NAAAAVLE

There is an appointment today for a work-up on a lame cow. "Playing the odds", what digits are most likely to be involved, because these are the digits most often affected in dairy cattle?

*Lateral rear digits*. Over 80% of foot disease involving the digits involves the rear digits. Additionally, approximately 85% of these involve the lateral aspect. This is because they bear the majority of their rear limb weight on the lateral claw in the hind. In the front, cattle put most of their weight on their medial claw.

A sheep farmer that you work with has had 5 four-to-five month old lambs die recently. They have glucosuria and decompose rapidly. You suspect Clostridium perfringens type D. Which of these steps would you recommend to try to prevent loss of more lambs?

*Vaccinate the lamb*s twice with toxoid/bacterin at 4 week intervals. Because it will take time for this active immunity to work, you can also give Cl perfringens type D antitoxin at the time you administer the first vaccination. Clostridial enterotoxemia in lambs is most frequently caused by Clostridium perfringens type D and affects lambs on rich feed. Vaccinating the dam provides passive immunity for about 2 to 3 months. Decreasing the quality of pasture from rich clover, or decreasing the amount of grain and concentrate can also be effective but is sometimes not practical from a production standpoint.

A 7-year old Arabian gelding is presented to you for clinical signs of fever and lethargy of 2 days duration along with signs of hind-limb ataxia and muscle fasciculations of the face and neck. The CBC and biochemistry profile are relatively normal and you decide to collect cerebrospinal fluid (CSF) from the lumbosacral space. Results of CSF analysis yields the following: Color Clear Total Protein 156 mg/dL (reference interval 50-80 mg/dL) Total Nucleated Cell Count 40 cells/mcL (ref interval less than 5 cells/mcL) Cytology Lymphocytic pleocytosis Based on the clinical signs and CSF analysis, which of the following is the most likely diagnosis and the most appropriate diagnostic test listed to confirm your diagnosis?

*WNV*. This is a mosquito born flavivirus that affects horses in multiple areas of the United States. Clinical signs are variable and can be mild (muscle fasiculations, slight ataxia) to severe (recumbency). Of note, muscle fasiculations is somewhat characteristic of WNV but fever may be detected in all patients. A readily available diagnostic test is the serum *IgM capture ELISA* which will detect infection, even in the face of vaccination. There is a vaccine available for WNV, making the clinical presentation less common.

What is the duration of estrus in a goat?

18 - 48 hrs = The entire estrous cycle lasts about 21 days during the breeding season. The average duration of standing estrus is 36 hr but can range from 24 to 48 hr depending on age, breed, season, and presence of a male. Breed-specific estrus duration has been reported for Mossi (20 hr), Angora (22 hr), Creole (27 hr), French Alpine (31 hr), Boer (37 hr), and Matou (58 hr) breeds. Ovulation normally occurs about 24 hours after the start of estrus.

Mycobacterium avium ssp paratuberculosis is most commonly recognized in cattle at which age?

2-5 years of age, although younger and older animals can develop Johne`s disease. Mycobacterium avium ssp paratuberculosis is the causative agent of Johne's disease in cattle. It causes wasting, diarrhea, and decreased production. The disease is economically devastating. There is no recommended treatment for the disease. Animals testing positive should be culled.

A Chihuahua presents to you after a recent "little-dog, big-dog" encounter. He has multiple bite wounds to his lateral abdomen and pelvic limbs. You want to lavage the wounds with a 2% chlorhexidine diluted to a 0.05% solution. You will need to add ______milliliters of chlorhexidine to a 1 liter bottle of saline to make the lavage.

25 --- You would add 25 mls of the 2% chlorhexidine solution to the 1000mls of saline to get a 0.05% lavage solution. To be absolutely perfect, you would want to remove 25 mls of the saline before adding the chlorhexidine solution.

What is the causative chemical agent of fog fever in cattle?

3-Methyl indole = Cattle that are moved to lush forage that is high in tryptophan metabolize the tryptophan to 3-methyl indole in the rumen which is toxic to the lungs, resulting in acute interstitial pneumonia and emphysema. This syndrome is known as fog fever, acute bovine pulmonary edema and emphysema, or grunts. 4-Ipomeanol is the chemical involved in moldy sweet potato poisoning, which yields similar pathology.

How soon after administration of a dose of dexamethasone for induction of parturition in a cow do you expect parturition?

48 hours. Parturition may occur anytime between 2 and 7 days but on average it occurs on the second day. A dose of 25-30 mg IM is sufficient.

What minimum proportion (%) of a herd or population must be immunized (not just vaccinated) in order for an infectious disease spread to begin to slow and eventually stop, if the basic reproductive rate (R0) for the disease is 3? (Note: it is given that R0 must be <1 for disease spread to decline and, at that point the immune proportion will be 1-1/R0).

67% ==== Ro (R naught) measures the number of new cases of an infectious disease generated by a contagious individual entering a naive (completely susceptible) population. For example, estimates for smallpox Ro = 5, and Ebola Ro = 2 to 4. In this example, one infected individual will transmit the agent, resulting in infection, to three other individuals. Propagation depends on the coefficient of transmission for the particular infectious agent and on the contact rate among individuals. The disease will spread/propagate through the population as long as at least one new case is generated by each infected case. The disease will cease to spread when the R0 drops below 1, indicating that a sufficient proportion of the population has developed immunity and no longer can support transmission of the agent to others. In developing vaccination strategies, a fundamental question is what proportion of the population must be immunized (vaccination that results in immunity) in order to prevent a new case from spreading infection through the population. The higher the R0, the higher the proportion of the population that will have to be immunized. When R0 < 1, the proportion of the population that is immune will be 1-1/ R0. This formula is derived from differential equation calculations of a geometric propagation of infection and subsequent increase in proportion of the population that becomes immune and no longer capable of supporting and transmitting the agent. The purpose of this question was to highlight this basic rate, which has been referred to frequently in the press, as related to Ebola and measles, and is the basis for veterinary vaccination programs against diseases like rinderpest and foot-and-mouth disease. Giesecke J. Modern Infectious Disease Epidemiology, pgs. 120, 238.

Many horses in a large group develop a rapid-onset high fever, weakness, depression, and cough. What step is most likely to lead you to a definitive diagnosis?

Acquire nasopharyngeal swab for viral isolation. Given the history of a rapidly-spreading infection with fever and cough, the most likely differential is equine influenza. This is caused by an orthomyxovirus. Other less likely rule-outs include equine viral rhinopneumonitis and equine viral arteritis. The way to definitively diagnose this is with viral isolation; a nasopharyngeal swab is the best sample. Growth in a bacterial culture would be more likely to indicate a secondary infection than a primary pathogen. Serology could be useful, but because influenza is so ubiquitous, paired titers are really needed to yield a diagnosis. Gross necropsy findings with influenza are fairly minimal and variable. Thoracic radiographs would not give you a diagnosis.

Which of these is a reliable way to differentiate between regurgitating and vomiting?

Active abdominal contractions indicates vomiting. Regurgitation is a passive event that does not have abdominal contractions. pH can be variable with either regurgitation or vomiting, depending on the food eaten and whether the vomiting is gastric or duodenal in origin. Salivation is a sign of nausea that generally indicates vomiting rather than regurgitation. Regurgitation can occur hours after a meal, especially in cases of megaesophagus, where the food sits in the esophagus until the animal positions itself in such a way that the expulsion of food occurs.

You are called to a swine breeding herd that is experiencing some abortions. On arrival you find out that there are 285 sows in the herd and 5 of them aborted overnight. Two days ago 2 other sows aborted. You are suspicious of Porcine reproductive and respiratory syndrome (PRRS). The herd has not used any PRRS vaccines for the past 18 months. All aborted fetuses have been discarded by the time you arrive. What diagnostic workup should you do?

Only test the 7 aborted sows for PRRS virus via serum PCR. PRRS causes abortions shortly after infection and therefore the sows should still be viremic at the time of the abortion. Your testing should be focused on the sick (aborted) animals. Random sampling is used when establishing the herd's status; in this case you are focused specifically on the status of the aborted animals. Antibody production takes time and therefore is most likely not present in the sows at the time of the abortion.

