Lit Infectious Flashcards
1
Q
a) What are the most common causal species of Bartonellosis in dogs in the USA, and the associated vector?
b) What are the clinical manifestations associated with canine bartonellosis?
c) What was the reported Bartonella spp. seroreactivity for dogs in the USA, and associated risk factors?
A
Lashnits JVIM 2021
a) Bartonella vinsonii subsp. berkhoffii (Bvb), Bartonella henselae (Bh), Bartonella koehlerae (Bk). NB all spp are pathogenic. No definitive vector identified yet, potentially arthropods (fleas & ticks).
b) Hemotropic & endotheliotropic G- bacteria. Vasoproliferative diseases – e.g. vasculitis, myocarditis, endocarditis, polyarthritis, granulomatous disease (lymphadenitis, rhinitis, hepatitis), epistaxis, neuro signs
c) 6.1%. Risk factors – mixed breeds (vs toy breeds), dogs 1-5.5yo (vs <1yo), dogs in West South Central & South Atlantic.
2
Q
(2 papers)
What was the seroprevalence of L. infantum in dogs residing in the US and Canada, and the major risk factor for seropositivity?
What about seroprevalence in the US military dog population?
A
Gin JVIM 2021
6.4% seropositivity – of which 8% foxhounds, 92% non-foxhound breeds.
Risk factor – travel to LI-endemic countries (87% seropositive dogs had travel). *NB zoonotic.
Seal JAVMA 2021
14.3% military dogs seropositive, of which 37.5% were privately owned & 5.6% government dogs. 81% of positive dogs had hx of travel to endemic areas. 6.5% of asymptomatic dogs were seropositive.
3
Q
What was the utility of serum cardiac troponin-I (cTnI) concentration to differentiate dogs with infective endocarditis (IE) from non-IE dogs? Answer should include test cut-off with relevant specificity & sensitivity.
A
Kilkenny JVIM 2021
Serum cTnI is higher in IE dogs vs dogs with preclinical MMVD or IMD (immune mediated dz). Cut-off of >0.625 ng/mL had 100% spec, 52% sens so positive cTnI supports IE. Also neg correlated with survival time in IE dogs.
4
Q
a) What were the most common clin path findings in canine schistomoniasis?
b) What are the treatment(s) for schistomoniasis & reported outcome?
A
Graham JVIM 2021
a) Hyperglob, high eosinophil count (>500/uL), increased liver enzymes (NB hyperCa uncommon). US evidence of visceral mineralization (intestines, liver, mesenteric LN).
b) Combo tx with praziquantel & fenbendazole. Variably effective, 73.5% survived to 6mths post diagnosis, HA-associated death in 17.6% of treated dogs.
5
Q
1) What cytologic finding is diagnostic for acute cytauxzoonosis?
2) Which sample had the highest detection rate of this cytologic finding?
3) Which sample had the highest cytologic agreement for diagnosis of acute CTX between novices & experts?
A
Sleznikow JVIM 2021
1) ID of schizont-laden macrophages.
2) Spleen FNA (77%) > LN FNA (56%) > blood film (33%).
3) Splenic FNA (sens 77.1%, spec 94.4%). VS LN FNA (sens 52.8%, spec 96.4%), blood film (sens 41.7%, spec 96.9%).
6
Q
1) What cytologic finding is diagnostic for acute cytauxzoonosis?
2) Which sample had the highest detection rate of this cytologic finding?
3) Which sample had the highest cytologic agreement for diagnosis of acute CTX between novices & experts?
A
Sleznikow JVIM 2021
1) ID of schizont-laden macrophages.
2) Spleen FNA (77%) > LN FNA (56%) > blood film (33%).
3) Splenic FNA (sens 77.1%, spec 94.4%). VS LN FNA (sens 52.8%, spec 96.4%), blood film (sens 41.7%, spec 96.9%).
7
Q
a) In cats inoculated with C felis oocysts, what timeframe post inoculation (PI) did oocyst shedding occur?
b) What was the diagnostic utility of faecal flotation compared to PCR?
c) What clinical manifestations were observed?
A
Scorza JVIM 2021
a) Oocyst shedding occurred by D10 PI, not detected by D15 PI.
b) Faecal float had some false negatives cf ITS1 PCR.
c) No clinical signs observed in this study.
8
Q
a) What is the gold standard test for diagnosis of coccidioidomycosis in dogs?
b) What was the % agreement between the point-of-care (POC) lateral flow assay (LFA) and this test?
A
Reagan JVIM 2021
a) Agar gel immunodiffusion [AGID] antibody assay
b) LFA assay demonstrated agreement with AGID in 32/36 (88%) Ab+ samples & 100% (12/12) Ab- samples.
–> LFA provides excellent predictive value for +ve results - but lower +ve agreement when low AGID titers - recommend confirmatory testing if LFA neg but high index of suspicion exists.
9
Q
a) Which clinicopathologic findings were negative prognostic factors in dogs with blastomycosis?
b) What was the overall survival rate to discharge and at 6 months post-diagnosis in dogs with blasto?
A
Motschenbacher JVIM 2021
a) BACU (Blastomyces Ag concentration in urine) >5ng/mL and/or severe RLS (radiographic lung severity scores; 3-4) had poorer survival (FU to 1 year).
b) Survival to discharge 87%; survival to 6 months 69%. (1 week, 85%; 2 months, 74%)
10
Q
What was the utility of anti-inflammatories in dogs with pulmonary blastomycosis?
A
Walton JVECC 2017
Use of anti‐inflammatories (NSAIDs and/or steroids) did not impact 30‐day survival.
BUT need for O2 supplementation was associated with significantly lower survival.
11
Q
Which markers of endothelial activation were useful in a) discriminating leptospirosis as a cause of AKI in dogs; predicting b) prognosis of lepto dogs, and c) development of pulmonary hemorrhagic syndrome (LPHS)?
A
Sonderegger JVIM 2021
a) Soluble intercellular adhesion molecule (sICAM-1), VEGF, and Ang-2 concentrations DID NOT discriminate lepto from non-lepto AKI.
b) In lepto dogs, VEGF and sICAM-1 were higher in non-survivors vs survivors – therefore predict outcome.
c) sICAM-1 predicted the development of LPHS.
12
Q
Intracranial coccidioidomycosis in dogs
* Most common clinical presentation
* 2 main MRI lesions
* Prognosis
A
Kelley JVIM 2021
Generalized tonic-clonic seizures were the most common CSx (55.6%).
2 MRI lesion categories: 1) granulomatous form with >/= 1 distinct, intra-axial, contrast-enhancing foci (37/45), 2) diffuse, bilateral, symmetrical lesions of caudate nuclei & frontal lobes (8/45).
Serum IgG titers ranged from 1:1 to ≥1:256.
All tx dogs with FU serology (34/45) had a reduction in titer. (82%) were alive ≥1yr after diagnosis; 13 of these dogs had FU times ≥2yrs.
Reported prognosis for intracranial Coccidioides infection is generally more favorable with medical tx cf earlier reports.
13
Q
- Which 2 biochemical parameters were significantly different in dogs with Neospora meningoencephalitis compared to non-infectious aetiologies?
- For each biochemical parameter stated above, what were the cut-offs established to differentiate between the above 2 populations, and the respective test sensitivity, specificity, and negative predictive value?
A
Jones JVIM 2021
1. CK & AST - significantly increased in Neospora dogs.
2. CK cut-off of 485U/L = 95.24% sens, 96.61% spec, NPV >99%.
AST cut-off of 57U/L = 94.44% sens, 85.71% spec, NPV 99%.
14
Q
In dogs with leptospirosis, ….. was common despite treatment with recommended antimicrobials, and may lead to …… following AKI. …..% dogs had a positive lepto urine PCR beyond the first 7-10 days.
A
Hetrick JVIM 2021
Persistent leptospiuria, chronic kidney disease, ~50-53% (17/32 dogs)
15
Q
When low dose praziquantel & fenbendazole was used to treat asymptomatic schistosomiasis in a population of dogs:
a) Which 2 diagnostic tests were used to evaluate for organism shedding?
b) What % of dogs achieved a negative result by D60 using each test?
A
Cridge JVIM 2021
a) Faecal saline sedimentation & faecal PCR
b) 100% dogs FSS neg; 66% FPCR neg
16
Q
1) Define caval syndrome.
