JVIM 2015-2019 Flashcards
How long does fibrinogen take to increase with inflammation?
24-72hrs to peak
Which is more sensitive at indicating presence of systemic inflammation in equine GI?
SAA
How to diagnose emND
Low serum vitamin E
Changes in muscle on histopath (neurogenic atrophy) and neuronal chromatolysis of SC
LDA in beef calves
Rare!
Associated w necrotic laryngitis
Do not roll them
What breed is high risk for LDA
Hereford
What breed are high risk for RDA and abomasal volvulus
Brahman influenced breeds
Differentials for a left sided ping and splash in CALVES
LDA, abomasitis, rumen ping, peritonitis
Borrelia burgdorferi
Equine lyme dz
Ixodes ticks spread it
Shifting leg lameness, attitude change, neuro dz, skin lesions, uveitis, laminitis
Histopath dx of neuroborreliosis
multifocal, asymmetrical pleocellular leptomeningitis and encephalomyelitis with perivasculitis and sclerosing vasculitis, and cranial and peripheral ganglionitis, radiculoneuritis and neuritis.
when identified, argyrophilic spirochetes predominate in the leptomeninges and dura mater with fewer lesions affecting the parenchyma of the brain or spinal cord
the most frequent extraneural manifestation of Borrelia infection is
Uveitis!
pheochromocytoma in horses
may cause acute death from intraperitoneal exsanguination
should be considered in horses presenting with colic, tachycardia, and hemoperitoneum
Oral sugar test
quantifies postprandial hyperinsulinemia and insulin dysregulation in response to PO glucose
Combined glucose insulin test
a measure of whole body insulin resistance
determines the individual’s response to IV dextrose and insulin
Hyperinsulinemia ____ ketone body formation and lipolysis
Inhibits
In pregnant cows, glucose crosses the uterus and placenta __?
insulin-independently
by the primary glucose transporters (GLUT1 and GLUT3)
diagnostic method of choice for insulinoma in cattle
IVGTT
apolipoprotein B gene (APOB) mutation
-inherited autosomal recessive genetic defect in Holstein calves
-also named cholesterol deficiency
-unspecific clinical symptoms of diarrhea and failure to thrive in young calves
Usefulness of serial thoracic ultrasonography to detect development of CS of R. Equi in foals
Good sensitivity 89%
Poor specificity 62%
–> used as SCREENING
Cattle treated for what are 3x more likely to die from right heart failure in feed lots?
Bovine respiratory disease
High altitude disease
Right-sided congestive heart failure (RHF), also known as high altitude disease or brisket disease
initiated by hypoxia-induced pulmonary arteriolar narrowing
Cattle exposed to the hypobaric hypoxia of high altitude have a greater baseline risk of alveolar hypoxia –> at greater risk of RHF than cattle at lower altitudes.
Ventricular premature depolarizations arise from
the ventricular myocardium
–> result in AV dissociation
–>they are not associated with a preceding P wave and the normal sinus P wave often is not conducted, resulting in a compensatory pause.
Atrial dysrhythmias are caused by
abnormal impulse formation in the atrial myocardium outside of the sinoatrial node.
In APD’s, the QRS and t-wave morphology is
Normal
In APDs, the S and T wave amplitude is a)_______
and the PQ and RR interval is b)______
whereas the R amplitude and QRS duration c)_____
Increased
Decreased
Do not change
APD’s are more to likely have what kind of t-wave?
A single positive t-wave
APD’s are associated with what kind of p-waves?
Singular, not bifid
Prolonged exercise is associated with what cardiac dysfunction?
LV diastolic dysfunction
myeloperoxidase
-an enzyme
-exacerbates mitochondrial damage initiated by the ischemia-reperfusion phenomenon, and thereby alters mitochondrial function.
-marker of neutrophil activation and degranulation
-is increased after colic sx
Delphinium contains?
Alkaloids that act as nicotinic acetylcholine receptor antagonists
Delphinium tx
Acetylcholine-esterase inhibitor
TX: Neostigmine, Phyostigmine (Temporary reversal)
Which centaurea species are toxic?
