Week of Feb 10, Day 3 Flashcards
What medication can be used in recently unblocked male cats to help reduce internal urethral sphincter tone?
Phenoxybenzamine can be used in this case to reduce internal urethral sphincter tone such that the cat may urinate more easily.
Methocarbamol is a muscle relaxant but would not directly help spasms of the urethra.
Prednisolone is not used to help reduce inflammation or spasms in the urethra and may predispose the cat to contracting a urinary infection, especially while his bladder and urethra are compromised.
Phenylpropanolamine is used to treat urinary incontinence from urethral hypotonicity most often in dogs and would be contraindicated in this case.
Amitriptyline is an anti-depressant medication that has been implicated as part of a treatment plan for cats with cystitis, although benefit has never been proven. Because cats with cystitis can flare up during times of stress, the amitriyptyline has been thought to help prevent this. This medication would not work to stop spasms in the urethra.
What stain is used to identify different types of bacteria? This stain most commonly looks for what type of bacteria? Give some other examples.
Acid-fast staining is used to differentiate specific types of bacteria known as acid-fast organisms. Acid-fast stain is most commonly used to look for Mycobacteria, which are acid-fast. Nocardia and some bacterial spores and coccidian parasites are also acid-fast. In this case, an acid-fast stain would differentiate Nocardia (which is acid-fast) from Actinomyces (which is not acid-fast) organisms.
What stain is used to diagnose fungal infections?
A KOH test is used to aid in the diagnosis of fungal infection, usually cutaneous infections from dermatophytes.
+/- Silver staining
What stain is used to ID amyloid fibrils?
Congo red stain is typically used to stain for amyloid fibrils and may sometimes be used to identify a specific type of Shigella.
What stain is used to ID proteins?
Silver staining is used to identify proteins, commonly type Ill collagen. It may also be used to identify certain fungal organisms.
Topic: Drugs
- At what rate (rapidly or slowly) is propofol distributed and cleared in dogs and cats ?
- Repeated propofol usage has been shown to cause what in cats?
- How quickly does propofol have to be used once opened? Explain why. Is there an alternative?
- List the ROA of propofol.
- What is a common side effect of propofol?
- Propofol is rapidly distributed and cleared in dogs and cats which allows for rapid and smooth induction and recovery in most cases.
- Repeated propofol use has been shown to cause Heinz body anemia and signs of illness in cats.
- Because propofol is in an emulsion that can grow bacteria, it must be used within 6 hours of being opened unless you have the new formulation which can last up to 28 days (Propoflo 28).
- Propofol can only be given intravenously.
- Apnea is the most common side effect of propofol administration.
Topic: Hepatic Lipidosis in Cats
- Describe a classic case of hepatic lipidosis in a cat.
- What is seen on bloodwork that is highly suggestive of 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.
How can you determine if a tissue protruding from the anus is a prolapse vs an intussusception?
The best way to distinguish is to pass a blunt probe between the protruding mass and anus. If the probe contacts a fornix within a couple of centimeters it is likely a rectal prolapse, but if it passes 5-6 centimeters easily then an intussusception is more likely.
A dextrose solution may help to reduce edema associated with the tissue but would not in itself reduce the protrusion.
Exploratory surgery would be indicated and is the recommended treatment for intussusceptions. This would be a definitive way of determining if it is a prolapse vs. intussusception but this is the more invasive way of determining and is not the only way. If it is a rectal prolapse, more conservative therapy should be considered before surgery.
How do you determine if a feline diabetic patient’s insulin is working for them, assuming they are not exhibiting any clinical signs and are doing well overall.
- Check the BG nadir. If it is within the normal range (60-125 mg/dL) then you are good.
- Check the duration of the curve. The duration of action of insulin i 9-10 hours so as long as it works within that time frame, then it is good.
- Check that the majority of your values are less than 250.
If you have checked all of these parameters off, then these findings indicate good control of the diabetes, and no changes in treatment are necessary.
Topic: FIP
- Signalment
- Transmission
- Pathogenesis
- Clinical signs
- Diagnostics
- Treatment
- Prevention
- Younger cats: 6 months to 2 years most commonly
- 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.
–> 2 forms of the disease
a. Effusive (Wet)
b. Dry
● Effusive form
a. Characterized by widespread vasculitis
b. Leaking of protein and fibrin rich fluid into pleural and peritoneal cavities.
● Dry form
a. Granulomatous reaction in tissues
b. May involve nervous system, kidneys, eyes, lymph nodes or other sites.
c. More difficult to diagnose - Effusive Form - Fluid analysis is key to diagnosis
a. Is Typically dark yellow, sticky and viscous
b. Non septic, high protein (globulins), A:G ratio <0.4
● Dry Form - Challenging diagnosis but some common findings include
a. Mature neutrophilia, lymphopenia, non-regenerative anemia and a hyperglobulinemia.
b. Serology for feline coronavirus is available but can be difficult to interpret.
c. Gold standard of diagnosis remains histopathological examination of biopsied tissues.
i. Characteristic changes include perivascular pyogranulomatous inflammation.
