RykuPrep Study Guide
RykuPrep Study Guide
Major differentials for feline upper respiratory tract disease include Chlamydophila felis,
Feline calicivirus, & Feline herpesvirus.
Classic lesion for Feline Infectious Peritonitis is pyogranulomatous vasculitis.
o Diagnose FIP with biopsy and histopathology.
Serology for FIP is unreliable due to cross-reaction with feline
coronavirus. 7B protein ELISA test is also unreliable.
o Rivaltas test has the highest negative predictive value (best for ruling out FIP).
Linear foreign bodies such as string cause intestinal plication.
Lead toxicity has neurologic signs and basophilic stippling of erythrocytes. Treated with
Ca-EDTA.
o Do not use sodium EDTA. EDTA binds calcium and can cause a hypocalcemia;
Ca-EDTA is needed to prevent hypocalcemia.
Taurine deficiency in cats cause dilated cardiomyopathy and central retinal degeneration.
o Gray horses are predisposed to melanoma, which normally appear in the perineal
region.
The most sensitive test for Strangles (Streptococcus equi subsp. equi) is PCR of guttural
pouch wash for the S. equi M protein gene.
o For Strangles, reintroduce horses 30 days after resolution of signs, then 3
consecutive weekly negative nasopharyngeal cultures (after all that).
o Strangles has a similar presentation to the foreign disease Glanders.
Glanders is diagnosed with a Mallein test.
Abdominal paracentesis in horses is performed to the right of the midline and normally
retrieves yellow fluid.
Premature foals have short silky hair coats, pliant floppy ears, soft muzzle, incompletely
ossified carpal & tarsal bones, and laxity of flexor tendons.
Equines develop marked hyperbilirubinemia from fasting.
Nephrosplenic entrapment causes the left kidney to be obscured on abdominal ultrasound.
o The spleen may also be difficult to see.
o Can use phenylephrine to help treat.
Equine eosinophilic granulomas are nodular, non-ulcerative, and are not pruritic.
o Treat with systemic antibiotics, sublesional steroids, and surgical excision.
Equine Herpes Virus-1 (EHV-1) can cause mares to abort. Future breeding possibilities
should be unaffected, although the mare does not have permanent immunity and may be
infected again.
o Vaccinate against EHV at 5, 7, & 9 months gestation.
Tyzzers disease is caused by Clostridium piliformis in mice and foals.
o Causes acute necrotizing hepatitis.
Laryngeal hemiplegia is due to a damaged recurrent laryngeal nerve.
o Usually affects the left side.
o Causes an audible whistling sound on inspiration.
Culicoides flies can cause a type I allergic reaction, extreme pruritus, and self-trauma.
Hyperkalemic periodic paralysis is due to a heritable defect in voltage-gated sodium
channels.
o This is an autosomal dominant trait.
An auriculopalpebral nerve block lets you examine the eyes of a horse.
o This blocks the auriculopalpebral branch of cranial nerve VII (facial nerve). This
disrupts the motor innervation to the orbicularis oculi, which closes the eye.
o Does not offer any anesthesia.
o Perform with lidocaine at the caudal aspect of the zygomatic arch.
Foal heat diarrhea causes very mild diarrhea in 7 - 14 day old foals. Associated with
post-foaling estrous in the mare.
o Rhodococcus equi causes diarrhea and respiratory signs in 1 - 4 month old foals.
Rhodococcus equi is gram positive pleomorphic rods.
Causes pulmonary abscesses and an alveolar lung pattern.
Treat with erythromycin and rifampin.
o Clostridium perfringens Types A, B, & C causes severe and fatal diarrhea in foals.
Most will die within 2 days if not treated.
o Rotaviruses are the most common cause of viral diarrhea in foals.
Miniature horses are predisposed to hyperlipemia and hepatic lipidosis secondary to
anorexia.
o Miniature horses are also predisposed to colic due to small colon impaction. This
causes a dilated gas-filled colon.
In horses, subsolar abscess result from penetrating wounds or poor farrier work. Causes
severe lameness, heat and pain in the affected foot, and edema of the pastern & fetlock.
o Treat with adequate drainage, disinfectants, and poultices.
Gastric reflux with a pH > 5 indicates small intestinal obstruction or ileus.
The most common equine tumors are sarcoids.
o Sarcoids are locally aggressive fibroblastic tumors of the dermis and subcutis with
a variable proliferative epithelial component.
o Caused by Bovine papillomavirus types 1 & 2.
The most common equine bladder and gastric tumor is squamous cell carcinoma.
o The most common equine intestinal neoplasia is a lymphosarcoma.
Equine influenza is an orthomyxovirus spread via aerosol.
Choke (esophageal obstruction) is not an emergency; you have time to act.
o Most cases of choke resolve within 24 hours without treatment.
o Treat by sedating and passing a nasogastric tube to move the obstruction aborally
(away from mouth).
Meconium impactions in foals are treated with acetylcysteine enemas.
Windswept foals have valgus of one limb and varus of the contralateral limb.
Normal pCO2 in a horse is 40.
o Vitamin A deficiency is the only disease that will cause absent pupillary light
reflexes.
Bighead (Clostridium novyi Type A) causes edema of the head and neck.
o Treat with wound debridement and penicillin.
o No need to cull or isolate affected animals because it is part of the native flora.
