VIN Class 4 - Canine Info Flashcards

Question

What parasite is pictured here?

Answer 1

Ancyclostoma canis

Answer 2

Ancylostoma braziliense adult female

Answer 3

1. dogs 2. cecum 3. Ingestion of infective L2 stage eggs 4. fecal flotation with centrifugation, high specific gravity - Note: Due to intermittent shedding, density and small number of eggs, may be difficult to diagnose on fecal float 5. Single dose: Febantel + Pyrantel; Pamoate + Praziquantel (Drontal Plus)R; Fenbendazole for three days, repeated monthly for 3 months

Answer 4

1. gastrointestinal symptoms such as diarrhea and other - More severe possible symptoms include weight loss, anemia, lethargy and vomiting - May cause “Pseudo-Addison’s 2. Trichuris eggs are very resistant and may persist up to years in the environment

Answer 5

Whipworm - May cause “Pseudo-Addison’s - Due to intermittent shedding, density and small number of eggs, may be difficult to diagnose on fecal float - Trichuris eggs are very resistant and may persist up to years in the environment In the cecum!

Answer 6

1. dog, cat; In some cases, no clinical signs are noted; Some pets may “scoot” due to perianal irritation; Some cases may have non-specific gastrointestinal symptoms 2. Location: small intestine 3. Ingestion of infected intermediate host (most commonly fleas or lice). Gravid proglottids are voided in pet’s feces 4. Visualization of proglottid segments in feces and/or around perineal area or in the environment. Confirmation can be achieved by breaking open proglottids, adding saline and looking under microscope to identify packets and/or individual eggs. - Identification of egg packets on fecal floatation is rare 5. Praziquantel, Epsiprantel 6. Prevent ingestion of intermediate host. In addition to treating pet for D. caninum, make sure pet is receiving adequate flea and lice control

Answer 7

Tapeworms The small intestine

Answer 8

Dipylidium caninum

Answer 9

Dipylidium caninum

Answer 10

1. Dogs: T. pisiformis (most common) 2. In some cases, no clinical signs are noted. Some pets may “scoot” due to perianal irritation. Some cases may have gastrointestinal impaction 3. Taenia pisiformis: ingestion of intermediate host (rabbit) tissue that contain cysticerci 4. - Identification of proglottids on fecal material - Fecal float (high specific gravity) to look for eggs - Not always seen on fecal float because proglottids are not distributed evenly through fecal material - Additionally, eggs do not float consistently - Note: Taenia eggs are indistinguishable from Echinococcus eggs under the microscope 5. Praziquantel, Epsiprantel, Fenbendazole 6. Elimination of predatory activities

Answer 11

Taeniid spp. Looks like an upside down mushroom cap !

Answer 12

Taenia eggs are indistinguishable from Echinococcus eggs under the microscope

Answer 13

1. dogs 2. SI 3. Gravid proglottids are shed in feces - Intermediate host (usually rodents) ingests the eggs and hydatid cysts develop - Definitive host becomes infected by ingesting intermediate host containing multilocular cysts 4. Difficult to identify visually due to small size b. Requires testing such as CELISA or PCR to diagnose c. Note: Echinococcus eggs are not distinguishable from Taenia eggs under the microscope 5. Praziquantel

Answer 14

The internmediate host is usually a rodent?

Answer 15

Echinococcus granulosus egg

Answer 16

Hyatid cyst of E. granulosus.

Answer 17

1. This disease is characterized by instability of one or bot hip joints, leading to degenerative joint disease, OA, and subluxation of the hip. 2. German Shepherd, Golden Retriever, Labrador Retriever 3. 3-8 mo of age 4. - Pain on hip extension - Positive ortolani sign - Bunny hopping gait - Palpable crepitation over the hips 5. Ortho exam, xrays - Seen on xray: - Morgan line- osteophyte formation at insertion of joint capsule - Less than 80% coverage of femoral head - Remodeling, sclerosis & thickening of femoral neck - Joint laxity (see Penn HIP) - Perichondral osteophyte formation - Remodeling and sclerosis of the acetabulum 6. Over 80% of dogs will improve with conservative management but c/s will return later in life due to progression of degenerative changes. --> Conservative Management: - NSAIDs, weight management, nutraceuticals, conservative exercise --> Surgical: - Juvenile pelvic symphysiodesis: A procedure in which you cauterize or staple the growth plate in a dog 14-20 weeks of age. This encourages more acetabular coverage of the femoral head as the dogs grows. No improvement of hip dysplasia if it was severe pre-op; DJD still progresses. - TPO - Total Hip 7. Prevent over-nutrition; Over-nutrition during growth is related to a higher incidence of hip dysplasia. Conscious breeding

Answer 18

A triple pelvic osteotomy involves three cuts: the pubis, ischium, and ilium and placement of a special plate on the ileum to rotate the pelvis. This should result in increased acetabular coverage of the femoral head as the patient matures. Want to perform at 6 mo - 12 mo of age. Patient is not a good candidate if there is any evidence of DJD or subjectively the surgeon feels there is too much laxity

Answer 19

1. It originates on the medial surface of the lateral femoral condyle and inserts onto the craniomedial surface of the tibial plateau beneath the intermeniscal ligament. 2. Prevent cranial drawer, excessive hyperextension and internal rotation. 3. German Shepherds, Golden Retrievers, Labs, Boxers, Newfoundlands, Mastiff, Akita, etc. 4. Acute or chronic lameness that does not improve with rest, sit with knee rotated outward (positive sit test) +/- mild improvement with NSAID therapy. 5. Ortho exam, xrays - Positive cranial drawer, Positive tibial compression test (tibial thrust), Painful on extension. - Osteophytes typically present, especially along femoral trochlear ridge, tibial plateau, and patella; Joint effusion 6. Lateral suture, TPLO, TTA, cage rest for small dogs/owners who can not afford surgery; TPLO is gold standard.

Answer 20

One hand is placed on the distal femur with the thumb behind the lateral condyle. The other hand is placed on the proximal tibia with the thumb behind the fabella.

Answer 21

Lateral Suture (Extracapsular Repair) ● Heavy suture placed around fabella on lateral aspect and then through a hole in the tibia. This runs in similar orientation as the original cranial cruciate ligament except your prosthesis is outside the joint (“Extracapsular repair”). ● Usually done on smaller dogs <20kg . ● Can cycle, stretch, and break resulting instability

Answer 22

Tibial Plateau Leveling Osteotomy ● Osteotomy is performed at proximal tibia and the tibial plateau is then rotated and then stabilized with a bone plate. This biomechanically changes the leg such that there is more load on the caudal cruciate ligament (which can handle the load) and you eliminate tibial thrust. ● You did not fix the cranial cruciate ligament. Therefore, you will always have cranial drawer. However, the leg will be dynamically stable and prognosis is excellent.

Answer 23

Tibial Tuberosity Advancement ● Cut along cranial aspect of proximal tibia. ● Insert a cage in between the tibia to advance it. ● Goal is to make patellar tendon perpendicular to the tibial plateau. ● This results in elimination of tibial thrust similar to the TPLO. ● Newer procedure, but early results are comparable to TPLO thus far.

Answer 24

Ununited anconeal process (UAP), osteochondrosis dissecans (OCD) of the humeral condyle, fragmentation of the medial coronoid process (MCP), and elbow incongruity.

Answer 25

1. German Shepherds!!!! Basset Hound, Bloodhound, Lab Retriever, Newfoundlands 2. By 4-12 months you will see forelimb lameness with pain on flexion and extension. 3. Physis should be closed by 4-5 months of age - Radiographs: visualize un-united anconeal process best on flexed lateral projection. 4. Can try medical management with NSAIDS but usually unrewarding. Excision of anconeal process seems to provide most consistent results

Answer 26

1. Abnormal endochondral ossification resulting in thickening of the articular cartilage 2. Failure of immature cartilage to form bone in the (humeral head, elbow joint, etc) --> abnormal cartilage thickening --> malnourished cartilage cells die --> formation of a defect at the junction between cartilage and bone --> normal daily activity may cause fissures in the cartilage that eventually communicate with the joint, forming a cartilage flap. 2. Growth rate, genetics, hormonal imbalance, and diet 3. German Shepherds, Golden Retrievers, Labrador Retrievers, Newfoundlands, Rottweiler 4. By 4-7 mo of age you will see forelimb lameness, pain on flexion and extension of the elbow joint; Bilateral disease at least 50% of the time 5. Xrays - Shoulder: Defect (flattening) present in the humeral head on X-rays of the shoulder. Older dogs that have chronically untreated OCD present with large calcified fragments “joint mice” and osteoarthritis. - Subchondral bone defect & surrounding sclerosis - Deposition of new bone - Ununited anconeal process, fragmented coronoid process 6. Surgical removal of flap and debridement of subchondral bone gives fair to excellent results with most dogs. - Typically performed arthroscopically https://www.acvs.org/small-animal/canine-elbow-dysplasia/ https://www.google.com/search?sca_esv=3ec8625b255dccb3&q=fragmented+coronoid+process+dog+radiograph&udm=2&fbs=ABzOT_CWdhQLP1FcmU5B0fn3xuWpA-dk4wpBWOGsoR7DG5zJBr1qLlHFB6ZBcx-Arq68_wdJlnBwAHirUEMwdE4O8L3EsOBFudme3Tao3KPzT2BTFLr2mwwWDogIjAMMisnTxQF3jo-eMbkcqf6NRauwjSOZkIzuDxRHRvQjDldojY7n11qrNAseRBnsUiJfrjTwE9iBSeZON5KKLu12rw-UtNuhjMkMVw&sa=X&ved=2ahUKEwiR8u_a7PWLAxWIjYkEHVjvORsQtKgLegQIEhAB&biw=1406&bih=857&dpr=2 https://vetrica.com/osteochondrosis-in-the-dog/ https://www.ethosvet.com/blog-post/elbow-dysplasia-in-dogs/

Answer 27

1. Labrador Retrievers, Golden Retrievers, Newfoundlands, Rottweilers 2. Usually by 4-7 months of age you will see Forelimb lameness and pain on flexion and extension of elbow ● May be bilateral 3. rads - Medial coronoid process may be large, blunted, or have osteophyte associated with it on the lateral view 4. Surgical removal of the fragment or arthroscopy for removal of fragment are most common treatments.