2) Risk factors for retrograde migration of HW into RA?
3) In the study, high worm burden occurred in ….% dogs; however prevalence of dogs with intracardiac HW & caval syndrome was only…..%.
Majority of dogs with IC HW were ……… (…%) and had a high likelihood of ……. (…%).
Common clinical findings included …. and ……
Common clin path findings in dogs with high worm burden included ……(list 3)
A
Romano JVIM 2020
1) Caval syndrome (CS) = dirofilarial hemoglobinuria. HW within the RA obstruct blood flow & result in RBC lysis –> hemoglobinuria. Can also be caused by intracardiac HW.
2) High PA pressures, reduced CO, large HW burden, simultaneous or delayed maturation of worms, administration of preventative or adulticide therapy.
3) 81%; 25%
Small breeds, 75% (esp Chihuahuas), pulmonary hypertension (93%).
Lethargy, pigmenturia (43%).
Anemia (36%), pigmenturia (52%), bilirubinuria (78%).
17
Q
(2 papers)
Feline mycobacteriosis:
- Most common CT findings?
- 2 most common isolates in cats with non-tuberculous mycobacteriosis (NTM) in Northern California?
- Distinguishing features between M. avium & rapid growing mycobacteria (RGM) infections in cats?
A
Major JFMS 2016
M. microti & M. bovis most common isolates in this study.
CT findings widely variable. Most commonly thoracic pathology - usually a mix of >1: bronchial, alveolar, ground glass or structured interstitial lung patterns (usually mixed). Tracheobronchial, sternal and cranial mediastinal lymphadenomegaly common (80%).
*Others - abdominal or peripheral lymphadenomegaly, hepatosplenomegaly, mixed osteolytic/osteoproliferative skeletal lesions, cutaneous/SQ masses/nodules.
*
Munro JVIM 2020
M smegmatis & M fortuitum
M. avium infections - more likely than RGM infections to be disseminated.
RGM cats - disease of the skin/subcutis (100%) & outdoor access (93%) = primary features
Abx profile – resistance to FQs & aminoglycosides common among M avium isolates; high prevalence of resistance to 3rd & 4th gen cephalosporins noted in RGM spp.
Death/euthanasia noted in M avium cats (not RGM). ~30% RGM cats went into remission.
18
Q
Pneumocystis facts (select one per statement for a-c):
a) Intra/extracellular
b) Bacteria/fungal/ protozoal/viral
c) Commensals/pathogens
d) Location?
e) Causes in dogs?
f) Predisposed breeds & associated gene mutation?
A
Merill JVIM 2020
a) Extracellular
b) Fungal (yeast-like)
c) Commensals (low #s)
d) In pulmonary alveoli
e) Inherited immunodeficiencies, distemper, TKI administration, CD40L gene mutation (case report in Shih Tzu).
f) CKCS, Mini Dachshunds.
CD40L deficiency –> impairs T-cell costimulation, leads to combined cellular (T-cell) & humoral (B-cell) immunodeficiency.
19
Q
What is the treatment for feline cytauxzoonosis?
What genetic mutations were documented in a cat with C. felis infection resistant to the treatment(s) listed above?
A
Hartley JVIM 2020
Atovaquone & azithromycin
M128 cytochrome b mutations (isoleucine = M128I & valine = M128V) NB same mutation as B. gibsoni in dogs
Resistance occurs even with higher atovaquone dosing.
20
Q
Bartonella:
- Gram positive or negative?
- Which vectors?
- Predilection sites (name 2)
Baronella rochalimae
- Reported clinical manifestations?
A
Ernst JVIM 2020
G-
C. felis (fleas)
RBCs (intraerythrocytic), endothelium
Infective endocarditis (most often)
Seizures
Abx-responsive arthropathy
21
Q
What was the main limitation affecting diagnostic performance of the in-house Histoplasma antigen enzyme immunoassay (IM EIA) compared to the MiraVista enzyme immunoassay (MV EIA) to diagnose histoplasmosis in dogs?
(Note similar paper in cats - Rothenburg JVIM 2018)
A
Clark JVIM 2020
IM EIA has modest (poorer) diagnostic sensitivity of 70% - false negatives for dogs with histoplasmosis localized to the GIT). MV EIA has much higher sensitivity of 95% (tested positive in the false negs on IM EIA).
22
Q
(2 papers)
What is GS-441524 and its reported efficacy?
Key treatment considerations with neuro/ocular FIP compared to non-neuro FIP?
A
Dickinson JVIM 2020
Adenosine nucleoside analogue; halts viral replication.
May require higher doses for CNS/ocular involvement (>/= 10mg/kg).
Pederson JFMS 2019 (did not include neuro & ocular FIP)
Overall safe & effective tx. After a 12-week course, 18/26 cats healthy after 1 round of treatment. 8/26 cats relapsed with 3-84d (2 with neuro signs); of which 5 had success after 2nd tx at higher dose.
Optimum dose reported = 4mg/kg SQ q24hr for min12wks
23
Q
What was the efficacy of GC376 (3C-like protease inhibitor) in treating FIP? What adverse effects were noted?
A
Pedersen JFMS 2018
Required min 12 weeks treament. 13/19 cats had relapse of which 8 cats had severe neuro signs & 5 cats abdominal lesions.
SE: transient stinging upon injection, occasional foci of SQ fibrosis & hair loss. Retarded development & abnormal eruption of permanent teeth in cats treated <16–18 wks old.
24
Q
Describe the following for pythiosis insidosum infections in dogs in the US:
1. Geographical distribution
2. Any temporal/seasonal association
3. Which diagnostic tests?
4. Clinical presentation?
A
Nguyen JAVMA 2021
1. Most confirmed cases in SE USA (few in the West coast).
2. Mostly Sept-Feb (Autumn & Winter)
3. Serology (IgG) + 1 of the following: positive C&S (2% Sabrouraud dextrose agar), histo, PCR, or wet mount cytology (with KOH).
4. Granulomatous lesions, non-healing skin lesions/draining tracts
25
Ocular lesions are observed in .....% of cats with blastomycosis, with ....% cats presenting with unilateral involvement.
Ocular lesions present as ...... and/or ........ For each presentation, the most common findings included......
Morris JAVMA 2021
60%, 21% unilateral
Neuro-ophthalmic abnormalities (47%) - negative menace or tracking response, negative PLR.
Inflammatory lesions (53%) - anterior uveitis, active chorioretinitis, retinal detachment.
26
What infectious disease should be screened for in cats prior to receiving a renal transplant? How does seropositive status of this infection affect post-transplant outcome?
Ludwig JAVMA 2021
Toxoplasma gondii serology.
Cats are maintained on lifelong immunosuppressive tx with cyclosporine + prednisolone.
Lack of prophylactic tx in seropositive cats resulted in morbidity & death due to immunosuppression & recrudescence of infection.
Seropositive cats can be acceptable candidates for renal transplantation if lifelong prophylactic tx for toxo is provided (clindamycin or TMPS).
27
1. What is the causal organism for tularemia in dogs?
2. Risk factors?
3. Common clinical signs?
4. What is the main test used to diagnose infection in most dogs? Limitations of this test?
5. Survival outcome in hospitalised dogs?
6. Treatment?
Kwit JAVMA 2020
1. Francisella tularensis (G- coccobacillus).
2. Wild rodent/rabbit exposure.
3. Non-specific - lethargy, pyrexia, anorexia, lymphadenopathy.
4. Paired serologic titres.
Impt not to rely on a single titre as 1) acute serologic test results was negative in 95% cases, and 2) single high titre does not indicate active disease for dogs repeatedly exposed to bacteria in endemic areas.
Diagnosis based on >=4-fold increase in convalescent vs acute titres.
5. 100% survived to discharge.
6. Abx (gentamicin, doxy, enro, chloramphenicol), supportive care. Infection can be self-limiting.
28
What were key differences that may help distinguish between dogs with OSA vs Coccidioides osteomyelitis (C-OM) in terms of:
1. Signalment
2. Clinical presentation (lesion location)
3. Imaging findings
4. Prognosis for dogs with C-OM?
Shaver JAVMA 2020
1. C-OM dogs - younger, smaller
2. C-OM - axial lesions & non-adjacent polyostoci disease more common.
3. Radiographic findings significantly overlap!
4. Px fair to good - typically rapid clinical improvement after fluconazole tx started, but require long-term antifungal tx.
