Week 4 - March 3 Day 1 Flashcards
You want to give a pre-surgical dose of antibiotics to your patient. You have a 1 gram vial of cefoxitin that is reconstituted with 5 mls of sterile water. You want to give a 20 mg/kg dose to a 25 kg dog. How many mis do you give?
2.5
10
5
7.5
1.25
Explanation
The resulting concentration of the cefoxitin solution is 1gm/5ml or 200mg/ml.
The desired dose is 20mg/kg x 25 kg = 500 mg
200 mg/ml x _________ml= 500 mg,
Therefore the answer is 2.5
Topic: Canine Hypertrophic Osteodystrophy
- What is the current theory on the cause of this condition? Is there a breed predisposition?
- What is seen clinically in these patients?
- What diagnostic tests would you run? What would you see diagnostically?
- Is there any treatment?
- What is the prognosis?
- Weimaraners are predisposed and litter-mates will commonly be affected. Although the exact cause is unknown, the leading hypothesis is recent vaccination leading to hyper-reactivity of the immune system. In a study of 53 Weimaraners with HOD, all had been vaccinated within the past 30 days.
- Clinically you will see a painful, swollen, warm distal limb. Pain is elicited upon metaphyseal palpation.
- Radiographs - double physeal line
- Analgesics
- Prognosis is excellent although the patient may experience flare ups.
Topic: Canine Panosteitis
- List the clinical signs seen in this condition. What is seen on physical exam? Is there a breed disposition?
- What diagnostic tests would you run? What do you see?
- How is this condition treated?
- What is the prognosis?
- Typically seen in young large and giant breed dogs; more common in males. Will be pyrexic, acutely lame, painful on long bone palpation (femur, humerus).
- Increased medullary opacity in long bones, periosteal new bone
- Analgesics
- Prognosis is excellent although the patient may experience flare ups.
Topic: Legge-Perthes Disease
- Define this condition.
- What is the typical signalment?
- What will you see on exam?
- What diagnostic tests would you run? What do you see?
- How is this condition treated?
- What is the prognosis?
- Avascular necrosis of the femoral head
- 3-12 mo old small or toy breed dogs.
- Pelvic limb lameness
- Radiographs: moth eaten appearance of the femoral head and neck, decrease bone opacity at femoral epiphysis.
- FHO or total hip replacement, analgesics
- Prognosis with surgery is good to excellent
What is L-asparaginase used to treat and why?
What is a major side effect associated with L – asparaginase?
L-asparaginase is used to treat lymphoma. Leukemic cells are unable to synthesize asparagine and depend on exogenous sources for survival. L-asparaginase kills the enzyme asparaginase that makes asparagine, thereby killing the cancer cells.
L-asparaginase is a protein enzyme and therefore may elicit an immune response. Anaphylaxis is rare but usually would occur only after a patient had received a prior dose and developed antibodies to it.
Vincristine is used to treat what conditions? What is a major side effect associated with Vincristine?
Vincristine is used to treat lymphoma (apart of the CHOP protocol) as well as transmissble venereal tumors.
Vincristine is associated with paralytic ileus.
Lomustine is used to treat what conditions? What is a major side effect associated with Lomustine?
Lomustine is used to treat brain and spinal cord tumors, mast cell tumors, histiocytic sarcomas, or lymphoma.
Lomustine is associated with hepatotoxicity.
Doxorubicin is used to treat what conditions?What is a major side effect associated with doxorubicin?
Doxorubicin is used to treat lymphoma (apart of the CHOP protocol).
Doxorubicin is associated with cardiotoxicity.
Cyclophosphamide is used treat what conditions? What is a major side effect associated with cyclophosphamide?
Cyclophosphamide is used to treat lymphoma (apart of CHOP protocol) as well as immune mediated polyarthritis.
Cystitis is associated with cyclophosphamide.
What is a major side effect associated with L-asparaginase and doxorubicin?
Pancreatitis is associated with L-asparaginase or doxorubicin.
Topic: Foreign body obstruction
- What are the clinical signs of a FBO?
- What diagnostics should you run ? What do you see?
- How is this condition treated?
- If you have to perform a resection and anastomosis procedure on a foreign body obstruction patient, what risk are you most afraid of within the first 3 to 5 days postoperatively and why?
- Clinical signs include vomiting, anorexia, pain on abdominal palpation, diarrhea.
- A. Xrays - you will see multiple distended loops of intestine (gas filled)
B. AUS
C. +/- contrast rads with barium
D. Bloodwork - electrolyte imbalance, acid base abnormalities; Hypochloremia such as - A. Surgical removal (Enterotomy + removal) +/- resection and anastomosis (depends on health and viability of intestine)
B. Correct electrolyte +/- acid-bace imbalance
C. Post-op AB - Cefazolin if enterotomy of stomach and proximal intestine, Cefoxitin for lower SI and colon. - Your biggest concern is septic parotitis due to leakage at the incision site. This can occur if fibrin degrades at the incision site before proper college and deposition. The most common time for this procedure to fail is within the first 3 to 5 days.
Topic: Urolithiasis
- What are the most common types of urinary stones in dogs and cats?
- Medical dissolution is possible for what stones?
- Which urinary bladder stones are radioLUSCENT?
- What type of diets should be used for urinary stones?
- What are the general management considerations for all stone types?