Answer 28

1. Most commercial antifreeze 2. Sweet 3. Ethylene Glycol is metabolized into alcohol dehydrogenase --> glycoaldehyde --> glycolic acid --> glyoxalate and oxalic acid 4. - Stage 1: 30 min - 12 hrs post ingestion --> Neuro phase/ drunken behavior, anorexia, vomiting, PU/PD, Ca oxalate crystalluria - Stage 2: 12-24 hrs post ingestion --> Cardio phase where you see tachypnea and tachycardia, often unnoticed - Stage 3: 12 -72 hrs post ingestion --> Renal failure, MA, elevated osmolar gap, HypoCa, HyperGlucosemia 5. In order for tx to be effective, you must start tx before toxic metabolites are generated. - Fomepizole = inhibits alcohol dehydrogenase; most effective within 8 hrs of ingestion; very expensive - 20% ethanol = competitively inhibits alcohol dehydrogenase, less effective than Fomepizole but useful within 4-8 hrs of ingestion; Can worsen C/S - GI protectants, IVF, Diuretics 6. Prognosis is good if therapy started within 4-8 hrs. Guarded if patient is azotemic. Grave if oliguria/anuria present w/o dialysis treatments.

Answer 29

1. Acids = burns in mouth, esophagus, and stomach; Alkali = lesions appear in 8-12 hrs 2. Dilute milk or water, GI protectants for several days, monitor for development of ulcers - DO NOT induce vomiting because this will further damage the esophagus. - DO NOT administer activated charcoal as that will bind acids and alkalis.

Answer 30

1. Nontoxic and only cause mild GI upset. 2. Do not use paint thinners or turpentine as that can be irritating and painful to skin and foot pads. 3. If ingested, administer dilute milk or water, GI protectants; DO NOT induce vomiting due to risk of aspiration pneumonia.

Answer 31

1. Penitrem A, a neurotoxicant produced by Aspergillus spp. 2. Panting, restlessness, hypersalivation, Incoordination and fine motor tremors **, Can progress to tonic spasms, hyperthermia, ataxia and seizures 3. History, P vomiting up large amounts of garbage. 4. Induce emesis ONLY if not neurologically compromised/recumbent, Activated charcoal, methocarbamol for muscle tremors, diazepam or phenobarb for seizures, GI protectants.

Answer 32

1. Warfarn - 1st gen, brodifacoum and bromidialone - 2nd gen, Diphacinone (indandione). 2. The toxic effect is by inhibiting Vitamin K1 epoxide reducatase --> prevents activation of vit K dependent coag factors 2,7,9,10 3. Depends on location and severity of hemorrhage; commonly in body cavities, hemmorhagic shock - pale mm, prolonged CRT, tachycardia, weak pulses, abdominal distension, resp distress. These signs typically occur 3-7 days post ingestion but compounds and persists for 4-6 weeks. 4. - PT/PTT: prolonged for both. Takes 36-72 hrs for PT because that depends on Factor 7 which has the shortest half life of all vit k dependent coag factors. PTT takes 3-5 days to see. 5. - If within 2-4 hrs induce emesis. - If within 8-12 hrs give AC +/- sorbitol - Treat with Vit K1 for 4 weeks OR check PT 36-72 hrs later to determine if Vit K1 is needed. - Check PT 48-72 hrs after completion of Vit K1. - If O is unsure if P ingested rat bait or not, only induce emesis if PT is normal. Perform PT, put on Vit K1, check Pt 48-72 hrs after completion of Vit K1. - if P is presenting with hemorrhage secondary to coagulopathy, need ot give plasma transfusion ASAP because plasma is needed for immediate hemostasis.

Answer 33

1. Inhibits oxidative phosphorylation and ATP production, especially in neurons --> Loss of ability to maintain osmotic gradients, cerebral edema, increased intracranial pressure. 2. If ingested a high dose, will see tremors, seizures, hyperexcitability, and hyperthermia < 12 hrs post-ingestion. If ingested a lower dose, won't see signs for a few weeks post ingestion then will see ascending paralysis beginning in the hindlimbs. 3. If acute, gastrointestinal decontamination (emesis or gastric lavage and activated charcoal) ● Once clinical signs present, largely symptomatic/supportive care a. Seizure treatment/prophylaxis b. Treatment for increased intracranial pressure i. Mannitol and/or furosemide to reduce cerebral edema ii. Incline plane 30° to promote venous return ● Severe clinical signs warrant poor prognosis

Answer 34

1. Precursor converted into active Vitamin D after ingestion --> increased intestinal absorption of calcium and mobilization from bones --> severe hypercalcemia, hyperphosphatemia and organ injury. 2. PU/PD, GI upset, Acute renal failure, cardiac arrhythmias. - Presence of hyperphosphatemia (12 hrs post-ingestion), hypercalcemia (24 hrs post) and azotemia (36-48 post). 3. If acute, emesis and activated charcoal - Hypercalcemia present a. Saline diuresis and loop diuretic (i.e. furosemide) to promote urinary calcium excretion. b. Corticosteroids can be used to decrease intestinal Ca absorption and urinary retention. c. Bisphosphonates (pamidronate) inhibit osteoclast activity and bone re-absorption. - Azotemia present a. Supportive care for acute renal failure. b. Prognosis guarded to grave once progression to renal failure occurs.

Answer 35

Soft tissue sarcomas (STS) in dogs are composed of a variety of tumors derived from mesenchymal cell origin. These tumors include peripheral nerve sheath tumors (PNST), hemangiopericytomas (HPC), fibrosarcomas (FSA), liposarcomas, malignant fibrous histiocytomas, myxosarcomas, rhabdomyosarcomas, leiomyosarcomas, etc. These tumors are all grouped together because they all share the same biologic behavior. They are all locally invasive while their potential for metastasis can be determined by their histologic grade.

Answer 36

Constitute 15% of all skin and subcutaneous tumors in dogs ● Common histologies affecting the skin and subcutaneous tissue include FSA, PNST, and HPC ● All are very locally invasive regardless of grade ● Metastatic potential can be determined by histologic grade ● Treatment is aimed at surgical removal with wide margins ● Local recurrence is common following conservative excision.

Answer 37

1. - FNA: May be read out as “spindle cell proliferation” in well-differentiated tumors ● Most exfoliate poorly leading to sparsely cellular samples - Biopsy: Occasionally required for diagnosis if FNA is non-diagnostic ● Required for grading - Thoracic rads to check for metastasis - CT or MRI recommended for surgical planning 2. Wide excision with a minimum of 3 cm margins is ideal in locations that are amenable to such a surgery. Amputation not recommended. - Radiation therapy recommended if surgical margins are incomplete or narrow. - Consider chemo if metastasis is present, high grade tumor, or at visceral site. (Adriamycin (doxorubicin) based chemo protocols are most commonly used.)

Answer 38

Grading ● Biopsy required for grading ● Gives probability of metastasis a. Low or intermediate grade tumors have a < 20% chance of metastasis. b. High grade tumors have a 40-50% chance of metastasis. ● Factors assessed for grading a. Differentiation of tumor i. Well differentiated, moderately differentiated, or poorly differentiated. b. Percent necrosis in tumor i. No necrosis, <50% necrosis, >50% necrosis. c. Mitotic index i. <10 mitoses/10 high power fields, 10-19 mitoses/10 high power fields, >19 mitoses/10 high power fields. Control Rates ● Incomplete surgical excision with adjuvant radiation therapy. a. 95% 1 year control b. 85% 3 year control c. 75% 5 year control ● Only up to 1/3 of affected dogs die of tumor related causes.

Answer 39

Hemangiosarcoma (HSA) is a malignancy of endothelial cells that normally line blood vessels. It can develop any place in the body that has blood vessels, but most commonly occurs in the spleen of dogs. Another form of the disease is the cutaneous form, which is induced by ultraviolet radiation from the sun. Because of the biological differences between the cutaneous and visceral forms of the disease, we will discuss each of them separately in this PowerPage.

Answer 40

Most commonly affects large breed dogs such as German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, etc. a. Most commonly affected organ is the spleen i. Other commonly affected organs include the right atrium (auricle), liver, retroperitoneal space, subcutaneous tissue. ● The most common tumor to metastasize to the brain ● Often present through emergency for acute hemoabdomen and hypovolemic shock, or pericardial. effusion and cardiogenic shock. a. May have history of “good days” and “bad days” associated with small bouts of internal hemorrhaging and re-absorption of the blood. ● Highly metastatic via blood vessels and direct contact seeding within the abdomen if tumor ruptures. ● Median survival times generally do not exceed 1 year, regardless of treatment.

