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Nursing 2 Flashcards

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1
Q

Duagnostic tests For cv disease

A 
Blood tests 
Ecg
Thoracic radiography 
Blood pressure 
Echocardiography
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2
Q

What do the ventricles do during diastole

A

Relax and fill

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3
Q

What do the ventricles do during systole

A

Squeeze and pump

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4
Q

Congenital heart disease

A

Young animqls
Abnormalities of heart development
Aortic stenosis, pulmonic stenosis, patent ductus arteriosus, ventricular septal defect

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5
Q

Aquired heart diseases

A

Adults
Dog- myxomatosis mitral valve disease, dilated cardiomyopathy, pericardium effusion
Cats - hypertrophic cardiomyopathy
Arrhythmias

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6
Q

Typical fininhd of heart failure

A 
Reduced cardiac output - weak peripheral pulses, tachycardia, pale mm, prolonged crt
Weakness, exersise intolerance? Symcope 
Heart murmur 
Gallop sounds 
Arrhythmias
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7
Q

Signs of comgestion in heart

A

Usually short history of clinnical signs
Leftside = lungs = pulmonary odema, tachypnoea, dyspneoa, cough
Rightsided = systemic = distended peripheral veins, pleural effusion

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8
Q

Haematology tests for

A

Systemic diseases

Anaemia

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9
Q

Biochrm tests fir

A

Kidney values

Electrolytes

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10
Q

Cardiac biomarkers testing

A

Cardiac troponin

N.terminal proBtype natinetic peptide

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11
Q

What does hypotension do

A

Increases cardiac output

Can contribute to progression of disaster

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12
Q

Hypotension signs

A

Might decimpressed heart failure

250mmhg is concerning

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13
Q

Normal systolic

A

120-140 mmHg

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14
Q

Use of ECG

A 
Diagnose cardiac disease
Treatment options 
Severity od disease and prognosis 
Progression of dusease 
Response to treatment
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15
Q

Thoracic radiographs

A 
Size of heart 
Cardiomyopathy 
Trachea 
Increased sternal contact 
For cough, tachypnoea, dyspnea, 2views of rigjt lateral, dorsoventral, congestive heart failure, lung pathology
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16
Q

Most important congenital cardiac diseasses

A

Stenosis of great vessels- aortic- pulmonic
Patent ductus arteriosus
Ventricular septal defect

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17
Q

Stenosis of great valves 3 types

A

Narrowing coukd be;
Subvalular (below valve)
Valvular (stiffening of vessel)
Supravavular (rigid tissue in vessel)

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18
Q

Aortic stenosis

A

Subvalvular
Left ventricular hypertrophy
Lefr sided congesrivd heart failure

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19
Q

Pulmonic stenosis

A

Valvular
Right ventricukar hypertropy
Right sided xongestive heaet failure

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20
Q

Clinnical signs and treatment of stenosis

A

Asymptomatic, arrhythmias, exersise intolerance, syncope, congestive heart failure
Beta blocker,

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21
Q

Patent ductus arterisus

A

Normal fetal cennection between pulmonary artery and aorta. Should close after birth when take first breath.
If remains patent
- blood flows from aorta to pulmonary artery
- loud continuous murmur left heart base
- incidental findings
- congestibe heart failure

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22
Q

Treatment of patent ductus arteriosus

A

Interventional closire
Surgical ligation
Congestive heart failure therapy

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23
Q

Ventricular septal defect

A 
Most commin location
Usually asymptomatic 
Right sided systolic murmur 
(Small defect = loud murmur)
(Large defect = soft murmur)
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24
Q

