Block 6 Week 1 Flashcards
When do the 1st, 2nd, and 3rd molars erupt in a horse?
2.5
3.5
4.5
When are the newly erupted teeth “in wear”?
6 months
What is the number of the canine in the triadian system?
04
What sex usually has canines?
Males
What is the number of the wolf tooth?
05
What may happen where a wolf tooth NEEDs to be extract?
Blind wold tooth
When do foals deciduous teeth firth errupt?
01 = 6d
02 = 6w
03 = 6m
What equine teeth have caps?
06, 07, 08
What is the last tooth to errupt?
08
How many teeth are a foal born with?
12 (4 arcades with 3 premolars each)
What type of feed will develop larger points?
Hay (vs pellets)
Why does hay develop larger points?
Larger role powerstroke required
What is the toxicity/bacteria from clover called?
Slobbers
What is dropping of feed called?
Quidding
What is the most common clinical sign in dental-related sinus (sinusitis) disease?
Unilateral nasal discharge
What is the most common tooth for infection?
09
What is the hardest part of the tooth?
Enamel (96% mineralized)
What is the tooth made of from the outside in?
Cementum > Enamel > Dentin
What does floating do?
Removes sharp enamel points
What are cheek teeth enamel overgrowths?
Points
Where are hooks most common?
Maxillary 2nd premolar (106 and 206)
Where are ramps most common?
Mandibular 3rd molar (311 and 411)
What is a step?
Excessive crown often due to opposing missing tooth
What is the equivalent of a cavity in a horse?
Infundibular caries
What tooth is most affected by dental diseases?
09 tooth
What is the definition of an infundibular caries?
Progressive acidic demineralization secondary to bacterial fermentation
What does EOTRH stand for?
Equine Odontoclastic Tooth Resorption and Hypercementosis
What is EOTRH?
Tooth resorption and destruction in addition to cemental deposition.
Mainly proliferative (hypercementosis)
What is the pathophysiology of EOTRH?
Aged mouth has less periodontal ligament but exposed to same masticatory force. Continued stress causes micronecrosis and release of cytokines leading to recruitment of clastic cells
What is the mean age of diagnosis?
24
What is deglutination?
Act of swallowing
What are the 3 steps to deglutination?
Oropharyngeal phase
Esophageal phase
Gastroesophageal phase
What are the 3 steps to the oropharyngeal phase?
Oral
Pharyngeal
Cricopharyngeal (UES relaxation)
What are clinical signs associated with swallowing disorders?
Dysphagia
Regurgitation
Hypersalivation
Exaggerated swallowing
What is esophagitis?
Inflammation disorder of esophageal mucosa
What are 3 exogenous causes of esophagitis?
Caustic agents / chemicals
Foreign bodies
Drugs (pill-induced)
What is an endogenous cause of esophagitis?
Gastric reflux
Theres no protection from stomach acid above the LES
What is a very common predisposing cause of reflux esophagitis?
General anesthesia
What is a very common drug to cause esophagitis via pill-induced esophagitis?
Doxycycline
What causes the prognosis of esophagitis to decreases significantly?
Healing with stricture
What is the gold standard to diagnose esophagitis?
Endoscope
What are the most common sites for esophageal FBs?
UES
Thoracic inlet
Heart base
LES
Need to refer an esophageal FB is you dont have an endoscope ASAP
What is most common cause of an esophageal stricture in a cat?
Doxycycline/clindamycin tablets in CATS
List 2 other causes of esophageal strictures
Gastroesophageal reflux during anesthesia
Secondary to foreign body
What are 2 diagnostics for esophageal stricture?
Barium swallow study
Endoscopy
What is a congenital malformation of great vessels and branches that entraps the intrathoracic esophagus?
Persistent right aortic arch (PRAA)
Esophagus runs right under the aortic arch so if there is a ligamentum arteriosum, it will squeeze the esophagus
What is clinical sign of PRAA?
Regurgitation of solid food at weaning (young)
What is the most common type of megaesophagus?
Idiopathic
(Congenital or acquired)
What is the second most common type of megaesophagus?
Myasthenia gravis
What is a large risk associated with megaesophagus?
Regurgitation resulting in recurrent aspiration pneumonia
Should you do a barium swallow study for megaesophagus?
NO!! RISK OF ASPIRATION
What is a diagnostic test for myasthenia gravis related megaesophagus?
AchR antibody titer test
What is the vomiting center only found in cats?
Vestibular center
What are the 2 vomiting centers in dogs and cats?
Abdominal viscera
Chemoreceptor trigger zone
What vomiting zone does hydrogen peroxide work on?
Abdominal viscera
What vomiting center does apomorphine work on?
