Week 2 Day 3 Flashcards
Topic: DKA in felids
You should recognize that this cat has many of the signs and findings of diabetic ketoacidosis.
Specifically, those signs in this case include PU/PD, anorexia, weight loss, azotemia, cystitis, dehydration, ketonuria, and hyperglycemia.
The most important treatments for this cat are gradual correction of dehydration, typically with isotonic crystalloids such as lactated Ringer’s solution supplemented with potassium. Concurrently with correction of dehydration, insulin therapy should be initiated with regular insulin at approximately 1 unit/kg/day with monitoring of blood glucose. This can be done with intermittent dosing or a continuous infusion of insulin. Parameters must be made in order to help determine if more or less insulin is needed.
Bicarbonate is useful in some cases but should only follow rehydration as overzealous bicarbonate therapy can lead to alkaline overshoot, hypokalemia, hypocalcemia, paradoxical CSF acidosis, hypernatremia, and hyperosmolality.
Ampicillin is a good antibiotic choice due to bactericidal activity against Gram-positive cocci and high urine concentrations pending urine culture and sensitivity results. It is not the most important treatment initially.
What additional testing should be run prior to starting treatment in a feline patient recently diagnosed with hyperthyroidism and why?
A chemistry panel should be run first prior to starting treatment in order to get baseline liver and kidney values. Hyperthyroidism tends to mask renal insufficiency. Once treatment begins, the insufficiency is unmasked and they become azotemic. Therefore, may clinicians begin hyperthyroidism treatment with methimazole then recheck renal function when the T4 is normal. If there is no evidence of underlying renal disease, a more permanent treatment option, such as I-131 therapy, is used. Additionally, methimazole can be hepatotoxic and hyperthyroidism itself can cause an increase in liver enzymes.
Note: Hyperthyroidism often causes increased renal perfusion and increased GFR.
Topic: Heartworm in Cats
- What are the most common clinical signs?
- Cats with heartworm may be asymptomatic but common clinical signs include a peracute death presentation due to worm emboli/migration. Chronic signs such as anorexia, weight loss, lethargy, and exercise intolerance may be seen occasionally. Heart failure, cough, and dyspnea can occur with this disease but often are not present due to the small worm burdens usually
carried by cats. Aelurostrongylus, Capillaria, and Paragonimus are lung parasites that can all cause coughing in a cat.
What are some common post-operative complications of a thyroidectomy in a hyperthyroid cat? Explain each.
A. Hypocalcemia can occur due to damage or excision of the parathyroid glands.
B. Horner’s syndrome occurs when the sympathetic trunk running through the neck is damaged.
C. Laryngeal paralysis occurs with damage to the recurrent laryngeal nerve running through the neck.
D. Hypothyroidism can occur secondary to removal of the affected thyroid gland or glands.
Taurine deficiency in cats is associated with?
Dilated cardiomyopathy and ECCENTRIC hypertrophy
Cats with taurine deficiency can develop feline central retinal degeneration (FCRD) in addition to cardiomyopathy. This is because photoreceptors contain large amounts of taurine and cats cannot synthesize it. The classic lesion is an elliptical area of tapetal hyperreflectivity starting in the area centralis dorsolateral to the optic disk that progresses to a horizontal band and eventually can involve the entire fundus. (see photo)
Polydactyly is an __________ ___________ trait.
Autosomal dominant
Strongyloides stercoralis mainly causes a _______ diarrhea and possibly _______ in puppies and kittens. It passed in the feces in the L1 _______ form. The best technique for recovering larvae is the ?
Strongyloides stercoralis mainly causes a mucoid diarrhea and possibly anemia in puppies and kittens. It passed in the feces in the L1 larvae form. The best technique for recovering larvae is the Baermann technique.
Topic: Isospora in Cats
Zoonotic concern?
Coccidiosis or infection with the protozoan Isospora is very common in young cats and dogs. The disease is very difficult to disinfect and rid from the environment. It is important to pick up the stools as soon as possible to avoid sporulation and contamination of the environment with cysts. Luckily,
Isospora is species-specific so zoonosis is not a concern.
What drugs are effective for treating Mycoplasma in cats? What side effect do you need to keep in mind when treating cats specifically?
Acceptable treatment options for mycoplasma in cats are doxycycline and enrofloxacin. Cats should be treated for 3 weeks in most cases. Remember that doxycycline can cause esophageal stricture in cats, and administration should be followed by water. This therapy should be effective in most cases but often does not completely eliminate the organism from the body, and cats may remain carriers of the pathogen.
Topic: Cholangiohepatitis
What treatment is indicated when discrete choleliths are seen or complete biliary obstruction is identified.
If this had been a more typical case of cholangiohepatitis without choleliths or complete biliary obstruction, the treatment of choice would be ?
Choleliths are relatively rare in dogs and cats compared to humans but are seen sporadically.
Surgical decompression
supportive care and fluid therapy plus treatment with ampicillin, metronidazole, ursodeoxycholic acid.
