DC Sem 2 Flashcards
1
Q
What are some common ddx for oesophageal luminal obstructions?
A
FB Neoplasia Hiatal hernia Oesophageal stricture Infectious (spirocercosis)
2
Q
What are some causes of acquired megaoesophagus?
A
- Neuromusc/ immune mediated (eg. myasthenia gravis)
- Endocrine (hypoA, hypoT?)
- Gastrointestinal (oesophagitis)
- Paraneoplastic (thymoma)
- Toxic (lead, OPs)
- Incidental (excitement, GA, vomiting)
3
Q
What is pyridostigmine?
A
drug used in tx of MG. It works by inhibiting acetylcholine esterase (increases Ach signalling)
4
Q
What would you use in a treatment trial to rule out parasites in a dog with diarrhoea?
A
Fenbendazole 50mg/kg every 24hours for 3 days
Would also do faecal screening (smear, Zn sulphate floatation and/ or Giardia ELISA)
5
Q
What are some examples of oral protectants?
A
Kaolin-pectin
Bismuth
Activated charcoal
6
Q
What are some examples of anti-acids?
A
Omeprazole
Famotidine/ ranitidine
7
Q
What are the classifications of a hernia?
A
Congenital/acquired
True/ False
Reducible/ incarcerated
Strangulated
8
Q
What are 9 nine locations of hernias? Which of these are associated with non-traumatic acquired or congenital hernias?
A
- Paracostal
- Dorsal lateral
- Inguinal**
- Umbilical**
- Femoral**
- Scrotal**
- Perineal***
- Prepubic rupture
- Ventral/ subxiphoid
9
Q
What are breed dispositions for congenital inguinal hernias? What are predispositions for acquired inguinal hernias?
A
Congenital: young male dogs, CKCS, cocker spanie, daschund
Acquired: older entire females. obesity, perineal hernias in intact males
10
Q
What is the difference between the two main types of abdominal hernias?
A
- Traumatic- lacks a true peritoneal sac increasing risk of incarceration (blunt force trauma at region of abdominal wall attachment)
- Incisional- rare. after OVH. fat entrapped in incision or inappropriate suture material/ handling
11
Q
What are the breed dispositions for a perineal hernia? What are other potential causes?
A
Older entire male dogs Pekingese, boston terrier, corgi, boxer, poodle, bouviers, old english sheepdogs Pot causes: Androgens gender differences relaxin prostatic disease neurogenic atrophy
12
Q
What are the surgical treatment options for a perineal hernia?
A
- Traditional herniorrhaphy
- Internal obturator muscle transposition
- Superficial gluteal transposition
- Semitendinosus
- Prosthetics- mesh
**always castrate at same time. May also consider colopexy, cystopexy, ductus deferopexy to prevent caudal movement
13
Q
What is the difference between regurg and vomiting?
A
Regurg= passive process. No nausea or retching, no repeated swallowing. Sign of oesophageal disease. No bile or digested food
Vomiting is the opposite of this. Involves salivation (to neutralise gastric contents), swallowing, relaxation of GO sphincter, retrograde giant contractions (against a closed glottis) and expulsion of ingesta.
14
Q
What are ddx for ACUTE vomiting?
A
Gastroenteritis Septic or other peritonitis Pancreatitis Acute haemorrhagic diarrhoea syndrome Intestinal obstruction
15
Q
Where are the most common sites for intussusception? What are some predisposing causes?
A
Ileocolic junction and jejunojejunal
Active enteritis in young animals (deranged motility)
Acute renal failure, neoplasia or previous intestinal sx
16
Q
What is cPLI?
A
Canine pancreatic lipase produced exclusively by pancreas. Not altered by pred and has very high sensitivity in acute forms.
17
Q
What things may lead to the onset of acute pancreatitis? What are potential clinical signs?
A
High fat/ low protein diets (in dogs, not so much cats)
Hyperlipidaemia
Drugs (azathioprine, KBr)
Trauma
Hypoxia
Potential CSs:
vomiting, diarrhoea, anorexia*, jaundice, abdominal pain, DKA, cardiac arrhythmias, acute renal failure, resp distress, CNS signs
18
Q
In regards to pancreatitis, gastric acid suppression should be avoided unless…?
