Term
You are examining a 12-year old spayed female Border Collie. You note that her pupillary light reflex is slow and incomplete. Her menace and palpebral responses are normal. You see that the iris-pupil margin is somewhat irregular. Fundic exam is shown in the image. What is the most likely cause of the slow PLR? Both eyes are similarly affected.
[image] |
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Definition
| iris atrophy. This is a normal canine fundus in the picture. Iris atrophy is a normal aging change seen in almost all dogs over 10 years old. It leads to scalloping of the iris margin and sometimes a moth-eaten stroma. It can cause absent or incomplete PLRs, dyscoria, or anisocoria |
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Term
what are 3 common causes of morbidity and mortality of anal sac adenocarcinomas in dogs? |
|
Definition
Metatatic
Renal damage
Lymphadenopathy obstructing the pelvic cancal
Apocrine gland anal sac carcinomas are usually very small (often < 1 cm). The usual clinical signs and problems come from either local or distant metastasis or from hypercalcemia due to secretion of PTH-rP by the tumor cells. Even a 1 cm tumor frequently affects local lymph nodes and can cause marked lymphadenopathy and pelvic canal obstruction. These tumors frequently metastasize early and they frequently cause hypercalcemia which can lead to renal damage. |
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Term
A 7-year old male castrated Doberman presented for lethargy, anorexia, and a left forelimb lameness. He was started on meloxicam two days ago for neck pain and improved significantly but became very lethargic and inappetent last night. On physical exam, he had full range of motion in his neck, a hunched stance, conscious proprioceptive deficits in all feet, and his left forelimb was held in an abducted stance. He had a short choppy gait in his thoracic limbs and long lanky gait in his hind limbs. Hematochezia was noted on rectal palpation. Brief ultrasound did not show any evidence of pleural, pericardial, or abdominal effusion. The owners do not wish to pursue any diagnostics. What is your recommended treatment plan for the neurologic disease process you suspect? |
|
Definition
Wobblers
Discontinue meloxicam. Start an oral opioid-based pain medication for 5 days. Then start an anti-inflammatory dose of a steroid.
The hematochezia is likely due to gastric ulceration secondary to meloxicam administration, which should be discontinued immediately. Medical management for Wobbler's syndrome involves an anti-inflammatory dose of a steroid. There is a three to five day wash out period needed after stopping meloxicam and before starting prednisone. |
|
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Term
| what values are usually increased in canine hyperadrenocorticism? |
|
Definition
ALT increases due to swelling and death of some hepatocytes.
SAP increases due to a steroid induced isoenzyme of SAP from the liver. Mild cholestasis due to swelling of hepatocytes also contributes to a minor part of the increase in SAP.
Cholesterol is elevated in up to 90% of hyperadrenocorticism cases. |
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Term
In canine cushings, what is the expected value of BUN? |
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Definition
| BUN is usually low in patients with hyperadrenocorticism secondary to the increased diuresis that occurs with elevated cortisol levels. |
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Term
A decrease in bile will result in less absorption of Vitamin ____ which results in decrease availability of coagulation factors__ ___ __ and __ |
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Definition
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Term
Extrahepatic biliary obstruction can occur for a variety of reasons such as
(3)
If severe enough, the inability to secrete bile into the duodenum will result in decreased absorption of Vitamin ___. thatis necessary for coagulation factors II, VII, IX, and X.
To detect the abnormality, a_______ may be recommended as factor VII has the shortest half-life and it will thus be prolonged. |
|
Definition
neoplasia, choleliths, and pancreatitis
vit k
PT |
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Term
Frequently, owners question the value of spaying or neutering a dog. In this case, you have a hesitant owner that has come in with her new female Bichon Frise of twelve weeks of age.You tell her Spaying after the first heat cycle will result in an approximately _____% likelihood of mammary cancer |
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Definition
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Term
Spaying prior to the first heat results in a____% incidence of mammary carcinoma.
A spay after the first heat results in an increased incidence of___%. Finally, a spay after the second heat yields an approximately ___% incidence of mammary carcinoma. |
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Definition
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Term
| What drug used to treat gastroenteritis can cause feces to darken and look like melena when given orally? |
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Definition
|
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Term
| central venous pressure is is a direct measure of blood pressure in the |
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Definition
|
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Term
| What is the ideal incision site for a foreign body gastrotomy? |
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Definition
| Halfway between the greater and lesser curvature of the stomach |
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Term
| What is the ideal incision site for a foreign body gastrotomy? |
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Definition
| Halfway between the greater and lesser curvature of the stomach |
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Term
| For what type of surgery would nitrous oxide be contraindicated for use as part of an anesthetic protocol in a dog? |
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Definition
GI Sx
Nitrous oxide moves into closed gas spaces such as the intestines. As such, its use is contraindicated in bowel surgeries.
You should also be aware that nitrous oxide decreases fractional inspired oxygen levels although this can be managed and monitored in most instances. Nitrous oxide is contraindicated when pathology such as pulmonary bullae are present. |
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Term
The image below is from an aspirate taken from a lytic bone lesion seen on radiographs of a nine year old female Vizsla dog. Choose the correct cell type of origin AND classification.
[image] |
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Definition
This is an osteosarcoma. The classification scheme for tumors by cell of origin and cytologic description is:
Sarcoma- These tumors come from mesenchymal cells and are named by the specific cell type such as fibroblasts (fibrosarcoma) and osteoblasts (osteosarcoma). Cytologically, they tend to appear as isolated spindle-shaped cells with elongated cytoplasm and often oval nuclei. Those are the features you should have identified in the image. If you identified several cells that have pink areas in the cytoplasm which likely represent osteoid, well done! |
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Term
Carcinoma- These tumors come from______ cells including cells of glandular tissues such as salivary glands, mammary glands, and cells lining most tissues including squamous cells or transitional cells. The cytologic appearance is that of cohesive clusters of cells. Cells are often polygonal in shape. |
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Definition
| Carcinoma- epithelial cells |
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Term
Round cell tumors- There are 5 round cell tumors and most but not all come from blood cells.
Remember, these are sometimes also referred to as sarcomas (i.e. lymphosarcoma or histiocytic sarcoma). Cytologically, they appear usually as large populations of cells that are not in defined clusters. The cells have a round shape, often with unique identifiable features such as the purple granules in mast cell tumors. |
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Definition
lymphoma,
mast cell tumors,
plasma cell tumors,
histiocytic tumors,
transmissible venereal tumors. |
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Term
When measuring Vitamin B12 (Cobalamin) and Folate levels in a dog with suspected small intestinal bacterial overgrowth, which finding is most supportive of this diagnosis? |
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Definition
Increased FOLATE
Decreased CObalamine
The reason for this is that bacteria synthesize folate leading to decreased absorption of cobalamin. |
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Term
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? |
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Definition
| The correct answer is 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. Ketoconazole and itraconazole are good choices. |
|
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Term
| spherules on cytology of a BAL is pathognomonic for _____ |
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Definition
|
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Term
most likely to cause the abnormality seen in this radiograph?
