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You perform an abdominal ultrasound to evaluate a Yorkshire Terrier with a suspected liver shunt. After finding the shunt vessel, you complete the ultrasound and find several calculi in the bladder. What is the most likely type of stone? Cysteine Struvite Urate Xanthine - ✔✔The correct answer is urate. Animals with portosystemic shunts are very predisposed to developing urate uroliths due to their inability to metabolize purines appropriately. A 2-year old male castrated Border Collie presents for a 1-week history of small bowel diarrhea. A fecal flotation shows numerous Giardia cysts. What is the treatment of choice for this dog? Ipronidazole Metronidazole Decoquinate Albendazole - ✔✔Metronidazole Black walnut toxicity causes what condition in horses? Laminitis Hypersalivation Renal failure Pulmonary edema - ✔✔The correct answer is laminitis. Although the specific toxic principle in black walnuts responsible for causing laminitis or acute lameness in horses is unknown, evidence suggests juglone (a napthaquinone) plays a role. Do not use black walnuts for horse bedding.
Which of these would be appropriate for a horse with hyperkalemic periodic paralysis (HYPP)? Brome hay Timothy hay Alfalfa hay Beet molasses - ✔✔The correct answer is timothy hay. Of these choices, the only feed with low potassium is timothy hay. A low potassium diet is the most important nutritional modification in the treatment of HYPP. Regular exercise and feeding smaller, frequent meals can also reduce clinical signs. This disease is inherited in an autosomal dominant fashion, and owners should be discouraged from breeding affected animals. A 16-year old budgerigar presents with progressive unilateral paresis of the right leg (see image). There is normal flexion and extension of the hip joint with decreased flexion, extension, and sensation below the knee. The remainder of your skeletal and neurologic examination is unremarkable. Which of the following is most likely in this bird? Intervertebral disc disease Botulism Marek's disease Renal neoplasia Lead toxicosis - ✔✔The signalment and progressive unilateral paresis are most suspicious for renal neoplasia of budgerigars. Affected birds develop paresis due to pressure exerted on the sciatic nerve by a renal tumor. There is typically normal flexion and extension of the hip joint with decreased flexion, extension, and sensation below the knee as described here. Disc disease is uncommon in birds. Lead toxicity can lead to peripheral neuropathy and paresis but typically there are more multifocal or other accompanying signs such as polyuria/polydipsia, gastrointestinal signs, wing droop, head tilt, or convulsions. Marek's disease typically affects younger animals. Botulism typically presents with flaccid paralysis of the legs, wings, and neck. Severe combined immunodeficiency is a lethal autosomal recessive trait in Arabian foals. Heterozygotes are clinically normal. If the heterozygote carrier rate for the genetic mutation is 8%, what is the expected frequency of Arabian foals that are homozygous for the mutated allele?
findings are as described in the question. The disease can be clinically indistinguishable from mild forms of Newcastle disease, laryngotracheitis, and infectious coryza. Virus isolation is needed to obtain a definitive diagnosis. A 4-year old male castrated Basenji presents for polyuria, polydipsia, and weight loss. Blood work shows P=2.5 (2.9-5.3 mg/dl), K= 3.1 (3.9-5.1 mEq/L), total CO2= 12 (17-25 mmol/L). The remainder of the blood work is within normal limits. Urinalysis shows 3+ glucose. Which of the following is your most likely differential diagnosis? Pyometra Fanconi syndrome Pyelonephritis Diabetes mellitus - ✔✔The correct answer is Fanconi syndrome. Fanconi syndrome is an inherited disease in Basenjis. The disease involves renal tubular defects causing an abnormal loss of electrolytes and solutes leading to hypophosphatemia, hypokalemia, and metabolic acidosis. DM is less likely because serum glucose is normal. The lab abnormalities present in this dog are not consistent with pyelonephritis. Pyometra is not a viable choice as the signalment describes a male. The image shows an infarct in the liver discovered on post mortem exam of a mature beef cow which died one hour before in a western mountain pasture, after being observed to appear normal one day earlier. There is also dark red urine in the bladder. The pasture contains native plants, some pine trees, and a marshy area with water plants. The cows are unvaccinated and were never wormed. Given this history and the lesion found, the most likely cause of death is Blue-green algae toxicity Death camas toxicity Bacillary hemoglobinuria Viral hepatitis Pine needle poisoning - ✔✔Also known as redwater, bacillary hemoglobinuria is caused by germination of Clostridium Novyi type D spores in the liver after anaerobic damage by migrating liver fluke larvae. Cl. Novyi was formerly called Cl. hemolyticum. Vaccination can prevent this disease. What is the most common cause of maxillary sinusitis in a horse, as seen in the necropsy image below?
