Hip Dysplasia: Definition
abnormal development of coxofemoral joint => laxity => remodeling => degeneration
Hip Dysplasia: Signs
exercise intolerance, bunny hopping, stiff, forward wt shift
Hip Dysplasia: Stance
Wide - compensatory
Narrow - degeneration
Hip Dysplasia: Dx
Rads (OHA, PennHip) ortolani test
What is Coxa Valga?
adaptive response to abnormal stress
Hip Dysplasia: Tx
supportive (wt management, NSAIDs), TPO, FHO, THR
Coxofemoral Luxation: Dislocation Positions
Caudovental - leg is abducted and flexed, stifle rotated inward
Craniodorsal - relaxed extension
Coxofemoral Luxation: Caudoventral Tx
reduce, hobble 10-14d
Coxofemoral Luxation: Craniodorsal Tx
reduce, ehmer sling 4-14d
Legg-Perthes Dz: Pathophysiology
ischemia to femoral head =>necrosis
Legg-Perthes Dz: Dx
Early: radiopacity of lat. femoral head, focal bone lysis
Later - flat, mottling of femoral head, thick femoral neck
Legg-Perthes Dz: Tx
FHO
Cranial Cruciate Ligament Tear: Signs
effusion, atrophy, crepitus
CCL Tear: Dx
(+) drawer sign, tibial thrust
CCL Tear: Tx
Extracapsular - lateral suture, tight rope
Tibial Plateau Leveling Osteotomy, Tibial Tuberosity Advancement
Meniscal Tears: Types
bucket handle (intrameniscal)
Meniscal Tear: Tx
partial meniscectomy
Patellar Luxation: Pathogenesis Poss.
medial malalignment of quadriceps => medial displacement of tibial tuberosity, shallow trochlear groove
Patellar Luxation: Grades
I - can be luxated but pops back in (in-in)
II - luxates but can be reduced (in-out)
III - luxated most of the time, can be reduced (out-in)
IV - fixed luxation (out-out)
Patellar Luxation: Dx
PE, rads
Patellar Luxation: Tx
mild - monitor for progression
Mod/severe - bone/soft tissue reconstruction,
Carpus/Tarsus: Hyperextension - Locations
antebrachiocarpal, middle carpal, carpometacarpal, combo
Carpus/Tarsus: Hyperextension - Tx
pancarpal arthrodesis
Carpal Laxity Syndrome: Tx
self correcting
Common Calcanean Tendon Rupture: Tx
3 loop pulley/ locking loop pattern, immobilize joint w/ no tension on tendon
Ovarian Dzs: Examples
cyst, noeoplasia, ovarian remnant syndrome
Ovarian Cyst: Types
nonfunctional (incidental)
functional
Ovarian Cyst: Signs
dependant on hormone produced, prolonged stage of estrus
Ovarian Cyst: Tx
sx - removal
Ovarian Neoplasia: Origins
Epithelial, Stromal, Germ Cell
Ovarian Remnant Syndrome: Etiology
sx error
Ovarian Remnant Syndrome: Signs
recurrence of estrus cycle despite spay
Ovarian Remnant Syndrome: Dx
vaginal cytology, hormone assays
Ovarian Remnant Syndrome: Tx
sx
Pyometra: Signs
recent cycle, PU/PD, septic, fever, abdominal pain, poss. discharge
Pyometra: Dx
CBC (sepsis), DI
Pyometra: Tx
stabalize -> OHE
Metritis: Etiology
dystocia, obstetric manipulation, retained fetus/placenta, devitalized uterine tissue
Metritis: Signs
systemic illness
Metritis: Dx
CBC (sepsis), DI
Metritis: Tx
supportive, antibiotics, sx
Cystic Endometrial Hyperplasia: Signs
muco-/hydro-/hematometra, asymptomatic - or- systemic
Cystic Endometrial Hyperplasia: Dx
U/S
Cystic Endometial Hyperplasia: Tx
OHE if hematometra, supportive
Uterine Torsion: Signs
Acute abdomen, shock
Uterine Torsion: Tx
OHE
Uterine Rupture: Signs
min. -or- septic peritonitis (if pyometra)
Uterine Rupture: Tx
OHE
Uterine Prolapse: Tx
manual reduction, OHE
Labor: Order of Signs
Temp drop ->
Stage 1 - restless, nesting ->
Stage 2 - fetal expulsion ->
Stage 3 - placental expulsion -> involution
Dystocia: Dx
prolonged gestation (>68d), toxemia during gestation, stage 1 lasting >24hrs, no puppies >36h post temp drop, stage 2 > 30min, >4hr between puppies
Dystocia: Tx
uterine stim (oxytocin), C-section, en-bloc OHE
Canine Mammary Tumor: Dx
cytology, biopsy
Canine Mammary Tumor: Sx Techniques
lumpectomy, simple mastectomy, regional mastectomy, Chain Mastectomy
Lumpectomy: Procedure
remove solitary mass
Simple Mastectomy: Procedure
removal of a single mammary gland
Regional Mastectomy: Procedure
removal of glands 1-3/3-5
Chain Mastectomy: Procedure
removal of entire chain
T/F: The later you spay, the more likely the chance of Mammary Tumor.
