What conditions can be prevented or lessened by gonadectomy?
Females: pyometra, ovarian tumors, uterine tumors, mammary tumors, urinary incontinence
Males: Testicular tumors, prosthetic hyperplasia, perineal adenoma, perennial hernias
What drug used to prevent unwanted pregnancy, but can predispose to pyometra even in young bitches?
Estradiol
What is the relationship between Early Gonadectomy and joint disease especially enlarged breed dogs?
More joint disease is seen in dogs neutered young. Even more so with males.
What is the effect of gonadectomy on behavior?
Less aggression especially “mate finding” aggression. But the effect on other forms of aggression is probably negligible and overrated
Less roaming behavior in males
Should gabapentin be used as a sole agent for pain?
No
How is gabapentin removed from the body?
Kidneys
What is the best way to administer gabapentin to dogs and cats when used as pre-clinic sedation?
Give a dose the night before the
appointment
Dogs/cats: 20 to 25 mg/kg PO the evening before the appointment and 20 to 25
mg/kg PO at least 1 to 2 hours before the appointment
What is venlafaxine?
serotonin and norepinephrine reuptake inhibitor
What conditions is venlafaxine used to treat in cats?
high arousal conditions, impulsive aggression
What is the main adverse effect of venlafaxine in cats?
decreased energy
Is protection from disease guaranteed with vaccination?
No
Should shelter dogs with mild disease, be vaccinated
2022 AAHA canine vaccination guidelines state shelter dog with mild illness may be vaccinated
Name a condition that can be life-threatening and can be triggered by vaccination. Note that "can be.” is not the same as "will be”
immune mediated polyradiculitis
What is another name for immune mediated polyradiculiytis?
Guillain–Barré syndrome (GBS) or coon hound paralysis
Should cats with FELV or FIV be vaccinated?
Yes if otherwise healthy
No if cat is clinically sick
Should sick cats with FIP be vaccinated?
No
Can dogs that are on ilunocitinib (zenrelia) be vaccinated?
No according to the manufacturer.
What kind of vaccine is best to use on animals on chemo?
killed vaccine. But still best to take precautions
Should pets on. anti inflammatory doses of glucocorticoids or topical steroids be vaccinated?
In most cases yes.
Maybe not when auto immune doses used
What diseases have titres available to indicate protection?
panleukopenia, parvovirus, canine distemper, adenovirus
Can pregnant animals be vaccinated?
Best to avoid
Name five causes of epistasis in dogs.
Trauma
neoplasia
infection (tooth root abscess)
fungal
bacterial
coagulopathy
Parasitic
Foreign body
What is the goal standard radiologic imaging technique for nasal problems?
CT scan
What should a clinician do first, nasal radiography or rhinoscopy? Why?
Do radiography first. The process of doing rhinoscopy can cause bleeding or temporary changes in the nasal cavity which would impact radiographic appearance
What drug that many clinicians have can be used to control epistasis? Give me a topical drug and a systemic drug?
Topical: epinephrine, phenylephrine
systemic: blood transfusion therapy, desmopressin
What technique is described in the article, "epistasis in dogs” can a clinician do to control epistasis? (note that I have never done the technique described)
improvised nasopharyngeal tamponade device (ie, condom affixed to a nasogastric tube)
What is the name of the product described in the article about promoting water intake in cats?
Hydra Care by Purina
What is a real life concern about clients giving subcutaneous fluids to cats at home (not mentioned an article)?
You will create a behavioral problem. The cat will start running away from you when you approach him or her.
Is the urethral muscle relaxant prazosin good or bad according to the article? Why?
Bad. It does not prevent recurrence, it stresses the cat, it adds cost. Note this conclusion is for recurrence, not for unblocking a cat that comes in obstructed
Is topical corticosteroids good or bad to control of otitis external in dogs?
They are good. They help a lot.
Ask Dr. Dave about his homemade Paumanok ear formula
Take a 4 ounce container of Oticlenz or equivalent ear cleanser. Remove 20 cc. Add 10 cc dexamethasone injectable. Add 10 cc of Betadine solution. Applied to ears 2 to 4 times per week. Maybe three drops each t
ime.
What are other things a clinician can do to prevent otitis external from returning?
ear cleaning
omega 3 fatty acids
hyposensitization - good in theory but not as easy as it sounds
hypo allergenic diet (sometimes)
What is “marsupialization”?
