Block 5+6 Flashcards
(410 cards)
1
Q
What is the most common ectoparasite of dogs and cats?
A
Ctenocephalides felis felis (cat flea)
Ctenocephalides Canis (dog flea)
2
Q
Where does the adult ctenocephalides live?
Other stages?
A
Adult: Entire life on the host
Other: environment
3
Q
A
4
Q
How long does it take for the flea egg to hatch?
A
1-10 days
5
Q
What is the lifespan of an adult flea?
A
100 days
5
Q
What is the only life stage that is not susceptible to flea treatment?
A
Pupa (can wait up to 140 days for a stimulus before it emerges)
6
Q
What type of hypersensitivity reaction is FAD?
A
Type 1 = immediate IgE hypersensitivity (Type IV less common
7
Q
When are most FAD developed?
A
At 1-5 years (uncommon prior to 6m)
8
Q
What is FAD primary lesion?
A
papules
9
Q
What is the dermagram for FAD?
A
“Pants region”
10
Q
What are hot spots?
A
Pyotraumatic dermatitis
11
Q
What are the top 3 pruritic skin diseases in dogs?
A
Sarcoptic mange, FAD, CAFR
12
Q
What are the 3 thing that make up eosinophilic granuloma complex?
A
Eosiniphilic plaques
Indolent ulcer
Linear granuloma
13
Q
What must be in the flea treatment to see an immediate response to therapy?
A
adulticide
14
Q
What are the 3 canine demodex?
A
Demodex canis (medium)
Demodex cornei (small)
Demodex injai (long)
15
Q
What is the likely cause of disease caused by demodex?
A
Immunocompetence (normal resident on skin)
16
Q
What are the 2 forms of demodex infection?
A
Localized and Generalized
17
Q
What are teh 2 forms of generalized demodex?
A
Juvenile (>12m)
Adult (>18m) likely has compromised immune system
18
Q
Which type of demodex do you treat?
A
Generalized!!
19
Q
In general, demodex in dogs is not pruritic but a secondary infection could cause pruritus
A
20
Q
How long should demodex take to resolve?
A
4-8 weeks
21
Q
What should be considered in anaimals that have generalized demodicosis?
A
It is heritable so spay/neuter
22
Q
What are the 4 types of generalized demodicosis?
A
Squamous: scaly, alopecia
Dorsal scaly skin
Pustular (red mange): may be life threatening, Gram - deep infection
Pododemodicosis: Difficult to treat, just the paws
23
Q
What are the 3 types of feline demodex
A
D. cati (long)
D gatoi (stubby)
D. felis (medium)
24
What is special about D. gatoi?
It is pruritic AND contagious
25
How do you diagnose demodicosis?
Deep skin scrape or trichogram
26
what is a pyoderma?
A skin infection that includes pus technically
27
What predisposes an animal to a pyoderma?
Something alters the normal cutaneous defense mechanism
28
In general, what is a predisposing factor to pyodermas?
Anything that compromises the immune system
29
What is the most common agent with pyodermas?
Staphylococcus pseudintermedius
30
Other than penecillins, what is s. pseudintermedius usually resistant to?
Streptomycin and tetracycline
31
What does s. pseudintermedius produce?
beta lactamase (can't use penecillins)
32
What is the most frequent type of pyoderma in dogs?
Invasion of the epidermis and follicular ostium "bacterial folliculitis"
pustule, bacteria getting into the hair follicle space
32
What are surface pyodermas?
Infection confined to the intefollicular epidermis
Hot spots
33
What will deep pyodermas have?
Draining tracts
34
What are 3 parts to the diagnosis of pyoderma?
Recognition of skin lesion
Bacterial identification - skin cytology
**identify underlying primary disease (most important)
35
What has the job of organ of protection?
Stratum corneum (outer most part of epidermis)
36
What is filaggrin?
Protein that plays a role in maintaining skin barrier function
37
What happens with atopic dermatitis?
Loss of function mutation with filaggrin
38
What is first line of defense for topical barrier rehydration?
Shampoos
39
What is downside to conditioners?
usually left on after showers
40
What is the best treatment for ears?
Creams and ointments
41
What is seborrhea sicca?
Dry skin (dandruff)
42
What is seborrhea oleosa?
Greasy skin
43
What is her favorite cream?
Bio-Groom Super Cream Conditioner
44
What do ceramides do?
Repel transepidermal water loss
Repel irritants
44
What does sulfer do?
Keratolytic & Keratoplastic
Not a good degreaser
45
What is the chronic form of pruritus?
Lichenification
46
What are 3 things in cat pruritus not seen in dogs
Non-inflammatory alopecia
Miliary dermatitis
Eosinophilic granuloma complex
47
What is specifically concerning about scabies?