Diagnosis and treatment of ventricular septal defect

A

Diagnoses ECG
Usually none neccessary
Heart failure treatment

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25
Myxomatosis mitral valve disease
``` Most common cardiac disease Idipathic = heridiatry Small breed dogs Adult onset Mitral, tricuspid valve Diagnosis - ECG ```
26
Symptoms of myxomatosis mitral valve disease
``` Thickeming of valve leaflets - reguritation of blood - left atrial dilation - left ventricular dilation Prolapse of valve leaflets Left sided apical systolic heart murmur Slow progression - long asymptomatic period - murmur maybe incidental finding May progress to left sided congestive heart failure ```
27
Dilatef cardiomyopathy
``` Frequent cardiac disease Idiopathic Large breed dogs Adult onset Left apical systolic murmur not always present Disease of myocardium - left ventricular dilation - decreased systolic function - Arrhythmias Diagnosis ECG Long asymptomatic period Prognosis gaurded- progression may br rapid. ```
28
Pericardual effusions
``` Large breed, adult dogs Causes - idiopathic, neoplasia Fluid in sac around heart compromised filling. - decreased cardiac output - right sided heart failure Diagnosis ECG ```
29
Pericardial effusion treatment
``` Pericardiocentisus - drain Mild sedation, left lateral recumbency Large catheter Visualise window Check for clotting Check pcv of fluid Measure volume drained ```
30
Hypotrophic cardiomyopathy
Most common cardiac disease in cats Genetic causes adult onset Exclude other causes of hypotrophy - hyperthyroidism - systemic hypertension Increased myocardial thickness impairs fillinh in diastole ECG diagnosis Incidental finding Heart murmur, gallop sound Present with pulmonary oedema, pleural effusion Preducted by stress, anaesthesia, fluid yherapy
31
Heart failure is xue to
Disease progression Decompensation of previously stable heart failure Development of impedence of cardiac filling
32
Left sided heart failure
Congestion of pulmonary curculation; pulmonary oedema | Tachypnoea, dyspneoa, pulmonary crackles
33
Right sided heart failure
Congestion of systemic circulation
34
Treatment of heart failure
``` Flurosemide Minimise stress Oxygrn ACE inhibitor Water must be available ```
35
Whatdoes DUDE stand for
Defecating urinating drinking eating
36
Horse defecating
4-13 piles a day | Approx 17g for a 500kg/d horse
37
How much should a horse drink
40-60ml/kg/d
38
Horse eating
1.5-2.5 bodyweight of dry matter/day | 18hr grazing
39
Horse auscultation
Lungs and trachea hard to hear Heart clear left and right may hear ‘dropped beats’ may be murmurs. Abdomen gut sounds in all quadrants. Caecal emptying - right dorsal quadrant, toilet flushing.
40
Sick horse
Bright alert responsivd appear outwardly normal. But usually. Disinterested in surroundings/ less reaction to change. More static - stood sleepy / recumbent. Disengaged with others, stood alone.
41
Presenting signs of stomach pain (colic)
``` Rolling Looking at flank Grinding teeth Stretching Anorexia/ inappetent Recumbent Pawing Digging bed Reduced feacal output ```
42
Presenting signs of resp disease (horse)
``` Excersise intolerance Extended head and neck position Increased abdominal effort. Heave line Flared nostrils Coughing Nasal / ocular discharge Epistaxis ```
43
Presenting signs of liver disease (horse)
``` Dull Inappetent Weight loss Photosensitisation Jaundice Head pressing Diarrhoea ```
44
Presenting signs of dental disease (horses)
Dropping food Weight loss Slow to eat Hallitosis
45
Presenting signs of lameness (horses)
``` Recumbentcy Abdominal posture Resting limb Slow to move Sweating Lame with moving Poor performance Changed behaviour and excersise Inappetent ```
46
Equine routine vaccine
Influenza and tetanus
47
Equine stud vaccines
Herpes, rotavirus, equine viral arterilis, equine infectious anaemia
48
Equine influenza
``` Im dose day 0 day 21-92 day 150-215 6 months for FEI competing horses Annual booster < or = 365day Acute onset resp disease - pyrexia, nasal duscharge, coughing - horse sick but rarely fatal Highly contagious Only 40% vaxxed in uk ```
49
Tetanus
``` Im injection - primary vaccine 4-6 weeks apart - 3rd vaccine 1 year - then every 2-3 year Uncommon, high motality Spastic paralysis - muscular contraction - extended head, neck, spine, elevated tail - flared nostrils - wide open eyes - erect ```
50
Equine dentistry
Routine exam - gag / speculum - every 6-12 months for healthy adult - remove sharp enamel points - removal of rostral/ caudal hooks
51
Equine worming
``` Padlock maintenance Minimise shocking density Maintain consistent population Poopick 2x/week or more Rest+ rotate pasture Always turn foals out onto clean posture ```
52
Removing dried mud from horse
Dandy brush or curry comb
53
Horse body brush
Ised all over
54
Equine hoof care
Shoeing depends on growth and wear, comformation and hoof quality. Routine trip and shoe every 4-8 weeks
55
Horse shoes provide
Protection support gait
56
Surgical treatment of boas
Soft palate resection Tonsil resection Removal of extended laryngeal sacules Laser assisted tubotomy
57
Pre surgical prep boas
``` Full discussion will surgeon to inc ASA grade Biochem Oxygen kennel/ mask Minimal stress via handling Occular lube peri op Periop intemse monitoring is vital ```
58
Surgical prep boas
Ensure all equipment is prepared | Thoracic radiography ususlly performed
59
Monitoring boas
Ox saturation > 98% Capnography 35-45 mmHg Use ippv or mechanival ventilator Blood pressure mean not below 60mmHg.
60
Laryngeal paralysis
Vocal cords unable to abduct (oprn) in response to excersise and resp demands
61
Laryngeal tie back
Avoid excitemrnt and high temperature Diagnosis under light lane of anaesthesia Surgery performed on left side of neck Left arytenoid cartilage permanently tied open
62
Congenital Palate defects
Clegt upper lip - surgery wt 3-4 months | Clinnical signs
63
Aquired palate defects
Trauma
64
Common causes of resp failure
``` Airway obstruction Ruptured diaphragm Pulmonary oedma Pneumothorax Neoplaia Infection Toxic ```
65
Clinnical signs of upper resp diseases
Nasal discharge Sneezing Reverse sneezing Stendor / snony
66
Non GA URT investigation
Toutine bloods Tests for bkeeding disorders Serology for fungal disease Viral testing in dogs
67
GA investigations
Full oral exam Dental probing Nasopharyngeal swab in cats Imaging endoscopy
68
Cough pathophysyology
Protective reflux to clear excess secretions Cough receptors in large airways amd low density of cough receptors in nose sinus phynx and pleura Cough arc reflex P
69
Canine chronic bronchitis
Chronic bronchial inflammation woth secretion of mucous. | Middkr aged ti old dogs
70
Canine infectious tracheobronchitis
``` Kennel cough A complex of several viruses, bacteria snd other micro orgsnidms may be thr csuse. Highky contagious Cough suppressants may be used Vaccine protocols ```
71
How to position stable blovk
Avoid upwind dust sources Trees = shelter but leaves block drainage Southfacing= sunlight and warmth
72
Stable pollutants
Dust allergens irritants | Ammonia bacteria
73
Mucking out
``` Daily full clean Remove all faeces and soiled bedding Lift all bedding and place ckean Sweep floor Remove bedding add fresh ```
74
What foes drying stable floor teduce
Ammonia and mould
75
Tracheal collapse
Middle aged small and toy breeds Degeneration of tracheal rings Signs- harsh cough triggered by exhalent stridor buikd up over time. Diagnose - right and lateral radiograoh at peak expiration Bronchoscopic Fluroscopy real time x rays
76
Management of travheal collapse
Weight loss harness avoid smoke meducal surgical.
77
Extraluminal ring prosthesis
Good outcome 75-89% of time Invasive Risk management Complications
78
Intraluminal stent plCement
Less invasive Durable materual but can fatigue under pressure Complicatioms Vital yo control coughing post surgery
79
Bronchoscopy
Inflammation, mucous, airway narrowing
80
Pulmonary parasites
Intestinal wirms Lung worms Heart worms
81
Advantages of standing sedation
Reduces ga risks Msy reduce costs Anatomical advantages Less facilitues and experts required
82
Disadvantages of standing sedation
Not all horses have suitable temperment Less control over situation Need control of environment Duration limmited so speed critical
83
Horse standing surgery
Sedated but consious patient Iv catheter Rehional la
84
Regurgitation
Passive return of food | Hallmark of oesophageal disease.
85
Reguritation secondary problems
Malnutrition Dehydration Anorexia Aspiration pneumonia
86
Stages of vomiting
Prodromal phase- nausea (restless,agitated,hypersalivation,gulping,lip smackinh, licking) Retchijh (inhibition of salivation, mixing of gastric contebtd, duodenal retroperistalsis) Explusion Relaxation
87
If diarrhoea is from the si itll be
Large volume, watery, notmal frequency, normal colour, +/- melana
88
If diarrhoea is from thr li
