Small Animal Diseases and Management - Exam 1

What is heart failure?

Failure of the heart to pump as it should. Happens when blood returning to the heart cannot be pumped back to the body at a rate to match the needs of the body

How is heart failure different than congestive heart failure?

it is an advanced form of heart failure that allows edema (fluid) to accumulate in the body

What was determined to be the cause of feline dilated cardiomyopathy?

taurine deficiency in cats

Hypertrophic cardiomyopathy more commonly affects....

cats

Dilated cardiomyopathy more commonly affects....

dogs

When we say that a cat has a saddle thrombus, what is wrong?

thromboembolism which is a serious and common complication of myocardial disease in cats that affects the left side of the heart, renal artery, cerebral arteries, and mesenteric arteries
90% will lodge at the distal aortic trifurcation

What are the clinical signs seen with saddle thrombus?

acute rear leg pain and paresis, cold foot pads, unable to palpate femoral pulse, and history/diagnosis of myocardial disease

What is TPA?

tissue plasminogen activator

How does TPA help patients with saddle thrombus?

results in the breakdown of the clots

Why do we have to be careful dosing aspirin in cats?

it can cause toxicities because of the poor ability to metabolize and excrete salicylates

What is patent ductus arteriosus?

a condition where the ductus arterioles does not close after the animal is born

What does a patent ductus arteriosus do to the blood flow in the heart?

it results in blood being shunted from the pulmonary artery to the descending aorta

What is the murmur that is associated with patent ductus arteriosus called?

a continuous machinery heart murmur

Where is a continuous machinery heart murmur best heard?

left side

How is a patent ductus arteriosus treated.

with surgery before the age of 2 years

When does a patent ductus arteriosus usually close?

7-8 days

How does pulmonic stenosis affect the heart?

the outflow tract (pulmonary valve) from the right ventricle is narrowed which causes increased ventricular pressure and results in right ventricular hypertrophy, which causes the right atrium to become enlarged

When we are talking about tetralogy of fallot, what is wrong with the heart?

A genetic malformation of the heart. It includes pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect (VSD), and an overriding aorta. Due to these defects, there is an increase in the resistance on the right side, pressure and there is a right to left shunt between the pulmonary and systemic circulation. Deoxygenated blood from the right ventricle is shunted through the VSD and mixes with the oxygenated blood in the left ventricle which results in hypoxemia, cyanosis, and secondary polycythemia

What four things are associated with tetralogy of fallot?

pulmonic stenosis
right ventricular hypertrophy
ventricular septal defect
overriding aorta

What is right ventricular hypertrophy?

right atrium becomes enlarged

What is a ventricular septal defect?

the left side of the heart is usually overloaded and enlarged (because of a hole in the ventricle)

What is an overriding aorta?

aorta is displaced to the right

Where would we best hear a murmur associated with tetralogy of fallot?

left side

How is tertalogy of fallot treated?

Surgical which required cardiopulmonary bypass and can be managed medically by exercise restriction, phlebotomy to remove excess RBC, and oxygen therapy

What is persistent right aortic arch?

There are blood vessels that serve a function in the fetus, but then naturally deteriorate as the embryo grows. Sometimes the vessels in the chest cavity, aortic arches, will fail to disappear . Right aortic arch is one of the vessels and it passes near the esophagus

If the PRAA is not corrected, what kind of damage can it cause?

the esophagus is trapped between it and the heart which inhibits the growth and function of the esophagus, thus restricting food passage to the stomach. This can cause regurgitation of solid food, aspiration pneumonia, fever, dyspnea, cough, weight loss

What is the most common cardiovascular disorder in small animal medicine?

chronic mitral valve insufficiency

What is the most common cause of chronic mitral valve insufficiency?

chronic periodontal disease

Explain how chronic periodontal disease plays a role in chronic mitral valve insufficiency.

The bacteria that are found in the calculus and tartar on the teeth are showered into the bloodstream. They are carried to organs with large blood supply like the heart, liver, and kidney. Once they reach the heart, they colonize the mitral valve leaflets causing them to thicken. The thickening causes the valves not to close completely, and blood from the left ventricle regurgitates back into the left atrium. Overtime, the left heart overload occurring due to the regurgitation can lead to heart failure.