A 4-year old female spayed mixed breed dog presents for further evaluation. She has a 24 hour history of increased respiratory rate and decreased appetite. Owners note that she is an indoor/outdoor dog. Based on these radiographs, what is the best treatment?

THORACOCENTESIS --- This patient has a left sided pneumothorax. Pneumothorax can be secondary to trauma, ruptured bullae, infection, or neoplasia. The radiograph shows an elevated heart off the sternum as well as collapse of the lung lobes. Notice there are no bronchi or vessels extending caudally toward the diaphragm due to collapse of the lung. Pericardiocentesis would be indicated if you had a very large globoid heart, suggestive of pericardial effusion. The heart does not appear enlarged and there is no pulmonary edema making intravenous furosemide a poor choice. Do not confuse a collapsed lung lobe for a lung mass.

Systolic pressures in different parts of the equine heart and great vessels

The approximate pressures are RA=12 to 28 mm Hg; RV=30 to 59 mm Hg; PA=34 to 48 mm Hg; LV=140 to 148 mm Hg; AO=131 to 144 mm Hg; CA=142-157 mm Hg

A valuable bull that has been heavily grain fed for show for over 3 months is found bleeding from the nose. You examine the animal and note a fever of 104 F(40 C), rapid respiratory rate, and HR of 90 beats/min. You tell the owner that this bull may have developed rumen acidosis in the past, a resulting liver abscess and has now developed ___________.

Vena caval thrombosis and metastatic pneumonia----By chance a liver abscess in a few animals that develop rumen acidosis may form near the posterior vena cava and cause infected thrombi to break off and move down pulmonary arteries into the lung until they lodge and form an abscess. Pulmonary embolic abscesses then create tracts from affected arteries to an airway, which results in pulmonary bleeding. This condition is extremely difficult to treat successfully and animals usually die within months of a massive bleed.

Most foodborne illness in the United States is caused by which of the following?

Viruses --- According to the CDC, about 2/3 of foodborne illnesses in the United States are caused by small round-structured viruses (Norwalk-like caliciviruses)

Three feedlot yearling steers in a small home ranch operation present with star-gazing, blindness, diarrhea, anisocoria, and strabismus. On physical exam, the steers are found to be underweight and in poor condition. The animals are being fed unsupplemented wheat and straw. Pupillary light response is absent in both eyes of all three. The operator reports that yesterday another steer with similar signs convulsed and died when being brought to the squeeze chute. Which of the following is the most likely diagnosis?

Vitamin A deficiency. The clinical signs are very similar in these neurologic diseases. However, pupillary light reflex will stay intact with polioencephalomalacia, salt poisoning, and lead poisoning. PLRs disappear with vitamin A deficiency as a result of retinal degeneration and constriction of CN II at the level of the optic foraminae. Blood work will usually be unremarkable in these guys. CSF changes include a mononuclear cell pleocytosis of 40-50 cell/dl and increased protein of approximately 140mg/dl. It is more common for unsupplemented feedlot animals to be deficient because they do not have access to vitamin A rich, green, succulent, plants. The vitamin A requirement for most species is between 40-80 IU/kg of body weight daily.

You are asked to recommend treatment for a 12-year old Thoroughbred mare that has seasonal insect hypersensitivity affecting a large percentage of the body (see image). Which of the following treatment is NOT likely to help with this problem?

Weekly application of topical antipruritic shampoo --- Multiple therapies are commonly needed to control this problem. Certainly steroids (oral or parenteral) will alleviate the hives and decrease the pruritus, and fly spray will help cut down the frequency that the horse is exposed to fly bites. Hyposensitization injections may help for long-term control but are not always efficacious. However, topical shampoos are not likely to do anything.

A feedlot asks you to examine a 6-month old steer calf that is showing bloat. He has been in the feedlot for 2 weeks, is not gaining weight, and is still on a transition ration. He is the only animal in the pen affected. You find he has T=104 F (40 C), HR=96, RR=38, and the cranioventral lungs sound harsh with wheezing on both inspiration and expiration. The areas are also consolidated on percussion. The rumen contains gas which disappears when you pass a stomach tube, but the rumen has very poor motility. What is your diagnosis?

type 1 vagal indigestion --- Free gas bloat in young animals is often secondary to bacterial bronchopneumonia, and mediastinal lymph node inflammation that affects the thoracic vagus nerve. Once the gas accumulates, it stops motility and decreases appetite. Treat the pneumonia with antimicrobials. The gas can also be relieved by creating a small temporary rumen fistula.

The patient in the photograph presented after being sat on by the owner. This is a small mixed breed dog and is approximately 2-years old. This patient is otherwise healthy per the owners and there are no major health concerns. Why is it recommended that this fracture not be treated with a cast?

Small breed dogs have poor blood supply to the distal radius and ulna and are less likely to heal with a cast ----- Small breed dogs have been shown to have a decreased blood supply to their radius and ulna. This seems to make them predisposed to fractures at this location. Additionally, healing is impaired as compared to fractures in other locations. Placing a cast on such a patient runs the risk of inadequate stability and subsequent nonunion. As long as fractures are reducible and adequate reduction and stability can be achieved with a cast, it would be appropriate in a dog that is not a small breed.

A miniature horse presents for colic. What cause of colic are they prone to?

Small colon impactions --- !!!!

A radiograph of a dog shows areas of consolidation with air bronchograms. What radiographic pattern is this?

ALVEOLAR -- The classic "trees in the fog" appearance on radiographs of airways coursing through consolidated lung is an alveolar pattern.

A 4 year old female spayed ferret presents to you for bilateral flank alopecia. Which of these is a common cause of this sign in ferrets?

Adrenal disease. Progressive alopecia is the most common historical finding with adrenal disease (adrenal tumors) in ferrets. Ferrets are not thought to develop hyperthyroidism and hypothyroidism with significant frequency.

You are starting insulin therapy for a newly diagnosed diabetic feline patient. Blood glucose is 520 mg/dl (60-120 mg/dl). Urinalysis shows 3+ glucose and is negative for ketones with a trace of protein. Which of the following tests should this patient and all diabetic patients receive upon initial diagnosis?

All newly diagnosed diabetic patients should have their *urine cultured*. Diabetics are prone to getting urinary tract infections due to the chronic presence of glucose in their urine. Any underlying infection can lead to insulin resistance and make regulation of diabetes difficult to achieve. Blood pressure and ECG are good tests for all patients in general but aren't necessarily tests that are directly related to diabetes regulation. A thyroid level should be checked in all older cats, for general health screening, but hyperthyroidism is not associated with diabetes mellitus. If a patient has diabetes which is difficult to control, concurrent hyperthyroidism should be ruled out. Fructosamine level is helpful in trying to determine if a cat actually has diabetes if their glucose level is elevated and also as a follow up to determine regulation. Cats that have markedly elevated glucose levels, glucosuria, and clinical symptoms of diabetes do not necessarily need to have a fructosamine checked at the time of diagnosis.

You are called to a farm to check some pigs that have severe respiratory problems and are not responsive to antibiotic treatment. These pigs are housed in an outdoor facility and are about 9 to 10 weeks old. The pigs have been vaccinated for PCV2 and Mycoplasma hyopneumoniae. What should be one of your top differentials?

Ascaris suum or the swine roundworm. A. suum larvae travel through the liver and into the lungs causing verminous pneumonia which is usually not responsive to antibiotics as the worm larvae continue to do significant lung damage. Raising pigs outdoors is a significant risk factor for roundworm infestation. PRRS does cause respiratory problems, but usually the secondary bacterial infections are controlled with antibiotics. None of the other parasites listed cause pneumonia. Trichuris suis is the pig whipworm, Oesophagostomum dentatum is the nodular worm, and Stephanurus dentatus is the kidney worm. RESP dz

A 8-year old male Doberman Pinscher is being treated by your colleague for dilated cardiomyopathy. You hear an arrhythmia on exam and record the following ECG. What is your diagnosis?

