Zuku Flashcards

Question

What are ongoing losses in fluid therapy? A - Urine output B - Fluids given minus extracellular volume estimate C - Fluid lost during panting D - Vomit and diarrhea E - Percent dehydration multiplied by body weight

Answer 1

D) Ongoing losses are typically vomiting, diarrhea or other losses into a third compartment (i.e. pleural or abdomen cavity, subcutaneous space). These are sometimes called contemporary losses. A classic example of a disease with significant ongoing losses is a puppy with parvovirus who has both diarrhea ad vomiting or a horse with acute colitis. Sensible losses are easily measured, like the fluids the animal loses by urination. Insensible losses are the fluids an animal loses that are hard to measure, through breathing and via the skin. In humans and animals that sweat (like horses), sweating is part of insensible losses. Remember that all three types of loss must be accounted for (or at least estimated) when calculating fluids needed to rehydrate a dehydrated animal.

Answer 2

a) In horses, retained placenta and septic metritis can cause acute laminitis. Other causes of equine laminitis include: gain overload, overeating lush spring grasses, insulin dysregulation, colic, endotexemia, exposure to black walnut (Juglans migra) shavings, over-exercice on hard surfaces, lameness on one limb requiring overdependency on opposite leg, which then develops laminitis

Answer 3

b) The preferred answer is to improve sanitation and install a smooth-floored enclosure. Bumblefoot (pododermatitis) in guinea pig usually occurs secondary to poor sanitation, obesity and wire cage floors or rough bedding. If detected early, switch to smooth-bottom flooring, keep the enclosure clean, and change to a softer bedding. Chlorexidine soaks and debridement can help the feet. Prognosis is guarded. Avoid penicillins in guinea pigs.

Answer 4

d) Test herd, cull positives, remove claves from dam at birth This is likely to be Mycobacterium avium subspecies paratuberculosis (john's disease). NO Rx: test-and-cull programs offer best chance of attaining a Mycobacterium avium subspecies paratuberculosis-free herd. Calves, kids, or lambs should be birthed in manure-free areas. Fro dairy cattle, calves should be removed from dam immediately after birth, bottle-fed pasteurized colostrum or colostrum from test-negative dams. They should be segregated as much as possible from adult cows and their manure until more than one year old. Must also remove calves at birth from the dam to prevent. REPORTABLE in many states

Answer 5

d) Serial progesterone testing is the most commonly used hormonal assay method for estimation of the approximate ovulation day in bitches. Progesterone levels are typically measured every two or three days once significant cornification is seen in the vaginal cytology of a prostrés bitch.Baseline progesterone is 0 to 1 ng/mL. About 48 hours prior to ovulation, a rise in progesterone (greater than 2 ng/ml) is seen, corresponding with the luteinizing hormone (LH) surge, which is the actual stimulus for ovulation. The progesterone level increases to 4-10ng/ml (or in some reports up to 15 ng/ml) on ovulation day. For natural breeding or insemination with fresh or chilled semen, dogs are usually bred at least twice, typically on days 2 and 4 after the estimated ovulation date. Serial daily measurement of serum LH is also a recognized method of estimation of ovuation day in bitches and is in fact the most definitive diagnostic test available. However, LH testing is hampered by expense, necessity for daily testing, and problems with availability of tests. Administration of exogenous LH has not been shown to be safe and effective in inducing estrus in dogs. While vaginoscopy is a useful adjunct in breeding management, progesterone measurement is a more accurate method. Estrogen measurement is of little value for estimation of ovulation day because peak levels vary from dog to dog and do not necessarily correlate with the fertile period. Ovarian ultrasonography is not commonly used in clinical practice in dogs.

Answer 6

d) Don't think too hard on this: As prevalence of a disease goes down, PVP of your serologic test also goes down. That is, as your disease becomes more and more rare, the predictive value of your same old test gets worse. That is all you need to know. Read more only if you want to see the math (but you don't need it). Lets say prevalence of a pedunculate giblet disease is 30% in 1000 turtles (that's 300 infected, 700 disease-free, then). A test with 90% sensitivity would correctly Dx 270 (cell "a") with the disease (true pos) and correctly say 30 were negative (cell "c"). A test with 90% specificity would correctly would correctly Dx 630 (cell "d") as disease-free (true negs) and correctly say 70 were positive (cell "b"): PVP=a/(a+b)=210/(270+70)=79%.

Answer 7

b) Vitamin E deficiency. Acquired equine motor neurone disease is uncommon today due to horse owner awareness. When it occurs, it is usually seen in older adult horses. Owners may say that the horse can "walk better than it can stand" when a horse has acquired equine motor neurone disease. The horse will stand still trembling in a tucked up stance, but it will walk well (but in short strides). Sometimes the horse has an "elephant on a ball" stance.

Answer 8

d) granulomatous meningoencephalitis. The lesion in this case localizes to the left cerebellum causing the left hypermetria and a right paradoxical head tilt. Granulomatous meningoencephalitis often affects this area. Another top differential would be a cerebellar neoplasm.

Answer 9

d) At least 60% of treated horses improve. The prognosis is guarded to fair for treatment of equine protozoal myeloencephalitis (EPM). Less than 25% recover completely, but at least 60% of treated horses improve. affected animals typically improve by 1-2 ataxia grades (on the mayhem ataxia scale of 1-5). The earlier treatment is started, the better the outcome. 10-20% of horses relapse within 2 years of initial diagnosis.

Answer 10

a) The cecal nematode Heterakis gallinarum transmits Histomona meleagridis (a protozoan), the causative agent of blackhead disease. Clinical signs of histomoniasis include listlessness, droopy wings, unkempt feathers, yellow droppings. Clinical signs of Ascardia galli infection include diarrhea, anemia, and decreased egg production. Birds infected with Capillaria or Eimeria have hemorrhagic enteritis. Clinical signs of Raillietina (tapeworm) infection range from none to enteritis.

Answer 11

d) Holstein-Friesian cattle inherit syndactyly, or "mule foot", a simple autosomal recessive trait, more often than other breeds. Syndactyly is the partial or complete fusion of the digits of one or more feet. Forefeet are affected most often. Affected animal walk slowly, usually with a high-stepping gait. They may also be more prone to hyperthermia than normal cows.

Answer 12

b) Dribbling milk from the nose and mouth with a weak, non retractable tongue is a cardinal and early sign of toxicoinfectious botulism (shaker foal syndrome). In foals most often occurs due the bacteria entering via a moist umbilicus. Affected foals demonstrate signs of progressive symmetric motor paralysis, including stilted gait, muscular tremors, and frequent recumbency. Mortality is higher than 90%; may find foal dead or disease can progress over a week. Most often seen in foals 1-2 months of age.

Answer 13

a) Vaccination program. Ewes in flocks with vibriosis-associated abortion should be vaccinated annually 2 weeks prior to breeding.If it's the ewe's first vaccine, give a booster mid-pregnancy. Vibriosis (Campylobacter fetus fetus, C. jejuni jejuni, and C. lari) is associated with late-term abortion or stillbirths; fetus usually autolyzed. It is orally transmitted. Outbreaks tend to occur ever 4-5 years. dx- dark field or fluorescent antibody of placental tissue: uterine discharge; fetal abomasa contents, liver, or lungs. Long acting oxytetracycline are effective against some C. jejuni and C. fetus fetus, but there us increasing resistance in US sheep operations. Daily dihydrostreptomycin or penicillin can also be used but is more labor intensive. Strict hygiene is critical in stopping an outbreak. Chloranphenicol is prohibited in food animals. C.jejuni is zoonotic.

Answer 14

d) Treat urea/non-protein nitrogen (NPN) toxicity with a luminal infusion 2-8 liters 5% acetic acid (vinegar) and 3-10 gallons of cold water. The vinegar decreases luminal pH which slows absorption of un-ionized ammonia. Repeat Q 6 hours up to 48 hours. Best results if animal is still ambulatory. It is often impossible to treat these cases before they die because of rapid progression to death. If possible, Rx with IV fluids. If necessary, relieve bloat. Urea/NPN toxicity is related to ammoniated feed toxicity which causes so-called "bovine bonkers". Manage ammoniated feed toxicity by removing the ammoniated feed and treating severe cases with anticonvulsants like diazepam.

Answer 15

a) You need a very sensitive test if: disease is rare (e.g.:BSE), early Dx improves prognosis (e.g.: HIV in people), the disease is highly lethal or consequences of missing a case are severe (e.g.: rabies, brucellosis, BSE, screw-worm, FMD, EIA). Remember that a highly sensitive test will have very false negatives. That means if a test is highly sensitive, you can trust a negative test.

Answer 16

c) Yes, turkeys can get Marek's disease. A transient paralysis with one leg forward, one leg back is a classic sign of Marek's-just don't expect to see it in all birds. Typically affected birds show only depression, then death. You may see diffuse or nodular lymphoid tutors are visible in various organs, particularly the liver, spleen and other organs. Lymphoid infiltrates can cause distortion of the pupil and enlargement of feather follicles ("skin leukosis"=condemnation of carcasss).

Answer 17

c) Treat the other calves with vitamin E/selenium. Think of white muscle disease when you see sudden death and endocardial plaques in a young calf, lamb or kid with a history of recent vigorous exercise. Typically seen in young, fast growing animals (i.e.: calves 2 weeks-6 months). Clinical signs may include dyspnea (due to myocardial disease), stiff gait, arched back, weakness, recumbent but BAR (bright, alert, responsive). Sudden death may resemble enterotoxemia, should see acute bloody diarrhea, convulsions, opisthotonos in first days of life with enterotoxemia.

Answer 18

a) 0.45% and 5% dextrose are hypotonic fluids. The osmolality of half-strength or 0.45% saline is 155, dextrose is 252 milliosmoles/L (and the dextrose is quickly metabolized, leaving free water). The calculated serum osmolality os usually 280-310 mOsm/kg in healthy animals. Hetastarch and Vetstarch are colloids composed of high molecular weight starches in saline, they are isotonic. Normosol-R and Lactated ringers are a balanced isotonic crystalloids, at 296 and 272 most/L, respectively. %% Dextrose in 0.9% saline is an isotonic crystalloid solution (dextrose is quickly metabolized, leaving 0.9% saline which is isotonic). Normosol-M is actually somewhat hypertonic at 364mosm/L. It is used only for maintenance. It has low levels of sodium and chloride and more potassium than replacement type fluids.

Answer 19

b) This is a typical presentation of ringworm (trichophyton mentagrophytes var mentagrophytes). As with most species ringworm in immunocompetent animals is usually self-limiting with good husbandry and sanitation. Commun: up to 15% of clinically normal guinea pigs harbour T. mentagophytes. Young animal are more susceptible. Overcrowding, poor sanitation and other stressors predispose. Treatment (systemic antifungals, +/- topical shampoos) will speed resolution of infection and minimize chances of infecting other animal or people, but it is somewhat labor intensive and long-term (4-8 weeks). Systemic Rx: itraconazole (10 mg/kg/day, PO) r terbinafine (30-40mg/kg/day, PO) for 4-8 week. If using a topical Rx: Enilconazole (0,2% at a dilution of 1:70) or miconazole shampoo (+/- chlorhexidine), once or twice/week. Decontaminating the environment every 14 days is also important for control: can use enilconazole (0.2%) or concentrated chlorine laundry bleach (1:10) solutions.

Answer 20

d) These findings are normal in a neonatal foal. The heart rate ad a finding of a continuous murmur on the left side (due to slight opening of the ductus arterioles, which usually closes within 4-5 days) ar normal in newborn foals. Persistent patent ductus arterioles is rare in horses.