Contagious ecthyma is caused by a parapoxvirus. Affects lambs and kids.
o
Scabs fall off within 1 month.
o Can cause low-grade fever and make animal not want to eat.
o Microscopically resembles proliferative granulation tissue.
Bovine papular stomatitis (BPS) is a parapox virus is similar to contagious ecthyma.
o Causes fever and raised oral lesions that will resolve in a few weeks.
Ovine Progressive Pneumonia (OPP) is a lentivirus of the family Retroviridae and is the
most common cause of pneumonia in sheep.
Hydroallantois is a disorder of the placenta that results in accumulation of fluid during
the last trimester. The cow is clinically affected.
o Calf usually dies and the cow usually becomes infertile.
Hydramnios is a disorder of the fetus with thick viscous fluid accumulated. The cow is
not clinically affected and has a good prognosis for future pregnancies.
Blue tongue is an RNA orbivirus that mainly affects sheep, but also cattle.
o Causes fever, widespread multisystemic vasculitis, oral lesions, mucopurulent
nasal discharge, pulmonary edema, white streaks in muscle, and lameness.
Causes loss of epithelium and edema in the tongue. This can turn the
tongue blue.
Blue tongue is a teratogen and can cause abortions.
Causes hydranencephaly (destroyed cerebrum) in lambs born from sheep
infected with blue tongue.
Cattle may suffer reproductive losses but rarely show signs of the systemic
disease. Aborted or live weak calves can have white eyes due to cataracts.
o Spread by the midge Culicoides sonorensis.
o Appears similar to Foot and Mouth Disease.
Johnes disease (Mycobacterium avium spp paratuberculosis) usually affects cows 2 5
years old.
o Causes enlarged mesenteric lymph nodes and granulomatous bowel.
o Johnes disease is associated with Crohns Disease.
Obese cows are predisposed to fatty liver syndrome when they encounter a negative
energy balance.
Spastic paresis is a hereditary disease that causes continuous stiffness of the hocks
(tibiotarsal joint).
o Treat with gastrocnemius tenectomy.
Volcanic soils often cause copper deficiency.
Sheep are very prone to copper toxicity, which causes a hemolytic crisis.
o Cattle feed is a common source of copper toxicity.
Uterine prolapses occur immediately postpartum.
o Vaginal prolapses occur late in pregnancy.
o Rectal prolapses are associated with straining to defecate.
Femoral nerve paralysis in calves causes the inability to bear weight on pelvic limbs and
dog sitting without bony abnormalities.
o Prevent in the future with delivery via Cesarean section.
In order to do a standing laparotomy in a cow, you must perform a paravertebral nerve
block to desensitize nerves T13, L1, & L2.
Pododermatitis circumspripta involves a lesion in the sole/bulb junction.
With sole abscesses in cows, put wooden hoof block on claw that is not affected.
Lice are usually species-specific and have 6 legs.
o Mallophaga are biting lice.
o Anoplura are sucking lice that can cause anemia.
Poloxalene will destabilize froth and help cure bloat.
The most common ocular tumor of cattle is squamous cell carcinoma. Ocular squamous
cell carcinoma has a heritable and sunlight component.
o Euthanize beef cattle with lymphoma or squamous cell carcinoma because they
cannot be eaten.
o If you do surgically remove the eye, use a five-point orbital block using lidocaine.
Clostridium perfringens type C enteritis causes acute hemorrhagic diarrhea and death in
piglets up to 1 week-old.
o High morbidity and mortality.
Enteric colibacillosis (enterotoxogenic E. coli) causes diarrhea in piglets up to 2 weeksold, but is not bloody and does not cause death.
Coccidiosis in pigs (Isospora suis) causes high morbidity and low to moderate mortality.
o Affects 1 3 week old piglets.
o Not responsive to antibiotics.
o Best prevention is improved sanitation.
Transmissible gastroenteritis is caused by a Coronavirus. It causes diarrhea and
complete mortality in piglets less than 2 weeks-old.
o Causes mild diarrhea in older pigs.
Swine dysentery (Brachyspira hyodysenteriae) causes bloody diarrhea and death in
grower and finisher pigs.
o A cash flow statement involves the sources of cash and uses of cash over a period
of time.
o A net book value is the same as equity, which equals assets minus liabilities.
Cohort studies are best for examining the temporality of disease (exposure precedes
disease).
When using drugs extra-label, legally you should not do so if there is a legal alternative.
However, if a specialist would do it then you are unlikely to be sued.
Pathology
ALT is a hepatocellular leakage enzyme increased with liver inflammation and necrosis.
o AST is a hepatocellular leakage enzyme increased with liver inflammation and
necrosis. Also seen with muscle damage.
If AST >>> ALT, consider muscle damage and evaluate creatinine kinase
(which is muscle specific).
o ALP is increased with cholestasis. More specific for cholestasis but not as
elevated in cats.
Glucocorticoids cause an increase in ALP in dogs.
o GGT is increased with cholestasis. More specific for cholestasis in dogs.
o Albumin is only made in the liver. Liver failure will have hypoalbuminemia.
o BUN is decreased with liver failure.
o Hypocholesterolemia will be seen with liver problems.
Hypercholesterolemia will be seen with decreased biliary excretion of
cholesterol (extrahepatic obstruction).
o Unconjugated bilirubin is processed from heme and conjugated in the liver.
Pre-hepatic hyperbilirubinemia will have increased conjugated bilirubin.