Zoonotic
48
What is specifically rare in cats?
Infectious etiologies (yeast or bacteria)
49
What should you put every cat on no matter what?
Flea prevention
50
***What is AD/FASS considered?
A diagnosis of exclusion
51
Is there a connection between a recent diet change and a CAFR?
No
52
What are the 4 cutaneous reaction patterns in cats?
Feline symmetric alopecia
Head and neck generalized pruritus
Miliary dermatitis
Eosinophilic granoloma complex
53
Do hair and saliva tests work for CAFR?
N
54
Do serum or skin allergy tests work for CAFR?
No
55
What are teh 2 general choices when it comes to selecting a diet for CAFR diet trial?
Novel ingredient
Hydrolyzed protein
56
How do a hydrolyzed diet work?
Proteins are broken down into amino acids so small that they are too small to cross bind with IgE (Type I) on mast cell
57
How should a hydrolyzed diet be picked for cats?
Send the patient home with all hydrolyzed options and let them pick the one that they like the best
58
How long should a food trial be tried?
8-12 weeks
59
What is the average time to flare with rechallenge?
7 days
60
What cells migrate to skin in atopic dermatitis pathogenesis?
Th2 cells
61
When does AD usually set in?
Younger dogs (6m to 3 years)
62
Is there a primary lesion for atopic dermatitis?
No
63
What is the most outstanding feature?
Pruritus
64
Is there seasonality with atopic dermatitis?
Yes
65
What is the average onset of Feline atopic skin syndrome?
young (6m to 12m)
66
Is feline atopic skin syndrome seasonal??
No
67
What are the 3 P's of ALD (Acral Lick Dermatitis)
Primary (boredom/stress), predisposition (change in habitat), perpetuating factor (bacterial infection)
68
What are the 3 pruritic feline dermatoses?
Allergic
Parasitic
Infectious
69
Is miliary dermatitis a disesae?
No
70
What are the 2 types of feline symmetric alopecia?
Self-induced and non-self-induced
71
How do you tell if it is self induced or not?
Trichogram!
72
What are the 4 off label treatments for demodicosis?
Fluralaner
Sarolaner
Afoxolaner
Lotilaner
72
What is the time frame for spontaneous resolution of demodex in 90% of cases?
4-8 weeks
73
What coul dbe a cause of non-self-induced alopecia?
Endocrine
-Hyperthyroidism
- D. mellitus
- hyperadrenocorticism (Cat cushing)
Paraneopastic
-biliary carcinoma
74
What are the 4 clinical presentations of demodicosis?
Squamous, greasy, pustular, pododemodicosis
74
What do you change with different species of demodex?
Nothing, all treated the same
75
What are the 3 methods of diagnosis for demodicosis?
Deep or superficial skin scrape
Hair pluck
Biopsy
(Generalized >5 spots, local <5 spots)
76
What should you never use for treatment of demodicosis?
Steroids!
77
What is the reason for no longer using high-dose ivermectin?
MDR1 mutation
78
What is the best treatment for demodicosis then?
One of the "laners" but it is extra label
79
Where is feline demodicosis localized?
Chin and periorbital area
80
What does feline democidosis look like?
Feline acne
81
What is most important part of treating acute moist dermatitis (hot spots)?
Treating the underlying cuase
81
What is important about demodex gatoi?
Pruritc and contagious
82
How do you treat demodex cati?
2% lime sulfur
Bravecto (Fluralaner) / revolution plus
83
How do you treat demodex gatoi?
Same way but need to treat all cats that were in contact
84
What is the etiology of acute moist dermatitis?
Self inflicted
85
What is another name for acute moist dermatitis?
Hot spots
86
What are the 3 forms of localized deep pyoderma?
Interdigital furunculosis
Canine acne
Deep hot spot
87
What are cytology characteristics of chin acne?
Pyogranulomatous with eosinophils
88
What is intertrigo pyodermo?
Pyoderma related to lesions within skin folds
89
What breeds are most affected by fascial fold pyodermas?
Brachycephalic breeds
89
What is treatment for skin fold pyoderms?
Clip hair, treat infection and inflammation, wipes (Douxo - chlorhex), TrizChlor 4 (TrizEDTA/Chlorhex), Ointments/Lotion (Mupirocin - antibacterial, mometamax - mometasone, tresaderm - dexamethasone)
90
What are teh 4 types of intertrigo pyoderma?
Fascial fold
Lip fold
Vulvar fold
Tail fold
91
What is the hard-to-diagnose deep pyoderma in between digits?
interdigital furunculosis
92
What is furunculosis?
Rupture of a hair follicle
93
What is teh treatment for acute moist dermatitis?