Surgically opening up a fluid filled sack (cyst, abscess, pyometra) and suturing it to the skin, such that the fluid grains to the outside and not inside the animal. With this procedure, the fluid fill structure is not removed.
What is the problem with marsupialization to treat sialoceles?
High rate of recurrence
What is a big advantage of insulin Glargine 300?
Very good control with once a day injection
What is the goal standard radiologic imaging technique for nasal problems?
What is the disadvantage of glargine 300 (not mentioned in the article)
What are some contraindications to induce emesis in felines?
caustic or corrosive agents eg, bleach, chemicals),
high risk for aspiration pneumonia (eg, altered mentation, laryngeal paralysis, absent gag reflex),
protracted vomiting after toxin ingestion,
respiratory distress,
ingestion of a nontoxic or very low toxicity substance or dose,
severe acid−base
What is the name of the neuro anatomic site in the medulla oblongata that initiates vomiting?
Chemo receptor trigger zone (CRTZ)
What is the emetic agent of choice for cats?
Dexmedetomidine
What is the eye drop that is an emetic in cats? Note - I have not used this and it is off label
Brimonidine
Name five causes of epistasis in dogs.
Trauma
neoplasia
infection (tooth root abscess)
fungal
bacterial
coagulopathy
Parasitic
Foreign body
What pathological condition of the kidneys has the shortest medium survival time (MST)?
Amyloidosis
What is Podocytopathy?
Glomerular disease that results in protein loss - foot processes. Leaky filtration system.
What clinical pathology values are best to monitor kidney disease progression?
BUN, creatinine, BP, UPCR
What physical examination findings are best to monitor kidney disease progression? (Not in article)
Weight, appetite, breath odor, hydration, coat quality
What is the gold standard test for septic effusion?
Aerobic and anaerobic culture
What is the problem with this test?
Takes a long time to get results.
What is the difference between morbidity and mortality?
Morbiidity is the number or percentage of animals that are sick or have a condition as opposed to mortality - the number of animals that die from this condition
Describe the bioluminescence test?
Light has different physical properties when passed through fluid that has cells or bacteria in it versus clean fluid. This difference is largely consistent and can be used to diagnose bacterial infections as a point of care (POC) service.
Which organ is affected by focal myasthenia gravis (MG)?
Esophagus
Is MG painful?
No
What is the hallmark clinical sign of myasthenia gravis?
Weakness
What is the basis of “bunny hopping”?
The dog has more strength, pushing off with two legs than with just one leg..
What is the diagnostic test of choice for myasthenia gravis?
Anti-Colinesterase receptor antibody (AChR)
What class of drugs is used to treat myasthenia gravis and given an example?
Anticholinesterase drugs
What percentage of food allergic dogs respond within three weeks?
70%
What are some home management techniques to deal with anal sacculitis and impacted anal glands?
Add fiber to diet
Soak animals, butt and lukewarm water as needed up to once a day (fill the bathtub up with lukewarm water and sit the dog)
Keep parental hair clipped short
Omega-3 fatty acid
The author of this article called the dog's temperature of 102.5 F a slight temperature. Do you agree?
My opinion- I would not worry about a temperature of 102.5 unless it has been measured in the past and as consistently been lower. Temperatures tend to rise a little bit and excited dogs, which is what you would expect in a hospital situation. Also, there is inflammation in the perianal area and this will locally increase temperature.
How can you tell the difference between a vaginal prolapse and a uterine prolapse?
By Digitail palpation, you can feel the cervix with uterine prolapse. With vaginal prolapse, this is not possible.
How can you shrink swollen prolapsed tissue?
Hyperosmotic topical solutions: 50% dextrose, hypertonic saline.
What is the treatment of choice for Perianal fistula?
Cyclosprines
Why is ketoconazole sometimes added to the treatment regimen?
By its effect on the mitochondrial metabolism. Basically it slows the removal of cyclosporine such that you can get an equivalent response by using half the amount of cyclosporine. It’s a cost saving measure.
What can be done to decrease the occurrence of gastrointestinal upset due to cyclosporine?
Put the cyclosporine capsules in the freezer. Cold cyclosporine does not irritate the stomach
Title or Question
Describe the item or answer the question so that site visitors who are interested get more information. You can emphasize this text with bullets, italics or bold, and add links.What are other treatment options?
Prednisone
Oclacitinib
Tacrolimus topical
Azathioprine
UV light
Stem cell therapy (future possibility)
Are antibiotics recommended for perianal fistula? How about metronidazole?
