2024 JVIM ✔️

Question 1

Precision medicine using whole genome sequencing identifies a novel dystrophin (DMD) variant for X-linked muscular dystrophy in a cat

Answer 1

1Y M DSH
Progressive difficulty walking, macroglossia and dysphagia beginning at 6 months of age.

Trapezius biopsies = degenerative and regenerative myopathy

AST, CK elevated, mild hypokalemia

Dystrophin-deficient form of X-linked musculodystrophy due to stop gain variant dystrophin in genome sequencing.

Question 2

Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia

Answer 2

GESF = differential diagnosis for abdominal masses

median age 5.4y
30% DSH
Pedigree - ragdoll 25%
median duration of CS 90d
- weight loss 60%
- hyporexia 55%
- chronic vom 37%
- lethargy 35%
- chronic diarrhea 27%

Mass location
- SI 32%
- stomach 27%
- ICCJ 15%
- Colon 10%
- LN / mesentery 8%
- >1 mass 15%

Eosinophilia 50%
Hypoalbuminemia 28%

Surgery vs. medical management not significantly different with 88% cats alive at publication

98% treated with steroids.

Question 3

Development of a requirement for exogenous insulin treatment in dogs with hyperglycemia

Answer 3

Most dogs with randomly identified hyperglycemia did not develop a need for exogenous insulin treatment.

**3.5% with hyperglycemia and follow up developed insulin dependent DM. **

No association between the degree of hypergylcemia and time to requiring insulin.

Question 4

Acute hypernatremia and hypocalcemia after oral sodium phosphate administration to a dog

Answer 4

15y MBD
CS: tremors, altered mentation

**Oral sodium phosphate bowel prep given, then developed hypocalcemia, and hypernatremia **

Treated low sodium fluids and calcium gluconate

Normalized in 12h

Question 5

Medial strabismus (esotropia) at rest associated with contralateral paramedian thalamic ischemic infarction in 2 dogs

Answer 5

Pseudoabducens paralysis resulting in resting medial strabismus (esotropia) is a rare consequence of a contralateral paramedian thalamic ischemic infarction in people.

Median strabismus DDX
- abducens neuropathy
- extraocular myopathy
- **contralateral thalamic infarcts **

7y MN Border Collie
12y FS MBD
Both - peracute, non-progressive vestibular ataxia, R head tilt and median strabismus

MRI - left thalamic lacunar ischemic infarct

Question 6

A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs

Answer 6

No definitive pITP diagnostic test was found.

pITP cases - lower platelet counts, D dimer concentrations, and platelet membrane protein expression.

**Low hematocrit and high BUN concentration were associated with non-survival. **

Low hematocrit at admission, but not platelet count or DOGiBAT score, was associated with transfusion.

Question 7

The effect of ε-aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs

Answer 7

** EACA increased clot strength, but NO effect on outcome. **

Treatment with EACA at this dosage cannot be recommended as a routine treatment - may consider for severe.

No difference in # transfusions or hospitalization days.

No survival difference

Question 8

Clinical and imaging findings in dogs with nerve root signature associated with cervical intervertebral disc herniation

Answer 8

Nerve root signature = most commonly associated with lateralized or foraminal cervical disc herniations.

most prevalent with **C6-C7 ** (32%)

there might be unique anatomic factors that contribute to development of NRS at this site

Question 9

Spontaneous remission and relapse of diabetes mellitus in a male dog

Answer 9

An 8y. MN Min Schnauzer dx diabetes mellitus
- fasting hyperglycemia and glucosuria after a 2-week history of polydipsia and periuria.

Tx - insulin and dietary management. Insulin gradually reduced and d/c. Remission over 1y.

Re-resented for PU/PD, hyperglycemia, glucosuria.

Insulin therapy for remainder of life.

Etiopathogenesis of pancreatic beta cell loss makes remission rare in dogs, except for cases occurring with diestrus or pregnancy. This case demonstrates that diabetic remission is possible in dogs, even in cases without an identifiable reversible trigger.

Question 10

A retrospective study of the efficacy of zonisamide in controlling seizures in 57 cats

Answer 10

Zonisamide = well tolerated and effective

**median decrease in 1 seizure per month and 1 seizure day per month **

AE:
- sedation 17%
- hyporexia 17%
- ataxia 11%
- emesis 5%
- 1 cat - mild non-regen anemia
- 2 cats - metabolic acidosis
- 6 cats - ELE

Question 11

Serum symmetric dimethylarginine in older dogs: Reference interval and comparison of a gold standard method with the ELISA

Answer 11

Tested SDMA via ELISA and liquid chromatography-tandem mass spectrometry (gold standard)

ELISA = higher SDMA concentrations compared to LC-MS/MS

Device- or assay-specific RI

• age-specific RI for SDMA higher in older dogs compared to the general laboratory RI

Question 12

Comparison of timing of relapse in dogs with non-associative immune-mediated hemolytic anemia, thrombocytopenia, or polyarthritis

Answer 12

Risk of disease relapse in IMPA is highest in the first year after diagnosis, with a higher relapse rate compared with IMHA and ITP.