Clip and remove matted hair
Clean with chlorhexidine
Mild: Topical steroid
Severe: Systemic steroid
94
What defines a deep pyoderma?
Infection affects tissue deeper than the hair follicle
95
What lip is most commonly affected in lip fold pyoderma?
Lower lips
96
What must you rule out with deep hot spots?
Fungal infections
97
What is most likely seen on acute moist dermatitis' cytology?
Cocci and degenerate neutrophils
98
How do you differentiate beween deep hot spots and normal hot spots?
Deep hot spots will form hot spots when squeezed
99
How are deep hot spots treated differently from superficial moist dermatitis?
Systemic antibiotics are used based on culture results
Steroids are used to reduce self trauma
100
What do insect growth regulators not cover?
Not adulticidal
101
What does environmental flea control cover?
Larvicidial and ovicidal
102
What flea adulticide is toxic to cats?
***Synthetic pyrethroids
Ones that end in "thren"
103
What does IGR stand for?
insect growth regulator
104
What is the most common cause of superfiical pyoderma in dogs?
Staphylococcus pseudintermedius
105
Is S. pseudointermedius + or -
+
106
What other Staph can cause pyoderma?
S. schleiferi and S. aureus
107
What is the most important factors leading to the emergence of antimicrobial-resistance
use and misuse of antimicrobial therapy
108
What is the most common inappropriate use of antibiotics?
Inappropriate duration
109
What does MRS stand for?
Methicillin-resistant staphylococcus
110
What are MRS bacteria resistant to?
all beta lactam antimicrobials (cephalosporins +penicillins) and carbapenems
110
Should all patients with open wounds, abscesses or draining lesions be treated as if that have MRS?
Yes!
110
What is the definition of MDR drugs?
Bacteria that are resistant to at least 3 antimicrobial classes
111
What does MDR stand for?
Multi-drug resistant bacteria
112
What are most S pseudintermedius resistant to beside penecillins?
Tetracyclines
Streptomycins
113
What is a good empirical treatment of uncomplicated superficial pyodermas?
Cephalexin (1st gen)
114
How long should superficial pyodermas be treated?
7-10 days past clinical cure
115
How long should deep pyodermas be treated?
14-20 days past clinical cure
116
What is the most commojn cause of treatment failure?
Insufficient course of treatment
117
What is a bacterin commonly used?
Staphage lysate
118
What are 3 ways that you can get a cytology for mallasezia?
Cotton swab, superficial scrapings, acetate tape impressions
119
Which method identifies malassezia the most?
Acetate tape
120
What is a good topical option?
Miconazole 2% with 2% chlorhexidine shampoo
120
What is the best treatment of yeast?
Topical
121
What are 2 good systemic options?
Ketoconazole for 3 wks
Itraconazole for weeks
122
What are side effects of ketoconazole systemic use?
Hepatitis
Adrenal suppression
123
What species is very sensitive to side effects of ketoconazole?
Cats
124
Does ketoconazole or itraconazole have more side effects?
Keto has more! itra has less:)
125
How often are rechecks for yeast infections?
3-4 weeks
126
What is a non-azole effective against yeast?
Terbinafine
127
Is malassezia zoonotic?
YES!
128
What are the 3 phases of hair growth?
Anagen - active
Catagen - transition phase
Telogen - resting phase
129
What are hormones that affect hair cycle?
Thyroidal, gonadal, adrenal, pituitary, and pineal
130
What are 3 non-inflammatory follicular dysplacia alopecias?
Color dilution alopecia
Black hair follicular dysplasia
Seasonal flank alopecia
131
What are 4 non-inflammatory endocrine dermatopathie alopecias?
Sertoli cell tumors
hypothyroidism
Cushings
Alopecia X
131
What breed usually gets alopecia X?
Pomeranians
132
What breed usually gets pattern baldness?
Dachshunds
133
What is pathogenesis of post-clipping alopecia?
Not understood (hair cycle arrest)
134
What is color dilution alopecia?
Abnormality in melanin transfer and storage
135
What does trichosis mean?
A heavy growth of hair
136
What is a leucoderma and what skin condition can get it?
Loss of skin pigementation (white)
color dilution alopecia
137
What lesions are often seen with Cushings?
Comedones
138
What is seen with syndrome 4?
50% of cases show follicular dysplasia
139
What is treatment for hypothyrodiism?
Levothyroxine
140
What is a common sequela of hypothyroidism?
Secondary infection due to breakdown of epidermis resulting in recurrent pyoderma and otitis externa
141
What is the best way to manage sertoli cell tumors?
Castration
142
What is seen on trichogram for color dilution alopecia?
Hairs with large melanin clumps
142
What is atypical hyperadrenocortisism?