[image] |
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Definition
|
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Term
A 5-year old female spayed Labrador Retriever presents for further evaluation after jumping out of the back of a pick-up truck. What are the most likely regions for a traumatic hernia to occur |
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Definition
| flank or prepubic hernia most common |
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Term
A 12-week old pit bull presents for generalized pruritis and thinning of coat for over two weeks (see image). The puppy is the only animal in the house, and is on flea and tick preventative. The puppy has generalized thinning of the coat, scaling, and oily discharge. The puppy is pruritic wherever scratched. The rest of the physical exam is unremarkable. Skin scraping and impression smear shows mites and secondary pyoderma. What is the most common side effect of Ivermectin?
[image] |
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Definition
| see mild neurological signs like mydriasis and tremors and are able to stop the medication before more severe signs such as seizures and coma occur. Common signs of toxicity include ataxia, head tilt, and lethargy. Signs typically resolve within 24-48 hours after stopping ivermectin when seen. Worst-case scenarios are those with collie breeds or other dog breeds that have the ABCB1 (formerly the MDR-1) gene. This leads to toxic accumulation of drugs intracellularly, leading to severe neurological signs including comas and possibly death |
|
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Term
Diltiazem slows the heart by inhibiting the influx of calcium into the myocardial cell
t or f |
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Definition
|
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Term
| Multifocal areas of tapetal hyperreflectivity is a sign of acute or chronic chorioretinitis? |
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Definition
|
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Term
| What is the method of choice for diagnosing rabies? |
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Definition
| Direct fluorescent antibody test |
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Term
You are examining the eyes of a dog with all the signs of Horner's syndrome. After instilling topical hydroxyamphetamine, there is no change. You then instill topical phenylephrine and in 5 minutes, the eye returns to normal. What can you conclude about this dog's Horner's? |
|
Definition
he has a post-ganglionic lesion.
Hydroxyamphetamine acts by encouraging release of norepinephrine from the neuromuscular junction. If there is a pre-ganglionic lesion, NE will still be released by the postsynaptic neuron and signs will resolve.
If there is a post-ganglionic lesion, there will be no NE to release. Also, with a post-ganglionic lesion, denervation hypersensitivity to NE occurs. As a result, adding phenylephrine topically can cause a rapid response. With pre-ganglionic lesions, the response usually takes greater than 20 minutes. |
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Term
| This compound is an antidote for ethylene glycol toxicity? |
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Definition
| 4-Methylpyrazole (4-MP). It is used to inhibit alcohol dehydrogenase and is considered the preferred treatment for treating ethylene glycol toxicoses in dogs. 4-MP does not cause hyperosmolality, metabolic acidosis, and CNS depression like ethanol treatment can. 4-MP is given to dogs IV over a 36-hour period. The initial dose is 20 mg/kg (slow IV over 15-30 minutes), then 15mg/kg (slow IV) at 12 and 24 hours, and then 5mg/kg is given at 36 hours. 4-MP is not effective in cats. |
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Term
| A 3-year old male castrated Akita presents for a femoral fracture. Which fracture repair method is not an option? |
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Definition
| Type II external fixator. A type I external fixator can be placed from the lateral aspect of the femur, but the medial aspect of the femur can not be approached for a type II external fixator due to the bone being directly adjacent to the trunk of the animal. |
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Term
| You have a 7 year old female Great Dane patient that presents with a 2 cm dermal mass. Because she has a history of multiple benign dermal masses, you elect to perform a quick marginal excisional biopsy. You expect this to be a brief, 5 minute procedure, but you do need the dog to be anesthetized fully. Which of these is the barbiturate with the shortest duration and time to onset of action? |
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Definition
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Term
A normal CVP can range from _____ cmH2O.
What arange indicates hyPOvolemia? |
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Definition
|
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Term
T or F
Elevated blood cortisol concentration 4 hours and 8 hours post low-dose dexamethasone administration is diagnostic for hyperadrenocorticism, but it does not allow differentiation between PDH and a cortisol secreting adrenal tumor. |
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Definition
True
It is diagnostic for hyperadrenocorticism, but it does not allow differentiation between PDH and a cortisol secreting adrenal tumor.so a high dex test is warranted. |
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Term
| In PD cushings animals, the 4-hour post-cortisol concentration may sometimes be suppressed/elevated, whereas cortisol from adrenal tumors will not be suppressed/elevated after administration of a low dose of dexamethasone. |
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Definition
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Term
| A high-dose dexamethasone test will suppress a larger percentage of PDH or ADH patients (up to 75% will be suppressed, showing a decrease in cortisol after 4 hours). |
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Definition
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Term
| ___________stenosis is a congenital defect commonly seen in English bulldogs, beagles, miniature schnauzers, samoyeds, mastiffs, fox terriers, and other small breed dogs. It is characterized by a systolic murmur heard best on the left side over the heart base. Concentric hypertrophy of the right ventricle results from pressure overload of the chamber. Radiographically, concentric hypertrophy may show as mild chamber enlargement. The enlarged pulmonary artery segment is the post stenotic dilatation. |
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Definition
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Term
small breed dogs.
systolic murmur heard best on the left side over the heart base. Concentric hypertrophy of the right ventricle
enlarged pulmonary artery
this describes what heart condition? |
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Definition
|
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Term
| _______stenosis occurs more commonly in large breed dogs, and radiographs would show left chamber enlargement and post stenotic dilatation of the ______ |
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Definition
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Term
| _______ valve degeneration is usually found in older dogs and would cause a murmur heard best at the left apex of the heart. |
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Definition
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Term
| _______ dysplasia typically occurs in large breed dogs, particularly Labrador retrievers, and results in marked right sided cardiomegaly and right heart failure. The murmur is heard best on the right side. |
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Definition
|
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Term
| proper treatment for glaucoma (primary or secondary) in a dog? |
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Definition
Topical latanoprost (prostaglandin analog)
IV mannitol
Topical dorzolamide (carbonic anhydrase inhibitor)
Oral methazolamide (carbonic anhydrase inhibitor) |
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Term
| You are performing a fracture repair of the tibia and fibula in a 4-year old Siberian Husky. What would provide at least 12 hours of analgesia after the procedure? |
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Definition
0.1 mg/kg preservative free morphine given epidurally
Epidural morphine is an effective analgesic for 12-24 hours |
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Term
| A 2-year old male castrated mixed breed dog presents for an altered gait after being hit by a car. On physical exam, the thoracic limbs had decreased biceps and triceps reflexes and decreased muscle tone. The pelvic limbs had hyper-reflexive patellar and gastrocnemius reflexes and increased muscle tone. Where is the spinal cord lesion? |
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Definition
|
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Term
Atrial septal defect with systemic hypertension
what is noted on Hx, PE, CBC?
blood is shunted right to left instead of left to right. |
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Definition
lethargy and exercise intolerance.
dark red mucous membranes
heart murmur.
hematocrit of 70% (35-57%) |
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Term
| Zinc toxicity from ingestion of pennies minted after 1983 can cause which of the following? |
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Definition
| hemolysis. Zinc causes a Heinz body anemia and hemolysis. |
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Term
| what are the clinical signs you would see in a dog with chocolate toxicosis? |
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Definition
The toxic principle of chocolate is methylxanthines (specifically theobromine and caffeine). Methylxanthines can cause CNS excitation tachycardia, vasoconstriction.