Answer 41

1. - AUS: HSA often appears cavitary and fluid-filled; Also used to identify free abdominal fluid, primary and metastatic lesions, especially in the liver, lymph nodes, and serosal surfaces. - FNA + cytology: unrewarding - Surgical biopsy: Splenectomy recommended for suspected splenic lesions or for those with a chance of rupturing (cavitary, large, fluid-filled). Incisional biopsies (Tru-cut, punch biopsy, etc.) that do not remove the entire tumor run the risk of hemorrhage. - Thoracic radiographs: To identify pulmonary metastasis and pericardial effusion. - **CBC, chemistry panel, urinalysis: Common findings: anemia (with or without regenerative response), thrombocytopenia, presence of schistocytes - Cardiac ultrasound - Coagulation panel - CT or MRI 2. Resuscitate and stabilize with IV fluids and blood products as necessary for hemoabdomen. ● Exploratory surgery to remove the primary tumor and biopsy abnormal tissues. ● Adriamycin-based chemotherapy to help delay development of metastasis and prolonged survival 3. Prognosis of the splenic form depends on the stage of the disease and whether or not Adriamycin is administered: ● Surgery alone: median survival time 3 weeks-3 months ● Stage I – single lesion without hemorrhage and treated with surgery and Adriamycin-based chemotherapy: 9 months. ● Stage II – single lesion with hemorrhage and treated with surgery and Adriamycin- based chemotherapy: 5-6 months . ● Stage III – metastasis present treated with Adriamycin chemotherapy: 3.5 months

Answer 42

Induced by chronic sun exposure ● Dogs with increased risk: a. Breeds with unpigmented skin and white haircoat, thin short hair, high amounts of sun exposure. b. Fawn colored Pit Bulls, Whippets, Dalmations, English Pointers, etc. ● Commonly affected sites: a. Sparsely haired areas b. Ventral abdomen and medial thighs c. All sun-exposed areas are abnormal and have potential to undergo malignant transformation and form multiple tumors. d. Can occur in conjunction with solar-induced squamous cell carcinoma. ● Biological behavior is different from visceral and subcutaneous forms of HSA a. About 1/3 may metastasize and are more likely associated with advanced, invasive forms of the disease. Treatment ● Surgery to remove invasive or problematic (bleeding, infected) lesions. ● Prevention: apply sunblock or keep indoors during intense sunlight hours for dogs with thin hair coats and unpigmented skin. Prognosis ● May live for years with these tumors. ● New tumors will form since all of the affected skin is abnormal.

Answer 43

1. most common malignant oral tumor in the dog 2. Chow Chows, Golden Retrievers, Poodles, and Cocker Spaniels. 3. Melanocytes 4. Amelanotic and may not contain any melanin 5. Morphologically, OMM can look like neoplasms of mesenchymal (sarcoma), epithelial (carcinoma), or round cell origin. 6.

Answer 44

1. Biopsy is needed to definitively diagnose OMM 2. Minimum database, Regional lymph node aspirates, Thoracic radiographs 3. Cross sectional imaging with CT or MRI are often helpful in assessing bone involvement and in surgical planning 4. Treatment of choice for the primary tumor is surgical excision with wide margins, which usually necessitates removal of underlying bone (partial mandibulectomy or maxillectomy). - Radiation therapy is useful in shrinking the tumor or temporarily slowing its growth if surgical excision is not an option or if there is high chance of local recurrence; carboplatin and cisplatin, have shown mild efficacy in temporarily shrinking gross OMM lesions. 5. - Tumors size: tumors <2cm have a median survival time of about 17 months - >2cm have a median survival of about 5.5 months - Tumor location: dogs with tumors in the rostral oral cavity have longer median survival rates than those in the caudal oral cavity

Answer 45

1. Common primary bone tumor in dogs 2. Most commonly occurs in large and giant breed dogs in the metaphyseal regions of the appendicular skeleton. Distal radius, proximal humerus, distal femur, proximal tibia (“away from the elbows and toward the knees”). 3. - limb rads: Classically a lytic and productive lesion at the metaphysis of the bone. Do not cross joints into adjacent bones. - FNA + cytology: Aspirate the center of the lesion often result in “reactive bone”; possibility of pathologic fracture with aspiration or biopsy. - Biopsy: May be required for a definitive diagnosis in equivocal cases. - Thoracic rads: Pulmonary metastasis visible in less than 10% of cases at the time of diagnosis but will develop in the future in most cases. - bone scan or nuclear scintigraphy: Used to find or rule out suspected bone metastasis. - Bloodwork: Elevation in alkaline phosphatase on a chemistry panel is associated with a worse prognosis. 4. Amputation is the most effective way to alleviate pain of bone destruction. Palliative as most dogs will develop metastasis in the future - Limb sparing procedures have a high rate of chronic resistant infections, tumor recurrence, etc. - radiation? - chemo?

Answer 46

Technetium-99–hydroxymethylene diphosphonate binds to areas of active bone and is detected in imaging. ● Sensitive, but poorly specific. a. Increased uptake can occur with bone tumors, arthritis, fractures, or osteomyelitis. ● Alternatively, full body radiographs can be performed.

Answer 47

radiation: Can be effective in palliating the pain of bone tumors in up to 75% of cases, for about 2- 3 months. a. No detectable improvement in pain in 25%. ● Pathologic fractures may be more likely to occur if pain is well controlled and use of the limb is increased. chemo Proven to extend survivals over surgery alone. ● Chemotherapy protocols mostly consist of a platinum drug (cisplatin or carboplatin) as a single agent or in conjunction with Adriamycin (doxorubicin). ● Generally thought not to be effective if macroscopic disease is present. ● Bisphosphonates (pamidronate) are osteoclast inhibitors that can help palliate pain in patients where surgery is not an optio

Answer 48

1. Aqueous tear film deficiency. Usually bilateral and idiopathic that results in persistent conjunctivitis, mucopurulent discharge, superficial corneal vascularization, superficial corneal pigmentation, and fibrosis +/- corneal ulceration. 2. Occurs primarily in dogs, rarely in cats. Dogs: Most often associated with autoimmune dacryoadenitis (inflammation of the lacrimal gland) and destruction of both the lacrimal and nictitans glands. - Distemper, systemic sulfonamide, heredity, and trauma are less frequent causes of KCS in dogs. Cats: Chronic feline herpesvirus 1 (FHV-1) infections that scar the conjunctiva and openings of the tear ducts. 3. A. Schirmer tear test = diagnostic test of choice 4. A. Artificial tear solutions and ointments: Cyclosporin, Tacrolimus, Pimecrolimus B. AM-corticosteroid cream IF NO CORNEAL ULCER

Answer 49

1. Bupthalmos; big blue eye, Visual impairment, tortuous episcleral vessels 2. Tonometry: IOP > 30 mmHg, Ocular US, gonioscopy to look at iridocorneal angle 3. Topical or systemis: carbonic anhydrase inhibitor, beta-adrenergic antagonist, IV mannitol, +/- topical or systemic corticosteroids - CAI = dorzolamide - Prostaglandin analogue = Latanoprost 4. Always treat contralateral eye prophylactically. Treat even if blind to address pain.

Answer 50

1. Genetic inheritance (Miniature Schnauzer), metabolic disturbances such as diabetes mellitus, trauma, nutritional imbalance such as orphaned puppies on milk replacer, and lastly chronic uveitis - an inflammatory disease of vascular tissue deep in the eye. 2. Protein accumulation --> Opaque lens --> light can not pass through retina --> blindness. 3. Cloudy white pupil, decreased vision, +/- painful (chronic cases). 4. Uveitis, glaucoma (increased intraocular pressures), and lens luxation (dislocation of the lens), +/- retinal detachment --> blindness. 2. Blood and urine glucose, ocular US, electroretinography 3. Surgery - phacoemulsification. Small incisions are made in the cornea and the lens capsule to pulverize the lens and remove it via vacuum. Surgery should not be performed if the cornea is unhealthy. 4. Good to excellent with surgery (80-90% success rate). 5. Lenticular sclerosis which is a common sign of aging. This is a result of lens fiber compression --> degeneration --> translucency.

Answer 51

1. Entropion is the turning in of the edges of the eyelid so that the eyelashes and fur rub against the eye surface. Ectropion is a slack eyelid edge that is turned out, usually with a large notch or “crack” in the eyelid. It occurs mainly in larger dog breeds and is usually associated with excessively long eyelids (Bloodhound, Bullmastiff, Great Dane, Newfoundland, Saint Bernard, and several Spaniel breeds). 2. - Entropion: conjunctival and corneal irritation, and if protracted, corneal scarring, pigmentation, and corneal ulceration - Ectropion: Conjunctival exposure to environmental irritants and secondary bacterial infection can result in chronic or recurrent conjunctivitis. 3. Early spastic Entropion = Temporary eyelid-tacking sutures or surgical staples left in place for 2–3 weeks may be used. Established entropion = requires surgical correction that, in breeds with heavy upper facial folds (such as the Chinese Shar-Pei), may need to include tacking of the dorsal facial folds to achieve optimal results. Ectropion: - Topical anti-inflammatory medications may temporarily control mild or intermittent inflammation. - Mild cases may also be controlled by repeated, periodic lavage with eyewash and chronic lubrication with topical gel or ointment. - Generally, surgical eyelid-shortening procedures are indicated to provide more normal eyelid function and more appropriate protection of the globe.

