Bcse (SMR)

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BCSE REVIEW

Basic & Clinical Science EXAMINATION

PMAS-UAAR

My recommended sources for BCSE


Anatomy and Physiology of Farm Animals by Rowen D. Frandson

Merck Veterinary Manual

ZUKU revie (most importantly)


Note: All the content included in this file has been arrange for my BCSE preparation &
most of the data is from ZUKU review & Merck Veterinary manual mainly. ZUKU review
covers around 40-45 % of the actual BCSE, therefore your previous knowledge about
Veterinary medicine and your understanding about the clinical situations matters a lot.

Number of questions from different Domains and sections for BCSE

1 Anatomy Anatomy 18-20

2 Pharmacology,

Physiology, and Pharmacology, physiology, and toxicology 28-32

Toxicology

3 Pathology Anatomic pathology, clinical pathology, and pathophysiology 20-23

4 Medicine Etiology, pathophysiology, diagnosis, and treatment 50-55

5 Anesthesia Anesthesia 20-23

6 Surgery Surgery 22-25

7 Diagnostics Diagnostic techniques and diagnostic imaging 22-25

8 Euthanasia, species appropriate behavior, abnormal animal behavior,

Animal Welfare pain assessment and management, signs of abuse, species specific 6-7

husbandry, and restraint techniques

9 Disease prevention, epidemiology, nutrition, public health, and regulatory


Preventive Medicine 14-15
programs

The computer-based BCSE consists of 225 questions that must be completed within a 220-
minute test session. The format of the BCSE questions consists of multiple-choice and
alternative formats, such as matching, drag-and-drop and hot spot. You should answer all of
the questions because your score will be based on the number of correct answers you mark
(one point for each question correct). No points will be deducted for wrong answers. Twenty-
five of the 225 questions will be pretest items and will not be scored. These additional
questions will be intermingled with scored questions. You will not be able to distinguish
between the two.

You can read all the details about ECFVG certification and BCSE framework from the below mention link.

ECFVG - Basic and Clinical Sciences Examination Candidate Bulletin | American Veterinary Medical Association
(avma.org)
Notes sections

I. Dentistry

II. Radiology

III. Physiology

IV. Clinical anatomy

V. Clinical pathology

VI. Pharmacology

VII. Anesthesiology

VIII. Toxicology

IX. Surgery

X. Medicine

XI. Preventive Veterinary Medicine


DENTISTRY
Periodontium: include the gum, the tooth root, cementum, the periodontal ligament (collagen fibers/ sharpe’s fiber)
(gingival, trans-septal, alveodental), and the alveolar bone of the jaw to which the ligaments attach.

Pulp: living tissue. Composed of odontoblasts and fibroblasts and is supplied by blood vessels, nerves, and lymphatics.

Enamel: Non-living structure that provides a physical barrier against bacteria. 96 % inorganic and the hardest part.

Dentin: provides a physical barrier against bacteria. 30 % organic.

Sulcus: crevice area between gum-line and neck of a tooth.

Sulcular fluid flushes the sulcus with substances with antimicrobial functions. (IG’s/Ab)

Gingivitis: inflammation of gum.

Crown: above the gum line. Epulis: general term for gingival mass.

Canine ameloblastoma: most common benign oral tumor dogs, sometimes referred to as epulis.

Wolf teeth: First premolars seen in the upper arcade of 20-60% of horses.

Tooth resorption: with time it will show the underling of the tooth.

Prognathism: mandible is longer than maxilla. (Bulldog, Brachycephalic)

Bachygnathism: maxilla is longer than mandible. (parrot mouth/overbite/overshot jaw)

Malocclusion: when the teeth are not properly aligned and wear in weird ways.

Buccal side: tooth that faces the cheek Lingual side: tooth that faces the tongue Labial surface: of the tooth is nearest
to lips. Gingival is the area of the tooth towards the gums. Occlusal: chewing surface. Palatal: roof of the mouth.

Crown formation dates for dogs & cats: primary teeth → day 42 gestation – day 15 postpartum

Permanent teeth: 2nd week to 3rd-month postpartum

Gingival depth: normal depth of gingival sulcus in cats is 0.5-1mm and in dogs 1- 3mm.

Fighting teeth: are the upper 3rd incisor and upper and lower canines present in llamas and alpacas. Grow over 3cm
in length. They should be ground down or removed upon eruption at 18-24 months.

Feline teeth: cats should have all 30 teeth by 7 months of age.

Dog teeth: the dog should have all 42 teeth by 7 months of age.