29
What were the health benefits when UV germicidal irradiation of the air was applied in a multi-kitten environment?
Jaynes JAVMA 2020
Significantly reduced incidence of URT infections in kittens (by 87.1%) - likely role in preventing airborne transmission of feline resp pathogens.
Potentially useful as adjunct to standard infection prevention & control protocols.
30
What was a distinct syndrome identified in the renal biopsies of PLN dogs that were Borrelia C6 antigen positive vs seronegative?
Borys JVIM 2019
Rapidly progressive membranoproliferative glomerulonephritis.
31
What breed was most commonly identified in Borrelia C6+ve PLN dogs?
What were common bloodwork & urine abnormalities in these dogs?
Borys JVIM 2019
Retrievers/retriever mixes.
- Thrombocytopenia, anemia, neutrophilia
- Azotemia & hyperphosphatemia.
- Hematuria, glucosuria & pyuria despite negative urine culture.
No difference in polyarthritis (vs non-Lyme PLN dogs).
*NB: Lyme arthritis responds rapidly to doxycycline but NOT lyme nephritis - doxycycline for 2-3 months has no guaranteed improvement; require immunosuppressive tx.*
32
What was the prevalence of MDR organism carriage in patients at a veterinary hospital in Switzerland at admission, discharge & acquisition in hospital?
What were the 2 most common hospital acquired isolates from oronasal/rectal swabs in these patients?
Dazio JVIM 2021
MDR @ admission 15.5%, acquired 28%, 32% @ discharge.
Extended spectrum β-lactamase-producing E. coli (ESBL-E coli; 17.3%), β-lactamase-producing Klebsiella pneumoniae (13.7%).
33
Is minocycline a comparable alternative to doxycycline for E. canis infection?
Jenkins JVIM 2018
Assessed in NON-ACUTE infections in dogs.
100% minocycline treated dogs achieved negative PCR after 28 days of therapy (doxy in this study cleared by 21 days).
100% dogs PCR negative 7 days after completing tx, however long term FU not performed so cannot confirm if suppression or true clearance from blood.
34
Occult infection of which pathogen was identified after experimental Rickettsial rickettsii infection in healthy dogs?
Lashnits JVIM 2020
Bartonella spp. (vinsonii subsp. berkhoffii & henselae).
All affected dogs seroconverted to 1-3 Bartonella spp. between 7-18 days after Rr inoculation (ear tip vasculitis with intralesional Bb in 1 dog).
35
What serological test is used to diagnose Bartonellosis in dogs What is the reported Sn & Sp?
Does testing for more strains improve these?
Neupane JVIM 2018
Immunofluorescent antibody (IFA) testing.
Low Sn 62%, Sp 85%.
Lack of agreement with PCR (lots of positive PCR dogs were false neg on IFA).
No. IFA is technically time-consuming, increases diagnostic costs & does not substantially enhance overall diagnostic sensitivity in this study.
36
What is the geographical & seasonal distribution for Bartonellosis in North American dogs?
What are the risk factors for seropositivity to multiple Bartonella species?
Lashnits JVIM 2018
No specific distribution; Bartonella spp exposure present throughout NA & across the year.
Risk factors - male intact dogs, mixed breeds, **exposure to other vector-borne diseases (common; top 4 overall - Rickettsia > Babesia canis > HW > E canis**
37
Was neurobartonellosis documented based on CSF testing in dogs with inflammatory CNS disease?
Diagnostic test(s) with highest sensitivity to detect Bartonella spp?
Bartner JVIM 2018
Not in this study (1 dog was positive for B. henselae on PCR of blood).
*Possible reasons: bartonella not involved in inflammatory CNS disease, organism present in CNS tissues but not CSF, or present at undetectable levels using PCR.*
PCR + culture.
38
What disease has been reported in a dog infected with Bartonella
henselae San Antonio 2?
Donovan JVIM 2017
Pyogranulomatous pancarditis (intramyocardial Bh identified).
39
What % of IVCs removed due to clinical complications had positive bacterial cultures, and what was the most common isolate?
What factors are associated with IVC complications?
Guzmán Ramos JVIM 2018
39.6%
Acinetobacter spp. (21%)
Association with junior staff performing IVCs & use of steroid anti-inflammatories.
40
What coagulation disorders are documented in dogs with leptospirosis?
What is the prognostic significance?
Barthélemy JVIM 2017
Anaemia, thrombocytopenia, hyperfibrinogenaemia.
TEM profiles can be normal, hyper or hypo-coagulable.
Hypocoagulable > likely associated with bleeding diathesis, & worse prognosis (mortality 57% vs 21% for hypercoagulable)
DIC NOT prognostic.
41
What were the findings regarding 3 serological methods (POC & MAT) for leptospirosis testing in experimentally infected dogs? Which POC test was the most reliable?
Lizer JVIM 2018
**IgM-specific WITNESS (Zoetis) detected seroconversion in 100% dogs by D10, earlier than MAT** (gold standard) that detected seroconversion in 94% dogs by D14.
SNAP (Idexx) was inconsistent & performed poorly (only detected seroconversion in 9% dogs by D14). (*SNAP does not detect IgM-specific antibodies*)
WITNESS Lepto = POC test of choice for rapid & reliable screening.
42
Leptospiral-infected dogs may present with what disease without renal involvement?
What diagnostic tests were used to confirm infection?
Was treatment effective at clearance of organisms from liver tissues?
McCallum JVIM 2019
Chronic granulomatous hepatitis.
*100% dogs had increased liver enzymes.*
FISH + PCR speciation - isolated L. interrogans/kirschneri.
No; 75% (3/4) dogs had remained positive on post-tx biopsies (after doxycycline tx).
43
Which was the most common leptospiral serovar in USA dogs?
How is PCR used to identify leptospirosis serovar?
Why does MAT perform poorly in identifying casual serovar in infected dogs?
Harkin JAVMA 2016
L. kirschneri serovar Grippotyphosa (80%)
Variable number tandem repeat (VNTR) analysis is applied on urine samples with lepto DNA confirmed by PCR.
MAT has excellent Sp (100%) but poor Sn (max 41%) in speciation.
44
Which regions of the USA were significant space-time clusters for Lepto PCR positive dogs?
Smith JVIM 2021
Total 7 clusters from 2009-2016. 1 each located within the states of Arizona, California, Florida, S Carolina, South-central region, midwest & northeast region.
45
What seasonal factor impacted prevalence of leptospirosis in a dog population in Oregon? What other condition did these infected dogs present with?
Grayzel JAVMA 2016
Rainfall - exposure to water envrionment & contact with wildlife.
Dermatitis or otitis
46
What type of organism is Rhodococcus equi? (aerobic/anaerobic, intra/extracellular, G+/G-, morphology)
What are clinical manifestations reported in cats?
- Body systems affected
- Bloodwork abnormalities
- Imaging abnormalities
Treatment?
Prognosis?
Aslam JFMS 2019
Aerobic, intracellular, G+ coccobacillus.
**Pulmonary disease predominantly (90%). Cutaneous lesions only (10%). **
- 88.87.5% presented with dyspnea.
- Alveolar-interstitial lung changes (75%), pleural effusion, hepatomegaly, thoracic lymphadenomegaly, atelectasis of lung lobe (non-specific), pneumothorax.
- Inflammatory leukogram, thrombocytopenia. Hypoalb & hyperglob with low A:G ratio.
- Pyogranulomatous lesions - organism identified in 86% cases.
Azithromycin, erythromycin, gentamicin, FQs usually effective
Poor; 67% mortality overall.
47
What was the *B canis* seropositivity rate among purebred dogs
owned by non-commercial breeders in Michigan?
Clinical manifestations in affected dogs?
Johnson JAVMA 2018
0.4%. But endemic in commercial facilities producing dogs for household pets.
Diskospondylitis, uveitis, reproductive problems (abortion, infertility in males).
48
Based on a systemic review, was there a clinical benefit of vaccinating dogs against Lyme borreliosis?
Vogt JVIM 2018
Vaccinated dogs had reduced odds of developing clinical signs (lameness, depression, pyrexia, anorexia) cf unvaccinated dogs (OR 0.15-0.23). But quality & design of studies may be a limiting factor.