A
there is melena, haematemesis or regurg consistent with reflux oesophagitis
19
Q
In which breeds is myasthenia gravis as a cause of acquired non-obstructive regurgitation common?
A
GSDs, Golden retrievers, Abyssinian, Somali, Siamese
20
Q
What are some causes of acquired non-obstructive regurgitation?
A
- Neuromusc or immune-mediated (MG, distemper)
- Gastrointestinal (oesophagitis)
- Toxins (Lead, OPs, snake venom)
- Endocrine (hypoA, hypoT)
- Paraneoplastic (thymoma)
- Incidental (excitement, aerophagia)
21
Q
What are the four mechanisms of diarrhoea?
A
- Osmotic (poorly absorbable osmotically active solutes)
- Secretory (abnormal ion transport)
- Increased mucosal permeability
- Deranged motility
22
Q
What are common clinical signs of parvo in dogs and what are some main differentials?
A
Anorexia, vomiting, haematochezia
- FB
- Int intussusception
- Garbage disease
- Severe parasite infestation
23
Q
What are some DDx for bacterial enteritis?
A
- Parvo
- Parasite infestation
- Dietary indiscretion
- Acute haemorrhagic diarrhoea syndrome
- Tritrichomonas (in cats only)
24
Q
Are antacids indicated for chronic vomiting?
A
Not unless the patient is uraemic (in which case it will bind to PO4). Otherwise it may cause a rebound gastric hyperacidity and/or interfere with drug absorption
25
How long should gastric acid modifiers be used for?
If ulcers are NSAID induced-> 2-4 weeks
| If induced by severe oeophageal reflux-> 4-6 weeks
26
What are some disadvantages of using proton pump inhibitors?
When used with NSAIDs, causes duodenal ulceration
| PPI causes dysbiosis
27
What are some differential diagnoses for chronic vomiting?
```
Infl bowel disease/ chronic enteropathy
Dietary intolerance/ sensitivity
Intestinal lymphoma
Chronic pancreatitis
Structural
Neoplasia
HyperT
HypoA
Liver disease/ renal failure
etc
```
28
Before diagnosing gastric ulceration, what needs to be ruled out?
Drugs (incl. over the counter)
Systemic disease
Infl intestinal disease
Neoplastic disease
29
What dog breeds are predisposed to EPI?
Chow chows, collies and GSDs
30
Hypoalbuminaemia is albumin levels below...?
13g/L
31
How is FIP diagnosed?
It is a dx of exclusion. Take into account:
- Hx and signalment (young cats)
- Hyperglobulinaemia
- Mild-mod anaemia
- Stress leukogram
- green-yellow abdo fluid, often mucinous
- Rivalta's test
- fluid immunohistochem
- RT-PCR
32
What are some differential diagnoses for chronic abdominal pain?
- Chronic infl of pancreas or urinary tract
- Chronic gastric dilatation
- Gastric ulceration
- Infiltrative neoplasia
- Functional Intestinal spasm
- MS disease
(any "-itis" or ulceration, distension, torsion or compression)
33
What are some signs of large intestinal disease? What about colitis?**
- mucoid faeces**
- haematochezia**
- tenesmus**
- dyschezia
- weight loss/ vomiting (occasionally)
- constipation
- rectal prolapse/ perineal swelling
34
What are our main differentials for colitis in Australia?
- Fibre responsive (idiopathic) colitis
- IBD
- C. perfringens overgrowth
- Trichuris vulpis
35
Most LI conditions can be diagnosed with rigid proctoscopy. Some cannot though. Examples include...?
- Occult trichuriasis
- Ileocolic or caecocolic -Intussusception
- Typhlitis
- Neoplasia localised to transverse or ascending colon
36
Tritrichomonas foetus causes colitis with increased frequency of defecation. What cat breeds are predisposed? How may it be diagnosed and treated?
```
Bengals
Dx (in order of increasing sensitivity):
-Faecal smear (look for it moving)
-Specific culture system
-PCR
Tx: Ronidazole (beware of side effects- neurological)
```
37
IBS is a poorly defined disease of dogs. What may the disease involve?
Altered bowel motility, visceral hypersensitivity, psychosocial factors, NT imbalance, mucosal inflammatory cytokines
38
What are the different types of colitis?
