious peritonitis is not contagious and because her other cat died of FIP does not mean this cat will succumb to the disease
- d) You recommend a coronavirus titer to determine it the cat is actively infected
- e) Place the cat on L-lysine to prevent or suppress any infection with FIP
C)
Feline infectious peritonitis is not a contagious disease (mais transmission indirecte par voie feco-orale possible non?). It is a disease that is caused by a mutation of feline enteric coronavirus. It is unknown why in some patients this virus mutates and causes the FIP syndrome. It is most likely to occur in young or immunocompromised cats. Her other cat is not necessarily going to get FIP just from exposure. In fact, the majority of the cat population has been exposed to the feline enteric coronavirus.
Because most cats in the general population have been exposed, it makes interpretation of coronavirus titers difficult. The titers can be elevated due to prior exposure and not from FIP. The titers can only be interpreted in lieu of clinical signs, blood results, etc.
L-lysine is an anti-viral medication that may have some benefit for suppression of herpes virus but would not be a prevention or treatment choice for coronavirus.
The coronavirus is shed in the cat’s feces during active infection with coronavirus. Some infected cats do not shed the virus. The virus attacks the intestinal tract and causes GI upset. PCR on the feces would detect coronavirus, but does not distinguish between the enteric coronavirus and the mutated FIP form of the virus.
A 10-year old German Shepherd presents to you with the complaint of licking the anal area and scooting. On examination, you find numerous ulcerated tracts in the perianal area that are draining purulent fluid. What is the diagnosis?
- A) Anal sac impaction
- B) Anal sac abscess
- C) Clostridial colitis
- D) Perianal fistula
D) Perianal fistula
This is seen mainly in older German Shepherds, and licking the anus is a common presenting complaint. The key finding is the presence of multiple draining tracts in the perianal region that can actually be quite deep.
A 2-year-old Quarter horse filly presents with a history of intense pruritis and alopecia in the perineal area (see image). The owners indicated that they noticed the filly rubbing her tail head and perineal area along fences for a period of one week. What diagnostic test will you use to confirm your top differential?
- A) A fecal flotation to confirm Oxyruis equi
- B) A scotch tape test to confirm Strongyloides vulgaris
- C) A fecal flotation to confirm Cyathostomiasis
- D) A superficial skin scrape to confirm Chorioptes spp.
- E) A scotch tape test to confirm Oxyuris equi
E) A scotch tape test to confirm Oxyuris equi
The correct answer is a scotch tape test to confirm Oxyuris equi, the equine pinworm. While all of these diagnostic tests are important when you suspect parasitism, the scotch tape test will enable you to observe the eggs stuck to the hair. The egg laying activity by the female worm is what causes the intense pruritis. Occasionally, eggs can be found in a flotation, which may give you a false negative interpretation if not found. A superficial skin scrape is a great alternative for this case; however, Chorioptes spp. tend to infest breeds with feathered legs. An infestation of Strongyloides vulgaris or Cyathostomes will likely cause colic, diarrhea, and lethargy.
Tommy, a 4-year old male neutered domestic short hair, presents to you for frequent urination. Urinalysis reveals 4+ struvite crystals. An abdominal radiograph shows a 1 cm round calculus in the bladder. Tommy does not have a urethral blockage, and urine culture is negative. The owner says surgery to remove this stone is not an option due to finances. Which of the following would be the most important treatment for Tommy?
- A) Alkalinizing diet
- B) Potassium citrate
- C) Metacam
- D) Clavamox
- E) Acidifying diet
E) Acidifying diet
This cat most likely has a struvite bladder stone. This cannot be determined without a stone analysis, but based on the signalment of the patient, the crystalluria, and the radiograph, this is the most likely type. These types of stones typically form in urine with a high pH. Therefore, an acidifying diet would be appropriate for stone dissolution.
Calcium oxalate stones are the most common type of stone to form in acidic urine. For this type, an alkalinizing diet would be the most appropriate.
Clavamox would only be indicated if this cat had a urinary tract infection sensitive to this antibiotic. This cat had a negative urine culture.
Metacam can be used short-term to help with pain and inflammation associated with the cystitis from this condition but unfortunately Metacam is no longer recommend for use in cats in the United States.
Potassium citrate is a supplement that can be given in addition to an alkalinizing diet to prevent the formation of calcium oxalate stones. This would be contraindicated in this case.
A 4-year old male Thoroughbred horse presents to you for colic. During your work up, you note a painful enlargement at the root of the mesentery on rectal palpation. You suspect that the cause of the horse’s colic are adults from the egg shown in the picture below. Which of the following drugs effectively kills the adult organisms that can cause this condition?
- A) Rifampin
- B) Ivermectin
- C) Piperonyl butoxide
- D) Praziquantel
- E) Metronidazole
B) Ivermectin
Colic with an associated painful mass at the root of the mesenery is suspicious for verminous arteritis caused by damage to the cranial mesenteric artery and its branches by Strongylus vulgaris. The strongyle egg shown in the picture confirms the cause in this question. A number of anthelmintics are effective including benzimidazoles, pyrantel and ivermectin.
Praziquantel is effective against tapeworms. Rifampin and metronidazole are antibacterial drugs. Piperonyl butoxide is a pesticide synergist used in insecticide mixtures in horses.
In canine patients with primary hyperparathyroidism, a chemistry panel would show:
- A) Hypercalcemia, hyperphosphatemia
- B) Hypocalcemia, hypophosphatemia
- C) Hypocalcemia, hyperphosphatemia
- D) Hypercalcemia, hypophosphatemia
C) Hypercalcemia, hypophosphatemia
Patients with primary hyperparathyroidism would have hypercalcemia and normo to hypophosphatemia due to the law of mass action in which phosphorus decreases as calcium increases and vice versa.