Ruminant teeth: Ruminants should have all 32 teeth by 32 months of age

Swine teeth: swine should have all 44 teeth by 20 months of age.

Needle teeth are the piglet’s deciduous third incisors and canines that are sometimes removed after birth.

Horse teeth: horse should have all 36-44 teeth by 5 years of age. Tooth 109 (first molar) is the first to erupt between
9-12 months of age.

DISEASES
Periodontal disease: approximately 80% of dogs and 70% of cats will have periodontal disease by 2-3 years of age. It
is a general term that includes gingivitis and periodontitis.

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Gingivitis: in cats gram-negative (mostly) and anaerobes play a significant role.

Retained deciduous tooth: remove soon as possible. Open approach if it is not loose or pull hard if it is loose.

Enamel hypoplasia is caused by trauma, systemic (fever, distemper), nutritional deficiencies (hypocalcemia), fluorosis,
tetracyclines, and hereditary (rare). In dogs is usually by distemper, in cattle by fluorosis.

Fluorosis is the major cause of bovine enamel hypoplasia.

Dental caries: uncommon in dogs and rare in cats. Differences in oral flora from humans. Diets are free of easily
fermentable carbohydrates. Dogs have slightly alkaline saliva.

Feline Odontoclastic resorptive lesions (FORL): also known as neck lesions. Tooth material resorbed around the neck
of a tooth. Infectious. Cause unknown.

Sinusitis: usually due to tooth root infections of caudal 4 maxillary teeth (4th PM, 1-3 M).

Tooth abscessed: usually happens in upper 4TH premolars in dogs. (Carnassial tooth root abscess)

Gingival hyperplasia: (firm tissue) can be idiopathic, or drug induced. Occurs due to alteration of calcium influx in
gingival tissues. Rx is removal.

Calcium channel blockers, antiarrhythmic, immunosuppressant, phenytoin in cats.

INSTRUMENTS
Periodontal probe: is blunt and is used to gently measure the depth of the gingival sulcus.

Spot probing Circumferential


Inserting & withdrawing probe at a single area per tooth. Inserting probe in sulcus or pocket in at least 4 places.

SCALERS

Sonic dental scalers Piezoelectric scalers Magnetostrictive


No heat build up Least traumatic More frequency.
Do not apply more than 5 seconds But builds up heat Heat build-up
Less frequency Cause damage to tooth enamel if directed at 90-
Made up of ceramic disc degree.
Less fragile & made up of thin metal strips
Most used

Hand Scalers have 2 parallel sharp sides, used for supragingival calculus removal.

Curette scaler: has one sharp side and is used for subgingival calculus removal.

Ultrasonic scaler: remove light to moderate calculus above the gum line.

Shepherd hook: has a sharp tip and is used to detect cavities and broken teeth.

Extraction forceps: best to remove teeth or heavy calculus.

Alginate is used to make an impression of the teeth. Only apply alginate to clean teeth. Choose an appropriately sized
dental tray and fill it with alginate to produce a negative impression of the entire mouth. A final positive image is made
using dental stone.

Elevators & Luxators loosen the teeth.

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Dental explorers have a sharp tip and examine the tooth for surface irregularities, calculus, resorption, necrotic
cementum & mobility.

Metal crowns are used in working dogs (Canine & 4th PM)

Radiographic techniques
Parallel Bisecting Occlusal
used for mandibular premolars and For all teeth except mandibular evaluate nasal disease and identify
molars due to rostral symphysis of premolars & 3rd & 4th Molar. tooth remnants.
mandible and adjacent place of the minimizes the image distortion that
maxilla. occurs because of an inability to
place the x-ray film parallel to the Least used
central axis of a tooth.
If not used tooth appear artificially
foreshortened or elongated.
The beam is directed at a right angle Used when paralleling is not The film is placed on the occlusal
to a film that is placed intraorally possible. plane and the beam is directed at the
parallel to the long axis of the tooth. The beam is directed at a right angle right angle towards it.
to an imaginary line that bisects the
angle formed by the long axis of
teeth and plane of the film.

Endodontic: root canal treatment. Canine teeth are the most common site. Teeth become more brittle. Only dogs &
cats older than 12 months can undergo this procedure as the apex does not close until 10-18 months of age.

Exodontic is the extraction of diseased teeth.