What is the Atrial fibrillation?

is seen when there is no organized atrial contraction and causes cardiac output to decrease. It is usually associated with advanced stages of chronic atrioventricular valve insufficiency or cardiomyopathy.

What group of animals does atrial fibrillation seem more prevalent in?

large breed dogs, and dogs with cardiac diseases that cause an increase in the size of the heart.

What is ventricular fibrillation?

can be associated with congestive heart failure, cardiomyopathies, endocarditis, myocarditis, or neoplasia as well as electrolyte imbalances and acid/base abnormalities

Which arrhythmia leads to ventricular fibrillation if not treated?

Ventricular tachycardia

What are the treatments for ventricular tachycardia?

procainamide, tocainide, lidocaine, v-fib: defibrillation, IV fluids, sodium bicarb

What are the treatments for ventricular fibrillation?

intubate, respiratory assistance, IV fluids, cardiac, compressions/massage, epinephrine, defibrillation

What are the treatments for atrial fibrillation?

digoxin, calcium blockers - diltiazem, verapamil (dogs only)

What is a sinus arrhythmia?

a normal variant in some situations, especially dogs. The heart rate is regularly irregular because the change in rate coincides with respiration. The rate increases and decreases with inspiration and expiration

What small animal is a sinus arrhythmia normal in?

dogs

Of the AV blocks, which is most severe?

3rd degree AV block

What side of the heart is affected with canine heart worm disease?

right side

What are the stages of heart worm disease?

Mild- asymptomatic or cough
Moderate - cough, exercise intolerance, dyspnea, abnormal heart and lung sounds
Severe - cough, exercise intolerance, dyspnea, abnormal heart and lung sounds, enlarged liver, syncope, ascites
Caval Syndrome - Sudden onset of severe lethargy and weakness accompanied by hemoglobinemia and hemoglobinuria

What are some differences in canine and feline heart worm disease?

Cats seem to be more resistant to infection than dogs. If an infection occurs its usually a low burden in cats. The symptoms are different in cats than in dogs and they mostly relate to the respiratory system or GI tract

What is a pericardial effusion?

build-up of fluid within the pericardial sac that surrounds the heart

What are most pericardial effusions associated with in dogs?

cardiac tumors

What are most pericardial effusions associated with in cats?

congestive heart failure

What position do we want the animal in when doing a pericardiocentesis? Why?

lateral recumbency to be able to approach from the right side, this will help decrease the chance of hitting the coronary blood vessel.

What is rhinitis?

inflammation of the mucous membranes of the nasal passage

is rhinitis usually a primary disease, or does it occur secondary to another respiratory infection?

it is rarely a primary disease

Epitaxis is usually associated with what

trauma, foreign objects, or turmors

When talking about sinusitis in the dog, which sinuses are usually involved?

maxillary and frontal sinuses

what is the most common cause of sinusitis

tooth root abscess

What is the most common cause of laryngitis?

excessive barking, howling, or meowing

Why should any animal with voice changes should always be handled with care?

because rabies can cause a change in voice

What are the two forms of brachycephalic airway syndrome?

congenital and acquired abnormalities

What is the congenital abnormality in brachycephalic airway syndrome?

stenotic nares, elongation and thickening of soft palate, redundant pharyngeal tissue

What is the acquired abnormality in brachycephalic airway syndrome?

everted laryngeal saccule, enlargement of the pharyngeal mucosal and soft palate tissues, laryngeal edema, and potentially laryngeal collapse

How do we treat brachycephalic airway syndrome?

surgical correction

What structures are normally corrected in brachiocephalic airway syndrome?

stenotic nares, elongated palate, and everted saccules

What is infectious canine tracheobronchitis, and what is the common name?

highly contagious respiratory disease of dogs, kennel cough

What are the most common organisms that are isolated in infectious canine tracheobronchitis?

bordetella, bronteseptica, canine parainfluenza virus

How do we treat infectious canine tracheobronchitis? Can we clear this infection up with meds?