- Struvite and Calcium Oxalate
- Medical dissolution is possible for most stones except calcium oxalate.
- Cystine and urate stones are and therefore may NOT be visible on radiographs.
- An alkalinizing diet should be used for cystine and urate stones. A reduced protein diet should be used for cystine, urate, canine struvite, and to a lesser degree calcium oxalate stones.
- A. Increase urine volume by providing a diet with high moisture content.
B. Reduce the quantities of crystal-forming substrates.
C. Increase urinary solubility of crystal forming substrates via ph change.
Topic: Urolithiasis
What is the main treatment option for dogs suffering from urate bladder stones? Is there a breed predisposition?
The main treatment option is alkalizing the diet and allopurinol.
Allopurinol will reduce the amount of uric acid produced, but the patient must be closely monitored for the formation of Xanthine stones.
Urate are formed from diets high in protein which are metabolized to uric acid, acidifying the urine. The dalmatian breed is highly predisposed to the formation of urate stones.
Topic: Struvite Urolithiasis
- What are struvite urine stones composed of?
- In dogs, struvite stones are usually associated with? In cats?
- How do we treat struvite urolithiasis?
- Magnesium, ammonium, phosphate
- Urinary tract infections caused by urease positive microbes. In cats, struvite stones are sterile.
- A. Antibiotics based on urine culture and sensitivity.
B. Struvite stones thrive in an alkaline environment so we want to acidifiy the diet. Additionally, we want to give high quality, low protein diet to reduce the amt of urease.
- Low magnesium, phosphate, and ammonium diet. Decreased protein –> decreased urea –> less ammonia produced by the enzyme urease. This is important for dogs especially because of the urease positive microbes.
Topic: Canine urolithiasis
What are the main treatment options for cystine stones?
- Reduced protein, sodium restricted, urine alkalinizing diet.
- Urine alkalinizer (potassium citrate (preferred), or oral sodium bicarbonate)
- Cuprimine and 2-MPG (binds to cystine to form a more soluble compound) are treatments used for cystine stones.
Topic: Canine urolithiasis
- What breeds are prediposed to developing calcium oxalate stones?
- How is this treated?
- How can these be prevented?
- Schnauzers, Lhasa apso, Yorkies, Bichon Frise, Shih Tzu, Mini poodle
- These are the most difficult stones to treat; typically require surgical removal, voiding hydropulsion, or lithotripsy.
- Provide an alkalinizing diet to prevent new stones from forming!
A. Low sodium diet: high sodium intake increases urinary calcium. Also, low protein, Ca, oxalate, Vit D, sodium.
B. Adequate phosphorous concentration to prevent Vitamin D activation. Also, magnesium, Vit B6.
C.
What type of medication is Firocoxib? What happens if you give an NSAID and and a steroid together?
Firocoxib (Previcox) is a nonsteroidal anti-inflammatory (NSAID) with specific inhibition at the Cox-2 sites and sparing of Cox-1 receptors. As with any NSAID, it is contraindicated to give this medication in conjuction with a steroid due to the high likelihood of side effects. Combination of an NSAID with a steroid may result in renal compromise and failure, in addition to gastric ulceration and increased risk of gastrointestinal perforation.
What anesthetic agent is implicated in the cause of malignant hyperthermia? What c/s are seen?
It is a rare induction of a hyper-metabolic reaction in skeletal muscle of susceptible individuals by halothane. The syndrome is characterized by muscle rigidity, increased body temperature, increased oxygen consumption and production of CO2.
Topic: Canine Elbow Dysplasia
Elbow dysplasia is a global term for several congenital conditions which can occur. Name these conditions.
These include an ununited anconeal process, osteochondrosis of the humeral condyle, elbow incongruency, and a fragmented medial coronoid process.
The fragmented medial coronoid process tends to be the most commonly encountered condition.
Left untreated, the abnormal region may not only be fragmented and painful, but can also result in eventual cartilage eburnation of the apposing humeral condyle.
CN VII is responsible for _____________. Deficits in lacrimation would cause ?
Loss of motor function in the muscles of mastication would occur in CN _____ (__________ branch) deficits.
Strabismus of the eyes would be caused by deficits in CN _____ (_________ nerve), CN _____ (_____________ nerve) or CN _____ (__________ nerve).
Nystagmus occurs with CNS disease or CN ______ deficits.
CN VII is responsible for lacrimation. Deficits in lacrimation would cause exposure keratitis. Loss of motor function in the muscles of mastication would occur in CN V (mandibular branch) deficits. Strabismus of the eyes would be caused by deficits in CN Ill (oculomotor nerve), CN IV (trochlear nerve) or CN VI (abducent nerve). Nystagmus occurs with CNS disease or CN VIII deficits.
What is Collie Eye Anomaly?
Collie Eye Anomaly is a genetic disorder characterized by choroidal hypoplasia (layer of tissue under the retina of the eye), manifested by varying degrees of visual dysfunction with signs of large bizarre choroidal vessels visible on fundic exam
What is cricopharyngeal dysphagia?
This is a congenital disorder characterized by in-coordination
of the swallowing reflex leading to the signs described (the dog will repeatedly attempt to swallow and bring up food and will sometimes cough or sneeze concurrently).