49
What type of pathogen is Listeria?
Describe a clinical syndrome reported in cats.
Fluen JVIM 2019
Facultative anaerobe, G+. Saprophytic.
Rare cause of mesenteric lymphadenitis in cats (generally young-middle aged). Possible association with raw meat.
50
A meta-analysis in 2017 found *Mycoplasma felis* was associated with URT or LRT disease in cats? What was this dependent on?
Le Boedec JAVMA 2017
URT disease.
Significant association with disease only based on positive PCR of conjunctival/pharyngeal samples from non-shelter cats (asymptomatic carriage in shelter cats)
51
Which mycoplasma spp. was found to be associated with LRT disease in dogs? Which were commensals?
Jambhekar JVIM 2019
M. cynos = pathogen (consider spp-specific PCR in clinical cases)
M. canis & M. edwardii = commensal
52
Which Mycoplasma spp. may be transmitted transplacentally or during the peri-natal period in dogs?
Lashnits JVIM 2019
M. haemocanis
53
What is the clinical utility of MALDI-TOF MS?
Yaemsiri JVIM 2018
Analyzes protein composition of a bacteria/fungal isolate & compares it to a library of mass spectrometry
profiles (unique for each species). Thus can provide rapid identification of slow-growing fastidious organisms (e.g. Nocardia in a dog).
54
What are cell free DNA & nucleosomes?
What are their clinical utilities & significance of results?
Letendre JVECC 2017 & 2018
Cell free DNA (released from dying cells or NETs) & nucleosomes (DNA + histone proteins - also a cellular content) are markers of cell death & NETs. Used in sepsis/SIRS.
Measured using fluorescence assays.
Plasma cfDNA concentrations sig higher in dogs with sepsis/SIRS & severe trauma vs healthy controls. Nucleosomes higher in sepsis vs controls.
Ratio of cfDNA to neutrophil count higher in non-survivors.
55
What factors are associated with recurrence of secondary septic peritonitis in dogs post-surgery?
Fink JVECC 2018
10% recurrence rate.
Lower albumin & higher HCT pre-op; GI sepsis with FB being additional risk factor.
Barfield JVECC 2016
No significant prognostic indicators identified in this study - concluded that mortality rate for dogs having >1 surgery is similar to a single surgery for septic peritonitis
56
Most common cause of secondary septic peritonitis in cats?
Prognostic indicators?
Scotti JVECC 2019
Most comon cause = 2ndary to GI leakage.
Higher BG on presentation = negative px indicator.
Cats treated with appropriate empirical abx more likely to survive.
57
What disease is REM sleep behaviour disorder associated with in dogs?
Clinical manifestations?
What treatments were effective? What is the reported prevalence & prognosis?
Shea JVIM 2018
Tetanus (RBD = common sequelae, clinically similar to epilepsy).
Twitching, running & vocalization during sleep; episodes can be violent in 36% dogs & seizure-like in 40% dogs.
AEDs not effective.
Developed in 46% of surviving dogs, usually within 2 wks of discharge.
Episodes were static in severity & frequency in 100% dogs; and spontaneously resolved in 43% dogs within 6 months.
58
Which serological test is superior for diagnosing SNA Aspergillosis in cats - IgA, IgG or a combination? What is the reported Sn/Sp?
Taylor JVIM 2016
IgG alone Sn 100% & Sp 91.4% (ELISA).
IgA detected in most cats (91%) with SNA, but didn't add any advantage to IgA+IgG over IgG alone.
59
1. What was the median number of treatments required for canine SNA via minimally invasive approach? What was the advantage of this approach?
2. What was the outcome of dogs with SNA associated cribriform plate lysis receiving topical treatment in a separate study?
3. Based on a 2017 study, did another described technique involving meticulous debridement & clotrimazole cream in SNA dogs achieve similar success rates as previous reported techniques?
1. Ballber JVIM 2018
Median 2 treatments (q2wks) to achieve cure (negative results for Asper on endoscopy, fungal culture & histo).
Avoids need for frontal sinus trephination. Used without complications in small # of dogs with calvarium erosion.
2. Belda JVIM 2018
Topical therapy did not result in complications (esp seizures) in these dogs even with large lytic lesions. Authors suggested that lysis of the cribriform plate and/or frontal sinus floor are not necessarily contraindications to topical therapy.
3. Hazuchova JAVMA 2017
Topical tx by meticulous debridement, 5min flush with 1% clotrimazole prior to 1% clotrimazole cream application had similar-improved results compared to previous reported techniques. 1st tx successful in 68% dogs, overall success rate 94%. Trephination or adjunctive itraconazole tx did not influence no. of treatments needed.
60
Which mycotic organism has been reported to cause invasive rhinosinusitis resulting in disseminated disease in cats?
Cormack JVIM 2021
Aspergillus felis
61
Posaconazole - MOA?
What clinical benefit did posaconazole have when treating dogs with disseminated aspergillosis?
Corrigan JVIM 2016
Lipophilic triazole antifungal. Structurally similar to itraconazole. Inhibits lanosterol-14-alpha-demethylase, a fungal enzyme necessary for ergosterol formation & maintenance of cell membrane permeability. Fungistatic against some fungi but considered fungicidal against Asper. More potent/active vs itraconazole.
Drug is safe and well-tolerated, no dogs had increased liver enzymes documented (NB: only 10 study dogs).
Mean survival time 240 days. Long-term survival >1 year is possible with prolonged tx, but high rate of relapse - most dogs died or were euthanized due to progressive disease.
62
What endocrine derangements can be observed in dogs with blastomycosis? Do these have prognostic significance?
O'Brien JVIM 2018
Reduced 25(OH)D & PTH + higher iCa vs control dogs. No impact on survival, though lower [vitamin D] was associated with higher Np counts, pCO2, and bone & skin involvement.
63
What % of dogs with coccidiodomycosis had proteinuria? What renal pathology was infection associated with?
Mehrkens JVIM 2016
63% proteinuric (of which 25% had clinically significant proteinuria).
54% dogs that had renal biopsy findings consistent with ICGN. 33% dogs had normal glomeruli but granulomatous nephritis (intralesional
Coccidioides spherules identified in 1 dog).
64
What drug can be considered in cases of coccidoidomycosis refractory to fluconazole or itraconazole in dogs? What was the clinical efficacy of this drug?
Shubitz JVIM 2021
Posaconazole.
75% dogs recovered or achieved clinical remission. Dose reduction or discontinuation may be required due to hepatoxicosis (1/8 dogs in study).
65
Are there breed differences in clinical form of histoplasmosis?
Which azole is superior for the treatment of histoplasmosis in dogs?
Name a positive prognostic indicator & 3 negative indicators.
Wilson JAVMA 2018
Toy breeds - mostly GI form, working/herding breeds - mostly disseminated form.
Either itraconazole or fluconazole can be used to achieve clinical remission. Remission rate 64% (fluconazole) to 71% (itra).
Positive px indicator - D+
Negative px indicators - Great Pyrenees breed, hyperCa, hyperBIL
66
Is histoplasmosis antigen useful in predicting remission & relapse in cats?
Hanzlicek JVIM 2016
At diagnosis - urine more sensitive (93%) than serum (73%) for antigen detection.
Antigen levels significantly decrease with effective tx (before clinical remission). Sensitive (90%) but not specific for remission (64% urine, 52% blood).
Become concerned for relapse if concentrations increase again.
67
How did 2 Histoplasma antigen enzyme immunoassays (IMMY EIA vs MV EIA) compare when used to diagnose histoplasmosis in cats?
(Note similar paper in dogs - Clark JVIM 2020)
Rothenburg JVIM 2019
MV EIA: Sn 94%, Sp 97%, accuracy 96%. Overall higher Sn/SP vs IMMY.
POC IMMY EIA may be useful, but may need modifications to improve diagnostic performance to match that of MV EIA.
Cut-off of 0.25ng/mL had Sn 89%, Sp 80% & 83% accuracy. Cut-off of 1.1 ng/mL had LOWER Sn 77%, but HIGHER Sp 97% & higher accuracy 89%.
Both assays had similar (moderate) agreement with both 0.25ng/mL & 1.1ng/mL cut-offs.
68
Abdominal cryptococcosis was most commonly diagnosed in what age range of dogs and cats? What were predominant imaging findings, and surgical findings in a subset of these patients?
