VIN Feline Questions Flashcards
Which one of the following choices is the most significant risk factor for feline leukemia virus (FeLV)
infection in the cat?
A. Age
B. Breed
C. Gender
D. Geographic location
E. Time of year
Answer: A
Young kittens are more susceptible
FeLV-A is the archetype and responsible fro most natural infections
Risk factors:
- population density (cattery)
- access to the outdoors
- Virus is spread via oronasal contact and bite
wounds - Infected but healthy cats act as a reservoir and excrete large quantities of virus in saliva
- Kittens are highly susceptible; infected queens may transmit virus to kittens in utero or through nursing
- Older cats develop resistance
- Most common cause of cancer in cats, most commonly diagnosed malignancy is lymphoma
- Leukemia also common in cats with FeLV infection
- Causes a high degree of antigenemia
- Immunosuppression results from high degree of antigenemia present in infected cats –> immune complex forms
- Low complement
- Low white blood cell populations, abnormal white blood cells
- Infected cats may:
1. be PROGRESSIVELY infected or (virus replicates exgtensively and cats usually die within a few years)
2. be REGRESSIVELY infected or (mount immune response but do not entirely eliminate viral replication; some pro viral DNA is detectable via PCR but cat does not develop FeLV associated disease or shed)
3. be ABORTIVELY infected (have FeLV AB and do not get sick) - Testing
- ELISA (point of care - in clinic). NEgative ELISA tests are reliable
- If positive, then PCR (follow up testing in lab). if PCR is also + cat is progressively or regressively infected and should be isolated from other cats until confirmed diagnosis; both tests have high specificity and sensitivity
- Therapy is supportive
- Vaccinate all kittens and at-risk cats
A 7-year-old indoor male neutered cat is presented for reluctance to eat. On oral examination, the cat’s mouth looks like this. A complete blood count reveals lymphopenia. This cat’s mouth does not improve after dental cleaning.
This cat had a positive FIV test prior to the dental cleaning. The owner has two other cats in the household, both of which have tested FIV-negative. These three cats have lived in the household together for two years and have a stable relationship with no fighting
What is the most accurate statement regarding this cat?
A. This cat is likely to experience opportunistic infections.
B. This cat is likely to transmit FIV to the other cats in the household.
C. This cat may transmit FIV to an immunosuppressed person.
D. This cat will have a shorter lifespan due to FIV infection.
E. This cat would benefit from a raw diet.
Answer: A
A 2-year-old, female cheetah at an exotic animal park is evaluated for:
* lethargy,
* weight loss,
* diarrhea, and
* antibiotic-unresponsive fever
On examination the cheetah has yellow mucous membranes, extensive gingivitis, and is depressed and severely emaciated.
After tranquilization, abdominal palpation reveals multiple masses and irregularly shaped kidneys.
Abdominocentesis produces straw-colored, viscous fluid with a specific gravity of 1.040.
Macrophages, neutrophils, and lymphocytes are evident on cytological exam of the fluid.
Which one of the following choices is the most likely diagnosis?
A. Feline infectious peritonitis
B. Feline panleukopenia
C. Hemobartonellosis
D. Hypovitaminosis A
E. Iron deficiency anemia
Answer: A
Which one of the following choices is the most definitive means of confirming the presumptive diagnosis of feline infectious peritonitis (FIP)?
A. Biopsy of abdominal masses
B. Cytology of abdominocentesis fluid
C. ELISA test of serum
D. Magnetic resonance imaging (MRI) of the abdomen
E. Radiograph of the abdomen
Answer: A
Biopsy is the gold standard for definitive diagnosis because tissue is obtained for specialized and specific tests. If masses are granulomatous and feline coronavirus particles are discovered, then it confirms infection.
PCR on abdominal effusion can help diagnose FIP. Serological analyses are unreliable because + results only demonstrate exposure, which most cats have been exposed.
- FIP is a fatal coronavirus- a mutation of a common
Gl virus - FIP has a bimodal age of onset (young under 3 yrs of age or older)
- FIP-infected cats will usually appear unthrifty, with a waxing-waning fever. Lab findings include:
- high total protein
- high globulin
- low albumin
- neutrophilic leukocytosis
- albumin-globulin ratio less than 0.6
- fever is often not antibiotic responsive
A 15-year-old female cat is presented for anorexia.