Crepens = Russian knapeweed
C. Soloistitalis = yellow star thistle
Only toxic to horses!
Specific lesion of yellow star thistle
Nigropalladial encephalomalacia
The mechanism of action of the Conium alkaloids
The most serious effect occurs at the neuromuscular junction, where the alkaloids act as nondepolarizing blockers like curare.
The systemic effects generally are less severe and include nicotinic effects, such as salivation, mydriasis, and tachycardia, followed by bradycardia. This probably is a result of their action on autonomic ganglia
Toxic hemlocks
Conium maculatum (poison hemlock)
Cicuta spp (water hemlock)
Piperidine alkaloids
nACh receptor agonists
Found in hemlock
What causes mousy urine smell?
Poison hemlock
Is hemlock fatal when grazed in early spring or eaten in hay?
Late season hay- why cattle more likely to get it and die
Zigadenus
Death camas
Contains steroidal alkaloids
Most prevalent= zygacine
Which bacteria may be decreased in any treated calves?
Butyrate producing firmicutes
Clinical icterus in cattle
Serum bili > 51umol/l
BoAstV CH13/NeuroS1
Neurotropic bovine astrovirus
Non-suppurative encephalitis
Cut off for insulin dysregulation
basal insulin >32 lIU/mL2
or insulin >100 lIU/ mL 45 minutes post-CGIT
What fluid is best for the rapid resuscitation of hyperkalemic diarrheic calves
Small-volume hypertonic NaHCO3 infusions
Better than hypertonic NaCl or glucose
Hypertonic (8.4%) sodium bicarbonate solution
sound physiologic basis in the initial treatment of neonatal hyperkalemic diarrheic calves
solutions induce rapid plasma volume expansion, correct concomitant acidemia and have a marked and sustained potassium-lowering effect.
treatment advantage of sodium bicarbonate over the use of a hypertonic sodium chloride infusion with an identical sodium load, indicating that alkalinization is an effective potassium-lowering mechanism.
Acidemic neonatal diarrheic calves can release considerable amounts of insulin in response to a hyperglycemic glucose challenge, which resulted in a similar decline in cK than in calves after administration of sodium bicarb
Octreotide
Octreotide is a somatostatin analog that suppresses insulin secretion
Cutoff gg/l in colostrum
50 gg/l
Which cows produce colostrum with higher immunoglobulin content?
Older or higher parity
Does dexamethasone affect lactate?
Daily administration of dex has been shown to increase lactate
What is the main Indication for abx use in calves?
Bovine resp-dz — pneumonia
Important to get culture and sens if you can
Blind tube BAL BEST METHOD
Pleuropneumonia and survival in horses
Increased ck on admit = decreased survival chance
Thoracotomy = increased survival
Which mycoplasma has been found to be part the of respiratory microbiota and also play a role in development of BRD
M. Dispar
Immune-mediated myositis
predominantly described in Quarter horse and related breeds
characterized by rapid and diffuse symmetrical muscle atrophy predominantly of gluteal and epaxial muscles, lethargy, and stiffness.
The primary laboratory findings include increase in creatine kinase and aspartate aminotransferase activity on a serum biochemistry panel.
The main histological feature of skeletal muscle biopsies is mononuclear cell infiltration of predominantly CD4+ T-lymphocytes and myonecrosis.
Immune-mediated myositis belongs to a group of inflammatory myopathies.
High survival rate unless concurrent fever and illness.
Monitoring of renal variables is important because renal insult resulting in failure is a potential complication.
myositis can have a favorable outcome if clinical signs are recognized early and treatment with corticosteroids is initiated promptly along with supportive care and treatment of any concurrent illness including antimicrobial therapy for those horses with concurrent bacterial infection.
P. tenuis nematodiasis in horses
cervical scoliosis and analgesia were attributed to continuous dorsal gray column lesions, whereas general proprioceptive (GP) ataxia and upper motor neuron (UMN) paresis were associated with surrounding white matter involvement.