Role of polishing in veterinary dentistry


Plaque: soft biofilm (retentive). Calculus is mineralized plaque (honeycomb-like structure)

Benefits Aims of polishing

• Teeth fully visible to operate • Smooth tooth surface


• Decrease plaque biofilm • Disrupt plaque biofilm
• Smooth enamel easily cleaned • Decrease surface area by scratching
• Water spray irrigation and debris removed

Tooth eruption
Occlusal surface: Eliptical> trapezoid > round > triangular (as the age increases)

Arch: Semicircular > straight line (as the age increases)

The angle between upper & lower incisors: Acute (as the age increases)

Glavayne,s groove

Permanent tooth eruption in Horses


Incisor 1 2.5 years
Incisor 2 2-3.5 years
Incisor 3 3-4.5 years
Canine 4-5 years

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Modified Triadan system

The modified Triadan system provides a consistent method of


numbering teeth across different animal species. The system is
based on the permanent dentition of the pig, which has 11 teeth
in each quadrant - three incisors, one canine, four premolars,
and three molars. The grand total is 44 teeth.

• Central incisor is always 01


• The canines are always 04
• 1st molar is always 09
• Premolars are 5-8, Last PM is 08

DENTAL FORMULAS

Species Deciduous Permanent


I C PM M TOTAL I C PM M TOTAL
Horse 3 0 3 24 3 1 3-4 3 42
3 0 3 3 1 3 3

Cow/ Sheep/ 0 0 3 20 0 1 3 3 32
Goat 3 1 3 3 1 3 3

Pig 3 1 3 28 3 1 4 3 44
3 1 3 3 1 4 3

Dog 3 1 3 28 3 1 4 2 42
3 1 3 3 1 4 3

Cat 3 1 3 26 3 1 3 1 30
3 1 2 3 1 2 1

Tooth resorption
Occurs by odontoclasts (cells like osteoclasts)

Stimulated by inflammation, pressure, orthodontic tooth


movement, idiopathic (cats Vit D deficiency).

Dogs- mandibular third PM

Cats- PM & Molars

Rx: Tooth extraction

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Oral Tumors in small animals
DOG CATS
I. Malignant melanoma (most common) I. Squamous cell carcinoma (gingiva+ tongue) (most
nd
II. Squamous cell carcinoma (2 ) common)
III. Fibrosarcoma II. Fibrosarcoma
III. Malignant melanoma

Clinical Signs: Halitosis, reluctant to eat, hypersalivation, swollen regional lymph nodes

Benign
Peripheral odontogenic fibromas/fibromatous epulis/ ossifying epulis

The most common benign tumor. More prone- Dogs > 6 years. Arise from periodontal ligaments. Not metastasize.

Canine acanthomatous ameloblastoma/ acanthomatus epulis

(most common benign oral tumor in dogs) Surgical excision 1cm healthy tissue. Ameloblastoma is a tumor of the
periodontal ligament. Familial gingival hypertrophy is a predisposition to benign gingival overgrowth that may exist
in brachycephalic breed dogs.

Diagnosis:

Biopsy, Cytologic diagnosis, Histologic dx

• Malignant melanoma =>vary in appearance( pigmented or not)


• Squamous cell carcinoma=> gingiva + palatine tonsil (unilateral)
• Lymphosarcoma => Bilaterally enlarged tonsils

TREATMENT: Surgery chemo

• Nontonsillar squamous cells carcinoma => prognosis is good


• Tonsillar squamous cells carcinoma => poor prognosis
• Fibrosarcoma => Guarded Prognosis

Local Anesthesia for dental procedures


The mandibular foramen is used for infiltration of local anesthetic blocks in the lower jaw.

The infraorbital foramen is used to help block the upper jaw

For 50-pound dog => 0.5 ml volume ( 0.1 ml cats)

o Foramen ovale: fetal heart.


o Apical foramen: tip of tooth root.
o Transverse foramen: an opening in cervical vertebrae…which artery enters
o Obturator foramen: crested where ischium and pubis come together.
o Vertebral foramen: formed by the body of vertebrae in the vertebral arch
o Sacral foramen: where sacral nerves pass through the sacrum.
o Greater sciatic foramen: found in pelvis.
o Panizza foramen: hole connecting two aortas after they leave the heart in crocodile.
o Omental foramen: connecting opening between greater sacs lesser soc in abdominal cavity.

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RADIOLOGY
RESTRAINTS
MANUAL MECHANICAL CHEMICAL
Tech or Vet hands Foam wedges, V/ U troughs Tranquilizers
Sandbags, Wooden spoons
Tape & Gauzes

Radiation safety: Time, distance, and shielding. Short time, distance from the x-ray source and patients, and shielding
by using the proper gloves, thyroid protectors, and aprons. (Bucky tray & collimation). Air blocks alpha, plastic stops
beta radiations.