The cat has been vomiting for several days.
On examination, the cat is depressed and emaciated with pale mucous membranes.
The owners report that the cat has been eating less, drinking a lot of water and urinating copiously for the last few months.
The cat has a BUN of 120 mg/dl. Serum creatinine is
4.8 mg/ di.
Which one of the following choices is the most likely concomitant finding on serum biochemical analysis of this cat?
A. Hypernatremia
B. Hyperphosphatemia
C. Hypobilirubinemia
D. Hypocalcemia
E. Hypoglycemia
Answer: B
Which one of the following choices is the most likely finding on abdominal palpation?
A. Ballottable abdominal fluid
B. Irregularly enlarged liver
C. Small irregular kidneys
D. Small thickened bladder
E. Uniformly enlarged ureters
Answer: C
Which of the following choices is the most likely cause of anemia associated with chronic renal failure?
A. Blood loss from hematuria
B. Decreased production of erythropoietin
C. Hypoplasia of bone marrow
D. Immune-mediated red blood cell destruction
E. Protein-deficient diet
Answer: B
Topic: Polycystic Kidney Disease
Chronic Renal Failure (CRF)
Hallmarks of chronic renal failure are:
* isosthenuria (usually precedes azotemia)
* azotemia (elevated levels of nitrogenous compounds in the blood),
* polydipsia, and polyuria
- Isosthenuria refers to the excretion of urine that has the same osmolality as plasma (or about 300 mOsm/I). Happens when kidneys deteriorate to the point where there is not enough renal mass to concentrate urine.
- A urine specific gravity below 1.007 is hyposthenuric
- A urine specific gravity above 1.035 is hypersthenuric.
- Cats in renal failure may have hypokalemia due to:
- Excessive renal loss,
- Anorexia, and
- Chronic metabolic acidosis.
Hyperphosphatemia is another common issue in feline renal failure.
Decreased glomerular filtration rate (GFR) results in high serum phosphorus (this is how phos is cleared)
Chronci interstitial nephritis in the cat may result in hyper or hypocalcemia but most animals maintain calcium homeostasis
Azotemia is classified into three broad categories:
1. Pre-renal,
2. Renal, and
3. Post-renal, depending on the cause.
Common diseases that mimic signs of chronic renal failure:
* Diabetes mellitus
* Hyperthyroidism can mask symptoms of renal failure;
Management of CRF can include:
* Anti-hypertensives
* Dietary phosphorus restriction or phosphate-binders
* Dietary protein restriction
* H2-receptor antagonists
* Erythropoietin administration
* Fluid therapy
* Kidney transplants or dialysis
(end-stage cases, expensive and time-consuming)
Ethylene glycol toxicity primarily affects which organ in the feline?
A. Kidney
B. Liver
C. Lung
D. Pancreas
E. Spleen
Answer: A
Ethylene Glycol toxicity
* Suspected or confirmed case presented within 1 hour of exposure - start immediate decontamination aka emesis and activated charcoal
* Less than 3 hours since ingestion, treat cats with fomepizole at extra-label doses which are higher than recommended doses for dogs
* Other elements of aggressive treatment include:
- Management of metabolic acidosis
- Correcting dehydration/ hypoperfusion (crystalloids, fluids), and
- Dialysis (if possible).
* The earlier treatment is instituted, the better.
Metabolism of ethylene glycol results in formation of several compounds that cause metabolic acidosis and severe renal tubular necrosis.
Both fomepizole and ethanol administration will decrease the amount of ethylene glycol metabolized.
Fomepizole inactivates alcohol dehydrogenase and ethanol by competitive inibiition of of ethylene glycol.
A 22-pound, spayed, 5-year-old, female tabby is presented for depression and lethargy. The cat has lost 3 pounds in the last 2 weeks. The owners boarded the cat 3 weeks ago while they vacationed and report that since they picked up the cat, its appetite has been greatly diminished.