Answer 52

1. Uveitis is inflammation of the deep tissues of the eye. 2. Leaky vessels within the iris, the colored portion of the eye. 3. In all species, the cause is usuallly idiopathic. - Unilateral uveitis: Penetrating and non-penetrating trauma, rarely intraocular neoplasms or helminths. - Bilateral uveitis: immune mediated and infectious diseases including = FIP, FeLV, FIV, Feline Toxoplasmosis, Systemic mycoses in dogs and cats, Canine brucellosis, Canine Ehrlichiosis Leptospirosis in horses, Bovine MCF, IBR, EVA, CSF. 4. Conjunctival hyperemia, photophobia, blepharospasm, aqueous flare (cloudiness of aqueous humor), color change of iris, midrange to miotic pupils. 5. Tonometry: IOP < 10 mmHg, BW to look for underlying cause 6. Topical or systemic corticosteroids or NSAIDs unless secondary to protozoal or fungal infection or corneal ulceration, topical atropine for pain, treat underlying cause.

Answer 53

When the eyelashes grow out of the meibomian gland along the eyelid margin. This condition is only treated if there is corneal/conjunctival disease. Treatment involves destroying the follicular base of the eyelids via cryotherapy.

Answer 54

This is a condition in which eyelashes grow out of the meibomian gland and subsequently protrude through the conjunctival surface --> corneal irritation. Tx via excision, cautery, or cryotherapy.

Answer 55

1. Pruritus in dogs and cats 2. Ctenocephalides felis felis 2a. Bartonella henselae, Dipylidium caninum, and Yersinia Pestis 2b. 27 eggs/day; lays eggs every 24-36 hrs 2c. 3 weeks ; in perfect conditions - 16 days. 2d. Flea infestation: leads to mild to moderate pruritus; Flea allergy dermatitis: patient is actually allergic to the flea saliva. This is a Type 1, 4, and basophil hypersensitivity. The salivary enzymes contain proteolytic enzymes, histamine-like compounds, anti-coagulants, haptens and antigens

Answer 56

1. Intense pruritus, erythema, alopecia, papules, pustules, excoriations, crusts, and moist dermatitis. - Hyperpigmentation and lichenification may develop in more chronic lesions. 2. In dogs - Caudal-dorsal distribution aka Base of tail, posterior/lateral aspect of rear legs and ventral abdomen; In cats - Often neck and face 3. Common cause of miliary dermatitis and eosinophilic granuloma complex 4. C/S, flea dirt, intradermal testing 5. A. Symptomatic and palliative therapy - Short term glucocorticoids B. Environmental flea Control - treat each animal in house, deep clean environment; will take 2-3 mo for fleas to be properly eliminated b/c pupa stage is 1-2 mo and is very resistant to environmental treatments. C. Adulticides D. Insect growth regulators

Answer 57

Eliminates fleas present on animal but does not prevent re-infestation. Depending on the product, may take minutes to 48 hours. Ex: Fipronil (toxic to rabits), Fluralaner, Alfoxalaner, etc.

Answer 58

Disrupt developmental process. Ex: Lufenuron, Pyriproxifen, S-methoprene

Answer 59

Permethrin; toxic to cats

Answer 60

The exact cause is unknown, but it is proposed to be due to a defect in intestinal absorption of zinc. Tx with zinc supplementation. Response to tx is seen within days.

Answer 61

1. Clinical signs consistent with DLE include depigmentation of the nasal planum, erythema, scaling, and loss of the "cobblestone" appearance of the nasal planum. Alopecia, crusting, scaling, and ulcerations can also be seen on the face, muzzle, lips, pinnae, and periorbitally.

Answer 62

An NSAID; do not give with steroid

Answer 63

1. Sarcoptes scabiei canis 2. A. Intense pruritus B. Small bumps C. Excoriations, crusts, and seborrhea on abdomen, chest, ears, elbows, and legs 3. Skin scrapings 4. A. Lime-sulfur dips B. Selamectin C. Single dose of fluralaner D. Ivermectin is effective, however is toxic in breeds that have the MDR1 mutation (e.g., collies) 5. It is zoonotic, however disease is self-limiting in humans

Answer 64

Sarcoptes scabei canis

Answer 65

1. Demodex canis 2. In the hair follicle and sebaceous glands 3. deep skin scrapings or hair plucking 4. A. macrocyclic lactones B. milbemycin oxime C. moxidectin, ivermectin D. isoxazolines

Answer 66

1. Cheyletiella yasguri 2. A. Intense pruritus (but sometimes no itching) B. Scaling on the back C. "Dandruff" that moves around on the animal's fur 3. Direct observation and microscopy 4. A. Lime-sulfur dips B. Selamectin C. Single dose of fluralaner D. Ivermectin is effective, however is toxic in breeds that have the MDR1 mutation (e.g., collies)

Answer 67

Cheyletiella yasguri

Answer 68

1. Collies and Shetland Sheepdogs 2. Atrophy of muscles and erosion, crusting, and alopecia of skin which is exacerbated by heat and sun exposure. 3. This condition is treated with corticosteroids, Vitamin E, and omega-3 fatty acids. Often unrewarding

Answer 69

1. Proptosis is anterior displacement of the globe and the eyelids become trapped behind the globe. This leads to secondary orbital hemorrhage,, swelling, and corneoconjunctival drying and ulceration. 2. Proptosis is most commonly caused by blunt trauma such as getting hit by a car, fighting with another animal, etc. 3. A. Lubricate the exposed cornea and conjunctiva. B. Surgery: Lateral canthotomy (cut lateral canthus of eye to relieve pressure) + complete temporary tarsorrhapy (closing eyelids together; two interrupted horizontal mattress sutures with stent). B1. Post op systemic and topical AB, corticosteroids, +/- mydriatics 4. Prognosis depends on pupil size and reflexes, duration of exposure, breed (brachys are predisposed), other systemic trauma. 5. KCS, corneal ulceration, blindness due to optic nerve degeneration, lateral strabismus if medial rectus muscle is injured.

Answer 70

1. Cherry eye is hypertrophy, inflammation, and subsequent prolapse of the nictating membrane. 2. Beagles, Bulldogs, Boston terrier, cocker spaniel, etc. 3. Surgical replacement. Partial or complete excision should be avoided as this predisposes the patient to KCS. 4. Increased risk of developing KCS; Even if replaced the dogs are still at risk of developing KCS. Monitor tear production of these dogs after surgery.

Answer 71

1. Weimaraners are predisposed and litter-mates will commonly be affected. Although the exact cause is unknown, the leading hypothesis is recent vaccination leading to hyper-reactivity of the immune system. In a study of 53 Weimaraners with HOD, all had been vaccinated within the past 30 days. 2. Clinically you will see a painful, swollen, warm distal limb. Pain is elicited upon metaphyseal palpation. 3. Radiographs - double physeal line 4. Analgesics 5. Prognosis is excellent although the patient may experience flare ups.

Answer 72

1. Typically seen in young large and giant breed dogs; more common in males. Will be pyrexic, acutely lame, painful on long bone palpation (femur, humerus). 2. Increased medullary opacity in long bones, periosteal new bone 3. Analgesics 4. Prognosis is excellent although the patient may experience flare ups.

Answer 73

1. Avascular necrosis of the femoral head 2. 3-12 mo old small or toy breed dogs. 3. Pelvic limb lameness 4. Radiographs: moth eaten appearance of the femoral head and neck, decrease bone opacity at femoral epiphysis. 5. FHO or total hip replacement, analgesics 6. Prognosis with surgery is good to excellent

Answer 74

1. Hereditary disorder 2. Ectopic development of the patella medial or lateral to the trochlear groove of the femur Patellar luxation can be classified according to the level of severity: Grade I — Clinical signs are mild and infrequent, and the patella can be manually luxated but easily returns to the trochlear groove. Grade II — The patella luxates during flexion of the joint and is repositioned during extension, causing animals to have a resolvable skipping lameness. Grade III — the dislocated patella is more frequently out of, instead of in, the trochlear groove, and lameness is consistent. Bone deformities are evident in these animals. Grade IV — Lameness and limb deformations are most severe. 3. Xrays, ortho exam 4. Surgery - varies based on severity of condition - can be as simple as a fascial releasing incision to deepening the trochlear groove, tibial crest transposition, etc. 5. Prognosis is good in mild or moderately affected patients.

Answer 75

1. Early on in life. In dogs, usually seen in German Shepherd Dog, Labrador Retriever. In cats, it is usually seen in Maine Coons since they are prediposed to developing hip dysplasia. 2. Heritable abnormalities such as elbow dysplasia (OCD, UAP, FMCP), angular limb deformities, etc). 3. A. Hyaline cartilage clefts and thinning B. Joint effusion C. Periarticular osteophyte formation 4. Lameness, difficulty rising, difficulty going up and down stairs, limited jumping and playing. 5. Xrays 6. Weight loss, controlled exercise, fatty acid supplementation, NSAID therapy, chondroprotectants such as glucosamine (support cartilage repair), acupuncture, laser therapy, +/- surgery (arthrodesis, joint replacement, etc).