Prognosis?
Johnston JSAP 2021
Young dogs (median 2yo), middle aged cats (median 6yo).
Imaging - mesenteric & intestinal lesions in most cases.
Sx - Intestinal intussusception (7/38; 18%).
Prognosis variable, fair-poor. MST: sx + med 730d, med alone 561d, sx alone 140d. Med - usually amp B IV + azole.
69
Describe the life cycle of feline lungworm.
What is the prevalence of lungworm of domestic vs feral cats based on a study population from Oregon? How many species were identified?
What 2 other infectious organisms were common in the feral cat population?
Bishop JFMS 2021
Aelurostrongylus abstrusus
Indirect life cycle. L1 larve mature into infective L3 in IH (invertebrate gastropods) >> cats ingest IH/paratenic hosts >> L3 migrate via lymphatic vessels to lungs & mature into adults.
24.2% (domestic), 17.2% (feral) - based on faecal samples (Baermann technique).
Toxocara, Taenia (tapeworm) spp. (Giardia low prevalence)
70
What are the risk factors for *Candida* urinary tract infections in dogs and cats?
Reagan JVIM 2019
Antibiotics in the last 30 days (dogs & cats), recent immunosuppressives (only cf dogs with malessezia, not dogs with bacterial cystitis), other non-infectious LUT diseases (cats). DM & history of hospitalisation were not associated in this study.
71
What is the most common infectious CNS disease in the cat?
What are the 3 clinical syndromes of this disease & MRI/CSF features?
Crawford JVIM 2017
Neurological FIP.
3 syndromes:
- T3-L3 myelopathy
- Central vestibular
- Multifocal CNS dz
MRI features (100% cases) - meningeal & ependymal contrast enhancement, ventriculomegaly, syringomyelia, foramen magnum herniation.
CSF - 100% cats had pleocytosis (variable - Np, Lc, mixed), marked increased TP.
*(ependymal cells = glial cells/epithelium that line the ventricles & SC central canal)*
72
What is the incidence of vector borne disease (VBD) in proteinuric dogs? Which VBDs were most common?
Purswell JVIM 2020
34% of proteinuric dogs had exposure to 1+ VBD on testing.
Rickettsia (19%), Ehrlichia (12%) & Borrelia/Lyme (9%) most common.
Higher exposure in dogs with lower alb & higher crea, intact dogs, autumn/spring.
73
What is the prevalence of tick-borne disease (TBD) in dogs of Southern California with immune-mediated disease?
What diagnostic methods increased TBD detection rates?
Kidd JVIM 2017
33% (exposure or infection).
Ehrlichia & Babesia most common (12% each).
Detection rate increased by 30% with repeated testing using convalescent serology & PCR, and novel PCR gene targets.
74
What is the causal agent & vector of Tick-Borne Relapsing Fever (TBRF) in dogs in the USA?
What is the hallmark feature used to diagnose infection?
Clinical manifestations? Name 1 common haemotologic abnormality.
Piccione JVIM 2016
Borrelia turicatae & Borrelia hermsii (spirochete bacteria).
Vector = Ornithodoros spp. ticks. (soft ticks)
Visualization of numerous spirochetes on standard blood smear examination (note different from Bb!)
Thrombocytopenia - usually severe (100% dogs)
75
What is the causal agent & vector of Tick-Borne Relapsing Fever (TBRF) in dogs in the USA?
What is the hallmark feature used to diagnose infection?
Clinical manifestations?
Name 1 common haemotologic abnormality.
Tx & response?
Piccione JVIM 2016
Borrelia turicatae & Borrelia hermsii (spirochete bacteria).
Vector = Ornithodoros spp. ticks. (soft ticks)
Visualization of numerous spirochetes on standard blood smear examination (note different from Bb!)
CSx - lethargy, inappetance, pyrexia, neuro signs (2/5 dogs).
Thrombocytopenia (100%; 5/5 dogs).
Tetracyclines. 4/5 dogs had resolved CSx & thrombocytopenia.
76
What is a major risk factor for B. gibsoni infection in the USA?
What is the Sn/Sp of a point-of-need insulated isothermal PCR (iiPCR) assay to diagnose Babesia gibsoni & Babesia spp. in high-risk dogs?
Cooke JVIM 2018
American Pit Bull Terriers (or Pit Bull type dogs). Dogs that fight.
B. gibsoni - Sn 90%, Sp 99%.
Others - Sn 87%, Sp 98%.
Overall few false positives - likely represent true infections in high-risk animals. ~10-15% false negatives. Reasonable screening test.
Adv: easy to learn, portable, short processing time <2hrs.
77
What are the negative prognostic indicators of acute Babesia infection?
Eichenberger JVIM 2016
Higher lactate, triglycerides & phosphate; lower HCT, leukocytes, TP & platelet counts.
78
What is the recommended treatment and follow up for Babesia gibsoni infection? Was there a more cost effective treatment & monitoring period found for dogfighting cases?
Kirk JVIM 2017
Azithromycin & atovaquone for 10 days. Follow up PCR to check for clearance traditionally at 60 & 90 days.
This study used compounded atovaquonone, and found that 30d PCR result was usually predictive of 60d PCR result. Successful tx in 93% dogs defined by 2 consecutive neg PCRs at 30 & 60d.
79
What biochemical/metabolic changes occur as part of the acute phase response to Babesiosis?
Milanović JVIM 2019
Dogs with acute babesiosis had a marked acute phase response, characterised by increased SAA. Also lower cholesterol, phospholipid, alpha-lipoproteins; and higher ApoA-1, Overall these dogs have alterations in HDL particle diameter indicative of an altered reverse cholesterol transport.
80
(2 papers - misc Babesia spp.)
What bloodwork abnormalities are seen with Babesia conradae infection? What is a key risk factor for transmission? What % of dogs had co-infections with blood-borne pathogens are what were these?
What about for Babesia vulpes?
Dear JVIM 2018 (B. conradae)
* Cytopenias (anemia, leukopenia, thrombocytopenia), hypoalb, hyperglob.
* Aggressive interactions/fights with other canids (esp coyotes) - similar to B. gibsoni. Possible tick vector (unproven).
* 55% had co-infections (16/29 dogs) - Mycoplasma haemocanis, Candidatus Mycoplasma haematoparvum, E. canis, Hepatozoon felis-like organism (1 dog)
Barash JVIM 2019
* B. vulpes usually reported in European dogs & NA foxes.
* Low prevalence: 0.2%, co-infection with B. gibsoni 0.31%
* Co-infections common: Mycoplasma, HWD, Wolbachia; co-exposures to Bartonella, Ehrlichia & Rickettsia spp.
* Similar bloodwork changes as B. conradae (+ proteinuria)
* Similar overrepresented breeds as other Babesia spp (Pitbulls & type breeds)
* Similar risk factor - dog fights
81
What gene mutation may confer *B. gibsoni* resistance to atovaquone? What is the prevalence of this mutation as reported in a N America study? And most commonly affected breed?
Birkenheuer JVIM 2018
Mutations in the B. gibsoni mitochondrial genome, specifically the M128 position of cytochrome b (cytb).
3.5% prevalence, with 12.1% new cytb mutants in Bg positive dogs.
American Staffies/American Pit Bull Terriers (74% dogs) - similar to previous reports.
82
xxx What is the sensitivity and specificity for RapidBac in detecting a UTI in dogs & cats?
Paper?
Dogs; Sn 97% and Sp 99%. Cats Sn 79% and Sp 98%
Jacob AJVR 2016
Dogs Sn 97% Sp 98% (similar)
83
What is ASB E coli 2-12 and what are its clinicial benefits?
Segev JVIM 2018
ASB = asymptomatic bacteriuria (E coli). Live biotherapeutic product.
Reported to have anti-infective & visceral analgesic effects in rodent models & people.
Administered as infusion via U cath into the bladder (10^10 CFU/mL).
Did not cause LUT signs in research dogs. In dogs with recurrent UTI, 4/9 had complete clinical cures, of which 3 had microbiological cure at D14.
No major AE, 2 dogs had mild self-limiting hyporexia.
84
What were the clinical characteristics reported about dogs infected with T cruzi?