Small volume, increased urgency and frequency, tenesmys, dyschezia, +/- mucous and blood
89
Categories of acute v and d
1) non fatal, may or may not need treatment 2) severe and potentially life threateninh, acute haemorrhage 3) surgicsl disease, foreign body
90
Dietry advice vomiting
If acute rest gut but free access to water. 24-36 hours then reintroduce bland food. 2-5 day transitiom to normal diet. Not for neonates.
91
Dietry advice diarrhoea
Feed through.
92
Gi foreign body
No obstruction - if small, smooth and gastric -> induce emesis - intestinal -> natural passage woth radiograohic monitoring - bones disolve in gastric acid Obstructive - surgery
93
Gastric dilation + volvulus (GDV)
Also gastric dilation. Acute dilation of stomach. May progres to torsion of stomach. Impated venous return. Shock and desth. Treatment Aggressive fluid therapy. Immediate decompresion - stomach tube. Iv antibiotics. Surgical correctuon.
94
Colitis
Colonic inflammation
95
Gastric ulcers treatment
Evaluate fir and remove / treat underlying cayse. Acid blocks. Coating agents. Analgesic. Nsaid overdose. Surgery.
96
Constipation
Impactipm of the colon or rectum eiyh feacal matter. | Excessivly hard/ dry.
97
Causes abs treatment of constipatinb
Dietry. Dehydration and electrolyte disturbance. Drug remayed. Environmental. Identify and correct underlying causr. Oral laxitives. Enemas. Surgery.
98
Hepatic dysfunction
Prehepatic - heamolysis Hepatic - failure of heoatic uptske Post hepatic - failure of excretion of bile.
99
Ascites
Fluid accumulation in the abdomen, typically refering to a watery fluif.
100
RER
30 X BW(kg) + 70
101
Possible consequences of obesity
``` Hepatic lipidosis Joint disease Excersose intolerance Diabetes Skin disease Cardio respiratory disease Flutd ```
102
Outline a safe weight loss plan
``` 1-2% per week Diet changes E cerise plan Behaviour changes MER based on idea not current weight ```
103
Choice of suture materials for GI surgery
Short duration absorption- monocryl
104
Oral tumours
Usually older animals , may be poor prognosis, may be expensive
105
Oronasal fistulae
May be secondary to trauma, dental extraction or ruinous. Need surgical repair to stop foot materials impacting nasal cavity
106
Pre and post op considerations specific to oral surgery
Pre - flush mouth of debris Post - ensure patient can’t eat / drink - food needs to be soft but easy firmed so easy to swallow. Feeding tube may be required.
107
Foreign body
Main sign is persistent or intermittent vomiting. May be removed endoscopically. May need surgery.
108
Pyloric obstruction
Fb or thickening / neoplasia at outflow of stomach known as ‘ gastric outflow disease’ surgery may widen or even remove pylorus.
109
Gastric neoplasia is
Often advanced by time of diagnosis
110
Gastric dilatation volvulus GDV
Food or gas accumulation in stomach. Stomach dilated with gas and rotates occluding oesophagus and venous drainage. Emergency.
111
Tube gastromy
Surgical or endoscopic placement of tube for nutritional support or decompresssion of stomach.
112
Gastric surgery specific nursing considerations
Pre and intra - treatment of dehydration / hypovolaemia as needed. Prep wide surgical site. Post - feeding low fat bland diet. Liquid died in case of pyloric obstruction. Continued treatment of fluid + electrolyte losses. Monitor fir arrhythmias in GDV.
113
Treatment plan for GDV
Treat shock - rapid admin of IV fluids IV antibiotics Decompression of stomach by passing stomach tube. Right lateral radio graph taken to confirm volvulus. ECG to check for ventricular dysrhyhmias Surgery to decompress and derotate stomach and asses stomach wall viability.
114
Why would you do an intestinal biopsy?
In cases of persistent or recurrent v or d
115
Enterotomy
Foreign body removal. | Can be simple (mass like) or linear (string line)
116
Enterectomy
Where guy is necrotic or neoplastic - section is removed abs ends sutured together.
117
Intussusseption
SI invaginates into itself and seen in young digs after d.
118
SI surgery specific nursing considerations
Pre and intra - keep intestinal contents moist. Wide surgical site. Clamps. Post - biopsy samples labelled. Encourage eating and drinking.
119
What intestinal surgery is higher risk
Li
120
Colectomy
Removal of colon
121
Specific nursing considerations of li surgery
Pre + intra - avoid enemas- slurry is likely to spill. Antibiotics possible. Post - label samples.
122
Horse abdominal pain signs
Rolling pawing flank watching lip curling
123
Abdominal exam
Auscultation 4 quadrants Transabdominal ballottement Look fir distension
124
Rectal exam
Most useful Can only feel part of abdomen. Distension impaction displacement Equipment
125
Stomach tubing horses
Gastric overfilling Occurs mostly with small si obstruction Can admit fluid and meds. Most likely will cause big nose bleed. Need stomach tube 2 buckets, one with water. Funnel jug sedation and lube.
126
Horse untraslund
Rectal or transabdominal
127
Abdominoparacentesis
``` Intestinal damage Haemoperitoneum Rupture Inflammatory / neoplastic cells Case select Fairly low risk. 2 techniques ```
128
House gastroscopy
Starve at least 12 hours Ulceration outflow obstruction impaction. Biopsy
129
Horse dental disease
``` Eruption disorders Dental decay Periodontal disease Fractured tooth Diastema Fillings , widenings , problems with removal ```
130
Oesphagus choke clinical signs and diagnosis
CS- neck extended, food / discharge from nose, cough, gag. Dehydration, acid base imbalance, weight loss. Aspiration pneumonia. Diagnoses- auscultation, bloods, gastroscopy, stomach tube
131
What causes gastroduodensl ulceration in horses.
Imbalance between inciting and protective factors.
132
Clinical signs and diagnosis of horse gastroduodensl ulceration
CS - poor appetite, recurrent colic, tooth grinding, dog sitting , poor performance. Diagnosis - gastroscopy
133
Gastric dilation and rupture
Pulmonary, secondary, idiopathic. Primary - gastric impaction, grain engorgement, acute or chronic colic. Secondary - more common, small or large obstruction. CS- overfilling of stomach, acute colic, tachycardia, fluid from nose, dehydration. Diagnosis - reflux, colic work up and gastroscopy Treatment- stomach tubing, underlying cause , Iv fluids, electrolytes
134
Are seizures more common in cats or dogs
Dogs
135
Normal cerebral activity
Neurones transmit info through chemical and electrical signals. This is regulated by large group of inhibiting cells called interneurones. If balance between excitation and inhibition input is altered a seizure occurs.
136
Seizure
Clinical manifestations of excessive abs or hypersyndrones. Usually self limiting neuronal discharges.
137
3 diagnoses seizure and definition.
Isolated seizure - lasting less than 3 mins and only occurs once. Cluster seizure - 2 or more within 24 hours with complete recovery in between. Status epilepticus - seizure lasting longer than 5 mins. 2 seizures without complete recovery in between. Neorological emergancy.
138
Types of seizure
Partial / focal Simple Complex Generalised (tonic / clonic)
139
Partial / focal seizures
Asymmetric, one part of the brain affected Facial twitching Hyoersalivation Consciousness maintained
140
Simple seizure
No change in mentation
141
Complex seizure
Change in mentation
142
Generalised seizure
Bilateral cerebral hemisphere involvement Autonomic signs Loss of consciousness Pre ictal ictal and post ictal phases
143
Seizure phases
Pre ictal Ictal Post ictal
144
Pre ictal
Minutes Before actual seizure Behaviour changes, altered mentation, attention seeking behaviour
145
Ictal
Seizure itself Less than 5 minutes Loss of consciousness, muscle contraction, urination/defecation
146
Post ictal
Minutes to days after siezure | Abnormal neuro signs
147
Extrac cranial seizures can be caused by
Toxins or metabolic
148
Intracranial causes of seizures can be
Structural or functional
149
Structural causes if sixties
Brain tumour Inflammation Hydrocephalus
150
Functional causes of seizures
Idiopathic epilepsy
151
Toxin causes of seizures
Slug bait Antifreeze Human drugs Permethrin in cats
152
Metabolic causes of seizures
Portosystemic shunt Hypoglycaemia Hypocalcalcaemia
153
Idiopathic epilepsy
``` Most common cause of seizures Animal between 6m and 6y Recurrent seizures Normal inter ictal neuro exam Normal metabolic investigation Normal mri scan of brain Normal csf ```
154
Diagnostics of seizures
``` History Bloods- haem, biochem, fasted blood glucose, pre and post bile acids MRI Csf analysis Videos Monitoring and recording Retinal exam and bp measurement ```
155
Siezure mimics
``` Narcolepsy/ cataplexy Fly catching Movement disorder Syncope 3rd degree AV block Canine epilogue cramping syndrome ```
156
Narcolepsy / cataplexy
``` Sleep / wake disorder Collapses are flaccid Inherited Lord of muscle tone No autonomic signs ```
157
Flycatching syndrome