1y relapse:
- IMPA 35%
- IMHA 11%
- ITP 11%

2y relapse:
- IMPA 41%
- IMHA 18%
- ITP 23%

** 90% of IMPA relapses occur in first 12mos **
56% for IMHA
50% ITP

Vaccine admin after diagnosis not associated with relapse

Question 13

Evaluation of a urine dipstick protein to urine specific gravity ratio for the detection of proteinuria in dogs and cats

Answer 13

dipstick urine protein to USG ratio (DUR)
- relatively reliable to ID proteinuria
- poor negative predictive value = can’t exclude proteinuria

Correlation between UPC and DUR
- not influenced by active sediment, glucosuria, or urine pH

canine UPCR >0.5 =an optimal DUR of 1.4
- sensitivity 89%
- specificity 83%
- PPV 96%
- NPV 63%

feline UPCR >0.4 = optimal DUR of 2.1
- sensitivity 70%
- specificity 100%
- PPV 100%
- NPV 75%

Question 14

Reason for euthanasia in dogs with urothelial carcinoma treated with chemotherapy or radiation therapy or both: A retrospective observational study

Answer 14

UC poor prognosis
MST 339d
Euthanized due to
- local progression 62%
—> most often due to urinary obstruction 77%
- metastasis 38%

No variables predictive of obstruction
Metastatic rate 56%

Question 15

Assessment of the likelihood of hypothyroidism in dogs diagnosed with and treated for hypothyroidism at primary care practices: 102 cases (2016-2021)

Answer 15

hypothyroidism - overly and incorrectly diagnosed in first opinion practice

only perform thyroid function testing in dogs with a high probability of the disease.

levothyroxine supplementation not indicated in ~50%

Question 16

Hypothalamic-pituitary-adrenal axis recovery after intermediate-acting glucocorticoid treatment in client-owned dogs

Answer 16

Most dogs experienced HPA axis recovery within a few days after steroid discontinuation.

However, 2/20 dogs required >8 weeks.

** Median time of axis recovery 3d **

dose and duration not correlated with timing of recovery

Question 17

Serum concentrations of complement C3 and C4 in dogs with idiopathic epilepsy

Answer 17

Dysregulation of classical complement pathway was identified in IE dogs.

Serum C3 and C4 = possible biomarkers for IE with higher seizure frequency

** Serum C3 + C4 concentrations significantly higher in dogs with IE. **

No significant differences observed in concentrations between dogs in tx vs. non-tx groups

Seizure frequency >3x / month higher C3 and C4 concentration

Question 18

Sensorineural deafness (CSD) in purebred white Devon Rex cats

Answer 18

occurrence CSD = 10% in white Devon Rex cats

Lower than previous studies of deafness in purebred cats

unilateral and bilateral deafness occurred equally

no association between blue irises and CSD

Question 19

Comparison of D-dimer concentration and thromboelastography for diagnosis of cerebrovascular accidents in dogs: A retrospective study

Answer 19

D-dimer / TEG alone = NOT diagnostic of CVAs in dogs

positive D-dimer result supports additional testing for CVA (high specificity)

neither d-dimer or TEG associated with CVA

neither helpful in differentiating hemorrhagic vs. ischemic

Question 20

Effect of amlodipine on the circulating renin-angiotensin-aldosterone system in healthy cats

Answer 20

Amlodipine - increased plasma renin, angiotensin I, and angiotensin II, and angiotensin 1-7

Amlodipine = nonspecific activation of both classical and alternative RAAS pathways

Question 21

Retrospective evaluation of 22 dogs with leptospirosis treated with extracorporeal renal replacement therapies (2018-2021)

Answer 21

Regardless of azotemia severity, dogs with AKI-L receiving RRT have a good survival rate to discharge (73%).

The number of body systems affected and hyperbilirubinemia might be associated with worse outcomes.

Max BUN and median creat did not affect outcome.

Question 22

Intraobserver and interobserver agreement of 8 segmental reflexes in healthy dogs

Answer 22

intra and interobserver high for extensor carpi radialis, withdrawal, patellar, and cranial tibial reflexes

Question 23

Detection of nephrocalcinosis using ultrasonography, micro-computed tomography, and histopathology in cats

Answer 23

AUS diagnosis of nephrocalcinosis correlated well with macro and microscopic disease at necropsy.

Strong correlation between macro and micro nephrocalcinosis.

Question 24

Clustering analysis of lipoprotein profiles to identify subtypes of hypertriglyceridemia in Miniature Schnauzers

Answer 24

spectrum of lipoprotein phenotypes within Mini Schnauzers that can not be predicted by triglycerides alone

Question 25

Candidate circulating microRNA biomarkers in dogs with chronic pancreatitis

Answer 25

in pancreatitis.... HIGHER - cfa-miR-221 - cfa-miR-222 - cfa-miR-23a - cfa-miR-205 - mmu-miR-484 - mmu-miR6240 - hsa-miR-1290 LOWER - mmu-miR-101a-3p

Question 26

Correlation between urine anion gap and urine ammonia-creatinine ratio in healthy cats and cats with kidney disease

Answer 26

ammonia excretion decreases as kidney function decreases ** urine anion gap NOT a substitute for urine ammonia-creatinine ratio ** was a difference between urine anion gap in healthy vs. ckd but significance is unknown.

Question 27

A retrospective study of hydrocortisone continuous rate infusion compared with administration of dexamethasone boluses in dogs with adrenal crisis

Answer 27

** NO difference in outcomes for bolus vs. CRI ** no differences in hosp time, fatality, # electrolyte measurements, or normalization of electrolytes.