Signs include vomiting, diarrhea, hyperactivity, polyuria, polydipsia, lethargy, tachycardia, cardiac arrhythmias, seizures, and death. |
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Term
| You are examining a dog for lameness and on radiographs; you find hypertrophic osteopathy of the metacarpal bones. What is the likely cause of this lesion? |
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Definition
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Term
10-year-old male castrated standard poodle presented for possible foreign body ingestion. The dog has otherwise been normal as far as the owners can tell. Abdominal radiographs are taken (see image) and the only abnormality you find is in the bladder. Based on your radiographic findings, you discuss possible causes of this abnormality and diseases to rule out. What test do you recommend to the owners?
[image] |
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Definition
| radiograph shows emphysematous cystitis, which is caused by the presence of gas forming bacteria. Even if a patient is asymptomatic, emphysematous cystitis typically has an underlying cause that should be determined and treated. The most common rule outs include Cushing's disease (ACTH stimulation test), diabetes mellitus (urinalysis to look for glucosuria), chronic urinary tract infections (urine culture) and bladder stones |
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Term
| A 6-month old male German Shepherd Dog presents for castration. A 4/6 left systolic murmur is heard best over the apex of the heart. Thoracic radiographs reveal a moderately enlarged left atrium. What is the most likely diagnosis? |
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Definition
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Term
| Dogs with which endocrinopathy have an increased incidence of sudden acquired retinal degeneration syndrome (SARDS)? |
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Definition
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Term
A 12-year-old mixed breed female spayed dog presents with a several-month history of lethargy, hair loss, and greasy skin. The patient's face, feet, and tail are not clinically affected and she is mildly pruritic. This photomicrograph shows the results of impression cytology obtained from the patient. What is the most likely name of the organism pictured?
[image] |
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Definition
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Term
| This is a filamentous, branching, gram positive bacteria that is a normal inhabitant of the mouth and oropharynx. It is commonly associated with grass awn migration. These are usually contaminated in the oropharynx and then migrate through the body from the respiratory or GI tracts. Many times it takes months to years to make a diagnosis. |
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Definition
|
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Term
| In a dog, Cushing's response is characterized by a Compensatory increase in _________ to maintain cerebral perfusion pressure. |
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Definition
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Term
Cerebral perfusion pressure=______ - _______
Cushing response is seen in situations where intracranial pressure increases such as in brain trauma. Why would you not want to reduce mean arterial pressure in this patient right away? |
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Definition
Cerebral perfusion pressure= Mean arterial pressure - intracranial pressure or (CPP=MAP-ICP).
In this case, you need to think before you intervene to decrease your patient's mean arterial pressure as this might eliminate cerebral blood flow and kill your patient. |
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Term
| A client brings in her dog that recently ingested rodenticide. You check the box and see that the active ingredient is cholecalciferol. The dog appears clinically normal right now. What would you be concerned might happen if you do nothing at this time? |
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Definition
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Term
| A 4-week old intact male Gordon Setter presents for an acutely swollen face and lethargy. On physical examination you note pronounced submandibular lymphadenopathy, and occasional pustules on the face in addition to the swelling. Cytology does not reveal an infectious cause. Which of the following is an appropriate treatment? |
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Definition
| This is a classic clinical presentation for juvenile cellulitis (puppy strangles). This disease is characterized by sterile granulomas and pustules that respond dramatically to glucocorticoids. The cause is thought to be an underlying immune dysfunction. Immunosuppressive glucocorticoid therapy should not be started until other infectious diseases have been ruled out. At a minimum a deep skin scrape, skin cytology, and trichogram should be performed to rule out Demodex, bacteria, and fungal infection. |
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Term
| What is the difference between stertor and stridor? |
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Definition
| The correct answer is that stertor is a gurgling noise usually generated in the nasal passages while stridor is a high-pitched sound usually generated near the larynx. This is always a source of confusion for veterinary students. Both noises are audible without the aid of a stethoscope and indicate an extrathoracic problem. |
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Term
| hyperkalemia causes ______standstill. What would you not see on an ECGin a hyperkalemic patient. |
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Definition
| atrial standstill....wouldnt see p waves |
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Term
| What drug used to treat gastroenteritis can cause feces to darken and look like melena when given orally? |
|
Definition
| Bismuth subsalicylate (Pepto-Bismol) |
|
|
Term
| Which organism is best visualized under dark field microscopy? |
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Definition
| lepto cause it doesnt stain well |
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Term
| What USG is an important nutritional goal in the management of struvite urolithiasis? |
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Definition
| Maintaining urine specific gravity of <1.020 |
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Term
| ______ is a relatively unusual condition that results in skin lesions as well as myositis. The skin lesions initially appear as papules and vesicles which then rupture, ulcerate, and may progress to crusty alopecic lesions. The myositis sets in a little later and atrophy of the temporalis muscle is often seen. In more severe cases the muscles of the distal extremities become involved and megaesophagus may be observed. Since muscle changes usually lag, other diagnostic tests such as a skin scraping and cytology are performed first to rule out other common conditions. The condition has a variable prognosis as the clinical signs may wax and wane. Medical management usually consists of pentoxifylline, prednisone, and cyclosporine. Prednisone and cyclosporine serve as immunomodulatory medications. Pentoxifylline is used to help improve bloodflow. |
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Definition
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Term
A 5-month old intact female mixed breed presents to your hospital for the progressive lesions seen on the image provided. The owner described the lesions as initially being papules and vesicles which eventually ruptured. Recently, the owner has also noticed that the muscles of the face appear to be atrophied. Muscle and skin biopsies were performed which came back supportive of a diagnosis of _______________. How is it treated?
[image] |
|
Definition
dermatomyositis
cyclosporine
pred
Pentoxifylline to increase circulation |
|
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Term
| Which of the fungal infections is considered contagious, either to other animals or to man (zoonotic)? |
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Definition
Sporotrichosis.
Sporothrix, especially in cats, is a high risk to veterinarians and care should be taken to limit contact with exudates and lesions in cats. |
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|
Term
What fungal disease could cause this?
[image] |
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Definition
| sporotrichosis contagiouse to people and other animals. careful when handling. |
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Term
| Which anesthetic agent is implicated in malignant hyperthermia? |
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Definition
|
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Term
| A dog presents to you after being struck in the head with a baseball bat. The dog is obtunded, but the rest of the physical exam is normal. Which of the following factors should you try to achieve in this patient to minimize intracranial pressure? |
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Definition
| The correct answer is high PaO2. PaCO2, blood pressure, PaO2, cerebral metabolism, and certain drugs can affect cerebral blood volume and intracranial pressure. In head trauma patients, you want to prevent an increase in intracranial pressure by keeping cerebral blood flow relatively low without causing hypoxia. To keep cerebral blood flow in the low-normal range, the cerebral metabolic rate and PaCO2 should be kept low. |
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Term
| Factors that would cause the cerebral metabolic rate to go up include 3 |
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Definition
| fever, seizures, pain, ... |
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Term
| In trauma patients Mean arterial pressure should be maintained in the normal range to prevent 3 |
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Definition
| hypotension, hypoxia, and cerebral ischemia. |
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Term
| What tests can be used to differentiate pituitary-dependent hyperadrenocorticism from an adrenal tumor causing hyperadrenocorticism in dogs? |
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Definition
Tests used to try to differentiate PDH from an adrenal tumor include LDDST,
HDDST,
abdominal ultrasound,
endogenous plasma ACTH assay. |
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Term
Dogs with hyperadrenocorticism
LDDST and HDDST results show elevated cortisol levels at the _____hour post-dexamethasone administration sample.
|
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Definition
8-hour post
(normal animals would show suppressed cortisol levels at the 8-hour sample). |
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Term
PDH patients will show brief cortisol suppression/elevation at the 4-hour post-dexamethasone sample on some LDDST and HDDST tests.