On exam, you note the following:
* Liver feels enlarged and smooth
* Temp 101.4° F (38.6° C)
* Total bilirubin = 6.0 mg/dI (normal: 0.1 - 0.5),
* ALP = 626 U/L (normal: 6 - 105),
* ALT = 112 U/L (normal: 10 - 100),
* GGT = 5 U/L (normal: 1 - 10)
* Radiographs confirm liver enlargement
What is your presumptive diagnosis?
A. Cholangiohepatitis syndrome (CHS)
B. Histiocytic cholelithiasis
C. Hepatic lipidosis
D. Extra-hepatic bile duct obstruction (EHBDO)
E. Oral diazepam toxicity
Answer: C
For choice A and D expect to see high GGT
Which one of the following is the best approach to therapy of idiopathic hepatic lipidosis in the cat?
A. Administration of a balanced diet via a feeding tube
B. Administration of dextrose intravenously
C. Immunosuppressive doses of oral prednisolone
D. Long-term (8 weeks) therapy with oral amoxicillin and clavulanic acid
E. Oral lactulose and oral enteric antibiotics
Answer: A
Hepatic Lipidosis: triglycerides accumulate in hepatocytes –> jaundice
Diagnosis based on:
* History and physical findings (stressed, anorexic, icteric, fat cat)
* Suggestive lab work: Increase in ALP> increase in ALT, normal GGT (Unclear as to why GGT is normal).
* Liver biopsy - only if poor response to therapy or if GGT is high.
- look for vacuolation of more than 80% of hepatocytes or histopath is necessary to confirm diagnosis but remember that these cats have coagulopathies and therefore the risk is too high
Therapy: supportive
High protein, high calorie diet is necessary
NOTE: With hepatic encephalopathy, one would use a reduced protein diet and Lactulose/PEG 3350, either via tube or as an enema
A 2-year-old male neutered cat is admitted in the morning for a routine health check-up.
The cat is the same (normal) weight as it was at the last examination 6 months ago.
The cat is growling loudly in the back of the cage and lunging aggressively toward passersby when you arrive that afternoon to examine it and draw blood for a CBC and serum chemistry.
After restraining the cat, a complete physical exam is performed.
It reveals mild tartar accumulation.
The serum biochemical analysis shows a blood glucose of 310 g/dI. (Normal = 63 - 132 g/dI.) The urinalysis shows 250 mg/di of glucose in the urine. (Normal = O.)
Which one of the following choices is the most likely explanation of the hyperglycemia and glucosuria in this cat?
A. Central diabetes insipidus
B. Diabetes mellitus
C. Ethylene glycol toxicity
D. Pancreatitis
E. Stress-related hyperglycemia
Answer: E
Which one of the following choices is the most accurate means of differentiating stress-induced hyperglycemia from diabetes mellitus in the cat?
A. Blood glucose curve
B. Serum fructosamine concentration
C. Serial serum glucose determinations
D. Serial urine glucose determinations
E. Ultrasound-guided pancreatic biopsy
Answer: B
- Serum fructosamine can be normal in a cat with transient hyperglycemia caused by stress
- Hyperglycemic response can be in excess of 300 or 400 mg/dl
- Once serum glucose > 250 mg/d for any length of time, you can see glycosuria
- Stress-induced hyperglycemia typically resolves after about 4 hours so hospitalizing and checking it later or sending home and having check at home is better
- Serum fructosamine will be high in a cat with chronic hyperglycemia due to diabetes mellitus
Diabetic cats can develop a neuropathy affecting the tibial nerves - these cats have a characteristic plantigrade stance that can resolve with control of diabetes. Myelinated nerve fiber injury in diabetic neuropathy is associated with microvascular neuropathy –> plantigrade stance
A 9-pound cat is admitted after being found collapsed on the floor. The cat has been eating voraciously and drinking a lot for several months prior to presentation and has lost 4 pounds since its last examination 12 months previously.
The owners report the cat has been vomiting for 4 days. On examination the cat is hypothermic, thin, and dehydrated. Serum biochemistry shows a BUN of 125 mg/di, a creatinine of 4 mg/di, and a blood glucose of 525mg/dI. A urine dipstick analysis reveals urine glucose of 3+ and 2+ ketones.
Which one of the following choices is the most likely
diagnosis?