Maximum permissible dose: expressed in silvert units (SV). 0.05 SV/ Year. (5rems= 0.05 SV)

ALAR stands for as low as reasonably achievable & refers to the level of occupational radiation exposure.

As the minimum radiography, all led protective devices once a year (annually) to look for any breaks in the lead
protection or any areas of wear that would minimize the efficiency. Gowns should never be folded as this can crack
lead protection. They may be rolled for transport. Gowns should be hung between uses and gloves should be stored
open so that the lead does not become cracked ( plus this helps minimize smell in the gloves

Focal film distance (FFD) is the distance between the tungsten target &
surface of the x-ray detector.

FFD influence many factors

• x-ray beam intensity


• image details

The absorbed dose of ionizing radiation by a unit mass of irradiated


material is measured in GRAY (Gy)

Key components of x-ray exposure include focal-film distance, Milliampere-seconds, and kilovoltage. X-ray films
should be stored at a vertical position, in a cold room with low humidity.

Radiographic density from the least dense to most dense: air, fat, water, bone, and metal.

An increase in distance between the film and x-ray source decreases the x-ray intensity by a factor of four.

Milliampere-seconds: Milliampere multiplied by the time. Example: 300milliamperes for 1/20th of second.
Milliampere-seconds equal: 300 * (1/20) = 15mAs

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Kilovoltage (kV): has the greatest influence on radiographic contrast. Controls the penetrability of the x-ray. (HIGHER
the kVp --- LOWER the contrast)

Overexposed radiograph (very dark): occur if milliampere-seconds (mAs) or kilovoltage (kV) are set to high or if the
speed of an intensifying screen is too fast. (Also, by incorrect measurement of body part thickness or too short a focal
distance from x-ray tube to the patient.)

overexposed radiography, it has too much exposure to the x-ray, and it will be darker. The patient body stops some x-
rays from penetrating all the way to the x-ray film which lies under the patient, then the underlying film will be whiter
paler lighter. when there is nobody, radiography will be darker or blocked because x-ray penetrates and expose film
without any tissue to stop them.

Underexposed radiograph (very light): long distance between the x-ray tube to the patients, low mAs, or low kV. Soft
Tissue x-ray: lower kVp and higher mAs setting. That is due to the relatively low contrast between viscera and adipose
tissue.

Thorax x-ray: high kVp

Bone x-ray: lower kVp and higher mAs setting.

Blurring: might be caused by poor film-screen contact, patient movement or poor centering of the primary x-ray beam.
To minimize blurring use high mAs and low time.

Distortion: if the distance between the object and the film is increased

Magnification: if the distance between the x-ray source and the film is increased.

Black Spots: appear if the developer solution falls on an undeveloped x-ray film.

White Spots: appear on developed film from defective cassette screens and the presence of dust or grit on the film
surface.

Grey Films: too much scatter or if the light is turned on while undeveloped films are out.

Yellow film: if the fixation is too short or if the fixer solution is exhausted.

Tree pattern (linear dots): caused by static electricity production due to low humidity.

Radiographic Landmarks: of the left side include gas bubbles in the stomach fundus, caudal kidney, descending colon,
and the apex of the heart.

Anticlinal vertebra: anatomical landmark usually at T11 in dogs where the spinous process is upright or vertical. It is
the vertebra where the incline of the spinous process changes from caudal to cranial pointing.

Hair clip: this should be done to decrease ultrasound reflection because hair traps air.

Fluoroscopy: use to evaluate dynamic processes and moving structures, such as regurgitation, tracheal collapse,
esophageal motility, myelography, CVS studies, fracture reductions, catheter/stent placement.

Screen films are not very sensitive to x-rays (but are sensitive to visible light) and require SHORT exposure time than
non-screening films.

Non-screen films require LONG exposure times and produce radiographs with superb detail being great for dental
studies. They are sensitive to X-rays!

Digital radiography (DR): systems are divided into direct and indirect systems. Direct DR has no light intermediate and
x-rays are directly converted. Indirect DR, the X-ray results in a light flash from a scintillation plate that is then
registered into an electrical signal.

Developing order: developing solution, rinse baths, fixer, and wash bath.

Developing solution: converts silver halide crystals exposed to x-rays in the film to black metallic silver.
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First, wash bath: Stop the film developing process

Second wash bath: prevent contamination of the fixer.

Fixer solution: removes and cleans away the unexposed silver crystals and hardens the film. The film should soak in
the fixer bath for twice as long as it was in the developer.