Patients with adrenal tumors causing Cushing's will not exhibit suppression/elevation of cortisol levels at the 4-hour post-sample. |
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Definition
Pituitary suppression
adrenal tumors - not exhibit suppression of cortisol levels at the 4-hour post-sample. However not always the case. |
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Term
If you look at the ____-hour post-dexamethasone sample to determine if the patient has Cushing's or not (should be elevated with Cushing's).
You look at the_____-hour post-sample to try and differentiate if the patient has PDH (will show cortisol suppression) or if you cannot determine if the patient has PDH or an adrenal tumor (no cortisol suppression).
|
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Definition
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|
Term
if the patient has PDH Cushings (will show cortisol suppression at 8hr)
or if you cannot determine if the patient has PDH or an adrenal tumor (no cortisol suppression). |
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Definition
so basically if the 8 hours is low then most likely PDH cushing.
if its still high at 8 hr, then most likely adrenal. confirm with US |
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|
Term
these signs are compatable with what tumor in dogs?
urinating like female
atracting other males
gynecomastia
cryptorchid
truncal alopecia and hyperpigmentation
aplastic anemia
|
|
Definition
|
|
Term
A 1-year old female Golden Retriever presents with bilateral exophthalmos that has taken place over the past 2 days. It is not painful, and no swelling is evident. The dog is otherwise healthy. What condition do you suspect?
and how its it treated? |
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Definition
| Extraocular polymyositis is a condition seen primarily in young Goldens and they present with the signs above. It is kind of similar to masticatory muscle myositis in that it occurs due to an autoimmune reaction against muscle antigens. It is treated with prednisone +/- azathioprine |
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|
Term
The production and release of ADH (vasopressin) is controlled by serum osmolality and blood volume in a normal dog
t or f |
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Definition
|
|
Term
| With central diabetes insipidus, the patient has a problem with the function of the ________ (ADH production) and/or _________and/or_________(ADH release) so the patient cannot respond to the changes in serum osmolality or blood volume and pressure |
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Definition
hypothalmus
neurohypophysis/posterior pituitary |
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|
Term
| The urine specific gravity of a Central Diabetes Insipidus patient is usually _____ to _____ |
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Definition
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Term
| You are treating a dog with lymphoma with prednisone, L-asparaginase and vincristine at the same time. Thirty minutes after administering all 3 drugs, the dog begins to vomit intractably, have diarrhea, and is weak and unable to get up. Pulses at that time are weak on palpation and his mucous membranes are pale pink. He recovers a few hours after being treated. Which of the following changes should be made to the remainder of this dog's chemotherapy protocol? |
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Definition
| The signs described above are consistent with anaphylaxis, a potential side effect of treatment with L-asparaginase. Vincristine can also cause vomiting and diarrhea, but it usually takes a few days before they start, as opposed to within an hour of administration as seen with allergic reactions to L-asparaginase. |
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Term
| any animal with an acute behavioral change or flaccid paralysis is a ______suspect. |
|
Definition
|
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Term
| Cyanosis or blue mucous membranes is an indicator of oxygenation and is generally observed when arterial PO2 is less than ____. |
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Definition
|
|
Term
| What is the average water intake of a normal dog versus a dog with Cushing's? |
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Definition
| Normal: 10-60 ml/kg/day; Cushing's: 80-100 ml/kg/day |
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Term
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?
[image] |
|
Definition
| 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. |
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|
Term
| Which value is not usually increased in canine hyperadrenocorticism? |
|
Definition
| BUN due to excessive diuresis |
|
|
Term
| This is an idiopathic condition where the exocrine cells of the pancreas atrophy with minimal inflammation. |
|
Definition
|
|
Term
Chronic pancreatitis is a much more common cause of EPI in ___than ____.
For this reason, ______ with EPI do not usually have concurrent diabetes mellitus because the endocrine cells are spared, whereas ____ often do have concurrent DM. |
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Definition
|
|
Term
True or false
Neoplasia and infection are rare causes of EPI. |
|
Definition
| yes they are rare causes. most common cause is acinar atrophy in dogs and chronic pancreatitis in cats |
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|
Term
| The syndrome is characterized by muscle rigidity, increased body temperature, increased oxygen consumption and production of CO2. |
|
Definition
|
|
Term
This dog has been on chronic steroid therapy and has now developed this lesion seen in the photograph. Biopsy results of the skin show a broad based budding organism. What is your diagnosis?
[image] |
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Definition
|
|
Term
| A 9 month old shepherd cross presents for lethargy and exercise intolerance. Your physical exam reveals dark red mucous membranes and a heart murmur. A CBC reveals a hematocrit of 70% (35-57%). Which of the following could NOT explain the given findings? |
|
Definition
| Atrial septal defect with systemic hypertension |
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Term
he image below is from an aspirate taken through the soft palate from a mass in the nose of an 8-year old male neutered Rhodesian Ridgeback dog. Choose the correct cell type of origin AND classification.
[image] |
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Definition
epithelial carcinoma
This is a nasal adenocarcinoma. The classification scheme for tumors by cell of origin and cytologic description is:
Carcinoma- These tumors come from epithelial cells including cells of glandular tissues such as salivary glands, mammary glands, and cells lining most tissues including squamous cells or transitional cells. The cytologic appearance is that of COHESIVE CLUSTERS of cells. Here, you can see some of the tight cellular junctions in the cluster which is typical. Cells are often polygonal in shape. |
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Term
| what si the difference between carcinoma and sarcoma |
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Definition
Carcinoma- These tumors come from epithelial cells including cells of glandular tissues such as salivary glands, mammary glands, and cells lining most tissues including squamous cells or transitional cells. The cytologic appearance is that of COHESIVE CLUSTERS of cells. Here, you can see some of the tight cellular junctions in the cluster which is typical. Cells are often polygonal in shape.
Sarcoma- These tumors come from mesenchymal cells and are named by the specific cell type such as fibroblasts (fibrosarcoma) and osteoblasts (osteosarcoma). Cytologically, they tend to appear as isolated spindle-shaped cells with elongated cytoplasm and often oval nuclei. |
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Term
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Definition
| Piroxicam is a non-steroidal anti-inflammatory and is contraindicated in any patient receiving corticosteroids due to risk of cumulative GI toxicity. |
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Term
| What is the treatment of choice for nasal aspergillosis in dogs? What is a possible complicatin of using this drug? |
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Definition
Topical antifungal therapy is considered more efficacious and less costly than long-term systemic antifungal therapy.