Antibiotics are generally not recommended. Metronidazole usually is avoided too, but if it is used, it is for its immune moderating effect.
What dog breed is most associated with perianal fistula?
German Shepherd
What is PO1?
A brucellosis specific antigen used for diagnostic purposes
Is brucellosis more common in young dogs or old dogs?
Young dogs, especially males that roam.
What condition is typically associated with brucellosis? Think radiographic diagnosis.
Discospndylitis
Is brucellosis easy to cure?
No hard to cure. And has potential zoonotic potential.
Why is apoquel (oclacitinib) contraindicated in dogs <1 yr?
oclacitinib is contraindicated in dogs <1 year of age because of the risk for systemic infections in puppies with immature immune systems
Are beta lactam antibiotics good for neonatal dogs
Yes
If one chooses to use opioids in neonatal puppies, how should the dosage be adjusted if at all?
The dose should be reduced by 50% for premedication and 30% for analgesia.
What is the problem of using fluroquinilones and puppies and kittens?
Joint problems
What is the problem of using tetracycline in puppies? Does this concern carryover to doxycycline?
Staining dental enamel
Doxycycline is more lipid soluble, and as a result is less likely to stay enamel
Explain how the statum corneum plays a role in canine atopic dermatitis
In dogs with CAD, structural and immunologic abnormalities weaken this barrier, allowing increased allergen penetration and promoting the chronic inflammation and pruritus that characterize CAD
Can nutrition be used to treat or control canine atopic dermatitis? If so, how does this work?
Several nutrients contribute to maintaining the integrity and function of the skin barrier. Foods enriched with fatty acids (eg, linoleic acid, eicosapentaenoic acid, docosahexaenoic acid) and antioxidants (eg, zinc, vitamins C and E) may help support skin health and modulate inflammatory pathways.
How can therapeutic bathing help a dog with a topic dermatitis (not fully explained in the article)?
Washes away allergens
Strengthens the epidermal barrier - fatty acids, oatmeal, and/or ceramides
Title or Question
Describe the item or answer the question so that site visitors who are interested get more information. You can emphasize this text with bullets, italics or bold, and add links.What factor that impacts clinical signs in atopic dogs can not be controlled? (not fully explained in article.)
Antigen exposure, e.g. pollen count
Topical therapy is not important to treat canine atopic dermatitis. True or false.
False
Name five indications for doing an ECG
• Tachycardia or bradycardia detection during physical examination
• Syncope or collapse
• Confirmed cardiomyopathy on echocardiography or when suspected based on thoracic radiographs or cardiac biomarkers
• Monitoring during sedation or anesthesia, as well as perioperative monitoring
• Monitoring of patients involved in trauma or exposed to toxicity
• Systemic illness requiring hospitalization
• Electrolyte abnormalities
• Pericardiocentesis
• Drug monitoring, including antiarrhythmic therapy, for effect or adverse effects
• Calculation of a mean heart rate in atrial fibrillation
What is p pulmonale and what does it indicate?
Tall p waves indicate rt atrial enlargement
With canine sinus arrythmia, is the heart rate faster with inspiration or expiration? Why?
Faster with inspiration – vagus which slows the heart rate nerve is inhibited
Wide and bizarre QRS complexes are associated with supraventricular lesion or ventricular lesion?
Ventricular
What does AGASACA stand for?
Apocrine gland anal sac adenocarcinoma
Where is the most common anatomical site for anal gland carcinoma to metastasize two?
Sub lumbar lymph nodes
Should rectal examination be part of every annual canine physical examination or at least in dogs over 15 pounds?
Yes – amongst many reasons, anal gland tumors will be detected sooner
Why is it better to remove anal sack, tumors sooner than later?
Less opportunity to metastasize, easier surgery with less complications, better results
What is the treatment of choice for anal sac tumors?
Surgery
What is the common name for fly larvae?
Maggot
Can screw worm (Cochliomyia hominivorax) flies lay eggs in health tissue?
Yes
Can humans get screw worm (Cochliomyia hominivorax)?
Yes
Screw worms live predominantly in warmer states. Under what circumstances might they be encountered in cold states?
Rescue + transportation.
What is the best source for information about small animal parasite?
Where do you send suspect samples of new world screw worm? (not in article)
Are Isoxazolines (ie, afoxolaner, sarolaner, lotilaner) effective against new world screw worms?
Yes
Describe sterile insect technique to control NWS.
Male screw worms are raised and irradiated. This makes them sterile. They are released into affected areas and mate with females. But result in no offspring.