Wash bath: removes processing chemicals from the film and prevents film discoloration.

Potter Bucky Grid: diaphragm is a moveable x-ray grid. When using it increase the kVp by 20% or increase exposure
by a factor of 4.

Grid: like the focusing in a camera. A high-ratio grid permits fewer x-rays to pass through it from the animal and fewer
x-rays reach the film needing longer exposure time, but you get a better (high resolution) radiograph. Should always
be used in thicker tissue (>10cm thick).

Collimator: beam-restricting device that decreases the production of scatter radiation. It improves safety and image
quality.

Low voltage electrical circuits: provide the electricity needed to heat the filament.

Glass and aluminum filters: removes less-energetic x-ray from primary beam

Intensifying screen: decrease the amount of radiation needed for a diagnostic radiograph.

Stationary anodes are used for dental units. They have smaller capacity for x-ray production as compared to rotating
anodes so not useful for large body parts.

MYELOGRAPHY: It is used to diagnose the spine and spinal cord.

MAGNETIC RESONANCE IMAGING(MRI): Preferred imaging modify for the brain to the spinal cord. With MRI a
radiography pulse disrupts hydrogen nuclei within tissues. The intensity of radio waves signal produced from this
disruption creates the image. MRI requires no ionizing radiation to create an image. Also, MRI provides superior
image resolution and anatomic definition compared to CT. Also, MRI provides superior image resolution and anatomic
definition compared to CT. Like COMPUTED TOMOGRAPHY (CT), MRI provides a cross-sectional image of the patient's
anatomy.

CT : X-ray beam passes transaxially through a small segment of patient; an image is created by measuring x-ray
attenuation (drop off) at sequential sites b. compare construct data and show image.

It is best for imaging the internal architecture of the nasal cavity. It is also useful for the throat, abdomen, vasculature
and musculoskeletal system.

DIGITAL RADIOGRAPHY: A specialized detector panel converts x-ray into electrical signals; an analog image is created
which is digitalized. image display on a computer screen can be enhanced with magnification rotation and adjustment
in brightness contrast and zoom.

Computed radiography uses a photostimulable storage phosphor (not the film) in a protective cassette that is then
electronically read.

Digital imaging & communication in medicine (DICOM) is a universal digital image that allows sharing of electronic
images with hospitals, specialists. (teleradiography)

Digital images are stored on a remote HARD DRIVE called PICTURE ARCHIVAL COMPUTING SYSTEM.

Nuclear Medicine: Technetium 99 (radionuclide) is administered to a patient; photon emission is defected and
recorded with a gamma scintillation camera. Used to detect tumor metastasis of bones so-called Bone scan. It is useful
to locate bone lesions, pulmonary emboli, thyroid evaluation, kidney & lung function.

Focused assessment with sonography for trauma (FAST): Dx thoracic trauma in dogs & cats.

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ULTRASONOGRAPHY: The transducer emits a short pulse of sound into the patient. when this wave hits the echogenic
structure, some of the waves are reflected back to the transducer and create the image. strength of sound reflected
determines the brightness.

Doppler ultrasounds are used to visualize moving structures.it can be used to determine cardiac outflow or
regurgitation, presence or absence of vascular thrombi, and detection of portal vascular anomalies. Doppler emits
ultrasonic waves from a piezoelectric crystal in the probe and is placed over the peripheral artery.

Ultrasound mode: A mode is for one-dimensional display and shows in echoes as spikes on-screen (amplitude mode).
B mode brightness mode or 2-dimensional imaging. M mode ultrasonography the motion of the organs is displayed as
a wave line across the screen is used for echocardiography.

Linear array ultrasound probe for rectal palpation.

Anechoic or sonolucent: structures that produce few or no echoes. Both are dark on ultrasound.

Echogenic or sonodense: structures produce strong echoes, so these are bright on the ultrasonic image. Hyperechoic:
the structure that produces more echoes than nearby structures.

Hypoechoic: structure that produce fewer echoes than nearby structures.

Through transmission (Acoustic enhancement): when the ultrasound hits non-attenuating structures. Usually
happens in the gallbladder.

Reverberation artifact (Comet tail): occurs when ultrasound meets strong reflector like gas, usually in lungs or bone.
Shadowing: occurs when ultrasound hits highly reflective structures like uroliths.

Radiolucent: means clear and appears black in the radiograph. Air is radiolucent.

Radiopaque positive contrast media: Barium and iodine. Appear white in the radiograph.