Chemoreceptor trigger zone (delta 2)
What vomiting center does xylazine work on?
Chemoreceptor trigger zone (alpha 2)
What is closed during vomiting to inhibit aspiration?
Glottis and nasopharynx
What does it mean if vomiting undigested food >10hrs post consumption?
Delayed gastric emptying
What does it mean if it is projectile vomiting?
Gastric or upper small bowel obstruction
Will a dog reingest vomitus?
NO
What is seen normally in primary GI diseases?
Vomiting AND diarrhea
What is seen in normally in extra-GI diseases?
Vomiting
What are some common extra-GI diseases that may cause V+?
Acute/chronic pancreatitis
Acute/chronic Liver disease
acute/chronic kidney disease
Hypoadrenocorticism
Sepsis
***What are extra GI-diseases that chronically may affect cats?
Hyperthyroidism
Heartworm disease
What are chronic reasons for primary V+ (+/- D) in dogs
IBD
Neoplasia
Infection
GI ulcer
What vomiting center do primary GI diseases target?
Gut afferents
What vomiting center do secondary GI diseases target?
chemoreceptor trigger zone
What do you do first to characterize vomiting?
ALWAYS rule out extra-GI causes first
How do you rule out extra-GI causes?
Minimum database
T4, HW
How do you get metabolic acidosis from vomiting?
Animals will vomit up more base (duodenal) than acid resulting in a metabolic acidosis (Duodenal vomiting)
What color is duodenal vomiting?
Brown
How do you get a metabolic alkalosis from vomiting?
Stomach acid is lost primarily by a pyloric obstruction (foreign bodies) causes body to be left with a metabolic alkalosis (Gastric vomiting)
Vomiting and/or diarrhea can be attributed to either a primary GI or extra-GI cause
EXTRA GI = Liver, pancreatitis, kidney failure, hypoadrenocorticism
FOR CATS ADD HYPERTHROIDISM AND HEARTWORM DISEASES
What is the most important Primary GI diagnosis to rule out?
Obstruction
Parvo
What is the most important extra-GI diagnosis to rule out?
Acute pancreatitis
Organ failure
What is the most common dental disease in small animas?
Periodontal disease
What is the only reversible stage of periodontal disease?
gingivitis
What is the large breed dog poster child for periodontal disease?
Greyhounds
Are cats prone to dental disease?
YES
What is stage 1 periodontal disease?
Gingivitis
What is CWD on dental chart?
Crowding
What is M on dental chart?
Mobility
What type of dog are remaining deciduous teeth most common?
Toy breeds
What is tooth wear due to rubbing against something foreign?
Abrasion
What is tooth wear due to tooth - tooth contact?
Attrition
What is trauma to a tooth causing the death of the tooth?
Pulpitis
What is the fracture of the top of a tooth called?
Crown fracture
What is a crown fracture without pulp showing?
Uncomplicated fracture
Are complicated and uncomplicated fractures at risk of infection?
YES
What is something that doxycycline can do to teeth?
Cause permanent staining (not enamel defect)
What are the equivalent of cavities?
Caries
What is caused by an unerupted tooth?
Dentigerous cyst (usually first lower premolar)
If any teeth are missing in a dog, what should you do?
Take dental rads
What tooth is predisposed to resorptive lesions in cats?
3rd mandibular premolar
What is a type III resorptive lesion?
1/2 tooth has root and 1/2 tooth has resorption of root
What is severe uremia necrosis caused by?
Leptospirosis
What is widespread oral inflammation that required full mouth extractions?
Stomatitis
What is excessive growth of gingiva (common) that may trap bacteria causing periodontal disease?
Gingival hyperplasia
What is a benign tumor of the mouth?
Epulis
What is the most common oral tumor in dogs?
Melanoma
What is the most common oral tumor in cats?
Squamous cell carcinoma
What is the technique where the plate/film is placed behind the tooth and the rad beam directed straight to the plate?
Parallel technique
What is the technique where the film is placed at a 90 degree angle to the tooth?
Bisecting angle technique
What teeth can you really only do the parallel technique on?
Mandibular teeth
What teeth are always radiographed using bisecting?
Canines
What is the # of the carnassial tooth on the top?
08
What is the # of the carnassial tooth on the bottom?
09
If you are looking at the maxillary incisors, what will the quadrant on the left of the image be?
100s
Just opposite of what youd think
Name the parts of the tooth from the pulp out
Pulp > dentin > enamel
Where is cementum?
Hard tissue forming the surface of the root
What teeth is cat missing on the mandible?
06 and 07
What is that act of swallowing called?
Deglutition
What is difficulty swallowing, prehending, or chewing?
Dysphagia
What 2 phases does regurgitation come from?