P-tenuis lesions in camelids
Spinal cord white matter
The positive predictive value of a positive test is _____ when the prevalence of disease is low, as is the case for the prevalence of EPM among neurologically normal horses.
Decreased!
Borrelia burgdorferi infection usually causes
Sub clinical or no disease in horses
30-45% seroprevalence
How can you diagnose neuroborreliosis?
Not with Lyme multiplex assay!
Post Mortem histopath
The Lyme multiplex assay
is a bead-based multiple antigen immunofluorescent assay that detects antibodies against B. burgdorferi outer surface proteins (Osps) that have variable expression.
-OspA is primarily expressed within the tick
-OspC is expressed during early infection of the mammalian host
-OspF during more chronic infection.
This assay can be performed on serum and CSF
Diseases caused by mycoplasma
mastitis, arthritis, pneumonia, otitis media, tenosynovitis, and reproductive disorders
Mycoplasma mastitis
-multiple affected quarters coupled with unresponsiveness to treatment.
-Adults and calves can also be affected by arthritis and pneumonia
-otitis media - only observed in calves
Mycoplasma culture
-specific enriched culture media needed
-buffer to ph 7.3-7-8
- colonies look like fried eggs
- limit for defection is 272 Cfu/ml in milk
Cons of mycoplasma culture from milk
- slow growing
- easily overgrown other bugs
- Intermittent shedding means you need repeat samples
When is fecal shedding of listeria highest on small farms?
Spring
What values predict negative outcome in down dairy cows?
- HR > 100
-cTnI >0.7ng/ml
-lactate not relevant
CDH applied at the onset of sepsis results in what?
Decrease in IL-6 and COX-2, and decreased lamellar leukocytes
Bovine hereditary zinc deficiency
a keratinization disorder
caused by a mutation in the SLC39A4 gene
Zinc deficiency-like syndrome
-moderate to severe crusting dermatitis mainly on the head, ventrum, and joints.
-Respiratory and digestive tract inflammations were frequently observed.
-Zinc supplementation did not lead to remission of CS in 4; slight anemia in 8; hypoalbuminemia in 6 but reduced serum zinc concentrations in only 3. Mucosal erosions/ulcerations were present in 7 calves and thymus atrophy or reduced thymic weights in 8 calves.
-Histologically, skin lesions were indistinguishable from BHZD.
-ZDL syndrome should be suspected in Fleckvieh calves with crusting dermatitis together with diarrhea
- OR - respiratory tract inflammations without response to oral zinc supplementation.
-Definite diagnosis requires molecular genetic confirmation of the PLD4 mutation.
AUTOSOMAL RECESSIVE
Best tx for hypophos
Mono- or di- sodium hydrogen phosphate
60 grams orally
multiple acyl-CoA dehydrogenase deficiency (MADD)
A definitive diagnosis of MADD is made by identifying a specific pattern of accumulation of acyl carnitines and urine organic acids caused by alberrant fatty acid and amino acid metabolism
ECG’s in hyperkalemic calves
Conclusions and Clinical Importance: Hyperkalemia in neonatal diarrheic calves is associated with serious cardiac conduction abnormalities. In addition to increased S and T wave amplitude voltages, alterations of P and Ta wave amplitudes are early signs of hyperkalemia, which is consistent with the known sensitivity of atrial myocytes to increased cK1.
S wave amplitude voltage decreased when cK1 >7.4 mmol/L
QRS duration increased when cK1 >7.8 mmol/L
J point amplitude increased when cK1 >7.9 mmol/L
ST segment angle increased when cK1 >9.1 mmol/L
P wave amplitude was characterized by a second commonbreak point at cK158.2 mmol/L, above which value the amplitude was 0.
Prognosis of cattle with necrotic laryngitis after sx
-Overall survival 65%
-Higher mortality if <6 months old
The venous partial pressure of carbon dioxide (pCO2 64.5 mmHg) was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2 were 49.1 and 86.4%, respectively. Instead of pCO2, total carbon dioxide (TCO2) could also be used, with similar diagnostic accuracy.