Answer 76

1. German Shepherds, Collies and English Setters 2. Inadequate synthesis and secretion of digestive enzymes by the exocrine pancreas --> inactivity of digestive enzymes in the lumen of the small intestine. 3. The most common cause of EPI in dogs is pancreatic acinary atrophy. 4. The most common cause of EPI in cats is pancreatitis. 5. Malassimilation of nutrients (fats, carbs, proteins, vitamins, trace elements) + SIBO 6. Polyphagia, diarrhea and weight loss in a young animal 7. A. BW is usually normal B. Trypsin-like immunoreactivity or pancreatic lipase immunoreactivity is low (< 5 ug/l) 8. A. Exogenous pancreatic enzyme supplementation is the cornerstone of treatment of canine and feline EPI. - Powdered pancreatic extracts are usually adequate B. Parenteral cobalamin, vitamin K and oral vitamin E supplementation C. Highly digestible, low-fiber diet The correct answer is pancreatic acinar atrophy. This is an idiopathic condition where the exocrine cells of the pancreas atrophy with minimal inflammation. Chronic pancreatitis is a much more common cause of EPI in cats than dogs. For this reason, dogs with EPI do not usually have concurrent diabetes mellitus because the endocrine cells are spared, whereas cats often do have concurrent DM. Neoplasia and infection are rare causes of EPI.

Answer 77

1. Canine pancreatitis is almost always sterile. The etiology is not known, but these risk factors should raise your suspicion: ● Fat – obesity, fatty meals, hyperlipidemia ● Systemic inflammation, trauma, ischemia ● Endocrine diseases – hyperadrenocorticism, diabetes mellitus ● Drugs – azathioprine, l-asparaginase, tetracycline, doxorubicin ● In cats, the causes of pancreatitis are not as well understood 2. --> Dogs ● Mainly GI signs: vomiting, diarrhea, anorexia, cranial abdominal pain. A dog that hunches in a “praying posture” is a diagnostic clue for pancreatitis. ● Severe necrotizing pancreatitis can cause hypovolemia, fever, tachycardia, jaundice, and the systemic inflammatory response syndrome (SIRS). --> Cats ● Tend to have non-specific lethargy and anorexia and may or may not have any of the other GI signs listed above for dogs. 3. A. BW: Serum amylase and lipase are nonspecific and unreliable but may be markedly elevated. B. Imaging: AUS C. cPLI or fPLI - most SENSITIVE TEST 4. --> Dogs: A. Delay feeding OR post-duodenal feeding by tube, and/or feeding a NO fat diet B. IVF C. H2 blockers (i.e. Ranitidine) and anti-emetics D. Analgesics --> Severe Pancreatitis: A. Antibiotics are only indicated if pancreatic necrosis or sepsis is suspected B. +/- Plasma or heparin administration --> Chronic Pancreatitis A. Low fat, highly digestible diet --> Cats: A. Pain management B. Antiemetics C. Antibiotics D. H2 Blockers E. Treat underlying disease

Answer 78

1. Struvite and Calcium Oxalate 2. Medical dissolution is possible for most stones except calcium oxalate. 3. Cystine and urate stones are and therefore may NOT be visible on radiographs. 4. An alkalinizing diet should be used for cystine and urate stones. A reduced protein diet should be used for cystine, urate, canine struvite, and to a lesser degree calcium oxalate stones. 5. A. Increase urine volume by providing a diet with high moisture content. B. Reduce the quantities of crystal-forming substrates. C. Increase urinary solubility of crystal forming substrates via ph change.

Answer 79

The main treatment option is alkalizing the diet and allopurinol. Allopurinol will reduce the amount of uric acid produced, but the patient must be closely monitored for the formation of Xanthine stones. Urate are formed from diets high in protein which are metabolized to uric acid, acidifying the urine. The dalmatian breed is highly predisposed to the formation of urate stones.

Answer 80

1. Magnesium, ammonium, phosphate 2. Urinary tract infections caused by urease positive microbes. In cats, struvite stones are sterile. 3. A. Antibiotics based on urine culture and sensitivity. B. Struvite stones thrive in an alkaline environment so we want to acidifiy the diet. Additionally, we want to give high quality, low protein diet to reduce the amt of urease. - Low magnesium, phosphate, and ammonium diet. Decreased protein --> decreased urea --> less ammonia produced by the enzyme urease. This is important for dogs especially because of the urease positive microbes.

Answer 81

1. Reduced protein, sodium restricted, urine alkalinizing diet. 2. Urine alkalinizer (potassium citrate (preferred), or oral sodium bicarbonate) 3. Cuprimine and 2-MPG (binds to cystine to form a more soluble compound) are treatments used for cystine stones.

Answer 82

1. Schnauzers, Lhasa apso, Yorkies, Bichon Frise, Shih Tzu, Mini poodle 2. These are the most difficult stones to treat; typically require surgical removal, voiding hydropulsion, or lithotripsy. 3. Provide an alkalinizing diet to prevent new stones from forming! A. Low sodium diet: high sodium intake increases urinary calcium. Also, low protein, Ca, oxalate, Vit D, sodium. B. Adequate phosphorous concentration to prevent Vitamin D activation. Also, magnesium, Vit B6.

Answer 83

1. AKA VALLEY FEVER; Arizona, California, Nevada, and New Mexico 2. Midwest and Mississippi river valley 3. Ohio River Valley (east of the Mississippi River) 4. Washington, Oregon, California

Answer 84

1. Dogs, cats 2. Can be found in the soil; distributed by bird and bat feces 3. Inhaled -> converted to yeast and replicated in lungs -> moves inside blood cells -> circulates throughout body 4. --> Dogs: ■ GI: Weight loss, bloody stool, diarrhea (dogs > cats) ■ Respiratory: Cough, breathing difficulty, increased RR ■ Other organs can be affected as well (Nodular skin lesions, joint swelling etc.) --> Cats ■ Respiratory: Cough, breathing difficulty, increased RR ■ Weight loss and anorexia (No bloody stool) ■ Other organs can be affected as well (Nodular skin lesions, joint swelling etc.) 5. A. CBC: Anemia, neutrophilic leukocytosis, thrombocytopenia B. Chemistry: Hypoalbuminemia, hypercalcemia possible C. Radiographs: Diffuse or linear, nodular interstitial pattern, hilar lymphadenopathy, pleural effusion D. Fungal culture: Dangerous due to infectious aerosolization to lab workers E. Antigen testing: Serum, CSF or urine 6. A. Itraconazole: for 4-6 mo or at least 1 mo post c/s - Side effects: Anorexia, diarrhea, vomiting, hepatic enzyme elevations, vasculitis - Recheck monthly to monitor liver values 7. Decline in antigen concentration after 1-2 months of treatment is a good sign

Answer 85

1. Dogs and cats; think hunting dog 2. Soil fungus – in decaying vegetation, pigeon and bat feces 3. Inhaled -> converted to yeast and replicated in lungs -> moves inside blood cells -> circulates throughout body 4. stays in lungs more than other fungi but can also invade other body systems ○ Cough, increased RR, increased effort ○ Lethargy, anorexia and weight loss ○ Lymph node enlargement ○ Other body systems ■ Bone infection: Lameness ■ Urinary tract: Bloody urine ■ Eye: Light sensitivity, pain, glaucoma ■ Skin: Draining tracts, proliferative lesions, purulent material 5. Chest radiographs: a bronchointerstitial “snowstorm” pattern of pneumonia likely in hilar areas ○ Impression smear of cutaneous lesion or of draining tract -> Very thick-walled budding yeast ○ CBC: Chronic inflammation – mild anemia, monocytosis, lymphopenia, eosinophilia ○ Chemistry: Hypoalbuminemia, hyperglobulinemia ○ Urinary antigen test or PCR 6. Itraconazole for at least 2-3 mo and continue for 1-2 mo post c/s - Side effects: Anorexia, diarrhea, vomiting, hepatic enzyme elevations, vasculitis - Recheck every month to monitor liver values 7. Decline in urine antigen concentration after 1-2 months of treatment is a good sign

Answer 86

1. Cats more susceptible than dogs; dogs likely have more severe disease 2. Transmission is through pigeon poop, soil 3. Inhaled -> spread by macrophages in the bloodstream to organs 4. Respiratory – sneezing, nasal discharge (mucoid or hemorrhagic) ○ Weight loss, lethargy, anorexia ○ Ocular changes ○ Neurologic abnormalities ○ Cutaneous lesions more likely in cats ■ Roman nose presentation (swelling of bridge of the nose) 5. CBC: nonspecific – nonregenerative anemia, leukocytosis ○ Chemistry: changes reflect whichever organ is involved ○ Cytology: round, purple/blue with thick capsule ○ Serology 6. Amphotericin B +/- fluconazole for 3-5 mo to a year and for 2 mo post c/s - Side effects: nephrotoxicity, vomiting, anorexia - Must monitor kidney values (and hepatic values if on -azole 7. Monitor with latex agglutination antigen test to evaluate response to treatment

