Dog Cat Medicine EXAM 1

what do the canine core vaccines protect against?

• rabies

• distemper

• adenovirus

• parvovirus

what do the feline core vaccines protect against?

• rabies

• panleukopenia

• herpesvirus

• calicivirus

• feline leukemia virus (cats < 1 yr)

what do the canine noncore vaccines protect against?

• parainfluenza

• bordetella

• leptospirosis

• borrelia burgdorferi

• influenza

what do the feline noncore vaccines protect against?

• feline leukemia virus

• chlamydophila felis

• bordetella

distemper, adenovirus and parvovirus are given in a __________ vaccine

combination

what are canine core vaccine protocols for dogs below 16 weeks old?

what are canine core vaccine protocols for dogs above 16 weeks old?

leptospirosis vaccine might not ________ for serovars not listed on the vaccine

cross-protect

leptospirosis vaccine protocol:

vaccinate dogs > 12 weeks of age with a series of 2-3 vaccines, 3-4 weeks apart. Repeat annually if risk persists

intransal bordetella vaccine also includes…

CAV-2, parainfluenza virus

bordetella vaccine protocol:

can be given at >8 weeks of age. recommended at least 1 week prior to exposure

canine influenza vaccine targets which strains?

H3N8 ± H3N2

canine infuenza vaccine protocol:

2 doses given 2-4 weeks apart, revaccinate annually if risk persists

borrelia vaccine protocol:

2 doses given 2-4 weeks apart, revaccinate annually if risk persists

what are feline core vaccine protocols for cats up to 16 weeks old?

what are feline core vaccine protocols for cats above 16 weeks old?

FeLV is considered core in cats ______ years of age because of increased susceptibility

<1 year

what is FeLV vaccine protocol:

2 doses, 3-4 weeks apart after 6 weeks of age. Revaccinate 12 months after last dose in series and continue to vaccinate annually if risk persists

FHV-1 and FCV vaccines do not offer…

complete protection

can rabies serology be accepted in lieu of vaccination?

no

when can you not vaccinate?

• systemic, not stabilized disease is present

• receiving immunosuppressive treatments

• another vaccine given very recently

• FeLV +

components of hemostasis:

• blood vessel

• adequate platelet mass and function

• adequate plasma coagulation factor levels and function

what cause hemorrhage?

• trauma or inflammation

• reduced platelet number or function

• reduced number or function of coagulation factors

primary hemostatic defect

lack of platelet plug

signs of primary hemostatic defect:

• petechia/ecchymoses

• gingival bleeding

• epistaxis

• hematuria

• hematemesis/melena/hematochezia

• hematoma after venipuncture

signs of secondary hemostatic defect:

• hemothorax

• hemoabdomen

• hemarthrosis

• epistaxis

• hematemesis/melena/hematochezia

• large eccymoses

von Willebrand disease

quantitative or qualitative deficiency in von Willebrand factor

von Willebrand factor

glycoprotein that helps platelets adhere to sites of vessel injury

larger von willebrand factors are more/less effective

more

von Willebrand disease signs:

• prolonged bleeding

• excessive bruising after trauma

• bleeding from gums, nose

type 1 VWD

• most common

• quantitative VWF reduction but remaining functions the same

type 2 VWD

• decrease in large VWF

• moderate to severe bleeding, spontaneous hemorrhage

type 3 VWD

• complete absence of VWF

• severe bleeding, spontaneous hemorrhage

diagnosing VWD

• BMBT

• VWF antigen test

• DNA test

interpreting VWF antigen results

managing type 1 VWD with no previous bleeding:

• DDAVP (desmopressin)

  • given 30 min prior to surgery

  • helps for 2-4 hrs in affected dogs

DDAVP (desmopressin)

stimulates VWF release

managing type 1 VWD with mild previous bleeding:

• give DDAVP

• ± plasma with VWF prior to procedure

managing type 1 VWD with moderate-severe previous bleeding:

• consider risk vs benefit of procedure

• consider referral to hospital with 24 hr monitoring following procedure, transfusion support, specialty care

how to treat VWD bleeding event:

• first aid (compress, cold pack)

• one dose DDAVP

• plasma

• potentially RBC

secondary hemostatic disorders:

• hereditary

  • hemophilia A, B

  • other factor deficiencies

• acquired

  • liver dysfunction

  • toxicity

  • DIC

  • others

anticoagulant rodenticides cause bleeding via…

vitamin K antagonism→lack of production of factors II, VII, IX, X

signs of anticoagulant rodenticide toxicity:

• dyspnea, coughing

• exercise intolerance

• hematomas

• hematemesis

• melena

• hematuria

• pale MMs

• signs secondary to bleeding in other location

anticoagulant rodenticide toxicity diagnosis:

• prolongation of PT, PTT, ACT

• anemia and thrombocytopenia

• effusions

anticoagulant rodenticide toxicity treatment:

• vitamin K1 2.5-5 mg/kg

• transfusion

• supportive care

• thoracocentesis if effusion

• charcoal and emesis if acute ingestion

hemophilia A

factor VIII deficiency

hemophilia B

factor IX deficiency

delayed post op bleeding happens in around 30% of _________

greyhounds

diagnosing DIC:

• thrombocytopenia

• increasing PT/PTT

• evidence of fibrin clot lysis

• CBC-schistocytes/RBC fragments

treating DIC:

• treatment of underlying disorder

• supportive care

• treatment of coagulation abnormality depending on phase of DIC

thromboembolic disease

inappropriate clot formation secondary to other diseases

mechanisms of thromboembolic disease:

• increased prothrombotic factors

• endothelial dysfunction

• decreased endogenous anticoagulant factors

most common thromboembolic diseases:

• arterial thromboembolism in cats with hypertrophic cardiomyopathy

• pulmonary thromboembolism

thromboembolic disease signs:

• lack of arterial perfusion

• lack of venous drainage

• dyspnea with PTE

acute patient physiological lab evaluation (APPLE) triage system requires…

blood results

what are parts of veterinary triage?