CONTRAST MEDIA
Soluble ionic organic iodides soluble nonionic Insoluble inert Radiolucent gases
radiopaque radiopaque
Examples iothalamate, diatrizoate lohexol, iotolan, barium sulfate nitrous oxide, air, and
and iopamidol carbon dioxide
USES • gastrointestinal studies Myelograms Gastrointestinal • cystograms
• intravascularly Blood vessels motility studies. • Gastrograms.
• in joints, the Fistulography
• urinary tract Salivary ducts
• abdomen Urinary tract
• wounds
• salivary ducts.
Not used intrathecally for myelography. Can cause aspiration
pneumonia

Bronchial pattern: irregularly thickened walls of bronchioles that look like donuts. End-on bronchioles are normal in
the hilar region unless there is an abnormal thickening of bronchiole walls.

Interstitial pattern: decreased visualization of pulmonary vessels, cardiac and diaphragm silhouettes.

Alveolar pattern: air bronchograms.

Vascular pattern: this can suggest either hypervascularity or hypervascularity.

Hypovolemia: the heart is small and lifted off the sternum. The pulmonary vasculature, as well as the aorta and caudal
vena cava, may also be reduced in size. The lungs will also appear darker.

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Pneumothorax: notice dark airspace below the lungs, between them and the chest wall. The heart is not touching the
sternum. Decreased to absent lung sounds are also characteristic. Aspiration pneumonia: radiographic changes in
dependent lung fields (cranio-ventral).

Heartworm: Radiographically, look for right ventricular enlargement and bulging of the main pulmonary artery. The
pulmonary knob sign in the VD view is present in 60-70% of cases. A severe case may exhibit the “reverse D” signs on
the VD view.

Peritoneal effusion: distended abdomen with poor peritoneal detail throughout the abdomen.

Foreign body: multiple loops of enlarged small intestine associated with loops filled with gas and fluid.

Linear foreign body: plicated loops of bowels with eccentric comma-shaped gas bubbles.

Ringbone: is exostosis (bone growth) in the pastern or coffin joint of a horse, associated with periostitis and
osteoarthritis. High ringbone occurs on the lower part of the large pastern bone or the upper part of the small pastern
bone. The low ringbone occurs on the lower part of the small pastern bone or the upper part of the coffin bone. Low
ringbone is harder to see as it occurs in the hoof of the horse.

Wobbler syndrome/ cervical vertebral instability/ caudal cervical spondylomyelopaty

Cervical vertebral canal stenosis (congenital). Dx by myelography.

Cortical Stress Fracture: Common in young racing horses. Treatment is screw fixation (+/- osteostixis).

Hemivertebra: a wedge-shaped vertebra, which can be an asymptomatic finding or may present with scoliosis,
kyphosis, paresis, and ataxia. Typically, thoracic.

Avascular/Aseptic necrosis of the femoral head (Legg Perthes):

Salter-Harris: fractures involving the physis (growth plate).

S I Straight Fracture straight across cartilage of physis. Also known as capital physeal fracture.
A II Above Fracture above physis
L III Lower Fracture below physis in the epiphysis
T IV Through Fracture through metaphysis, physis and epiphysis
R V Rammed Crushed physis

Planking artifact: overexposure or plate saturation results in linear striations in the background of the image.

Uberschwinger artifact results in a lucent halo around metal implants. This can be mistaken for bone lysis around
metal implants.

Severe underexposure results in grainy appearance also called “noise” or “quantum mottle”.

Improper use of heel effect will result in the non-uniform appearance of the image. Heel effect occurs when the x-ray
beam is more intense at cathode than anode side, resulting in uneven x-ray photo distribution.

Overexposure causes the disappearance of soft tissues surrounding bones.

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Foreshortening artifacts: structures being radiographed is not in contact with table causing structures to appear
shorten than actual size.

Elongation artifacts occur when the beam is not centered.

Gridlines occur if the lead strip in the grid is too thick.

Ghost image occurs while taking the 2nd radiograph after 1st that required high exposure.