1. LP
2. Clostridial
3. Granulomatous
4. Tritrichomonas foetus
5. IBS
39
What are your main ddx for haematochezia?
- colitis
- infectious disease
- metabolic disease
- rectal adenocarcinoma
- rectal polyp
40
To dx idiopathic megacolon, what needs to be ruled out first?
Pelvic stenosis
Neurological disease
Neoplasia
Metabolic disease
41
How do you treat idiopathic megacolon?
If mild, then dietary fibre. If it recurs, emollient laxative +/- cisapride (prokinetic)
If mod, relieve impaction. Then fibre + cisapride + lactulose. If recurs, then replace cisapride with ranitidine and add stimulant laxative.
If severe:
- colectomy (dilation or hypertrophy >6mo or hypertrophy <6mo)
- pelvic osteotomy (if hypertrophy <6mo)
42
When doing an enterotomy, where should you incise? How about when doing a gastrotomy?
Antimesenteric side of unaffected intestinal wall
Longitudinal incision in ventral wall bw greater and lesser curvature in relatively avascular area
43
What is short bowel sydnrome?
Is distal or proximal resection better tolerated?
What does it lead to?
Malabsorption rom lack of functional length of SI.
(reduced SA; gastric and intestinal hypersecretion; bacterial overgrowth; decreased transit time.)
Risky if >50% resected
Proximal resection better tolerated
Steatorrhea, weight loss, diarrhoea, electrolyte disturbances
44
What are potential post-op complications of GIT surgery?
```
Gastro-oesophageal reflux
Septic peritonitis
Adhesions
Short bowel syndrome
Ileus
```
45
What are some priniciples to keep in mind when doing an oesophagotomy?
- Oesophagus has a segmental blood supply.
- Cervical oesophagus can be accessed from ventral midline. --Cranial thoracic oesophagus can be accessed by left 3-4th IC space, lower can be accessed via right 3-5th IC space
- 2 layer closure is better than a single layer
- Bring omentum through diaphragm if needed
46
What are your landmarks for an incisional gastropexy?
Stomach wall parallel to the lesser curvature
| Last rib and transverse abdominal muscle
47
What are the most common gastric and intestinal neoplasias in dogs and cats?
Gastric:
Adenocarcinoma (dogs)
Lymphosarcoma (cats)
Intestines:
Adenomatous polyps (dogs) in rectum (benign) and adenocarcinoma (mal)
Adenocarcinomas>lymphoma>MCT (cats)
Need 3-5 cm margins on resection
48
What are some risk factors for peritonitis post surgery?
Pre-operative peritonitis
Hypoalbuminaemia
Intestinal FB
49
What are Bates Bodies?
Focal calcified bodies resulting from dystrophic mineralisation of necrotic mesenteric fat (seen on abdominal radiographs)
50
Molar teeth come through at what age for dogs and cats?
5-7 months (dogs)
| 4-5 months (cats)
51
What are the three stages of tooth development? What marks the beginning of the last stage?
Bud Cap Bell
Bell: Addition of 4th layer (statum intermedium) marks beginning of this stage
52
How is enamel produced?What makes up majority of the adult tooth?
by ameloblasts
Dentin produced by odontoblasts (primary produced during developing, secondary produced throughout life of vital tooth; tertiary produced in response to injury).
53
What are the four components of the peridontium?
Gingiva
periodontal lig
cementum
alveolar bone
54
What is a normal sulcus depth in dogs and cats?
<1mm in cats, <3mm in dogs
55
What are the three techniques used in dental radiology?
1. Parallel (film placed parallel to tooth root for mandibular cheek teeth)
2. Bisecting angle technique (place plate as close as you can parallel to the long axis of tooth root. X-ray beam is parallel to bisected angle)
3. Simplified technique (90, 45 and 20 degree angles)
56
What are the steps of a complete dental treatment?
1. Presurg exam and consult
2. Supragingival cleaner
3. Subgingival plaque and calculus scaling
(4. Residual plaque and calculus id)
5. Polishing
(6. Sulcal lavage)
(7. Fluoride: incorporates into enamel)
8. Oral evaluation with periodontal probing and dental charting
9. Dental radiographs
10. Treatment planning
(11. Application of a barrier sealant)
12. Client education
57
What are the three types of tooth resorption?