Ehmer slings prevent weightbearing. Additionally, they aid in maintaining some degree of abduction and internal rotation of the affected limb. In dogs, they are placed and maintained for 7-10 days.
Velpeau slings are placed on the front limb to prevent weight-bearing. They are often placed after medial shoulder instability surgery.
Spica splints are large padded bandages placed over the affected limb and torso, often in order to immobilize proximal fractures.
Schroeder-Thomas splints represent another type of splint that has been used in the past for fracture immobilization.
Topic: Canine Repro
Dark red vaginal discharge occurs normally for up to ________ after whelping.
Subinvolution can cause fresh bleeding for ___________ post-partum.
Metritis is usually accompanied by ________ signs and may have ________ vaginal discharge but not usually hemorrhage.
Retained placentas typically _______ occur in bitches.
Pyometras occur during the ______ phase when _________ levels are high, up to ___ weeks after estrus, and would not occur ?
Dark red vaginal discharge occurs normally for up to 6 weeks after whelping. Subinvolution can cause fresh bleeding for 12-15 weeks post-partum. Metritis is usually accompanied by systemic signs and may have abnormal vaginal discharge but not usually hemorrhage. Retained placentas typically do not occur in bitches. Pyometras occur during the luteal phase when progesterone levels are high, up to 9 weeks after estrus, and would not occur post-whelping.
List and describe the different forms of shock:
Hypovolemic shock is characterized by a critical reduction in intravascular volume (severe dehydration, hemorrhage, third-space loss). The decrease in intravascular volume (preload) results in a decrease in stroke volume and subsequently cardiac output, which will eventually result in a decrease in tissue perfusion and oxygenation.
Cardiogenic shock is the result of a decrease in myocardial contractility with subsequent decrease in oxygen delivery. It is always associated with primary heart disease.
Obstructive shock occurs when there is an abnormal blood distribution that impairs blood return such as in gastric dilation-volvulus where obstruction of the vena cava can occur or in pericardial tamponade.
Distributive or vasogenic shock is typically secondary to sepsis and anaphylactic reaction causing vasodilatation.
Topic: Canine Otitis Externa
- What is typically seen in the ear canal of a dog?
- List the clinical signs.
- How is it treated?
- High number of malassezia yeast visualized on cytology. This organism can be responsible for perpetuating otitis externa. It is not unusual to see yeast in the ear canal of a dog; however, yeast numbers of greater than 5 per high powered field can be considered abnormal.
- Other clinical signs of otitis externa may include ear pain, pruritis, aural discharge, bad odor, and neurologic signs.
- Effective treatments for uncomplicated otitis externa typically contain an antifungal, antibiotic, and an anti-inflammatory. Since this dog primarily has a yeast infection it is imperative that the ear medication prescribed has an anti-fungal.
- Triple antibiotic ointment (neomycin, bacitracin, and polymyxin B) Note: no antifungal here
- Tresaderm (thiabendazole, neomycin, and dexamethasone)
- Mometamax (mometasone, gentamicin, clotrimazole)
- Otomax (gentamicin, betamethasone valerate, and clotrimazole).
Additionally, the ears should be cleaned before applying the ear medication. Many ear cleaners contain antifungals too (Triz Ultra + Ketoconazole), which may enhance treatment response.
What is usually damaged in a dog with a ruptured cranial cruciate ligament? Explain why.
The medial meniscus is commonly damaged in a dog with a ruptured cranial cruciate ligament because the meniscus is closely associated with the medial collateral ligament, which prevents the meniscus from moving around within the joint when the femoral condyle compresses and slides against it. When there is joint instability following the CCL rupture, the medial collateral ligament is no longer able to prevent movement of the medial meniscus and damage occurs
The lateral meniscus is not associated with the collateral ligament and can freely move around when compressed by the femur.
A 2-year old male castrated Bull Mastiff with a history of travel in the west coast presents to your clinic for a chronic cough and a recent development of lameness of his right hind limb. On physical exam you notice a draining lesion over the lame region of the right hind limb. You perform chest radiographs and see a diffuse bronchointerstitial pattern which is nodular in some regions. You also identify hilar lymphadenopathy. You suspect that you know what you are dealing with and perform a broncho-alveolar lavage for cytology. Just as you suspected, you see spherules.
What is your diagnosis?
Coccidioidomycosis. The travel history and clinical signs are consistent with this answer.
Additionally, finding spherules on cytology is pathognomonic for Coccidioidomycosis. Prolonged antifungal
treatment will be necessary. Fluconazole is the treatment of choice.
Carbonic anhydrase inhibitors (such as ___________) act by ___________ aqueous production, which is partially dependent on the conversion of _________ to ______________. It can be used topically or systemically.
Latanoprost (Xalatan) is a _____________ analog frequently used ____________ in the treatment of glaucoma.
IV mannitol works to decrease _______ through its properties as an __________ attractant; it is not used topically.
Atropine is _________________ in some glaucoma cases.
Tacrolimus is used as a topical ______________, and used most commonly for ?
Carbonic anhydrase inhibitors (such as dorzolamide) act by decreasing aqueous production, which is partially dependent on the conversion of carbon dioxide to bicarbonate. It can be used topically or systemically.
Latanoprost (Xalatan) is a prostaglandin analog frequently used topically in the treatment of glaucoma.
IV mannitol works to decrease lOP through its properties as an osmotic attractant; it is not used topically.