Answer 87

1. Cats and dogs affected 2. after heavy rainfall, dust storms or earthquakes spores come to surface and inhaled 3. Inhaled -> lymphatic dissemination to organs 4. Cough, increased respiratory effort ○ Weight loss/lethargy/weakness ○ Lymphadenopathy ○ Seizures ○ Lameness/bone pain ○ Uveitis/blindness 5. CBC: Nonregenerative anemia, neutrophilia ○ Chemistry: Hypoalbuminemia, hyperglobulinemia, if liver is involved -> elevated liver enzymes, if the kidneys are involved -> BUN and phosphorus increases ○ Radiographs: Diffuse, interstitial or mixed alveolar pattern, most will have hilar lymphadenopathy ○ If draining tracts, impression smears may reveal spherules with double walls and full of endospores ○ Serology ○ Culture only in a special lab. 6. Ketoconazsole, Itraconazole for at least 3 mo and 2 mo post c/s. Can add Amphotericin B is not responding to tx. - Side effects: Anorexia, hepatic enzyme elevations, adrenal insufficiency, cataracts (with >12 months therapy)

Answer 88

1. Clinical signs include vomiting, anorexia, pain on abdominal palpation, diarrhea. 2. A. Xrays - you will see multiple distended loops of intestine (gas filled) B. AUS C. +/- contrast rads with barium D. Bloodwork - electrolyte imbalance, acid base abnormalities; Hypochloremia such as 3. A. Surgical removal (Enterotomy + removal) +/- resection and anastomosis (depends on health and viability of intestine) B. Correct electrolyte +/- acid-bace imbalance C. Post-op AB - Cefazolin if enterotomy of stomach and proximal intestine, Cefoxitin for lower SI and colon. 4. Your biggest concern is septic peritonitis due to leakage at the incision site. This can occur if fibrin degrades at the incision site before proper college and deposition. The most common time for this procedure to fail is within the first 3 to 5 days.

Answer 89

1. Isospora spp. 2. Young puppies and kittens (4-12 weeks) in highly populated and contaminated areas. 3. Diarrhea 4. Fecal flotation 5. Sulfonamides such as Sulfadimethoxine or trimethoprim sulfa. 6. Maintain a clean environment; organism is highly environmentally resistant so need to use chlorine to disinfect. - It is important to pick up the stools as soon as possible to avoid sporulation and contamination of the environment with cysts. 7. Luckily, Isospora is species-specific so zoonosis is not a concern.

Answer 90

1. Horner's syndrome occurs secondary to either a) trauma to the brachial plexus, thorax, or neck, b) otitis media/interna, c) guttural pouch disease in horses, or d) a lesion at in the hypothalamus, T1-3, or the cranial cervical ganglion (most common form of Horner's). 2. C/S include miosis, ptsosis, and enopthalmos.

Answer 91

1. Giardia duodenalis/intestinalis 2. Giardia A and B are zoonotic, the others are host specific 2. Weight loss, chronic greasy diarrhea (usually no blood). - May present asymptomatic 3. Fecal-oral transmission, fomites, drinking untreated water from wells/lake water, eating contaminated food. - The type of giardia that infects dogs and cats does not infect humans. The giardia that infects dogs does not infect cats and vice versa. 4. Humans 5. In humans it is! 6. Fecal examination of the trophozoite; Giardia should be distinguishable from trichomonads which have a single nucleus and an undulating membrane. 7. Fenbendazole, metronidazole.

Answer 92

1. Sarcoptes scabei 2. A. Intense pruritus B. Small bumps, excoriations, crusts, and seborrhea on abdomen, chest, ears, elbows, and legs 3. A. Skin scraping B. Positive pinnal-pedal reflex 4. A. Lime-sulfur dips B. Selamectin C. Fluralaner - not labeled D. Ivermectin but not in collies

Answer 93

1. Otodectes cynotis

Answer 94

1. Demodex canis 2. There are 2 clinical forms of canine demodicosis: Localized (limited to a small area) and generalized (found on the entire body). A. Localized demodicosis is usually seen in dogs less than 1 year old. Affected dogs will have 1 to 5 small, isolated areas that are usually hairless, red, and scaly. B. The generalized form of demodicosis can occur in young dogs (juvenile-onset) or in adults (adult-onset). Affected dogs have severe disease with widespread inflammation of the skin. - Juvenile-onset generalized demodicosis is the result of an inherited immune system defect. - Adult-onset generalized demodicosis is often associated with an underlying disease that has suppressed the immune system (such as cancer, Cushing disease, hypothyroidism, or diabetes). - Both types of generalized demodicosis can cause hair loss, reddened and swollen skin, increased pigmentation (darkening of the skin), raised lumps that look like acne, and scabs. Secondary bacterial infections (pyodemodicosis) are common. 3. Deep skin scrapings 4. A. Spot tx: Moxidectin + Imidacloprid B. Ivermectin, milbemycin oxime, or fluralaner

Answer 95

1. methylxanthines, theobromine, and caﬀeine; The darker the chocolate, the higher the concentration of toxins 2. Signs start in 6-12 h and last up to 72 h in severe cases: A. Low dose: vomiting, diarrhea, restlessness, polydipsia B. High dose: agitation, ataxia, tremors, tachycardia, and ventricular premature contractions (VPCs) C. Very high dose: seizures, hyperthermia, cardiovascular decompensation, coma, death --> Pancreatitis a risk w/in a few days from fat content in chocolate 3. A. Emesis and AC if recent, repeated AC w/ ongoing clinical signs B. IV ﬂuids and Tx GI signs C. Methocarbamol for tremors, diazepam for seizures D. Anti-arrhythmogenics to control VPCs and other arrhythmias E. Monitor ECG, BP, acid-base, and electrolytes (hypokalemia possible)

Answer 96

1. A. Hypoglycemia: onset at 30 m to 18 h depending on product ingested; vomiting, weakness, ataxia, seizures B. Liver failure: 1-2 d w/ higher dose exposure; vomiting, depression, icterus, coagulopathy 2. A.Liver failure w/ hyperbilirubinemia, prolonged clotting times B. Hyperphosphatemia (poor prognostic indicator) 3. A. Early emesis, no AC B. IV ﬂuids w/ dextrose (hypoglycemia can last 24 h) C. Frequent BG checks D. Liver enzyme monitoring q24h x 3 d E. Heptatopretactants (e.g., N-acetylcysteine, S- adenosylmethionine, silymarin) F. Transfusions (plasma +/- whole blood) for coagulopathies

Answer 97

1. Tartaric acid in grapes causes renal damage 2. A. First 12-24 h (acute): minimal signs, occasionally vomiting/diarrhea B. 24-72 h post-ingestion (subacute) Vomiting, diarrhea, abdominal pain Dehydration PU/PD +/- subsequent decreased urine output 3. A. Acute: no bloodwork changes B. Subacute: azotemia +/- hypercalcemia, hyperphosphatemia, SG < 1/030 w/ casts in sediment C. Late stage: anuria, worsening azotemia and hyperkalemia 4. A. Emesis + activated charcoal (AC): ideally w/in 6 h, but up to 12 h post-ingestion B. Fluid diuresis x 48 h, longer if azotemic C. Recheck renal values, electrolytes q24h x 3 d D. Anuric failure: rehydrate and consider furosemide, mannitol, or dopamine; +/- hemodialysis E. Symptomatic treatment for GI upset: antiemetics, antacids, antidiarrheals

Answer 98

1. Ibuprofen causes renal damage. Aspirin causes hepatic disease. 2. A. Ibuprofen: anemia, low protein from GI ulcers, azotemia, tubular casts and proteinuria B. Aspirin: Anemia, low protein from GI ulcers, increased buccal mucosal bleeding times (indicating platelet dysfunction) w/ normal platelet count, metabolic acidosis, increased liver enzymes and hyperbilirubinemia 3. Emesis, IVF, GI protectants, blood transfusions, diazepam for seizuress, diuresis for renal damage 4. A. Aspirin: Major active metabolite is salicylic acid; inhibits platelet function for the life of the exposed platelets (thus most commonly used therapeutically as antithrombotic) B. NSAIDS inhibit prostaglandins by blocking COX enzymes that are needed for normal kidney blood ﬂow and generating GI mucosal barriers

Answer 99

1. A. Generalized lymphadenopathy B. Anorexia C. Vomiting D. Weight loss E. Dyspnea 2. A. Cytology: predominance of lymphoblasts; biopsy required for definitive diagnosis and grading B. Stage with thoracic radiographs and abdominal ultrasonography C. Anemia, thrombocytopenia, neutropenia with bone marrow involvement D. Hypercalcemia E. Bone marrow aspirate F. Phenotype with flow cytometry or immunohistochemistry to determine if B or T cell 3. Chemotherapy with combination protocol is best 4. A. T cell lymphoma has poorer prognosis ("B is better") B. Prednisone before chemotherapy will decrease response to chemotherapy C. Many dogs can achieve remission with chemotherapy

Answer 100

1. A. Large or giant breed, bimodal age incidence (1.5-2y then 7-9y) B. Chronic, progressive lameness (acute if pathologic fracture) C. Cough if pulmonary metastases present 2. A. Radiography: bony lysis (moth-eaten) and periosteal bone formation B. Thoracic radiographs: 3 views to detect metastatic disease C. CBC, chem profile, UA to stage D. Fine needle aspirate (FNA) or biopsy (best to confirm diagnosis) E. CT for axial tumors and to help plan surgery or radiation therapy 3. A. Palliative care B. Amputation C. Radiation D. Chemotherapy for micrometastasis (doxorubricin, carboplatin) 4. A. 75% are appendicular; common locations are proximal humerus, distal radius, distal femur, and proximal tibia ("away from elbow, toward knee") B. 90% of dogs will have clear thoracic radiographs at initial diagnosis, but most will develop mets later, even with amputation C. Survival is 4-12 months, elevated ALP associated with poorer prognosis