Type 1: periodontal ligament and roots remain distinct on radiographs (extraction of entire tooth and tooth roots)
Type 2: Ligament and roots of teeth become radiographically indistinct as they are replaced by bone (intraoral resorptions- extraction or crown amputation)
Type 3: both type 1 and 2 present
58
What are tx options for carious lesions in teeth?
If they don't involve the pulp, restorative dentistry
| If they do, Root canal tx or extraction
59
Signalment for IMHA?
2-7 yo, small to medium, often toy breeds
More females
Cats <6yo, male DSH/mix
60
How does hypophosphataemia lead to anaemia?
Causes depletion of RBC ATP-> increased RBC rigidity-> haemolysis
61
What are some examples of congenital RBC defects?
1. Pyruvate kinase deficiency Basenjis, westies, Abyssinians, Somalis)
2. Phoshofructokinase deficiency (spaniels)
62
What is the drug of choice for tx of mycoplasma haemofelis?
Doxycycline (5mg/kg twice daily). Prevent with indoors, separation of infected cats and flea control?
63
An animal has IMHA if it fulfils what criteria?
Anaemia +
≥ 2 signs of immune-mediated destruction
≥ 1 sign of haemolysis
64
What is the tx for IMHA?
1. Fresh packed RBC transfusion
2. IV fluids as req'd
3. Omeprazole as req'd (GIT ulcers)
4. Drugs:
- immunosuppressive dose of pred (+/- IV dexamethasone day 1)
- Cyclosporine OR Azathiprine (not in cats though) OR Mycophenolate mofetil
- antiplatelet drug (clopidogrel)
65
What factor deficiencies are present with haemophilia A and BB?
Haemophilia A= Factor VII
| Haemophilia B= Factor IX
66
What factor has the shortest half life
7
67
What are some potential causes of non-regenerative anaemia?
- Chronic infl
- Endocrine disease
- CKD
- Bone marrow disorder
- End stage Fe def anaemia
68
What is a normal BMBT? What does this assess? In which cases might buccal mucosal bleeding time be prolonged?
```
< 4 mins
Primary haemostasis (i.e. platelet function)
```
vWD, NSAID therapy, uraemia, thrombocytopaenia
69
What does the activated clotting time assess?
Secondary haemostasis. Intrinsic and common pathways. (run at 37 degrees)
70
What does prothrombin time measure? In which cases might it be prolonged?
Extrinsic and common pathways.
Rodenticide poisoning
71
What are some potential consequences of providing fluids to a hypovolaemic patient?
```
Not replacing what is lost
Dilutional coagulopathy
Anaemia
Pulmonary oedema
(reach for whole blood after 40-60ml/kg)
```
72
What are some DDx for non regen anaemia?
Remember Vitamin D (vascular, idiopathic, trauma/ toxin, anomaly, metabolic, inflammatory/ infectious, Neoplastic, Degeneration)
73
What are some causes of Pure red cell aplasia? How do you treat?
Can be primary or secondary to immune mediated disease, parvo, FeLV, or drugs (chloramphenicol, phenylbutazone, oestrogen)
Pred (if refractory consider chlorambucil or cyclosporin)
74
How do you treat Fe def anaemia?
Treat inciting cause + iron supplementation (ferrous sulphate PO or iron dextran IM)
**Ferrous sulphate may ->GIT irritation as it binds tetracycline. Iron dextran may cause hypersensitivity
75
What are some potential causes of non-traumatic haemoabdomen?
- Haemangiosarcoma (most common)
- splenic haematoma
- splenic torsion
- hepatocellualr carcinoma
- carcinomatosis
76
Where do haemangiosarcomas commonly spread to?
Liver**, omentum and right atrium
77
What is the prognosis for splenic haemangiosarcomas?
With surgery alone MST=50d. With sx and doxorubicin, MST= 267d
78
In which dogs are splenic torsions most common?
Large to giant breed dogs
79
Measurement of serum bile acids is a measure of what?
Reflects enterohepatic circulation and hepatocellular function (responsible for fat absorption)
Indicated for PSS
80
What are some causes of acute hepatopathies
Infectious
Toxins (food/ mycotoins)
Drugs (paracetemol, carprofen)
Other (GDV, DIC etc)
81
What are the treatment options for paracetemol toxicity?