Answer 21

a) The suspensory ligament is most likely to be damaged with fracture of the proximal sesamoids due to its insertion onto these bones. Proximal sesamoid fractures are relatively common, caused by overextension. The prognosis for return to soundness is often predicated on the extent of the damage to the suspensory apparatus problems are the number one cause of racetrack deaths.

Answer 22

e) Cervicothoracic: C6-T2 Weak, hypotonic (lower motor neurone-LMN) forelimbs and spastic paresis (upper motor neuron-UMN) hindlimb are signs of a cervicothoracic (C6-T2) lesion. May see worse signs in fores than hinds. Note: This is the opposite presentation as Schiff-sherrington syndrome i.e.: severe acute spinal cord trauma in the region of T3-L3, where in lateral recumbency, the thoracic limbs are rigid and extended and the pelvic limbs appear flaccid in comparison. However, pelvic limb reflexes are normal to increased, as would be expected with an upper motor neurone lesion. Can localize T3-L3 lesions by checking cutaneous trunk reflex- the lesion is usually 1-2 vertebrae cranial to where the reflex disappears. With C1-C5 would expect UMN signs in all 4 limbs, usually worse un hinds. With a T3-L3, would see UMN hind limb signs and normal forelimbs.

Answer 23

e) Omeprazole is a proton pump inhibitor that decreases gastric acid secretion. Omeprazole inhibits the sodium/potassium proton pump at the luminal surface of parietal cells. Parietal cells normally secrete hydrogen ions into the stomach, a key component of acidic HCL. Other drugs that decrease gastric acid secretion include the H2-receptor antagonists cimetidine, ranitidine, and famotidine and a synthetic prostaglandin E1 analog called "misoprostol". Carprofen, etodolac, deracoxib, meloxicam and firocoxib are all non steroidal anti-inflammatory drugs (NSAIDS) that may cause gastric acid secretion.

Answer 24

e) Lymphomia originates in solid tissues. In general, lymphoma and leukaemia both arise from malignant transformation of lymphoid cells and are named based on tutor location. Lymphoma= solid organs and bone marrow. Leukemia= blood circulation and bone marrow. Leukemias can also arise for myeloid cells (monocytes, basophils, eosiphils, megakaryocytic, erythrocytic precursor cells). Lymphoma is a tutor of lymphocytes that originates mainly in solid lymphoid tissues including the bone marrow, thymus, lymph nodes, and spleen. In addition, common extra nodal sites include the skin, eye, CNS, testis, and bone. Lymphomas are further distinguished according to their location (multi centric, cutaneous, CNS, GI). Leukemia is a malignant neoplastic disease of the WBC, RBC or platelet precursors with neoplastic cells in the bone marrow and peripheral blood. Leukemias are further distinguished according to their behaviour (acute or chronic) and their precursor cell (lymphoid or myeloid). So you will see names like Acute Lymphocytic Leukemia (ALL) or Chronic Myeloid Leukemia (CML). In cats, FeLV infection is an important risk factor for both leukaemia and lymphoma. FIV infected cats have a higher than expected incidence of FeLV-negative lymphomas.

Answer 25

a) Leukoencephalomacia and hypertension. Fumonisin is another Fusarium app. mycotoxin associated with moldy corn. In equids, look for CNS disease (equine leukoencephalomalacia). In pigs, see hypertension and pulmonary deem (porcine pulmonary edema- PPE). Think of reproductive dysfunction (estrogenism, vulvovaginitis) with zearalone, the only known mycotoxin with primarily estrogenic effects. Slaframine toxicoses causes profuse salivation, primarily in horses and occasionally in cattle. due to the fungus Rhizoctomia leguminocola (black patch disease) on red clover (Trifolium pratense) especially in wet, cool years. Trichothecenes are a group of related cytotoxic mycotoxins associated with many fungi. Think of vomitoxin (and vomiting) and also of immunosuppression. Refusal to eat contaminated feed is a typical sign, due to taste aversion. Macrocyclic trichothecen-related diseases have several specific names, including the best known, staphybotryotoxicosis.

Answer 26

d) The fracture has left the pulp exposed, requiring endodontic treatment. Extraction is not necessary if the radiographs and the peridontal tissue are normal

Answer 27

b) This is fowl cholera, caused by Pasteurella multocida. Think sudden onset septicaemia. Signs vary greatly. In acute fowl cholera, dead birds are first indiction of disease. May see clinical picture described above. With chronic cases, see localized infections: sternal bursar, wattles, joints, tendon sheaths, footpads swell with fibrinosuppurative exudate. See torticolis if meninges, middle ear, cranial bones infected. With infectious coryza think acute respiratory disease with nasal discharge, sneezing, and swelling under the eyes, cause by Avibacterium (haemophilus) paragallinarum. With infectious laryngotracheitis (ILT) look for gasping, coughing, blood stained beaks, blood occluding trachea on necropsy. In most states ILT is reportable. Infectious bronchitis is characterized by respiratory signs, decreased egg production and poor egg quality. Classically may see" wrinkled eggs" with infectious bronchitis. Newcastle disease is characterized primarily by respiratory signs. Severe forms include depression, neurologic signs or diarrhea. Look fo GI hemorrhage with most severe form, viscerotrpic velogenis newcastle disease (VVND), which is reportable!

Answer 28

d) Perform a Western blot FIV test. The feline immunodeficiency virus (FIV) ELISA is the standard screening test to determine if the cat has circulating antibody to FIV. A western blot antibody test for FIV is the standard confirmatory antibody test. However, the western blot also cannot differentiate antibodies caused by infection from those caused by vaccination. Note- new PCR tests show promise for confirming FIV infection regardless of vacicnation status, but are not yet the standard of clinical practice. PCR was not among the answer choices in this question to avoid confusion, and mimic the real test. On the real exam, you should not expect to see equivocal, controversial or cutting-edge new treatments or diagnostic tests. A western blot test is especially important in areas with low FIV prevalence, where the risk of false positive FIV ELISA is higher. Remember that cats vaccinated for FIV will test positive for FIV antibodies by FIV eLISA and western blot. Kittens up to 6 months of age born to seropositive queens can also be seropositive, even though they are not infected, due to persistence maternal antibodies. Seropositive kittens should be retested at grease than 6 months of age. This is different form feline leukemia virus (FeLV) testing because the FeLV eLISA and IFA measure antigen, not antibodies, so FeLV vaccination does not interfere with testing

Answer 29

a) You cannot tell if either kid is truly CAE positive or negative yet. Should probably retest both after 90 days, or at next semiannual herd testing. A positive ELISA test for caprine arthritis encephalitis (CAE) in a kid less than 90 days old may reflect maternal antibody or a false positive. A negative test in a kid less than 90 days old does not rule out CAE (though most kids infected at birth form colostrum develop a measurable antibody response by 4-10 weeks after infection). Note lots of qualifiers about CAE testing: A positive test in an adult goat implies infection, but does not confirm that clinical signs were caused by CAE virus. Negative tests do not rule out CAE infection. Definitive Dx is to find characteristic lesions by biopsy/necropsy. Virus isolation can substantiate Dx, but may not be practical on herd basis.

Answer 30

e) A lab pattern of low platelets, increased bleeding time and across the board increases in aPTT, PT, TT and FDP tests suggests disseminated intravascular coagulation (DIC). DIC is not a disease in its own right- it is a complex hemostatic defect characterized by enhanced coagulation and fibrinolysis, secondary to other diseases. Firbinolysis and depletion of clotting factors leads to hemorrhage. Many, many diseases, all of them bad, can precipitate DIC. This case presentation (pale, old German shepherd with Hx of collapse, bleeding and an abdominal mass) suggests hemangiosarcoma. Remember you H disease associated with DIC: heartworm, heart failure, hemolytic anemia, hemangiosarcoma, hemorrhagic gastroenteritis, hepatic disease, especially hepatic lipidosis in cats. Gastrci dilatation-volvulus, mammary gland carcinoma and pancreatitis can also lead to DIC.

Answer 31

b) Enzootic pneumonia in grower/finisher units is a likely sequela of porcine reproductive and respiratory syndrome (PRRS). This history ans clinical presentation are consistent wit PRRS. It is common for the grower/finisher units to have increased severity of enzootic pneumonia once the infection has spread to all parts of the herd. PRRS is caused by a highly contagious arterivirus that is spread via fomites, aerosolization, insects, and silent shedders. There are two typical phases. First, reproductive failures as described in this herd and second, post weaning respiratory diseases. The initial outbreak lasts about 1-4 months, but the disease can become chronic and endemic. PRRS is the most economically significant disease affecting US swine production today. Dx: virus detection and serology on oral fluid samples. Rx: none, prevention is key. Know the status of replacement gilts and boars, isolate incoming stock. Nursery depopulation has been used 12-18 months after the initial outbreak when only the growers/finishers are still affected. Other effective methods: whole herd depopulation-repopulation, test and removal, and herd closure.

Answer 32

b) Potassium. This is a classic presentation of a cat with hypokalemic myopathy which is often due to potassium loss from renal disease. Other causes of generalized weakness and neck ventroflexion include polymyositis, organophosphate toxicity, myasthenia gravis

Answer 33

a) Active immunization with Clostridium novae toxoid before the late summer is the most effective way to control and prevent infectious necrotic hepatitis (Black disease) in sheep. Because vaccinated sheep have long-term immunity after only one shot, only new introductions to the flock (lambs and sheep brought in from other areas) need to be vaccinated. Reducing the number of snails (intermediate hosts for fluke cercaria) with molluscicides or by fencing off wet areas may not be practical due to expense or amount of pasture lost. Likewise, use of flukicides is complicated but the need for careful timing and long withdrawal times for meat and milk.

Answer 34

b) Treponematosis (rabbit syphilis, vent disease) and hutch burn (urine burn) resemble each other and are often confused. Treponematosis (rabbit syphylis, vent disease) is a venereal disease of rabbits caused by Treponema paralysis cuniculi. Affects the genitalia, may affect eyes and nose. Hutch burn is caused by wet and dirty floors, affecting the anus and genitalia. Remember that caudal equine neuritis (polyneuritis equipment) in horses may present with utile scald on the thighs. Other signs include a weak tail, hypotonic anus, urine dribbling and focal retention. There may be a history of rubbing or chewing the the tail head.

Answer 35

a) Low dietary copper levels causes bones of growing animals to be brittle because they do not develop the normal trabecular structure. Higher fractures rates are seen in Cu deficient than in Cu replete animal. Pathologic fractures are more common during periods of exertion, such as the morning round up. Rough handling exacerbates the number of fractures. Treatment off Cu deficiency includes copper glycerinate injections, and feeding of mineral mixes with Cu. Copper boluses can also be given. In areas with high levels of molybdenum (Mb) in the soil, Cu levels are often low. Mb interferes with absorption of Cu, hence Mb excess results in Cu deficiency. Pathologic fractures can be seen with hypovitaminoses D growing cattle, but this is unlikely in beef on pasture in the southern US. Calcium deficient calves may also develop a similar syndrome of pathologic fractures.