Atrial fibrillation. Although the rate is not fast, there are no discernible P waves and the R-R interval varies with each beat. This irregularly irregular rhythm is a hallmark of atrial fibrillation. Normal sinus rhythm and sinus arrhythmia are incorrect as there are no P waves apparent. Atrial premature complexes is wrong because the irregularity is from the fibrillation waves in the atria, not a discrete premature focus. Second degree heart block is not correct because no P waves are seen, as would be expected with intermittent block.

3rd degree atrioventricular block

Atrioventricular (AV) block describes abnormal conduction between the heart's pacemaker and the remainder of the heart muscle tissue. Third degree AV block is the most malignant rhythm of the three classes of AV block because it represents complete dissociation between the pacemaker firing and ventricular contraction. Thus, on the rhythm strip, there is no association between the pacing (p waves) and the heart producing a beat (the ventricular contraction as represented by the QRS complex). As a result of stimulation from the sinoatrial node, P waves appear at a regular rhythm while the AV node fires at its own rhythm resulting in dissociated QRS complexes at 80-110 bpm (the resting pacemaker of the ventricle is 80-110 bpm in cats). On the rhythm strip above, you can see P waves in varying locations next to the QRS complexes. Some P waves are even on top of the QRS complex. First degree AV block is when there is increased distance between the P waves and the QRS complexes. Second degree AV block is when there are intermittent/occasional P waves without a corresponding QRS complex. Atrial fibrillation is a rhythm showing a bumpy baseline, and irregularly irregular QRS complexes firing at a fast speed.

The most common underlying pathology causing feline hyperthyroidism is ______.

adenomatous hyperplasia. Adenomatous hyperplasia is the cause for about 70-75% of cases of feline hyperthyroidism. Thyroid adenomas are responsible for about 22-29% of cases and thyroid carcinoma occurs in about 1-3% of cases. Goiter is defined as an enlargement of the thyroid gland, and can be secondary to adenomatous hyperplasia, adenoma, or carcinoma.

You just began working in the intensive care unit and you notice a Cornish Rex exhibiting fever, restlessness, vomiting, urticaria, and hemoglobinuria. What do you think is happening?

Blood transfusion reaction. This is the perfect random question. The fun fact to remember is that Cornish rex, British short hair, and Devon rex cats are predisposed to having Type B blood type. Type B cats have anti A antibodies and tend to have acute transfusion reactions as compared with type A cats. Also, realize that the clinical signs being exhibited are those of anaphylaxis and that will help you narrow down the choices.

Which of these dog breeds is most heavily predisposed to having dystocia?

Boston terrier --- Brachycephalic animals are predisposed to developing dystocia due to a combination of puppies with large heads and mothers with flattened pelvic inlets.

Which of the following infections is not a differential for lameness in a young pig?

Brachyspira hyodysenteriae (formerly known as Serpulina hyodysenteriae). B. hyodysenteriae is the agent for swine dysentery in pigs. It can cause mucohemorrhagic diarrhea from the age of 3 weeks to adulthood if previously unexposed. The other listed infectious agents are common causes for arthritis in young pigs (H. parasuis, S. suis, M. hyorhinis, Erysipelas)

Iodine deficiency occurs most commonly in which of the following birds?

Budgerigars. Iodine deficiency in budgerigars causes goiter or thyroid hyperplasia. Clinical signs are usually respiratory-related due to pressure of the enlarged thyroid on the syrinx. Regurgitation may also occur due to blockage of the thoracic inlet. Treatment and prevention include iodized calcium blocks or specially-iodized seed mixes.

Several litters of 2 to 3 day old pigs have recently died rapidly with hemorrhagic enteritis. Post mortem lesions include mucosal hemorrhage, necrosis and emphysema in the small intestines. What pathogen is most likely to cause these signs?

C. perfringes type C -- The age of these affected pigs along with the rapid course of hemorrhagic and necrotic enteritis help you come to this conclusion. As with many Clostridial diseases, vaccination is the most effective means of control. Other important clostridial diseases of swine include C. perfringens type A, C. difficile, C. tetani, C. botulinum, C. novyi, C. septicum, and C. chauvoei.

A 4-year old FS cat presents for its annual exam which is unremarkable. The owner complains about a chronic cough so you perform a CBC and chemistry panel. HCT- 45% (30-45%) WBC- 10,500/ul (5,500-19,500/ul) Neutrophils- 4,000/ul (2,500-12,500/ul) Lymphocytes- 1,000ul (1,500-7,000/ul) Monocytes- 500/ul (0-900/ul) Eosinophils- 5000/ul (0-800/ul) Na- 145 mEq/L (146-156 mEq/L) K-4.1 mEq/L (3.7-6.1 mEq/L) Cl-115 mEq/L (115-130 mEq/L) ALT-40 U/L (25-97 U/L) AST-30 U/L (7-38 U/L) Albumin- 2.8 g/dl (2.8-3.9 g/dl) Globulin- 4.9 g/dl (2.6-5.1 g/dl) BUN-16 mg/dl (19-34 mg/dl) Creatinine- 1.1 mg/dl (0.9-2.2 mg/dl) You perform a routine fecal flotation; an image from the fecal flotation is shown below. What is your diagnosis?

Capillaria ---- This is consistent with the clinical signs of cough. The peripheral eosinophilia could be caused by any of the parasites listed. Therefore, it is important to be able to recognize parasite eggs. Capillaria ova, as seen in the image, look similar to Trichuris eggs but are smaller and have asymmetric terminal plugs. Most cases of Capillaria are asymptomatic but chronic cough may be seen. Paragonimus is found by fecal flotation and have a single operculum. Aelurostrongylus larvae are recovered by Baermann.

Yellow Star Thistle

Centaurea solstitialis. In some horses which ingest large quantities, it can cause nigropallidal encephalomalacia, which is loss of the globus pallidus and substantia nigra, and extrapyramidal nuclei, which control muscles of prehension. Loss of these nuclei causes tremors and dystonia of the lip muscles and tongue. Centaurea repens (Russian knapweed) can also cause similar lesions.

The most common lesion associated with in utero infection with feline panleukopenia virus is _______.

Cerebellar hypoplasia. Cerebellar hypoplasia is the most common lesion seen in cats infected in utero. Nonsuppurative myocarditis is seen in dogs infected in utero.

You receive a call from a small family farmer who would like to blood test 5 pigs for the upcoming county fair. The county fair is in just 10 days. They bred their 2 sows to 2 high value boars. They purchased the semen from a national boar stud. All pigs have been growing quite well, to the point they were concerned the pigs will be too heavy for the fair. As the second pig is snared and you start to collect your blood sample, it starts shaking uncontrollably. It turns blotchy and goes into respiratory distress. As the pig is released, you try some chest compressions but are not successful. The pig dies. The owner grants permission to necropsy the pig. You perform the necropsy immediately. It is difficult to position the pig for necropsy as it is still stiff. Necropsy reveals pulmonary edema and pale soft musculature often containing hemorrhages. Which of the following should be your recommendation to the owner?

Change genetics for his next matings -- talk to the owner about changing his genetics for his next mating. The sudden rigor mortis of the pig as well as the soft pale muscle on a pig that just died is very suggestive of porcine stress syndrome (PSS). PSS is a simple recessive genetic myopathy. Pigs with heavy muscling and fast growth (desired characteristics in show pigs) can many times carry this gene. This condition can be eliminated from a herd through the selection of genetics. In this case at least one of the sows must be a carrier that was bred to a carrier boar. Antibiotics, water, and mycotoxins have no effect on the clinical presentation of the condition. This genetic condition often results in death of the pig when triggered by excitement, stress or placed under some anesthetics (especially halothane).

Your client's turkey developed nasal and ocular discharge, weight loss, inappetence, and then died. You performed a necropsy and found pneumonia, multifocal necrosis in the liver and spleen, and severe pericarditis. Histopathologic findings included many basophilic intracytoplasmic inclusions found in the affected organs. What is the most likely cause of death?