Uncomplicated: amoxicillin/clavulanic acid(Clavamox), doxycycline
Complicated: gentamicin, amikacin, cefazolin
Antitussives: hycodan (hydrocodone bitartrate), codeine, Torbuttrol (butorphanol tartare)
Branchodialators: aminophylline, Brethine (terbytaline), theophylline
Supporative care: don't excite the animal, remove collar, clean nose with warm bath cloths, +/- nebulization/humidifier

When talking about a collapsing trachea, what is causing the problem?

The tracheal rings losing their ability to hold the trachea open during respiration

What dogs is a collapsed trachea most commonly seen in?

middle age to old toy and miniature breed dogs that are obese

Is surgical treatment for a collapsed trachea curative? Why or why not?

it is often unrewarding due to numerous complications

In cats with feline asthma, what is happening to the airway to cause the clinical signs seen?

disease causes spontaneous bronchoconstriction, airway inflammation, and airway hyperactivity

Is feline asthma a curable disease?

usually not possible

What are the clinical signs associated with feline heart worm disease?

cough dyspnea, weight loss, anorexia, vomiting, lethargy, weakness, sudden death

Are the signs in feline heart worm disease more or less severe when compared to the dog?

more severe

What do we do to treat feline heart worm disease?

cage rest/confinement for 4-6 weeks, steroids, bronchodilators, furosemide, +/- oxygen

Can immiticide be used in cats

no

What are the main differences in feline viral rhinotracheitis and feline calcivirus?

-Feline viral rhinotracheitis: feline herpes virus, is a highly contagious respiratory disease of cats, it has a high morbidity and moderate mortality rate, infections can occur in vaccinated and unvaccinated cats, and transmission is by aerosolization and by direct contact. The virus only remains in the environment for 18-24 hours, food bowls, clothing, beds, and toys can act as fomites. Clinical signs: acute onset of sneezing, conjunctivitis, rhinitis, fever, keratitis, anorexia (from fever, inability to smell), abortion
-Feline Calicivirus: is an acute, highly contagious upper respiratory tract disease, it has a high morbidity and a low mortality, it is resistant to disinfectants and can remain active in the environment for several days. The clinical signs are more severe in kittens 2-6 months of age and transmission occurs through direct contact with infected cats. The clinical signs are fever, ocular nasal discharge with little to no sneezing, conjunctivitis, oral ulcers, pneumonia, acute painful lameness.

What is pleural effusion?

A build-up of fluid inside the pleural space which causes respiratory distress in the patient

What are some causes go pleural effusion?

Congestive heart failure(especially right side), neoplasia, foreign body, trauma, pulmonary infection

Describe blastomycosis.

it is found in Kentucky, Illinois, Tennessee, Mississippi, Indiana, Iowa, Ohio, Arkansas, and North carolina
It is transmitted by inhalation and the three clinical forms are primary pulmonary infection, disseminated disease, and local cutaneous infection

Describe Coccidioidomycosis

It is found in California, Nevada, Utah, Arizona, New Mexico, and Texas and the clinical signs may not appear for weeks to years after the animal has been exposed

Describe Histoplasmosis.

It is most common in Ohio, Missouri, and the Mississippi River valley
It is associated with birds and bat feces.
The main source of infection is inhalation.

Describe Cryptococcosis.

It is found in avian feces/excretement (especially pigeon droppings).
Immonuosuppressed animals are more commonly affected than healthy animals and it is transmitted through inhalation

Describe Aspergillosis.

It is found in decaying vegetables, sewage, compost piles, and moldy seeds/grains.
The route of transmission is inhalation, and the nasal cavity is the most common location of lesions in the dog.

What age dogs are mot commonly affected by pulmonary neoplasia?

dogs between 9-12 yers old

What can a primary lung tumor meta size to?

to regional lymph nodes, long bones, brain, eyes, heart

Most primary lung tumors are \______.

adenocarcinomas

Are primary or metastatic lung tumors more common

Metastatic

What is the treatment of choice for tumors that are resectable?

surgical excision

What are some important questions to ask a patient we suspect is anemic?

a. Is the pet on any medications?
b. Have the owners detected any blood loss or dark tarry stool?
c. Have the owners noticed any fleas?
d. Has the cat recently been tested for FeLV or FIV?
e. Has the owner noticed any ticks on the dog?
f. Has the pet been vaccinated recently?
g. Has the female received any shots for mismating recently?