Answer 36

``` c) abdominal distension (potbelly), polyuria, polydipsia (PU-PD) and cuteness atrophy are common signs of hyperadrenocorticism. About 85% of hyperadrenocorticism cases are pituitary dependent. Stump promettra can also cause PU-PD, but the dog usually is ill and does not have the cutaneous atrophy. ```

Answer 37

e) Damage to the recurrent laryngeal nerve ( a branch of the vagus (CN 10)) causes laryngeal hemiplegia- a paralysis of the abductor muscle (dorsal cricoarytenoid muscle) controlling the glottic cleft in the larynx. This allows the vocal fold (usually left side) to evert into the lumen of the larynx, obstructing airflow, leading to a roaring sound, and most importantly, slowing the horse

Answer 38

a) Use high-dose antibiotics for sick piglets. This is exudative dermatitis ("greasy pig disease"), caused by Staph hyicus. Responds to most antibiotics (pen, amoxicillin, TMS, erythromycin, lincomycin, tyrosine, Ans, ceps) at high dose 7-10 days, plus topical antiseptic. In severe outbreaks, antibiotics for contact pigs recommended for a few ays. Disinfection, good environnemental hygiene important. In chronically affected herds, autogenous bacteria's have been used with some success to decrease incidence.

Answer 39

a) Remove fermented rumen contents, flush with saline This is the clinical picture of a luminal drinker calf with chronic indigestion from milk deposited directly into the rumen. Treat by removing the fermented material and flushing the rumen with saline. Attempt to induce gastric/reticular groove closure during feeding by inducing vigorous sucking activity with a finger before feeding milk. If calves relapse, consider weaning. The problem occurs due to failure of the gastric groove reflex which normally shunts milk directly into the abomasum (bypassing the rumen). Most often seen in bucket fed claves who gulp their milk.

Answer 40

a) This is a classic presentation for dilated cardiomyopathy. Prognosis is guarded- with Rx may live for 6 months to 2 years. Px especially poor for dobermans. Rx varies, but foundation includes the "3 D's" -- Diet (low salt), vasoDilatation (enalapril), Diuretics (furosemide), +/- Digoxin (+ionotrope to strengthen contraction). Note that dobermans can be sensitive to digitalis, so may need lower doses. So, remember your "DCM D's": depressed dilated dogies need diet, dilators, diuretics (and maybe digoxin, but overdose is doom).

Answer 41

c) This is the clinical picture of vitamin A deficiency, a problem primarily seen in Turtles, but also in alligators and other reptiles. Look for swollen eyes, discharge from nose/mouth/eyes and ear infections. Vitamin A deficiency can pridespose to a bacterial pneumonia. Like other key reptile issues (metabolic bone disease for example), the problem is basically nutritional and preventable. Inclusion body disease is a viral problem of boa constrictors and some pythons. Septicemic cutaneous ulcerative disease (SCUD) is a shell disease (Citrobacter freundii). Look for pitted shells. Herpesvirus causes oral mucosa necrosis, anorexia, regurgitation, oral, ocular discharge, but discharge from the nose and swollen eyes should put vitamin A deficiency, not herpes, at the top of your DDX. West nile virus (WNV) has been diagnosed in farmed alligators with multi organ necrosis, heterophilic granulomas, heterophilic perivasculitis, and lymphoplasmacytic mengiongoencephalitis. Very high WNV viremia tigers have been reported in different reptiles, suggesting that they may play a role as amplification hosts for the virus. Zoonotic note: remember salmonella when you think of hildren with pet turtles or other pet reptiles

Answer 42

d) At least 60% of treated horses improve. The prognosis is guarded to faire for treatment of equine protozoal myelencephalitis. Less than 25% recover completely, but at least 60% of treated horses improve. Affected animal typically improve by 1-2 ataxia grades (on the mayhem ataxia scale of 1-5). The earlier treatment is started, the better the outcome. !--20% of horses relapse within 2 years of initial diagnosis.

Answer 43

c) Salmonella typhimurium os associated with rectal stricture in growing pigs. Caused by an ulcerativeproctitis that damages rectal tissue. Can see large numbers of cases. Can see sporadic rectal strictures as a sequelae to rectal prolapse. Intestinal spirochétoses is a post-weaning diarrhea seen in the absence of Brachyspira (serpulinaj) hyodusenteria (swine dysentery), but similar presentation to it. This syndrome is being recognized more frenquetly worldwide.

Answer 44

d) Feminization syndrome. Nonpainful unilateral testicular selling in an old dog should make you think if neoplasia, especially an estrogen-secreting sertoli cell tumor, which can cause feminization syndrome. See gynécomastie, penile atrophy, pendulous prepuce, attraction of other males, blood dycrasias, +/- bone marrow depression (via high estrogen), bilateral alopecia. Remember that cryptorchidism increases risk of sertoli cell tumor. About 25%-29% of sertolis develop feminization syndrome and 70% of intra-abdominal testicular tutors, regardless of type, cause feminization syndrome. May see prostate hypertrophy with sertoli, but it is due to squamous metaplasia, not the classic (and common) benign prostatic hypertrophy (BPH). Hypothyrodoism and BPH are common older dog conditions, but not associated with unilateral testicular hypertrophy. Remember that sex hormones are also secreted but the zona reticulates of adrenal cortex and can see feminization or virwlism with excess secretion.

Answer 45

e) Tularemia is a disease primarily of wild rabbits caused but Francisella tularensis. Upt to 90% of human tularaemia cases are linked to wild lagomorph exposure. Tularemia is a Category A bioterrorism agent. Reportable. Treponematosis (rabbits syphilis, vent disease) is a venereal disease of rabbits caused but Treponema parlais cuniculiculture. Encephalitozoonis is a protozoal disease caused by Encephalitozoon (Nosema) funiculi. Typically does not cause illness in rabbits, but is an emerging disease of immunosuppressed humans. Myxomatosis ( "big head") is a fatal disease of domesticated rabbits caused by myxoma virus, characterized by mutinous skin lesions or "myxomas". According to USDA APHIS, myxomatosis is also reportable.

Answer 46

``` c) An experienced practitioner can reliably feel the "membrane slip"of bovine chorioallantoic membranes rectally at 30-35 days. Elle placentomes around 70-75 days; feel fremitus ( vibration in uterine artery of the gravid uterine horn) between 90-120 days. One way to remember these is that the earliest occurs in reverse alphabetical order i.e.: Slip 30-35 days Placentomes 70-75 days Fremitus 90-120 days ```

Answer 47

d) These are normal age related changes. Rat normally live two to three years, though some may live to five years of age. With age, the hair coat of white rats normally develop yellowing fur. They may also show a brownish, granular sebaceous secretion at the base of affected hair shafts which an owner may mistake for a skin parasite

Answer 48

d) Choanal stressa is one of the most common congenital problems of South american camelids. Choanal atresia occurs when the caudal nares (choanes) fail to open during embryologic development. Can be unilateral or bilateral and may cause complete or partial blockage.

Answer 49

a) Think of hypochloremic metabolic alkalosis due to hydrochloric acid (HCl) sequestration in the abomasum of a cow with a displaced abomasum. Abomasal hypo motility, ongoing Hal secretion into the abomasum, and partial abomasa outflow obstruction all contribute. Metabolic alkalosis can also be due to HCl loss in mono gastric animals who vomit. In a similar way, metabolic acidosis can be due to HCO3 loss in saliva if animal cannot swallow, or from diarrhea.

Answer 50

e) The mare will need an episiotomy ( a surgically planned incision on the perineum and the posterior aginal wall) prior to foaling. Sometimes an episiotomy may be needed prior to breeding by a stallion if the remaining vulvar cleft is too small to permit intromission. A Caslick operation (vulvoplasty, a superficial form of episioplasty) is used to treat pneumovagina in horses to prevent genital infections and infertility.

Answer 51

a) According to the AVMA's principles of veterinary medical ethics, "ethically, the information within veterinary record is considered privileged and confidential. It must not be released except by court order or consent of the owner of the patient. Veterinarians should secure a written release to document that request."

Answer 52

d) Very high GGT levels are seen with colostrum absorption. In newborn pups, lambs, and claves, an increase in GGT up to a 1000 times is normal when they receive high levels of colostrum from the dam. High levels of GGT are produced in the mammary epithelium during lactation. When evaluating bloodworm, reference ranges specific for the age of the patient should be utilized.

Answer 53

e) Edema disease is caused by Shiga toxin-producing E. coli (STEC). Look for severe acute illness ranging from parachute death with no signs to CNS involvement with ataxia, paralysis, and recumbency in healthiest pigs one to two weeks after weaning. Hemagglutinating encephalomyelitis virus (HEV), is almost exclusive to piglets less than four weeks old. Two clinical presentations: vomiting and wasting disease (VWD) and encephalitic. Clostridium perfringens type C enteritis, also called enterotoxemia in other animals, is characterized by a hemorrhagic diarrhea in one to three day old piglets. Porcine proliferative enteritis i principally a diarrheal disease of growing finishing (40 to 80 lbs) pigs and young breeding pigs. Epidemic transmissible gastroenteritis (TGE) in non-immune pig herd characterized by high morbidity and high mortality in piglets less than one week old.

Answer 54

e) Toxoplasma gondii infection can cause severe abortion storms in sheep. Clinical signs pathognomonic of T. gonds are bright to dark red cotyledons with white foci of necrosis. The intercotyledonary areas of placenta are normal. With Brucella and Histophilus obis the abortion rate is much lower. Abortion caused by Listeria spp. is associated with the feeding of silage.

Answer 55

c) Removal of mares from affected pastures is necessary for control of mare reproductive loss syndrome (MRLS). The exact pathogenesis of MRLS is unknown, but exposure to/ingestion of "hirsute" or hairy caterpillars appears to be a risk factor. Early and late-term abortions have been reproduced by oral administration of whole Eastern tent caterpillars (Malacosoma americium) or their exoskeletons. Eastern tent caterpillars were associated with a large outbreak in Kentucky in 2001-2 here're over 3000 pregnant mares aborted. Other episodes have been seen in Florida (2005) and Australia (2007) with exposure to other animals of hirsute caterpillars. The most current theory - damage to the oral mucosa or intestinal lining by the setae (spines) of the caterpillars introduces bacteria that causes bacteriaand subsequent infection of the fetus and/or placenta. Early embryonic loss, abortion, stillbirths, weak foals, and infected foals are seen. Swollen umbilical cords are also often seen in aborted fetuses. Feeding hay and removal of wild cherry trees, a major food source for caterpillars, is also beneficial in reducing the incidence of MRLS abortion.

Answer 56

b) In cats, there is a common opening of the pancreatic and common bile ducts into the duodenum. It is thought that this may predispose them to ascending cholangitis and pancreatitis after vomiting associated with inflammatory bowel disease, resulting in extrahepatic biliary obstruction. Other possible aetiologies of EHBO include neoplasia, biliary stricture, duodenal obstruction, diaphragmatic hernia, and parasitic infection. In allocates, there is a lack of bile entry into the intestinal tract, leading to decreased absorption of fat and fat soluble vitamins such as vitamin K, potentially resulting in coagulopathies. Except in transient cases that are related to acute pancreatitis, surgical intervention to relieve the obstruction is required as well as appropriate supportive car, antimicrobial treatment, and vitamin K administration.

Answer 57

a) Normal male crias are born with adhesions between the free end of the penis and the prepuce. AS they sexually mature these adhesions gradually detach, so puberty can be seen clinically when the penis can be completely exteriorized. Castration prior to puberty may result in continued adhesions. In Peru, males are not generally used for breeding until 3 years of age. Male slams reach puberty at approximately 21 months (range 9-31 months). Alpacas mature earlier, around 12 monts of age.

Answer 58

c) Both mother and baby are safe. The toxoplasmosis organism causes birth defects in a developing fetus if a mother is infected for the first time in her life while pregnant (i.e.: IgM positive while pregnant). Toxoplasmosis is not generally dangerous to immune-competent people and a positive IgG result suggest a previous infection. There are challenges to toxoplasmosis testing in pregnant women (false positives). If a pregnant woman is IgM positive, confirmatory tests must be done.