More hormones are secreted like estradiol
142
What is seen on histopath for color dilution alopecia?
Follicles are misshapen and melanin clumping is seen in lower segments
142
What is teh most sensitive test for hypothyroidism?
T4 and fT4
142
What is treatment for alopecia X?
Melatonin + Trilostan + microneedling + laser therapy
142
What percent of HAC are pituiatry dependent?
80-85% (most)
142
What is the most common endocrine disease in dogs?
Hypothyroidism (primary)
142
What is the first sign of alopecia X?
Loss of secondary hairs causing a puppy-like coat
142
What is seen with sydrome 3?
Strucutral defect of the hair shaft
142
What is seen on bloodwork for 75% of hypothyroidism cases?
Hypercholesterolemia
143
What can be used if there is metastasis?
Cisplatin
143
What can you use in combination with T4 and fT4 to increase sensitivity?
TSH (by itself, not sensitive)
144
What is calcinosis cutis?
a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues
145
Where does the alopecia usually first appear?
In areas of friction like the collar
146
When does seasonal flank alopecia usually occur?
Late fall, early spring
147
What are 2 decent screening tests for Cushings
LDDS
Creatinine:cortisol ratio
148
What is a common characteristic of hypothyroid alopecia?
Rat tail and myxedema
149
What percent of cryptorchid dogs get sertoli cell tumors?
70%!
150
What is Black hair follicular dysplasia?
All black hairs are lost until there arent any left
151
What usually causes the excess cortisol secretion?
Pituitary microadenomas
(macroadenomas cause neuro signs)
152
What parts of the body are usually spared from alopecia X?
Head and distal legs
153
When should you recheck hypothyroid doseage and response?
6-8 weeks
154
What is treatment for black hair follicular dysplasia?
None
155
What do pituitary adenomas caused?
Increased ACTH secretion causing more cortisol
156
What is the definition of hyperadrenocroticim?
Excess cortisol production
157
What are 4 syndromes of pattern baldness?
1 - pinnae, ventral neck, ventrum, caudomedial thighs
2 - Hyperpigmentation of pinnae
3- Bald thigh sydrome of sighthounds
4- American water spenial alopecia (neck, trunk, caudal thigh)
158
What do you need to know about sighthounds and T4?
Their range is lower than other dogs
159
What percent of thyroid gland must be destroyed beofre clinical signs develop?
75%
160
What is the mean age of hypothyroid diagnosis?
7.2y
161
What is hyperkeratosis?
a condition characterized by an excessive thickening of the outermost layer of the skin, known as the stratum corneum
162
What is treatment for hypothyroidism?
Levothyroxine
163
What is seen on histopath for seasonal flank alopecia?
Finger-like projections into the dermis
164
What test do you perform if you suspect iatrogenic disease?
ACTH stim
165
UC:CR has a low ot high specificity?
LOW
166
What will be seen during an ACTH stim for it is iatrogenic cause?
Minimal to no increase in cortisol levels
167
What is the treatment for AT cushings?
Mitotane, trilostaine, surgery
168
What is the treatment for PDH Cushings?
Mitotane, trilostane, surgery, radiation
169
What is canine scabies?
Sarcoptes scabiei canis
170
What is feline scabies?
Notoedres cati
171
What is walking dandruff?
Cheyltiella
172
what do posterior legs of sarcopted canis look like?
2 pairs, do not extend beyond border of its body
173
Does scabies respond to steroids?
No
174
What are the predilection sites for scabies?
Pinna, hock, elbow, ventrum
175
What are the most common lesions of scabies?
Papules
176
What is a unique was to diagnose scabies?
Pinnal-Pedal reflex
177
What is treatment for scabies?
Advantage Multi
Moxidectin + Imidacloprid
178
Is cat mange zoonotic?
YES!
178
What is life cycle length of cat mange?
17-21 days
179
What is something charateristic of cats infested with mange?
The notoedric hemit
179
How do you treat cat mange?
NO FDA approved treatment!
Lotilaner
flurilaner
sarolaner
selamectin
sulfur dip
180
How long is cheyletiella life cycle?
21-42 days
181
How many life phases are there?
5
182
Where is pruritus usually localized?
Dorsal
183
What is easiest diagnosis in cats?
Fecal float
184
How long do oyu have to treat cheyletiellosis after resolution of signs?
2-4 weeks
185
Does cheyletiella live longer off host than other mites? What does this mean?
Yes, need to treat environment!
186
How long are spores off host viable?
Months
187
What are 3 phases of ring worm development
1. Adherence to skin cells (hours)
2. Penetrate stratum corneum (days)
3. Invasion of dermatophyte (weeks)
187
What is most common type of ringworm in dogs? cats?