What is the difference regenerative and nonregenerative anemia? Also, give an example of each.

1. Regenerative anemia means that the bone marrow can still respond but not keeping up with the bodies need. It will always stem from extra-marrow causes and results from hemolysis or blood loss. It is caused by immune mediated, oxidant injury, parasites, blood loss, or mechanical RBC fragmentation. Regenerative is diagnosed by a HIGH reticulocyte count (PCV, RBC, and Hb are all low).

2. Nonregenerative anemia means that the bone marrow is not responding nor meeting the demand for the body. It can be caused by bone marrow and extra-marrow disorders. It results from chronic inflammatory disease, chronic renal disease, and acute hemorrhage or hemolysis (1st 48-96 hrs). It is caused by nutritional or mineral deficiencies, toxicities, infection (FIV, FeLV, Ehrlichia). Nonregenerative is diagnosed by a LOW reticulocyte count (PCV, RBC count, and hemoglobin are low).

What are some clinical signs seen with anemia?

pale or icteric mucus membrane, lethargy, exercise intolerance, pica, and decreased overall activity. These signs can either be acute or chronic and can vary in severity

What are some things that can be evaluated to aid in the diagnosis of anemia?

The PCV and plasma should be examined to look for evidence of hemolysis. We also need to check for TP and agglutination

How does chronic kidney disease lead to anemia?

The primary cause of anemia caused by chronic kidney disease is bone marrow failure secondary to the inadequate production of erythropoietin by the kidney. It is exacerbated by iron deficiency anemia, inflammatory or neoplastic disease, GI blood loss, and hemolysis.

What blood borne parasite is a common cause of anemia in cats?

Mycoplasma hemofelis

How do the two forms of Cytauxzoon affect the cat from a hematological standpoint?

The intracellular form produces an anemia, and the extracellular form produces blood stasis and vascular occlusion.

What tick is responsible for transmitting Babesia canis? What happens to the infected RBC?

The brown dog tick (Rhipicephalus sanguineus) is responsible in transmitting Babesia canis. This results in the hemolysis of the infected RBC.

What is one of the most common causes of Heinz body anemia in dogs?

Cats seem to be more susceptible than dogs due to their hemoglobin structure.

What is the most common cause for spontaneous bleeding in the dog?

Thrombocytopenia

Decreased numbers of circulating platelets can be due to what?

1. Decreased platelet production - most common cause of thrombocytopenia in the cat

2. Increased platelet consumption - occurs in dogs and cats with DIC

3. Increased platelet destruction - most common cause of thrombocytopenia in the dog

4. Increased platelet sequestration - usually caused by splenomegaly or hepatomegaly (rare)

What is IMHA?

Immune-Mediated Hemolytic Anemia - the cause is unknown; the RBC destruction occurs because of the presence of antibodies that attach to RBC membrane. These cells are then removed by the immune system causing the anemia.

What are the 2 categories of IMHA?

1. Primary (idiopathic) (unknown cause)- most cases

2. Secondary - Babesia, lepto, Ehrlichia, FeLV, heartworm disease, certain drugs

What tests can help with the diagnosis of IMHA?

CBC +/- Coomb's test (only 75%) (Coomb's shows agglutination)

i. Treatment of IMHA is aimed at what?

Is aimed at improving tissue oxygenation and managing immune response

What is immune mediated thrombocytopenia?

The cause is unknown, but it is the same and IMHA but the platelets are attacked by the animals' immune system. The platelets are coated with antibodies or complement-antibody complexes, destruction may occur in the spleen, bone marrow, or liver

i. What are some clinical signs that you may see with immune mediated thrombocytopenia?

Animals usually present for bleeding, petechial and Ecchymotic hemorrhages on the skin and mucosal surfaces, weakness, and lethargy.