Answer 59

a) Think of mitral regurgitation/insufficiency on a Cavalier King Charles Spaniel of any age, or in old male Cockers with a Hx of cough, laboured breathing, and exercise intolerance. Remember that chronic obstructive pulmonary disease with fibrosis can cause similar signs-primarily older animals. Here are 4 other big cardio predispositions: If you see an intermittently fainting Boxer, think of Boxer cardiomyopathy. A rapid, irregular heart rate in a middle-aged, depressed, coughing, exercice-intolérant Doberman, suggests dilated cardiomyopathy (DCM). Think of Sick Sinus Syndrome (SSS) when you hear "Fainting Female Miniature Schnauzer". Also see SSS in dachshunds, cockers, west highland whites. Think Tetralogy of Fallot in a young bulldog, keeshond, wire-haired fox terrier with cyanosis, exercise intolerance. Remember young Miniature Schnauzers and Wirehaired Fox terriers are predisposed to Mega-esophagus.

Answer 60

d) This is a common presentation of Cauda equine syndrome. Look for PAIN in the lumbosacral area (elicited by tail raise, hindlimb extension), LMN hindlimb, especially Sciatic nerve damage at L7-S1 (lack withdrawal), +/- urinary/fecal incontinence, +/- self mutilation of tail, perineum, pelvic limb. Lesion due to compression of caudal equine at L7-S1 (lumbosacral stenosis). Can be congenital (awn development dorsal arch L7-S1, small dogs, Border collies) or acquired (degenerative changes, big dogs, especially German Sheperd, Rottweiler, Boxer). Wobbler syndrome (aka cervical vertebral instability, (caudal) cervical spindomyelopathu) is a congenital cervical spinal cord disease. Affected dogs are born with vertebral canal stenosis which can worsen later in life due to intervertebral disc disease, vertebral malformation and/or ligamentous hypertrophy. Usually seen at C5-C6 or C6-C7 in Dobies>5 years, Great Danes< 2 years. Diskospondylitis is a good second choice on your DDX of a large middle aged dog presenting with lumbosacral pain. Due to bacterial/fungal infection of intervertebral disk and adjacent vertebral bodies. Look for systemic signs like fever (1/3 of patient), weight loss, anorexia.

Answer 61

d) Alteration in diet Mild, self-limiting diarrhea in a foal 7-14 days of age is called foal heat diarrhea, because it coincides with the first estruc cycle post-foaling in the dam. Causes of foal heat diarrhea are poorly understood, but are thought to be related to a foal's tendency to start sampling hay and grain practice coprophagy by 5 to 7 days of age, with consequent alterations in bacterial flora. Foals are active and alert, with a normal appetite and vital signs. Clinical signs such as fever and lethargy, hematochezia or melon, and laboratory findings such as neutropenia are not routinely observed.

Answer 62

e) 30-90% of adults in colonies are asymptomatic carriers of Pasteurella multocida so not every positive nasal swab means pathology. Like shipping fever in cattle, pasteurellosis in rabbits is multifactorial: stress (crowding, kindling) can precipitate disease and other organisms can be isolated from clinical cases. (Pseudomona app., Bordetella bronchiseptica, Staph app. and Strep app.). P. multimode is gram-negative, nonmotile coccobacillus. Therapy is difficult and even long-term antibiotics often do not completely eliminate the bacteria.

Answer 63

e) 97% of cats positive for feline leukaemia virus (FeLV) by IFA remain persistently infected and viremic for life. The FeLV ELISA is more sensitive that the IFA (fewer false negatives, so trust a negative test more), so it is a better general screening test with which to start. The FeLV IFA is more specific than the ELISA. (fewer false positive, so trust a positive test more) so it is a better confirmatory test for any cats with a positive FeLV ELISA. Three things to remember about FeLV and vaccinations: 1. FeLV ELISA and IFA tests measure antigen, not antibody, so FeLV vaccination does not interfere with testing. 2. Vaccinate FeLV-positive cats yearly against respiratory, enteric viruses with inactivated vaccines. 3. FeLV vaccination for FeLV-negative cats has been associated with sarcomas. Vaccinate LOW on the LEFT hind.

Answer 64

d) An experienced practitioner can reliably feel fremitus (vibration in uterine artery of the gravid uterine horn) between 120 and 150 days. Remember that remits in the uterine artery is a supportive of pregnancy but not conclusive evidence of pregnancy. An experienced practitioner can reliably feel the membrane slip of chorioallantoic membranes rectally at 30-35 days and can feel placentomes at around 70-75 days. Placentomes and membrane slip are cardinal signs of pregnancy. One way to remember these is that the earliest occurs in reverse alphabetical order i.e.: slip 30-35 days placentomes 70-75 days fremitus 90-120 days

Answer 65

b) It is 89%. Remember- you are comparing two tests here. PVP means "Of the turtles my test says are positive (27), how many are truly positive?"

Answer 66

a) This is the clinical picture of munge (idiopathic nasal/perioral hyperkeratotic dermatosis). Some affected animals have lesions on the bridge of the nose and around the eyes and ears. Average age of one is 6 months to 2 years old. Rx- address secondary bacterial infections (e.g., daily 10% povdone iodine scrubs and apply 7% tincture of iodine). If minimal response, include a topical glucocorticoid or intralesional triamcinolone acetone. If still no response, evaluate immune function. Dorsal nasal alopecia is characterized by alopecia over the bridge of the nose with normal to variably scaly, hyper pigmented, and thickened skin. It is more common in dark-haired animal. It can be secondary to fly bites or rubbing the nose. Animals with idiopathic hyperkeratosis (zinc-responsive dermatosis) present with thickened, nonpruritic papules with tightly adherent crusts in the less densely haired areas of the perineum, ventral abdomen, inguinal region, medial thighs, and axilla. Signs can begin at any age.

Answer 67

e) Typically, expect an increased anion gap with: diabetic ketoacidosis, renal failure, ethylene glycol toxicity, lactic acidosis from grain overload or strenuous exercise. Anion gap is typically measured as positive cations (Na+, K+) minus negative anions (total CO2, Cl-). You can also calculate the anion gap using HCO3- in place of TCO2. Anion gap= (sodium+potassium)-(TCO2+chloride). Decreased anion gap is uncommon. Think hemodilution, hypoalbuminemia, hypercalcemia.

Answer 68

c) This is a classic scenario of an outbreak of pleuropneumonia, caused by Actinobacillus pleuropneumoniae. Primarily a growing pig disease, although adults can be affected as well, ans sows can abort. Mortality is high if untreated. Survivors may experience lowered growth rates and have a persistent cough.

Answer 69

b) Pasteurella multocida is the causative agent of fowl cholera. Older chickens are more vulnerable than are younger chickens. The description above is of chronic fowl cholera. In acute fowl cholera, there are usually no clinical signs before a large number of birds die. Classic lesions of Marek's disease are enlarged sciatic nerves and lymphoid tumors. It is a highly contagious disease, but may be subclinical in many cases.

Answer 70

a) Swollen sore muzzles with mucous membrane erosions, high fevers and lameness suggests infection with blue tongue virus. Bluetongue is almost exclusively seen in sheep, though white-tailed deer, pronhorn antelope and desert bighorn sheep in North America can be severely affected. Rare in cows. Reportable. Bluetongue is indistinguishable from foot and mouth disease (FMD), so that is a good second choice. But FMD is unlikely in the scenario above because FMD mainly affects pigs and cattle. Ovine progressive pneumonia (OPP) is a chronic disease of wasting and dyspnea in sheep and goats, caused by lentivirus (retrovirus family). App is most common in animals older than 4 years and rarely occurs in sheep and goats under 2 years of age.

Answer 71

e) Hookworws (Ancylostoma spp.) may cause cutaneous larva migrant in people. Note that roundworms (Toxocara spp., Toxasacaris spp., Baylisascaris spp.) are also zoonotic, causing visceral and ocular larva migrans in people. In dogs, whipworms, Trichuris spp. are associated with hypoadrenocorticism-like syndrome (hyponatremia, hyperkalemia, azotemia, metabolic acidosis). Whipworm infection has been suggested as one cause of cecocolic intussusception. Habronema spp. in horses can cause tumorlike stomach nodules and sometimes cutaneous lesions. Trichostrongylus spp. cause parasitic gastritis and enteritis in sheep, goats, and cattle.

Answer 72

d) Dystocia in the sow is present when one hour or more has passed between piglets. Intervention should be swift to prevent death of piglets from anoxia. Dystocia is not common in swine but when it occurs, it is often due to uterine inertia, similar to other animal that produce multiple offspring. Other causes include fetal malposition, fetopelvic disproportion, obstruction of the pelvic canal, deviation of the uterus, and excitement in the dam. Medical therapy can be given with oxytocin and/or calcium only when an obstructive dystocia is not present.