Atropine is contraindicated in some glaucoma cases.
Tacrolimus is used as a topical immunosuppressant, and used most commonly for dry-eye.
Topic: Lymphocytic Portal Hepatitis
- What are the clinical signs?
- How is this condition diagnosed? What do you see? How does this differ from chronic cholangiohepatitis?
- What is the prognosis? Compare this to chronic cholangiohepatitis.
- How is this condition treated?
- Pyrexia, lethargy, dehydration, inappetence, vomiting, and icterus.
2.The key to this diagnosis is the liver biopsy - will see infiltration of lymphocytes and plasma cells but not neutrophils into portal areas. This is in contrast to chronic cholangiohepatitis which typically has neutrophils in portal areas. - Chronic cholangiohepatitis carries a fair prognosis with about half of cats doing poorly (dead or euthanized within 3 months) and half of cats responding favorably to treatment with long term survival. For cats with lymphocytic portal hepatitis, although treatment can be challenging, the disease is very slowly progressive and the reported mean survival is approximately 3 years.
- Prednisone?
What drugs are contraindicated in cases of chronic feline bronchial disease?
Atropine & any beta blocker.
Atropine thickens bronchial secretions and encourages mucous plugging of the airway.
Stimulation of beta-2 receptors in smooth muscle leads to bronchodilation. If blocked –> bronchoconstriction
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.
You check blood gases on a cat in the intensive care unit with renal disease.
They read as:
PaCO2= 28 (28-34 mmHg)
pH= 7.23 (7.25-7.4)
Pa02=100 (90-100 mmHg)
Base excess= -8 (-5 to +2 mmol/L)
HCO3 = 12 (16-20 mmol/L)
What can you conclude?
The correct answer is that the cat has primary metabolic acidosis with compensatory respiratory alkalosis. The low pH tells you the cat is acidemic so the primary disorder must be an acidosis because compensatory mechanisms will never overshoot the primary abnormality.
In this case, the negative base excess or low HCO3 tells us there is a metabolic acidosis (renal disease can cause this). The low PaCO2 tells us there is a respiratory alkalosis or hyperventilation. The primary abnormality must be the metabolic acidosis. The respiratory alkalosis can then be interpreted as compensatory.
A 10-year old female spayed calico has presented for further evaluation of a previously diagnosed mass in the neck region. The mass had been diagnosed as a thyroid adenocarcinoma and has now abscessed. Chest radiographs show a bronchial pattern with no obvious evidence of metastasis. Blood work shows a slightly decreased T3 and T4. Which of the following is a likely complication from this mass?
The correct answer is Horner’s syndrome. This is likely as a result of direct disruption of the sympathetic trunk traveling along the neck. Any time there is a neck mass present, it is important to evaluate the patient for the possibility of Horner’s syndrome. Additionally, disruption of the recurrent laryngeal nerve should be considered as this will result in laryngeal paralysis.
Hypercalcemia of malignancy is always a possibility with any mass; however, it is not reported commonly with thyroid adenocarcinomas in cats.
Hypertrophic cardiomyopathy can be a feature of hyperthyroidism, which is usually secondary to a thyroid adenoma. Based on this patient’s blood work, there is no evidence of hyperthyroidism.
Renal failure is not a reported complication.
Tritrichomonas foetus is a flagellated parasite most commonly found in kittens that have had an unresponsive diarrhea. The parasite can be very difficult to diagnose. It is most often responsive to Ronidazole.
Bone tumors are relatively ______ in cats, but the most common bone tumor in cats is ___________. In cats, osteosarcomas are ________ to metastasize so ____________ in many cases can be curative.
Osteosarcomas are most commonly found in the _______ limbs in cats.
Cats with appendicular osteosarcoma have a much better prognosis than dogs with osteosarcoma due to a ________ rate of metastasis. Some papers cite a survival time of over 2 years, but a more recent study sited approximately 12 months. In comparison, dogs with appendicular osteosarcoma have a median survival time of approximately ____-____ months with amputation alone. Metastasis to the _______ in dogs is usually the reason for death.
Bone tumors are relatively rare in cats, but the most common bone tumor in cats is osteosarcoma. In cats, osteosarcomas are slow to metastasize so amputation in many cases can be curative.
Osteosarcomas are most commonly found in the hind limbs in cats.
Cats with appendicular osteosarcoma have a much better prognosis than dogs with osteosarcoma due to a lower rate of metastasis. Some papers cite a survival time of over 2 years, but a more recent study sited approximately 12 months. In comparison, dogs with appendicular osteosarcoma have a median survival time of approximately 3-4 months with amputation alone. Metastasis to the lungs in dogs is usually the reason for death.
Treatment for coccidia is usually with ?
Droncit- Primarily for ?
Revolution- For ?
Strongid- Primarily for ? and ?
Clavamox- A broad spectrum antibacterial
Metronidazole- Primarily for ?, also used for ?
Treatment for coccidia is usually with sulfonamides such as sulfadimethoxine or trimethoprim sulfa.
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
The correct answer is immune destruction of the thyroid gland causing a decrease of T4 into the normal range.
Immune destruction of the thyroid gland occurs in hypothyroid dogs but does not typically occur in cats.