Chlamydia psittaci. The intracytoplasmic inclusions, along with involvement of multiple organs and supportive clinical findings, are indicative of this disease. Chlamydia psittaci is known as ornithosis in turkeys.

What is the most common cause of exocrine pancreatic insufficiency in the cat?

Chronic pancreatitis --- This is the case in cats, in contrast to dogs, which develop EPI from pancreatic acinar atrophy.

Septicemic cutaneous ulcerative disease (SCUD) in turtles is most commonly caused by which pathogen?

Citrobacter freundii. SCUD in turtles causes pitted scutes that slough with underlying purulent exudate. Petechia on the skin and liver necrosis also commonly occur. Prevention is aimed at good husbandry, and chloramphenicol is the treatment of choice.

A 13-year-old, male neutered Labrador retriever patient presents for a quality of life consult. The owner is concerned that his dog has progressively become more painful in the hips. He was diagnosed with hip dysplasia at a young age and the owner elected to treat him conservatively by providing low impact exercise, maintaining a lean body weight, and administering non-steroidal anti-inflammatories as necessary for pain. There are several nutraceuticals available that have been touted as having some benefit in patients with osteoarthritis. Which of the following will result in an increased production of less inflammatory eicosanoids?

Consuming a high concentration of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) has been shown to result in the preferential use of these compounds to form eicosanoids. Eicosanoids derive from either omega-3 or omega-6 fatty acids. Omega-6 eicosanoids are generally pro-inflammatory, while omega-3 eicosanoids are less inflammatory. Omega-3 fatty acid supplementation results in a decrease in pro-inflammatory omega-6 eicosanoids; providing potential benefit to patients with osteoarthritis. Carnitine is thought to potentially aid in weight loss as it is involved in fat metabolism, but there are limited studies demonstrating significant clinical benefit to supplementation at this time. Glucosamine is a precursor of glycosaminoglycans which is a major constituent of the joint and thought to be of great importance for joint health. Chondroitin is also an important constituent of cartilage and helps provide resistance to compressive force. It is commonly administered in conjunction with glucosamine. The amount of clinical benefit of glucosamine and chondroitin supplementation is not currently well established.

Bracken Fern

Contains thiaminase primarily neurotoxic

Which of the following is a complication of long-term sling application on a limb?

Contracture of muscles -- Other complications of long-term sling application include joint fibrosis and disuse muscle atrophy.

A baby bird is presented to you for severe respiratory distress. It is being hand-fed a commercial formula with oil added to it. The bird appears quite heavy for its age and is very dyspneic. What condition should you suspect?

Hepatic lipidosis. In pediatric birds, hepatomegaly is essentially normal, but lipidosis develops when they are fed a high-fat diet, often a formula supplemented with peanut butter or oil. They are typically heavy for their age and show severe respiratory distress. Initial treatment should be minimal and consist of cooling and oxygen therapy. Typical signs of vitamin A deficiency are squamous metaplasia of the mucous membranes and submandibular abscessation. A xanthoma is an accumulation of friable yellow fatty tissue.

In macaques, this relatively non-pathogenic disease can cause a fatal encephalitis if transmitted to humans.

Herpes simiae. This is a herpes B virus. Old world monkeys can transmit this disease by bite or scratch. Macaques are the most frequent carriers. In monkeys, the disease can cause mild cold sore like lesions in times of stress. This strain of herpes is potentially fatal to humans. Similarly, humans carry a strain of herpes (herpes simplex virus) which can cause fatal encephalitis in monkeys. Hepatitis B, tuberculosis, and measles are all zoonotic, but do not cause encephalitis.

What is the underlying cause of postparturient hemoglobinuria?

Hypophosphatemia --- one observes decreased erythrocyte ATP which is not compatible with maintenance of ATP-dependant membrane pumps, and cells lyse.

A chicken producer is concerned that geese infected with West Nile virus were found near his farm. He has instituted strict biosecurity measures for his chickens as well as a mosquito control regimen. Which of the following additional recommendations is most appropriate?

Crows, geese, and exotic birds are susceptible to clinical disease from West Nile virus. Many birds and mammals can become transiently infected if bitten by mosquitoes that are infected with West Nile virus. However, there is no evidence that clinical disease develops in chickens or turkeys. Chickens and turkeys quickly develop antibodies and clear the virus. Infected poultry are also not thought to represent a reservoir for the virus or a significant public health risk.

A budgerigar is showing signs of squamous metaplasia of the oral mucosa, conjunctiva, and upper airways. It has developed associated bacterial sinusitis (see image). In a pet bird, what are these clinical signs most suggestive of?

Hypovitaminosis A. The functions of vitamin A are related to epithelial maintenance, vision, and skeletal development. In birds, problems with the skeleton or vision are rarely seen with vitamin A deficiency. Vitamin A deficiency can manifest as squamous metaplasia of the oral mucous membranes or glands. Glands may be entirely converted to squamous epithelium with keratin material and can look like abscesses or pustules but are essentially keratin cysts. They should be differentiated from lesions of pox, Candida, and Trichomonas. Lesions of the conjunctiva, nasolacrimal duct, upper GI tract, and upper respiratory tract can occur. Presenting signs may include severe dyspnea or respiratory signs.

A cat owner brings her 8-month old female spayed cat to your clinic and is concerned about the cat's scratching and destruction of her furniture. She is concerned about potential adverse effects associated with onychectomy and asks for your advice with this problem. Which of the following statements is consistent with the American Veterinary Medical Association's (AVMA's) position on the declawing of domestic cats?

Declawed cats should be housed exclusively indoors

Two mares are presented for crusting dermal lesions on their *dorsum and pasterns*. The lesions are "paintbrush" like lesions and have purulent material exudating from them. A direct smear of the lesion shows branching, *filamentous*, *gram positive* bacteria. What is your most likely diagnosis?

Dermatophilosis - Dermatophilus congolensis is a gram positive, non-acid fast, facultative anaerobic actinomycete. It causes a crusting dermatitis in large animals when there is high moisture on the skin as well as mechanical irritation. Horses with long, wet haircoats are often affected. Lesions are commonly on the dorsum and pasterns of horses and are classically described as paintbrush lesions. It can be diagnosed with a direct smear preparation. Treatment includes keeping the haircoat clean and dry and penicillins if the lesions are severe. Lesions typically heal rapidly.

Which of the following is contraindicated in the treatment of Mannheimia hemolytica in cattle?

Dexamethasone === Giving a steroid will further immunosuppress the animal and result in death. All other choices are acceptable treatment options.

What is the most common intranasal tumor in the dog and cat?

Dog: Adenocarcinoma, Cat: Lymphosarcoma. The key word in the question is intranasal. Cats get many squamous cell carcinomas of the nasal planum, especially white cats in the sun, but lymphoma is the most common intranasal tumor of cats.

A 1.5-year old male castrated Boxer presents for exercise intolerance and syncopal episodes. Cardiac auscultation reveals a grade 4/6 left systolic murmur heard best at the base of the heart. Thoracic radiographs show a mildly enlarged left ventricle and left atrium, and segmental enlargement of the ascending aorta. What test will best help you to confirm your tentative diagnosis?

ECHO -- The breed, clinical history of syncope, radiographic findings, and auscultation findings are most consistent with aortic stenosis. Echocardiography would be the best method for diagnosing the disease in which you would find left ventricular concentric hypertrophy, stenosis of the aortic outflow tract, and post-stenotic dilatation of the ascending aorta. A Holter monitor is the test of choice for arrhythmogenic right ventricular cardiomyopathy (ARVC) which is also seen in Boxers and causes syncope but does not fit with the physical exam or radiographic findings. Also called Boxer cardiomyopathy, ARVC is a disease associated with fibrofatty infiltrate into the right ventricle resulting in electrical conduction disturbances and resultant VPCs. A CT scan would not add more information, and cardiac motion typically causes resolution problems on thoracic CT scans. The signs are not consistent with heartworm, which is primarily a right heart problem, or with hemolytic anemia, which a Coombs' test might be useful for.