True
Canine Mammary Hyperplasia: Appearance
multiple small masses after heat
Inflammatory Carcinoma: Appearance
rapid progression, highly metastatic
Inflammatory Carcinoma: Tx
terminal, not sx
Feline Mammary Tumor: Tx
aggressive chain mastectomy on affected side
Fibroadenomatous Hyperplasia: Appearance
benign, progesterone dependant, looks like 6pack
Fibroadenomatous Hyperplasia: Tx
OVE
Vagina: Sx Approaches
epsiotomy, ventral approach, transpelvic
Vestibulovaginal Stenosis: Pathogenesis
retained embryonic epithelial tissue -or- hypoplastic
Vestibulovaginal Stenosis: Signs
recurrent vaginites +/ UTI, incontinence
Vestibulovaginal Stenosis: Dx
contrast DI, vaginoscopy, digital exam
Vestibulovaginal Stenosis: Tx
catheterize urethra (to protect), sx
Recessed Vulva (“hooded vulva”): Signs
skin fold dermatitis, vaginitis, urine pooling
Recessed Vulva: Tx
vulvoplasty
Vaginal Edema/hyperplasia: Appearance
edematous mucoas protrudes from vulva
Vaginal Edema/hyperplasia: Tx
self limiting, OHE, resection of affected tissue
Cryptorchid: Locations
abdominal, inguinal, prescrotal
Cryptorchidism: Cx Order
remove abnormal testicle first
Testicular Torsion: Signs
anorexia, lethargy -or- pain, shock
Testicular Torsion: Tx
sx
Testicular Neoplasia: Types and Dz
Sertoli cells - feminism syndrome
interstitial cell - testosterone
Hypospadias: Definition
incomplete formation of penile urethra
Hypospadias: Signs
urine scalding
Hypospadias: Tx
urethrostomy proximal to abnormality
Paraphimosis: Definition
inability to retract penis into prepuce
Paraphimosis: Etiologies
congenital, trauma, infection, priapism
Paraphimosis: Tx
manual retraction, phallopexy
Benign Prostatic Hyperplasia: Digital Exam
symmetrically enlarged, pain free prostate
Benign Prostatic Hyperplasia: Tx
cx
T/F: Prostatic Abscess/Prostatitis doesn’t require pre-existing BPH to develop.
false.
BPH is required for development
Protatitis: Signs
dyschezia, painful urination/defication, purulent discharge
Prostatitis: Digital Exam
symmetrical, painful
Prostatitis: Tx
mild - antibiotics, fluids, cx
Severe - antibiotics, omentaliztion, cx
Prostatic Cyst: U/S
“double bladder”
Prostatic Cyst: Tx
ressection and omentalization, cx
T/F: Cx dec. risk of Prostatic Neoplasia.
False.
cx isn’t protective against prostatic neoplasia
Prostatic Neoplasia: Signs
dysuris, hematuria, dyschezia
Prostatic Neoplasia: Tx
nothing effective
What tumors is cytology useful for diagnosing?
mast cell tumor, melanoma, lymphoma
What’s the difference between Incisional and Excisional biopsy?
incisional - remove piece of tumor
excisional - remove entire tumor + margins
Neoplasia: Excision Classification
marginal - remove just mass
wide - remove extra 2-3 cm
radical - remove entire compartment (amputation)
When should lymph nodes be aspirated?
prior to sx
Pertonitis: Pathophysiology
inflammation -> vasodilation -> hypovolemia -> coagulopatihies
Peritonitis: Classification
primary vs secondayr
aseptic vs septic
focal vs generalized
Primary Peritonitis: Example
FIP
Aseptic Secondary Peritonitis: Examples
chemical, bile, pancreatitis, uroperitoneum
Peritonitis: Dx
CDC/chem, blood gas, coag panel, DI, abdominocentesis
Peritonitis: Tx
stabalize -> exploratory +lavage
fluids (colloids), antibiotics, analgesia, nutrition, post-op monitor
Gastric Foreign Body: Signs
vomit, lethargy, pain
Gastric Foreign Body: Dx
rads, U/S, endoscopy
Gastric Foreign Body: Tx
stabalize -> removal (endoscopy, sx, emesis)
Pyloric Stenosis: Pathophysiology
congenital hypertrophy of pyloric muscle
Pyloric Stenosis: Signs
intermittent vomiting, thin, abdominal distension
Pyloric Stenosis: Dx
contrast rads, endoscopy, U/S
Pyloric Stenosis: Tx
sx
Chronic Hypertrophic Pyloric Gastropathy: Classification
Grade 1 - muscular hypertrophy
Grade 2 - msucular and mucosal hyperplasia
Grade 3 - mucosal hyperplasia + muscular and submucosal inflammation
CHPG: Dx
contrast rads, U/S, endoscopy
CHPG: Tx
Y-U pyloroplasty, pylorectomy
Pylorectomy: Billroth I Procedure
excise pyloris, attach duodenum to gastric incision