Question 28

Evaluation of risk factors for sleep-disordered breathing in dogs

Answer 28

Risk factors for obstructive sleep disordered breathing - brachycephaly - severity of BOAS - increasing weight

Question 29

Diagnostic and predictive ability of hyperbilirubinemia severity in cats: A multicenter retrospective study

Answer 29

most hyperbilirubinemia is mild biliary obstruction 8% all treated surgically tbili to differentiate obstruction vs not = >3.86 increased age = increased risk of obstruction

Question 30

Serial monitoring of pancreatic lipase immunoreactivity, C-reactive protein, abdominal ultrasonography, and clinical severity in dogs with suspected pancreatitis

Answer 30

CRP, MCAI, and owner assessed health not sig. different between groups Panc on AUS in the absence of clinical or BW abnormalities may indicate resolving disease. AUS evidence of panc persistent for longer than other changes.

Question 31

Automated echocardiographic left ventricular dimension assessment in dogs using artificial intelligence: Development and validation

Answer 31

AI can be trained to measure linear LV dimensions with performance indistinguishable from experts.

Question 32

Relationship between syringomyelia and myxomatous mitral valve disease in Cavalier King Charles spaniels

Answer 32

association between MMVD and SM was not confirmed in this cohort of CKCS Symptomatic SM - smaller LV and LA size.

Question 33

Association of a novel dystrophin (DMD) genetic nonsense variant in a cat with X-linked muscular dystrophy with a mild clinical course

Answer 33

9y MN DSH persistent muscle swelling and difficulty breathing ALT, AST, CK elevations muscular dystrophy = hypertrophy of the skeletal muscles EMG = pseudomyotonic discharges, dive-bomber sound Histopath - muscle necrosis and regeneration Nonsense genetic variant in dystrophin gene (DMD) Mild clinical signs, long term survival

Question 34

A novel ITGA2B double cytosine frameshift variant (c.1986_1987insCC) leads to Glanzmann's thrombasthenia in a cat

Answer 34

Glanzmann's Thrombasthenia = congenital platelet disorder Impaired platelet aggregation and clot retraction **autosomal recessive variant in ITGA2B **

Question 35

Weishaar's classification system for nodal metastasis in sentinel lymph nodes: Clinical outcome in 94 dogs with mast cell tumor

Answer 35

Low grade/low-risk MCT with nonpalpable and normal sized SLN have a favorable outcome independently from the histological nodal class. Early/overt metastasis in normal lymph nodes can occur in 33-68% LN extirpation routine Sentinel LN different from regional in 28-63% cases.

Question 36

Risk factors and implications associated with ultrasound-diagnosed nephrocalcinosis in cats with chronic kidney disease

Answer 36

Ultrasound prevalence of nephrocalcinosis in CKD cats = 61% increased prevalence in those with hypercalcemia 81% Risk factors - higher iCa - higher phos - higher creat - higher ALT FGF-23 rate of change differed between groups. Cats with nephrocalcinosis -increasing creat and phos, decreasing body weight **--> May be associated with progression**

Question 37

Environmental radon, fracking wells, and lymphoma in dogs

Answer 37

Dogs with lymphoma lived closer to wastewater wells - but not close proximity (<20km). No differences in county radon levels or proximity to fracking.

Question 38

Blood pressure in hyperthyroid cats before and after radioiodine treatment

Answer 38

27% hypertension in untreated **Hypertension resolved in about 50% after treatment** Uncommon to develop new hypertension after tx (10%) - not typically associated with azotemia or iatrogenic hypoT Possibility of situational hypertension.

Question 39

Effect of institutional antimicrobial stewardship guidelines on prescription of critically important antimicrobials for dogs and cats

Answer 39

Adherence to guidelines = POOR despite an increase in culture and susceptibility testing. No change in frequency of confirmed infection, positive cultures, or resistance. Fluoroquinolones most common critically important antibiotic prescribed. Guidelines followed in 60% Failure to perform c/s 46% Use of unnecessary high-tier drugs 43%

Question 40

Assessment of hemostasis in hyperthyroid and euthyroid cats using two viscoelastic assays and platelet aggregometry

Answer 40

Hyperthyroid cats = altered hemostasis Increased clot amplitude Increased clot firmness Faster coagulation times

Question 41

Comparison of chemotherapy outcomes between normal and high serum cortisol concentration in dogs with lymphoma

Answer 41

Higher cortisol = lower response to chemotherapy = lower progression free survival time = lower overall survival

Question 42

Peripheral and intestinal T lymphocyte subsets in dogs with chronic inflammatory enteropathy

Answer 42

Periphery CIE - higher activated Th - higher regulatory T cells Intestinal epithelium CIE - lower activated Th - lower regulatory T cells - lower CD4/CD8 ratio - higher cytotoxic T cells - higher IFN-y producing T cells T cell alterations occur in CIE blood IFN-y T lymphocytes and systemic immune-inflammation index = possible biomarkers

Question 43

Prevalence, clinical presentation, and etiology of myelopathies in 224 juvenile dogs

Answer 43

**Frenchie 23% Pug 8% ** **Vertebral malformation 18% ** Spinal arachnoid diverticulum 12.5% traumatic fracture 10% AA instability 8% Osseous cervical spndylomyelopathy 8% IVDD 5% Vertebral malformation - younger, screw-tail, pug breeds, T3-L3 SAD - screw-tail, pug, non-painful IVDD - older, screw-tail, pug, shorter duration of CS - not common in <18mo

Question 44

Effects of prednisolone on 1,2-O-dilauryl-rac-glycero glutaric acid-(60-methylresorufin) ester-lipase activity and pancreatic lipase immunoreactivity in healthy cats