Esophageal phase or gastroesophageal phase
Is dysphagia common in cats?
NO
What normally causes dysphagia in cats?
secondary to structural abnormalities
Oral tumor, ulcer, stomatitis
What do you rule out first for oropharyngeal disease?
Structural disease
What is the first thing in the diagnostic plan for oropharyngeal disease?
Thoracic rads for aspiration pneumonia
What causes a honking sound where arytenoids do not move?
Laryngeal paralysis
How do you rule out a functional disease?
Barium swallowing study
What is the failure of opening of the upper esophageal sphincter?
Achalasia
What is the lack of coordination between pharyngeal and cricopharyngeal phase of swallowing
Dyssynchrony
What is inflammation of the esophagus?
Esophagitis
What is narrowing of the esophagus?
Esophageal stricture
What is essentially the only functional disease of the esophagus?
Megaesophagus
What type of disease does dysphagia indicate?
oropharyngeal disease
What type of disease does regurgiation indicate?
Esophageal disease
What type of disease does regurgitation and dysphagia indicate?
Painful esophageal disease (esophagitis or FB) or diffuse neuromuscular disease
YOU MUST RULE OUT STRUCTURAL CAUSES BEFORE DIAGNOSTIC FOR FUNCTIONAL DISEASE
What must be tested for in patients with megaesophagus or functional neuromuscular disorders?
Anti-acetylcholine receptor antibodies
for myasthenia gravis
What is gastritis?
Inflammation of gastric mucosa
What is the most common type of gastritis?
Idiopathic gastritis
What is the most common type of fungus that causes gastritis?
Histoplasma
What does gastroenteritis mean?
Stomach AND intestines
What does repeat vomiting cause?
Bilious Vomiting Syndrome (reflux gastritis)
What is the non-immunologic food sensitivity?
Food intolerance
For chronic gastritis, what is a bacteria that may cause pathology but is also a normal gut microbe?
Helicobacter
What is the stomach worm of the dog and car?
Physaloptera rara
If you hear the history “morning vomiting of bile stained fluid but otherwise healthy”, what should you think?
Bilious vomiting syndrom
What should you think first when you think about gastroduodenal ulcers?
NSAIDS or steroids
What do mast cell tumors secrete?
Histamines
Due to increased histamines, mast cell tumors activate the chemoreceptor trigger zone causing vomiting
In terms of gastric ulcers, what should you avoid the concurrent use of?
NSAIDs and steroids (or other NSAIDs)
What should you do if there is evidence of bleeding elsewhere outside of GI bleeding?
Run coag test and check platelets (IMHA?)
What do NSAIDs inhibit the production of?
prostaglandins
Why do cats tend to produce more trichobezoars than other species?
They have long contractions (interdigestive migrating motor complexes)
What is the most common cause of delayed gastric emptying/
Mechanical obstruction (FB, neoplasia, GDV, polyp, etc)
What is the most common cause of functional gastric motility disorder?
Idiopathic
What is the #1 clinical sign of delayed gastric emptying?
Vomitus of partial of undigested food >10 hours after eating
What is a breed risk factor for GDV?
Deep chested dogs
What are 2 food-related risk factors for GDVs?
Rapid eating
Single meals
What 3 things (all sort of related) are caused by GDV to venous return?
Caudal vena cava compression
Impaired venous return to heart
Hypovolemic shock
What are the 6 important clinical signs of GDV?
Non-productive retching
Abdominal distension and tympany
Tachycardia
Pallor
Shock
What type of rads do you take on a suspected GDV dog?
RIGHT LATERAL!!
What dog breed is most likely to get GDV?
Great dane
A diagnosis of a functional gastric motility disorder is presumptive and is considered a diagnosis of exclusion
Whats the hepatocellular panel for hepatocyte injury for large animal include?
AST, ALT, SDH
Whats the cholestasis panel include?
ALP, GGT, Bilirubin
What is most specific liver enzyme for hepatocellular injury in dogs and cats
ALT
What is most specific liver enzyme for hepatocellular injury in large animals?
SDH
Which of the liver enzymes are not liver specific?
AST
If AST and CK are high, what should you consider instead of liver damage?
Muscle damage
High ALP is significant because half life is so short
What artery supplies that hard palate?
Major palatine artery
What does the palate do?
Stimulates sensory nerves to help trigger swallowing
What parts of the palate can cleft palate affect?
Soft, hard, and both
Does a cleft lip need to be treated with no clinical symptoms?
NO
What can predispose to cleft palate (2)
Stress of mother
Intrauterine trauma
What are the 4 salivary glands?
Sublingual, mandibular, zygomatic, parotid
What is the most common cause of salivary gland disease?