Why does this work in southern United States but not South América
South America is too extensive, and terrain is too big and diverse
What is "diascopy"?
Diascopy involves applying pressure to the skin, often with a microscope slide, to determine whether the skin blanches (ie, turns white; positive diascopy) or remains red (negative diascopy).
What is negative diascopy and what does it mean?
Skin remains red when pressed with a glass slide > RBC outside of blood vessels
What adverse effects can happen?
GI erosions and ulcers.
What category of disease is negative diascopy associated with?
Immune mediated disease
What are ketorolac and diclofenac?
topical ophthalmic NSAIDs
What drug is better, ketorolac and diclofenac?
topical ophthalmic NSAIDs
What adverse effects can happen?
GI erosions and ulcers.
What common long lasting ear medicine contains both terbinafine and florfenicol
Claro
The author describes neurogenic keratoconjunctivitis sicca (nKCS)
No. But it can take over two months to resolve.
What can be done to lessen the chance of this happening?
Examen the tympanic membrane (not always so easy)
What are ketorolac and diclofenac?
topical ophthalmic NSAIDs
What drug is better, ketorolac and diclofenac?
topical ophthalmic NSAIDs
What adverse effects can happen?
GI erosions and ulcers.
Take the online quiz
This was very difficult. I got one out of five my first go round. The good news is that everyone learns more from the mistakes they made then from getting the answer right.
You will have a better chance of getting questions right if you review solensia
What to do in a clinically healthy dog with <2x upper limit of reference value
Wait 3 to 4 weeks and recheck ALT so long as dog rremains clinically normal
What to do: Healthy patients with ALT ≥4 times the limit of the reference interval for >12 weeks
Abdominal ultrasound
What metal element can silently cause a lot of liver problems
Copper
In what circumstances would one do a more comprehensive work up
Dog is clinically sick
other clin path abnormalities
abnormal bile acid
Breeds with familial liver issues
What are the two broad categories of anemia?
regenerative
nonregenerative
What length of time (number of days) is the cut off point to indicate regenerative vs nonregenerative anemia?
5 days
What are the five major causes of non-regenerative anemia? How many can you name without looking back at the article?
Anemia of inflammation
Anemia of Chronic Kidney Disease
Hormone-Associated Anemia
Immune-Mediated Nonregenerative Anemia
What protein transfers iron out of macrophages?
ferroportin
What causes non-regenerative anemia in kidney patients?
Decreased EPO
Uremic toxins increase RBD fargility
Bleeding intestinal erosions and ulcers
Decreased appetitie
Myelophthisic Anemia (Space-Occupying Lesions)
What endocrinopathies are most associated with non-regenerative anemia?
Hypothyroidism
Hypoadrenocorticism
What is the distinguishing feature of immune mediated non-regenerative anemia?
The immune directed activity is directed at RBC precursors at some point before they are released into circulation
What procedure is absolutely necessary to diagnose bone marrow space occupying anemia?
Bone marrow aspirate with cytology and bone marrow biopsy.
What is the minimal length of time to put a dog on that has Furunculosis?
40 days
What length of time (number of days) is the cut off point to indicate regenerative vs nonregenerative anemia?
5 days
Why was the patient described not treated with topical shampoo?
Painful
Why and how can this condition be easily missed in many dogs
Thick coat hides lesions which can be surprizing big.
What diagnostic procedure is quick and can help choose initial antibiotic until Colle sensitivity results are in?
Cytology
Rods > start with fluroquinilones
cocci > stsrt with cephalexin or clindamycine
What information should be included when you send off a cytology specimen to a clinical pathologist?
signalment
clinical history
medication history
full description of the sampled lesion or mass eg, size, location, duration, shape, texture, appearance.
Attach a picture
What is a phrase used to describe Blastomyces dermatitidis ? (not directly mentioned in article)
Big Blue Balls
What does Mycoplasma haemofelis look like on a blood smear of an infected cat?
Blue dots on surface of RBC's (easy to miss)
What is the best test for Mycoplasma haemofelis?
PCR.
What is the shape of Sporothrix schenckii?
Cigar shaped
What is the classic feature of Cryptococcus neoformans on cytology?
Large cells with thick clear capsule
Describe the cytologic appearance of Anaplasma phagocytophilum?
Morulae (clusters of small bacteria) inside of neutrophils)
Is Anaplasma usually clinical?