You are examining a 13-year old Standardbred brood mare 5 hours after parturition. You note that the placenta is still present in the reproductive tract of the mare (see image). What is the most appropriate therapy?
- Administer penicillin (IM) until the placenta is expelled on its own
- Do nothing; the placenta is not considered retained until 12 hours post-parturition and it will likely be expelled by this time
- Administer oxytocin (IM or IV) and lavage the uterus to facilitate removal
- Place physical traction on the placenta and remove it manually
- Administer oxytocin (IM or IV) and lavage the uterus to facilitate removal
* Most texts state that the placenta in a mare is retained after greater than 3 hours post-parturition; therefore, this would be considered a retained placenta. Oxytocin, along with uterine lavage, will cause the uterus to contract and facilitate expulsion of the placenta. Strong physical traction on the retained placenta is generally considered contraindicated, as you may tear the placenta and leave remnants of it within the uterus, resulting in possible complications. Broad-spectrum antimicrobials are often administered to decrease the incidence of metritis but alone would not be appropriate.*
You are called out to examine a 4-year old dromedary who was castrated 10-days ago and is now not eating. The groin and prepucial area is extremely swollen. The camel is unable to stand and is drooling. His neck is extended and he appears to be unable to swallow. Which of the following is most likely responsible for these symptoms?
- Rabies virus
- Clostridium tetani
- Trypanosoma evansi
- Methicillin-resistant Staphylococcus aureus
- Clostridium tetani
This camel is showing signs of tetanus. The organism was likely introduced into the body through the castration wound. It is recommended that camels are vaccinated against tetanus prior to castration.
While rabies may cause paralysis of the tongue and difficulty swallowing, the recent history of castration in this camel makes tetanus most likely.
Trypanosoma evansi is transmitted via biting flies and causes a slow wasting disease in camels.
A dog presents with acute onset vomiting, hemorrhagic diarrhea and fever. On fecal examination, you find many large fluke eggs (fr. = oeufs de douve). You question the owner and discover that the dog was recently in Oregon on a boating trip. What agent is most likely causing the clinical signs in this dog?
- Nanophyetus salmincola
- Neorickettsia helminthoeca
- Rickettsia rickettsii
- Oxytrema silicula
- Neorickettsia helminthoeca
The correct answer is Neorickettsia helminthoeca. This rickettsial organism is the causative agent of salmon poisoning. It is carried in the fluke, Nanophyetus salmincola, which requires the snail, Oxytrema silicula in its life cycle. The snail is what confines occurrence of salmon poisoning to the northwest coast.
A 4-month-old terrier cross presents for inability to eat. The puppy is bright, alert, and responsive on exam. Heart rate is 148, respiratory rate is panting, and temperature is 101.8 F (38.8 C). The puppy is extremely painful when his lower jaw is palpated, and cries and pulls away when you attempt to open his mouth. Sedated oral exam is unremarkable. Radiographs are available for review (see image). What do you tell the owner about prognosis?
- This can be cured with antibiotics based on culture and sensitivity. NSAIDs can be used for discomfort.
- Chemotherapy can prolong quality of life for a few of months, however prognosis is grave.
- Surgical removal of dentigerous cysts will likely be curative, however long term dental disease is common.
- This will regress within a year, and symptomatic support is needed for discomfort.
- This will regress within a year, and symptomatic support is needed for discomfort.
* Craniomandibular osteopathy (CMO) is seen in young dogs and is exemplified in this radiograph. Terrier breeds predominate, but CMO can be seen in any breed. The disease is self-limiting and regresses typically by 1 year old. It is thought to be a type of hypertrophic osteodystrophy (HOD) and occurs mostly in the mandible but can also affect the tympanic bulla, temporal bones, and temporomandibular joints. Treatment is supportive with nonsteroidal anti-inflammatories to control pain, similar to HOD. Radiographic signs will also regress with time.*
Closure of the eyes is mediated by cranial nerve ____ and opening the eyes is mediated by CN ____.
- III, VII
- V, VII
- V, III
- VII, III
- VII, V
- VII, III
Closure of the eyes is performed by the orbicularis oculi muscle innervated by the facial nerve. Opening of the eye is by the levator palpebrae superioris innervated by the oculomotor nerve.
The trigeminal nerve supplies sensory innervation to the eye.
A 4 -year old domestic short haired cat presents for anorexia and weight loss of 1 week. Physical exam reveals a body condition score of 7/9, jaundice of the skin and sclera, and dehydration of 4%. Temperature is normal. Bloodwork shows: ALT=303 (25-97 U/L) GGT=1.8 (0-6 U/L) ALP=1170 (0-45 U/L) bilirubin=3.0 (0-0.1 mg/dl) Radiographs show an enlarged liver. What is the most important treatment for the cat’s likely diagnosis?
- Parenteral vitamin K injections
- Oral clavulanic acid and amoxicillin for 4 weeks
- Esophagostomy tube feeding
- Oral S-adenosylmethionine for at least 1 month
- Esophagostomy tube feeding
*The cat described likely has hepatic lipidosis. Cats that are greater than 2 years of age and obese have the greatest risk for hepatic lipidosis. Often these cats are indoor-only and have had a recent stress in their life. An obese cat that is not eating with the above symptoms is most likely to have hepatic lipidosis.
An ALP elevation that is greater in magnitude than GGT is also suggestive of hepatic lipidosis. A bile duct obstruction, cholangiohepatitis, lymphoma, and FIP are other differentials but are less likely with the given information.*