M. canis. M. canis (both!)
188
What is most common type of ringworm?
Microsporum canis
189
What is a nodular dermtophytosis?
Kerion (dome-shaped exudative nodule)
190
What cats get pseudomycetoma?
Persian cats
191
What is treatment for pseudomycetoma?
Systemic therapy +/- surgical excision
192
What are 3 differential diagnoses for dermatophytosis?
Demodicosis
Staph folliculitis
Pemphigus complex
193
What is diagnosis for ring worm?
Wood's lamp
Trichogram
Fungal culture
Histopath
PCR
194
What color is woods lamps?
Apple green
195
What percent of M canis fluoresce?
50%
195
What is best recommendation for daignosis?
Fungal culture
196
What should you do if hairs fluoresce under the wood's lamp?
Fungal culture
197
When do you do a biopsy?
Kerion or pseudomycetoma
198
What do you treat with in every ring worm infection?
Sytemic therapy until 2 negative fungal cultures
199
What are the 3 treatments for ring worm systemically?
Ketoconazole (NOT in cats!!!)
Itraconazole
Terbinafine
200
How long do you treat for?
Until 2 negative fungal cultures
201
What is the age of juvenile cellulitis?
3wks to 4months
202
How do you treat juvenile cellulitis?
Prednison
Cyclosporine to achieve remission
Abx for secondary infection
203
What gram + cause paronychia?
Staph and strep
204
What Gram - cause paronychia?
E. Coli, proteus, pseudomonas
205
What is treatment for paronychia?
Wipes with chlorhexidine or antifungal
206
What is dermatophytosis of the nail bed called?
Onychomycosis
207
If you see multiple affected paws, what should you do?
Take radiogrpahs of lungs
208
What is this called?
Lung-digit syndrome
209
What cancer likely is causing this?
Bronchial adenocarcinoma
210
How do you treat SLO?
Empiral treatment. Mostly with steroids or cyclosprorine
211
How do you treat SND?
IV amino acid infusion
High protein diet
Zinc supplementation
Eventually euthanasia
212
How do you treat anal sac impaction?
Frequent expression
213
How do you treat anal sac infection?
Topical therapy (Mometamax, otomax)
214
What are the 3 main mechanisms suggested to explain development of autoimmunity?
Molecular mimicry
Epitope spreading
bystander activation
215
What disease is bystander activated?
Systemic Lupus Erythematosus (SLE)
216
What are the 2 most common autoimmune skin diseases in dogs and cats?
Pemphigus and Lupus
217
What are the 3 types of pemphigus?
P. foliaceus
P. erythematosus
P. vulgaris
218
What causes pemphigus?
Autoantibodies against demoscollins
Desmocollins form part of the desmosome
219
When else are acnothocytes seen?
In dermatophytosis caused by trichophyton mentagrophytes
220
What are acanthocytes?
Detached keratinocytes
221
What are teh 4 distribution areas of PF?
Dorsal muzzle
Pinnae
Pawpads
Paronychia (in cats around pawpad)
222
Why is it important to rule out infectious causes first?
Treatment will be immunosuppressive so don't want to limit healing ability
223
What is uniquely targest in pemphigus vulgaris?
Oral cavity and other mucocutaneous jxns
224
What exacerbates DLE?
UV light
225
Cobblestone is classic appearnce of lupus
Animal is usually otherwise healthy with lupus
226
What is treatment for lupus?
Sunscreen
Topical steroid
Tacrolimus
Vitamin E
227
What are 2 pig side effects for pred?
Iatrogenic cushings
Diabetes mellitus
228
What is contraindicated in cats?
Azathioprine!!
229
What is use of azathioprine?
Can be used as steroid sparing agent or as a sole therapy
230
What is main side effect of cyclosporine?
Vomiting
231
What diseases can tacrolimus be used as the sole therapy for topcially?
DLE and PE
232
What are the treatment options for autoimmune skin diseases?
Pred
Dexamethasone
Tacrolimus
Mycophenolate mofetil
Cyclosporine
Azathioprine
Vitamin E
Chlorambucil
Triamcinolone
Sunscreens
233
What are 3 common diseases difficult to control that may result in mortality (QOL euthanasia maybe)?
Atopic dermatitis
Canine generalized demodicosis
Otitis externa/media
234
What 3 neoplasias is paraneoplastic alopecia associated with?
Pancreatic adenocarcinoma
Bile duct carcinoma
Hepatocellular carcinoma
235
What are the 5 most common drugs to cause cutaenous reactions?
Sulfonamides
Penicillins
Cephalosporins
Levamisole
Dietyl carbamazine
236
What are teh 3 manifestations of cutaneous adverse drug reactions?