Hepatopathy will have increased unconjugated bilirubin.
o Sorbital dehydrogenase (SDH) is the most liver-specific enzyme in ruminants and
horses.
Tuberculosis is an infectious granulomatous disease that primarily affects the lungs.
o It is usually caused by Mycobacterium species.
o The most important diagnostic test is the intradermal tuberculin test.
False positives are expected because there is cross-reactivity with other
mycobacteria.
Antigens are injected into the skin. If an animal has experienced the
bacteria than they should mount an immune reaction.
o Humans usually get an airborne infection.
There is not good zoonotic transfer from animals because the infection is
not usually spread via aerosols.
Most common primary brain tumors in dogs are oligodenrogliomas & astrocytomas.
o The most common primary brain tumors in cats are meningiomas.
o
o Indicate a regenerative anemia.
o Horses do not release reticulocytes.
Heinz bodies indicate oxidative damage.
Howell-Holly bodies are nuclear remnants and may indicate increased erythropoiesis.
o
Acanthocytes can indicate hemangiosarcoma.
o
Macrocytosis is large erythrocytes and is usually seen with regenerative anemias.
o Microcytosis is usually seen with hepatic disease, portosystemic shunts, and iron
deficiency.
Toxic neutrophils indicate intense neutrophil production and shortened maturation time.
A left shift is an increase in immature (band) neutrophils.
o A regenerative left shift is a mature neutrophilia with smaller numbers of band
neutrophils.
o A degenerative left shift means there are more immature band neutrophils than
mature neutrophils.
Glucocorticoids cause SMLE.
o Increased segmented neutrophils and monocytes.
o Decreased lymphocytes and eosinophils.
Epinephrine causes increased in neutrophils and lymphocytes.
Disseminated Intravascular Coagulation (DIC) is not a primary disease but secondary to
underlying diseases.
o The underlying disease causes an uncontrolled systemic inflammatory response
characterized by massive activation and consumption of coagulation proteins,
endogenous inhibitors, fibrinolytic proteins, and platelets.
o Usually induced by exposure to tissue factor and activation of the extrinsic
pathway of coagulation.
o DIC causes a decrease in fibrinogen because it is utilized.
Normal cavity fluid should be a transudate (low protein and cells).
o To distinguish a septic exudate from a normal exudate, look for intracellular
bacteria.
Pathogenic hemorrhage is indicated by phagocytosis of erythrocytes by macrophages.
Benign neoplasms have uniform cell appearance, whereas malignant neoplasms have
variable cell appearance.
Carcinomas are malignant neoplasms that arise from epithelial cells of glandular tissue.
o Cytologically, carcinomas appear as clusters of epithelial cells.
Sarcomas are malignant neoplasms of mesenchymal cells.
o Cytologically, sarcomas appear as solitary spindle cells.
Round cell tumors include mast cell tumors, lymphoma, plasma cell tumors, histiocytic
tumors, and transmissible venereal tumors.
Parasites
Lice have 6 legs; ticks and mites have 8 legs.
Fecal sedimentation is good for testing for eggs that sink, like most fluke (flatworm)
eggs.
o A direct fecal smear can find any egg or larva passed in feces, but it doesnt
increase the concentration of the parasites.
Haemonchus contortus is the most important goat parasite.
o The barber pole nematode that causes anemia.
Strongyloides stercoralis is a roundworm that causes mucoid diarrhea and anemia in
puppies and kittens.
o Diagnose with the Baermann fecal technique.
Moniezia are tapeworms of cattle.
o
rectangular or triangular eggs
Trichomoniasis (Tritrichomonas foetus) in cats is a protozoal infection that causes large
bowel diarrhea.
o Affects young cats who will grow out of the infection without treatment.
o Treat with Ronidazole.
Aerostrongylus abstrusus is the lungworm of cats and is treated with ivermectin or
fenbendazole.
Neospora caninum is a protozoan parasite that causes abortion in cows and neurologic &
muscular abnormalities in dogs.
Urinary System
The upper urinary tract consists of the kidneys and ureters.
o The lower urinary tract consists of the bladder and urethra.
A nephron is the functional renal unit. A nephron consists of a glomerulus and a tubule.
o Glomerular diseases result in proteinuria and eventual tubular disease.
o Tubular diseases result in loss of concentrating ability & eventually azotemia.
Uremia is not a laboratory value. It is a set of clinical signs seen with kidney disease.
Includes vomiting, lethargy, anorexia, weight loss, dehydration, diarrhea, and oral
ulceration.
o One possible sign of uremia is gastric ulceration. Treated with:
Famotidine - H2 blocker (blocks HCl acid production)
Omeprazole - proton pump inhibitor
Sucralfate - cytoprotective agent (binds to ulcer site)
Dogs must lose 65% renal function to become unable to concentrate urine & 75% renal
function to see azotemia.
o In cats, 75% of renal function must be lost to lose concentrating ability.
Polydypsia is > 100 mL/kg/day.
o Polyuria is > 50 mL/kg/day.
Pollakiuria (frequent urination with small volume), dysuria, and stranguria (straining drop
by drop) are signs of lower urinary tract disease.
The kidneys excrete H+, phosphorous, potassium, and BUN / creatinine.
o Problems with urinary excretion result in metabolic acidosis, hyperphosphatemia,
hyperkalemia, azotemia, and hypocalcemia (secondary to hyperphosphatemia).
o With chronic renal failure, the bodys compensatory mechanism to
hyperphosphatemia is secondary hyperparathyroidism.