A. Diabetic ketoacidosis
B. Hepatic carcinoma
C. Hepatic lipidosis
D. Inflammatory bowel disease
E. Pyelonephritis
Answer: A
Which one of the following is most likely to be below the normal value on serum biochemical analysis in cases of feline ketoacidosis?
A. Creatinine
B. Glucose
C. Potassium
D. Protein
E. Urea nitrogen
Answer: C
Potassium values are often low in cases of DKA due to vomiting and anorexia.
What is the most likely effect of insulin on serum potassium levels?
A. Decrease because more potassium moves intracellularly
B. Decrease because renal loss increases
C. Increase because more potassium moves extracellularly
D. Increase because renal loss decreases
E. No effect
Answer: A
Levels will decrease because more K moves intracellularly. Insulin causes this along with glucose. In animals suffering from DKa HYdrogen ions move into cells adn K moves out –> marked depltion of total body K+. These cats become very hypokalemic due to insulin administration. Carefully monitor this!!
DKA
- Characterized by ketosis and hyperglycemia
- Frequent concurrent conditions:
- Pancreatitis,
- Cholangiohepatitis, and
- Sepsis/Infection
- The prognosis is fair to good if adequate therapy is administered:
- Rehydration,
- Insulin therapy with regular insulin,
- Correction of electrolyte levels, and
- Treatment of complicating diseases.
A 13-year-old female indoor/outdoor domestic shorthair cat is presented for vaccinations.
The cat weighed 12 pounds one year ago, and today it weighs 9.5 pounds. The owners have not changed the cat’s diet and, in fact, report the cat has an excellent appetite and is very active. They are unconcerned about the weight loss.
Bilateral nodules are palpable on the neck, and the cat has a heart rate of 295 bpm.
Based on the disease at the top of your differential list, which one of the following choices is the next step in confirming a diagnosis in this cat?
A. Gastroscopy
B. Intestinal biopsy
C. Serum glucose
D. Thoracic ultrasound
E. Total T4 concentration
Answer: E
Hyperthyroidism
- Usually caused by functional adenoma of both thyroid glands
- Typically middle-aged or geriatric
- Excellent appetites and activity levels
- Polyuria, polydipsia are common
- Gl signs - vomiting and voluminous soft stools
- Treatment options:
- Radioactive iodine-131 therapy = tx of choice
- Methimazole twice daily = controlled but not cured
- Thyroidectomy = if performed, parathyroid glands must be preserved to maintain Ca homeostasis
- lodine-deficient diet
Concurrent renal disease must be managed appropriately
7 yr old, intact, female DSH cat
See radiograph image on phone.
Which one of the following choices is the most likely finding on histopathological analysis of a biopsy of a feline mammary mass?
A. Carcinoma
B. Fibroepithelial hyperplasia
C. Fibrosarcoma
D. Lipoma
E. Mastitis
Answer: A
In rads: mammary masses are seen ventrally
Thoracic rads are standard because mammary tumors metastasize to the chest and would be indicative of not pursuing surgery.
Aggressive sx = disease free for for 1 yr in 50 % of cats
See image of cat with oral ulceration in mouth
Which one of the following choices is the most appropriate next step in the management plan for this cat?
A. Biopsy of the mass
B. Long-term daily oral prednisolone therapy
C. Radiation therapy
D. Soft food diet
E. Surgical excision of the mass
Answer: A
Biopsy will ID cause of mass
Biopsy of above cat revealed SCC and mass had integrated into tonsils.
Which one of the following choices is the most likely prognosis for this cat?
A. Excellent
B. Good
C. Fair
D. Poor
E. Cannot say without more information.
Answer: D
Oral SCC carries poor prognosis in felids
Which one of the following choices is the most important risk factor for cats in the development of oral squamous cell carcinoma?
A. Dry food diet
B. Frequent consumption of artificially flavored cat treats
C. Lives outside
D. Owners are smokers
E. Regularly bathed with pyrethrin flea shampoos
Answer: D
Cats living with an owner who smokes are 4x more likely of contracting oral SCC compared to those that live with nonsmokers. Particulate carcinogens on the coat –> grooms itself.
SCC is the most common oral cancer.