Answer 101

1. The most common dermal malignancy in dogs. 2. Boxers, pugs, Boston terriers, other brachycephalic breeds (MCTs they develop are less aggressive and low grade tumors). 3. Mast cell granules release histamine, heparin, proteases, and cytokines when they degranulate. A. May cause GI ulcers, bleeding, poor wound healing, anaphylactoid reactions (vasodilation, hypotension, collapse, etc.) 4. Patnaik system A. Evaluate cell differentiation, mitotic figures, and invasiveness in surrounding tissues 5. The “great pretender” as they can look and feel like anything from a skin plaque, nodule, rash, or lipoma. 6. A. FNA; Grade can NOT be determined by cytology B. Biopsy of mass; Occasionally required for diagnosis if FNA is non diagnostic. Required for grading C. FNA or biopsy of regional LN D. +/- AUS and Xrays if indicated for high risk of metastasis (LN, Liver, Spleen, and Thoracic LN) 7. If metastasis is not present: A. Sx: Excision with 2-3 cm lateral margins and 1 fascial plane deep B. +/- Adjuvant radiation therapy if complete margins are not obtained If metastasis present: A. Vinblastine, CCNU, or other alkylating agents Supportive Care: A. Prednisone B. H1 Blocker: Diphenhydramine C. H2 Blocker - Famotidine, Ranitidine Tyrosine Kinase Inhibitor A. Toceranib (Palladia): First FDA-approved drug for canine cancer in the United States. Works by Inhibiting aberrant cell signaling pathways found in MCTs.

Answer 102

1. A. Palpable mammary chain mass or ulceration B. Intact or late spayed female 2. A. Excisional biopsy and histopathology B. FNA of regional lymph nodes C. 3-view thoracic radiographs and abdominal ultrasonography to screen for metastatic disease 3. A. Surgery depends on size and location (lumpectomy, regional/simple mastectomy, radical mastectomy), but best if can excise with a minimum of 2-cm margins in all planes +/- Inguinal lymph node removal B. Adjuvant chemotherapy for gross metastasis or advanced stage 4. A. 50% benign, 50% malignant B. Multiple tumors are common as are multiple tumor types C. Poorer prognosis if > 3 cm, lymph node involvement, or distant metastasis D. Spaying after 2 yr does not decrease risk

Answer 103

1. Hemangiosarcoma (HSA) is the most common primary tumor of the spleen in dogs and leads to the formation of abnormal blood vessels which can rupture and bleed. This tumor can also be found in the liver, skin, and heart. HSA is aggressive both locally and has a high rate of metastasis. 2. A. Lethargy B. Difficulty rising C. Abdominal distension D. Sudden death 3. A. Xray - look for metastasis B. Splenectomy C. Biopsy + histopathology 4. Surgery followed by chemotherapy A. Chemotherapy is strongly recommended due the aggressiveness of HSA and the short survival time with surgery alone (1-3 months). - The chemotherapy of choice is doxorubicin. 5. A. Without surgery, most pets succumb to their disease within one month. B. With surgery alone, survival times range from 1 to 3 months. C. With the addition of chemotherapy dogs have a median survival time closer to 6 months.

Answer 104

1. A. Hansen Type I (Chondrodystrophic breeds): AKA Disc extrusion - Nucleus pulposus extrudes through annulus fibrosus --> Spinal chord/nerve root compression. B. Hansen Type II (Non-chondrodystrophic breeds): AKA Disc protrusion - Annulus fibrosis bulges out --> Nucleus pulposus herniates within annulus fibrosis --> diffuse compression C. Hansen Type III: AKA Low volume, high velocity - concussive injury to spinal chord; occurs in any breed 2. A. Reluctance to walk/jump, paresis, ataxia, +/- paralysis B. Cervical damage: Low head carriage, tetraparesis C. Thoracolumbar: Arched back, paraparesis D. Perform full neuro exam 3. A. Orthogonal spinal rads to r/o fracture, luxation, neoplasia B. CT, MRI, myelography - MRI > CT 4. A. Pain w/ no or mild neuro deficits: Strict cage rest x 4-6 w - Muscle relaxants (e.g., methocarbamol) - Analgesics (e.g., NSAIDs (preferred over steroids) and opioids) B. More severe deficits - Decompressive surgery 5. Presence of deep pain is the most important prognostic indicator

Answer 105

1. Wobbler's Syndrome 2. A. Disc-associated: Congenital vertebral canal stenosis w/ later intervertebral disc extrusion B. Osseous-associated: Osseous malformation and osteoarthritis compress the spinal cord 3. Doberman (> 7 yrs) or Great Dane ( > 3 yrs) A. Chronic progressive hindlimb weakness and ataxia +/- forelimb involvement B. Increased extensor tone in all limbs C. Cervical pain D. If caudal-cervical lesion: proprioceptive ataxia and weakness more obvious in hindlimbs. 4. A. Spinal Rads B. MRI > CT with myelogram 5. A. Medical: Exercise restriction, steroids/ NSAIDs= 50% of cases improve B. Surgical: Best chance for neuro recovery - 80% of cases improve 6. Short term = good, Long term = poor A. Most dogs deteriorate w/in 3 y of Dx regardless of Tx B. Great Danes and Dobermans are largely overrepresented - likely genetic.

Answer 106

1. A. Idiopathic B. Secondary to: - Myasthenia Gravis - Congenital: German Shepherd, Mini Schnauzer, Fox Terrier, - Vascular ring anomaly - Temporary due to drug: Ketamine, Xylazine 2. A. Regurgitation: undigested food and water (different from vomit) B. Coughing, drooling C. Weight loss D. +/- Weakness (if d/t myasthenia gravis, polyneuropathy or polymyopathy) E. +/- Pneumonia 3. A. Thoracic rads +/- contrast esophagram B. AC Receptor AB test C. ACTH stim D. T4 + Free T4 E. Lead levels F. EMG/nerve conduction 4. A. Tx underlying condition B. Upright feeding C. Cisapride: to aid in gastric emptying and reduce esophageal reflux D. PPIs (pantoprazole, ompreazole) or H2 receptor blockers (famotidine, ranitidine)

Answer 107

1-2 Myasthenia gravis is an autoimmune disease that is caused by the destruction of acetylcholine receptors in the body. This can be congenital, where the patient is born with less ACh receptors than normal - this is rare, or due to hypothyroidism, cancer, a thymoma, or idiopathic. - Acquired MG: German Shepherds, Akitas, Lab Retrievers, Golden Retrievers, Newfoundlands, Scottish Terriers - Congenital MG: Jack Russell Terriers, Springer Spaniels, Smooth Fox Terriers 3. Generalized muscle weakness after activity but improves with rest. - +/- focal muscle weakness - Regurgitation - Vocal changes - Difficulty swallowing - Inability to close eyelids 4. - ACh AB test - Tensilon test: if MG positive, will temporarily improve muscle strength - Xrays 5. A. Pyridostigmine bromide: prolongs ACh at the receptor B. +/- pred C. Elevated feedings D. Tx underlying condition E. +/- Sx 6. Depends on underlying cause - Some dogs can go into remission in a few months - Others may need life long treatment

Answer 108

1. Primary IMHA usually occurs in young to middle aged dogs (6-8 yr) A. Predispositions - Females - Cocker spaniels B. Can be idiopathic (> 60% of cases) or d/t drugs, neoplasia, infection, vaccine related. 2. Onset of acute: - Anorexia, lethargy - Tachypnea, weakness, collapse - Pale MM - Icterus in 50% of patients - Heart murmur, splenomegaly - Tachycardia, tachypnea 3. A. Regenerative anemia (IMHA is the most common cause of hemolytic anemia in dogs) B. Polychromasia is almost always present C. Spherocytes (abnormally shaped RBC) IN DOGS ONLY D. Saline test - dilute blood with saline --> autoagglutination E. Leukocytosis F. Thrombocytopenia G. Positive Coomb's test H. Elevated ALT and bilirubin - Elevated liver enzymes due to severe anemia and hypoxia 4. A. Concurrent immune mediated thrombocytopenia (Evan's Syndrome) B. DIC C. Thromboembolism common and often fatal (Spleen, pulmonary, liver) 5. A. Immune suppression: prednisone = first line; cyclosporine, chlorambucil (cats) = second line; can combine two to reduce time on pred or get faster response B. Adjuvant IVIg: Block Fc receptors on MQ from binding to RBC and destroying them so it does not treat the patients long term, but in giving transfusion, those RBC are spared for that time. May see anemia lessen and give us time to give blood transfusion and have prednisone do the work. C. Clopidogrel or baby aspirin (acetylsalicylic acid) 6. A. Infectious = Rickettsia, Babesia, Mycoplasma, Cytaxuzoon B. Neoplasia = Lymphoma, malignant histiocytosis C. Toxins/Drugs = Zinc pennies made after 1982, onions, garlic, Cephalosporins, Sulfa AB