Euthyroid sick syndrome occurs when concurrent illness causes T4 to decrease from being high down into the normal range, or from the normal range to below normal. Fluctuations of T4 down into the normal range can occur early on in the disease.
Occult hyperthyroidism occurs when the T4 is in the high normal range and the clinical signs are mild. In these pets, a free T4 by equilibrium dialysis can make the diagnosis of hyperthyroidism.
Describe GGT and ALP levels in a case of Feline Hepatic Lipidosis.
GGT is NORMAL
ALP is ELEVATED
Cholangiohepatitis in cats can be due to ascending infection or immune-mediated damage to the liver and is commonly seen in conjunction with inflammatory bowel disease and/or pancreatitis.
A 2-year old female DSH cat presents for weight loss, anorexia, dyspnea, and lethargy. She was previously treated with antibiotics but is still febrile on physical exam. You detect pleural effusion and notice that the abdomen is distended. On CBC, there is a non-regenerative anemia, neutrophilia, and lymphopenia. On chemistry there is hyperproteinemia and a slight elevation in liver enzymes.
Spread of the virus that leads to this disease usually occurs from which route of transmission?
Fecal oral transmission
The primary source of infection of the FIP virus is due to fecal-oral transmission. Eventually, feline corona virus mutates to a virulent feline infectious peritonitis virus which is able to multiply in macrophages. Ideally, a strong cell-mediated immune response eliminates the virus, but in some cats, the infection can become latent and is reactivated with stress. If a cell-mediated immune response is not mounted, pyogranulomatous vasculitis will occur due to the deposition of antigen-antibody complexes in the venous endothelium. Complement-mediated inflammation results in pleural and peritoneal effusion (wet form) and partial cell mediated immune response results in slow viral replication with granuloma formation (dry form).
What is the difference between Obstructive, Restrictive, Labored, and expiratory push breathing?
Asthma causes expiratory dyspnea, or a marked abdominal push seen on expiration with normal inspiration.
This occurs as a result of collapse of the lower airways during expiration. This occurs in asthmatics because negative intrathoracic pressure (exerted during expiration) can more easily cause collapse of the thickened and weak bronchial walls. This traps air inside the alveoli. During the next inspiratory cycle, there is decreased fresh air exchange and increasing hypoxemia.
Obstructive breathing is characterized by long slow inspirations and can be accompanied by stridor or stertor.
This occurs as a result of upper airway disease such as laryngeal paralysis, brachycephalic airway syndrome etc.
Restrictive breathing occurs as a result of pleural space disease and causes short, shallow and rapid breathing.
Labored breathing is a catch-all phrase to describe short rapid and deep breathing. This generally occurs with pulmonary parenchymal diseases such as pulmonary edema or pneumonia.
What is the main mode of FeLV transmission? Where else can the virus be shed?
The correct answer is 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.
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.
BONE VS BOG SPAVIN
The correct answer is bone spavin: osteoarthritis of the distal intertarsal joint and/or tarsometatarsal joint. Bog
spavin is synovial distention of the tarsocrural joint, which you cannot see or appreciate with the given image.
The only true answer with the information given is osteoarthritis of the distal tarsal and tarsometatarsal joint. Al
you have to do is memorize which spavin correlates with the appropriate anatomy. This question is designed to
help you use the information given and not to get caught up in over analyzing the question.
This 2 year old mare in the picture presents for an intermittent left thoracic limb lameness which resolves after working the horse. On physical exam, a palmar metacarpal bulge, heat and tenderness is detected upon palpation.
What is your diagnosis?
The correct answer is tendonitis. The intermittent lameness and bulge at the metacarpals are classic for bowed tendon or tendonitis.
Which of these is not an expected lab finding in a horse with pituitary pars intermedia dysfunction (also known as
Cushing’s disease)?
Stress leukogram
Elevated alkaline phospha
Hyperglycemia
Low urine specific gravity
The correct answer is an elevated alkaline phosphatase. The horse, unlike the dog, does not have a steroid-induced isoenzyme of alkaline phosphatase. Hyperglycemia is common due to the counter-insulin effects of cortisol. Low urine specific gravity is a common feature of Cushing’s seen in dogs and horses and is the reason affected animals are polyuric and polydipsic. The stress leukogram (neutrophilia, lymphopenia) is due to the effects of cortisol as well.
Calculate the extracellular volume of a 450kg horse.
The correct answer is 9OL. Total body water is 60% of body weight. Extracellular fluid is approximately 1/3 of total body water, therefore
450kg x .6 = 270L total body water
270L x .33 = 89.1L ECF.
ECF is composed of plasma, interstitial fluid and transcellular lymph such as CS and synovial fluid.
Lethal white foals have aganglionosis of the intestines which leads to hypomotility, megacolon, constipation, colic, and death.
Equine Glomerulonephritis
The correct answer is long term furosemide administration. Horses with glomerulonephritis are usually polyuric.
Furosemide is only indicated for oliguric renal failure. The other choices (plasma transfusion, low protein diet, corticosteroids) are commonly used in the treatment and management of glomerulonephritis. A low protein diet will help decrease the amount of proteinuria and blood urea nitrogen circulating at any given time, therefore helping reduce the degree of azotemia.
Myoglobinuria is characterized by _________ urine that does not clear on __________ along with ________-colored plasma. Myoglobin does not bind to serum proteins and is _________ excreted before reaching levels that would discolor the plasma.