Answer 44

anti-inflam pred does NOT increase lipase and pLI Values did not differ between tx or control

Question 45

Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long-term disability

Answer 45

82% survival to discharge 65% alive at 6mo with 36% having persistent neuro defects Pug, epileptic seizures, paresis, higher neurodisability scale (NDS) = negative prognosis Higher NDS at presentation - more likely to have persistent defects Relapse = incomplete resolution at 6mo, higher NDS, longer duration of CS

Question 46

Positive clinical outcome using a modified dosing regimen of benznidazole in dogs at high risk for infection or acutely infected with Trypanosoma cruzi

Answer 46

2 dogs receiving prophylaxis = healthy without cardiac disease for 2y dog that did not receive - acute death due to T. cruzi Other dog - infected with T. cruzi but successfully treated with higher benznidazole

Question 47

Evaluation of neurofilament light chain (NfL) as a biomarker in dogs with structural and idiopathic epilepsy

Answer 47

Neurofilament light chains - higher in dogs with structural epilepsy No association between time of seizure and NfL concentration

Question 48

Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation

Answer 48

Acid exposure time (AET) = 3.3% Reflux events 70 Clinical score and BOAS severity not correlated with AET Age negatively correlated with AET AET improved after BOAS Wireless pH monitoring documented GER with SHH, ID subclinical events, and showed improvements after BOAS surgery.

Question 49

Clinical features and outcome of 10 dogs with suspected idiopathic vestibular epilepsy

Answer 49

Vestibular epilepsy = focal seizures with transient signs of vestibular disease Evaluated dogs with recurrent vestibular episodes Pugs - 50% 2 dogs had generalized tonic-clonic seizures EEG interictal spikes 100% responded to anti-seizure meds ** Hypothesis of epileptic origin **

Question 50

Descriptive analysis and prognostic factors in cats with myeloma-related disorders: A multicenter retrospective study of 50 cases

Answer 50

Guarded prognosis Bone marrow plasmacytosis 63% Splenic involvement 86% Liver involvement 71% Anemia 67% Thrombocytopenia 34% Both are risk factors for shorter survival Melphalan + pred = 87% Cyclophosphamide + pred = 90% Chlorambucil + pred = 100% MST 122d - not associated with drug protocol

Question 51

Effect of sodium-glucose cotransporter 2 inhibitor canagliflozin on interstitial glucose concentration in insulin-treated diabetic dogs

Answer 51

Adding to insulin may help improve glycemic control. median fractional excretion of glucose - 1.1% insulin + SGLT2 - 0.3% insulin More hypoglycemia if treated with both

Question 52

Clinical and magnetic resonance imaging findings in a French bulldog puppy with genetically confirmed congenital hypothyroidism

Answer 52

7mo M Frenchie Abnormal mentation and gait Proprioceptive ataxia, pelvic limb paraparesis, strabismus Ventriculomegaly Thinning cerebral parenchyma Widen sulci Dx: hydrocephalus and goiter Low TT4, fT4, normal TSH Congenital hypothyroidism Positive genetic test for thyroid peroxidase mutation Tx: thyroxine, improved CS

Question 53

Utility of focused cardiac ultrasonography training in veterinary students to differentiate stages of subclinical myxomatous mitral valve disease in dogs

Answer 53

Moderate to good agreement with students and cardiologists More accurate with large hearts

Question 54

Congenital spongiform leukodystrophy in 2 female littermate German shepherd puppies

Answer 54

9wk GSD Severe high-frequency, low-amplitude trembling that worsened with movement white matter - bilateral, diffuse, severe spongiosis Severe diffuse myelin loss Peripheral nerves = spared Diffuse astrogliosis and astrocytosis NOT the aspartoacylase (ASPA) gene

Question 55

Effect of leukoreduction on the omics phenotypes of canine packed red blood cells during refrigerated storage

Answer 55

**Leukoreduction - preserves energy metabolism, prevents oxidative lesions ** non-LR = higher free short/med chain FA, carboxylic acids (pyruvate and lactate), and AA (arginine and cystine) LR = higher ATP, antioxidants

Question 56

Incidence and characterization of aerophagia in dogs using videofluoroscopic swallow studies

Answer 56

Aerophagia = >1/3 volus volume containing air OR air results in gastric distension >1/3 end gastric volume **Incidence 40% ** Dogs with mixed resp and GI CS more likely to have aerophagia 60% vs. resp only 25% More common in - brachycephalic - obstructive upper airway - pathologic penetration / aspiration scores - gagging dogs **Independent predictors = mixed CS, brachycephaly, upper airway obstruction **

Question 57

Vincristine-induced adverse events related to body weight in dogs treated for lymphoma

Answer 57

Vincristine dosed at ≤0.6 mg/m2 does not increase the risk of hematologic AEs in dogs weighing ≤15 kg.