``` Unknown cause Like chasing or trying to chase fly Mins- hours Normal mentation No autonomic signs ```
158
Movement disorder
Episodic Patient remains conscious Involuntary movements that are spontaneous and uncontrolled Neurologically normal between episodes
159
Syncope
``` ‘Fainting’ Temporary loss of consciousness Reduced oxygenation to the brain Cardiac related Neurological Hypoglycaemia ```
160
3rd degree AV block
Prolonged hypoxic event | Partial seizure like episodes
161
Canine epileptoid cramping syndrome
Movement disorder Common in border terriers No autonomic signs Normal mentation
162
If discovering a patient siezure then…
``` … Note time Call clinician in charge for help Remove any dangers Dom lights Reduce noise Limit handling Monitor vital signs Follow seizure plan ```
163
When a siezure patient comes in…
``` Reassure owner Triage Oxygen therapy Iv access Anticonvulsants Check temp Active cooling Mannitol Continuous rate infusion Intubation ```
164
Nursing interventions of assisted feeding
Avoid food buffets in kennels. Avoid prescription diets. Try different textures. Antiemetics? Appetite stimulants? TLC. Offer food away from kennel. Painful? Warm food. Offer usual diet or favourite items. Is condition worsening?
165
When is a feeding tube placed?
Anorexic for 48hrs or more. If vet anticipates patient to be anorexic after procedure. Trauma near head mouth or neck. To administer oral hydration or meds.
166
What are the 3 types of feeding tube?
Naso oesophageal Oesophageal Percutaneus endoscopic gastromy (PEG)
167
Naso oesophageal tube placement equipment
``` Surgical staples Feeding tube Syringe that fits the tube. LA Sterile lube, gloves, water and tape ```
168
Duration of Naso oesophageal tube and how to remove
Up to 7 days Remove by removing staples Use non sterile gloves and pull gently from nose
169
Equipment for oesophageal feeding tube
``` Oesophageal feeeing tube Sterile gloves Non sterile gloves Curved artery forceps Surgical prep equipment Scalpel blade Bandaging material ```
170
How long to have oesophageal feeling tube and how to remove
Weeks - months | Non sterile gloves to remove tube. Cut sutures abs gently pull away. Apply primary dressing to cover site.
171
Can anyone be called an exotic specialist?
Only if they have a diploma
172
How to transport rabbits and rodents
Secure box or carrier
173
How to transport reptiles
Provide heating | Snakes in pillowcase
174
How to transport fish
Double plastic bag in water proof box with second bag of water
175
How to transport birds
Cage or box. | Birds of prey can be held on hand
176
Fish tuberculosis
Local non healing ulcers. Reduced appetite, weight loss and body deformities. Zoonosis. Cause localised lesions. Prevention - wash hands, don’t have exposed wounds, don’t share sinks.
177
Ringworm
Fungal infection, spread by contact. | Causes scaly itchy patches often but not always circular. Wear gloves when suspected. Wash hands after handling.
178
Euthanasia in different species
Mammals IV or into liver/kidney Rabbit ear vein Rodents cranial vena cava Reptiles Iv and check heart stopped with Doppler Snake intracardiac or into liver Lizard - tail vein Chelonia - jugular Birds gas down then iv jugular or tibiotarsal. Large birds then liver Fish anaesthesia followed by injector into spinal cord behind gil
179
What type of breather is a rabbit
Nasal
180
Where to blood sample a rabbit
``` Lateral saphenous Marginal ear vein Cephalic Jugular Volume _ max 1ml per 100gms ```
181
Rabbit fluid therapy
Crystalloids first choice for fluid imbalance Colloids may be used to bring up blood pressure or in case of blood loss. Blood tramsfusuons may be preferred. REM they have high metabolic rate.
182
Rabbit GI stasis
Emergency Common Reduced or stopped intestinal motility Signs- anorexia, absence of droppings, bloated Causes - stress, inappropriate diet, other disease Treatment - pain relief, fluids, syringe feeding, fix underlying cause
183
Rabbits and blood glucose
Very useful ti assess pain 5-10 is normal 15-20 pain 20+ liklry GI obstruction
184
Vestibular disease
Head tilt, circling, middle ear infection
185
Why would rabbit have fecal blockage
Too many carbs Obesity Dental disease Back pain
186
Three S of wildlife rescue
Sure? Can you be sure before you try to rescue Safety! Your own safety comes first Stress! Minimise stress maximises survival
187
Treating vs euthanising wildlife
Balance stres Of treatment against successful return to wild. Some species have to be released by licences person.
188
Anaesthetising fish
``` Inhalation so as open system in constant exchange with environment. Penoxethanol Ms222Tricaninemethone 5 mins of anesthesia out of water. Remove when can’t hold itself upright. ```
189
Fish diagnostic tests
``` Mucous scraping (dorsal or pectoral fin) Bacteriology Blood sampling Radiography Ultrasonography ```
190
Fish injection?
Under scale at 45 degrees
191
VPIS
Veterinary poisons information service
192
Information that’s important when suspect poisoning
What when dose Up to date body weight If asymptomatic, unknown or low risk product - call VPIS Symptomatic or known ingestion of high risk product - immediate vet attention
193
Owner instructions and advice when suspect poisoning
Owner should bring - product label or photo, sample of product. Approx time and quantity. Advice - if dermal contamination prevent self grooming. Ensure other pets or children don’t have access. Don’t follow internet remedies
194
What to get while waiting for poisons patient to arrive
If dose of substance and bw already known then consult poisons service. Prepare for triage and initial managed. Get oneself, vet, hospital sheet, Cateter abs fluid therapy, oxygen, diagnostics samples, decontaminates, emetics
195
Managing poisons
Remove / eliminate toxin. (Induce emesid, gastric lavage, cutaneous decontamination,haemodilalysus) Reduce ongoing absorption. Dilute toxin.
196
Induction of emesis
Emesis empties 40-60% gastric contents. May enhance effectiveness if feed small meal prior. Indicated within 2-3 hrs after oral ingestion if non corrosive intoxicant. Contraindicated if intoxicant is corrosive/ irritant Dogs - apomorphine sc Cats - xylazine Im
197
Gastric lavage
Uncommon. | Known intoxication ingested within last hour and emesis unsuccessful or contraindicated.
198
Cutaneous decontamination
Wear appropriate ppe. Clip affected regions in long haired patients. Warm water. Mild shampoo / detergent. Avoid ocular contamination.
199
Reducing ongoing toxin absorption
Enteric absorbents | Intralipids.
200
Enteric absorbents
Reduce ongoing absorbing. | Activated charcoal mixed with wet food or via stomach tubining following gastric lavage.
201
Intralipid
Creates a ‘lipid sink’ in Iv space. Used for liphilic toxins.
202
Nephrotoxins may cause…
… acute onset azotemia
203
Acute onset azotemia
Sudden onset. Relate to AKI, inappetent, lethargy, vandd.
204
Neohrotixin management
Decontamination - induce emesis, activated charcoal. Antidotes. Nursing. Prognoses depends on toxin.
205
Neurotoxin clinical signs
``` Hyperexcitabikity Agitation Muscle tremors Risk of hypothermia Seizures Obtundation, coma ```
206
Respiratory arrest
Patent is not breathing, apnoea
207
Cardiac arrest, cardiopulmonary arrest
Patent has no cardiac output | Not breathing
208
CPCR cardiac vs thoracic pump
Cardiac in cats abs small dogs | Thoracic in medium to large breed dogs
209
Cardiac pump
Compression of thorax directly over heart
210
Thoracic pump
Compression of widest point if thorax.
211
Stored whole blood
>8hr collection | No functional platelets, loss of clotting factors
212
Packed red blood cells
Separated from plasma by centrifuging. The PCV is higher than whole blood. 42 day expiry date
213
Fresh frozen plasma
Stored at -18•c for less than a year. Contains all coagulation factors. Contains physiological concentration of albumin and other plasma proteins.
214
Frozen plasma
Stable coagulation factor remains. Labile factors will be lost. Stored at
215
Cryoprecipitate
Made by slowly and partially thawing fresh frozen plasma which is then centrifuged again. Rich in fibrinogen
216
It is ideal to use the blood product that most closely replaces what is missing because
It reduces likelihood of transfusion complications. | Allows blood products to be most effective.
217
Blood type is determined by…
… proteins / antigens found on red blood cells
218
Symptoms of a blood transfusion reaction
Fever, tachycardia, dysponea, muscle tremors, vomiting, weakness, collapse,
219
Blood typing dogs
The dog erythrocyte antigen - DEA Labs can type 1,3,4,5,7 each are positive and negative Dogs posses no naturally occurring antibiotics against DEA1
220
What blood type are Siamese cats usually
A
221
What blood types are rag dolls usually
AB
222
Cat blood types
A B AB | Naturally occurring alloantibodies are present in plasma.
223
Major blood cross match