Parathyroid hormone (PTH) increases calcium and decreases phosphorous.
Blood Urea Nitrogen (BUN) is formed in the liver from metabolism of ammonia.
o BUN is the best measure of liver function and also shows kidney function.
High BUN means GFR is low and kidneys are not working. Low BUN
means liver is not producing it.
BUN does not exceed normal value until 75% of kidney function is
lost.
Azotemia is high levels of BUN and/or Creatinine in the blood.
o Azotemia can be due to decreased GFR (prerenal, renal, or postrenal), high
protein diet, GI hemorrhage, steroids, or tetracyclines.
o Elevated creatinine is more specific for decreased GFR than elevated BUN. The
only other cause of elevated creatinine is well-muscled dogs.
Proteinuria can be due to glomerular disease, post-renal hemorrhage or inflammation, or
protein overload.
o Examples of glomerular disease include glomerulonephritis and amyloidosis.
Struvite uroliths are normally sterile in cats and normally associated with bacterial
infection in dogs.
o You want an acidifying diet to treat struvite uroliths.
o Other types of uroliths require an alkalinizing diet to prevent.
o Dalmatians are prone to ammonium urate stones.
Dalmatians have a genetic defect in making allantoin from urates in the
liver. This predisposes them to forming urate stones and getting urinary
tract obstructions.
Treat stones with allopurinol and a low-purine diet to alkalinize the urine.
Allopurinol therapy in turn predisposes Dalmatians to Xanthine stones.
o Struvite and calcium stones can be seen on radiographs. Urate and cysteine
stones cannot.
o Most equine uroloiths are calcium carbonate and calcium phosphate.
The most common urolith in ferrets is sterile struvite.
Phenylpropanolamine is an alpha-adrenergic agonist that treats urethral sphincter
mechanism incontinence.
o Phenylpropanolamine is used to treat dogs who leak urine.
Phenoxybenzamine is used to treat hypertonicty of urethral muscle.
A uroabdomen will have hyponatremia, hypochloremia, hyperphosphatemia, and
azotemia.
o Urine is high in potassium and low in sodium & chloride; the electrolytes
equilibrate with the blood.
A key finding of pyelonephritis is bacterial or leukocyte casts in urine.
Urethral obstruction commonly causes hyperkalemia. 0.9% NaCl is the best fluid to treat
this.
o During the immediate post-obstructive period, cats may develop hypocalcemic
tetany.
Urohydropropulsion is the expulsion of cystic calculi after anesthetizing an animal by
application of manual pressure to the bladder to expel the stone through the urethra.
o Best done in thin female dogs. Not done in male dogs because their long, narrow
urethras and os penis increase the likelihood of obstruction.
Protein-losing nephropathies are treated with ACE-inhibitors, low protein diets, & aspirin
(to decrease hyper-coagulable state). No antibiotics are given.
Treatment for urethral prolapse is urethropexy and castration. Most often seen in English
bulldogs.
Myoglobinuria is characterized by brownish urine that does not clear on centrifugation
with normal-colored plasma.
o Myoglobin doesnt bind to serum proteins, so it is cleared to the urine before it
builds up and discolors the plasma.
Check if fluid is urine by comparing creatinine to serum. Fluid:serum creatinine ratio of
greater than 2:1 is indicative that the fluid is urine.
Hypoproteinemia can cause low serum calcium but is not associated with clinical signs of
hypocalcemia.
o Serum chemistry measures calcium bound to proteins.
o The accurate measure of calcium is ionized calcium (iCa).
Iguanas in renal failure can have episcleral injection, swelling of the pharyngeal region,
and painful abdominal palpation.
Cardiology
Blood pressure = total peripheral resistance * cardiac output
o Cardiac output = heart rate * stroke volume
Eccentric hypertrophy is an increase in cardiac mass with an increase in chamber size.
Seen with diastolic stress.
o Concentric hypertrophy is an increase in cardiac mass with no change or a
decrease in chamber size. Seen with systolic stress.
Patients with compromised cardiac output have exercise intolerance, decreased growth,
or muscle wasting. Pale mucous membranes, weak pulses, cold extremities, low
temperature.
o Patients with right-sided backward failure (congestive failure) have ascites (in
dogs) or pleural effusion.
Will see ventral or brisket edema, true jugular pulse, and bottle jaw in
large animals.
o Patients with left-sided backward failure (congestive failure) have coughing,
exercise intolerance, and sleeps in sternal recumbency.
Heart sounds:
o S1 is closure of AV valves (ventricles are filled with blood).
S1 indicates beginning of systole.
o S2 is closure of semilunar valves (aortic and pulmonary valves; ventricles are
empty of blood).
S2 indicates beginning of diastole.
o A gallop rhythm is when you hear either S3 or S4, which are diastolic sounds.
This is normal in large animal species but indicates pathology in small animal
species.
S3 is passive ventricular filling (mid-diastole).
S4 is active atrial contraction (end of diastole).
On the left side, remember P-A-M
o 3rd intercostal space you can hear the pulmonic valve (right ventricle pumping into
the pulmonary artery)
o 4th intercostal space you can hear the aortic valve
o 5th intercostal space you can hear the mitral valve
o Fair prognosis, increased risk for infective endocarditis, and sudden death may
occur at any time.
o Treated medically with Atenolol (beta-blocker).