Conversely, hemoglobinuria is associated with a ________ discoloration of the plasma because hemoglobin is maintained in the plasma _________ and is lost in the urine more ______.
Myoglobinuria is characterized by brownish urine that does not clear on centrifugation along with normal-colored plasma. Myoglobin does not bind to serum proteins and is quickly excreted before reaching levels that would discolor the plasma.
Conversely, hemoglobinuria is associated with a reddish discoloration of the plasma because hemoglobin is maintained in the plasma longer and is lost in the urine more slowly.
With EPM, the important signs to remember are __________, ________, and ___________. Lateralization of the signs (____________) and _____________ and/or __________ muscle atrophy are most consistent with EPM.
Herpes myeloencephalitis is caused by ________ and often has an _________ onset following an episode of 4? on the farm. This condition often affects _________ than one horse on a farm. The ataxia and weakness is usually ___________.
Cervical vertebral stenotic myelopathy (CVM) and equine degenerative myeloencephalopathy are seen in younger horses (< 3-4 yrs of age).and typically cause _________ signs with the __________ usually a grade worse than the forelimbs. The signs of CVM may be worsened by flexing or hyperextending the neck.
Polyneuritis equi is more common in _________ horses and usually starts with _____________ progressing to anesthesia. There is ____________- paralysis of the 4? leading to urine _____________. You may also see tail _________ and urinary and fecal _________ as a result.
Verminous myeloencephalitis is less common and the onset is usually sudden with rapid deterioration and death.
With EPM, the important signs to remember are asymmetry, ataxia, and atrophy. Lateralization of the signs (asymmetry) and quadriceps and/or gluteal muscle atrophy are most consistent with EPM.
Herpes myeloencephalitis is caused by EHV1 and often has an acute onset following an episode of fever, cough and nasal discharge or following abortions on a farm. This condition often affects more than one horse on a farm. The ataxia and weakness is usually symmetric.
Cervical vertebral stenotic myelopathy (CVM) and equine degenerative myeloencephalopathy are seen in younger horses (< 3-4 yrs of age) and typically cause symmetric signs with the hindlimbs usually a grade worse than the forelimbs. The signs of CVM may be worsened by flexing or hyperextending the neck.
Polyneuritis equi is more common in mature horses and usually starts with hyperesthesia progressing to anesthesia. There is progressive paralysis of the tail, rectum, bladder and urethra leading to urine dribbling. You may also see tail rubbing and urinary and fecal incontinence as a result.
Verminous myeloencephalitis is less common and the onset is usually sudden with rapid deterioration and death.
Equine protozoal myeloencephalitis (or myelitis) can affect any age horse and is caused by Sarcocystis neurona. It should be suspected in this case due to the asymmetry of clinical signs, as it is a multifocal disease of the central nervous system.
Wobbler syndrome and degenerative myeloencephalopathy are diseases seen primarily in younger horses (< 3-4 years of age). Degenerative myelopathy causes a symmetrical ataxia. Cauda equina neuritis typically causes tail rubbine and urinary and fecal incontinence.
What stimulates ADH secretion in the horse?
The correct answer is hyperosmolality and decreased circulating volume. In the horse, as in other species, ADH
increases renal water reabsorption and urine osmolality by increasing permeability of the collecting tubules.
Osmoreceptors in the hypothalamus detect subtle changes in plasma osmolality. If osmolality rises, you will
hope to see ADH secretion so that the urine excreted would be more concentrated. The same is true if
circulating volume decreases; thus, a lesser volume of water would be lost. When ADH secretion does not occur
or if the kidneys are unable to respond to ADH, this is likely diabetes insipidus, and animals will be very polyuric,
polydipsic and have extremely dilute urine.
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Both small intestinal obstruction and duodenitis-proximal jejunitis (DP)) present with similar clinical signs. The problem is that a small intestinal obstruction will be a _________ disease, and duodenitis-proximal jejunitis responds better to _________ treatment. The cause of duodenitis-proximal jejunitis remains __________. Clinical signs include acute colic with increased respiratory rate, heart rate, and pain. Additionally, there will be lots of ?
After _____________ of the stomach via nasogastric intubation and removal of excess ______________, horses with DPJ may appear much more comfortable.
Both small intestinal obstruction and duodenitis-proximal jejunitis (DP)) present with similar clinical signs. The problem is that a small intestinal obstruction will be a surgical disease, and duodenitis-proximal jejunitis responds better to medical treatment. The cause of duodenitis-proximal jejunitis remains unknown. Clinical signs include acute colic with increased respiratory rate, heart rate, and pain. Additionally, there will be lots of gastric reflux. After decompression of the stomach via nasogastric intubation and removal of excess gastric/intestinal fluid, horses with DPJ may appear much more comfortable.
A 3rd degree burn involves the epidermis, dermis, and adnexal structures. Alternatively, a 1st degree (superficial) burn involves the epidermis only; a 2nd degree (partial thickness) burn involves the epidermis and may go down to the deep dermis. 4th degree burns involve total destruction of the skin, fat, fascia, bone and muscle.
This classification scheme would generally apply to all animals, not just horses.
In a foal with uroperitoneum, the creatinine in the abdominal fluid will be at least ________x as much as the serum creatinine.