Answer 73

``` a) Encephalomyocarditis virus (EMCV) is caused by a cardio virus in the family picornaviridae. Confusingly, the virus is named for its effects on mice. Think of rodents and exotic zoo mammals with EMCV. Pig-to-pig contact, contamination of swine feed and water by rodents or ingestion of dead rodents may cause disease. See pulmonary deem and copious transudate in the respiratory tract, cousin cardiac failure. Zoo outbreaks of EMCV have included lions, African elephants, rhinos, hippos, sloth, llamas, antelope and nonhuman primates. An outbreak of lion deaths at a Florida zoo in the USA occurred after feeding them the carcass of an African elephant that had died of EMCV. Edema disease is a neurologic disease caused by a hemolytic Escherichia coli producing Shiga toxin e2 and F18 pili resulting in high mortality in recently-weaned pigs. Glasser's Disease, caused by Hemophilus paresis is usually an acute disease of 6 to 8 week-old pigs which causes fibrinous arthritis, polyserositis, and meningitis. Porcine Reproductive and Respiratory Syndrome (PRRS), is an arterivirus causing reproductive failure and post-weaning respiratory disease. Pseudorabies is a herpesvirus: infection causes CNS disease in neonates, respiratory disease in weaned pigs, and fever in all age. ```

Answer 74

a) Think of facial nerve paralysis (CN 7) with a unilaterally droopy face. Remember the facial nerve is motor to the muscles of facial expression (explaining the right side drooped ear, lip and eyelid) and innervates the lacrimal and salivary glands. Loss of innervations can lead to a dry eye, and possibly to exposure keratitis if animal losses ability to close eyelid from damage to facial nerve innervation of the orbiculares oculus muscle. Idiopathic in 75% of canine cases (25% of cats). Can also see these signs with middle ear damage (from otitis media), from facial nerve trauma (ear surgery in dogs, or pressure from halter buckles in anesthetized horse), or neoplasia. Think more of a dropped jaw with trigeminal nerve neuropathy (CN 5).

Answer 75

b) This is the clinical picture od so-called "pullout disease," which usually causes very high mortality (potentially approaching 100%) in young birds. Until recently, pullout disease and fowl typhoid were thought to be causes by different bacteria. Genetic analysis has shown that in fact they are caused by two closely related biovars of the same bacteria, Salmonella enterica subsp. enteric serovar Gallinarum. Pullorum disease is caused by serovar Gallinarum biovar Pullorum (a.k.a Salmonella Pullorum). Fowl typhoid is caused by serovar Gallinarum biovar Gallinarum (a.k.a Salmonella Gallinarum). Pullorum disease was once common in North America but has been eliminated from most commercial chicken stock. The disease may occur in other typer of avians (e.g., guinea fowl, quail, pheasants, sparrows, parrots, canaries and bullfinches).

Answer 76

a) Administration of alprazolam 30-60 minutes to storms is one example of an appropriate medication regimen for thunderstorm phobias. Other anxiety-evoking events can include gunshots, owner departure, visits to the veterinarian, car rides, exposure to other dogs or strangers on a walk and visitors to the home. Anti-anxiety medications (e.g., alprazolam or diazepam) are useful for their rapid-onset of action. Administer 30-60 minutes prior to storms. Can use in combination with other psychotropic drugs such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) when managing concurrent behavioural issues such as separation anxiety. In addition to medication, behaviour modification should be implemented. Techniques include changing the dogs' emotional response to there stimulus (counterconditioning), rewarding any reduction in the phobic behaviour and minimizing the pet's exposure to panic-inducing stimuli.

Answer 77

d) Ferrets are susceptible to acetaminophen toxicity. Like cats, ferrets metabolize acetaminophen slowly, because they are deficient in glucuronyl transferase. There are unsubstantiated web reports of pot bellied pigs reacting poorly to acetaminophen, but we have not yet seen peer-reviewed papers to verify this. There are recommended acetaminophen dosages for dogs, rabbits, rodents and guinea pigs, but high doses are toxic to dogs and other animals so don't overdo it. In cats, toxicity can occur with 10-40 mg/kg. In one report, 3 of 4 dogs showed clinical signs of methemoglobineia at 200mg/kg, but toxicity can be seen at lower dosages with repeated exposures.

Answer 78

e) The first heart sound (S1- the lub in lub-dub) is caused by closure of the atrioventricular valves (AV valves, mitral and tricuspid). The second sound (S2) is the closure of the aortic and pulmonic valves (semilunar valves). A third sound (S3) is the end of rapid ventricular filling and a fourth sound (S4) is atrial systole (atrial contraction). You can often hear all 4 sounds in horses, but typically hear only S1 and S2 in cattle and small animals.

Answer 79

a) Horner's Syndrome is idiopathic in 50% of dogs and 45% of cats. It is caused by a lack of sympathetic innervation to the eye. See four ocular signs with Horner's: 1. Miosis (constricted pupil) 2. Protrusion 3rd eyelid (nictitans) 3. Enophthalmos (sunken eye) 4. Ptosis (drooped eyelid, +/- anisocoria. Look for classic increased anisocoria in the dark. Other diagnostic tests depend on where suspect primary disease. If you can get a primary diagnosis, (e.g. Guttural pouch mycosis in horses, brachial plexus avulsion, otitis media, etc.) must treat that.

Answer 80

d) Common plants containing pyrrolizidine alkaloids (PA) are: Senecio vulgaris, S. jacobea, Amsinckia intermedius, Heliotropium europaeum, Crotolaria spectabilis. Although generally not palatable, livestock will eat there plants when baled in hay or on pasture when forage is scarce. Chronic ingestion allows accumulation of toxic levels of PA, resulting in hepatic fibrosis. Poisoning is most common in horses and cattle. Sheep and goats ar more resistant to toxic effects. Hepatic pathology with associated clinical signs is the most common manifestation of pyrrolizidine alkalosis in domestic animal species. Clinical signs may not be seen for several weeks of months after initial exposure. Consumption of the offending plant may even have ceased months earlier. Clinical signs include loss of body condition, anorexia, dullness, and constipation of diarrhea. Photosensitization and hepatoencephalopathy can also occur. Persea spp. (avocado leaves) contain person. Signs of toxicity are: non infectious mastitis, abrupt cessation of milkflow, heart failure. Nerium spp. (oleander) contain cardiac glycosides. Signs of toxicity are: sudden death, weakness, diarrhea, cardiac arrhythmias. Lupinus spp. (lupine) contain alkaloids. Signs of toxicity are: birth defects (ingestion at 40-70 days in cattle), abortion, tremors, incoordination, head pressings, seizures. Astragalus and Oxytropis (locoweed) contain alkaloids (swainsonine). Signs of toxicity are: excitability, incoordination, difficulty eating, exaggerated mouth movements, depression.

Answer 81

a) Cows are predisposed to post-parturient bovine metritis by many things, including: dystocia, overfeeding in dry period, Ca-P imbalance in feed. Cows are also predispose to metritis by: retained placenta, contaminated calving environnement, abortion, malnutrition. In cattle, the causative bacterial organisms isolated most often are Trueperella progenies alone or with Fusobacterium necrophorum or other gram-negative anaerobes. Specific diseases associated with bovine metritis or endometritis include brucellosis, leptospirosis, trichomoniaisi and bovine campylobacter.

Answer 82

c) Idiopathic trigeminal neuritis, involves cranial nerve 5, (CN5) and is characterized by acute onset of flaccid jaw paralysis. Affected animals cannot close their mouth and have difficulty eating and drinking. In some cases unilateral or bilateral Horner's syndrome, facial paresis, and decreased facial sensation are present. Most common in dogs, rare in cats. Cause is unknown. Idiopathic facial nerve paralysis, cranial nerve 7 (CN7) results in the inability to move the eyelid, lip or ear and dryness of the eyes and mouth. Masticatory myositis, an immune-mediated disease of dogs, is characterized by pain on opening the mouth and swelling of the muscles of mastication (acute) or atrophy of the temporals and massage muscles with the inability to open the mouth due to fibrosis (chronic). Myasthenia Gravis (MG), a neuromuscular disease, typically presents with episodic or exercise-induced weakness due to impaired transmission of acetylcholine at the neuromuscular junction of skeletal muscles. Meningoencephalitis, inflammation of the brain and meninges, should always be on the differential list. Lesions may be anywhere in the CNS and may present with any neurological signs.

Answer 83

a) The most likely cause of a large uterine mass intact female potbellied pig is a uterine leiomyoma. These tumors do not typically metastasize so a cure may be achieved by surgical removal of the uterus.

Answer 84

d) Aortic stenosis (also called sub-aortic stenosis), is a systolic, ejection-type (crescendo-decrescendo) heart murmur which may be heard most loudly on the left chest between the 2nd and 5th intercostal space (IC) or at the thoracic inlet (lateral to trachea). Inherited in Newfoulands. Predilection in many big breeds- german shepherd, golden retriever, boxer, rottweiler. Mitral dysplasia and other mitral valve problems are heard further back on left at 5th-6th IC. More common in cats. With pulmonic stenosis see right ventricular hypertrophy, because pulmonic valves blocks outflow from R ventricule (mostly dogs). Tricuspid dysplasia is heard further back on right at 5th-6th IC> Uncommon. Expect a continous murmur with patent ductus arterioles (PDA). Vast majority detected at first vaccination visit.

Answer 85

c) Dexamethasone is allowed in food animals, but may cause abortion in pregnant animals. Typically, use dexamethasone in cattle to induce parturition (20-30 mg, IM, given within 2 wk of normal term). Diethylstillbesterol (DES) is banned for use in food producing animals and should never be used. Chloramphenicol has been associated with bone marrow suppression/aplastic anemia in exposed humans, and is contraindicated in food-animals. According to a 2006 report from the food and drug administration (FDA) the se of estradiol cypionate (ECP) in animals is illegal. ECP has been used as an estrogenic hormone fro reproductive therapy in food animals, but even extra-label, this is not allowed. Furazolidone a nitrofuran, is not allowed in food animals.

Answer 86

a) A disease of dogs in the Southern US and tropical climates, Spirocerca lupine (esophageal worms) make reactiove granulomas of variable size in the esophageal, gastric or aortic walls. Large granulomas may become neoplastic (osteosarcoma, fibrosarcoma). Some dogs develop spondylitis or enlargement of the extremities characteristic of hypertrophic osteopathy. Typically asymptomatic, but large granulomas can cause esophageal obstruction. Spirocercosis may also lead to aneurysm in the thoracic aorta or an ossifying spondylitis of the posterior thoracic vertebrae. Habronema app. in horses can cause tumorlike stomach nodules and sometimes cutaneous lesions. Blastomycosis most common in dogs, cats and humans is characterized by pyogranulomatous lesions in various tissues. Placental infection in horses with Coccidioides immitis have been described, leading to abortion and osteoporosismuelitis.

Answer 87

b) Portosystemic vascular shunt. Signs of hepatic encephalopathy (ataxia, disorientation, vomiting, diarrhea) beginning after weaning combined with polyuria/polydipsia ("drink and pee a lot") in a cryptorchid male Yorkshire terrier says congenital portosystemic vascular anomaly. (PSVA, also referred to as a portosystemic shunt). PSVA are seen most in pure-breeds. Think small- Mlatese, yorkshire terrier, miniature schnauzers (but can also see in old english sheepdogs, irish wolfhounds). Usually in young animals, especially after weaning. Cryptochidism is common. Lead poisoning can cause vomiting, diarrhea and CNS signs (blind, hyperactive seizures). Can see PU/PD in older animals but Hx here puts PSVA first on DDX.

Answer 88

c) Pentobarbital is one of the most commonly used drugs in IV euthanasia solutions. The AVMA report states IV injection of a barbituriques acid derivative is the preferred method for euthanasia of dogs, cats, other small animals and horses. Potassium chloride can be used in conjunction with general anesthesia. Phenytoin and lidocaine are often added to pentobarbital-containing euthanasia solutions to increase cardiac depressant effects. Thipental is an ultra-short acting thiobarbiturate used for anesthesia inductions and for short procedures. It is currently unavailable in the Us and Canada.

Answer 89