Question 58

The effect of feeding on serum concentrations of cobalamin, folate, trypsin-like immunoreactivity, and pancreatic lipase immunoreactivity in dogs with signs of chronic gastrointestinal disease

Answer 58

**Clinical interpretation changed after feeding** - cobalamin 27% - folate 35% - cTLI 20% - cPLI 12% cTLI and cobalamin @ 2 and 4h = baseline Folate @ 2h = baseline

Question 59

Malignant transformation and subsequent leptomeningeal carcinomatosis of a gastric polyp in a dog

Answer 59

Adult Scottish terrier Malignant transformation of a gastric polyp to a gastric adenocarcinoma over 14mos. Subsequent mets to the leptomeninges

Question 60

Echocardiographic and electrocardiographic findings in Irish Wolfhounds eating high-pulse or low-pulse diets

Answer 60

Irish Wolfhound Cardiomyopathy = resembles. DCM High pulse diet = peas, lentils, chickpeas, dry beans **High pulse diet associated with higher prevalence of VPCs (17% vs. 2%) ** No sig. differences in echo measurements between groups.

Question 61

A de novo nonsense variant in the DMD gene associated with X-linked dystrophin-deficient muscular dystrophy in a cat

Answer 61

Nonsense variants in AnAms1.0 and felCat9 Changes absent in parents = de novo mutation

Question 62

Prognostic potential of copper, zinc, copper/zinc ratio, cobalamin, and serum amyloid A in cats with panleukopenia

Answer 62

**Copper, Cu/Zn, cobalamin, SAA = excellent biomarkers for prognosis with panleukopenia (FPV) ** Non-survivors = HIGHER copper HIGHER SAA HIGHER Cu/Zn ratio LOWER cobalamin sensitivity 100% specificity 80% PPV 90%

Question 63

Safety profile and effects on the peripheral immune response of fecal microbiota transplantation in clinically healthy dogs

Answer 63

Not associated with change in dysbiosis index, peripheral immunologic variables, or adverse events.

Question 64

Utility of immature platelet fraction in the Sysmex XN-1000V for the differential diagnosis of central and peripheral thrombocytopenia in dogs and cats

Answer 64

Central = bone marrow failure Peripheral = consumption, destruction, sequestration Differentiate central vs. peripheral based on presence of active thrombopoesis CENTRAL (lower) immature platelet fraction - <6.9 dogs - <13% cats Reference interval - dogs: 0.5 - 8% - cats 1 - 40.3%

Question 65

Evaluation of muscle mass and intramuscular fatty infiltration in dogs with hypercortisolism and their association with prognosis

Answer 65

hypercortisolism causes muscle atrophy and IM fatty infiltration = poor prognosis

Question 66

Traumatic and iatrogenic sciatic nerve injury in 38 dogs and 10 cats: Clinical and electrodiagnostic findings

Answer 66

causes - surgery 42% - trauma 33% Positive outcome - ability to flex and extend tarsus - 1.45 mV for compound motor action potentials Clinical motor function predicts better recovery than sensory function.

Question 67

Development and validation of a questionnaire to assess health-related quality-of-life in cats with hyperthyroidism

Answer 67

excellent internal consistency QOL poorer in hyperthyroid cats

Question 68

Total thyroxine, triiodothyronine, and thyrotropin concentrations during acute nonthyroidal illness and recovery in dogs

Answer 68

acute illness can interfere with thyroid function for up to 21 days during recovery tT4 normalized early tT3 normalized late no concurrent low tT4 and high TSH during study (real hypothyroid)

Question 69

Granuloprival cerebellar cortical degeneration in a Yorkshire Terrier and Lagotto Romagnolo dog

Answer 69

Granuloprival degeneration = cerebellar cortical degeneration progressive cerebellar dysfunction - wide based stance, cerebellar ataxia, intention tremors, loss of menace but normal vision MRI - marked diffuse decrease in cerebellum size Euthanasia Histopath - marked, diffuse thinning of granular cell layer

Question 70

Pulmonary thrombotic pulmonary hypertension managed using antithrombotic and pulmonary vasodilator treatment

Answer 70

8y Leonberger presented for acute dyspnea, cyanosis, weakness Hx IMPA - treated with immunosuppressants Suspected pulmonary thrombosis Treated with O2, clopidogrel, heparin Persistent dyspnea, dx PH Beraprost sodium to treat PH CT confirmed filling defects in PA Monteplase = recombinant TPA to treat thrombus Doing well 400d layer

Question 71

Safety and biologic activity of a canine anti-CD20 monoclonal antibody in dogs with diffuse large B-cell lymphoma

Answer 71

Apparently safe when given with doxo and effectively depletes B-cells Statistically significant CD21+ B cell depletion at 7 days persisting through treatment T cells remained unchanged Recovery of B cells delayed 4+ mos Well tolerated, one hypersensitivity reaction 1E4-cIgGB anti-CD20 monoclonal antibody

Question 72

Influence of body weight, age, and sex on cerebrospinal fluid peak flow velocity in dogs without neurological disorders

Answer 72

BW, age, sex influence CSF peak flow velocity >20kg - higher flow at foramen magnum and C2 <2y - higher flow at ventral foramen magnum Females - lower CSF at ventral foramen magnum.

Question 73

Evaluation of antimicrobial purchasing by companion animal veterinary facilities in Canada, the United Kingdom, and the United States of America (2019-2021)

Answer 73

UK higher clavamox purchase less cephalosporin purchase General purchasing trends Intraregional differences

Question 74

Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation

Answer 74

SAA higher for diagnosed and suspected cases than ruled out cases. Diagnostic cuf-off SAA 51 - sensitivity 88% - specificity 94% SAA may be suggestive of pyelo Low concentration may help rule out if suspicion is low.