The correct answer is twice. This finding is diagnostic for a uroperitoneum. In a foal, this is usually due to urinary bladder rupture at the time of parturition due to large pressures exerted on the urinary bladder during parturition.
Equine viral arteritis can be transmitted via?
The correct answer is venereally. Carrier stallions can infect mares. It can also be spread by aerosol. Equine viral arteritis (EVA) is in the genus Arterivirus, family Arteriviridae and causes vasculitis leading to edema,
conjunctivitis, rhinitis, and abortion.
A 3 month old Arabian colt is presented for 3 episodes of pneumonia; the first episode of pneumonia was observed at 7 weeks of age. Each episode of pneumonia is responsive to oral antimicrobials, but when these are discontinued, evidence of respiratory disease occurs several days later. A complete blood count reveals that the foal is persistently lymphopenic. What condition should you suspect?
The correct answer is combined immunodeficiency. Any Arabian foal with persistent infection should be suspected of having this heritable immunodeficiency of B and T lymphocytes. Typically, foals with CID do not demonstrate evidence of repeated infection until maternal antibodies begin to wane. There is no treatment for this disease.
A 3-month-old paint colt presents to you after flipping over backward while being led by the owner the previous day.
Clinical signs at the time of presentation are shown in the image (head tilt, flaccid ear, muzzle deviation). Based on the history and clinical signs, what cranial nerves are damaged and what is the most likely diagnosis?
The correct answer is damage to cranial nerves VII (facial nerve) and VIII (vestibular nerve) on the left side caused by fracture of the basisphenoid bone. This is a common injury when a fractious young foal rears up and falls backward on the poll. The basisphenoid bone becomes injured resulting in injury to cranial nerves VII and VIII. Damage to the facial nerve results in the muzzle deviation (opposite direction of the side of injury, in this case deviated to the right), ptosis of the left eye and drooping of the left ear. Damage to the vestibular nerve results in the head tilt.
Equine Herpes Virus Myeloencephalitis
Clinical signs that are common with EHV myeloencephalitis include ?
The ____________ CSF with the _______ protein and _________ cell count (albuminocytologic dissociation) is also very suggestive of EHV myeloencephalitis.
Virus isolation can be attempted on buffy coat samples, nasal swabs, and/or CSF in an attempt to identify the virus.
The correct answer is Equine Herpes Virus Myeloencephalitis. Clinical signs that are common with EHV myeloencephalitis include bladder paralysis with urine dribbling, fecal retention, and hindlimb ataxia. The xanthochromic CSF with the high protein and normal cell count (albuminocytologic dissociation) is also very suggestive of EHV myeloencephalitis. Virus isolation can be attempted on buffy coat samples, nasal swabs, and/or CSF in an attempt to identify the virus.
In the Spring of 2001, a syndrome later termed Mare Reproductive Loss Syndrome, also known as MRLS, occurred in central Kentucky. This resulted in the abortion of 20-30% pregnant mares. Which of the following was NOT a manifestation of MRLS?
Fibrinous pericarditis
Early fetal loss
Neonatal foal deaths
Fetal or neonatal hemoabdomen
Late-term abortion
The correct answer is fetal or neonatal hemoabdomen. All other choices listed were potential disease
manifestations of MRLS. The exact pathogenesis of MRLS is still unknown, but the presence of eastern tent
caterpillars was strongly associated with the disease. Later, experimental studies in which pregnant mares were
exposed to or fed, via NG tube, eastern tent caterpillars resulted in early and late fetal loss.
Equine degenerative myeloencephalopathy
Stringhalt is a myoclonic disease affecting one or both __________ limbs. It causes spasmodic ___________ of the leg. The etiology is unknown but ______ _______ poisoning is thought to be associated with the condition. Diagnosis is based on clinical signs, but __________ can be used to confirm the diagnosis. Treatment involves ____________ of the __________ digital extensor; however, not all cases respond to the treatment.
Stringhalt is a myoclonic disease affecting one or both pelvic limbs. It causes spasmodic hyperflexion of the leg. The etiology is unknown but sweet pea poisoning is thought to be associated with the condition. Diagnosis is based on clinical signs, but electromyography can be used to confirm the diagnosis. Treatment involves tenectomy of the lateral digital extensor; however, not all cases respond to the treatment.
You suspect that an 18-year old post-parturient Thoroughbred mare has uterine artery hemorrhage based on a low PCV (14%), tachycardia (heart rate 70 beats/min), and the history of foaling 12 hours ago. Which of the following drugs would potentially help in a hemorrhaging mare?
Aminocaproic acid is the best choice of those listed. This medication is believed to facilitate clot stabilization by blocking the activation of plasminogen to plasmin. As you may recall, plasmin is the active enzyme that dissolves clots; therefore, aminocaproic acid inhibits fibrinolysis. The other medications listed would have an
anti-coagulant effect and would be contraindicated in this mare.
You examine a 4-year old Holstein dairy cow which freshened 2 weeks ago. She has a history of abrupt cessation of lactation and loss of interest in feed. T=105F, HR=90 and RR=30. The cow has an arched back and is treading and swishing her tail frequently. On rectal exam you find an enlarged and painful left kidney. You catch urine in a cup after stimulating her to urinate. Which description of the urine best fits what you would expect to find in this cow?