c) Think of sacroiliac (SI) disease in an athletic jumping horse with: -intermittent hindlimb lameness localized in the croup (rump) -evidence of back pain -swelling over the tuber sacrale ("hunter's bumps") Horses with hunter's bumps can be sound if the injury has completely healed, but lameness can be observed if the injury is recent or has never resolved. It is important to rule out other causes of hind end lameness or back pain/strain. Ultrasound per rectum or local anesthesia infiltration of the SI region can help confirm the diagnosis. However, most often treatment is administered instead (i.e., inject area with steroids and analgesics) and the response to therapy monitored. Coxofemoral luxation is rare in horses due to a deep acetabulum and the presence of the accessory ligament of the hip, unique to horses. Overlapping vertebral spinous processes (a.k.a. "kissing spines") is a problem of thoracic and lumbar vertebra under the saddle area, seen in short-backed eventing horses (hunter/jumpers, dressage). Cauda equina (polyneuritis equi) can cause gluteal muscle atrophy, but also causes tail paralysis, urinary and fecal incontinence, perineal analgesia or parenthesis, and mild hind limb ataxia.

Answer 90

d) Cauda equina neuritis and herpesvirus myelencephalopathy. Horses with caudal equine neuritis (also called polyneuritis equine) have a progressive symmetric LMN paresis of the tail, bladder, rectum, anal sphincter. Look for urinary incontinence, fecal retention, and a weak or paralyzed tail. May see hind limb paresis if lumbosacral cord is affected. Cranail nerves can also be affected, but typically cranial involvement is asymmetric. May see temporal or master atrophy (cranial nerve 5), facial paralysis, and exposure keratitis (cranial nerve 7), head tilt, or other CNS signs. Cause i unknown, may be an autoimmune process. Grave prognosis. Eventually euthanized. Herpesvirus myeloencephalopahty (EHV-1) may also present with urinary incontinence, but this is a relatively uncommon manifestation of equine rhinopneumonitis. You would expect to hear a history of the more common EHV signs in other horses from the same farm, like respiratory disease ("snots") in foals and abortions in mares. Bracken fern toxicity (Pteridium aquiline) causes thiamine deficiency in monogastrics (like horses) and bone marrow depletion, aplastic anemia and bladder tumours in ruminants. In horses, look for signs of anorexia, weight loss, incoordination, and a crouching stance with feet placed wide apart. Horses may have trembling muscles when forced to move.

Answer 91

b) The spinal nerves, T13, L1, and L2 must be blocked to completely desensitize the flank of a cow. The paravertebral (PV) nerve block targets these nerves. It can be performed via two techniques- the proximal or distal PV block. The proximal block places local anesthesia in the space just caudal to the transverse processes of the vertebrae- T13, L1 and L2. The distal block is placed at the ends of the transverse processes of the vertebra- L1, L2 and L4 as there nerves gradually course caudally after they exit the spinal foramen. Proper placement of the anesthetic results in warming of the skin from vasodilation, anesthesia of the skin and body wall, and a curvature of the spine in some cows. The latter is caused by relaxation of the epaxial musculature on the affected side; the spine curves in a convex manner.

Answer 92

c) Neonatal foals given oral iron supplements at birth can develop toxic injury to their liver and subsequent hepatic encephalopathy. Foals are born with a high serum iron level and absorb iron more readily than adult horses.

Answer 93

c) Grave A lab pattern of low platelets and across the board increases in bleeding time, APTT, PT, TT and FDP tests suggests disseminated intravascular coagulation (DIC). Remember that DIC also stands for " death is coming". Prognosis is typically grave and mortality is high even with treatment. DIC is not a disease in its own right. It is a complex hemostatic defect characterized by enhanced coagulation and fibrinolysis, secondary to other diseases. Fibrinolysis and depletion of clotting factors leads to hemorrhage. Many diseases, all of them bad, can precipitate DIC. Remember your H diseases associated with DIC: heartworm, heart failure, hemolytic anemia, hemangiosarcoma, hemorrhagic gastroenteritis, hepatic disease, esp. hepatic lipidosis in cats. Gastic dilatation-volvulus (GDV), mammary gland carcinoma and pancreatitis can also lead to DIC.

Answer 94

e) Fetopelvic disproportion, where the fetus is too large to pass through the maternal pelvis canal, is the most common cause of dystocia in cattle. It is a significant cause of calf losses, especially in first-calf heifers. Fetopelvic disproportion may occur in small heifers with normal sized calves or in cows with large fetuses. Dystocia occurs on average in 10-15% of first-calf heifers and in 3-5% of mature cattle. The incidence of dystocia in heifers increases as the age and size of replacement heifers decreases. The size of the sire and other factors also contribute to the incidence of dystocia. Close monitoring of heifers and early intervention are necessary to prevent calf loss.

Answer 95

c) Proximal enteritis, or duodenitis-proximal jejunitis, is a clinical syndrome characterized by large volumes of gastric reflex resulting from excessive fluid and electrolyte secretion into the small intestine and small intestinal inflammation and edema. Laminitis is an important potential sequela. The cause is unknown but several bacteria and toxins including Clostridium difficile, Clostridium perfringens, Salmonella and fumonosin B1 mycotoxins have been implicated. Ulcerative duodenitis is a disorder of foals resulting in fever, colic, diarrhea, and delayed gastric emptying. Lawsonia intracellular causes proliferative enteropathy in foals and weanlings, a disease characterized by hypoproteinemia, diarrhea, chronic ill thrift, and ventral edema. Right dorsal colitis is typically a result of non-steroidal anti-inflammatory drug toxicity and results in hypoproteinemia and colic. Cantharidin toxicity (blister beetles, Epicauta spp. ) causes a wide range of clinical signs predominated by profuse diarrhea, strangurie and pollakuria, and colic.

Answer 96

b) Systemic sulphonamides like trimethoprim-sulfa have been associated with keratoconjunctivitis sick (KCS), sometimes irreversibly. Another drug-associated cause of transient KSC is the combination of recent general anesthesia and atropine. Other causes of KCS include: distemper, immunologic (think ATOPY), breed (PUGS, Yorkies), and trauma (proposed eyeballs).

Answer 97

a) The two most common causes of polioencephalomalacia (PEM) are: -Low thiamine (due to thiamine activity from plants like bracken fern of low thiamine diets) -high sulfur in the diet (which can come from a high molasses-urea diet, corn or sugar cane byproducts, water, or other plants, including alfalfa, Canada thistle, kochi, and lambsquarter

Answer 98

b) Feline leukemia virus seropositive and seronegative cats share similar response rates to initial treatment with chemotherapy for lymphoma. However, survival times are shorter for cats with FeLV compared with FeLV negative cats. Most US cats with mediastinal, multi centric, or spinal from of lymphoma are FeLV-positive.

Answer 99

c) Think renal tutor with progressive unilateral lameness in budgerigars (and poor prognosis). The sciatic nerve passes through the renal parenchyma in birds, and budgerigars are prone to neoplasia in general. Avian polyomavirus is a young bird disease characterized by lethargy, crop stasi, death, and sometimes subs hemorrhages after injections. Pacheco's disease- think "sudden death" in younger birds. Hypovitaminosis A- Think sinusitis, "bu-eyes" (exophthalmia) sublingual abscesses, white plaques. Broken bone possible, but would expect acute onset, not progressive.

Answer 100

c) The palmar digital nerve block (also called a PD or heel block) would anesthetize at least the palmar third of the foot, including the navicular bone. Historically, the PD block was considered to anesthetize the palmar/plantar 1/3 of the foot and sole. However, it has been shown that it desensitizes 70-80% of the foot in mort horses. All of the other nerve blocks can desensitize the navicular bone too, but would not be as specific as a palmar digital nerve block. The abaxial sesamoidean nerve block (ASNB, also called a pastern or foot block) would anesthetize the entire foot and much of the pastern. Sometimes an ASNB is needed to completely eliminate or diagnose navicular lameness, but it is less specific the the PD block. Allow four-point nerve block (also called low palmar or solar block) would desensitize the fetlock and areas distal to it. The median and ulnar nerve block would anesthetize the carpus and areas distal to it. The tibial and perineal nerve block would anesthetize the tarsus and areas distal to it.

Answer 101

c) Think of nerve enlargement with Marek's disease. Also can see distortion of the pupil and enlargement of feather follicles ("skin leukosis"=condemnation of carcass). May see one leg forward, one leg back, a transient paralysis. Think infectious laryngotracheitis (ILT) if there is blood occluding trachea on necropsy. Remember wrinkled eggs go with infectious bronchitis. Think infectious coryza with sinusitis, swelling under eyes.

Answer 102

b) Stephanurus dentatus is the swine kidney worm. Found worldwide, particularly in tropical and subtropical areas. Seen in the US as a parasite of pigs raised outside in the southeastern and south-central states.

Answer 103

e) Potassium-spatring diuretics (i.e.. spironolactone) are aldosterone antagonists sometimes uses with furosemide as part to the treatment plan for congestive heart failure (CHF). Aldosterone, the mineralocorticoid produced in the adrenal cortex, acts on the distal convoluted tubules (and collecting ducts) of the nephron to retain Na+ and water, secret K+ and increase blood pressure. With CHF, aldosterone levels are increased due to activation of the renin-angiotensin-aldosterone system. In contrast, see decreased aldosterone secretion (and decreased blood pressure) with hypoadrenocorticism.

Answer 104

d) Estrus in cats generally lasts 6--7 days (range 1-10 days). Cats are seasonally polyestrous and induced ovulators. The length of feline estrus is affected by wether a male is present. If a male is present, estrus typically lasts 1-4 days. Without a male, estrus lasts 7-10 days and recurs in 2-3 weeks. Unlike dogs, the feline estrus cycle is controlled by day length. In North America, cats go through an anestrus period in December and January when day length is less than 12 hours.

Answer 105

b) | Diaphragmatic hernia is most likely to cause dyspnea with gastrointestinal sounds auscultable in the chests.

Answer 106

b) Vascular damage secondary to amniotic vesicle palpation in the first 6 weeks of embryonic development can lead to intestinal ischémie and atresia in calves. Inherited atresias of the intestine are relatively common in large animals. Only 30% of calves with atresia coli survive to adulthood. Surgical correction is not recommended in Holstein calves because atresia coli is probably heritable in this breed. Congenital atresia ani, (imperforate anus, seen most in cattle, sheep, pigs) occurs when the dorsal membrane separating the rectum and anus fails to rupture. Clinical signs at birth include tenesmus, abdominal pain and distention, retention of faces, absence of an anal opening.

Answer 107

b) Disseminated intravascular coagulation. Schistocytes are produced by the mechanical fragmentation of erythrocytes on intravascular fibrin strands. They are most commonly associated with conditions that affect blood flow or clotting like disseminated intravascular coagulation (DIC), heart worm, hemangiosarcoma, and glomerulonephritis. Cobalamin deficiency causes a microcytic anemia (pernicious anemia). Systemic lupus erythematous may cause anemia, thrombocytopenia, and leukopenia or keukocytosis. Think of methemoglobinemia, Heinz bodies, and hepatoxocity with acetaminophen toxicity in cats.

Answer 108

a) Interruption of inhibitory neuron inpu from lumbar spinal cord. with severe trauma between T2-T13, inhibitory pathways (esp. around L2-L4) are interrupted and cervical intumescence neutrons (C6-T2) are "released", causing extensor hypertonia in the forelimbs. Think of schiff-sherrington syndrome when you see a combination of forelimb extensor rigidity and hind limb flaccid paralysis, in an animal that has just had major spinal trauma, like being hit by a car.

Answer 109

b) Tetanus and Clostridium perfringens type C and T toxoids are the core vaccines recommended in South American Camelids. Rabies vaccination is indicated in rabies-endemic areas. Use of the vaccine for EHV-1 in camelids (when exposed to exotic equids) has caused blindness and should only be used when necessary. Vaccination for BVDV may provide an antibody response and protection when exposed. No vaccines are licensed for use in camelids.

Answer 110

e) A palmar digital block (also called the heel block) will anesthetize the bulbs of the heel. This mimics the effect of a palmar digital neurectomy, the last-ditch treatment to lengthen the athletic life of a horse with caudal heel pain (navicular disease). Remember that neurectomy will eliminate pain, but not disease- you do it when there has been no improvement from medical Rx after 6-12 weeks.

Answer 111