Recipients serum and donors rbc
224
Minor blood cross match
Donors serum and requires rbc
225
Crissmatching should be performed prior to blood transfusion when
Recipient has received transfusion >4 days ago History of transfusion reaction Transfusion histiry unknown Ideally for all feline transfusion and all Dalmatian’s
226
Open blood donation
One or more additional sites of potential bacteria entering
227
Closed blood donation
Only exposure is uncapping the needle. Only suitable for large dogs.
228
What blood donation techniques has a longer shelf life
Closed donation
229
Blood sampling lizard
Ventral tail vein | Underside of tail go to bone then out slightly
230
Blood sampling snakes
Ventral tail vein | Cardiocentesis
231
Blood sampling tortoises
``` Jugular sampling (right) Subvertebral sinus. ```
232
Fluid therapy of reptiles
``` Soaking Oral Intracoelmic Subcut but not much discs Iv but hard to maintain access Intraossrus ```
233
Autonomy
When drops tail
234
Metabolic bone disease
Imbalance between calcium and phosphorus abs lack of VAD3. | Symptoms - fractures rubber jaw weakness muscle tremors.
235
ecdysis
Shedding problems. Usually use to poor husbandry. Provide humidity - shedding chamber. Gently ease retained shed.
236
Why do small mammals often require higher drug doses
They have higher metalbic rates
237
Overflow incontinancs
Overflow occurs when patient is unaware bladder is full.
238
What an happen if a bladder is constantly full
UTI
239
Urine scalding
Around peritoneal area. | Keep clean and dry.
240
Bladder management
Express 6-8 hours. If passing urinary catherrr start by emptying bid as Ridk of trauma. Undwelling catheter emptied 3-4 times a day. Sterile procedure.
241
Decubital ulcers
Open skin wound caused by continued pressure of skin on firm surface. Tissue ischemia is skin causing injury. Most likely on bony prominences. Develop rapidly once formed. Prevent by turning every 4 hours, more in honey breeds. Deep padded bedding and prop with pillows.
242
Sims of physiotherapy
Promote recovery Prevent further complications Neuromuscular conditions Spinal cord damage.
243
Benefits of physio
``` Pain management Improve range of motion Reduce muzzle contraction and tension Stimulate nervous system Improve blood perfusion Improve cardiorespiratory capacity Encourage relaying of motor patterns Weight management ```
244
Define critical care nursing
Nursing that focuses on the care of critically I’ll or unstable patients. Patents with life threatening or potentially life threatening problems.
245
What patients require critical care nursing
``` Cv unstable Resp distress Neurological disease Multiple trauma Systemic disease Extensive wounds / burns Electrolyte imbalances Neonate ```
246
How to triage
Quick physical assessment of 3 major body systems | Cv resp and neuro
247
Critical patients that need constant monitoring
Critical patients and those likely to deteriorate
248
Critical patients that need monitoring every 15-30 minutes
GA recover , starting blood transfusions
249
Critical patient that needs monitoring every 1-2 hours
Needing meds. Monitoring rr. Hypoglycaemia patients.
250
Critical patient that needs monitoring every 4-6 hours
Stable but clinical status may deteriorate
251
What can a weak thready pulse indicate
Decreased systolic BP
252
What can a bounding pulse indicate
Sepsis
253
What can a snappy pulse indicate
Anaemia
254
Doppler blood pressure
Manual reading of systolic bp | Uses sound waves to detect arterial blood flow as an audible sign
255
Oscillometric blood pressure
Machine reading of systolic diastolic and map bp | Detects oscillations as blood flow returned to occluded artery
256
Invasive blood pressure
Measured directly from artery Very accurate, gold standard Continuous measurement
257
Causes of dysponea
Upper airway obstruction. Pleural space disease. Pulmonary parenchyma disease. Upper airway disease.
258
Anuria
No urine production
259
Dysuria
Difficulty passing urine
260
Oliguria
Reduced urine output
261
Pollakiuria
Passing small amounts of urine often
262
Stranguria
Straining to urinate
263
Catheterisation is
I steering a urinary catheter into the urethra up to the level of the bladder
264
Why would you catheterise a patient
``` To empty the bladder prior to surgery To obtain a urine sample To put in contest media for x rays To maintain patency or unblock To monitor urine output To divert urine Prevent urine scalding ```
265
Alternatives to catheterisation
Manual expression Free catch Cystocentisus
266
Types of urinary catheter
Portex - rigid, single use, side holes, not designed for indwelling Foley - soft, silicone/latex, inflatable balloon filled with sterile water holds in place, proffered to indwelling Jackson cat - Tom cat catheter, hoof gor unblocking, side holes can cause problems, not good for indwelling Slippery Sam - good for unblocking obstructions, short term indwelling
267
Risks of urinary catheterisation
``` Urethral rupture Urethral trauma / inflammation Urethral structure formation Infection Blockage or obstruction of catheter ```
268
In a hospital setting how often would you typically measure urine output
Every 4 hours
269
How to measure volume of urine patent has produced
Closed system collection
270
Why would you monitor urine output
Tells us about renal function | Tells us if fluid therapy is appropriate
271
Normal urine output of animal
1-2mls / kg / hour
272
Which kidney is more cranial
The right
273
Azotemia
Elevation of urea +/- creatinine in blood stream
274
Uraemia
Clinical signs associated with azotemia
275
Polydipsia
Excessive water intakr
276
Pyelonephritis
Bacteria kidney infection
277
Renal insufficiency
Measureablr reduction of kidney function
278
AKI
Acute kidney injury | Sudden onset kidney disease
279
CKD
Chronic kidney disease | Over 3 month duration of kidney disease
280
What is one of the first readily measureAblr sign of kidney disease
Inability to concentrate urine
281
Urinalysis
``` USG - how concentrated Dipstick Microscopy Cytology Bacterial vulture ```
282
Endogenous waste products excreted by the kidneys
Urea and creatinine
283
What does azotemia indicate
Refuced glomerular filtration of blood
284
Prerenal, renal and post renal azotemia
Prerenal - inadequate renal perfusion Renal - reduced functional mass of kidneys Postrenal - kidneys are functional but waste products are not excreted
285
Normal response to Prerenal azotemia
To preserve at much water as possible = produce concentrated urine
286
Renal azotemia signs
USG less than 10/30 in dogs or 10/35 in cats
287
Diagnose post renal azotemia
Imaging
288
Cystoscopy
Direct visualisation of lower urinary tract
289
Acute kidney injury
Acute nephron damage / dysfunction
290
Chronic kidney disease
Chronic nephron loss, gradual decline in renal function
291
Intrinsic AKI
Toxins / drugs Ischaemic - hypofusion Infectious - lepto Cutaneous and renal glomerular vasclopathy
292
Clinical signs of AKD
Azotemia, uraemia, lethargic, depressed, inappetant, nauseas Increase in posassium = cardiac arrhythmias/ death Hyper/hypo perfusion
293
AKI management
``` Remove underlying cause - stop nephrotoxic drugs, if recent ingestion gastric decontamination. Supportive management etc. specific treatment Fluid therapy Treat hyperkapaemia ```
294
Chronic kidney disease
More common in cats. Typically older patients. Functional or structural kidney disease. Irreversible and progressive kidney damage abs dysfunction. Management aimed at protecting remaining nephrons and managing clinical consequences.
295
Historical findings of CKD
``` Subtle and non specific PUPD Weight loss Lethargy weakness Inappetence ```
296
Catabolic state
Reduced body / muscle condition
297
Consequences of systemic hypertension
Target organ damage - ocular, renal, cardiac, neurological | High blood pressure
298
Non invasive blood pressure
Doppler | Oscillometric
299
Diagnosis of CKD
Concentrated urine with azotemia. Lab findings. Blood pressure. Imaging.
300
Cystitis
Urolithiasis Neoplasia Drug infused Implants / indwelling devices
301
Size of urolith
Macroscopic. Can be seen.
302
Size of crystal
Microscopic
303
Urinary crystals make up
Uroliths
304
Crystalluria
Crystals in Uria
305
Most common urinary stones
Struvite Calcium oxalate Urate
306
The less dilute the urine the less risk of
Crystal and stone formation
307
Symptomatic upper urinary uroliths
Nephroliths Abdominal pain, anorexia, lethargy, haematuria Uteroliths
308
Symptomatic lower urinary uroliths
Obstruction - unproductive/ minimally productive urination. Cystoliths = cystitis signs. Maybe predispose to utis
309
Can crystals predict stone type
No
310
Best principal of urolith management
Dilute urine, encourage water intake and voiding.
311
Feline idiopathic cystitis
``` Young to middle aged cats. Overweight/ inactive/ indoor. Nervous disposition. Dry diet. Stressors. Autumn/ winter ``` A susceptible cat in provocative environment.