Cloudy and bloody
This cow is likely to have acute pyelonephritis. It is most commonly ascending and associated with E. coli, other coliforms, or Corynebacterium renale. You could also use ultrasound to confirm the diagnosis, but finding neutrophils, RBCs and bacteria with these signs is indicative of acute pyelonephritis.
A necropsy of an aborted bovine fetus shows enlarged lymph nodes and spleen, destructive lesions to the thymus, and evidence of chronic granulomatous infection. What is the most likely cause of this abortion?
A. Epizootic bovine abortion
B. Infectious bovine rhinotracheitis
C. Tritrichomonas foetus
D. Brucellosis
The correct answer is epizootic bovine abortion (EBA), also called foothill abortion. EBA is an important disease for beef producers in the foothill and mountainous regions of California, Northern Nevada and Southern Oregon. The lesions described in the question are consistent with this diagnosis. The etiologic agent of EBA is a bacteria, Pajaroellobacter abortibovis and the vector is a tick, Ornithodoros coriaceus.
Tritrichomona foetus is involved with early embryonic death.
Brucellosis abortions are rare since it has been almost completely eradicated from the U.S. Lesions include autolysis, placentitis, and bronchopneumonia.
Infectious Bovine Rhinotracheitis (IBR) causes rapid fetal death; therefore, there is very little time for fetal response. Lesions you are likely to see include autolysis and focal necrosis of the organs.
The correct answer is to cull all cattle that test positive. Johne’s disease in cattle is caused by Mycobacterium avium subsp paratuberculosis affecting the small and large intestine. Clinical signs include emaciation, wasting, and edema, with variable diarrhea. Diagnosis is by serology and identification of the acid fast bacteria. There is no effective treatment for the disease. Positive animals must be culled from the herd.
The correct answer is intravenous iodine. It is commercially available as a 20% solution at a dose of 15 ml/100 Ibs (66mg/Kg). The clinical signs are suggestive of lumpy jaw, which is caused by Actinomyces bovis. The prognosis is poor, so most animals should be culled. Penicillins are reportedly successful at arresting the lesion in very early cases. However, there may be a better chance with intravenous 20% sodium iodide. That being said, due to concerns that iodide may cause abortion and because of food safety concerns, the label warns not to use sodium iodide in pregnant or lactating cattle. Ceftofur may not be used in this extra label fashion.
Several steers in a feedlot have interdigital lesions as shown in this image. They are lame and the lesion appears to be painful. You diagnose interdigital necrobacillosis or infectious footrot. Which of the following is the most effective feedlot treatment?
One dose of 40 mg/kg florfenicol is reported to be an effective therapy and would be favored by a feedlot because the single treatment would avoid costly repeated handling. The use of chloramphenicol is prohibited in cattle in the USA.
In cattle, most cases of rabies are the paralytic type, but these aggressive cases do occur. In livestock, the incubation period for rabies may range between 2 weeks and up to 6 months depending on the site of inoculation.
Anemia due to anaplasmosis can sometimes cause cattle to become wild and aggressive, but the pink mucous membranes rule that out in this case.
If trying to abort a cow between 5-8 months of gestation, what will work best?
The correct answer is PGF2-alpha and dexamethasone. This is because at this point (5 to 8 months), both the
CL and the fetus are involved in maintaining the pregnancy.
The correct answer is uterine tear. With a traumatic fracture or damage to nerves, the cow would have gone down right away rather than an hour later. Hypocalcemia is possible but less likely in this case where the calf had to be forcibly extracted which can result in a uterine tear, and would be unlikely to make her pale and
tachcardic
Vagal indigestion vs displaced abomasum
The single most effective way to combat FPT in a 3-day old calf is to ?
transfuse 20 to 40 ml/Kg body weight of plasma
Soils of this type are often high in molybdenum and borderline low in copper, as well as often having alkaline water high in sulfates. The molybdenum and sulfates bind the little available dietary copper and make it biologically unavailable, resulting in copper deficiency secondary to high molybdenum. Signs of copper deficiency include achromotrichia (washed-out hair color), poor growth/weight loss, and diarrhea. Abnormal bone growth or spontaneous fractures can also be observed in some herds.
A veterinarian wishes to know which plants are photosensitizing. He provides you with samples from the hay to pick from, and you tell him that___________ can cause secondary photosensitization.
Ammi majus
Erodium
Amsinckia intermedia
Hypericum perforatum
The correct answer is Amsinckia intermedia. This plant (aka fiddleneck, fireweed, and tarweed) contains pyrrolizidine alkaloids. PAs are hepatotoxic and cause three classical liver lesions. Do you recall them?
Megalocytosis, biliary duct hyperplasia, and fibrosis.
As a result of liver damage, the liver will be unable to clear normal chlorophyll breakdown products such as phylloerythin, which causes photosensitization secondary to liver damage. The other answer choices are primary photosensitizing agents.
Preconditioning involves being sure that calves are weaned several weeks before entering the feedlot, vaccinated against infectious bovine rhinotracheitis (IBR), bovine viral diarrhea (BVD), Parainfluenza-3 (PI3), and Clostridial diseases. They should be dewormed, and dehorned and castrated if not already done. Ideally, the calves should also have learned to eat from a bunk and drink from a trough before entering the feedlot. Then, when the calves are mixed with calves from other ranches, they are less likely to succumb to respiratory disorders.