Lavender foal syndrome
a lethal disorder of Egyptian Arabian foals
dilute coat color and profound neurologic dysfunction
autosomal recessive inherited disorder
frameshift mutation in exon 30 of the myosin Va gene (MYO5A) that results in premature termination of transcription
Cerebellar abiotrophy
Cerebellar abiotrophy is inherited as an autosomal recessive trait and is associated with a single-nucleotide polymorphism on chromosome 2 (13074277G>A), located in the 4th exon of TOE1 and in proximity to MUTYH on the antisense strand.
-results in loss of Purkinje neurons + secondary loss of the granular cell layer of the cerebellum.
-CS recognized at birth or up to a few months of age and include ataxia, hypermetria, intention tremors, and lack of menace response.
SCID in Arabians
a 5-base pair deletion in the gene encoding the catalytic subunit of DNA-dependent protein kinase (DNA-PK) and is inherited as an autosomal recessive trait.
The lack of activity of DNA-PK leads to failure of T and B lymphocytes to cut, rearrange, and anneal genes that encode surface-expressed antigen-specific receptors. Foals with SCID lack mature functional B and T lymphocytes have profound lymphopenia (<1,000/lL) and low immunoglobulin concentrations followed by agammaglobulinemia after maternal antibodies disappear.
The frequency of the SCID gene carrier state was estimated to be 8.5% in the Arabian population
RLN is best currently described as 
A distal axonapthy with clear involvement of both RLN’s
Mononeuropathy of the left
Atypical myopathy is caused by
acquired multiple acyl-coenzyme A (CoA) dehydrogenase deficiency (MADD) resulting from ingestion of hypoglycin A (HGA).
This substance is present in the seeds and seedlings of Acer pseudoplatanus.
Hypoglycin A is metabolized to toxic methylene cyclopropyl acetyl-CoA (MCPA-CoA) that inhibits lipid, amino acid, and choline metabolism
The common laboratory findings for AM horses are
increased serum creatine kinase (CK) and aspartate aminotransferase (AST) activity, increased concentrations of acylcarnitines, glycine conjugates, and some amino acids.
E321G MYH1 mutation
Associated with immune mediated myositis in QHs
strong association between the E321G MYH1 mutation and nonER in QH-related breeds. In total, 67% of nonER QH possessed the MYH1 mutation compared to 5% of randomly selected healthy QH.
exercise was NOT a trigger for rhabdomyolysis in horses with the MYH1 mutation
Rate of AF recurrence in horses
39% at 1 year after cardioversion
How did sotalol affect TVEC procedure?
Significantly less energy was required for electrical cardioversion in the sotalol group
The increased AFCL after sotalol treatment indicates slowing of the atrial activation rate.
Sotalol
Class Ill anti-arrhythmic and b-blocker
Commercially available viscoelastic tests
dynamic viscoelastic coagulometry (Sonoclot), thromboelastometry (TEM), and thromboelastography (TEG)
These tests are similar and provide a holistic view of the time to clot formation, the strength of the clot formed, clot retraction, and clot lysis, using whole blood samples.
Oxygen saturation of hemoglobin (SaO2)
is the ratio of fully oxygenated hemoglobin to the total hemoglobin in the blood capable of binding oxygen, measured via oximetry or calculated from partial pressure of oxygen (pO2).
The 4 principle determinants of venous oxygen saturation values are
arterial oxygen saturation
hemoglobin concentration
cardiac output
tissue oxygen consumption
In healthy (or at least clinically stable) animals the SvO2 and ScvO2 are consistently in the range of 70–75% and 65-70%, respectively.