Idiopathic
What is a sialocele?
A subcutaneous cavity containing saliva
What is the most common sialocele?
Cervical sialocele
What is the second most common sialocele?
Sublingual sialocele
What sialocele is likely to cause exophthalmos?
Zygomatic sialocele
Where is cervical sialocele located?
Ventral neck
Remove gland to fix
What are 4 diseases of salivary glands?
Inflammation (sialadenitis)
Infection
Stone formation (sialolith)
Neoplasia
What does a lot of nasoreflux indicate?
A small intestine disease
What is ileus
inhibition of intestinal propulsion without signs of mechanical obstruction
What type of liver value is also associated with bone growth?
ALP
What can also cause an increase in ALP values outside of the body?
Corticosteroids
ALP in cats is almost always more sensitive for cholestatic liver disease than GGT except for one instance, what is it?
Feline hepatic lipidosis, ALP will be high but GGT won’t
What are 3 causes of increased GGT activity
Drugs
Biliary hyperplasia
Cholestasis
What are the 3 broad categories that cause hyperbilirubinemia?
Pre-hepatic
Hepatic
Post-hepatic
What may cause hyperbilirubemia of pre-hepatic cause?
Hemolytic disorder
Do horses get megaesophagus?
Yes but rarely (Friesian - burping)
What is the most common esophageal disorder in horses?
Choke
What is the common sequela after choke? (2)
Aspiration pneumonia
Stricture
What is a common clinical symptom of choke?
BILATERAL nasal discharge
HORSES ARE OBLIGATE NASAL BREATHERS
How should you feed to prevent choke?
Slow feeding
What type of feeds should be given to prevent choke?
Good, soft feeds
What should be done to their teeth to prevent choke?
Adequate dental care
What is the most common tumor in the esophagus of horses?
Squamous cell carcinomas
What is an abnormal amount of nasogastric reflux to get?
> 2L
What does EGUS stand for?
Equine gastric ulcer syndrom
What are 4 risk factors for EGUS?
Intense exercise
Meal feeding
Low roughage feeding
High concentrate feeding
What is a cause of equine gastric glandular disease?
NSAIDS
More severe because constantly exposed to acid
What should be a huge concern in foals in terms of gastric ulcers?
NSAIDs
What parasite would you find in the stomach of horses, potentially incidental?
Gasterophilus intestinalis (bots)
What are the 3 aspects of hepatobiliary screening
CBC, chem, UA
What in the CBC may contribute to liver disease?
Anemia
What 3 liver enzymes are released during hepatocellular injury?
AST, ALT, SDH
Of the two, AST and ALT, which is less liver specific?
AST
What can elevated AST also be responsive to?
Muscle breakdown
If AST is higher than ALT, what should you think?
Muscle breakdown
What 2 enzymes are most prominent in cholestasis?
ALP and GGT
If glucose is decreased, what does this indicate about the function of the liver?
<30% fxn
What does decreased serum cholesterol indicate?
Decreased hepatic synthesis
What does increased serum cholesterol indicate?
Secondary to cholestasis
Where is albumin synthesized?
Only in the liver
What does decreased synthesis of clotting factors indicate?
<30% function
What are the 2 primary methods of liver function?
Serum bile acid
Blood ammonia levels
What happens to bile acid metabolism during hepatic disease?
Shift toward more renal excretion of bile acids
What is the primary test for portosystemic shunting?
Blood ammonia levels
What is pancreatic inflammation?
Pancreatitis
What about stools is an indicator of pancreatitis?
Large stools
What species gets acute pancreatitis more?
Dogs
What species gets chronic pancreatitis more?
Cats
What is the most common clinical finding for acute pancreatitis in dogs and cats?
Dehydration!!!
What is a common clinical finding for pancreatitis in cats?
Hypothermia
What do clinical findings do cats with pancreatitis get?
Lethargy, anorexia, hypothermia
Do most dogs presenting for pancreatitis vomit?
YES! (90%)
What is the most accurate way to diagnose pancreatitis?
Spec PLIs
What is the most accurate way to mis-diagnose pancreatitis?
Spec PLIs
What is normal, suspicious, and pancreatitis levels for Spec PLIs?
<200 normal
200-400 maybe
>400 probably pancreatitis
Is SNAP PLI valuable?
Good at ruling out (Sensitive)
Should really never use SNAP PLI
Is ultrasound a reliable way to help diagnose pancreatitis?
Yes!
What can hypersalivation in a cow result in?
Acidosis
Is bloat an emergency?
YES!!
What is the bacteria responsible for lumpy jaw?
Actinomycosis
What is the bacteria responsible for wooden tongue?
Actinobacillus ligneressi