Foreign body Tooth root abscess Brachygnathia Dentigerous cyst Guttural pouch mycosis - ✔✔The correct answer is tooth root abscess. Commonly the first molar teeth are involved. Clinical signs include weight loss, quidding (dropping half chewed feed), halitosis, swelling, and unilateral purulent nasal discharge. A 5-month old kitten presents to you with a rectal prolapse, as shown in the photo. What is the most common cause of rectal prolapse in a kitten? Gastrointestinal parasites Panleukopenia Dysautonomia Trauma - ✔✔The correct answer is gastrointestinal parasites. You should perform a fecal float and smear. This cat probably has severe diarrhea and has been straining. Dysautonomia is possible but very rare. Panleukopenia does not usually result in a rectal prolapse, but is a cause of diarrhea. A 7-year-old ewe presents with abscessation of the supramammary lymph nodes. What is the most likely diagnosis? Caprine arthritis and encephalitis virus Trueperella pyogenes E. coli Mycoplasma mycoides Corynebacterium pseudotuberculosis - ✔✔The correct answer is Corynebacterium pseudotuberculosis. This is a description of caseous lymphadenitis. This disease of sheep and goats is of economic importance because it causes weight loss and ill thrift, can become a herd problem, and could be a public health concern.
Hyperglycemia - ✔✔Hypoglycemia. Xylitol is a sugar alcohol present in sugar-free gum that, when ingested, causes a rapid release of insulin in dogs. After ingestion, clinically significant hypoglycemia can develop within 30 minutes and can last for more than 12 hours. Acute hepatic necrosis and failure after higher doses of xylitol ingestion can occur as well. You have diagnosed nitrate poisoning in a group of yearling cattle which were grazing Sudan grass. Which of the following is the most effective treatment? Methylene blue Vitamin B Digitalis Sodium thiosulfate Calcium gluconate - ✔✔Methylene blue. Nitrate toxicosis causes methemoglobinemia, in which the blood appears chocolate brown. As a result, the oxygen carrying capacity and delivery is greatly reduced and the animal may die. Methylene blue is usually administered IV as a 1% to 4% solution, with a total dose of 4 to 15 mg/kg body weight to cattle, for treating nitrate toxicosis.Nitrates are found in high levels in many plants and some water sources. The nitrate is converted in the rumen to nitrite and then absorbed into the blood, which causes oxidation of the heme iron to the +3 ferric state (called methemoglobin). Methylene blue restores the iron in hemoglobin to its normal (reduced) oxygen- carrying state. This is achieved by providing an artificial electron acceptor for NADPH methemoglobin reductase (RBCs usually don't have one; the presence of methylene blue allows the enzyme to function at normal levels). The NADPH is generated via the hexose monophosphate shunt. Cats with taurine deficiency develop which of the following? Myocarditis Restrictive cardiomyopathy Hypertrophic cardiomyopathy Dilated cardiomyopathy - ✔✔The correct answer is dilated cardiomyopathy. Taurine is an essential amino acid for cats because they cannot synthesize it. Taurine deficiency causes dilated cardiomyopathy (DCM). Since DCM is relatively uncommon otherwise in cats, taurine deficiency should be suspected in any cat with DCM. Several does in a large goat herd, all of which are in late gestation, have not been able to rise to the standing position. They are being fed good quality grass and alfalfa hay. It is December and the weather