Often involving ileum, colon, mesenteric lymph nodes and liver. - It is unlikely that you will be asked much about treatment of FIP since options are limited
● No effective treatment/cure
a. Cyclophosphamide (Cytoxan) and corticosteroids are palliative and may reduce signs.
b. Occasional reports of treatment with interferon gamma or pentoxyfylline - Vaccine:
a. Licensed for use in kittens over the age of 16 weeks. However, kittens may become infected
after maternal antibodies wane at 4-6 weeks.
b. The current vaccine can result in false positive FECV titers
● Best prevention measures are good cattery procedures
a. Hygiene is essential. Good nutrition, general health status, sanitation and
avoiding overcrowding.
b. This disease may be a problem even in a well maintained cattery.
T/F: Nearly all cats are exposed to FECV but only a fraction will develop FIP.
True
A cat presents after having fallen from a high rise. On physical examination, the cat is dyspneic, there is blood and abrasions around the mouth, and there are decreased lung sounds dorsally. What should you do next?
This cat has traumatic pneumothorax. Thoracocentesis is indicated prior to any other treatments or diagnostic tests as the pneumothorax is the cat’s most immediately life threatening problem.
Topic: Feline Mammary Hyperplasia
- Define feline mammary hyperplasia
- Signalement
- Etiology
- Treatment
- Ddx
- Feline mammary hyperplasia, or fibroadenomatous hyperplasia, is a benign, often drastic enlargement of the mammary glands typically seen in younger cats.
- This syndrome classically has a rapid onset and is seen in pregnant and non-pregnant, unspayed females. It is uncommonly seen in males and spayed females.
- In cycling females, this condition is caused by hormonal stimulation from a functional ovary producing progesterone. Megesterol acetate is a synthetic progesterone that can cause this side effect.
- It is generally treated by ovariohysterectomy. If the mammary gland has become severely infected or ulcerated, a mastectomy may be required. If no source of progesterone can be identified, or if the glands do not respond to spaying, a progesterone receptor blocker such as aglepristone can be administered as well.
Differential diagnoses for this condition include mammary neoplasia and mastitis. Mammary cancer more commonly affects older cats and would be less likely to affect all glands simultaneously and symmetrically like the cat shown in the picture. Mastitis would be painful, inflamed, and the cat would likely be acting systemically ill.
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?
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.
In 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.
You have a 6-kg cat that you wish to raise his PCV from 15 to 25%. You plan to administer packed red blood cells. How many milliliters of packed red blood cells will this cat need?
The correct answer is 60 ml. In order to raise the PCV 1% you will need to give 1ml/kg of packed red blood cells. So it takes 6mls to raise this cat’s PCV by 1%. If we are going to increase it by 10% we will need 60ml of packed red blood cells.
The cat in the image has mammary gland hyperplasia or fibroadenomatous/fibroepithelial hyperplasia. It most commonly occurs in young, intact female cats due to increased progesterone exposure. It is characterized by affecting one or more mammary glands, which become enlarged and are non-painful. Most affected cats are systemically well and do not show signs of illness or pain. Treatment for the condition is removal of the source of progesterone via ovariectomy or ovariohysterectomy. If no source of progesterone can be identified, or if the glands do not respond to spaying, a progesterone receptor blocker such as aglepristone can be administered as well.
Differential diagnoses for this condition include mammary neoplasia and mastitis. Mammary cancer more commonly affects older cats and would be less likely to affect all glands simultaneously and symmetrically like the cat shown in the picture. Mastitis would be painful,
inflamed, and the cat would likely be acting systemically ill.
Interpret the following blood gas results from a 4 year old female spayed dog:
Base excess= -8 (-5 to 0 mmol/L)
Anion gap=18 (8-25 mmol/L)
pH 7.30 (7.35-7.45)
pCO2=29 (34-40
The correct answer is metabolic acidosis, respiratory alkalosis. The normal base deficit/excess of a dog is about -5 to 0 mmol/L. This
means that this dog has a base deficit and therefore a metabolic acidosis. Although this dog has a base deficit, she still has a normal anion
gap (18-25 mmol/L). There is a slight acidemia as normal pH is approximately between 7.35-7.45. Finally, normal pCO2 is approximately
- This dog is hyperventilating and blowing off CO2. In other words, she is blowing off acid; therefore she has respiratory alkalosis. Causes
of metabolic acidosis with a normal anion gap can include loss of bicarbonate due to diarrhea