Pylorectomy: Billroth II Procedure
excise pyloris, attach jejunum to side of stomach => duodenum to become a blind sac
Pythiosis: Signs
wt. loss, v/d, hematochezia
Pythiosis: Dx
histo, elisa
Pythiosis: Tx
sx excision, itraconazole
GDV: Pathophysiology
bloat and rotation of stomach so that the pyloris is over (clockwise)/ under (counter-clockwise) the esophagus
GDV: Cario Effects
low pressure vein compression, poor venous return, hypotension, hypoxemia, reperfusion injury
GDV: Respiratory Effects
dec. ventilation => inc. CO2 => respiratory acidosis
GDV: Signs
looking/biting at abdomen, praying posture, retching, distended abdomen
GDV: Dx
lat rads
GDV: Tx
stabalize (fluids (crystaloid + colloid), gastric decompression) -> sx (derotate and excise devitalized tissue)
GDV: Sx Preventatives
gastropexy
Intestinal Foreign Body: Pathophysiology
oral gas + fluid accumulation and distension, wall ischemia
Intestinal Foreign Body: Signs
v/d, anorexia, depression, pain
Intestinal Foreign Body: Dx
rads +/- contrast
Intestinal Foreign Body: Tx
removal - enterotomy/ resection and anastomosis
Intestinal Viabilty: Evaluation
paristalsis pinch, color, perfusion (fluorescein infusion)
What is the layer of strength in the Intestine?
submucosa
Intestinal Sx: Suture Patterns
simple continuous/interupted, modified gambee
Linear Foreign Bodies: Sx
multiple enterotomies, cathetherize foreign body
Intestinal Sx: Complications
sepsis, adhesions, dehiscence, ileus, short bowel syndrome
How much intestine must be missing for Short Bowel Syndrome to become apparent?
> 70%
Intussuseption: Etiologies
parasites, virus, foreign body, neoplasia
Intussuseption: Dx
rads, U/S
Intussuseption: Tx
manual reduction -or- resection and anastomosis
Mesenteric Tosion: Signs
abdominal distension, hematochezia, shock
Mesenteric Torsion: Dx
rads
Mesenteric Torsion: Tx
fluids, sx
Cecal Inversion: Signs
diarrhea, hematochezia, tenesmus, wt. loss
Cecal Inversion: Dx
contrast rads
Cecal Inversion: Tx
manual reduction -or- colotomy, typhylectomy
Megacolon: Signs
mass on palpation, depression, anorexia, dehydration, vomit
Megacolon: Dx
rads
Megacolon: Tx
correct dehydration, inc. fiber, stool softeners, laxatives, prokinetics -or- subtotal coletomy
Anal Prolapse: Tx
manual reduction w/ purse string if viable -or- resection
Why should enemas not be given sooner than 12hrs prior to sx?
the inc. fluid inc. risk of leakage
Rectum: Sx Approaches
transanal, dorsal, rectal pull through, lateral, ventral
Anal Sac Dz: Signs
swollen, poss. fever, painful, discharge
Anal Sac Dz: Tx
express, irrigate, treat underlying dz, anal acculectomy
Perianal Fistula: Signs
tenesmus, dyschezia, licking, discharge, pain
Perianal Fistual: Tx
clean, antibiotic, immunosuppression, sx
Splenic Hemangiosarcoma: Signs
non-specific abdominal signs
Splenic Hemangiosarcoma: Dx
CBC/chem, coag, rads, U/S
Splenic Hemangiosarcoma: Tx
complete splenectomy, chemo
Splenic Torsion: Signs
Acute - pain, shock, DIC
Chronic - malaise, intermittent acute signs
Splenic Torsion: Dx
U/S
Splenic Torsion: Tx
fluids, antibiotics, splenectomy (don’t untorse)
Pancreas: Biopsy Techniques
guillotine, lobar dissection, pinch biopsy
Pancreatic Pseudocysts: Dx
U/S (hyperechoic mass), cytology
Pancreatic Pseudocysts: Tx
U/S guided drainage, resection + omentalization
Pancreatic Abscess: Etiology
sequela to pancreatitis
Pancreatic Abscess: Dx
U/S, cytology
Pancreatic Abscess: Tx
emergency sx (debride and omentalize)
Biliary Mucoceles: Dx
U/S
Biliary Mucoceles: Tx
cholecystectomy
Cholecystoduodenostomy: Sx Procedure
attach gal bladder directly to duodenum
Portosystemic Shunt: Classification
extrahepatic vs intrahepatic
congenital vs acquired
PSS: Signs
failure to thrive, wt. loss, intolerance to anesthesia
PSS: Lab
microcytic anemia, neutorphilia, dec. BUN, inc. bile acids + ammonia
PSS: Dx
UA, DI (microhepatica), portagraphy, U/S
PSS: Tx
Until Sx - lactulose dec. protein, antibiotics
Sx - occlude w/o causing hypertension, ameroid constrictor/ cellophane banding