Low values, representing increased oxygen extraction, occur when oxygen delivery is insufficient to meet metabolic demand. Pathological impairment of oxygen delivery can be due to lung disease with impaired oxygenation of blood (resulting in reduced arterial hemoglobin saturation), low hemoglobin concentration (resulting in low arterial oxygen carrying capacity), impaired circulation (due to decreased effective circulating volume and other causes of reduced cardiac output), or any combination of these. Therefore, animals with unexplained low ScvO2 or SvO2 values should be evaluated for the presence of pulmonary disease, anemia and states of reduced cardiac output, including hypovolemia, cardiac disease or arrhythmias. Because ScvO2 orSvO2 may also be reduced by any cause of high tissue oxygen consumption relative to delivery, conditions such as shivering or muscle tremors should be controlled before assuming that low saturations are due solely to pathological imbalance.
Esmolol
a short acting b1-blocker that has been studied in both clinical and experimental studies of patients with sepsis
A useful classification system for cows with clinical mastitis utilizes 3 categories
(1) abnormal secretion (visible abnormalities in milk)
(2) abnormal secretion and gland (clinical evidence of udder inflammation, including the presence of heat, redness, swelling, pain, and decreased milk production)
(3) abnormal secretion, gland, and cow (clinical evidence of systemic illness, including fever, decreased appetite, and rumen fill). Subclinical mastitis is not detectable during routine physical examination but is identified by detecting the presence of inflammatory biomarkers or mastitis pathogens in glandular secretions when an intramammary infection is present
Traditional contagious mastitis pathogens
S. agalactiae and S. aureus,
a contagious mastitis pathogen most commonly associated with subclinical infection of long duration,
Corynebacterium Bovis
bladder neoplasia vs. hemorrhagic cystitis syndrome
had lower hematocrits, were older, more likely to be female, and more likely to have a mass detected on ultrasonographic examination of the bladder than horses with hemorrhagic cystitis syndrome
Idiopathic hemorrhagic cystitis
a newly described cause of hematuria and stranguria in horses, associated with the presence of proliferative, hemorrhagic bladder mucosa on cystoscopy.
Affected horses should be reevaluated in 2–4 weeks, because they have an excellent prognosis.
chronic enzootic hematuria
is associated with bracken fern toxicity, which can progress to bladder neoplasia. Infection with bovine papilloma virus-2 may play a role in progression to bladder cancer in affected cattle
recognized risk factor for obstructive urolithiasis
Early castrations especially in goats vs sheep
High grain diet
Obesity
the most common clinical signs observed in small ruminants with obstructive urolithiasis
anorexia, colic, teeth grinding, increased heart rate, and abnormal to absent micturition. The latter sign is often regarded as most specific of urolithiasis, with attempts at urination often accompanied by colic, straining, and further expressions of pain.
In our study, signs of pain were recorded only in 50% of all animals. In contrast, colic was reported by the referring veterinarians or owners in 58.1% of the cases.
Clinical signs of blocked ruminants- stages
Clinical signs can be divided into:
-early stage: discrete unspecific clinical signs
-painful stage: frequent straining, expression of pain and moderately reduced general condition
-advanced stage: markedly reduced general condition
-eventually recumbency
Variables associates with non-survival of obstructive urolithiasis
very poor clinical condition upon presentation, obesity, castration, and evidence of uroperitoneum.
abnormal PCV, severely increased serum creatinine concentrations, and increased CK were associated with increased risk of nonsurvival.
Presence of signs of colic or macroscopic appearance of urine was not significantly associated with outcome.
Oak toxicity in cattle
Acute kidney injury (AKI) secondary to ingestion of oak leaves, buds, and acorns (Quercus spp.) has been described in cattle worldwide.
Hydrolyzable tannins are metabolized by rumen microbes to form pyrogallol, which is hepato-and nephrotoxic.
With the development of AKI, the mortality rate can be as high as 83%.
Conventional management of AKI includes fluid therapy to correct dehydration and restore renal perfusion, correction of electrolyte and acid–base abnormalities, and supportive care to address the poor rumen motility and gastroenteritis associated with uremia.
When is hemodialysis indicated for acute kidney injury?
in the face of anuria, failure of conventional therapy to induce diuresis and control uremia, fluid overload, severe electrolyte derangements, severe azotemia, or complications of severe uremia