Topic: Foreign Body in Felids
A string that has been present for _____ than a couple of days or one with evidence of ________ of the intestines should not be ________ or _____ because the risk of intestinal perforation is _____.
A string that has been present for more than a couple of days or one with evidence of pleating of the intestines should not be pulled or cut because the risk of intestinal perforation is high.
What is the permanent dental formula formula for a cat?
2(13/3 C1/1 P3/2 M1/1).
Topic: Eosinophillic/Collagenolytic Granuloma
Feline eosinophilic granuloma complex consists of 3 separate clinical syndromes. Describe each.
1) The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the nose, chin (as in this case), oral cavity, or caudal thighs. The lesions are typically raised and ulcerative or nodular as seen here.
2) The eosinophilic plaque occurs most frequently on the abdomen and medial thighs but can appear other places. They appear as single or multiple, raised, red, often ulcerated lesions of varying size (0.5-7 cm). They frequently have a cobblestone appearance and unlike eosinophilic ulcers, these are often pruritic. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy.
3) The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the upper lip and may be unilateral or bilateral. They often have a characteristic central area of yellow to pink tissue with a slightly raised circumferential edge
The underlying cause of eosinophilic ulcers and collagenolytic granulomas are unknown, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested.
Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems. Some cases respond to antibiotic therapy but most require glucocorticoid therapy.
Topic: Otodectes cynotis
- What is used to treat this condition?
- Milbemycin, Ivermectin, Selamectin (more effective as preventative than for immediate treatment)
Round cell tumors include?
lymphoma, mast cell tumor, plasma cell tumor, histiocytoma, transmissible venereal tumor, +/- melanoma and certain neuroendocrine tumors
A basal cell tumor is what type of tumor?
An epithelial tumor (epithelioma/carcinoma)
What are the clinical signs seen in cats with glaucoma?
Cats rarely show acute changes with glaucoma like dogs, so they often present with signs of chronic glaucoma which are:
A. Buphthalmos
B. Corneal fibrosis
C. Lens luxations
D. Mydriasis
E. Tapetal hyperreflectivity and retinal vascular attenuation
F. Pale optic discs.
Strabismus is not a component of glaucoma.
What drug is contraindicated in the tx of feline asthma and why?
Atropine b/c it thickens bronchial secretions and encourages mucous plugging of the airway.
What is the most likely cause of aortic saddle thrombi in cats? Describe the pathophysiology, treatment, and prognosis.
The most likely cause of aortic saddle thrombi in cats is cardiac disease; with the most common being hypertrophic cardiomyopathy, restrictive cardiomyopathy, and dilated cardiomyopathy. The left atrium becomes dilated, and turbulent blood flow through left atrium activates platelet aggregation.
Thrombi form in the left atrium and eventually dislodge into systemic circulation. Emboli can lodge in the brain, kidneys, Gl vessels, and aortic bifurcation. Even if treatment is successful, recurrence is common.
Successful treatment consists of appropriate pain medication, supportive therapy for typically 2-4 days, and treating the underlying cause while the thrombus is broken down. Use of thrombolytics should be used cautiously as adverse reactions are common.
What can happen in the immediate post-obstructive period in a cat that was recently unblocked?
In some cases, during the immediate post-obstructive period, cats will develop hypocalcemic tetany.
The mechanism is considered to be secondary to laws of mass action that drive down calcium as a result of existing hyperphosphatemia. Judicious use of calcium gluconate can quickly restore their electrolyte balance and prevent further complications such as hypocalcemic seizures.
While performing a ventral midline ovariohysterectomy you decide to use the spay hook. What structure are you hoping to retrieve with the spay hook?
The broad ligament
How do cutaneous mast cell tumors in cats differ from dogs?
Contrary to cutaneous mast cell tumors in dogs, young Siamese cats (less than 4yr) with the histiocytic subtype of mast cell neoplasia will typically have their tumors spontaneously regress.
Therefore, as long as the patient is not suffering it is reasonable to wait for these to resolve on their own. In general, it is safe to say that feline mast cell neoplasia is much less aggressive than is seen in dogs. Cutaneous mast cell tumors do not need the aggressive surgical margins that are typically recommended for Grade Il or Ill canine mast cell tumors. Furthermore, follow up radiation therapy is rarely indicated.
What types of bacteria are typically found in cat bite abscesses? What medications are typically used to treat them?
The most frequently isolated bacteria in cat bite abscesses are anaerobes. These include obligate anaerobes such as Fusobacterium spp., Bacteroides spp., and Clostridium spp. as well as facultative anaerobes such as Pasteurella spp. and Actinomyces spp.
Because anaerobes are the most common isolates, it is believed that most cat bite abscesses can be effectively treated by establishing good drainage. Nevertheless, many if not most veterinarians, elect to additionally treat these with antibiotics. Be sure to choose an antibiotic that will be effective against anaerobes such as clindamycin or amoxicillin with clavulanate.
Topic: Toxocara spp in Cats