JVIM 2019: Younger than negative dogs. No breed or sex differences. Risk factors were infected housemate or litter mate. Dogs were more likely to have VPCs, combinations of ECG abnormalities, and increased cTnI (0.129 + )
85
What was the outcome of dogs with trypanosomiasis (Chagas disease) treated with amiodarone and itraconazole?
Madigan JAVMA 2019
Trialled amiodarone 7.5mg/kg q24h & itraconazole 10mg/kg q24h for 12mths, adjusted to maintain plasma [ ] 1-2ug/mL.
Controls = untreated.
MST longer in treated dogs vs controls (23mths vs 15mths).
Treated dogs became negative 6-24 months after starting the study. Clinical improvement occurred in 53/54 treated dogs but in none of the untreated dogs.
86
What was the prevalence of Trypanosoma Cruzi in Texas shelter dogs? Which other pathogen was this comparable to?
Hodo JVIM 2019
18% of dogs were seropositive (only 1% quantitative PCR positive). Comparable to Dirofilaria - 16% positive.
87
What were the cardiac characteristics & risk factors identified in dogs infected with T cruzi in a Texas population?
What were the diagnostic features of acute chagas myocarditis reported in a family of Boxer dogs? Were there any distinct features compared to other breeds?
Meyers JVIM 2019
Infected dogs were significantly younger (median 6yo). No breed or sex differences. Toy (29%) or non-sporting (24%) breeds most common.
Risk factors - infected housemate/litter mate.
Infected dogs more likely to have VPCs, combo of ECG abnormalities, increased cTnI (0.129+ng/mL).
Vitt JVIM 2016
* Litter of puppies 10wko. Presented with ascites 2' to R-CHF, GI signs.
* Mode of transmission - not likely transplacental/transmammary, but infected faeces from insect vectors or ingestion of vector (endemic area).
* 1 puppy - ECG or echo WNL but acutely died; PM histo - severe pancarditis & abdunant amastigote pseudocysts in cardimyocytes. T cruzi PCR positive on tissue.
* Concluded that echo & ECG also insensitive in acute infections even with severe histo changes; may be WNL.
* Serial negative IFAs in puppies - likely low/absent Ab concentrations due to acute infections. So antibody detection not useful for acute infection or asymptomatic dogs.
* 1 puppy had high cTnI (0.847)
88
What is Pythiosis, and body systems commonly affected?
What is the most effective treatment for pythiosis?
What were the components of a successful medical management approach to pythiosis in 3 dogs from a 2019 case report?
Reagan JVIM 2019
Pythium insidiosum is an aquatic oomycete (water mould).
GI, cutaneous.
Aggressive sx resection with wide margins.
Itraconazole, terbinafine and prednisolone (ongoing for 5yrs+ after diagnosis). Complete resolution of clinical signs, regression of colonic masses & progressive decreases in serological titres (monitored every ~6mths).
89
What are the preferred diagnostic methods for Angiostrongylus vasorum infection in dogs?
Cannone JVIM 2018
**ELISA for antibody detection & qPCR on BALF**. These had higher Sn compared to antigen detection methods (AngioDetect or ELISA) & faecal Baermann analysis (L1 larvae) - which had Sn <50%.
90
What are the ROTEM (rotational thromboelastography) characteristics of dogs with Angiostrongylus vasorum and why are they important? What treatments are available?
Were hemostatic abnormalities prognostic for survival?
Sigrist JVIM 2017
A. vasorum dogs can develop bleeding diathesis.
**Hyperfibrinolysis** in 67% bleeding dogs & 11% non-bleeding dogs) in this study.
- 60% dogs with hyperfibrinogenolysis had **hypofibrinogenemia. **
**TXA ** decreased/resolved hyperfibrinolysis.
**FFP** normalised MCF in 6/8 (75%) dogs with hypofibrinogenemia.
67% survival to discharge, not different between dogs with & without bleeding.
91
What was the seroprevalence of heartworm in cats in the USA in 2017, and most common in which region?
What factors were associated with increased prevalence?
What is a key difference in treatment goals for HWD in cats vs dogs?
What other non-respiratory signs can be associated with HWD in cats?
Levy JAVMA 2017
0.4%, most common in SW USA.
Risk factors - outdoor access (3x risk), being unhealthy (e.g. oral disease, abscess, bite wounds, respiratory dz), retroviral positive.
In contrast to dogs, curative treatment is not safe or practical for cats, so treatment is aimed at palliation of clinical signs. HW preventives are safe and highly effective in cats.
Neuro signs, V+, sudden death rare.
92
Which mosquito species were positive for D immitis infection in Florida?
Ledesma JAVMA 2019
Anopheles quadrimaculatus, Culex erraticus, Culex nigripalpus,
Coquillettidia perturbans, Culiseta inornata, Aedes albopictus, Aedes aegypti
93
(2 papers)
What is the recommended adulticide treatment for HWD in dogs?
Is milbemycin (combined with spinosad) effective for the treatment of microfilaremia in HW-infected dogs?
What clinical effects were noted in HWD-infected dogs treated with doxycycline & monthly 10% imidaclopride + 2.5% moxidectin?
Melarsomine dihydrochloride (organoarsenic). HW guidelines recc ML administratoin for 2 months prior to starting adulticidal tx to remove immature stages that are not susceptible to adulticide.
Note: studies involved experimental HW infection
Grant JAVMA 2018
MBO-spinosad tx repeated monthly resulted in decreased MF counts (by 61-96%) from baseline. As they were incompletely microfilaricidal, not recommended for use as a microfilaricide.
No severe AE (mild transient V+).
Savadelis JVIM 2020
Treated group had higher ALT & ALKP on D28, and higher pulmonary arterial thrombus score (% vessel occluded). No sig diff in TXR & echo evidence of HWD between groups. Overall well tolerated.
94
What is the reference test for detection of Giardia spp. in dogs/cats?
What is the Sn/Sp of POC tests, in comparison to the reference test to diagnose Giardiasis?
What additional test can be added to increase their Sn/Sp to be comparable?
Saleh JVIM 2018
Direct immunofluoresence assay (IFA) to detect Giardia cysts in faeces.
POC tests - Sn 82%+ & Sp 90%+ (Bayesian analysis: Sn 83% & Sp 95%).
Adding ZnSO4 centrifugation increased results to be comparable to IFA.
95
What protocol was effective for control of Giardia duodenalis in infected group-housed dogs?
Saleh JAVMA 2016
Fenbendazole x10d. D5 - dogs bathed & moved into clean disinfected kennels. Assigned kennels were disinfected & dried at 26.7degC for 24hrs.
100% dogs shed Gd cysts. 0% dogs had cysts detected on D8 & 13 of tx. 1 dog had 1 cyst on D20 but subsequent faecal analysis neg.
Sequence analysis revealed Gd in this study was Genotype C - zoonotic transmission unlikely.
96
Most common clinical manifestations of E ewingii infection?
What clinical diagnoses apart from the common ones mentioned above are reported in E ewingii infection in dogs?
What % had comorbidities?
Qurollo JVIM 2019
Pyrexia, polyarthritis > lameness.
Joint pain 34% = most common PE finding.
Diagnosis of other disease in 68%.
Other CSx - **Renal disease 17%, IMHA 14%.**
Clin path findings - **neutrophilia 56%, abnormal Lc counts 61%, increased ALKP 57%, increased ALT 40%,** increased SDMA 32%, proteinuria 74% with mostly inactive sediment.
Dx - IFA positive in 43%, ELISA 82%.
Coinfections included bartonella, Rickettsia rickettsii & Borrelia burgdorferi.
97
What is the most prevalent Ehrlichia species in the south, mid-western & eastern USA? What is its vector?
Found in which blood cell on cytology & main ddx?
Qurollo JVIM 2019
E. ewingii
Amblyomma americanum (lone star tick).
Granulocytes (e.g. Np). DDx anaplasma phagocytophilum.
98
What are the documented coagulation changes during E canis infection?
Shropshire JVIM 2018
Thrombocytopenia, platelet activation, presence of anti-platelet antibodies.
Hypercoagulable & hypofibrinolytic (TEG) - persistent for variable periods after doxycycline tx.
May explain lack of bleeding seen in some dogs despite significant thrombocytopenia.