• telephone triage

• waiting room triage

• primary survey

• secondary survey

steps of telephone triage:

what conditions require immediate consultation?

• respiratory distress

• choking, gagging, coughing

• cyanosis, white MM

• collapse, loss of consciousness

• status epilepticus

• heat stress/heatstroke

• distended abdomen, unproductive retching

• massive bleeding

• inability to urinate/no urine production

• acute poisoning

• electric shock/burns

what conditions require consultation ASAP (1-2 hrs)?

• cluster seizures

• paresis/paraplegia

• esophageal/linear foreign body

• trauma, bite wounds, fractures

• stranguria

• severe vomiting/diarrhea

• hematemesis/hematochezia

• opthalmological abnormalities

• acute deterioration

• lethargy, recumbancy

• pain

what is examined on waiting room triage?

• level of consciousness

• respiratory pattern, rate, effort, noise

• HR, MM, CRT, pulse quality

• temp

what are considered life threatening abnormalities?

• white, cyanotic, grey muddy, severely hyperemic MM

• bradycardia: cat <120 bpm, dog <40-60 bpm

• tachycardia: cat >240 bpm, dog >180 bpm

• irregular heart rhythm

• perforated or open body cavities

• distended abdomen

• hyperthermia >41 degrees C

• hypothermia <36.7 degrees C

• stranguria with firm bladder

• dystocia

• acute poisoning

• burns, chemical injury

with verbal consent, what can be done in waiting room triage?

• IV

• initial diagnostics and stabilization

• emergency procedures

• resuscitation status

what drugs can be used to treat hypoglycemia?

dextrose

what drugs can be used to treat hypocalcemia?

calcium gluconate

what drugs can be used to treat hyperkalemia?

• dextrose

• insulin

• calcium gluconate

what drugs can be used to treat seizures?

• midazolam

• diazepam

what drugs can be used to treat malignant ventricular arrhythmias?

lidocaine

what drugs can be used to treat anaphylaxis?

epinephrine

what drugs can be used to for cardiopulmonary resuscitation?

• lidocaine

• epinephrine

• vasopressin

• atropine

• flumazenil

• naloxone

• atipamezole

primary survey steps:

• CPR if needed

• assessment of major body systems

• brief history

what body systems are assessed in the primary survey?

• respiratory

• cardiovascular

• CNS

• other: urogenital, abdomen, etc

what are parts of respiratory system evaluation?

• visual exam

• auscultation

• pulse ox

increased inspiratory effort =

upper airway obstruction

increased expiratory effort =

lower airway obstruction

rapid shallow breathing =

pleural space disease, reduced lung compliance

brown MM =

methemoglobinemia

dull/quiet lungs =

pleural space disease, lung consolidation

how to stabilize respiratory distress?

• minimize stress

• sedate

• oxygen supplementation

what are parts of cardiovascular system evaluation?

• perfusion

• auscultation and pulse

• shock index

• ECG rhythm

how to stabilize cardiovascular distress:

• vascular access

• IV fluid resuscitation

• vasopressors, antiarrhythmics, pericardiocentesis

4 criteria to treat ventricular tachycardia:

1. symptomatic

2. >160-180 bpm

3. polymorphic/ multiform VPCs

4. R on T phenomenon

how to treat ventricular tachycardia:

• lidocaine bolus of 2 mg/kg

• followed by lidocaine CRI

what are parts of CNS evaluation?

• mentation/level of consciousness

• pupils

• cushings reflex

• posture

• gait and spinal integrity

cushings reflex

CNS response to increased ICP→hypertension, reflex bradycardia

how to stabilize seizures:

• diazepam .5 mg/kg

• phenobarbital, levetiracetam

• propofol, isoflurane

how to stabilize increased ICP:

• hypertonic saline

• mannitol

how to stabilize hypoglycemia:

• oral corn syrup

• 50% dextrose bolus: .5-1 mL/kg

• 2.5-5% dextrose CRI

how to stabilize hypocalcemia:

10% calcium gluconate: .5 mL/kg IV

how to stabilize hyperkalemia:

• 10% calcium gluconate: .5-1 mL/kg IV over 2-5 min

• insulin .25-.5 u/kg IV + 50% dextrose 2-4 mL/u insulin

diagnosing sepsis in triage:

• glucose >1.1 mmol/L

• blood lactate >2 mmol/L

diagnosing uroabdomen in triage:

• serum K+ dog >1.4:1

• serum K+ cat >1.9:1

diagnosing bile peritonitis in triage:

serum bilirubin >2:1

what is completed in secondary survey:

• full PE

• thorough history

• problem list

• diagnostic plans

• full discussion (findings, prognosis, financial implications, written consent)

TBW is ___% BW

60

how much of BW is ICF?

40%

how much of BW is ECF?

20%

ECF consists of…

• interstitial fluid

• plasma

how much of BW is interstitial fluid?

15%

how much of BW is plasma?

5%

what questions are indications for fluid therapy?

• resuscitation: is the patient in shock?

• rehydration: is patient dehydrated?

• maintenance: is patient eating or drinking?

• ongoing losses: how to predict?