is cold. They have reduced feed intake and the most severely affected individuals appear blind and depressed, and two have died. On post-mortem examination, your only finding is that they have fatty livers and 4 fetuses each. The physical exam is otherwise not very revealing except that all have significant ketonuria. What steps should be taken to prevent more does from developing this disorder? Calcium gluconate IV IM dexamethasone Add magnesium oxide to food Increase energy intake Feed anionic diet - ✔✔Increase energy intake. About one lb/head/day of good quality grain should be introduced by mid gestation for sheep and goats carrying multiple fetuses. The prognosis for animals already showing clinical signs is poor and treatment is expensive. A C-section can be done, IV glucose administered slowly by drip. This should be followed by rumen transfaunations and feeding 15 to 30 ml propylene glycol every 12 hours, as well as feeding high quality feed. A 6-year old Sun Conure presents for evaluation of a skin lesion. The owner reports that the bird is very sensitive on the wing near the lesion. On your exam, you note an oval swelling involving the feather follicle as seen in the image below. What is the best treatment for feather cysts? Treat with systemic antibiotics for 4-6 weeks Squeeze and express the material out of the feather cyst No treatment is necessary as feather cysts typically resolve spontaneously Surgical removal of the feather cyst and follicle Lance and drain the feather cyst, flush with saline - ✔✔Surgical removal of the feather cyst and follicle. Feather cysts are the avian equivalent of an ingrown hair. A growing feather is unable to protrude through the skin and curls within the follicle. Since feathers are much larger than hairs, cysts can be quite large and painful. They commonly are found in the primary feathers of the wing. The cysts contain keratinized feather material that can be expressed or excised but commonly recur. Treatment of choice is surgical removal of the involved feather follicle. A group of dairy calves were fed a home-made grain mix that had a high percentage of cottonseed (photo shows seed and oil). Cottonseed is a good source of protein. A few days after being started on this new grain mix, the calves began having problems including dyspnea, and weakness, followed by death in several calves. What is the toxic principle acting here?
uterus which can be retracted, discharging a brownish red mucoid non-odorous lochia through the vagina. The left rear quarter of her udder is swollen, hot, painful, and discolored, and contains a serum- like secretion with clumps of fibrin in it. What is your diagnosis? Metritis Grain overload Hypocalcemia (milk fever) Coliform mastitis Displaced abomasum - ✔✔This is a case of severe acute coliform mastitis, and the absorbed endotoxin (LPS) is causing many of the systemic signs observed. The cow needs to be aggressively treated with IV fluids, NSAIDS, and supportive nursing. The gland should be frequently milked out. The use of both intramammary and systemic antimicrobial drugs to which most coliforms are susceptible is still controversial, but is often done in cows in a severe state of illness as in this case. While this cow may have secondary hypocalcemia, treatment with calcium needs to be approached cautiously, as endotoxic animals have very sensitive myocardium and arrest may occur if calcium is given IV. If given, preferred routes of calcium administration would be subcutaneous or oral. A 12-year old male neutered domestic short hair cat presents for ongoing evaluation of diabetes mellitus. The cat was diagnosed 6 months ago and has continued to be markedly polyuric, polydipsic, polyphagic, and has been gaining weight. The cat is currently receiving 10 units of glargine insulin every 12 hours. On physical exam, the cat weighs 15 pounds (6.8 kg) and has an enlarged head, abdomen, and paws. What imaging modality would be most appropriate to try and prove what you suspect is causing the uncontrolled diabetes and weight gain in this cat? Radiographs of the thorax Computed tomography (CT scan) of the abdomen Ultrasound of the neck Magnetic resonance imaging (MRI) of the head Ultrasound of the abdomen - ✔✔Magnetic resonance imaging (MRI) of the head. This cat has the signs and symptoms of acromegaly. Acromegaly is caused by excessive growth hormone release from the pars distalis from a tumor in the pituitary gland. Excessive growth hormone causes a defect in the insulin receptors on target cells causing insulin resistant diabetes mellitus. The enlarged head, paws, abdomen, and weight gain despite uncontrolled diabetes is due to the anabolic effects of the growth hormone. Treatment for this condition includes radiation therapy to the pituitary tumor, high doses of insulin to try and control the diabetes, and somatostatin analogs (octreotide) to try and inhibit the release of growth