Pulmonic stenosis is seen in smaller breed dogs.
o Has a systolic murmur at left base with normal pulses.
o May cause right heart enlargement.
o Treat with balloon valvuloplasty +/- Atenolol (beta blockers)
Carina elevation is the best radiographic estimation of cardiomegaly.
o Carina should be 1/3rd - 1/4th of the chest width from the spine.
On radiographs, the cranial part of the heart is the right side. The caudal part of the heart
is the left side.
A vertebral heart score measures the heart cranio-caudal and dorso-ventral. Measure the
lines against the T4 vertebrae. Should be < 10.5.
When looking at pulmonary vasculature:
o big pulmonary arteries = pulmonary hypertension
o big pulmonary veins = left-sided congestive heart failure
o big pulmonary arteries and veins = left-to-right shunt
o small pulmonary arteries and veins = right-to-left shunt or hypovolemia
Tetralogy of Fallot is the most common defect that produces cyanosis. It has four
components: pulmonic stenosis, large ventricular septal defect, right ventricular
hypertrophy, & dextropositioning (overriding) of the aorta.
o Results in a right-to-left shunt, hypoxemia, cyanosis, and polycythemia.
o Treat with surgery and non-selective beta blockers.
rd
o Ventricular Premature Complexes have wide and bizarre QRS complexes with
AV dissociation (no associated P waves).
Wide and bizarre QRS complexes are almost always VPCs.
VPCs are more deadly in the short-term than supraventricular VPCs.
Narrow QRS complexes with associated P waves are
supraventricular premature complexes.
Arise from irritated regions of ventricles.
Ventricular rhythms are more life-threatening than supraventricular
rhythms.
Treat ventricular arrhythmias with lidocaine (Sodium channel blocker).
Lidocaine is not useful for supraventricular tachycardia
A string of VPCs in a row is called ventricular tachycardia.
Treat ventricular tachycardia with procainamide, lidocaine, or
defibrillation in drug-resistant cases.
o Atrial fibrillation causes tachycardia, sounds like tennis shoes in a dryer, and
has an irregular ECG with absent P waves.
Causes flutter-like waves.
Thromboembolism in cats has acute hindlimb paresis; high CK, AST, & ALT
o Normally due to blood stasis in large left auricle (atrial appendage).
o Treat with heparin and analgesics. Recurrence is common.
Endocarditis (inflammatory heart valve disease) is normally secondary to another
primary infection.
o Usually has an irregularly shaped growth on the valve.
o In dogs, most commonly affects mitral and aortic valves (left side).
o In large animals, most commonly affects tricuspid and pulmonary valves (right
side).
Hypertension is treated with Enalapril (ACE-inhibitor) in dogs and Amlodipine (calcium
channel blocker) in dogs and cats.
Most common neoplasia in the heart is right atrial hemangiosarcoma, which can first
prevent with pericardial effusion.
o Chemodectomas (aortic body tumors) occur in brachycephalic breeds.
o Lymphoma infiltrates the myocardium in cattle.
Treat supraventricular tachycardias with Atenolol or Digoxin.
o The most common supraventricular tachycardia is atrial fibrillation.
Normal central venous pressure is 0 - 10 cmH20
o A large increase in central venous pressure (> 12 cmH20) indicates ascites.
The most common vascular ring anomaly resulting in constriction of the esophagus in
dogs is a persistent right 4th aortic arch.
o Treat with surgical resection of the ligamentum arteriosus.
Congestive heart failure is treated with oxygen (in-hospital), Furosemide, ACE-inhibitors,
and Pimobendan.
o Pimobendan is a positive inotrope that increases myocardial contractility.
o Causes a modified transudate pericardial effusion.
Atrial septal defects can include a patent foramen ovale.
o Usually left right and cause a functional pulmonic stenosis (due to right
ventricular overload).
o Causes right ventricular hypertrophy and pulmonary vasculature enlargement.
o Do not need to close a small, uncomplicated atrial septal defect.
o In horses, failure of closure of the foramen ovale results in a right atrium left
atrium shunt.
Ventricular septal defects are the most common congenital cardiac defect in all species
except dogs.
o Cause a holosystolic murmur heard on the right sternal border.
o Usually occur just below the pulmonary valve, so the right heart does not see
much of an increase in blood and therefore does not have hypertrophy.
o Causes enlargement of left heart and pulmonary vasculature.
o Treat with pulmonary artery banding. This causes pulmonic stenosis, increases
right heart pressure, and lessens the shunt.
The most common cause of cardiac arrest in dogs is systemic hypoxemia.
Dermatology
o
o Microsporum canis is most common cause of ringworm in cats and dogs.
Microsporum gypseum is geophilic (soil) and usually affects dogs.
Trichophyton mentagrophytes affects rodents and goats.
Microsporum nanum affects pigs and llamas.
Scratches is chronic seborrheic dermatitis of the pastern. Generally associated with hot or
muddy environments; treat by keeping horses in a clean and dry environment.
Hepatocutaneous syndrome is a necrotizing skin disorder often associated with liver
diseases.
o Diagnosed with skin biopsy and histology.
o Clinical signs include diffuse hyperkeratosis of footpads with ulceration and
fissures, peri-ocular lesions, and lesions at the tips of the ears.