The currently recognized treatment of choice is clotrimazole, a synthetic imidazole that has an 80% cure rate with single administration.
The main potential complication is CNS exposure to the drug if there has been erosion of the cribriform plate. |
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Term
| What is the correct post-exposure prophylaxis protocol after being exposed to rabies for an unvaccinated human? |
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Definition
| Injection of human rabies immune globulin followed by 4 injections of approved rabies vaccine |
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Term
A 12-year old English Bulldog presents with anorexia and severe, generalized pain. What is the best description of the lesions in this radiograph?
[image] |
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Definition
polyostic agressive
There are multiple lytic lesions in the cervical and thoracic vertebrae, especially visible in C2 and in the spinous processes of the T1-T8. There are also lytic lesions in the proximal humerus of one leg and in the bones of the skull. |
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Term
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Definition
| It is unknown what exactly causes Alopecia X, but it has been shown to be genetic. Nordic breeds and Pomeranians are most commonly affected. Alopecia X causes an arrest of the hair cycle. |
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Term
Melatonin may help some pets with this condition.
[image] |
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Definition
alopecia X
Nordic breeds and Pomeranians are most commonly affected. |
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Term
| A 10-year old Shih Tzu presents for collapse. A diagnostic work up shows a mass on the right kidney, which was subsequently removed and biopsied as renal carcinoma. Which abnormality in the CBC can be associated with renal carcinoma and why does this occure? |
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Definition
polycythemia
Renal carcinomas have been associated with erythropoietin secretion, causing elevations in hematocrit as a paraneoplastic syndrome |
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Term
| _________ (abnormality with platelets) can be seen with hemangiosarcoma and multiple myeloma. |
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Definition
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Term
| Hyperestrogenism can be seen with ________ tumors. |
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Definition
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Term
| Demodicosis often coincides with bacterial infections. On a recheck examination of an 8-month old pit bull with demodicosis you find swelling and furunculosis over the lateral thighs that is draining serosanguinous fluid. Cytology of the fluid reveals 4+ cocci, and you diagnose a deep bacterial pyoderma. You culture the lesion and start Clindamycin based on the culture results. The dog returns in four weeks for another recheck examination. No bacteria are found on cytology, and clinically the dog looks excellent. You repeat a skin scrape and find Demodex mites. You inform the owner to continue Ivermectin. What should you do regarding continuation of antibiotics? |
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Definition
continue ABx another 2 wks
Deep lesions usually heal on the surface before the deeper infection is resolved; making clinical cure difficult to assess. Therefore, antibiotic treatment should be continued for 7-21 days after the tissues return to normal. In general, deep infections can require 6-8 weeks of antibiotic treatment and even 12 weeks for severe cases. Superficial infections require 3-4 weeks of antibiotic therapy or one week past clinical resolution. |
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Term
| You are examining the eyes of a dog and see that he has a positive menace response and dazzle reflex is visual but lacks a palpebral reflex. Where does he have a lesion? |
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Definition
CN 5 opthalmic motor branch
This animal has no visual deficits, as evidenced by his menace and dazzle, which rules out lesions in CN II or the visual cortex. The normal menace response indicates that CN VII is functioning as well. The lack of a palpebral then indicates a sensory deficit for which CN V is responsible. |
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Term
A 2-year old mixed breed dog presents for a mass on her upper lip that the owners noticed three weeks ago (see image). It has not grown in size, and does not seem to bother the dog. On physical exam the dog is bright, alert, and responsive with no other significant findings aside from the mass. The mass is smooth, less then 1cm in diameter, and localized to the skin. How would you recommend confirming your tentative diagnosis, and what do you tell owner regarding prognosis?
[image] |
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Definition
Fine needle aspirate, prognosis likely good
young dog most likely a histiocytoma. |
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Term
| A 3-year old Golden Retriever presents for acute onset of a non-painful myelopathy localized to the spinal segments from T3-L3. The dog has superficial and deep pain perception and some motor function present in its pelvic limbs. It also has hyperreflexive patellar and gastrocnemius reflexes. The dog is diagnosed with a fibrocartilagenous embolism (FCE). What do you tell the owners? |
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Definition
| Most dogs with FCE usually get better on their own with nursing care |
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Term
What is the most appropriate medical treatment for transitional cell carcinoma at the trigone of the bladder, as depicted in the photo?
[image] |
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Definition
Piroxicam and carboplatin chemotherapy
Transitional cell carcinoma of the bladder in dogs can be palliatively managed with non-steroidal anti-inflammatory drugs such as piroxicam.
Progression-free interval and survival can be extended with the addition of chemotherapy. The most commonly used agents are carboplatin, cisplatin, and mitoxantrone. Although cisplatin is effective against TCC, it has increased nephrotoxicity with piroxicam and is less commonly used these days in the author's experience. Secondary infections can be treated with appropriate antibiotics. |
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Term
Which of the following drugs is an FDA-approved treatment for a neoplasm in dogs?
- Doxorubicin (Adriamycin)
- Temozolomide (Temodar)
- Toceeranib phosphate (Pallidia)
- CCNU (Lomustine)
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Definition
Toceeranib phosphate (Pallidia)
In 2009, toceranib (Palladia) became the first FDA-approved veterinary chemotherapeutic for treatment of cancer. Toceranib is an inhibitor of a membrane-bound signaling molecule called a receptor tyrosine kinase (RTK). Many mast cell tumors are known to have mutations in an RTK that contributes to their aggressive behavior and can be blocked by this drug. |
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Term
| In 2009, ________ became the first FDA-approved veterinary chemotherapeutic for treatment of cancer. Toceranib is an inhibitor of a membrane-bound signaling molecule called a receptor tyrosine kinase (RTK). Many mast cell tumors are known to have mutations in an RTK that contributes to their aggressive behavior and can be blocked by this drug. |
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Definition
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Term
| ______ causes marked splenic dilation with blood and a corresponding decrease in hematocrit concentration. |
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Definition
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Term
most likely cause of lymphoplasmacytic rhinitis as seen in this patient?
[image] |
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Definition
idiopathic
As the name implies, these patients have a mixed population of lymphocytes and plasma cells when biopsied. Many consider the condition to be an idiopathic immune-mediated disorder.
ypical clinical signs include a history of unilateral or bilateral nasal discharge of several months duration. Large-breed dogs are more often affected and the age may vary |
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Term
. You want to choose anesthetic agents that do not cause the spleen to enlarge/engorge.
what surgery could this be a problem in |
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Definition
Morphine followed by ket/val
splenectomy |
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Term
You are seeing a dog that you suspect has iatrogenic Cushing's disease from high-dose prednisone administration. What would you expect on blood samples submitted for ACTH and cortisol levels submitted to a commercial lab?