312
Urogenic incontinence
Upper motor neurone lesion - spastic bladder, difficult to express Lower motor neurone lesion - flaccid bladder, easy to express
313
Non neurogenic incontinencs
Urethra sphincter mechanism incompetence. Anatomical defects. Urge incontinence.
314
USMI - urethral sphincter mechanism incompetence.
Most common non neurogenic incontinence in dogs. Common in larger breed spay bitches. Leak during recumbency.
315
Treatment of USMI
Tighten sphincter Oestrogens Urethral cuffs Surgical repositioning of bladder
316
Initial investsgoon of surgical diseases of urinary tract
Bloods Urinalysis Radiography Ultrasonography
317
Renal neoplasia
Carcinomas are the most common renal tumour in dogs. Haematuria, palpapable abdominal mass as well as vague signs. Pulmonary metastasis Is present in half of dogs. In cats lymphoma I’d most common renal tumour
318
Renal trauma
May follow RTA or bite injury
319
Renal stones
Aetiology similar to other uroliths. Often with those with chronic renal failure. May be dissolved with diet or antibiotic therapy
320
Surgical removal of renal stones
Nephrotomy - incision through the body of the kidney. | Risk of reduction in renal function short term.
321
Kidney disease secondary to uteric disease
Ureters are at risk of trauma during spaying. | Uretal obstruction may Aldo be managed by nephrectomy
322
Urethral ectopia
Congenital anomaly in dogs resulting in yesterdays opening into urethra.
323
Bladder neoplasia
Not uncommon I’m elderly patients. Present with haematuria, frequency/ urgency or obstruction. Most are malignant.
324
Incontinence
Various causes; congenital or acquired | More common in females because of anatomy - rare in cats
325
FLUTD
Secondary to some kind of bladder disease. | Leads to urethral obstruction in some male cats.
326
Urethral neoplasia
Rare cause of obstruction, but important in elderly bitches. Most common form is transitional cell carcinoma.
327
Prostatic disease
Prostate surrounds the urethra of the male. | Disease is rare in cats.
328
Benign prostatic hyperplasia (BPH)
Causes dyschezia or dysuria Seen in older entire males Managed with anti androgens Often castration preferred as definitive treatment
329
Prostatitis
Bacterial infection, often together with BPH. Disease of entire males. Managed with antibiotics or castration.
330
Prostatic abscess
Variable systemic signs.
331
Prostatic cyst
Entire males | Treat with deroof and omentalisation and castration
332
Prostatic neoplasia
Disease of elderly dogs Usually very painful Slightly more common in castrated animals Poor prognosis
333
Wound classification
Class 1: 0-6 hours old, clean laceration, minimal contamination Class 2: 6-12 hours old, significant contamination Class 3: older than 12 hours, gross contamination
334
Wound contamination
Clean - created under sterile conditions Clean contaminated - minimal contamination, easily removed, surgical, tract penetrated, minimal spillage, can close after appropriate treatment Contaminated - gross contamination with foreign debris, can close after treatment Dirty / infected - infection already exists, never close primarily
335
Types of wounds
Incision - created by sharp objects, smooth edges, minimal surrounding trauma Abrasion - created by blunt trauma / shearing force, damage to skin, included damage to epidermis Avulsion - tearing of tissue from attachment, avuldion of limbs, degloving Laceration - irregular wound created by tearing, variable damage to tissues Puncture - penetrating wound by sharp object, minimal superficial damage but substantial deeper damage
336
Stages of wound healing
Inflammatory phase Proliferation phase Maturation phase
337
Inflammatory phase of injury
Occurs within 72 hours Haemorrhage occurs within minutes of the injury Vasoconstriction- reduced haemorrhage and allows clot to form Vasodilation to release clotting elements into wound. Triggers healing process. White blood cells leak from the blood vessels into the wound initiating through debridement phase.
338
Early proliferate stage
Begins 3-5 days post injury Reconstruction phase Granulation tissue fills the wound Fibroblasts lay network of collagen in the wound bed which gives strength to tissues Epithelial cells from the wound margins migrate to cover wound
339
Late proliferating stage
Wound contacts | Epithelisatiom
340
Maturation stage
Behind 2-4 weeks post injury Remodelling phase Begins when wound has filled in and resurfaced Collagen fibres reorganise, remodel and mature to give wound tensile strength forming scar tissue
341
Goals of wound management
``` Prevent further round contamination Remove foreign debris abs contamination Debride dead and dying tissue Promote viable vascular bed Promote drainage Select appropriate method of cliure ```
342
Asses viability of tissue
``` Colour Warmth Pain Bleeding Skin circulation ```
343
How often should you change wound dressing
Depends on type of wound, volume of exudate, type of dressing in place, stage of found healing.
344
How often should a wet to dry / dry to dry dressing be changed
Daily or twice daily
345
Who often should a granulating wound dressing be changed
Every 2-3 days
346
Surgical drains
Passive abs active drains available. Depends on location, requirement abs also patient considerations when considering which one you use. Think about anatomy abs how well drain will work.
347
How often should a dressing be checked abs why
``` 4-6 hours Damp / wet Slipping Patient interference Tightening Check the toes for moisture / temp Patients tolerance of dressing ```
348
Abscess
Localised collection of purulent material lined with granulation and fibrous tissue. Normally points and bursts leading to drainage.
349
Signs of abscess
``` Pyrexia Anorexia Vomiting Pain Swelling Discharge ```
350
Treatment of abscess
Drain and flush Maintain drainage Treat with antibiotics
351
Cellulitis
Arises from acute inflammation. Distribution puss through tissue (not localised like abscess) Painful, sensitive, pyrexia, swelling.
352
Sinus
Infected blind ending tract leading from a focus of infection (deeper tissues) and I body surface or mucous membrane. Not lined with epithelial tissue but lined with granulation tissue.
353
Signs of sinus
Pyrexia pain sensitive disease specific
354
Fistula
Abnormal tract between two epithelial surfaces or connecting an epithelial surface to the skin. May arise as a result of injury or trauma. Signs- chronic infection, visually abnormal, physically abnormal Need surgical repair
355
Ulcers
‘Lord of the epithelial surface if a tissue’ (skin / mm) Shallow lesions caused by trauma aggravated by poor blood supply and or infection. Often slow to heal. Pain swelling visual appearance infection Remove cause keep clean and dress wound care Causes- pressure, poor blood supply, irritants, pathogens
356
Corneal ulcer
Varies in depth Causes - trauma, bacteria, eyelash or eyelid disorders Signs - increased lacrimation, ocular pain, ocular discharge, blephrospasm
357
Decubitus ulcer
Pressure sore | Pain, open wound, pyrexia, sensitivity, restricted movement
358
Cysts
Abnormal sac filled with fluid or semi solid matter lined with epithelium. Swelling, visual appearance, restriction of movement, secondary problems
359
Haematoma
Blood Vessels burst and blood accumulate in tissues. May occur anywhere. Trauma? Surgery? Clotting? Blood vessel abnormalities? Swelling, Pain, discolouration
360
Ruptures
Protrusions of organs or sift tissue through an unnatural opening or tear. Usually arises as results of trauma although may be weakness which predisposes tear.
361
Hernia
Abnormal protrusion of organs or soft tissue through a natural opening. Usually occurs through the abdominal wall.
362
Classifications of hernias / ruptures
Reducible Irreducible / incarcerated Strangulated
363
Reducible hernia or rupture
Contents can be repositioned to the original anatomical location. Usually corrected under gentle pressure.
364
Irreducible/ incarcerated hernia or rupture
Contents cannot be repositioned to the original anatomical location. Due to adhesions it’s other complications.
365
Strangulatdd hernia or rupture
Contents become devitalised for ti blood vessels being restricted. Life threatening and serious emergency.
366
Umbilical hernia
Common in puppies and kittens. Mishandling at birth may be factor. Usually just a little fat but sometimes some abdominal contents.
367
Inguinal hernia
Occurs through imguinal canal. Females- often see a swelling by groin extending to vulva. Males- fat or intestine may herniate into scrotal sac. Ultrasound or radiography used to determine severity.
368
Perineal hernia
Most common in elderly dogs due to chronic constipation which leads to excessive straining. The muscle layers around the anal sphincter gradually break down. May be either unilateral or bilateral.
369
Diaphragmatic rupture