Cutaneous histiocytomas occur in dogs < 3 years old.
o Causes alopecia, raised nodules that often ulcerate and regress on their own.
o No treatment is necessary unless the lesions persists; then remove surgically.
Psychogenic alopecia is extremely rare in cats and can only be diagnosed after ruling out
all possible allergies (flea, environmental, & food).
Barbering commonly occurs with pigmented mice. Causes alopecia with no pruritus and
normal skin.
In cattle, a corn is removed by surgical removal using sedation and local anesthesia.
Familial dermatomyositis is seen in Collies & Shetland Sheepdogs. Causes severe
dermatitis on nose and ears.
o Diagnosed with skin and muscle biopsies.
o Will regress and recur.
Puppy strangles (canine juvenile cellulitis) causes generalized lymphadenopathy, fever,
and pustular lesions on face.
o Thought to be immune-mediated and treat with immunosuppressive doses of
prednisone.
Feline acne is a common deep pyoderma of the chin in felines. Treat by cleaning with
antiseptic solutions.
Discoid Lupus Erythematosus causes loss of cobblestone appearance of the nose,
depigmentation of the nasal planum, and alopecia & crusting on the face.
Systemic lupus erythematosus is an autoimmune disease that can affect the joints,
kidneys, bone marrow, and lymph nodes.
o Externally, systemic lupus erythematosus causes lesions at the mucocutaneous
junctions.
Test with an anti-nuclear antibody test.
Canine pinnal alopecia is a breed-related disease most commonly seen in Dachshunds.
Epidermal collarettes are circular lesions with peelings edges.
o Epidermal collarettes are remnants of previous primary lesions.
Papules are circumscribed, solid elevations of skin with no visible fluid.
o Macules are flat changes in surface color.
o Folliculitis is inflammation of the hair follicle.
Furunculosis is deep, swollen, and painful folliculitis.
o Pyoderma is inflammation / infection of the skin.
Acanthosis nigricans causes hyperpigmentation of the axilla and groin.
o Primarily occurs in Dachshunds.
Ophthalmology
Neurology
Thoracic limbs get their nerves from C6-T2 & pelvic limbs get their nerves from L4-S2.
Limbs that gain nerves from the area of a spinal cord lesion will have decreased reflexes
and proprioceptive deficits.
o Limbs caudal to a spinal cord lesion will have normal to hyper-reflexes and
proprioceptive deficits.
o Limbs cranial to a spinal cord lesion will be unaffected.
Dogs with fibrocartilaginous embolism usually get better on their own with nursing care.
With radial nerve disease, the elbow is dropped, the digits are knuckled onto their dorsal
surface, and the limb is unable to bear weight.
o Commonly due to lying on the limb for long periods.
An anal reflex implies function of spinal cord segments S1 S5.
Cervical spondylopathy is a malformation of the cervical vertebral canal that causes
sporadic ataxia, paresis, and UMN signs in all limbs.
Cushings reflex states that with elevated intracranial pressure, the body increases
systemic blood pressure to perfuse the brain by overcoming the increased ICP. The
hypertension leads to bradycardia. Cushings reflex causes hypertension and bradycardia.
o Maintain high PaO2, low PaCO2, low cerebral metabolic rate, & normal mean
arterial pressure.
o Treat increased ICP with mannitol and increasing angle of head.
Chlorhexadine and aminoglycosides are associated with peripheral vestibular disease.
o Metronidazole is associated with central vestibular disease.
Cranial nerve VII (facial nerve) damage can cause exposure keratitis because it is
responsible for lacrimation.
o Cranial nerve V (trigeminal nerve) damage can cause loss of motor function in the
muscles of mastication.
The mandibular branch of cranial nerve V (trigeminal nerve) provides motor innervation
to the muscles of mastication.
Type I disc herniation is acute. Type II disc herniation is chronic.
Horners syndrome is due to disruption of the vagosympathetic trunk. Causes miosis,
enophthalmos, ptosis, prolapsed 3rd eyelid, and sweating.
o Neck masses, chest masses, chronitc otitis, retrobulbar disease, guttural pouch
disease, hypothyroidism, and diabetes mellitus can result in Horners syndrome.
Chorioretinitis does not cause Horners syndrome.
Unilateral facial nerve paralysis in cats is usually idiopathic.
o Clinical signs are usually permanent and the opposite side of the face may
become affected.
Theriogenology
Dentistry
o Enamel makes up most of the crown of the tooth and covers the dentin.
o The pulp cavity contains blood vessels and nerves and is covered by dentin.
o A fractured tooth exposes pulp and makes the tooth painful & suseceptible to
infection.
Apical means toward the tooth root.
o Occlusal is towards the crown
o Buccal means towards the cheek.
o Lingual means towards the tongue.
Hypsodont teeth are high-crowned teeth found in large animals and rodents.
o Radicular hypsodont teeth are continuously erupting, but not growing (there is a
finite amount of tooth). Found in horses and cattle.
o Aradicular teeth are continuously growing. Found in rodents.
Brachydont teeth are less-crowned teeth. Consist of deciduous and adult teeth. Found in
dogs, cats, and humans.
Dog dental formula is 2x (3142/3143) = 42 teeth.
o Cat dental formula is 2x (3131/3121) = 30 teeth.
o Ruminant dental formula is 2x (0033/4033) = 32 teeth.