You shine a light in a cat's right eye and see that the right eye constricts but not the left eye. You then shine a light in the left eye and the left eye does not constrict but the right eye constricts. Where is there a lesion in the pathway?

EEEEEfferent to left eye because no matter which eye the light is shined in, there is no motor (or efferent) response in the left eye.

Which ophthalmic abnormality is most common in newborn lambs?

ENTROPION --- it is also commonly seen in pigs. Usually, the lower eyelid will be affected.

A Thoroughbred racehorse presents to you for having poor performance, stopping at the ends of races, and having labored breathing. After races, the horse swallows excessively and will sometimes cough. What is your most likely diagnosis?

Exercise-induced pulmonary hemorrhage. This has multiple other names, and horses with this condition are sometimes referred to as bleeders or as bobbling, chocking, or gurgling. It is thought to be extremely common in Thoroughbreds. In this condition, following exercise at speed and large efforts from the lungs, pulmonary damage occurs and bleeding starts, usually in the caudal dorsal lung lobes. Common clinical signs are excessive swallowing after exercise because the horse is swallowing blood that was brought up. They may also cough to clear blood from their airways. Epistaxis is actually only seen in about 10% of horses with exercise induced pulmonary hemorrhage. The other options in this question such as airway disease and heart failure would not be consistent with this horse's excessive swallowing after racing.

A recently freshened 4-year old Guernsey with a body condition score of 4/5 presents for decreased milk production, anorexia, and depression. On physical exam, she has a mild fever and is ketotic. No pings were auscultated during the physical exam and a rectal exam was unremarkable. What is the most likely diagnosis?

Fatty liver syndrome. Fat cows are more predisposed to fatty-liver syndrome when they encounter a negative energy balance. Shortly after parturition, their energy needs increase dramatically with lactation. Clinical signs are vague so you must be able to reach the answer by paying attention to the signalment. Further, an RDA will present with much more systemic signs and you will be able to hear a ping. PA toxicity and oleander toxicity are possible but less likely given the signalment and clinical signs. Remember, oleander is cardiotoxic and causes arrhythmias and PAs will cause chronic damage to the liver.

You receive a call from a local farmer who is having trouble with a gilt farrowing. This is a small producer with just 20 sows. This is the last gilt to farrow in the group. No other gilts have had any problems. The gilt started farrowing 3 hours ago. So far she has had 8 pigs born alive and 1 stillborn. The gilt seems to be straining for the past 15-30 minutes but nothing has come out. He performed a vaginal exam and "armed" her and is not able to feel anything in the birth canal. No fetal membranes have been passed. What should you tell the farmer to do next?

Give oxytocin and recheck in 20 mins --- The normal duration of farrowing ranges from 1.5 - 4.5 hours with an average interval between pigs of 15 - 20 min. In this case the fact that the farmer did a vaginal exam and "armed" her tells you there are no pigs in the birth canal and thus manual extraction is not possible at this time. Prostaglandins causes luteolysis of the corpora lutea and release of relaxin, which causes relaxation of the birth canal and cervix and is primarily used to induce parturition, not to assist in dystocia. The indications that the gilt has been straining with no fetal membranes passed suggest she is not done. Gilts traditionally have smaller litter sizes than sows. Her current numbers of 8 born alive and 1 stillborn make it difficult to know if there are any more pigs left in her or not. On average sows today will have 11 -13 pigs born alive per farrowing. The gilt has been farrowing for only 3 hours and there are no pigs stuck in the birth canal so there are no indications that a C-section is necessary at this time. Oxytocin is very effective in creating uterine contractions. The best option at this time is to administer the oxytocin and recheck the gilt in 20 minutes.

An 8-year old, retired, racetrack Greyhound presented for lameness of the right forelimb. Radiographs showed a mixed proliferative and lytic lesion in the region of the proximal humerus. Blood work showed: HCT=54 (35-57 %) TP=5.9 (5.4-7.5 mg/dl) ALP=568 (1-114 U/L) ALT=42 (10-109 U/L) T. Bili= 0.5 (0-0.3 mg/dl) creatinine=0.9 (0.5-1.7 mg/dl) BUN=49 (8-28 mg/dl) Three view chest radiographs show no lung or heart pathology. What recommendations will you make to the owners?

Greyhounds are one of the most predisposed breeds to *osteosarcoma*. Any geriatric greyhound with a lameness should be evaluated promptly for this reason. Unless the patient has a highly suspicious history of living in, or being exposed to, areas with high levels of fungal organisms, the radiographic findings are almost confirmatory for osteosarcoma. Regardless of a strong suspicion, core biopsies or a needle aspirate of the lesion should be obtained prior to a definitive treatment. The appropriate treatment in dogs without radiographic evidence of metastasis is amputation followed by chemotherapy. Amputation alone will provide a 2-3 month survival period. While amputation with chemotherapy yields a 9-12 month survival period. Definitive radiation therapy is not possible for these tumors. However, radiation therapy is great when using it as a palliative mode of therapy. The only feature of the blood work which is of note is the ALP. Studies have shown that an elevated ALP is associated with a more aggressive tumor. Aside from informing the owners of this potential, it is still recommended to proceed with amputation and chemotherapy. In these situations, some surgeons and oncologists may recommend performing a CT of the chest to evaluate the chest for metastasis more thoroughly prior to proceeding with surgery and chemotherapy.

Which of these is most likely to provide a definitive diagnosis that a dog with chronic nasal discharge has nasal aspergillosis?

HISTOPATH -- Diagnosis of nasal aspergillosis is based on demonstrating the organism in diseased tissue. A CT is great for looking at turbinate destruction but can look very similar if there is a nasal tumor. Cytology usually does not reveal fungal hyphae. Fungal culture is very unreliable; about one third of dogs with nasal tumors may have growth on fungal culture. Serology is also riddled with false negatives and positives. Histopathology usually reveals pyogranulomatous inflammation and necrosis with numerous fungal hyphae. The yield of biopsies can be greatly improved with assistance from rhinoscopy where white fungal plaques are often visualized. Diagnosis is sometimes made from rhinoscopy alone although this is less definitive than histopathology.

A 10-year old female spayed calico has presented for further evaluation of a previously diagnosed mass in the neck region. The mass had been diagnosed as a thyroid adenocarcinoma and has now abscessed. Chest radiographs show a bronchial pattern with no obvious evidence of metastasis. Blood work shows a slightly decreased T3 and T4. Which of the following is a likely complication from this mass?

HORNER's syndrome --- This is likely as a result of direct disruption of the sympathetic trunk traveling along the neck. Any time there is a neck mass present, it is important to evaluate the patient for the possibility of Horner's syndrome. Additionally, disruption of the recurrent laryngeal nerve should be considered as this will result in laryngeal paralysis. Hypercalcemia of malignancy is always a possibility with any mass; however, it is not reported commonly with thyroid adenocarcinomas in cats. Hypertrophic cardiomyopathy can be a feature of hyperthyroidism, which is usually secondary to a thyroid adenoma. Based on this patient's blood work, there is no evidence of hyperthyroidism. Renal failure is not a reported complication.

Which anesthetic agent makes a dog's myocardium more susceptible to catecholamine induced arrhythmias?

Halothane. Xylazine may actually have a protective effect on the heart from catecholamine induced arrhythmias. Sevoflurane is a halogenated inhalation anesthetic similar to isoflurane. When sevoflurane comes in contact with soda lime, a degradation product called compound A forms which has been shown to cause renal necrosis in laboratory rats. Etomidate is an intravenous anesthetic agent which has very few side effects on the cardiovascular system, and is therefore often used with patients with cardiac disease.

What is the growth medium of choice for Mycoplasma bovis?

Hayflick's agar -- Mycoplasma bovis does NOT grow well on the other choices provided. Additionally, you will want to grow it in a microaerophilic environment.