Usually arises due to trauma Animal quickly becomes dysponeic especially if the tear is Large as the abdominal contents fall forward into chest. Animal usually finds breathing easier if sitting up. Repair involves ippv as once abdominal cavity is opened air will enter thoracic cavity
370
Ventral or abdominal rupture
A general term which refers to a tear anywhere on the abdominal wall other than the umbilical or Inguinal areas. As there is no predisposition it usually arises due to trauma.
371
Bacteria
Single celled organism. Reproduce by binary fission. Coccoid, bacillus, spiral Different staining and cellular characteristics.
372
Viruses
Sub microscopic organisms Diverse morphologies Requires a living cell to replicate
373
Fungi
Eukaryotic Multicellular Heterophobic Sexual or asexual reproduction
374
Parasites
Worms, Protozoa, ectoparasited Eukaryotic multiccelled organisms. Host adapted. Depends on host for survival.
375
Protozoa
(Parasite) Single celled organism Eukaryotic Capable of sexual and asexual reproduction Often have cyst (dormant) and trophozoite (active) forms
376
Infectious feline upper resp tract disease.
``` ‘Cat flu’ Common, esp in multi cat houses Feline herpesvirus Feline calico virus Chlamydia felis Secondary bacterial infections. ```
377
Feline herpes virus 1
Enveloped DNA virus. Post exposure / infection most cats become lifelong carriers. Stressful event - reactive virus and get more clinical signs. Lives in nerves - trigeminal ganglion Fomite/ close contact transmission
378
Feline calicivirus
Non enveloped single stranded RNA virus. Carrier state. Lifelong. May be asymptomatic.
379
FHV / FCV transmission
Direct / indirect contact Infectious agents in resp secretions Replicate in urt epithelial cells and lymphoid tissue FCV also replicated in systemic tissues. Incubation 2-6 days. Viral shedding occurs from 1 day post infection before CS
380
CS of FHV / FCV
2-6 days post infection Range from very mild to severe/ life threatening Exacerbated by secondary opportunistic infections Oral, nasal, ocular, systemic Predisposes cat to gingivostomatisis and lingual ulcers
381
Diagnoses of FHV / FCV
Swabs - PCR, virus isolation, culture
382
Feline upper respiratory tract infections nursing care
Clean face, warm wet water, soft wipes , improved comfort and smell Barrier creams , prevent scalding Ocular lube Nebulisation to loosen secretions
383
FHV / FCV vaccination
Protection not complete. Attenuated live or inactivated Kittens from 6-8 weeks, every 3-4 weeks until 16 weeks old. Revax at 1-3 years after.
384
Feline immunodeficiency virus and feline leukaemia virus
Enveloped RNA viruses Poor survival outside of host Retroviruses
385
FIV is similar to …
Human immunodeficiency virus (HIV) but it’s not zoonotic. | Infected cats may develop feline AIDS boy not all cats with FIV do.
386
Is FeLV or FIV more pathogenic
FeLV , more direct associating with clinical disease
387
FIV transmission
Bite wounds - high conc in saliva Infected blood products Venereal rare
388
FeLV transmission
``` Close contact Allogrooming, fomites Vertical very effective Infected blood products Venereal rare ```
389
FIV infection
``` Clinical course is similar to AIDS Lifelong although prolonged asymptomatic phase common. Infection -> acute phase Replicates In Local lymphoid tissue Peak viraemia 8-12 weeks post infection Terminal phase ```
390
FIV diagnosis
Common to screen sick cats Screening tests detect antibodies. False positives are rare.
391
FeLV clinical manifestations
Anaemia / bone marrow disorders Neoplasia Immunosuppression
392
FeLV associated immunosuppression
Various infections | Impaired response to vaccinations
393
FeLV related anaemia / bone marrow disorders
FeLV anaemias are typically non regenerative but regenerative is possible. Neutropenia Thrombocytopaenia
394
FeLV related neoplasia
Most commonly known lymphoma Thymic lymphoma Most lymphoma cats are FeLV negative
395
FeLV diagnosis
Screening blood tests
396
FIV and FeLV home management
Indoor only - no hunting Ideally separate positive abs negative cats Both viruses labile outside host Regular health checks Vaccinate against the core vaccinabkr disease
397
FCoV feline coronavirus
``` RNA viruses Large Enveloped Mistakes occur frequently during replication Virulence varies ``` Faeco orally transmitted High prevalence of infection. Low clinical sign rate.
398
What can feline coronary virus mutate into
Feline infectious peritonitis
399
Feline infectious peritonitis can be
Wet or dry
400
Wet FIP
More common Development of effusions and associated clinical signs Frequently jaundiced Lethargy inappetance weight loss and pyrexia are all common
401
Dry FIP
Development of pyo/ granulomatous lesions within multiple organs No effusions they may develop over time May be jaundiced Lethargy inappetance eight loss abs pyrexia Usually more chronic
402
Is toxoplasmosis zoonotic
Yes
403
What is the definitive host
The host in which parasitic sexual maturity and repro occurs
404
What is the Intermediate host
The host in which one or more stages if parasitic development occurs
405
What is the transport host
A host in which the parasites may survive but no parasitic development occurs. This host may be a vector / vehicle gif transmission to other hosts
406
Typically route of cat to get toxoplasmosis
Ingestin of bradyzoites in prey tissue
407
CS of toxoplasmosis
Non specific Lethargy , anorexia Ocular , neuro , Rarely GI signs
408
Diagnosis of toxoplasmosis
No specific exam / routine diagnostic findings. Look for response to organism. Look for organism - cytology/ histology. PCR.
409
Treatment of toxoplasmosis
Clindamycin. Supportive management. Poor prognosis.
410
Diagnostic approach of skin problems
``` History Physical exam Problem list Differential diagnoses Diagnostic plan ```
411
Diagnostic techniques of dermatology
``` Acetate tape for cytology. Skin scrapings - deep / superficial. Impressions smears. Flea comb. Trichogram. ```
412
Skin biopsy indications
Neoplasia - suspected or obvious Unusual or serious generalised dermatosis Condition poorly responsive to therapy Other diagnostic tests not helpful
413
Do you prep skin surface for a skin biopsy
No
414
Clinical signs of microbial infections
Intraepidermal pustules are easily disrupted by grooming, scratching or bathing. Primary lesions may be transient abs secondary lesions if crusting, erosions may predominate. Peripheral spread produces an annular lesion.
415
Pyoderma cs
Lesions and sometimes pruritus are antibiotic responsive. | Disease tends to recur if underlying cause is not identified and managed.
416
Pyoderma therapy
Usually responsive in 3-4 weeks. Topical therapy useful in removing scale crust abs exudate from skin surface. Reducing number of bacteria. Promote drainage of deeper lesions reduce pain and pruritus. Use 2-3 times weekly.
417
What is malassezia
Opportunistic yeast pathogen. | Immune response of dogs to microbial allergens.
418
Malassezia diagnosis
Impression smears with a dry swab of direct slide contact. Acetate strip preps. Culture.
419
What can otitis externa be a major sign of
Malassezia infection
420
Factors influencing efficacy of flea control
``` Formulations Hair coat length Bathing / swimming Use of insecticidal products Insect growth development inhibitors ```
421
How much flea larvae can you hoover
20%
422
Why is carpet shampooing and steak not recommended for flea infestations
Residual humidity is ideal for larval development
423
Treatment for cats and dogs with flea allergy dermatitis
On animal insecticide | An environmental insecticide
424
Diagnostid of démodex
Deep skin scrapings Hair plucks Skin biopsy Predisposition
425
Life cycle of sarcoptes scabsiei is hoe long?
3 weeks
426
Canine sarcoptes diagnosis
Skin scrapings Skin biopsy Elisa blood test Mite transmission
427
Cheyletiellosis
Hypersensitivity response to mites.
428
CS of lice
Pruritus and scaling of dorsum May develop severe self trauma Common in young animals, debilitated animals and in over crowded households
429
Pets travel scheme
Dogs cats ferrets Control risk for rabies Arthropod bourne diseases Tapeworms
430
Puppy worming protocol
Treat 2 weeks then 4.6.9,12 weeks thrn every 3 months
431
Worming bitch
Daily from day 42 to 2 weeks after whelping.
432
Worming I’m cats
No transplacental transmission | Treat kittens from 3-4 weeks.
433
Parvovirus
Severe haemorrhaging coming abs or diarrhoea with leukopenia Major cause of haemorrhagic gastroenteritis. Faeco oral spread. Inactivated by formalin and hypochlorite disinfectants. Part of CORE vaccination.
434
Parvovirus infects rapidly dividing tissue such as
Neonatal myocardium Intestinal crypt Bone marrow
435
Signalment of parvovirus
Setverity exrreemly variable Unvaccinated adult Inadequately protected puppy
436
What is the immunity gap
Gap between mothers colostrum antibodies wearing off and vaccination
437
CS of parvovirus