Ruminants do not have upper incisors or canines.
o Horse dental formula is 2x (3[0-1][3-4]3/3[0-1]43) = 36 - 42 teeth.
Dogs have 6 teeth that are 3-rooted (P4, M1, M2). All are in the maxilla
o The carnassial tooth in the dog is the upper 4th premolar.
A probe is used to measure gingival pocket depth and tooth mobility.
o An elevator breaks down the periodontal ligament.
o A scaler removes supragingival calculus.
o A polisher removes plaque and smooths teeth after a scaler is used.
o Extraction forceps are used to remove a tooth after the periodontal ligament is
broken down.
The most common canine oral malignancy is a melanoma.
o The most common feline oral malignancy is a squamous cell carcinoma.
o The most common gingival mass in dogs is focal fibrous hyperplasia.
Endodontics is any treatment involving the pulp cavity, such as a root canal.
o A root canal removes infected pulp cavity and fills it.
The best antibiotics for dental infections are clindamycin & clavamox because they kill
anaerobic bacteria.
o If there are dental infections, start on antibiotics a few days before the dental
cleaning.
o Animals that have extractions should stay on antibiotics for 2 weeks after
extractions.
A short-term treatment for periodontal disease is daily chlorhexidine rinses.
Feline Odontoclastic Resorption Lesions (FORL) are most often found on the first
premolars (307 & 407) and are very painful.
o These are resorbing teeth that need to be extracted. Internally and externally
affected. (Extract entire tooth.)
Do not combine oral surgeries with systemic surgeries because oral surgeries cause
significant bacteremia, which can cause wound infection.
Horse teeth must be floated on the lingual side of the mandible and the buccal side of the
maxilla.
o The horse mandible is narrower than the maxilla.
Horses commonly get malocclusions, rostral hooks, caudal hooks, and retained deciduous
teeth.
o Caries (tooth decay due to bacteria) are due to decalcification of the teeth and are
rare.
Dentigerous cysts in horses are due to having tooth tissue in the ear.
o Causes a mucopurulent discharge around the ear.
o Treat with surgical removal.
Most cases of canine oral papillomatosis resolve without treatment in 3 months.
The oldest tooth in the horse is premolar 1 (the wolf tooth). Erupts at 6 months old.
o Incisors erupt at 2.5, 3.5, & 4.5 years-old.
o Canine teeth in horses erupt at 4 years old.
o Galvaynes groove begins at 9 years-old.
In cows, the permanent incisors are present at 1.5, 2.5, 3.5, and 4.5 years-old (from first
to fourth incisor).
Orthopedics
o Primary bone tumors usually occur at the metaphysis whereas metastatic bone
tumors usually occur at the diaphysis
Osteosarcoma is the most common primary bone tumor.
o Occurs away from the elbow and towards the knee.
o Amputation is curative in cats but has less than a 1 year-survival time in dogs.
Valgus is a lateral deformity of the limb; varus is a medial deformity.
o Diagnose angular limb deformities with carpal and tarsal radiographs.
The treatment for hip dysplasia that gives the best return to function is a total hip
replacement.
o A bunny-hopping goat is commonly seen.
o Will see a positive Ortolani sign (femoral subluxation in hip joint).
The treatment for severe carpal hyper-extension injuries is carpal arthrodesis (joint
fusion).
Most coxofemoral luxations are craniodorsal.
Routes of infection to joints include foreign body, hematogenous spread, and extension of
cellulitis.
o Lymphatic spread is not a rout of joint infection.
Long-term sling application can cause muscle contracture, muscle disuse atrophy, and
joint fibrosis.
The 3 goals of articular fracture repair are complete anatomic realignment, rigid fixation
of fracture fragments, & early return to function.
o Goals of long bone fracture repair are extended rest and at least 50% anatomic
alignment.
Feed large breed puppies a low-calcium diet to prevent skeletal abnormalities.
Small breed dogs have a poor blood supply to the distal radius and ulna and are less
likely to heal with a cast.
Rabbit fractures do not heal well with splints.
In an adult horse, tibia fractures carry a grave prognosis.
o P1, P3, & ulna fractures can be repaired well.
Foal carpal bones should be fully ossified at time of birth. Incompletely ossified carpal
bones indicates a premature foal.
Intramedullary pins are strong against bending but do not provide good stability by
themselves.
o Use in conjunction with bone plates.
Femoral fractures in calves are easily treated with intramedullary pins.
Salter-Harris fractures:
o
o
Panosteitis is long bone inflammation usually seen in young, rapidly growing, large
breed dogs.
o Radiographs show focal intramedullary densities.
o Self-limiting, painful condition that causes limping and lameness.
o Treat with carprofen and limiting activity.
Luxating patellas in dogs are usually to the medial side.
o Most common in small breed dogs.
o Surgical repair involves medial release of soft tissues, block recession of trochlear
groove, lateral transposition of the tibial tuberosity, and lateral imbrication of the
retinaculum.
Osteochondritis dissecans (OCD) occurs in young large breed dogs and is painful.
o Causes endochondral ossification of the epiphyseal cartilage.
o OCD of the shoulder is the most common location is commonly bilateral.
o Treat by surgically removing cartilage flaps and giving NSAIDs.
o Osteochondritis is least common in cattle.
Feline mandibular symphysis separation commonly occurs when cats fall from
heights.
o Treat with circummandibular cerclage wire placed caudal to the canine teeth.
o Remove cerclage wire after 6 weeks.
o Not a true fracture because the mandibular symphysis never closes.