Erythema multiforme
Toxic epidermal necrolisis
Cutaneous vasculitis
237
What is the most common type of reaction?
Erythema multiforme (59%)
238
What is diagnosis of toxic epidermal necrolysis?
Nikolsky sign (skin slough)
239
How do you treat toxic epidermal necrolysis?
Fluid therapy
Wound management
Immunosuppressive drugs
240
How do you treat cutaneous vasculitis?
Pentoxifylline***
Immunosuppression
Doxycycline niacinamide
241
What are the 3 P's of otitis?
Predisposing factor
Primary cause
Perpetuating
242
What are common causes of otitis externa predisposition?
Stenotic ear canals
Hair in ear canal
Pendulous pinnae
243
What is the most common parasite to cause ear infections?
Otodectes cynotis
244
What is the most common cause of otitis externa in dogs?
Allergies
245
What is #1 cause of ear infection in cats?
Otodectes
246
What are the main cocci of the ear?
Staph pseudintermidius
247
What are teh main rods of teh ear?
Pseud. aeruginosa
248
What direction is the nystagmus on otitis interna?
Horizontal
249
What direction does the head tilt for otitis interna?
Toward the lesion
250
Is a C/S needed in every case?
No!
251
What xray views do you take to look at ears?
Right and left lateral OBLIQUES!
Rostrooventral-caudodorsal
252
Do you use MRI or CT for soft tissue?
MRI! CT for bone
253
Is Actinomycosis Gram + or -?
+ anaerobic
254
How do you treat actinomycosis?
Surgical debulking
Penecillin or amoxicillin
Continue treatment for 1 month after complete remission (3-4m total)
Relapse 15-42%
255
How do you treat nocardia
Surgical resection and antibiotics
Antibiotics based on susceptibility
Potentiated sulfas are common
Treat at least one month past
256
How do you treat mycobacterium?
Surgery + antibiotic based on susceptibility use at least 2
257
What class of antibiotic is almost always used?
Fluoroquinolones (and doxycycline apparently)
258
What is the usual length of therapy?
3-6 months (1 month past resolution)
259
What is acronym for Hypercalcemia?
HARDIONS
260
What are 3 causes of hyposthenuria in dogs?
Pschygenic, Cushing, diabetes
261
If there is low Ca, what will the phosphorus look like?
High (inverse relationship
262
What are the 2 causes of "profound hypercalemia?
Primary HP and hypercalcemia of malignancy
263
What diagnostics can you do to differentiate between primary HP and malignancy?
Malignancy panel (PTH-rP), minimal PTH-rP likely means primary HP
264
What is another diagnostic?
US to check size of parathyroid (enlarge likely means primary HP)
265
What is a treatment for primary hyperparathyroidism?
Surgical removal
US-guided ethanol ablation
266
What is a risk associated with surgical removal?
Hypocalcemia (post-op)
Need to monitor iCa at least once daily
267
What to do if there is hypocalcemia as a result?
Give Ca and/or calcitriol
268
Can you see calcium oxalate on rads in cat?
Yes
269
What does prozasin do?
Relaxes urethra
270
What age are idiopathic hypercalcemia cats?
Young to middle aged
271
How do you treat IHC?
Dietary motification
272
What are nutritional goals?
dietary calcium <200mg/100kcal
Ca:P <1.4:1
Increase water consumption
273
What is something that can be added to diet to normalize Ca?
Chia seeds
274
What are 2 medical managements of idiopathic hypercalcemia that dont respond to diet or chia seeds?
Pred - increases diabetes chances
Bisphosphates
275
What is a side effect of alendronate (a bisphosphate)
Osteosclerosis and mandibular osteonecrosis
276
Give 5 causes for hypocalcemia
Eclampsia
Pancreatitis
Malabsorption
Hypoparathyroidism
Secondary hyperparathyroidism
277
What is your top differential for super low Ca?
Secondary hyperparathyroidism or PLE (PLE you would see low proteins and cholesterol)
278
What is acute treatment of hypocalcemia?
Calcium gluconate
279
What is long term treatment of hypocalcemia?
Calcitriol
280
If PTH is high and iCa is normal, what is that consistent with?
Nutritional hyperparathyroidism
281
What are the 2 medical treatments for Cushings?
Mitotane
Trilostane
282
What is more common, pituitary or adrenal dependent Cushings?
Piuitary depenedent
283
What are the management complications if you dont treat Cushings?
proteinurea
hypertension
hypercoagulability
284
What is the best way to treat the protein urea associated with Cushings if you don't treat the root cause?
Telmisartan (best ACEi)
285
What is very important to check on Cushing physical exam?