ACTH willbe ------
Cortisol will be____ |
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Definition
| ACTH low, cortisol high. Prednisone is a synthetic corticosteroid that cross reacts with assays measuring endogenous cortisol levels, causing an artificially elevated cortisol measurement on blood tests. The feedback mechanism on the pituitary gland inhibits ACTH production, making it low. |
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Term
| 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? |
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Definition
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. |
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Term
| Administration of ______ results in release of von Willebrand factor, which will help patient with clotting when there is a very strong likelihood she is afflicted with von Willebrand's disease. |
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Definition
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Term
Which of the following is a non-adrenergic vasoconstrictor that can be used in dogs?
Vasopressin
Epinephrine
Phenylephrine
Isoproterenol
Dobutamine |
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Definition
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Term
Epinephrine and phenylephrine are ________ vasoconstrictors. I
Isoproterenol and dobutamine cause ______.
Vasopressin (also known as anti-diuretic hormone) is a V-1 receptor, __________, vasoconstrictor. |
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Definition
Epinephrine and phenylephrine - adrenergic vasoconstrictors.
Isoproterenol and dobutamine cause - vasodilation.
Vasopressin - non-adrenergic, vasoconstrictor. |
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Term
A 4-month-old terrier cross present 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 disease is this and how is it treated?
[image] |
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Definition
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. |
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Term
management of tachycardia associated with this arrhythmia in small animal patients: 4
[image] |
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Definition
Atenolol
Diltiazem
Procainamide
Digoxin |
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Term
| _______ is a non-specific beta receptor agonist, and will increase the ventricular rate in response to atrial fibrillation, thus is inappropriate in the management of a fib dysrhythmia. |
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Definition
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Term
| What is the typical ultrasonographic appearance of the abdomen in a dog with pancreatitis? |
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Definition
| The pancreas appears hypoechoic due to edema, and the mesentery appears hyperechoic due to focal peritonitis. |
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Term
| what are effects of non-steroidal anti-inflammatory drugs that are non-selective COX inhibitors? |
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Definition
NSAIDs reduce inflammation and pain by blocking the COX-1 and COX-2 pathways.
Non-selective COX inhibitor side effects include GI ulcers, inhibition of platelet function, renal damage, and reduction of fever. |
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Term
A 6-year old male castrated Borzoi dog presents to you with a one-year history of polyuria and polydipsia with no other clinical signs. A urinalysis confirms a specific gravity of 1.003 and no other abnormalities.
You tentatively diagnose central diabetes insipidus and elect to try the dog on desmopressin (DDAVP) to see if the PU/PD resolves. What reason best explains why you might not see a response within the first 24-48 hours, even if your diagnosis is correct? |
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Definition
| It may take up to 3 days to overcome medullary washout from being polyuric and polydipsic |
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Term
When examining the eye of a 6-year old Labrador Retriever, you see the brown, round circular masses shown in the image free floating in the anterior chamber. What is the most likely diagnosis?
[image] |
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Definition
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Term
_________ is an autoimmune disorder causing vesicles, ulceration, and crusting. It can affect the whole body, but it especially affects the mucocutaneous junctions and oral mucosa. The onset of the disease can be sudden (acute) or gradual over many weeks (chronic).
The disorder is caused by an______ autoantibody that binds to intracellular adhesion molecules (desmoglein) causing a loss of cohesion between keratinocytes resulting in acantholysis, vesicle formation, and eventually ulceration.
The treatment is immunosuppressive therapy with corticosteroids and frequently additional immunomodulatory or immunosuppressive drugs such as azathioprine, cyclophosphamide, chlorambucil, or others. Unfortunately, long-term therapy is generally required and these treatments cause serious side-effects long-term. Prognosis is poor and euthanasia is often performed. |
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Definition
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Term
You ask your technician to give a 1 ml/kg dose of lidocaine to a dog that is having ventricular premature complexes. You realize after it is too late that she miscalculated the dose and gave 10 times what you asked for. What is the most common early sign of lidocaine toxicity in dogs?How to cats show sensativity to overdose lidocain?
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Definition
In dogs, toxicity of lidocaine is manifest primarily as CNS signs. Drowsiness or agitation may progress to muscle twitching and convulsions at higher doses. This occurs before respiratory or cardiac depression. Hypotension may develop if an IV bolus is given too rapidly.
Cats are more sensitive to lidocaine toxicity and may show cardiac suppression and CNS excitation |
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Term
| A 5-year old male castrated English Springer Spaniel presents for a dental exam. The dog has a history of aggressive chewing on tennis balls and frisbees. The oral exam reveals brown, worn-down incisors, canines, and premolars. The dog is otherwise normal and healthy. What is the cause for the teeth turning brown? |
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Definition
| The teeth are brown due to the formation of tertiary dentin, which stains easily. |
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Term
in orderto prevent or manage struvite formation, one should try to maintain a urine USG around 1.020 with a pH of 6.5
True of F |
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Definition
true
to maintain dilute urine so that solutes do not concentrate to the degree that they form precipitates that lead to stone formation. Struvite stones (magnesium ammonium phosphate) tend to form in alkaline urine so ideal urine pH for struvite stone formers is usually around 6.5 |
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Term
| a key element in struvite stone formation is the presence of a urinary ________, particularly with urease-producing microbes, most notably staphylococcus and protease. |
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Definition
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Term
| how is Progressive Retinal Atrophy (PRA) different from SARDS? |
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Definition
| It is differentiated from SARDS by the clinical course and the fact that there are no retinal lesions in acute SARDS. |
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Term
| WHy do you NOT give a sighhound with a mstcell tumor morphine or thiopental? |
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Definition
In this case, thiopental is contraindicated because the patient is a sighthound. Thiopental is an ultra-short acting barbiturate. Recovery depends on redistribution to tissues, including fat. Because sighthounds have very little fat, they have prolonged recoveries and greater complications with these drugs.
Morphine is contraindicated in this patient due to the ulcerating mast cell tumor. Morphine can cause histamine release and should be avoided in mast cell tumor patients. |
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Term
| how does morphine affect mast cells |
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Definition
| Morphine can cause histamine release and should be avoided in mast cell tumor patients. |
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Term
A 1-year-old female spayed Corgi presents for a seizure. At home, she vomited what appeared to be paint chips. Peripheral blood cytology and a complete blood count showed 20 nucleated red blood cells/100 white blood cells, basophilic stippling, and a neutrophilic leukocytosis (see image). She received a dose of diazepam, which has controlled her seizures. What is the treatment of choice?
[image] |
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Definition
| Ca EDTA chelator for lead tox |
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Term
| what is the difference between major and minor cross matching? |
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Definition
Major crossmatch, you are looking to see if the factors in the plasma of the recipient are going to react to the donated red blood cells.