A 4-year old female spayed Doberman pinscher presents for lethargy and decreased appetite. The owner reports that over the past week, the dog has become increasingly listless and reluctant to go for walks You examine the dog and find mild joint effusion of the tarsi. T-104.3 F 40.2 C, HR-102 bpm, RR-32 bpm. The remainder of your physical exam is unremarkable. Complete blood count and chemistry panel show: Hematocrit - 28% (Normal 36%-50%) White Blood Cell Count - 15,500/ul (Normal 7,000-17,000/ul) Thrombocytes - 246,000/ul (Normal 200,000-900,000/ul) Calcium - 9.8 mg/dl (Normal 8-11 mg/dl) Phosphorus - 3.4 mg/dl (Normal 2.4-4.9 mg/dl) Total Protein - 5.8 g/dl (Normal 5.5-7.3 g/dl) Alkaline Phosphatase - 68 IU/l (Normal 10-80 IU/l) Alanine Aminotransferase - 14 IU/l (Normal 3-33 IU/l) Blood Urea Nitrogen - 20 mg/dl (Normal 10-22 mg/dl) Creatinine - 1.6 mg/dl (Normal 0.5-2.2 mg/dl) Glucose - 104 mg/dl (Normal 60-125 mg/dl) Urinalysis is within normal limits and urine culture was negative. Radiographs of the tarsal joints show joint effusion to no bony abnormalities. You perform arthrocentesis of each tarsal joint. You are able to aspirate about 0.15 ml from each joint; the fluid is thin and turbid. You do not have enough joint fluid to submit for analysis and culture so you make a slide for cytology which shows 3-4 nondegenerate neutrophils per high power field and occasional mononuclear cells. You are suspicious that the dog may have immune-mediated polyarthritis (IMPA). Which of the following are all known potential inciting causes or predisposing factors for this condition?

IMPA is often classified as being erosive or nonerosive. This case is an example of the nonerosive form based on the lack of radiographic evidence of cartilage or subchondral bone destruction. The erosive form is rare and is thought to account for <1% of the cases of IMPA. IMPA can be associated with a variety of systemic diseases or precipitating factors including systemic infectious, inflammatory or neoplastic disease or reactions to drugs or vaccines. *Systemic lupus erythematosus* is a progressive multiorgan autoimmune disease which frequently manifests with polyarthritis and may also cause concurrent hemolytic anemia, thrombocytopenia, glomerulonephritis, skin lesions, and lymphadenopathy. Drug induced IMPA has been associated with a variety of medications including *sulfonamides, lincomycin, erythromycin, cephalosporins, phenobarbital, and penicillins*. Vaccine associated polyarthritis has been suggested but association has been difficult to prove. Some breeds of dogs have particular predispositions to IMPA including Akitas (in association with meningitis) and Shar-Peis (in association with "Shar-Pei fever"). IMPA can also be associated with chronic infectious or inflammatory diseases including pyoderma, urinary tract infections, pneumonia, endocarditis, mastitis, heartworm, fungal infection, and severe periodontal disease. Chronic inflammatory bowel disease, intestinal overgrowth, and ulcerative colitis have been associated with IMPA. Distant neoplasia has also been associated with IMPA including squamous cell carcinoma, *mammary adenocarcinoma, leiomyoma, heart based tumors, and seminoma*. The clinical signs associated with IMPA are anorexia, weight loss, fever, lethargy, and lymphadenopathy. Up to 25% of dogs present with only nonspecific signs of systemic illness and without apparent gait abnormality or joint effusion. It is an important consideration for dogs with fever of unknown origin and may be the cause up to 20% of the time. IMPA is diagnosed by synovial fluid analysis although additional baseline diagnostics are indicated to screen for potential systemic or infectious causes. Normal synovial fluid is clear and viscous with <2.5 g/dl protein and <3,000 cells/ul with predominantly mononuclear cells. Joint fluid in IMPA may be thin, turbid, and increased in volume with higher amounts of protein and cells, often primarily nondegenerate neutrophils. Treatment of idiopathic IMPA centers on immunosuppressive therapy, often starting with prednisone and sometimes including an additional immunosuppressive drug such as azathioprine or cyclophosphamide. About 80% of dogs will respond to immunosuppressive doses of prednisone; however, half of dogs require long-term or additional drug therapy to maintain remission.

Which of the following is true about hernias in swine?

Inguinal hernias in pigs is heritable. Both inguinal and umbilical hernias occur commonly in pigs. Inguinal hernias occur more commonly in males than females, particularly after castration. They can be unilateral or bilateral and occur more commonly on the left side. Umbilical hernias occur in both sexes but are slightly more common in females.

You examine a Basset Hound with primary glaucoma in one eye. What would you tell the owner about his prognosis for the other eye?

It will probably also develop glaucoma in 6-12 months. The usual course for primary glaucoma is development in one eye with the contralateral eye following in 6-12 months. These animals have an iridocorneal angle that becomes increasingly compromised during the first few years of life and eventually causes an acute pressure spike in the eye.

Bone Spavin

It's osteoarthritis of the distal intertarsal joint and/or the tarsometatarsal joint. The description of the bony swelling and gait are consistent with this condition. The positive flexion test (sometimes called spavin test) as well as improvement with intra-articular anesthesia and the radiographic findings confirm the clinical suspicion. Bone spavin can be managed with a variety of measures including NSAIDs, injections of corticosteroids or hyaluronic acid into the joint, and corrective shoeing to assist in breakover and/or with heel support. Ultimately though, the disease tends to be chronically progressive until joint arthrodesis or ankylosis occurs. The process may occur spontaneously or can be accelerated by surgery including procedures to disrupt the joint cartilage and fill with bone grafts or chemical arthrodesis.

Where in the GI tract is folate absorbed?

JEJUNUM -- Folate is predominantly absorbed in the jejunum, in contrast to most other vitamins, which are absorbed predominantly in the duodenum (except for Vitamin B12 aka cobalamin, which is absorbed in the ileum).

A 4-year old dog presents for excessive licking of the right carpus of a 2-month duration. Upon examination you note an oval wound that is thickened, alopecic, and ulcerated. Based on clinical findings you make a presumptive diagnosis of acral lick dermatitis. Which statement is NOT true for acral lick dermatitis?

Lesion should resolve with topical Abx tx -- ost acral lick lesions are solitary and affect the carpus or metacarpus. About 50% will be diagnosed as idiopathic or psychogenic, but other diseases must be ruled out first including bacteria, fungal, demodicosis, trauma, allergy, and underlying joint disease. A full work-up may include skin cytology, fungal culture, biopsy, diet trial, skin testing, radiographs of the joint, and addressing behavioral disorders. Most of these lesions will have a deep bacterial infection and treatment should include systemic antibiotics based on a deep culture sample. Topical antibiotics may not penetrate the area well enough to resolve the infection. Management also includes treating the underlying cause. Many veterinarians will also prescribe topical or intralesional steroids. If no cause is found, then antidepressants or anxiolytics may be started. These lesions will rarely go away unless the underlying cause is identified and properly treated.

This is an ECG recording of a 9-year old male castrated Golden Retriever that had a bleeding splenic mass surgically removed approximately 4 hours ago. The heart rate is currently 186 bpm. The patient received 0.08mg/kg of hydromorphone approximately 45 minutes ago. PCV is currently at 24 (normal 33-58%). What is the best treatment option?

Lidocaine bolus, followed by lidocaine CRI -- This patient is exhibiting premature ventricular contractions which is commonly observed after splenectomy. Any patient that has a splenectomy should be monitored closely for that reason. Most of the time these are not severe enough to require treatment. There are some general guidelines for when to treat VPCs which include excessive pulse deficits, the patient is clinically affected, a heart rate greater than 180 bpm, or greater than 20 second stretch of continuous VPCs. In this case it is important to know that the patient was just given a dose of post-operative pain medication (at an appropriate dose) which rules out an elevated heart rate secondary to pain. The patient is anemic, but he is not anemic to the point of requiring an emergency transfusion. Transfusions are usually not administered unless there is expected ongoing blood loss (which is not the case) or the PCV is less than 20. Lidocaine is an anti-arrhythmic and is the typically the drug of choice for treatment of VPCs. A bolus is administered first to determine if the rhythm is responsive to lidocaine and then a CRI is initiated at 20-80 micrograms per kilogram per minute.