Question 75

Assessing breathing effort by barometric whole-body plethysmography (BWBP) and its relationship with prognosis in client-owned cats with respiratory distress

Answer 75

Breathing effort can be quantified by BWBP. Resp distres - higher minute volume per body weight Lower airway obstruction, parenchymal, and pleural disease had higher MV/BW 373 cutoff = abnormal breathing effort MV/BW associated with cardiorep mortality.

Question 76

Use of machine learning and Poincaré density grid in the diagnosis of sinus node dysfunction caused by sinoatrial conduction block in dogs

Answer 76

Machine learning and Poincare able to ID sinus node dysfunction. Sinus pauses >2s differentiated nervous system changes from sinus node dysfunction. ** Number and duration of pauses, not heart rate differentiates sinus node dysfunction. **

Question 77

Thromboelastometry for assessment of hemostasis and disease severity in 42 dogs with naturally-occurring heatstroke

Answer 77

Case fatality 31% Associated with death - Longer clotting time (hypocoagulable) - lower alpha angle - maximum clot firmness - maximum clot lysis **HYPOcoagulable - worse prognosis ** DIC and AKI more frequent in hypocoagulable dogs.

Question 78

Pseudohypoaldosteronism and acquired renal aldosterone resistance with hyperkalemic type IV renal tubular acidosis in 2 cats

Answer 78

One cat from AKI leading to CKD, treated with furosemide One cat from UTI secondary to urethral cath, treated with abx Aldosterone resistance causing hyperkalemic type IV renal tubular acidosis = pseudohypoaldosteronism Severely elevated resting and stimulated aldosterone levels = aldosterone resistance Aldosterone resistance leads to natriuresis, K retention, decreased urinary acid excretion = hyperkalemic renal tubular acidosis AR = marked hyperaldosteronemia with 2 or more: hyponatremia, hyperkalemia, nonanion gap metabolic acidosis

Question 79

Corticosteroid monotherapy versus combined cytarabine continuous rate infusion and corticosteroid therapy in dogs with meningoencephalitis of unknown origin: A blinded, randomized, controlled trial

Answer 79

NO difference between therapies.

Question 80

Client's understanding of instructions for small animals in a veterinary neurological referral center

Answer 80

Clients can only partially reproduce information provided at discharge (~60%). Least agreement on drug AE, CS, and confinement instructions Older clients, less info retained

Question 81

Comparison of hematologic variables between dogs with congenital intrahepatic and extrahepatic portosystemic shunts

Answer 81

IHPSS - higher frequency of anemia, microcytosis, hypochromia, more GI signs

Question 82

Salivary metabolomic identification of biomarker candidates for oral melanoma and oral squamous cell carcinoma in dogs

Answer 82

**Oral SCC - decreased seryl-arginine - decreased sarcosine ** Oral Melanoma - increase tryptophyl-threonine - decrease 1,2-dihydroxynapthalene-6-sulfonic acid - decreased hydroxyprolyl-hydroxyprolineDetection of Anaplasma phagocytophilum in an inflammatory pericardial effusion of a dog

Question 83

Detection of Anaplasma phagocytophilum in an inflammatory pericardial effusion of a dog

Answer 83

11y FS German Wirehaired Pointer 1wk lethargy, hyporexia, diarrhea, coughing Pericardial effusion + tamponade Mixed macrophagic and neutrophilic inflammation Morulae within neutrophils qPCR and cPCR positive for A. phagocytophilum Negative ELISA at presentation, positive 7d later Pericardiocentesis and doxycycline - no recurrence @1mo

Question 84

The echocardiographic pulmonary to left atrial ratio: A noninvasive variable for the hemodynamic classification of pulmonary hypertension in dogs

Answer 84

pumonary to left atrial ratio index may help assess PH <0.245 to identify isolated PH

Question 85

Clinical manifestations of chronic pancreatitis in English cocker spaniels

Answer 85

CP = duct destruction, interlobular fibrosis, periductular and perivenous lymphocytic aggregates Involvement of other organs common ECS with CP - high frequency of KCS - proteinuria - anal gland disease - atopy - immune mediated diseases Parti hair coats, blue roan = associated with CP Similar to IgG4-RD in humans

Question 86

A review: Pancreatic enzymes in the treatment of chronic pancreatic insufficiency in companion animals

Answer 86

EPI - 85% of pancreatic parenchyma is non-functional Impaired digestion and absorption ---> malnutrition Pancreatic enzyme replacement therapy - contain lipase, alpha amylase, proteases

Question 87

Treatment of Francisella philomiragia bacteremia in a dog

Answer 87

11y FS lab progressive lethargy, hyporexia, cough Febrile Neutrophilia, non-regen anemia, thrombocytopenia, increased ELE Blood culture isolated Francisella 6wk oral enrofloxacin Repeat blood cultures negative Clinically normal after 7mos

Question 88

Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum

Answer 88

Urethral diverticulum - differential for urinary incontinence contrast cystourethrogram diagnostic in all dogs All diverticulae = saccular 7/8 in prostatic urethra 1/8 membranous urethra Congenital in 7, acquired in 1 Concurrent abnormalities - renal dysplaisa - chronic pyelo - bilat. cryptorchid - pelvic urinary bladder Moderately to poorly responsive to proin Artifical sphincter improved continence in all dogs.