99
(5 papers)
What is the Sn/Sp of the following diagnostic tests for FIP:
1. ICC on CSF
2. PCR on CSF
3. PCR on mesenteric LN aspirates
4. PCR for FCoV on blood macrophages, serum vs effusion - which was most sensitive?
5. ICC on effusions
Grudendl JFMS 2016 (neuro FIP)
ICC on CSF: Sn 85% & Sp 83%. Sp considered too low (interpret with cytology).
Doenges JFMS 2016
PCR on CSF: Sp 100% but low Sn 42%. NPV 57% & PPV 100% in ALL cases (neuro + non-neuro). Sn increased to 85% if only used on cats with neuro/ocular signs.
Dunbar JFMS 2018 (dry FIP)
RT-PCR on mesenteric LN aspirates: Sn 90%, Sp 96.1%
Doenges JFMS 2017
FCoV PCR: highest Sn in effusions (88%) with Sp 89-100%. LOWEST Sn in blood (28% for Mp, 15% for serum) but Sp up to 100%. If effusion is absent, PCR on peripheral blood Mp preferred to serum.
JFMS 2017
ICC on effusions: Sn 85%, Sp 72%. DID NOT recommend this test due to low Sp (but higher Sp reported in previous studies)
100
Name 2 major & 1 moderate acute phase proteins (APP) in cats.
What is the best APP in effusion to differentiate FIP?
Hazuchova JFMS 2017
Major - serum amyloid A (SAA), α1-acid glycoprotein (AGP). Moderate - haptoglobin (Hp).
a1-acid glycoprotein (AGP) in effusion. Cut-off of 1550ug/mL had Sn & Sp 93% each.
101
What amino acid substitution in the spike protein is associated with FIP?
Sangl JFMS 2019
M1058L (leucine codon) substitution had 100% Sp & 70% Sn for predicting FIP.
102
(2 papers)
What is the significance of the S (spike) gene in cats with FCoV infection? Which sample types were most useful to identify the gene mutation?
Emmler JFMS 2020
**FCoV S gene mutations contribute to the change in virulence by enabling viral infection & replication in Mp.**
S gene mutations most frequently found in effusions (64%); followed by spleen, omentum and kidney IBs (50%); then mesenteric LN bx/FNA (45%), then spleen/liver FNA & liver bx (40%).
Recc examining a combo of different samples to identify mutation.
Felten JFMS 2017
RT-nPCR had Sp 100% in all samples (serum, plasma, effusion). Combined PCR + sequencing (for nucleotide transitions within S gene) had Sn 6.5% in serum/plasma & 65% in effusion. (Basically negative result for serum/plasma is useless & cannot exclude dz).
103
What is the reported prevalence of feline coronavirus viraemia in shelter cats and association with FIP?
Fish JFMS 2017
4.4% FCoV RNA qRT-PCR positive (Detects M gene mRNA). No correlation with FIP in the next 6 months in this population.
104
List hematological and biochemical changes (apart from protein levels) that are common in FIP cats.
What is the prevalence of a reduced A/G ratio in FIP?
Riemer JFMS 2016
Microcytosis +/- anemia (35%), band neutrophilia 44%. HyperBIL (more often in effusive FIP).
Lymphopenia not useful.
Hyperglobulinaemia in 89%
AG ratio <0.8 in 85%, <0.6 in 67%.
(Hyperproteinemia less useful, only 17.5%).
105
List hematological and biochemical changes (apart from protein levels) that are common in FIP cats.
What is the prevalence of a reduced A/G ratio in FIP?
Riemer JFMS 2016
Microcytosis +/- anemia (35%), band neutrophilia 44%. HyperBIL (more often in effusive FIP).
Lymphopenia not useful.
Hyperglobulinaemia in 89%
AG ratio <0.8 in 85%, <0.6 in 67%.
(Hyperproteinemia less useful, only 17.5%).
106
What CNS lesions were identified in FIP cats based on a necropsy study?
Mesquita JFMS 2016
Astrocytic reactivity (associated with areas of granulomatous or pyogranulomatous vasculitis/ perivasculitis), with vimentin-positive astrocytes.
Microglial cells with gitter cells positive for RCA-I seen with severe CNS lesions.
107
What differences in electrophoretic changes were observed between FIP cats diagnosed in 2 different time periods? What implication does this have on diagnostic testing?
Stranieri JFMS 2016
Frequency of electrophoretic abnormalities decreased over time (regardless of technique used) - lower TP, gamma globs & total globs.
Unknown mechnism but altered frequency may decrease diagnostic accuracy of SPE for FIP.
108
(2 papers)
What is the impact of vaccination on panleukopenia titres in healthy adult cats?
What about for asymptomatic retrovirus-positive cats?
Bergmann JFMS 2018
MLV product used.
Pre-vax titres >1:40 were present in 64% cats. Only 47% had adequate response to vax (4-fold increases). No cats with pre-vax titres >1:160 had 4-fold increase. Lack of previous vax/low pre-vax Ab titres were associated with a better response. Recommendation to check titres rather than regular revaccinations.
Bergmann JFMS 2018
In this study, pre-vax FPV Ab titres >/= 1:40 (indicating protection) were present in 100% RV+ cats.
Similar response to vaccination between RV+ & non-RV cats. No sig diff in % cats with adequate response to vax (4+ fold incr in titres).
No RV+ cats developed illness/AE post vax.
109
(2 papers)
How common is haemorrhagic D+ in cats with feline panleukopenia?
What are the 2 main infectious causal agents of FPL?
What is the prognosis for shelter cats with FPL?
What factors were associated with non-survival?
Barrs VCNA 2019
Uncommon (cf dogs); 3-15%.
FPV 95% cases, CPV variants (CPV-2a, b & c) 5%.
Mortality rate 50-80%.
Low leukocyte and/or platelet counts, hypoalb, hypoK at presentation.
Porporato JAVMA 2018
MST 3 days. Similar mortality rate (20.3% survived to discharge)
Negative px factors - lethargy, hypothermia, low BW & WBC count at D3, 4 & 7, glucose infusion associated with non-survival.
- Amoxy clav, maropitant, antiparasitics but not IFN-w associated with survival.
110
What % of cats were described to have a marked improvement of their FHV symptoms after famciclovir? What was the impact of high vs low dose? How many cats had adverse effects?
Thomasy JAVMA 2016
51% had marked improvement. Median time to improvement & degree of improvement was greater in the high dose group. AE in 10 cats.
111
(2 papers)
What are liposome TLR ligand complexes (LTC) potentially used for? What is their effect on kittens challenged with FHV?
Contreras JVIM 2019
Assessed effect of LTC on kittens with FHV-1.
Mucosally administered immunotherapy that non-specifically activates innate immune responses, as viruses activate TLR-3 & bacteria TLR-9.
In this study, LTCs reduced incidence of conjunctivitis, but increased respiratory scores. Also decreased FHV-1 DNA on swabs.
Wheat JVIM 2019
Assessed LTC in healthy cats. LTC rapidly activated WBCs, including upregulation of co-stimulatory molecule expression & cytokine production, & rapid recruitment of monocytes to oropharyngeal & nasal mucosa. LTC shows potential for protection from viral & bacterial RTI.
112
What was the effect of administering a feline pheromone on experimentally inoculated FHV-1 infection in kittens?
Contreras JVIM 2018
Decreased stress, possibly associated with reduced sneezing.
113
What are the performance of POC cryptoccoal assays CrAg LFA (IMMY) & CryptoPS (Biosynex) compared to LCAT as reference? Are these antigen or antibody tests?
Reagan JVIM 2019
Both dogs & cats.
IMMY Sn 92% & Sp 93%. Biosynex SN 80% & Sp 94.9%.
Both are antigen tests; overall Sn/Sp alternative to traditional LCAT assay with more rapid turnaround times.
114
(2 papers)
What H-N- is canine influenza viral infection (CIV)?
What patient age & clinical signs were common with CIV infection? What was the mortality rate for dogs with H3N2 viral infection?
How long should dogs with H3N2 be isolated for?
Newbury JAVMA 2016
H3N8 & H3N2. Neither reported to infect humans.
CIV positive dogs were more likely to be adult (1yo+) & inappetant. 3% mortality rate.
Dunn JAVMA 2018
Dogs should be isolated for >21 days. As shedding was documented up to 20d after the 1st positive PCR and onset of clinical signs, and may persist after clinical resolution.
115
What is the primary origin of D-lactate? In what viral disease is it increased and what is the impact?