hormone from the tumor. Surgical excision has been used as a form of treatment in people with pituitary tumors, but this has only been rarely reported in cats. What is the primary mode of transmission of West Nile Virus (WNV) between birds? Via saliva Via mosquitoes Via feces Via placenta Via Cnemidocoptes mites - ✔✔Via mosquitoes. Mosquito vectors are the primary mode of transmission for WNV between birds and other hosts (horses, humans). There are infrequent documented cases of the disease being spread by feces or saliva. No mites have been documented to transmit the disease. Birds do not have a placenta. A 6-month old Chocolate Labrador presents for limping and failure to gain weight. He is housed in an outdoor kennel with other hunting dogs. He is fed a large breed dry puppy food. He received his puppy shots at 8, 12, and 16 weeks old. He is quiet, alert, and responsive. His body condition score is 3/9, with rib exposure and poor fat deposition. His mucous membranes are pale pink, with a capillary refill time of 2 seconds. His heart and lungs auscult normally. No abnormalities are felt on abdominal palpation. He is an intact male, and both testicles are descended. The only abnormalities are the pads of his two front feet and left hind foot that he chews at frequently. What is diagnostic test of choice? PCV and TP CBC and chemistry panel Fecal float Radiographs Skin scraping - ✔✔Fecal Float. Hookworms (Ancylostoma and Uncinaria) are intestinal parasites that suck blood and can cause anemia, enteritis, coughing during larval migration, and dermatitis. Any young dog that is failing to thrive and/or has pale mucous membranes should be tested for intestinal parasites. Hookworm dermatitis, also called Ancylostomiasis is typically seen in conditions with poor sanitation and/or in kennels. Hookworms can be transmitted in utero, during nursing, or via 3rd stage larva penetrating the skin. The most commonly affected skin areas are the pads and interdigital spaces of the feet, but can include any
Cantharidin toxicity Bastard strangles Purpura hemorrhagica Idiopathic thrombocytopenia Type I hypersensitivity - ✔✔Purpura hemorrhagica. This is the clinical and histologic appearance of purpura hemorrhagica. It is a type-III hypersensitivity which is when antigen-antibody complexes accumulate, leading to disease. Purpura hemorrhagica most commonly occurs 2-4 weeks after exposure to certain infectious agents or vaccines. This condition is most commonly seen subsequent to infection with Streptococcus equi subsp. equi or vaccination against it but it can also be associated with other pathogens, particularly respiratory pathogens including other streptococcal species and equine influenza. Regardless of the cause, purpura hemorrhagica results from accumulation of antigen-antibody complexes that deposit on blood vessel walls and activate a strong immune response (vasculitis). The leaky blood vessels lead to hemorrhage and edema. Bastard strangles refers to the condition when Streptococcus equi subsp. equi creates abscesses in unusual sites (other than the lymph nodes draining the throat) such as abdominal or lung lymph nodes. Cantharidin toxicity (also known as blister beetle toxicity) leads to mucosal irritation and results in colic and cystitis. It can also lead to hypocalcemia. Primary immune-mediated thrombocytopenia (sometimes called idiopathic thrombocytopenia) can be seen in horses but is not consistent with the necrotizing vasculitis described in the case. Type I hypersensitivity reactions are immediate reactions (such as urticaria) invoked by an antigen or allergen. A 2-year old male neutered cat presents to you depressed, hypersalivating, and ataxic with muscle tremors. The owner reports that a pyrethrin-based spot-on formulation for flea control belonging to their Golden Retriever was accidentally applied on the cat earlier today. Which of the following drugs will you use to treat the cat's clinical signs?