c) Damage to liver and muscle cells of dogs and cats causes increased serum levels of alanine aminotransferase (ALT). ALT is considered a "leakage" enzyme. High levels are normally found in the cytoplasm of healthy cells. When hepatic or muscle cells are damaged, ALT leaks into adjacent tissue where it is picked up by the venous circulation. Other animals such as horses, ruminants, pigs, and birds do not have high levels of ALT inside cells. Aspartate aminotransferase (AST) is the predominant leakage enzyme in these animals. The magnitude of the elvation of leakage enzymes can be deceiving -are a few cells leaking a lot or many cells are leaking a small amount? Sever damage to a healthy liver may result in very high levels, while low levels may be seen when significant atrophy or fibrosis of the liver is present and few cells are left. Prognosis of the former may be good, for the latter it is certainly grim. Differentiation between muscle and liver as the source of increases in ALT/AST is determined by evaluation of other muscle (creatine phosphokinase and AST) and liver enzymes (AST, sorbitol dehydrogenase (SDH), gamma glutanyl transferase, alkaline phosphatase) the animal and the clinical evaluation. Leakage enzymes do not provide an estimate of actual liver function. This is evaluated by measurement of substances dependent on the efficacy of liver function such as bile acids, blood urea nitrogen, albumin, and glucose.

Answer 112

e) A history of recent antimicrobial therapy is common in cases pf Clostridium difficile associated diarrhea. Adult horses exposed to erythromycin are particularly at risk for C. difficile enterocolitis. Clostridium novae is the cause of infectious necrotic hepatitis, which is primarily seen in sheep but can also be seen in cattle , hogs, and horses. Lawsonia intracellular is the cause of proliferative enteropathy, resulting in diarrhea and hypopreteinemia in foals and swine.. Rhodococcus equine is a notable cause of pneumonia in older foals characterized by pulmonary abscessation as well as some extra pulmonary manifestations. Escherechia coli can be cause of septicaemia and diarrhea in foals and calves.

Answer 113

e) The major clinical complication of pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's disease) is laminitis. Laminitis affects more than 50% of the horses with PPID. Additional clinical signs include hirsutism, polyuria/poludipsia, muscle wasting, regional adiposity, decreased mentation, and immune suppression.

Answer 114

d) Poisoning with Conium maculate (Poison hemlock) is responsible for the death of this cow. At least 8 toxic piperidine alkaloids have been isolated from poison hemlock. Coniine is found in seeds and the mature plants; g-coniceine is found in young growing plants. Poison hemlock is toxic to all livestock and humans. Signs of toxicity develop 1-2 hours after ingestion and are usually fatal. Signs include nervousness, trembling, weakness especially of hind limbs, weak pulse, irregular heart rate, recumbency, coma and death. A mousy door exuding from the urine and breath is pathognomonic. Ingestion of poison hemlock during gestation causes arthrogryposes and other congenital defects in cattle, goats, and pigs.

Answer 115

a) Seasonal anestrus. Males are seasonal breeders and enter anestrus in the short-day months of late fall and winter. In anestrus the ovaries are inactive with small follicles and no corpus luted. During estrus, the uterus softens and multiple follicles form on the ovaries. During pregnancy the uterus has good tone.

Answer 116

d) The rumen is permanently fistulated in the left paralumbar fossa to allow cows to be donors for transfaunation of rumen contents to other cows. Transfaunation is used to threat other cows with conditions like luminal acidosis, vagal indigestion and peritonitis. Fresh ruminal fluid contains microbes (bacteria and protozoa), volatile fatty acids (VFAs), microbial proteins, vitamins, minerals, and other buffers. Ruminal fluid can also be collected via siphon from a stomach tube or from animal at the slaughter house. Ruminal fistulas are also used to study ruminant physiology.

Answer 117

d) Pasteurella multocida infection in conjunction with Mycoplasma Hyopneumoniae causes exudative bronchopneumonia, polyarthrites, and chronic lung lesions. Mycoplasma hyopneumoniae (also called "enzootic pneumonia") is a common, smouldering, low-level illness. Stressors (parasites, other infections, even weather) can result in sever pneumonia. Best managed by decreasing stressors with improved ventilation and decreased overcrowding. In endemic herds, ABX for sick individuals (ie: lincomycin, tyrosine, tiamulin, or a tetracycline) helps control illness, most likely by preventing secondary bacterial infection (like Pasteurella). Bacterin vaccines give good protection, decreases signs (coughing). Pre-farriwing vaccination of sows decreases colonization in suckling piglets.

Answer 118

d) Treat urea/non-protein nitrogen (NPN) toxicity with a ruminal infusion 2-8 laters 5% acetic acid (vinegar) and 3-10 galons of cold water. The vinegar decreases ruminal pH which slows absorption of un-ionized ammonia. Repeat Q6hours up to 48 hours. Best results if animal is still ambulatory. It is often impossible to treat these cases before they die because of rapid progression to death. If possible, Rx with IV fluids. If necessary, relieve bloat. Urea/NPN toxicity is related to ammoniated feed toxicity which causes so-called "bovine bonkers". Manage ammoniated feed toxicity by removing the ammoniated feed and treating sever cases with anticonvulsants like diazepam, pentobarbital sodium.

Answer 119

Don't think too hard on this: As prevalence of a disease goes DOWN, PVP of your serologic test also goes DOWN. That is, as your disease becomes more and more rare, the predictive value of your same old test gets WORSE. That is all you need to know.

Answer 120

a) You need a very sensitive test if: 1. Disease is rare (e.g.: BSE); 2. Early Dx improves prognosis (e.g.: HIV in people); or 3. The disease is highly lethal or consequences of missing a case are severe (e.g.: Rabies, Brucellosis, BSE, screw-worm, FMD, EIA). Remember that a highly sensitive test will have very false negatives. That means if a test is highly sensitive, you can trust a negative test.

Answer 121

c) Diabetes mellitus, Cardiomyopathy and Renal disease. Think first of Diabetes mellitus in older male cats (ave. 10 yr, 90% male) with feline acromegaly. First presenting sign may be PU/PD, polyohagia of diabetes. Weight gain in an unregulated diabetic cat strongly suggest acromegaly. Think also cardiomyopathy (˜50%; see weakness, dyspnea, systolic murmur, cardiomegaly/CHF, pulmonary oedema). Think also of renal disease (˜50%; see proteinuria, USpG 1.015-1.025, and glycosuria from diabetes). May see prognathism (long mandible), lameness (esp.cats), marked vertebral spondylosis.

Answer 122

d) 3.5 to 4 years. The 4th incisors are actually canine teeth. References for times of eruption vary by about 6 months because the times of tooth eruption vary among individual animals and breed.

Answer 123

c) IV fluids, NSAIDS, frequent milk feeding and antibiotics. Fever, diarrhea and sudden death in 8-week-old calves is highly suggestive of septicaemia due to salmonellosis. Isolate sick calves. Use of antiobiotics is controversial as they may prolong recovery and shedding and yield a carrier calf. However if an animal is septic it needs parenteral antibiotics. According to Pasquini's, prognosis is poor with neonatal salmonella and deaths can approach 100% in affected calves. In adults, antibiotics may yield a clinical cure, but Salmonellae can establish a biliary system and intermittently shed into GI system, leading to environmental contamination. Prevention is dependant on which species of Salmonella is causing the problems-host adapted or environmental.

Answer 124

b) This is a tricky question to help you remember that two diseases formerly classified as ehrlichia have now been re-classified. The causative organism of equine granulocytic ehrlichiosis (EGE) was originally classified as Ehrlichia equine, but is now called Anaplasma phagocytophilum due to DNA sequencing studies. Do not confuses EGE, a necrotizing vasculitis in horse with bovine anaplasmosis, primarily an anemia, with icterus, fever. Another name change occurred with the causative organism of Potomac horse fever (PHF), from Ehrlichia risticii to Neorickettsia risticii. PHF presents as a febrile colitis/diarrhea, with laminitis 3-5 days after diarrhea in horses of all ages: A big rule out is salmonella.

Answer 125

b) Radical excision of a sublingual malignant melanoma mass, with adjuvant therapy such as chemotherapy, radiation, and/or vaccination (off label since it is only approved for oral melanoma), is typically recommended. Melanoma of the digit is an aggressive, infiltrative tutor, with substantial metastatic potential and a poorer prognosis than cutaneous melanoma or other tutors of the digit. Fine needle aspirates of regional lymph nodes and thoracic radiographs should always be performed to assess for metastasis. Even if metastasis. Even if metastasis is not detected, many practitioners still employ adjuvant therapies. The median survival rate for dogs with sublingual melanoma treated with surgical excision is 12 months. The effectiveness of adjuvant therapy protocols in treating sublingual melanomas is not well described. The melanoma vaccina is only approved to treat oral melanoma, and contains DNA for human tyrosinase.

Answer 126

a) Cats have naturally-occuriring antibodies against the blood groups antigen they lack. Feline blood groups include A, B and AB (rare). Type A cats have naturally-occurring anti-B antibodies without any previous exposure to type B antigens. Type B cats have naturally-occurring anti-A antibodies. Type AB do not have antibodies of either group. Type B cats that receive type A blood are particularly susceptible to fatal transfusion reactions as a result of severe acute intravascular hemolysis. Type A cats that receive type B blood have a weaker reaction that commonly results in extravascular hemolysis. Type AB cats should receive type AB or type A blood. Unlike dogs, there are no universal donors in cats.

Answer 127

d) Ongoing losses are typically vomiting diarrhea, or other losses in a third compartment (e.g., the pleural or abdominal cavity, subcutaneous space). These are sometimes also called "contemporary" losses. Classic examples of diseases with significant ongoing losses are a puppy with parvovirus who has both diarrhea and vomiting or a horse with acute colitis. Sensible losses are easily measured, like the fluids the animal loses by urination. Insensible losses are the fluids an animal loses that are hard to measure, like through breathing and via the skin. In humans and animals that sweat (like horses), sweating is part of insensible losses. Remember that all three types of loss must be accounted for (or at least estimated) when calculating fluids needed to rehydrate a dehydrated animal.

Answer 128

a) A century ago, Mycobacterium bovid (bovine tuberculosis) used to be a common zoonotic health threat, transmitted through milk to children through their emerging teeth at the gums. Today, human cases of M. bovis are emerging more in bi-national communities with ties to Mexico who consume unpasteurized milk products (like fresh quest). Temperature of pasteurization is set by the toughest, most heat-resistant organism, which is Coxiella burnetii, the cause of Q fever. If the temperature is high enough, for long enough to kill Coxiella, it will also kill the other organisms. Brucella and Listeria can also be transmitted in milk. E coli is typically a contaminant from unsanitary milking conditions.

Answer 129

d) Antigenic drift is most important in the epidemiology of equine influenza. Point mutations in the genes for hemagglutinin and neuraminidase cause changes in these surface proteins that can lead to the development of new virus strains not recognized by antibodies to earlier strains. Because influenza is an RNA virus without proofreading ability, mutations can occur more rapidly with flu than mutations seen in DNA viruses like equid herpesviruses and adenoviruses.

Answer 130

a) If PT or PIVKA tests elevate at 48 or 72 hors in a case-patient with suspected anticoagulant rodenticide toxicity, start oral vitamin K1 at 1,5-2,5 mg/kg q 12h or 3-5mg/kg once daily. Continue treatment for 14 to 30 days, depending on the specific anticoagulant. Warfarin is a first generation, shorter-acting anticoagulant, brodifacuom is a second-generation long-acting anticoagulant. PT or PIVKA should be checked 48 hours after the last dose of vitamin K1. IF PT or PIVKA is still elevated after the last dose (16 to 32 days post exposure), restart vitamin K1 treatment for 1 week, then recheck PT or PIVKA 48 hours after last dose. Once the PT or PIVKA is normal at 48 hours, you can stop vitamin K1 treatment. Injectable vitamine K1 has no advantages over oral vitamin K1 and can cause anaphylaxis in some animals, even when injected subcutaneously. A blood or plasma transfusion is indicated for animals that present with overt clinical signs (hemorrhage, dyspneic, pale).

Answer 131

d) Up to 20% of cats may have diabetic remission (sometimes called transient diabetes) characterized by resolution of clinical signs weeks to months after beginning insulin treatment. Clinical diabetes mellitus may or may not recur in the future. Cats with two 2 (non-insulin-dependent) diabetes mellitus may respond to a treatment regimen of weight loss, diet, oral hypoglycemic drugs, and correction of concurrent insulin antagonistic disease; that is the can respond without injectable insulin. Persistant fasting hyperglycaemia (blood glucose greater than 200 mg/dL (11.1mmol/L)) and persistent glycosuria are confirmatory for diabetes mellitus, so "incorrect diagnosis" is a wrong answer in this case.