Mucomyst
Ascorbic acid
Cimetidine
82
What are some indications for exploratory surgery in patients with haemoabdomen?
1. Progressive signs of shock despite resus.
2. Decrease in peripheral PCV with increasing abdominal fluid PCV
3. Peritonitis (urine bile GIT rupture)
4. Penetrating abdo trauma
5. Diaphragmatic or body wall hernia
6. Abdominal mass
7. Evidence of organ ischaemia
83
What is the Pringle manoeuvre?
Temporary occlusion of hepatic artery and portal vein used to control hepatic bleeding
84
What is the prognosis for hepatocellular carcinoma?
Good with surg (MST>1460d)
85
What is the average canine perinatal mortality?
8-26%
86
In which situations should we intervene with canine parturition?
1. Obstruction
2. Not entered labor and progesterone <2ng/mL
3. Systemically ill
4. Foetal HR <160-180 bpm
5. Suspicion of uterine rupture or torsion
87
What options are available to ensure IgG transfer to puppies and kittens if poor milk production?
1. Maternal serum via stomach tube
2. Use of colostrum from a donor dam
3. Administer OT or dopamine antagonists to dam
If more than 24hours since birth, can give maternal serum via SC injection
88
What is the most important indicator of neonatal survival?
Birth weight!!! (a kitten should weigh 80-120kg, a medium breed puppy should weigh 200-300g)
89
What is the stomach capacity of puppies and kittens? What about their daily energy req?
40ml/kg
20-26kcal/100g/day
90
What env temp should puppies and kittens be kept at?
Day 1-7: 25-30 degrees
| Day 8-28: 28-24 degrees
91
When do you expect the umbilical cord to fall off in puppies and kittens? What reflexes are these animals born with?
Day 3-4
suckling reflex
Righting reflex
Pressing reflex
Also distress vocalisation is present at birth (up to 15 mins) and flexor dominance is present until day 4
92
What are some signs of hypoxia in the neonatal puppy/ kitten?
1. reflex bradycardia
2. reduced muscle tone
3. reduced or absent respiratory effory
4. MM colour
93
What are some causes of hypoglycaemia in puppies and kittens (6)? What are some signs of it?
1. Starvation/ malnutrition
2. Maldigestion
3. Poor nursing/ agalactia
4. Transient juvenile hypoglycaemia (toy/ small breeds)
5. Sepsis
6. Hepatic dysfunction
Signs include lethargy, anorexia, crying, muscle tremors, seizures and coma
94
What predisposes neonates to fluid deficits?
high SA:V
High met rate
increased skin permeability
poor renal water conservation
95
What is feline neonatal isoerythrolysis? What are some CSs? What are some tx options?
```
Type B queen x Type A Tom-> Type A kitten fed type B colostrum with naturally occurring alloantibodies to Type A antigens.
CSs:
-stop suckling
-pigmenturia (Hb)
-pale/ icteric
-sudden death
```
Tx:
- remove from type B queen for first 16 hours
- give colostrum from type A queen
- Blood transfusion (washed cells from type B mum)
- supportive care
96
What Abs are generally used in trialling antibiotic responsive enteropathy?
Oxytet
Metronidazole
Tylosin
97
What are some techniques to reduce gross contamination/ spillage when doing GIT surgery?
1. Orogastric intubation to drain stomach content
2. Isolation with lap sponges
3. Stay sutures
4. Suction
5. Use of appropriate antimicrobials
98
What are risk factors for dehiscence following gastrointestinal surgery?
1. Pre-op peritonitis
2. Presence of a FB
3. Hypoalbuminaemia
4. Delayed enteral feeding
99
what drugs may trigger IMHA?
methimazole, trimethoprim, penicillin
100
What drugs are used to treat B canis and B. vogeli?
B.canis- imidocarb, diminazine aceturate
| B.gibsoni- atovaquone and azithromycin
101
When is extra-hepatic bile duct obstruction (eg. mucocoele) a sx emergency?
1. Free abdo fluid with bacteria or bilirubin
2. Very sick pyrexic animal (unless pancreatitis)
3. Free gas on abdo radiographs
4. Obvious mass or stone in biliary system on imaging