Minor crossmatch involves recipient red blood cells and donor plasma. |
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Term
| A 4-year old female spayed Australian Shepherd presents for recurrence of left thoracic limb lameness. The dog has a history of a left radial fracture 12 weeks ago, which was repaired with a bone plate and has since fully healed. Over the past three days, the dog started limping on the left thoracic limb and has developed a draining tract over the site of the previous fracture repair. Radiographs of the limb show soft tissue swelling and lucencies around the bone plate and several of the screws. What should be done next? |
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Definition
Remove the bone plate and start antibiotics
Implants such as bone plates and screws can often be a nidus for infection. The lucencies around the bone plate and screws suggest instability of the implants, and the draining tract is suggestive of infection. Since the bone is already fully healed, the best treatment for this dog would be to remove the bone plate and screws and start antibiotics. |
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Term
| Which of the following will result in an increased production of less inflammatory eicosanoids i a dog with osteoarthritis? |
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Definition
| high concentration of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) has been shown to result in the preferential use of these compounds to form eicosanoids. Eicosanoids derive from either omega-3 or omega-6 fatty acids. Omega-6 eicosanoids are generally pro-inflammatory, while omega-3 eicosanoids are less inflammatory. Omega-3 fatty acid supplementation results in a decrease in pro-inflammatory omega-6 eicosanoids; providing potential benefit to patients with osteoarthritis. |
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Term
high concentration of __________ (eicosapentaenoic acid and docosahexaenoic acid) has been shown to result in the preferential use of these compounds to form eicosanoids.
Eicosanoids derive from either omega-3 or omega-6 fatty acids. |
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Definition
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Term
| ecosinoids are drived from omega ----- |
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Definition
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Term
| Omega-6 eicosanoids are generally anti or pro-inflammatory, while omega-3 eicosanoids are more or less inflammatory. |
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Definition
O6 - proinflammatory
O3 - less inflammatory |
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Term
Omega-3 fatty acid supplementation results in a decrease in pro-inflammatory omega-6 eicosanoids; providing potential benefit to patients with osteoarthritis.
t or f |
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Definition
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Term
| _______ is a precursor of glycosaminoglycans which is a major constituent of the joint and thought to be of great importance for joint health and ________ is also an important constituent of cartilage and helps provide resistance to compressive force. |
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Definition
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Term
You suspect prostatitis, Your antibiotic choice should be based on culture and sensitivity results, but because your patient is sick you will want to start an antibiotic that has good penetration of the prostate until the culture results are back. These 4 Abx are able to pass the blood-prostate barrier.
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Definition
Chloramphenicol, erythromycin, trimethoprim and fluoroquinolones
Cephalexin and cefpodoxime are cephalosporins and may be effective if the blood-prostate barrier is disrupted, but they would not be the first choice. |
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Term
name 1 H1 blocker
name 3 H2 blockers
how do they differ? |
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Definition
H1 blockers (diphenhydramine)
H2 blockers (famotidine, cimetidine, ranitidine, etc)
H1 and H2 antagonist are both two types of histamine antagonist.
H1 antagonist serves to reduce or eliminate effects mediated by histamine, released during allergic reactions.
H2 receptor antagonists are used to block the action of histamine on parietal cells in the stomach by decreasing the production of acid by these cells. |
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Term
| ____________ This is a gram negative motile, thin, S shaped or gull shaped rod. It can occur singly, in pairs or in chains. You can also isolate this organism with fresh fecal swabs streaked onto blood agar plate which grows in an oxygen-reduced atmosphere in 3-4 days |
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Definition
Campylobacteriosis
C. jejuni is most commonly isolated |
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Term
On physical examination of a dog, you find the mass depicted here projecting from the margin of the upper eyelid. What is the most likely diagnosis?
[image] |
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Definition
| The description fits the appearance and location of a meibomian gland adenoma. This is the most common ocular tumor of the dog and is usually benign. A chalazion is an obstruction of the meibomian gland and appears as a swelling within the eyelid rather than projecting from it |
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Term
| A dog presents to you after being struck in the head with a baseball bat. The dog is obtunded, but the rest of the physical exam is normal. Which blood gas parameter should you try to achieve in this patient to minimize intracranial pressure? |
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Definition
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Term
| To prevent an increase in intracranial pressure what paramters do you keep low and high? |
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Definition
you want to prevent an increase in intracranial pressure by keeping cerebral blood flow relatively low without causing hypoxia.
To keep cerebral blood flow in the low-normal range, the cerebral metabolic rate and PaCO2 should be kept low. |
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Term
| major potential adverse side effect of the chemotherapeutic drug adriamycin in dogs? |
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Definition
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Term
The drug that causes ileus is -----
The drug that causes anaphylaxis is -------
The drug that causes nephrotoxicity is --------
The drug that causes cystitis is --------- |
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Definition
vincristine
L-asparginase
cisplatin
cyclophosphamide |
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Term
An 8-year old female Chow Chow presents to you for difficulty eating. On oral exam, you see a 3 cm mass in the caudal maxilla. You are unable to obtain a fine needle aspirate because of the mass's location but you detect an enlarged mandibular lymph node and aspirate it. A representative field from the aspirate is shown in the image below. In addition to surgery (+/- radiation), which of the following is an APPROVED treatment option for this disease that you would mention to the owner?
[image] |
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Definition
| The image shows a lymph node with metastatic melanoma (the large cell with black melanin pigment). The ONCEPT vaccine, also commonly referred to as the "melanoma vaccine" was given a conditional product license in 2007 and was USDA approved in 2010 as a therapeutic vaccine for cancer treatment. |
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Term
________ is a receptor tyrosine kinase inhibitor approved for use in mast cell tumors in dogs.
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Definition
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Term
definitive diagnosis of multiple myeloma requires satisfying at least two of the following criteria:
1
2
3
4
DxTest? |
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Definition
1. Monoclonal gammopathy
2. Radiographic evidence of osteolytic bone lesions
3. >5% neoplastic cells or >10-20% plasma cells in the bone marrow
4. Immunoglobulin light chain proteinuria (Bence-Jones proteinuria)
serum electrophoresis to assess monoclonal gammopathy and a bone marrow biopsy to look for neoplastic infiltration of plasma cells. |
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Term
A 12-year old female Dalmatian has a Holter monitor placed for an arrhythmia heard on exam. The following trace is from that monitor; similar abnormalities were seen frequently throughout the 24hrs. What is your treatment recommendation for this arrhythmia?
[image] |
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Definition
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Term
| -------- is a "soft tissue sarcoma" due its locally invasive behavior and relatively low metastatic rate for most low and intermediate grade tumors? |
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Definition
| Peripheral nerve sheath tumor |
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Term
A 5-year old male neutered Dalmatian presents for hematuria, pollakiuria, and stranguria. Abdominal radiographs were unremarkable and an abdominal ultrasound showed evidence of urolithiasis. The patient was taken to surgery and the image depicts the surgical findings. What additional treatment options should be recommended to the owner?
[image] |
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Definition
Alkalizing diet and and allopurinol therapy
The stones in the image are most consistent with the appearance of urate stones, but even without recognizing their appearance, you should be able to guess that the dog has urate stones based on the Dalmatian breed, as they are highly predisposed to forming urate stones, and the apparent radiolucency of the stones since they were not visible radiographically.