Immune-mediated polyarthritis (IMPA) is usually non-erosive.
o Normally idiopathic.
Anesthesia / Drugs
With younger patients, you must be concerned about hypoglycemia and hypotension.
Until oxygen pressures reach < 60mmHg, there is little change in oxygen saturation.
o Oxygen pressure of 60 mmHg means there is 90% oxygen saturation. Below 60
mmHg, oxygen saturation declines rapidly.
Adrenergic receptors are stimulated by epinephrine and norepinephrine.
o Alpha-1 & Alpha-2 adrenergic receptors are sympathetic receptors located on the
arteries. They increase blood pressure by constricting arteries, which causes
bradycardia.
o Beta-1 adrenergic receptors are in the heart and increase heart rate & contractility.
o Beta-2 adrenergic receptors are in the lungs and smooth muscle. They dilate
bronchioles (let more air in lungs) and dilate skeletal muscles (to get more muscle
blood flow).
Blood pressure is the force of the blood pushing against the arteries.
o Vasodilators decrease blood pressure.
Vasoconstrictors increase blood pressure.
o Hypotension is systolic pressure less than 80mmHg & mean pressure less than 60
mmHg.
Treat hypotension by decreasing anesthetic gas, fluid boluses, and atropine
/ glycopyrrolate.
Small, young, cachectic patients are at risk for hypoglycemia during surgery.
o Can cause sympathetic hyperactivity.
Guaifenesin is a centrally-acting muscle relaxant with an unknown mechanism.
o Succinylcholine is a depolarizing neuromuscular blocking agent.
o Atracurium is a non-depolarizing neuromuscular blocking agent.
Premedication:
o Premedication is administration of drugs prior to anesthetic induction.
o Reduces apprehension, facilitates handling, enhancing peri-operative analgesia,
and minimizing adverse effects of anesthetic drugs.
o Acepromazine
This is a phenothiazine.
Tranquilizer that is a dopamine antagonist.
Commonly given with an opioid for neuroleptanalgesia (a state of minimal
responsiveness).
Major side effect is hypotension by being an alpha-1 antagonist. This is
offset by benefits in healthy animals, but dont use in hypovolemic
patients.
Also decreases seizure threshold and platelet function.
o Only decreases seizure threshold IV at higher doses.
Causes splenic dilation, decreased hemoglobin concentration, and
decreased hematocrit.
o Dont use acepromazine with splenic masses.
This can be reversed with the alpha-agonist phenylephrine, which
has no cardiac effects.
Not reversible and not an analgesic.
Protects from arrhythmias, is an antiemetic, causes penile protrusion in
horses, & is an antihistamine.
Decreases anesthetic requirements up to 40% (lowers MAC)
o Opioids can be used as premedications.
o Alpha-2 agonists: (Xylazine, Medetomidine, & Dexmedetomidine)
Ruminants are more susceptible.
Analgesics, sedatives, and muscle relaxants
Reversed by yohimbine & atipamezole.
Can cause bradycardia, AV block, and decrease GI motility. Causes
hypertension then hypotension.
Dont use in pregnant females because it increases uterine tone.
Inhibit insulin and cause hyperglycemia.
Inhibits anti-diuretic hormone (ADH), which means they increase
diuresis
Xylazine can be given to cats to vomit.
Avoid in critically ill and heart failure patients because of cardiovascular
effects.
o
o
Inhalant Anesthetics:
o Advantages over injectable anesthetics are minimal metabolism, rapid adjustment,
and the ability to give with oxygen.
o Inhalant anesthetics are the most cardiodepressive drugs.
o Inhalant anesthetics are vasodilators, which decrease blood pressure.
o Can cause malignant hyperthermia due to a hypermetabolic state, especially in
swine.
Treat with Dantrolene.
o Less potent & higher MAC = slower induction and recovery.
o Lower mean alveolar concentration (MAC) means increased potency.
Desflurane has the highest MAC & Isoflurane has the lowest MAC.
o Sevoflurane
Smoother induction.
Medium potency (less than isoflurane & more than desoflurane)
Produces breakdown product called Compound A which may cause renal
damage.
o Desflurane
Least potent
o Isoflurane
Most potent
o Halothane
Highly metabolized by the liver
Makes myocardium more susceptible to catecholamine-induced
arrhythmias.
Can cause malignant hyperthermia.
o Nitrous Oxide
Cannot be used by itself for clinical anesthesia because of its high MAC.
Azathioprine is an immune-suppressive drug not normally used in cats because of bone
marrow suppression.
Prednisone should not be used with infection because it will suppress the immune system.
o Cats and horses get prednisolone.
o Steroids also have anti-insulin effects (can cause diabetes), joint problems, skin
disorders, and renal disorders.
Cyclophosphamide is an immune-suppressive drug.
Ketoconazole can cause hepatotoxicity, anorexia, vomiting, diarrhea, and adrenal
insufficiency.
Ivermectin stimulates GABA, an inhibitory neurotransmitter.
o Ivermectin is active against mites, nematodes, and ticks.
Not active against trematodes (flukes).
Praziquantel only treats tapeworms.
Penicillins (Penicillin, Ampicillin, Amoxacillin) work by inhibiting formation of
peptidoglycan cross-links in bacterial cell walls.
Bacteria