Eyes for signs of systemic hypertension
286
Cushings increases the release of cortisol, which increases "stress" level. This will cause hypertension leading to proteinurea. Hypercoag idk but it does
287
What are the 2 ACEi availbale to treat hypertension?
enalapril and benazepril
288
What is teh ARB available to treat hypertension?
Telmisartan
289
What is the calcium-channel blocker available to treat hypertension?
Amlodipine
290
What are the 2 antiplatel drugs used to treat Cushings?
Plavix - clopidogrel
low dose aspirin
291
What is a post-ACTH stim for control?
2-6
292
What is a post-ACTH stim for Cushings?
>22
293
What is mitotane loading dose?
50mg/kg/day
294
What is trilostate starting dose?
1mg/kg PO BID or 2mg/kg PO SID
295
What should you base most of your dosing on for trilostaine?
Clinical signs
296
When should you attemp to do ACTH stim?
3-4 hours post-pill
297
"If moving from BID to SID, dont split the dose in hald at each time, give the same dose at each time, essentailly increasing dose by 2"
298
What dose will most dogs be controlled on?
2-4mg/kg/day
299
What is the issue with compounded trilostane?
Amount in capsule is incosistent
300
When should you recheck after a dose adjustment?
10-14 days
301
How do you treat hyperaldosteronism in cats?
Adrenalectomy is optimal treatment
302
What are the top 2 issues with hyperaldosteronism in cats?
Hyperkalemia
Hypertension
303
If surgery isnt an option for hyperaldosteronism what are medical treatments?
Hyperkalemia - supplement K and spironolactone
Control hypertension - amlodipine or telmisartan
304
What is definition of polydipsia in dogs?
>100mg/kg/day
305
What is polyuria defiintion of spec gavity?
<1.020
306
What are the only 3 differentials for a hyposethuric dog?
Cushings, pschogenic, diabetes
307
What does the 8hr of an LDDS need to be to not be consistent with Cushings
308
What does 4hr need to be to PDH?
50% suppressed from baseline
If it isn't, it is "not not" PDH
309
What is the most common clinical sign of Cushings?
PU/PD
310
What is typical Addison's?
Mineralcorticoids + Glucocorticoids
311
What is atypical Addison's?
Just glucocorticoids
312
What is DOCP?
Desoxycorticosterone pivalate
313
What is starting dose of DOCP?
1.5mg/kg
314
What is the duration of DOCP?
1 month
315
When should you recheck electrolytes?
25 days - before next dose
316
What are 2 values you want to keep track of when adjusting the DOCP dose?
hyponatremia and hyperkalemia
317
What is dose of pred?
0.1-0.2 mg/kg/day
Taper to lowest dose and frequency that controls clinical signs
318
When might you increase dose of pred and by how much?
Increase by double a few days before/during/after stressful events
319
What is a medication that provides both mineralcorticoids and glucocorticoids
Fludrocortisone
320
How to treat hypovolemic shock as part of Addisonian crisis?
Bolus 0.9%NaCl fluids
321
How to treat hyperkalemia during Addisonian crisis?
IV dextrost/insulin or calcium gluconate
322
How to treat Hypoglycemia as part of Addisonian crisis?
Dextrose bolus
323
How to treat Anemia as part of Addisonian crisis?
Give transfusion
324
What is typical Addisons
Na:K <27
325
What are teh only 3 disease types that can have hypocholesterolemia?
PLE
Addisons
Liver Dx
326
What are the treatment options for hyperthyroidism in cats?
Oral methimazole
Topical methimazole
Radioactive iodine - cure
Diet
Surgery - cure
327
What are the 2 types of methimazole?
Tapezole
Felimazole
328
What are some side effects associated with methimazole?
GI
Fascial pruritus
Increased ALT
Bone marrow suppression
329
What are the time points for monitoring methimazole
Phone convo at 48 hrs and 1 week
330
What percent of I 131 cats develop hypothyroidism?
10-30%
331
How do you treat a cat that has iatrogrenic hypothyroidism?
Levothyroxine
332
What is the dietary management for hyperthyroidism?
Iodine restricted
Can only eat this food forever...
333
How do you check for CKD complications before I-131?
Do a methimazole challenge
334
How do you treat hypothyroidism?
Levothyroxine
335
What species get hyperthyroidism mostly?
Cats
336
What species get hypothyroidism mostly?
Dogs
337
When do you check total T4 for monitoring/
4-6 hours after pill administration
Goal is middle to upper reference interval
338
What is apathetic form of hyperthyroidism and what pecent is it?
Cats feel ill rather than good, 10-15% of cats
339
What is the shortest acting insulin?
NPH
340
What is vetsulin?
Porcine lente insulin
Suspension
BID
U-40
341
What is a good insulin for cats?