Which of these measures would be most effective at reducing the risk of aminoglycoside toxicity?

Maintaining adequate hydration. As long as hydration is good, there should be acceptable renal perfusion which helps reduce the incidence of nephrotoxicity.

Which dermatophyte is most commonly associated with ringworm in the llama?

Microsporum nanum. M canis commonly affects dogs and cats. T mentagrophytes affects cattle and more commonly, goats. T verrucosum affects goats and more commonly, cattle.

Which of the following statements is true about pseudorabies in pigs?

Older pigs with the disease show respiratory clinical signs such as sneezing, nasal discharge, and coughing. Pseudorabies in young nursing piglets tends to cause neurologic signs such as incoordination, tremors, blindness, paddling, coma, and death. Weaned pigs may have both neurologic signs and respiratory signs such as sneezing, nasal discharge, and coughing. Older pigs tend to only have respiratory signs. Pregnant sows affected with the virus often have reproductive failure.

Cardiotoxins

Oleander, rhododendron, white snakeroot and yew

A mature pet goat is brought to you for diagnosis and treatment one morning. The owner found the wether in the feed room eating a bag of horse sweet feed (grain and molasses) some 3 hours ago. His abdomen is large and full. On examination you, note that his T=101F (38.3 C), HR=120, RR=42, and his rumen is overfull with watery fluid. The goat is either a very quiet pet or is depressed, as he stands in place with no restraint and lies down as soon as he can (see photo). You pass a stomach tube and take a sample of rumen fluid and it has a pH of 4.5. Based on this history and PE findings, which of the following treatments would be most effective?

Oral antacids containing magnesium oxide and magnesium hydroxide; IV fluids containing sodium bicarbonate; systemic penicillin. This goat has a classic history for grain overload, and the PE is compatible with rumen acidosis and metabolic acidosis. If not promptly and aggressively treated, this can result in death from metabolic acidosis and dehydration, as well as liver abscesses and mycotic rumenitis. Oral antacids, systemic buffers, and penicillin are all indicated. The safest effective oral antacids are MgO and MgOH. In some cases, a rumenotomy may also be indicated.

A beef cow presents for decreased milk production. On physical exam, the cow has a fever of 104.5F. Her urine is yellow, and the dipstick tests are normal. You make a blood smear and see an organism at the margin of the red blood cells. What is your treatment of choice for this animal?

Oxytetracycline -- the cow has Anaplasmosis, a rickettsial organism that is transmitted by ticks. Infected calves have a low mortality rate, but adult cattle have a 20-50% mortality rate with this disease.

Which of these signs are least compatible with an estrogen secreting Sertoli cell tumor in a dog?

PU/PD == Estrogen secreting Sertoli cell tumors are quite common in cryptorchid testes and cause the clinical signs of truncal alopecia, hyperpigmentation, gynecomastia, urinating in a female position, and bone marrow dyscrasias such as aplastic anemia. Attraction of other males can also occur. PU/PD is a sign commonly seen with endocrinopathies but not this one.

A cow presents to you as a result of decreased milk production. On physical exam you determine the cow has a much stronger pulse on expiration than she does on inspiration. What is this pulse associated with?

Pericardial effusion. Pulsus paradoxus is an exaggeration of normal variations in the pulse during respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales. It is characteristic of constrictive pericarditis or pericardial effusion. Atrial premature contractions are more likely to result in pulse deficits. Atrial fibrillation is likely to result in pulsus alternans, in which you see two quick normal pulses in a row followed by no pulse. A patent ductus arteriosus usually is found only in very young animals and results in waterhammer pulses which is a large bounding pulse with a sharp peak and very rapid decline.

cows teeth

Permanent incisors are fully erupted and in wear at 1.5, 2.5, 3.5 and 4.5 years of age (permanent incisors I1, I2, I3 and I4 respectively). The first permanent incisor erupts at 18 to 24 months, the second at 24 to 30 months, the third at 33 to 36 months, and the fourth erupts at 42 and 48 months. This means that the rough rule of thumb is a bit off for I1 in some animals, but it does help to remember these approximate times. There is some individual and some breed variability. After eruption, each tooth takes about 6 months before it is in wear.

A newly acquired Cockatiel with an unknown history presents for increased respiratory effort. Which of the following is the least likely differential diagnosis for this bird?

Polyoma virus infection. The avian Polyoma virus causes delayed feathering, diarrhea, gastrointestinal stasis, ascites, and death. Respiratory difficulty is not a classic clinical sign for Polyoma virus. Mycoplasma infection, chlamydiosis, and Bordetella infection are all respiratory infections in birds that can cause head shaking, sneezing, and rhinitis.

Which one of the following anatomic features is not found in old world primates such as the colobus monkey, proboscis monkey, or langur?

Prehensile tail. Old world primates are found in Asia and Africa, whereas new world primates are found in South and Central America. Some old world primates such as the colobus, proboscis and langur may have a long tail, but it lacks the ability to grasp; therefore, old world primate tails are never prehensile. Prehensile tails are only found in some species of new world primates.

An unvaccinated domestic short hair is brought to your clinic after biting a human. The cat appears clinically healthy. What is the best course of action?

Quarantine for 10 days, or euthanize it and test it for rabies. You may confine the cat and observe it for 10 days if it is vaccinated.

An 8-year old female spayed domestic short hair presents for lethargy, polydipsia, and vomiting. Chemistry panel shows TCO2= 11 mEq/L (13-21 mEq/L), blood glucose= 550 mg/dl (60-120 mg/dl), BUN= 55 mg/dl (19-34 mg/dl), creatinine 1.9 mg/dl (0.9-2.2 mg/dl). Urinalysis shows 3+ ketones and a large amount of glucose present. The type of insulin required to initially manage this patient would be _______.

REGULAR -- Regular insulin is a potent and short-acting insulin used to treat DKA patients. NPH and lente are intermediate-acting insulins usually used to initially manage diabetics without ketoacidosis. Ultralente is a long-acting and less potent insulin.

A 6-year old purebred Angus beef cow has chronic diarrhea, weight loss, and ventral edema. On physical exam you note T=102F (38.9 C), HR=80, and RR=20. You find an enlarged left kidney by rectal exam. Laboratory abnormalities include hypoalbuminemia, hyperglobulinemia, proteinuria, and elevated serum creatinine. What is the most likely diagnosis?

Renal amyloidosis -- in response to a chronic inflammatory (often infectious) process, amyloid can accumulate in the kidneys and result in chronic renal failure, consistent with these clinical signs and laboratory results. Pyelonephritis would have fever and white blood cells in urine ( and also RBCs in some cases), not only protein as was seen in this case.

A 9-year old spayed female Siamese cat is presented to you for a 6-month history of polydipsia (the owner has documented water consumption of 110 ml/kg/day) and a 1 month history of weight loss and progressively decreasing appetite. Which of the following is a likely differential to explain these clinical signs?

Renal failure is the differential most likely to be associated with pu/pd accompanied by decreasing appetite and weight loss. Most cats with diabetes mellitus have normal to increased appetites; diabetic ketoacidotic animals can be ill, but usually DKA follows a period of pu/pd, weight loss, and normal to increased food intake. Hyperthyroid cats can be pu/pd and have weight loss, but appetite is most often increased. Some EPI animals show pu/pd and most have weight loss, but most are ravenously hungry. Most animals with HCM are not pu/pd, and the disease is not routinely closely associated with decreased appetite or weight loss.

Which of the following is a common cause for diarrhea in growing and finishing pigs?

Salmonella. Salmonellosis occurs most commonly in grower and finisher pigs. Adults and nursing or weaning pigs are uncommonly affected by Salmonellosis. E. coli, Clostridium perfringens type C, Isospora suis, and rotavirus infections all commonly cause diarrhea in young nursing piglets, but uncommonly in growers and finishers.

Which of the following is the most likely side effect of KBr therapy in epileptic dogs?