Question 89

Viscoelastic coagulation monitoring parameters in cats with acute arterial thromboembolism

Answer 89

** cardiogenic ATE = hypocoagulable on VCM ** decreased angle (43degrees) A10, A20, MCF decreased CT, CFT, LI30, LI45 similar between groups

Question 90

Short colon syndrome in cats

Answer 90

Lymphoplasmacytic colitis CS - diarrhea - vomiting - weight loss - inappetence - no GI signs 13% Short colon and thickened

Question 91

Magnet-assisted endoscopic removal of ferromagnetic metallic gastric foreign bodies in 4 dogs

Question 92

Clinicopathological and diagnostic imaging findings in a dog with neurocandidiasis

Answer 92

3y GSD abnormal mentation, neck pain, ataxia MRI - multifocal, small, round, intra-axial lesions in forebrain CSF - severe neutrophilic inflammation Infectious disease negative Corticosteroids - transient improvement, then worsening Repeat imaging, nodules in temporal muscles. FNA of temporal mm - neutrophilic inflammation with hyalohyphoymcosis. Post mortem isolation of Candida albicans

Question 93

Platelet hyperresponsiveness and increased platelet-neutrophil aggregates in dogs with myxomatous mitral valve disease and pulmonary hypertension

Answer 93

PH in dogs with MMVD = due to increased pulmonary venous pressure **Platelet hyper-responsiveness. Increased neutrophil/plt interaction. ** Platelets may play a role in pathogenesis of PH PH + MMVD platelets - more surface P-selectin - persistent activation

Question 94

Use of neurofilament light chain to identify structural brain diseases in dogs

Answer 94

NfL = higher in structural epilepsy dogs Cutoff 27.1 = sensitivity 87%, specificity 75% Correlation between NfL and lesion size

Question 95

Clinical efficacy and tolerability of zonisamide monotherapy in dogs with newly diagnosed idiopathic epilepsy: Prospective open-label uncontrolled multicenter trial

Answer 95

Monotherapy - effective and well tolerated 76% had >50% reduction in seizure frequency - median dose 4.8mg/kg q12 - mean trough concentartion 18.9 ug/mL AE: decreased activity, hyporexia, vomiting, hind end weakness, soft stool or constipation All mild / temporary. No significant lab changes over 12 weeks. 55% seizure freedom

Question 96

Prevalence of Hemoplasma spp. positivity in potential feline blood donors and study of the association with selected clinical variables

Answer 96

Importance of screening!!! Prevalence 5.2% Hemoplasma seen more frequently in - pos. units from male cats - with FeLV - in winter

Question 97

Survival in dogs with meningoencephalomyelitis of unknown etiology with and without lesions detected by magnetic resonance imaging

Answer 97

** Presence or absence of MRI lesions = prognostically relevant ** 75% abnormal MRI 25% normal MRI Death higher in abnormal MRI dogs MST longer with normal MRI CSF NCC and secondary drug = not associated with death

Question 98

Urinary syndecan-1 in dogs anesthetized with isoflurane or sevoflurane: A randomized, prospective study

Answer 98

Syndecan-1 (SDC1) = marker of endothelial glycocalyx shedding Assess anesthetics and IVF on urinary SDC1 concentrations Urinary SDC1 to creatinine ratio (USCR) = higher after anesthesia **Quantity of IVF affected USCR**

Question 99

In-hospital mortality in dogs with protein-losing enteropathy and associated risk factors

Answer 99

In hospital mortality 22% - financial limitations - failure to improve - aspiration pneumonia (AP) Associated with mortality - longer hosp - longer CS - increase in CRP after 1-3d tx - Pugs = due to AP CRP may help predict survival

Question 100

A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs

Answer 100

Tracheal stenting - high risk of coughing - moderate risk of infection and granuloma formation Stenting does not alleviate need for medical tx or follow up

Question 101

Clinical methemoglobinemia secondary to administration of hydroxyurea at therapeutic doses in a dog

Answer 101

2.5y FS MBD Acute neuro signs Severe erythrocytosis Suspicious of polycythemia vera Admin hydroxyurea - within 2h = resp distress, cyanosis, methemoglobinemia Signs resolved within 24h Recurred again with lower dose of hydroxyurea **Methemoglobinemia secondary to hydroxyurea at therapeutic dose**

Question 102

A dose titration protocol for once-daily insulin glargine 300 U/mL for the treatment of diabetes mellitus in dogs

Answer 102

Glargine 300U/mL = basal insulin Suitable for once daily admin. Adjustments to the protocol may need to be made with certain dogs - ex: BID dosing, meal bolus etc. Without concurrent disease = more likely to receive Glycemic control good - excellent in 92% Hypoglycemia 6%

Question 103

Blood-brain barrier dysfunction and decreased transcription of tight junction proteins in epileptic dogs

Answer 103

Epilepsy = associated with BBB dysfunction Higher BBB permeability with IE **Matrix metalloproteinase-9 (MMP9) = increased** in serum, CSF, and piriform lobe in dogs with IE **Down-regulation of astrocytic potassium channels and tight junction proteins ** Deceased expression of Kir4.1 and claudin-5 BBB dysfunction may be a novel anti-epileptic target

Question 104

The diagnostic relevance of mesenteric lymph node biopsy in small intestinal lymphoma in cats

Answer 104

large B-cell = more likely to be transmural (68%) than mucosal Transmural T cells most common **43% of lymph nodes were neoplastic** **70% of small cell lymphoma showed no nodal involvement **

Question 105

Longitudinal analysis of echocardiographic and cardiac biomarker variables in dogs with atrial fibrillation: The optimal rate control in dogs with atrial fibrillation II study