RADIOGRAPHIC POSITIONINGS
Shoulder joint To allow its full visualization, the top leg needs to be rotated out of the field of view so that it
is not superimposed over the area of interest. The affected leg is down closest to the tabletop.
Chest Foreleg elbows can be superimposed over the lateral views of the heart, extend the foreleg
forward to allow better chest visualization.
Lateral spinal film It is important to remove all rotation of the chest wall, either by use of positioning aids.
Long bones Also, include joints proximal and distal to the bone of interest.
The tabletop technique can be used for limbs in small animals because they tend to be less
than 10 cm thick.
Cat Thoracic Caudal to border of scapula
radiograph Center beam at 5th & 6th rib
The caudal border of the film should be the L1 vertebral body.
Lateral pelvic Measure (midline over acetabulum)
radiograph Center beam (caudal portion of pubis)
Heart DV & R-Lateral
DV place heart closet to film
Small animals R-Lateral is preferred.
Metastasis 3 views.
R-LATERAL, L-LATERAL, VS/DV

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PAIN
Nociception: is the physiological mechanism in pain perception.
First order neuron: are sensory neurons that receive signals transform them into electric impulse and transmit to
spinal cord.
In spinal cord signal is passed to INTERNEURONS for amplification.
2nd order neuron: receive signal from peripheral nerves and transmit to brain.
In Thalamus signal meets 3rd order neuron that projects into cerebral cortex for perception & response to pain.
STEPS NAME PARTS INVOLVED Types
1 Transduction nerve ending Alpha delta & C Noxious/ painful stimuli
Alpha beta Non noxious stimuli
Alpha alpha Skeletal muscles
B fibers such as ANS
Ruffini’s (stretch),
Meissener’s
(vibration and
motion), Pacini’s
corpuscles
(vibration) and
Merkel’s disks (light
pressure)
2 Transmission nerve body
3 Modulation dorsal horn of the spinal cord
(Substance P helps in pain transmission in dorsal horn of spinal cord)
4 Projection thalamus and brainstem
5 Perception cerebral cortex
Neuropathic pain: Caused by damage to neural tissue and is usually present in chronic cases of pain.
Example: Horse with chronic laminitis
You can use gabapentin to treat NP.
Side effects of Gabapentin: Sleepiness. It contains xylitol and cause hypoglycemia and seizures.
Pathologic pain: response that is heightened beyond that needed to protect the patient from injury.
Physiologic pain: Protective response to an actual or potentially damaging insult. Also called nociceptive pain.
Visceral pain: Stretching, tension or inflammation of viscera.
Wind up: Sensibilization of nociceptors and pain pathways in response to intense bombardment of painful sensory
impulses in the phenomenon of Wind-up, which greatly amplifies the pain response. NMDA receptors in the spinal
cord are activated in the wind-up phenomenon. Ketamine, an NMDA receptor antagonist, is used to help prevent
the development of wind-up. Other NMDA antagonists include methadone, amantadine, and dextromethorphan.

How much an animal should eat? Basic Energy Requirement (BER) Formula: Kcal/day= (30× body weight in kg) + 70.
The metabolic requirement of a severely burned animal can increase substantially, so multiply BER by 2.

Cation has positive charge and Anion is a negative charge.

Stances
Plantigrade Digitigrade Unguligrade
Humans, bears, rabbits, kangaroos, animals are many carnivores and animals have hooves - cows, deer,
raccoons, mice, opossums, pandas, birds - dogs, cats, wolves, foxes, horses, pigs, hippos, giraffes; walk
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and others stand and walk in a many birds; all of these walks on all on the tips of the toes or hooves, on
plantigrade fashion, on the bottom of their phalanges/toes. the last phalanx; except for
of their entire foot, from phalanges, camelids, a variation of ungulates,
metatarsal/metacarpal bones, tarsal that walk on their second and third
bones/calcaneus, or heel bone. phalanges.
These are 'flat-footed' animals. The
calcaneus and tarsal bones= the hock
in other animals that walk on their
toes.
An abnormal plantigrade posture is seen in patients with injury to the Achilles, injury to the gastrocnemius
muscle(s), weakness from nutritional myopathy or neurologic disease, and in cats with diabetic neuropathy.

Aborally means moving away from the mouth.

Staphylococcus Aureus and some Corynebacterium are normal flora of the skin and mucous membranes.
Enterobacter spp. are normal flora of the gastrointestinal tract.

Germ Layers
Ectoderm Mesoderm Endoderm
forms the nervous system, tooth Forms the circulatory, skeletal, gives rise to the epithelium (tissue
enamel, posterior portion of the muscular, and urinary systems. Gives that covers, or lines, a structure) of
vagina, vestibule, epidermis, linings rise to connective tissue, anterior the pharynx, the larynx, endocrine
of mouth, anus, and nostril, sweat portion of the vagina, notochord, organs, trachea, lungs, the
glands, hair, and nails (hooves). The blood, bone marrow, lymphoid gastrointestinal tract (except mouth
adrenal gland if formed from the tissue, lymphatic vessels, body and anus), liver, the urinary bladder,
Rathke’s pouch. cavities, gonads (sex organs), genital and the urethra.
ducts and adrenal cortex.