Sedation. Possible side effects of KBr therapy include polyphagia, polyuria and polydipsia, ataxia, skin reactions, pancreatitis, and vomiting. However, sedation is more likely to occur than these.

You arrive at a beef ranch in a mountain meadow at 5000 feet elevation in the western US because the owner has called with the complaint of sudden death losses in adult cows, and another one staggering. You examine the sick animal and find fever of 105F (40.6 C), elevated respiratory rate, HR of 100/min, icteric mucous membranes, and weakness. You collect a urine sample and it appears dark red (see image). You also perform a post-mortem on one of the recently dead cows and find a hepatic infarct, icteric tissues and hemoglobinuria. The owner asks for a diagnosis, treatment, and prevention.

The diagnosis is *bacillary hemoglobinuria* caused by Clostridium novyi type D (formerly called Cl. hemolyticum). *Penicillin* can be given to any animal showing early signs. *Vaccination with Cl. novyi type D vaccine* is effective, and prevention should also include fluke control. Migrating *flukes* cause hepatic damage and anaerobic areas which results in germination of the Cl. novyi spores in the liver, an infarct, and production of the hemotoxin. Flukes are best controlled by controlling snails in wet areas, fencing off wet areas, and using routine fluke treatments.

Following a routine spay, a dog exhibits moderate respiratory distress upon recovery that worsens over the next two hours. You take radiographs and see a bronchoalveolar pattern in the cranial lung field. What is your biggest concern?

The dog probably has aspiration pneumonia. Aspiration pneumonia is the most likely complication from this type of anesthesia and surgery. Coupled with the radiographic findings, it is the best choice. A pneumothorax from surgery or pneumomediastinum from tracheal tube trauma could both certainly occur but don't quite fit this scenario. If you were wondering how soon you would see respiratory signs from aspiration and radiographic signs, it can be very quickly.

What can be concluded from a urine specific gravity of 1.004 in a dog?

The dog's renal function is capable of diluting urine. The dog is hyposthenuric (specific gravity between 1.001-1.007) which requires work to dilute the urine. Renal failure cannot be diagnosed without knowing the animal's BUN and creatinine status. You can not say the dog is PU/PD without knowing the quantity of water it drinks and quantity of urine it produces. A dehydrated animal should have concentrated urine, instead of dilute urine.

Treatment for Strongyle infestation in horses

The most common treatment for large and small strongyle infections are ivermectin, fenbendazole, and oxibendazole. The migrating larval forms of strongyles that cause verminous arteritis can be treated with ivermectin, fenbendazole, and thiabendazole.

A 2 year old Holstein dairy cow presents for lethargy, anorexia, and decreased production. On physical exam, the cow has a temperature of 104.5F (40.3 C), a respiratory rate of 68 bpm, a heart rate of 90 bpm, muffled heart sounds that have a distinct washing machine sound of splashing and dripping, heard best on the left side. The jugular veins are prominent. What is your tentative diagnosis?

The murmur results from development of pericarditis and may be described as a washing machine murmur. It results when there is a fluid-gas interface in the pericardial sac. The heart sounds are muffled because of the thickened and fluid filled pericardial sac. Tricuspid endocarditis would result in a loud right sided murmur. A ventricular septal defect would have a loud systolic or constant murmur heard on either side. A heart base tumor could cause muffled heart sounds but would not have the washing machine sounds and would be unlikely in a 2 year old cow (usually BLV lesions occur in older cattle).

A 6 year old Cocker Spaniel with a chronic history of ear infections presents to you circling to the left, with a left head tilt, and both rotary and horizontal nystagmus with the fast phase to the right. No other neurologic deficits are apparent except for a possible hearing deficit. It is difficult to perform a thorough otoscopic examination on the patient without sedation. The dog has been on multiple topical and systemic medications to treat otitis over the past few weeks, but the owner is not sure what they are. Which of the following drugs is a commonly implicated cause of peripheral vestibular disease?

The question is asking about peripheral vestibular disease; otherwise, metronidazole would be a good choice as a cause of central vestibular disease. Chlorhexadine is a topical drug implicated in ototoxicity and peripheral vestibular disease. Another excellent choice would be aminoglycosides including neomycin, kanamycin, tobramycin, amikacin and gentamicin.

A 6-year old male castrated German Shepherd Dog presents with difficulty rising and laying down in the pelvic limbs. Pelvic radiographs reveal severe bilateral hip dysplasia. Which is not a treatment option for this dog?

Triple pelvic osteotomy. Triple pelvic osteotomy should only be performed in young dogs (less than a year old) that have minimal secondary degenerative changes and deep acetabulums. NSAIDs are often used to medically manage patients with dysplastic hips. A total hip replacement is a treatment option for dogs that are not benefiting from medical therapy. An FHO is a salvage procedure for those in which either a TPO or total hip replacement is not an option.

A 9 year old female spayed Vizsla presents for a lump on her carpus. Excisional biopsy of the mass shows a low grade peripheral nerve sheath tumor. What do you tell the owner?

Tumor will prob recur locally in the future -- Low grade peripheral nerve sheath tumors (and most soft tissue sarcomas in general) on the trunk or extremities of a dog are locally aggressive tumors. They often recur after surgical excision if further therapy such as radiation therapy is not instituted adjunctively. The "low grade" designation means the tumor has a low likelihood of metastasis. If they do metastasize, the most common site of metastasis is the lungs.

A client with a pet pot belly pig carries it into your clinic one day, cradling it lovingly against her body. The complaint is pruritus and skin lesions; she mentions that she and her boyfriend also have similar lesions. You do a skin scraping on the pig and find Sarcoptes scabiei. What treatment should you now recommend?

Tx for mange --- The best treatment drugs are the avermectins; two doses at 2-week intervals will be required. The mange mite completes its entire life cycle on the pig. Also advise her to see her physician for herself and boyfriend. Finally, tell her this can spread to other species of animals, and the pig must be quarantined away from all other pets and livestock.

When placing an intraosseous catheter in a bird, which of the following bones would be the most appropriate to use?

Ulna -- Intraosseous catheters can be placed in birds in either the ulna or the tibiotarsus. Birds have pneumatized bones, and these must be avoided with IO catheters, since administration of fluids into a pneumatic bone would drown the bird. The humerus and femur are both pneumatic. The coracoid is not accessible for placement of a catheter. The radius is not a pneumatic bone, but in the bird, the radius is the smaller of the two bones of the antebrachium and is generally too small to use for catheterization

You are presented with an 8-month old Quarter horse filly with a chronic history of urinary incontinence. The image provides one of the findings on physical examination. The remainder of the physical exam, along with a CBC and chemistry profile, is normal. What is the most likely cause of these signs in this filly?

Urine scalding, as pictured, along with the age and gender of this patient, would lead to a high suspicion of an *ectopic ureter*. While this is a comparatively rare problem, it is the most common congenital anomaly of the equine urinary tract. Nearly 90% of the cases reported are fillies, with the primary complaint of urinary incontinence and urine scalding (dermatitis). Surgical correction has been successful. The chronic history in a young animal makes primary urinary tract infection less likely.

An 8 year old male castrated mixed breed dog presents for lethargy and depression. A chemistry panel shows a serum calcium = 13.2 mg/dl (9.1-11.7 mg/dl). Which of the following is NOT a differential diagnosis for this dog?

nutritional secondary hyperparathyroidism. Nutritional secondary hyperparathyroidism does not result in hypercalcemia. Lymphoma, anal sac adenocarcinomas, chronic renal failure, and primary hyperparathyroidism can all cause hypercalcemia in the dog.

You examine a cow with pruritic leg lesions consisting of papules, erythema, scaling, crusting, and alopecia (see image). Several animals in the herd have these same lesions. What should you do to make the diagnosis?

skin scraping to ID chorioptic mites. Chorioptes bovis (see image) is found in cattle, and it is a reportable disease. Treatment with ivermectin is usually effective. C. equi, C. ovis and C. capre are found respectively in horses, sheep and goats where they cause mange. Identifying the mite, along with lesion distribution, will determine which mange mite is responsible.