Methocarbamol Amoxicillin Acepromazine 2 - PAM Atropine - ✔✔Methocarbamol. Pyrethrins alter the activity of the sodium ion channels of nerves, which prolongs the period of sodium conductance. This increases the length of depolarization resulting in repetitive nerve firing. Cats are particularly sensitive to pyrethrin-containing products and can develop clinical signs within hours after administration. Affected animals should be bathed to remove remaining product. Minor clinical signs such as hypersalivation and ear twitching are usually self-limiting and do not require treatment. Control of marked tremors or seizures can be achieved with methocarbamol (Robaxin). A pregnant mare was brought out to your barn for observation in anticipation of parturition. After several hours of restless behavior, several gallons of allantoic fluid rush out from the vulva. Which of the following would you expect to happen next for a normal parturition? The placenta is expelled from the vulva The thin, white, glistening amniotic membrane emerges from the vulva The red, velvety, chorioallantoic membrane emerges from the vulva The hind legs of the foal emerge from the vulva - ✔✔The thin, white, glistening amniotic membrane emerges from the vulva.This case description is consistent with stage I of labor in the horse. The first stage of foaling typically lasts 30 minutes to 4 hours. During this stage, mares act restless and may exhibit signs similar to colic such as flank watching, pawing, and constantly getting up and down. When the placenta ruptures ("water breaks"), there may be several gallons of allantoic fluid that come out. Usually, within about 5 minutes, the second stage of labor begins and the foals feet and nose appear at the vulva, covered in the white, thin, glistening amnion. If a red, velvety, membrane is seen, this is the chorioallantois which indicates premature placental separation which can impair oxygen delivery to the fetus and can result in death of the foal. Usually, the muzzle will emerge from the amnion by the time the foal's hips pass through the pelvis but if not, the amnion can be gently broken and removed. Usually, the umbilical cord breaks naturally when the mare stands or foal begins to rise. Then, within 30 minutes to 3 hours after foaling, the placenta should be expelled. A dog presents to your clinic with tenesmus and swelling near the anus as seen in the image. On examination, there is a fluctuant swelling lateral to the anus, and on rectal exam, you note lateral dilatation of the rectum. Which of the following is the most common signalment for dogs presenting with this problem?
radiographs of the tibia which are shown below. Which of the following is the most appropriate treatment for the suspected condition? Fluconazole Ampicillin Surgical correction Splint stabilization Carprofen - ✔✔Carprofen. This is a case of panosteitis based on the young age of the patient and radiographic presence of focal intramedullary densities within the tibial diaphysis. Minor differentials could include osteomyelitis. Panosteitis is a self-limiting, painful condition characterized by limping and lameness. It typically affects the long bones of young dogs, usually between the ages of 5 to 18 months. It can occur with any breed, but it is more common in medium- to large-sized dog breeds. Treatment is primarily supportive consisting of limiting activity and anti-inflammatory drugs. Therefore, carprofen is the best answer choice listed. Pain lasts from weeks to months and resolves in nearly all cases. While these treatments reduce the pain associated with the condition, they may not alter the duration or course of the disease. What is the potential udder fate of goats infected with caprine arthritis encephalomyelitis virus? Hardbag The udder is not affected Bluebag Gangrene - ✔✔Hardbag. CAEV is a retrovirus and when it affects the udder it will cause fibrosis and result in a firm udder with agalactia. Treatment is ineffective and the goat should be culled. The disease is usually subclinical but can cause arthritis in adults and encephalitis in kids. A 4-year old male Manx cat presents to you because the owners found an empty, opened pill vial in the bathroom and the cat vomited. On physical exam, you note ptyalism and facial edema. The cat's mucous membranes are pale and slightly icteric. You perform a blood smear and detect Heinz bodies in erythrocytes. The cat's packed cell volume (PCV) is 26% (30-45%). The owners provide you a list of the medications in the medicine cabinet which are acetaminophen (Tylenol), finasteride (Propecia), enalapril (Vasotec), and omeprazole (Prilosec). What treatments should you institute for this cat?