Answer 105

HR mediated reverse remodeling may benefit survival ~50% did not have rate adequately controlled. No difference if early or late rate control. No variables to predict rate control success. **Rate control works - decreased cardiac dimension and low NT-proBNP **

Question 106

Efficacy and safety of once daily oral administration of sodium-glucose cotransporter-2 inhibitor velagliflozin compared with twice daily insulin injection in diabetic cats

Answer 106

Velagliflozin = senvelgo **Non-inferior, good QOL, no clinical hypoglycemia ** 54% success vs. 42% success with intermediate insulin. QOL, PU/PD improved Mean BG and fructosamine improved **AE: diarrhea = 38% **

Question 107

Retrospective evaluation of the effect of acid suppressant drugs on leukocyte ratios in dogs with mast cell tumors

Answer 107

** INCREASE in neutrophil to lymphocyte ratio in FAMOTIDINE tx ** possible effect on neutrophil trafficking possible immunomodulatory effects of acid suppressants.

Question 108

Factors influencing serum concentrations of levetiracetam in dogs with epilepsy

Answer 108

Phenobarbital decreased keppra concentrations dosage 99-216mg/kg/day of keppra needed to achieve human therapeutic levels - alone or concurrent with pheno

Question 109

Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol

Answer 109

**6wk protocol could be used to treat SRMA ** all cases responded relapses not stat diff. - 30% in 6mo protocol - 38% in 6wk protocol Most dogs only relapsed once (67%) 20% relapsed 2x 13% relapsed 3x

Question 110

Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs

Answer 110

**Recombinant human TSH can optimize I131 tx in dogs with thyroid carcinoma by increasing radioactive iodine uptake and tx efficacy. ** Thyroid carcinomas can be treated with I131

Question 111

Romiplostim for treatment of thrombocytopenia in dogs: A retrospective assessment and clinical outcomes

Answer 111

Romiplostim = thrombopoietin analog Well tolerated and promising therapy. Platelet count improved with variety of conditions - ITP, pancytopenia, chemo induced, etc. Median time for plt >50k = 4d Normalization 7d Survival to discharge depends on etiology. ~65% increased plt count

Question 112

Clinical features, treatment, and outcome of juvenile dogs with meningoencephalitis of unknown etiology

Answer 112

** Prognosis = poor ** Altered mentation 71% Ataxia 44% Seizures 30% Circling 25% Localization forebrain 38% multifocal 35% 31% alive at follow up MST all cause death 84d

Question 113

Comparison of grapiprant and meloxicam for management of postoperative joint pain in dogs: A randomized, double-blinded, prospective clinical trial

Answer 113

3d post-op = galliprant had lower pain severity scores and pain interface scores Galliprant is an alternative analgesic

Question 114

Vitamin D status in female dogs with mammary gland tumors

Answer 114

**dogs with mammary tumors do NOT have lower vitamin D concentrations ** supplementation unlikely to be useful PTH higher with malignant tumors

Question 115

Dietary magnesium supplementation in cats with chronic kidney disease: A prospective double-blind randomized controlled trial

Answer 115

hypomagnesemia = shorter CKD survival time **Magnesium rich, protein restricted diet is a novel tx for managing CKD-MBD Stabilizes FGF-23 and prevents hypercalcemia **

Question 116

Early progression during or after cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy indicates poor outcome with rescue protocols in dogs with multicentric lymphoma

Answer 116

Dogs with short progression free interval after CHOP had lower response rates to rescue tx. Immunophenotype (B vs. T) - NOT associated with outcome with elspar + pred tx - IS associated with outcome for Tanovea tx

Question 117

Methylprednisolone alone or combined with cyclosporine or mycophenolate mofetil for the treatment of immune-mediated hemolytic anemia in dogs, a prospective study

Answer 117

**Combined tx did not improve response in non-associative IMHA ** Death more common for methylpred + mycophenolate group at D60

Question 118

Value of repeated health screening in 259 apparently healthy mature adult and senior cats followed for 2 years

Answer 118

High prevalence and incidence of PE abnormalities and systemic disease in apparently healthy cats. Regular screening >7 21% apparently healthy had IRIS CKD >2 New conditions within 2y - 30% mature cats 55% senior cats

Question 119

Association of proteinuria at time of diagnosis with survival times in dogs with lymphoma

Answer 119

**proteinuria = NEGATIVELY associated with survival time in dogs w/ lymphoma ** 245d vs. 335d

Question 120

Assessment of cell cycle arrest biomarkers and neutrophil gelatinase-associated lipocalin to distinguish acute kidney injury from other diseases in dogs

Answer 120

Biomarkers for early diagnosis of AKI - normalized uTIMP-2 - uTIMP-2 x uIGFBP7 / uCr - Fractional excretion of NGAL

Question 121

A multimodal approach to diagnosis of neuromuscular neosporosis in dogs

Answer 121

13/16 - only neuromuscular signs 3/16 - CNS signs + neuromuscular signs **Multimodal diagnostic approach needed ** Serology in combo with other testing such as histopath parasite ID, DNA via PCR, or both histopath ID 9/16 serology 10/15 PCR 11/16

Question 122

Recovery of ambulation in small, nonbrachycephalic dogs after conservative management of acute thoracolumbar disk extrusion

Answer 122

Recovered ambulation in 12 weeks - 96% deep pain positive - 48% deep pain negative Median time to ambulation - 11d deep pain positive - 25d deep pain negative Recovery = NOT dependent on resolution of compression High proportion recovered with conservative management