Urate stone formation is promoted by acidic urine and diets high in purines which are metabolized to uric acid. Generally a low-purine alkalizing diet is recommended. Allopurinol therapy may also be used to reduce uric acid production but it requires monitoring as it may predispose dogs to different types of stones (Xanthine). |
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Term
| A 4 year old Doberman Pinscher presents for slowly progressive ataxia and paresis of all four limbs. The owners note that the ataxia is sporadic. On physical exam, the dog has hyperreflexive spinal reflexes in all four limbs, delayed conscious proprioception in all four limbs, and neck pain on ventroflexion. What is the most likely diagnosis? |
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Definition
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Term
| One of your colleagues has asked you to be the anesthetist for a lung lobectomy in an 8 year old Pug with a lung lobe torsion. He stresses that there will be times in the procedure where it is absolutely critical that the dog stay completely still, including no respiratory motion. Which of the following drugs could be used to do this while maintaining the dog under a reasonable surgical plane of anesthesia? |
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Definition
SUccinylcholine and isoflurane
To control all respiratory motion without pushing a dog to an excessive and dangerous plane of anesthesia, a neuromuscular blocking agent would be necessary. You would never use one of these alone for a surgical procedure as they do not provide analgesia or reduce consciousness, which is why an inhalant gas anesthetic is also used to maintain anesthesia in this case.
Options include succinylcholine which is a depolarizing neuromuscular blocker or one of the nondepolarizing neuromuscular blocking agents such as pancuronium, d-tubocurarine, and atracurium. |
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Term
| A 5-year-old Doberman presents for chronic pruritus and recurrent bacterial skin infections. The patient has been on a 4-week course of Cephalexin and continues to get new skin lesions despite this treatment. You suspect methicillin resistance and recommend a skin culture. The owner declines a culture and would like you to select another antibiotic empirically. Which antibiotic would be the best choice considering side effects and efficacy? |
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Definition
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Term
| A 3-year old German Short Hair Pointer presents for vomiting, lethargy, and diarrhea. A fecal exam reveals the eggs of Nanophyetus salmincola, the salmon poisoning fluke. What treatment should be administered to treat the symptoms of the dog? |
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Definition
tetracycline antibiotics.
The causative agent for the dog's clinical signs is Neorickettsia helminthoeca. Treatment of choice for this rickettsial agent is tetracycline antibiotics. The fluke itself is not responsible for the clinical signs, but may be treated effectively with Praziquantel. |
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Term
| A 6 year-old spayed female Cocker Spaniel named Lady is presented for lethargy. On physical exam, you notice that Lady has petechiae on her oral mucosa. You admit Lady to the hospital for testing and find that she has less than 25,000 platelets per uL (200,000-900,000/uL). You rule out Ehrlichiosis, Rocky Mountain spotted fever, babesiosis and drug-induced thrombocytopenia. What is a reasonable treatment option for this patient? |
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Definition
| For patients with immune-mediated thrombocytopenia, immunosuppressive doses of corticosteroids should be started. Cyclophosphamide can be given to help induce remission. Azathioprine can help maintain remission and can be given long-term, usually with fewer side effects than with corticosteroids. |
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Term
| A 7-year old female Standard Poodle presents to you for acute onset of vomiting and weakness after the owners returned from vacation. On physical exam, you estimate that the dog is 7% dehydrated, has a respiratory rate of 36 breaths per minute, heart rate of 44 beats per minute and temperature of 99 degrees F. You quickly attach ECG leads and expect to see which of the following abnormalities? |
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Definition
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Term
| Hansen's Type ____ disc disease usually involves chondrodystrophic dogs. It is usually acute, painful, and should be considered an emergency |
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Definition
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Term
A 10 year old female spayed Labrador Retriever has presented for difficulty getting up in the hind and apparent back pain for the last 3-4 weeks. Upon questioning the owner, you are told that her appetite is diminished but she is still eating. An orthopedic exam finds no pain or discomfort elicited on manipulation of the hips or stifles. A neurologic exam identifies substantial pain in the lumbosacral region; however, conscious proprioception is intact, and patellar reflexes are normal.
Radiographs of the lumbosacral region identify a lytic lesion at the L7-S1 endplates as well as surrounding bony proliferation. Which of the following diagnostic tests is likely to provide the most helpful additional information given your findings? |
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Definition
The diagnosis you should have in mind is discospondylitis. Be sure not to confuse this with spondylosis, which is typically not clinically significant and can be expected in most older dogs. The radiographic description is relatively specific for this condition. Neoplasia in the spine should be lower on your differential list because it typically does not cross joints. Disc herniation cannot be ruled out, and advanced imaging would be necessary to know for certain, but given the exam and radiographic findings, discospondylitis should be your top differential.
Discospondylitis is usually bacterial in origin, with Staphylococcus being the most common organism involved. Other organisms identified include Brucella canis, E. coli, Pasteurella, Aspergillus, and Streptococcus.
In an attempt to identify the causative agent, urine and blood cultures should be considered. The other answer choices are not as high yield in identifying the specific bacterial cause or underlying etiology. |
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| A 6 year old Cocker Spaniel with a chronic history of ear infections presents to you circling to the left, with a left head tilt, and both rotary and horizontal nystagmus with the fast phase to the right. No other neurologic deficits are apparent except for a possible hearing deficit. It is difficult to perform a thorough otoscopic examination on the patient without sedation. The dog has been on multiple topical and systemic medications to treat otitis over the past few weeks, but the owner is not sure what they are. Which drugs is a commonly implicated cause of peripheral vestibular disease? |
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Definition
| Chlorhexadine is a topical drug implicated in ototoxicity and peripheral vestibular disease. Another excellent choice would be aminoglycosides including neomycin, kanamycin, tobramycin, amikacin and gentamicin. |
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| ________ would be a good choice as a cause of central vestibular disease and is commonly used as an antibiotic |
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| What is the end-point of warfarin therapy in an animal with a pulmonary thromboembolism? |
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Definition
| A prothrombin time of 1.5 to 2 times normal |
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| What is a possible sequela of a dog ingesting mothballs? |
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Definition
| he toxic compound in mothballs is naphthalene which can cause acute hemolytic anemia, Heinz body anemia or methemoglobinemia, vomiting, and seizures. |
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| You have a 20 kg dog with a PCV of 15%. You wish to raise his PCV to 25%. How much fresh whole blood should you administer? |
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Definition
| The correct answer is 400ml. To raise the PCV 1% you need to give 2ml/kg of fresh whole blood. So, 40 ml will raise the dog's PCV by 1%, but since we need to raise it by 10%, you will need 400ml or fresh whole blood. |
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| An owner comes to your clinic very worried about her 3-year old Labrador that has developed watery to mucoid hemorrhagic diarrhea. On physical exam you notice that "Spanky" is depressed, weak, slightly pale, and dehydrated. What is your primary differential? |
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| A 3 year old male Weimaraner presents to your clinic with complaints of anorexia, weight loss, and progressive exercise intolerance and dyspnea with a dry, hacking cough. On physical exam, he is cachectic (BCS 2/9), febrile (103.8 F, 39.9 C), and has diffuse peripheral lymphadenopathy. Thoracic radiographs show a diffuse nodular interstitial pattern in all lung fields. Cytology of a lymph node aspirate shows suppurative inflammation. What is the MOST likely diagnosis to explain all of these findings? |
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| What is not a common sequela to a physeal injury in a young dog? |
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| Does osteochondrosis cause of physitis in young horses? |
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| While mitral insufficiency can and does lead to pulmonary hypertension, _______ insufficiency does not. |
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