No
Histoplasma capsulatum
oval-shaped yeast structures with a thin, clear halo and a basophilic, eccentrically placed nucleus in neutrophils and monocytes
Describe Leishmania infantum
Frequent small (2-5 µm), round-to-ovoid structures with basophilic nuclei and small rod-shaped kinetoplasts were noted extracellularly and within macrophages
Is Leishmania endemic in the USA?
No -
Always take travel history.
What kind of blood cells do you canine distemper virus (CDV) inclusion bodies occur in?
RBC's
neutrophils
Monocytess.
What are the two syndromes of zinc responsive of dermatitis? (ZRD)? And describe them.
Syndrome 1 - artic breeds (Huskies, Malamutes). genetic defect in Zn absorption
Syndrome 2 - dietary deficiency or "obstruction" to absorption - phytates
What is the best zinc supplement to use?
Zinc methionine
What is histopathologic lesion is classic for ZRD?
epidermal parakeratotic hyperkeratosis
What are the four types of wounds
clean
clean-contaminated
contaminated
dirty
What are the three phases of wound healing and what is their timeframe?
Inflammatory Phase (Days 0-4)
Proliferative Phase (Days 4-12)
Maturation/Remodeling Phase (up to 12-18 months)
Is moisture good for wound healing? Why?
foster autolysis of damaged tissue
aid leukocyte migration
encourage local preservation of cytokines and growth factors
enable contact of systemically administered antibiotics with the wound bed
encourage epithelialization
decrease scar production
decrease pruritus and pain.
What is the best way to get a sample for culture and sensitivity?
Tissue sample, e.g. punch biopsy - better then surface swab
What is the first step in wound management? (not mentioned in article.)
Anallgesia +/- sedation
How do wound dressings remove necrotic tissue from a wound?
As the covering layer dries, necrotic tissue stick to it and arre removed when the dressing is changed.
Describe the tie over technique for managing wounds?
Suture loops are made aound the wound edge
Umbilical tape is uswed in zig zag fasten to hold primary dressing in place
Initially, how often should the bandage be changed?
Atleast once a day
What is a unique and dangerous feature of New World screwworm (NWS)?
They can attack and ;ay eggs in healthy tissue
Can New World screwworms thrive in cold conditions??
No. 45 degrees F is the cutoff point
What are the clinical signs of NWS?
Soft tissue destruction made woorse by secondary bacterial infection
How is New world screwworm diagnosed?
identify the larvae (maggot)
How is new world screwworm treated?
Physical removal of larvae
wound care
antiparasitic administration
Name some anti parasiticides that are effective against NWS.
lotilaner (creedelio)
moxidectin (proheart)
praziquantel (droncit)
pyrantel (strongid)
afoxolaner (Nexgard)
sarolaner (simparica
Nitenpyram (capstar)
Spinosad (commfortis)
ivermectin (Ivomec)
What is sterile fly release?
Adult flies only mate once. Female flies that mate with a sterile male lay nonfertile eggs. Millions of sterile males can be produced through irradiation and released in areas where NWS is endemic or at risk for emergence.
Is New World screwworm reportable?
Yes
Where to get up to date information
Companion Animal Parasite council
CAPC
https://capcvet.org/guidelines/cochliomyia-hominivorax/
What is the best way to diagnose urethral tear?
positive contrast retrograde urethrography
What radiologic features suggest urethral tear?
presence of a perineal bulge
a perineal bulge larger in size
heterogeneous perineal tissue
What are the clinical signs of NWS?
Soft tissue destruction made woorse by secondary bacterial infection
What steroid is most commonly used for intra-articular joint injection?
Triancinalone (vetalog, kenalog)
For hyaluronic acid therapeutic joint injection, what is preferred - high molecular weight hyaluronic acid or low molecular weight hyaluronic acid
High molecular weight
How does platelet rich plasma (PRP) work?
Release growth factors - promotes healing
Mediates inflammation
modulates immune response
Globally, what is the most important reservoir of leptospirosis?
Rodents - especially rats
How can Leptospirosis be prevented?
Vaccination - most important
avoiding overcrowding in shelters and boarding kennels
implementing proper drainage infrastructure
providing rodent control
discouraging predation.
How can Leptospirosis best be diagnosed?
Diagnosis can thus be optimized by combining acute and convalescent phase serologic testing using a microscopic agglutination test (MAT) with PCR testing on urine and blood.
What is the best treatment for leptospirosis?
Doxycycline 5mg/kg bid for 14 days
What kind of vaccine should be used?
4 serovar