Emesis and methylene blue Activated charcoal and whole blood transfusion Prednisone and amoxicillin Acetylcysteine and S-adenosylmethionine - ✔✔Acetylcysteine and S-adenosylmethionine. Acetaminophen toxicity in cats usually occurs when owners administer the drug, unaware of its significant potential toxicity in cats. In this case, the cat's clinical signs are most consistent with acetaminophen toxicity based on the Heinz body anemia that is present. Cats can die from oxidative damage and methemoglobinemia within 1-2 days of ingestion. It may also be associated with hepatotoxicity in cats, although this is seen more frequently in dogs. Recall that cats are particularly sensitive to acetaminophen because they have decreased glucuronyl transferase activity which conjugates acetaminophen to glucuronic acid for excretion. As a result, 50- 60 mg (a single tablet) may be fatal for a 4-5 kg cat. Treatment should consist of toxin removal if possible by inducing emesis in some cases. As the cat in this case is already vomiting, this may not be necessary. Activated charcoal is controversial and should only be given if ingestion occurred within hours and should be administered very carefully in cats due to the risk of aspiration. The specific antidote is acetylcysteine which binds to some of the reactive metabolites of acetaminophen and increases the availability and synthesis of glutathione. Other treatments may include S-Adenosylmethionine (SAMe) which has hepatoprotective and antioxidant properties. Cimetidine can be given to inhibit the p450 oxidase in the liver and limit formation of toxic metabolites. Ascorbic acid can also be used as an adjunct treatment to bind toxic metabolites. In cats with signs of hypoxemia from severe hemolytic anemia (PCV <20%), a transfusion and further supportive care may be warranted. A horse presents to you for chronic, recurrent laminitis and skin disease. You notice on your exam that the horse has a particularly thick, long, wavy, and matted coat. The owner mentioned that this developed many months ago. What is a likely diagnosis? Pheochromocytoma Cushing's disease (Pituitary Pars Intermedia Dysfunction) Diabetes insipidus
FIP but not too specific. In greater than 50% of cats with the wet form of FIP, there will be hyperproteinemia. In greater than 70% of cats with the dry form of FIP there is hyperproteinemia. A client calls and says her cat was chewing on her lily plant two days ago and is now acting very sick. You tell her to bring the cat in immediately so that you can perform which of the following? Induce emesis and administer activated charcoal ALT, AST, GGT, and total bilirubin levels BUN and creatinine levels Abdominal radiographs to diagnose intestinal obstruction - ✔✔BUN and creatinine levels.Lily plant toxicosis is extremely serious and can cause rapid and fatal acute renal failure in cats. If ingestion is suspected, decontamination and aggressive fluid therapy, and monitoring of renal values are recommended immediately. In this case, since 2 days have passed, inducing emesis and administering activated charcoal would not be helpful. What you can do is check renal values (BUN and creatinine) and treat for acute renal failure. Ruling out an intestinal obstruction in a cat with this history is reasonable but not the best of the choices given. Rubiosis iridis as seen in this cat is a sign of what process in the eye? Lens luxation Iris atrophy Chorioretinitis Anterior uveitis Glaucoma - ✔✔The correct answer is anterior uveitis. Rubiosis iridis along with other signs such as aqueous flare, hyphema, hypopyon, keratic precipitates, and decreased intraocular pressure are all suggestive of anterior uveitis which can be caused by a number of infectious, immune-mediated, traumatic, and idiopathic causes.
A male goat presents for vocalizing and straining to urinate. He has been kicking at his abdomen. You detect crystals adherent to the hairs around the prepuce (see image). What condition should you suspect and try to rule out first? Lower intestinal obstruction Acute severe pyelonephritis Urinary tract obstruction Upper intestinal obstruction - ✔✔The correct answer is urinary tract obstruction due to calculi. This should be suspected in all male and castrated male goats (and sheep) with non-specific signs of disease or discomfort because it is so common. Common clinical signs associated with urinary tract obstruction are vocalization and dribbling of urine. Heaving or forceful abdominal contractions may be seen. Hematuria, dysuria, prolonged urination, and apparent abdominal pain are also common signs. The most important step of evaluation is exteriorization of the penis and examination of the urethral process because this is the most common site of blockage. In severe cases the entire urethra may be filled with calculi. Which of these is the most common cause of seizures in the adult ferret? Hypocalcemia Idiopathic epilepsy Hypoglycemia Hepatic encephalopathy Intracranial neoplasia - ✔✔The correct answer is hypoglycemia. Hypoglycemia secondary to insulinoma is the most common cause of seizures in the adult ferret. Keep in mind, a prolonged seizure can actually cause hypoglycemia, so the finding of low blood glucose in a seizuring ferret does not necessarily confirm a diagnosis of insulinoma. Idiopathic epilepsy has not been reported in ferrets. Hypocalcemia and hepatic encephalopathy can cause seizures, but are not as commonly reported as hypoglycemia. A 4-year old female spayed mixed Chihuahua presented to the emergency service at approximately 5am this morning after presumptively being attacked by a coyote. The patient has a flail chest and it is questionable if there is direct communication between the thoracic cavity and the environment (it was difficult to examine the dog due to her fractious nature). Exploration of the wound was performed, and once anesthetized, it was apparent she had a pneumothorax. The patient must be ventilated, as there is no vacuum present in the chest for lung expansion to occur. What pressure should the anesthetist not exceed if manually bagging the patient during anesthesia?