Venn JVIM 2020
Product of bacterial metabolism during anaerobic fermenation of CHO within the GIT. Stereoisomer of L-lactate; not measurable using current POC tests.
Higher in parvovirus pups cf controls (469 vs 306uM). Dogs hospitalised for <4d had lower baseline concentrations (400 vs 520) but no other impact on outcome.
116
What is the impact of FMT on parvovirus puppies with AHDS?
Pereira JVIM 2018
Faster resolution of diarrhoea & shorter hospitalisation (3d vs 6d). Mortality was not statistically different (36% vs 21.2%)
117
How is hyperimmune plasma produced and what does it contain? What is the benefit of providing hyperimmune plasma to CPV puppies?
Acciacca JVECC 2019
HIP is produced via plasmapheresis from healthy dogs hyperimmunized against CPV & E. coli --> results in a product that includes specific Ab against CPV (titers of 1:20 to ≥1:80) + anti-endotoxin Ab (1:10,000 to 1:60,000).
HIP at 10mL/kg IV within 1st 6hrs of hospitalisation resulted in lower shock index & lower lactate concentrations at 24hrs. No difference in hospitalisation duration & mortality rates (0% HIP vs 7% placebo) but study underpowered.
118
(4 papers)
What is the survival rate associated with inpatient vs outpatient treatment for parvovirus enteritis? What factors were positively or negatively associated with survival?
Chalifoux JVECC 2021
91% survival.
Negative biochemical px indicators affecting survival - low HCT, decreased BG (every 1mmol/L decrease >> 1.85x lower odds of survival), increased serum tMg at presentation.
Sarpong JAVMA 2017
75% survival for 3+ days (similar to papers below). Dogs prescribed a caloric supplement every 2-4 hours had a mortality rate of 19%.
Perley JVECC 2018
Shelter dog population. 83% survival.
Increased % BW during tx, increased # days with CSx prior to tx associated with survival. Hypothermia at presentation negatively associated with survival.
Venn JVECC 2016
Survival 90% for inpatients (vs 80% for outpatients).
Metabolic disturbances were frequent in the outpatient group, with 50% dogs requiring dextrose supp & 60% dogs requiring K+ supplementation. Concluded that outpatient protocol may be reasonable in select cases, but still require intensive supportive care & monitoring.
119
In a study involving dogs hospitalised in an ICU for 12+ hrs, what % were seropositive for distemper & parvo? How many negative dogs were vaccinated in the last 3 years?
Mahon JAVMA 2017
50% positive for distemper, 81% positive for parvo.
27/40 (67.5%) -ve distemper dogs were vaccinated. 3/15 (20%) -ve parvo dogs were vaccinated.
Study concluded that Ab titer necessary to prevent disease caused by CDV/CPV in critically ill dogs is unknown, but
adherence to infectious disease control guidelines is still warranted when infected dogs are in the ICU.
120
Do modified live intranasal vaccines with canine adenovirus (CAV-2), parainfluenza (CPIV) & BB lead to positive PCR?
Ruch-Gallie JVIM 2016
Yes, up to 28 days post vaccination. Higher no. of positive results (on nasal/pharyngeal swabs) from days 3-10.
*Development of qPCR & wild-type sequencing needed to improve PPV of current assays to distinguish vax from natural infection.*
121
Which of the following assays was the most Sn or Sp for detecting FeLV and/or FIV?
- SNAP
- WITNESS
- VetScan
- Anigen
Levy JVIM 2017
For FeLV: SNAP (Sn/Sp 100%) > Anigen (Sn 91%, Sp 95%) > WITNESS (Sn 89%, Sp 95%) > Vetscan (Sn/Sp 85%).
No sig diff for FIV amongst assays - Sn 91-97%, Sp 99-100%. Caution with false positives in most cat populations (low seroprevalence 1-5%).
122
What are 2 distingushing clinical features in cats with leishmaniasis (compared to dogs)? What was a common bloodwork abnormality?
Fernandez JFMS 2016
Most common signs – ulcerative nodular cutaneous lesions (75%) (vs dogs - visceral)
High incidence (56%) of cats with co-morbidities/immuno-suppressive conditions (mainly FIV)
Polyclonal gammopathy 85%
123
What was the incidence of adverse urinary effects in dogs diagnosed with leishmaniasis? What urinary tract signs were noted?
Torres JSAP 2016
13%. Xanthinuria, urolithiasis and/or renal mineralisation (alone or in various combo). 45% of these dogs had UT signs.
124
What was the level of agreement (good/poor) between a commercial POC ELISA & PCR for detection of FIV infection?
Nichols JVIM 2017
Good. 6.5% discordance (equal no. of false + PCR vs ELISA, 1 false neg PCR) when compared to viral isolation. Study highlighted importance of confirmatory testing with positive POC ELISA result.
125
What is the causal agent of Q fever? What clinical manfiestations can this cause in dogs & cats? What public health implications does this disease have?
Plummer JVIM 2018 consensus
Coxiella burnetii. Ubiquitous, small, pleomorphic intracellular G- bacteria. Replicates in placenta > produces a spore-like bacterial form = small cell variant (SCV) which persist in dust, manure & air of farms.
Clinical abortion in typically farm dogs/cats that scavenge on infected mammals/wildlife; also zoonotic risk.
Zoonotic; abattoir workers at risk. Infections principally occur through inhalation or ingestion (domestic ruminants are reservoirs).
126
What is the causal agent for melioidosis? Clinical manifestations?
Portacci JAVMA 2017
Burkholderia pseudomallei. G- bipolar, aerobic, non–spore-forming, motile rod. Intracellular.
Non-specific presentation & can affect any organ, but most commonly subclinical, or cause abscesses, septicemia & pneumonia.
Also reported: cats - ocular & neuro signs; dogs - fever, myalgia, epididymitis.
127
What canine breed is most at risk of developing Cuterebra inection & severe systemic illness?
What is the a major detrimental clinical manifestation?
What clinical manifestations were associated with non-survival?
Rutland JAVMA 2017
Yorkies (40%).
SIRS (50% dogs, 14% cats), DIC (40% dogs, 0% cats), dogs CNS disease.
Mortality rate 17% dogs, 4.5% cats.
128
What is a potentially effective tx option for dogs with SN aspergillosis & cribriform plate lysis?
Bray JAVMA 2020
Surgical fungal plaque debridement (rhinotomy and/or sinusotomy) + voriconazole PO (with TDM). Improved/resolved CSx for 6-15mths (FU). Tolerated drug well. (note small case series - 3 dogs)
129
What is a risk factor for demodicosis in cats?
Taffin JAVMA 2016
FIV+ status
130
What kind of organism causes Alaria infection? Which populations have the highest prevalence?
Johnson JAVMA 2017
Diplostomatid trematodes (mesocercariae is infective stage - encyst as metacercariae in lungs > coughed up then swallowed).
Feral cats (9%) & shelter/rescue dogs (1.8%).
131
Which body systems are typically affected by Strongyloides stercocoralis infection? What is involved in hyperinfection?
Graham JAVMA 2019
Skin, GIT, lungs
(Disseminated = liver, brain, heart, urinary tract)
Hyperinfection occurs due to immunosuppression (drugs etc). Often missed on faecal exam & no-mild CSx, but with hyperinfection may be more easily detected > disseminated infection.
132
Which body systems are typically affected by Strongyloides stercocoralis infection? What is involved in hyperinfection?
Graham JAVMA 2019
Skin, GIT, lungs
(Disseminated = liver, brain, heart, urinary tract)
Hyperinfection occurs due to immunosuppression (drugs etc). Often missed on faecal exam & no-mild CSx, but with hyperinfection may be more easily detected > disseminated infection.
133
What is a common presenting complaint in cats with histoplasmosis, and what samples should be considered for diagnosis?
Fielder JFMS 2019
Lameness (could be the only CSx) - inflammatory arthritis. Joint fluid cytology - detects organisms in most cases (22/25 cats) > cf Histoplasma urine Ag test.
134
2 papers
What lungworm species affects cats?
Cats with mixed lungworm infections had increased .....score but not ..... score compared to single lungworms infections.
Crisi JFMS 2016
Aelurostrongylus abstrusus, Troglostrongylus brevior, Capillaria aerophila
Febo JFMS 2018
Clinical severity, radiographic. Radiographic changes noted in some subclinical cats.