Answer 132

c) Bladder stones in horses are usually single, large speculated stones composed of calcium carbonate. The most common clinical sign exhibited by horses with cystic calculi is hematuria after exercise. hematuria is most evident toward the end of a voided urine stream. Other signs may include strangurie, pollakiuria and urinary incontinence. In adult mal geldings, urethral abstraction may also be associated with cystitis. If there is urethral blockage by smaller uroliths, strangurie, pollakiuria, incontinence, restlessness, colic and stretched posture may be more prominent.

Answer 133

a) The prognosis is good. 95% of dogs with digital squamous cell carcinoma (SCC) survive one year after amputation and 75% survive two years after amputation. SCCs have a low metastatic rate; most have not metastasized at the time of diagnosis. Chest radiographs and aspiration of local lymph nodes for cytology are necessary to accurately assess prognosis. In contrast, malignant melanoma of the digit is an aggressive tutor, with substantial metastatic potential and poorer prognosis. Median survival with resection is 12 months, with a 30% local recurrence rate. (That is, only 50% are still alive after 12 months).

Answer 134

c) A disease of dogs in the Southern US and tropical climates, Spirocerca Tupi (esophageal worms) make reactive granuloma of variable size in the esophageal, gastric or aortic walls. Spirocercosis may also lead to aneurysm in the thoracic aorta or an ossifying spondylitis of the posterior thoracic vertebrae. Typically asymptomatic, but large granulomas can cause esophageal obstruction. Large granulomas may become neoplastic (osteosarcoma, fibrosarcoma). Some dogs develop spondylitis or enlargement of the extremities characteristic of hypertrophic osteopathy. All of the other choices are gastric parasites. Ollulanus tricuspid in an uncommon gastric parasite of cats. Phylasopter spp is a stomach worm tat may cause vomiting, anorexia, dark faces in dogs and cats. Haemonchus spp, Ostertagia and Trichostongylus are found in the abomasum of ruminants. Gasterophilus are the larvae of horse bot flies, found in the stomach of horses.

Answer 135

b) Caudal heel pain (also called navicular disease) is an intermittent-onset lameness with a poorly understood pathogenesis. The horse may point affected foot with the heel off the ground to relieve the pressure of the deep digital flexor tendon on the painful navicular area. If both fores are affected, a horse may alternate pointing. Typically presents as an intermittent lameness early in the course of disease, with a shortened stride. The horse may tend to stumble. A flexion test of the distal affected forelimb can usually exacerbate the lameness temporarily.

Answer 136

d) There is no definitive ante mortem test for equine protozoal myeloencephalitis (EPM). Serologic tests including evaluation for surface antigens (snSAGs) and the indirect fluorescent antibody test (IFAT) show that a horse has been exposed to the organism. Positive serum results acne are difficult to interpret (can indicate exposure) but negative serum titers are often considered diagnostic to rule out EPM except in very acute cases of disease. A ration of serum to CSF antibody showing intrathecal antibody production against S.neurona combined with clinical suspicion is highly suggestive of a diagnosis of EPM. Definitive diagnosis requires post-mortem examination.

Answer 137

a) It is dangerous to rapidly correct for a hyperosmolar or hypoosmolar state (salt toxicity)-- could lead to brain swelling. It is best to gradually rehydrate the animals with small amounts of water given frequently. Most pigs showing clinical signs usually die regardless of treatment for salt poisoning and you are only trying to decrease mortality across the herd. Some references advocate use of slow infusion of slightly hypertonic IV fluids to decrease cerebral edema. This requires intensive care with frequent measurements of blood sodium concentrations. This may apply to pets, but is not realistic in a farm situation with multiple pigs.

Answer 138

e) The history, plus a lab pattern of low platelets, increased bleeding time and normal aPTT, PT, TT tests suggests immune-mediated thrombocytopenia the most common cause of spontaneous bleeding in dogs. It can be a primary disorder (idiopathic) or secondary to infections, neoplasia or certain drug therapies. Twice as common in females; cockers, poodles and old English sheepdogs are predicted, but can occur in any breed. Dogs with disseminated intravascular coagulation (DIC) often present with thrombocytopenia but will also typically have a prolonged PT and aPTT.

Answer 139

c) Oxalates are found in Sarcobatus vermiculatus (greasewood). Greasewood toxicity is seen primarily in sheep, sometimes in cattle, usually when large amounts are consumed over a short period of time. Oxalates occur in plants as salts of calcium, sodium, and potassium. Calcium oxalate is insoluble and is lost through the GI tract. Sodium and potassium oxalates are soluble and either 1) bind to calcium in the rumen and lost through the GI tract, or 2) are absorbed and react with calcium in body fluids. Death is attributed to hypocalcémie and/or kidney failure caused by calcium oxalate crystals in the renal tubules. Signs of oxalate toxicity include: dullness, lowering of the head, loss of appetite, operation from the herd; followed by excessive salivation with frothing, progressive incoordination; and finally, coma, irregular breathing, and death. Oxalate containing plants include: Sarcobatus (greasewood), Oxalis (sorrel) Rumex (dock), Halogeton, Amaranthus (pigweed), ans Chenopodium (lambs quarter). Oxalates are also produced by molds (Aspergillus niger) in contaminated feeds. Delphinium spp (larkspur) contain alkaloids. Hypericum perforated (klamathweed) contain hypericin. Hordeum spp (foxtail) cause physical injury. Solanum spp( nightshade) contain alkaloids.

Answer 140

b) E. coli causes the characteristic lesions of edema disease on recently weaned piglets. Marked swelling of the periocular region, forehead and submandibular area follow infection. Piglets may die peracutely. Usually only a few piglets in a group are affected, but affected piglets perish rapidly (within 12 hours). Hemolytic E.coli that produce F18 pili and Shiga toxin 2e are implicated in deem disease. To make a definitive diagnosis, E.coli must first be isolated and then characterized as an edema disease strains (that is, producing F18 pili and Shiga toxin 2e). The course is so rapid that treatment is ineffective. Antibiotics may be administered to unaffected pigs in the group. Brachyspira hyodysenteriae causes Swine dysentery also called bloody scours. Lawsonia intracellular causes Porcine proliferative enteritis (diarrhea, often with fibronecrotic casts). Clostridium septum is the agent of Malignant edema in many animals. Infection occurs through contaminated wounds and turns affected muscle dark brown of black. Streptococcus suis causes septicaemia and meningitis in wearers and growing pigs.

Answer 141

d) Holstein-Friesian cattle inherit syndactyle, or "mule foot", a simple autosomal recessive trait, more often than other breeds. Syndactyly is the partial or complete fusion of the digits of one or more feet. Forefeet are affected more often. Affected animals walk slowly, usually with a high-stepping gait. They may also be more prone to hyperthermia than normal cows.

Answer 142

a) The cecal nematode Heterakis gallinarum transmits Histomonas meleagridis (a protozoan), the causative agent of blackhead disease. Clinical signs of histomoniasis include listlessness, droopy wings, unkempt feathers, yellow droppings. Clinical signs of Ascardia galli infection include diarrhea, anemia, and decreased egg production. Birds infected with Capillaria or Eimeria have hemorrhagic enteritis. Clinical signs of Raillietina (tapeworm) infection range from none to enteritis.

Answer 143

e) Idiopahtic trigeminal neuritis, due to inflammation of cranial nerve 5 (CN 5), is characterized by acute onset of flaccid jaw paralysis. Affected animals cannot close their mouth and have difficulty eating and drinking. Seen occasionally in dogs, rare in cats. Cause is unknown. Idiopathic facial nerve paralysis, affecting cranial nerve 7 (CN 7), results in the inability to move the eyelid, lip, or eat and dryness of the eyes and mouth. Masticatory myositis is characterized by pain on opening the mouth and swelling of the muscles of mastication (acute) or atrophy of the temporals and master muscles with the inability to open the mouth due to fibrosis (chronic). Dysphagia, dysphonia, and stridor are most often associated with dysfunction of the vagus never, cranial nerve 10 (CN 10). Cricling and head tilt toward the side of the lesion with no other signs is a common presentation of vestibulocochlear nerve, cranial nerve 8 (CN8) lesions. Concurrent CN 7 paralysis and Horner's syndrome (ptosis, moisis, exophthalmos) may be present with middle and inner ear infections.

Answer 144

a) Edema disease is caused by shiva toxin-producing E.coli (STEC). Look for sever acute illness ranging from percute death with no signs to CNS involvement with ataxia, paralysis, and recumbency in healthiest pigs 1 to 2 weeks after weaning. Hemagglutinating encephalomyelitis virus (HEV), is almost exclusive to piglets less than 4 weeks old. Two clinical presentations: vomiting and wasting disease (VWD) and encephalitic. Clostridium perfringens type C enteritis, also called enterotoxemia in other animals, is characterized by a hemorrhagic diarrhea in 1 to 3 day-old piglets. Porcine proliferative enteritis is principally a diarrheal disease of growing finishing (40 to 80 lb) pigs and young breeding pigs. Epidemic transmissible gastroenteritis (TGE) in non-immune pig herds characterized by high morbidity and high mortality in piglets less than 1 week old.

Answer 145

b) Salmonella typhimurium is associated with rectal strictures in growing pigs. Caused by an ulcerative proctitis that damages rectal tissue. Can see large number of cases. Can see sporadic rectal strictures as a sequelae to rectal prolapse. Intestinal spirochétoses is a post-weaning diarrhea seen in the absence of Brachyspira (serpulinaj) hyzdysenteriae (swine dysentery), but similar in presentation to it. This syndrome is being recognized more frequently worldwide.

Answer 146

c) A proximal paravertebral block is performed via placement of local anesthetic just off the midline and caudal to the transverse processes of T13, L1, and L2 vertebrae. With a distal paravertebral block, local is placed above and below the ends of the transverse processes of L1, L2, and L4 vertebrae. The spinal nerves T13, L1 and L2 are targeted by a paravertebrl block to completely desensitize the Planck of a cow. Note the difference- proximal at T13, L1 and L2 distal at L1, L2 and L4, but the same nerves are affected because they gradually course caudally after exiting their spinal Forman. Proper placement results in warming of the skin from vasodilation, anesthesia of the skin and body wall, and a curvature of the spine in some cows. The latter is caused by relaxation of the epaxial musculature on the affected side; the spine curves towards the opposite side.

Answer 147

a) Think of hypochloremic metabolic alkalosis due to hydrochloric acid (HCl) sequestration in the abomasum of a cow with a displaced abomasum. Abomasal hypo motility, ongoing HCl secretion into the abomasum, and partial abomasa outflow obstruction all contribute. Metabolic alkalosis can also be due to HCl loss in mono gastric animals who vomit. In a similar way metabolic acidosis can be due to HCO3 loss in saliva if animal cannot swallow, or from diarrhea.

Answer 148

c) A lab pattern of low platelets, increased bleeding time and across the board increases in aPTT, Pt, TT and FDP tests suggests disseminated intravascular coagulation (DIC). DIC is not a disease in tis own right- it is a complex hemostatic defect characterized by enhanced coagulation and fibrinolysis, secondary to other diseases. Fibrinolysis and depletion of clotting facts leads to hemorrhage. Many, many diseases, all of them bad, can precipitate DIC. This case presentation (pale, older German Shepherd with Hx of collapse, bleeding and an abdominal mass) suggests hemangiosarcoma. Remember your " H diseases" associated with DIC: Heartworm, Heart failure, Hemolytic anemia, Hemangiosarcoma, Hemorrhagic gastroenteritis, Hepatic disease, especially hepatic lipidosis in cats. Gastric dilatation-volvulus (GDV), mammary gland carcinoma and pancreatitis can also lead to DIC.

Answer 149

d) PVN is 99%. The trick with this kind of question is to pick an imaginary number of animal that you test, like 1000, and fill out your 2x2 table from there.

Answer 150

a) A horse with edemia, icterus and fever should make you think first of equine infectious anemia (EIA) and equine viral arteritis (EVA). Conjunctivitis and rhinitis+ ventral edema says EVA in this case. Can see limb edema with equine granulocytic ehrlichiosi (caused by anaplasma phagocytophilum), but that choice is not on the list. Respiratory presentation with fever, cough and eyelid swelling in a horse shipped from spain or africa should set off reportable alam belle in your head for african horse sickness.

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