ProZinc
342
What are the 5 best for cats?
ProZinc
Tresiba
Levemir
Lantus
Toujeo
343
What are the 5 best for dogs?
Humulin
Vetsulin
Levemir
Toujeo
Tresiba
344
What formulation is Toujeo?
U-300
345
What is Bexacat?
SGLT2
Increases urine excetion of glucose
346
What are teh 4 factors associated with diabetes management?
Diet composition
Stable diet
Calorie intake and obesity
Feeding schedule
347
What is important about diet composition?
Increased fiber
Decreased simple sugars
348
What should the feeding schedule look like?
Consistent calorie content
Consistent timing of meals
BID feeding
349
What is the starting dose for cats and dogs of insulin?
Cats: 1U/inj
Dogs: 0.25/kg/inj
350
Is euglycemia a treatment goal?
No
351
what are the 3 goals of diabetes treatment?
Resolve clinical signs of diabetes
Prevent any consequences
Avoid hypoglycemia
352
What are complications of diabetes?
Cataracts will develop even in treated dogs
353
What is the best way to monitor diabetes?
Fructosamine
354
When would you use spot glucose?
When looking for hypoglycemia
355
o If you use a BG curve, how often should you check?
2 hrs
356
What insulin should you start with in a dog?
Vetsulin
357
What insulin should you start with in a cat?
ProZinc
358
When should you initally recheck?
2-3 weeks until controlled
Fructosamine at rechecks
359
What is the ranking of best monitoring approaches in order?
Clinical signs
Fructosamine or CGM
Glucose curves
360
What should BG not drop below in a diabetic patient?
100
361
What is a disease that would cause insulin demand to shoot up?
Pancreatitis
362
What are the 2 largest players in electrolyte derangements?
Potassium and phosphorus
363
What do potassium changes cause?
Heart issues
364
What do phosphorus changes cause?
Hemolysis issues
365
What is high in the biochem of diabetics?
cholesterol
366
What are the 4 aspects to treatment of DKA?
Fluids (Not NaCl!)
Electrolytes (P and K)
Insulin (Regular insulin plus dextrose)
Underlying disease
367
What is #1 reason for hypocalcemia in horses?
GI disease
368
What are the 4 causes of hypercalcemia in horses?
Vitamin D toxicosis
Cancer
Hyperparathyroidism
Renal failure #1 cause
369
Cryptococcus
Most common deep fungal infection in cats
Associated with pigeon droppings
Common nasal disease
Narrow base budding
Itraconazole or fluconazole for 6-12months
Maybe prednison for anti inflammatory for a little
370
Blastomycosis
Inhaled yeasts from ground
Ocular lesions in ~50%
Broad based budding
Itraconazole 30d beyond resolution of signs
Anti inflammaroy pred when starting
371
Histoplasmosis
Bat and bird droppings
Respiratory signs
Looks like a bunch of balls in a call on histo
Itraconazole
Fluconazole if CNS involvement
372
Sporotrichosis
Zoonotic
Penetrating wounds
3 forms: cutaneous, cutaneolymphatic, disseminated
Itraconazole Treat past resolution for 1 month
373
Cutaneous histiocytosis
Prednisone, or azathioprine, cyclosporine, leflunomide
Tetracycline or niacinamide as maintenance therapy
374
Sterline Nodular Penniculitus
Inflammation of fat
Surgical excision
Pred
375
Sterile granuloma/pyogranuloma syndrome
Surgical excision
Pred
Potential reaction to other bacteria present
376
Post grooming furnculitis (deep pyoderma)
Pseodomonas aeruginosa (Deep pyoderma!)
Common iwth backyard groom
Target Gram - fluoroquinolones (6-8wks)
377
Generalized deep pyoderma
Antibacterial baths
Topical antibacterial leave-ons
378
Puppy pyoderma (superficial pyoderma)
None if limited, topical shampoo
Systemic antibiotic if severe
<1 year old
379
Bacterial folliculitis
Pruritus can be none to intense
Has an underlying disease cause
"If it looks like ringworm, its proabably bacterial folliculititis"
380
Mucocutaneous Pyoderma
Treat underlying disease
Antibiotics
Treat for 1 week past resolution of signs
381
Atopic dermatitis
Choose from:
Antihistamines
Fatty acids
Topical
Nutraceuticals
Lipid-replacement therapy
Steroids
Atopica
Apoquel
Cytopoint
382
FASS
Antihistamines
fatty acids
nutraceutical
steroids
atopica
383
Contact dermatitis
Steroids
Pentoxifylline
384
Acral lick dermatitis
Treat underlying cause
Fluocinolone
Laser
No surgery
Antibiotics + trazodone
Phovia laser
385