Intestinal crypt necrosis - anorexic depressed abdominal pain Bone marrow necrosis Extreme risk of sepsis - uncerated GI tract and neutropenia Pyrexia
438
Diagnosis of parvovirus
Test every puppy with SI haemoragic diarrhoea abs or neutropenia Anaemia Electrolyte imbalances Elisa in house test
439
CPV treatment
Aggressive fluid therapy Crystalloids IO Monitor electrolytes and supplement as necessary NO trickle feeding once vomiting is controlled
440
Leptospirosis
Active or chronic hepatic abs or renal insult. Zoonotic. Infected urine - environmental contamination. Can’t replicate outside of host. Replicated in blood stream.
441
Clinical presentation of leptospirosis
Typically acute Hepatic injury Jaundice Renal injury or failur Pyrexia lethargy inappetance v and d
442
Diagnosis of leptospirosis
Demonstration of serologic conversion. | Organism identification.
443
Preferred antibiotic for leptospirosis
Doxycycline
444
Canine distemper virus
Multi systemic especially resp GI neuro dermatology. Enveloped. RNA. Doesn’t survive well in environment. Rare in uk due to vaccination. Oronasal secretions. Shed in all body secretions abs excretions before CS
445
Acute presentation of distemper
Highly variable Don’t show all signs. Pyrexia lethargy respiratory GI neuro secondary infections common Can recover from
446
Chronic distemper
More progressive signs Seizures ataxia myoclonus Ocular signs dental dermatological
447
Treatment of distemper
Only supportive care | Isolate/ barrier nurse
448
Canine adenovirus
Vaccinated against so rarely see Infectious canine hepatitis ‘blue eye’ CAV 1- infectious canine hepatitis CAV 2 - resp pathogen, kennel cough vaccine. Vaccination with CAV 2, protects against both.
449
CAV1
Survived at room temp Readily inactivated by disinfectants Typically juvenile or unvaccinated She’d in saliva urine or faeces Replicates In tonsils Cell injury and lysis Pyrexia lethargy inappetance v and d
450
Canine herepesvuris
Fading puppy syndrome
451
Canine infectious resp pathogens
Bordetella bronchiseptica Canine parainfluenza virus Canine adenovirus Typically consider KC complex
452
Kennel cough
Harsh and hacking Upper resp Highly contagious
453
Bacterial enterocolitis CS
``` Haemorrhagic v and or d Purexia Sepsis Maybe abdo pain Enterotoxaemia possible ```
454
Acute haemorrhagic diarrhoea syndrome
AHDS Mostly small breeds Some suffer repeated events Sudden onset Abdominal pain obtundation
455
Non invasive oxygen
Flow by oxygen Oxygen cafe Nasal prongs
456
Invasive oxygen
Nasal catheters Trans tracheal Et tube Ventilation
457
Levels of consciousness
Normal - alert abs responds normally to stimuli Obtunded - reduced alertness / consciousness easily roused with non noxious stimuli Stupourous - unconscious only rousable with noxious stimuli Comatose - unconscious no response to any stimuli including noxious
458
Non surgical fixing of a fracture
External coaptation | Conservative
459
Surgical management of fracture
Pin and wire ESF / IN Plate and screw
460
Advantages and disadvantages of non surgical fracture management
Reduce / avoid anaesthesia Avoid need for open surgical approach Cheaper materials Cheaper overall Fracture disease Insufficient stability leads to delayed or non union Malunion Cast sores / ischaemia
461
Fractured suitable for non surgical management
Pelvis scapula vertebra | Minimally displaced fracrurez
462
Layers of a cast
First layer stockinette Primary layer soft ban Cast material Vet cast
463
What increases the chances of thoracic / abdominal injuries?
Limb injuries
464
Signs of orthopaedic injury
``` Recumbency Limb wounds Deformity Abdominal mobility Crepitatipm ```
465
Robert Jones bandage
Immobilise fracture / luxatipn Controls swelling and oedema Comfort
466
Forelimb lamesness horse
Walking towards you | Head goes up as lame leg hits ground
467
Bundling lameness
Asssessed as going away
468
phases of laminitis
Developmental - between higher abs clinical signs Acute - onset of clinical signs , 72 hours Subacute Chronic
469
Periodontal disease
Inflammatory response To dental plaque biofilm that accumulates on all surfaces of the mouth Gingivitis earlies sign abs reversible Periodontists is irreversible
470
Calculus
Mineralised plaque Always covered by plaque Prime location for dental biofilm Doesn’t cause gingivitis - the plaque does
471
Gingivitis
Inflammation, reddening, often bleeding Hallitus Graded according to severity Treat by removing accumulated calculus Improve oral hygiene
472
Periodontitis
May develop in untreated gingivitis Inflammation involves gingiva but also surrounding etc. eventually teeth fall out
473
How many teeth do dogs have
42
474
How many teeth do cats have
30
475
Teeth attachment loss causes
Periodontal pockets Gingival recession Furcation exposure Tooth mobility
476
What dental cases would benefit from peri op antibiotics
When other surgery is carried out concurrently Patients with congenital heart disease Systemic disease
477
Indications of dental extractions
Advanced periodontal disease Retained deciduous teeth Tooth trauma tooth pump exposure
478
Most common endocrine condition in cats
Feline hyperthyroidism
479
Feline hyperthyroidism aetiology
Spontaneous secretion of thyroid hormones | Escaping control of hypothalamus and pituitary gland
480
Signalmemt of feline hyperthyroidism
``` 10-13 years Lethargy Intermittent anorexia Voice changed Muscle weakness Congestive heart failure Heat intolerance Mild pyrexia Dyspobea ```
481
Hip dysplasia
Developmental disease Laxity develops in joint capsule which allows hip to subluxate Mainly large abs giant breeds.
482
CS and diagnosis of hip dysplasia
Gait analysis and ortho exam | Imaging
483
Treatment of hip dysplasia
Non surgical - OA management | Surgical - growth plate fusion, total hip replacement, femoralhead and neck excision
484
Avascular necrosis of the femoral head
Unilateral hindlimb lameness, pain on hip extension, muscle wastage Diagnosis - imaging
485
Hip luxation
Usually due to trauma. Can be seen with hip dysplasia X rays
486
Patella luxation
``` Displacement of patella from groove Often bilateral Common in small breeds Usually developmental Characteristic gait. Clinical exam. Imaging. ```
487
Brainiac cruciste ligament disease
Most common cause of hind limb lameness in dogs. Usually trauma or hyperextensipn. Diagnosis - gait analysis, physical exam, cranial draw test, tibial thrust test.
488
Crop tubing
Use largest diameter tube- metal for parrots Palpate right side base of neck to confirm tube in crop. 2-8 hours depending on species
489
Sinus flushing of birds
Infraorbital sinus Flush for treatment or for diagnostic samples. Via Nares can be done conscious Via needle into sinus
490
Aetiology of diabetes
Destruction of pancreatic beta cells | Insulin resistance leading to beta cell exhaustion
491
CS of diabetes
``` PUPD Polyphagia and weight loss. Cataracts Diabetic ketoacidosis Concurrent disease ```
492
Diagnosis of diabetes
Glycosuria and persistent hyperglycaemia are necessary to confirm diagnosis
493
Most commonly used insulin dogs
Lente caninsulin
494
Why should intact females with diabetes be spayed
Progesterone is a cause of insulin resistance
495
What may ketones on the urine indicate
Poor glycaemic control
496
Insulin in cat
Prozinc
497
Equine metabolic syndrome
Very common Insulin dysregulation / resistance Obesity
498
What does in cuffing et tube prevent
Pressure necrosis in birds
499
Ocular sinister
Left eye
500
Ocular Dexter
Right eye
501
Ocular Uterque
Both eyes
502
Exophthalmos
Abnormal protrusion of eyeball
503
Globe Proptosis
Keep eye moist and come in quickly
504
Entropion
Eyelids inverted can be primary or secondary to trauma
505
Breeding year of horses
Males are seasonally polyoestrous | Mares cycle from spring to autumn
506
Mare pregnancy
11 months
507
Two features to describe a tumour
The tissue of origin - epithelial cell, mesenchymal cell, round cell Status - benign or malignant
508
The grade of a tumour depends on
Mitotic rate | Cellular abs nuclear characteristics
509
Metastatic potential
Ability to spread to distant tissues is a feature of malignancy
510
Paraneoplastic syndromes
PNS are signs arising from the indirect effect of tumours production and release of biologically active substances
511
Clinical staging of tumour aims to identify
Cystological or histologivsk grade Local invasion Metastatic spread.
512
Aims of tumour treatment depend on patient
Cure Remission Palliation
513
Cardiac cachexia
Loss of Jean muscle mass despite good appetite. Linked to heart ossued
514
When listening for heart murmurs what are you finding out
Timing and point of maximal intensity
515
Heart failure is usually due to
Congestion
516
Hypotension can indicate
Decomprnsated heart failure
517
Thoracic radiographs indicated for
Cough Dysponea Tachyponea

Year 2 (3 decks)

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