Answer 109

1. Infectious tracheobronchitis (URI) 2. Distemper, Bordatella bronchiseptica, canine influenza virus, canine adenovirus, canine parainfluenza virus. 3. Persistent, dry nonproductive or harsh cough followed by retching or gagging (cough inducible via tracheal or laryngeal palpation). A. +/- fever, anorexia, depression nasal dc, pneumonia, productive cough. 4. Xrays to rule out pneumonia or other causes of cough. Usually based on c/s. +/- PCR of nasal or pharyngeal swabs to rule out influenza. 5. Supportive care A. Avoid hospitalization if possible b/s highly contagious and kennel cough is self limiting anyway. B. If cough is nonproductive, give cough suppressant, +/- AB for severe cases. 6. Prevent via vaccination, proper hygiene. Good prognosis

Answer 110

A. Anestrus. There is low cellularity, and the vaginal epithelial cells are mostly parabasal. Original magnification, 200×; Romanowsky variant stain. B. Late proestrus. The vaginal epithelial cells are mainly large intermediate cells. Few superficial cells, RBCs, and bacteria are also noted. Original magnification, 200×; Romanowsky variant stain. C. Estrus. There is a predominance of superficial vaginal epithelial cells (full cornification) and clear background. Few bacteria are noted. Original magnification, 100×; Romanowsky variant stain. D. Early diestrus. There are small intermediate and parabasal vaginal epithelial cells, bacteria, numerous neutrophils, and moderate debris. Two metestrum cells (asterisk) are evident. Original magnification, 200×; Romanowsky variant stain.

Answer 111

1. Proestrus Estrogen is a hormone produced by the ovaries during proestrus and peaks one to two days before the next stage (estrus). The estrogen produced in this stage causes bloody vaginal discharge and swelling of the vulva (or external genitalia). Dogs will be attractive to and may demonstrate playful behavior with male dogs during this stage but are not yet receptive to breeding. This stage can last, on average, between six to eleven days. 2. Estrus Estrus begins when the female is receptive to breeding. Estrus generally starts with a surge in luteinizing hormone (LH) due to decreasing estrogen and increasing progesterone. These hormonal changes are what influence the female's receptivity to breeding. The vaginal discharge may change to straw-colored, although many variations exist between individuals. Estrus usually lasts five to nine days but may vary between one and twenty days. 3. Diestrus Diestrus begins when the female no longer shows signs of estrus, such as standing to be mounted. It is characterized by an elevation in progesterone, which peaks 2-3 weeks after ovulation and then plateaus at that elevated level for 1-2 weeks before slowly decreasing over 10-30 days. Progesterone (the pregnancy maintenance hormone) will increase during this stage, whether a dog is pregnant or not. Diestrus ends when progesterone concentrations return to baseline. During this stage, female dogs will no longer be attractive to males, nor will they allow mating. The external genitalia is indistinguishable between diestrus and the next stage, anestrus. 4. Anestrus Anestrus is the stage a dog enters either at the end of her heat cycle or after having a litter. Progesterone levels remain low throughout this stage. There is a period post-partum or after a normal heat cycle where the uterus must undergo a process called involution. This process repairs the uterus to prepare for repeating the estrous cycle and requires about four months to complete.

Answer 112

‣ Uteroverdin - Brown or green; acts as iron storage for pregnancy. If only see green pigment, what does this tell you? This area has been detached from the uterus which is why we see green discharge. If do not see anything coming out, this means animal will have a dystocia. ‣ When see puppies and a bit of green discharge = normal b/c detached from endometrium ‣ But if only see green pigment and no pup - bad (give her ten minutes to see what happens but if straining and nothing come out = bad ‣ 220-240 bpm: typical heart rate before term ‣ 180-200 bpm normal range on the whelping day; during Stage II parturition ‣ 160-180 bpm: stress; mild hypoxia? ‣ < 140-160 bpm: decreases postnatal survival --> dystocia --> ER

Answer 113

1. Yorkie, Pomeranians, etc. All toy/small breed dogs 2. "Honking" cough followed by a retch exacerbated by exercise. 3. A. Xrays (this is a dynamic disease so may be difficult to catch B. Fluoroscopy (capture dynamic xray images in real time) C. Endoscopy 4. Medical: A. Short course of corticosteroids B. Cough suppressant C. +/- weight loss Surgical: A. Tracheal stent only if unresponsive to medical management

Answer 114

1. Beta cells 2. Normally, when glucose levels fall below 60 mg/dL the body induces a negative feedback mechanism to prevent the release of insulin. In a case of insulinoma, the tumor does not respond to this negative feedback mechanism and continues to release insulin leading to hypoglycemia. 3. Intermittent neuro signs, weakness, seizing, non-specific lethargy. 4. AUS, bile acids, basal cortisol to rule out addison's, measure insulin and glucose levels, MRI/CT. 5. A. Diet: high fat, protein, complex carbs; multiple small meals to keep glucose stable. B. Glucocorticoids: start with lowest dose possible and only increase as necessary C. Diazoxide: prevents insulin release (VERY SEVERE GI SIDE EFFECTS) D. Surgery = TX OF CHOICE 6. Pancreatitis, diabetes mellitus 7. Short term = good, long term = poor; almost 100% metastasis

Answer 115

1. L3 larvae Dirofilaria immitis are transmitted by mosquitos. The Wohlbachia bacteria has been identified in heartworms. 2. 15-30 cm long and can live for 3-5 years 3. Pulmonary artery and the right ventricle leading to right ventricular hypertrophy. 4. Dogs: Signs consistent with r-sided heart failure A. Exercise intolerance, cough, dyspnea, ascites Cats: A. Acute: Due to worms dying --> embolism and inflammation --> salivation, tachycardia, shock, neuro signs, etc. B. Chronic: heartworm associated respiratory disease --> asthma like symptoms + vomiting, anorexia, weight loss 5. A. Dogs: - Heartworm antigen test is the test of choice; Detects ADULT worms; False negatives d/t Ag/AB complex, no adult females, light parasite load - Modified Knott’s test = may detect microfilaria (less sensitive than antigen test) - Xray: right sided cardiac enlargement (reverse D appearance) +/- right atrium B. Cats: - Heartworm antigen test = false negatives from low worm burden or all male infections - Heartworm antibody test = exposure but not necessarily infection - Thoracic radiographs and/or echocardiography can provide a diagnosis in some cases NOTE: On echocardiogram, heartworms appear as a distinct “double lined echodensity” 6. A. Dogs: Multi step process - To prevent new infection or tx susceptible larvae/microfilaria = macrocytic lactone - Start 2 mo prio to adulticide - Tx Wohlbachia bacteria = Doxycycline for 30 days prior to adulticide - Tx adults with melarsomina - 3 dose protocol: IM once, wait 1 month, then 2 doses 24 hr apart. - strict exercise restriction during adulticide therapy course B. Cats - Treatment is usually symptomatic with a heartworm preventative, bronchodilators and/or corticosteroids until the worms die (2-3 year life span in cats).

Answer 116

1. 6 mo to 6 yr; any breed, any age 2. A. Status epilepticus: One seizure lasting more than 5 minutes OR 2+ seizures with incomplete interictal recovery. B. Cluster seizures: 2+ seizures within 24 hrs 3. Dx of exclusion 4. A. Acute: IV diazepam OR midazolam, levetiracetam, or phenobarbital loading dose B. Chronic: Oral phenobarbital - Phenobarb side effects: PU/PD, polyphagia, hepatotoxicity 5. Normal lifespan, good quality of life

Answer 117

1. Older (onset at 8-14 yo), many pure breeds predisposed (German Shepherd is poster child) 2. Gene mutation causes SOD protein aggregates to accumulate in neurons 3. History of progressive hindlimb weakness, ataxia, and CP deficits A. Physical exam: - Early = Upper motor neuron signs in hindlimbs - Late = Lower motor neuron in hindlimbs progressing to forelimbs, end stage dysphagia, and respiratory dysfunction 4. Dx of exclusion 5. No tx at this time. A. Suggested Tx: Vitamin E, C, B supplementation, protease 12 inhibitors B. Physical rehabilitation to maintain muscle mass, nursing care 6. Px: Poor long-term because progression inevitable

Answer 118

1. A. Ixodidae family: Hard ticks (commonly Amblyomma spp., Dermacentor spp., Ixodes spp.) B. Argasidae family: Soft ticks (Otobius spp.) 2. Fever, anorexia, lymphadenopathy, splenomegaly, polyarthritis, etc. 3. C/S, finding ticks on patient 4. Doxycyline if suffering from clinical illness 5. A. Removal with forceps or hemostats close to skin and slightly twist B. Fipronil C. Fluralaner - NOTE: Both fipronil and fluralaner are flea adulticides but DO NOTa prevent re-infestation. - FIPRONIL IS TOXIC TO RABBITS

Answer 119

1. Canine distemper virus (paramyxovirus) 2. Aerosol, direct contact, fomites. 3. - Optho: KCS, Chorioretinitis - Pyrexia, serous to mucopurulent nasal discharge, lethargy, anorexia, vomiting, diarrhea. - Neuro signs 4. A. CBC: Leukpenia, particularly lymphopenia, occurs early in systemic disease B. RT-PCR of conjunctival, vaginal, or buffy coat smear C. Quantitative RT-PCR can distinguish infection from vaccination 5. Supportive care 6. Vaccination starting at 6-16 weeks of age

VIN Class 4 - Canine Info Flashcards

(154 cards)