Nucleus: transcribes DNA


Nucleolus: transcribes RNA
Rough endoplasmic reticulum (RER): used ribosomes to synthesized proteins.
Smooth endoplasmic reticulum (SER): produced lipids and steroids Golgi apparatus: processes proteins
produced by the RER and lipids by the SER for secretion.
Sarcoplasmic reticulum: stores and pumps calcium ions to initiate muscular contraction.
Mitochondria: produces adenosine triphosphate (ATP)
Plasmin: enzyme that breaks down fibrin through fibrinolysis.
The end product of the clotting cascade is Fibrin.
Histiocytes are associated with connective tissue.
Kupffer cells are associated with liver.
Osteoclasts are associated with bones.
Fimbria is for bacterial attachment and flagella for bacterial motility.
Osteocytes are found within lacunae of mature bone and are derived from osteoblasts.

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First heart sound and is made by the closure of the atrioventricular valves, the mitral valve (left side) and tricuspid
valve (right side). Second heart sound is made by the closure of the semilunar valves the aortic (left side) and pulmonic
valves (right side). Systole is the period of contraction of the ventricles of the heart that occurs between the first and
second heart sounds of the cardiac cycle. Diastole is the refilling of the heart with blood after the cardiac cycle. In
horses you can hear S3 and S4. S3 is the rush of ventricular filling and S4 is atrial systole (atrial contraction).

Conductivity of the heart works: SA node → AV node → Bundle of his → Purkinje fibers → ventricles. SA node
(cardiac pacemaker cells) is located in the right atrium near the entrance of the cranial vena cava. The Atrioventricular
node and the bundle of his are in the ventricular septum. The Purkinje cells are in the ventricles.

Heart structures include: 1. Left ventricle 2. Coronary artery 3. Right ventricle 4. Right
atrium, 5. Pulmonary trunk, 6. Arterial ligament (remnant of the fetal ductus arteriosus), 7.
Aortic Arch, 9. Brachiocephalic trunk, 10. Right atrium auricle, 11. Left atrium auricle, 13.
Pulmonary veins.

Cardiac muscle: exhibits automaticity, excitability, refractoriness, conductivity, and


contractility.

The ECG records the difference in surface electrical activity that is present between the electrodes selected over
time. The graphic display shows the variation in activity as cardiac contraction proceeds.

ECG leads: White on the right arm, green on the right leg, black on the left arm and red on left leg. Hint: White on right
and smoke (black) over fire (red) / Snow (white) over grass (green). The dog should be places in right lateral
recumbency, white the proximal limbs mostly perpendicular to the body. Ideally, the patient is relaxing and quiet.

Lead II: compares right arm (-) to left rear (+) and is commonly used for dogs, cats, avian and small exotics species.
Usually used 3 leads (red, black, and white)

Base-apex: usually done in horses, bovines, and caprine patients. Right arm is attached to the skin at the dorsum of
the base of the neck just cranial to the scapula and withers, left arm is attached on the chest just caudal to the point
of the elbow (about the 5th intercostal space), and the left leg is attached at the stifle region.

Atrial natriuretic peptides cause sodium wasting (natriuresis) and diuresis.

P wave is atrial depolarization and is usually biphasic in a horse. T wave is ventricular repolarization. A wave represents
the repolarization period of the atria and can only be seen in horses.

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ST segment Myocardial hypoxia will show depression or elevation of ST segment.

ECG 60 cycle interference: is a common problem especially in operating room.


The baseline cycles up and down at 60x per second.

Electrical alternans: is the alternating high and low amplitude R waves that is
caused by a swinging motion of the heart whiting the pericardial effusion.

Equine purkinje fiber are not located on the epicardial surface of the heart, they are very diffusely branched and
embedded into the myocardium. This produced a simultaneous (almost) contraction of ventricles. Therefore, the leads
need to be very close to the heart to capture the difference.

Mean arterial pressure is the average pressure found in the arterial system and thus corresponds most closely to
tissue blood flow and perfusion. Important to monitor anesthetized and critical care patients.

Diastolic pressure is important for coronary perfusion because blood flow into the cardiac vessels occurs primarily
between contraction during diastole. Calcium channel blockers are antiarrhythmic and have a negative inotropic
effect.

Vasoconstriction triggered by Alfa 1 stimulation, while vasodilation is triggered by Beta 1 stimulation. In addition, the
increase HR and myocardial contractility results from stimulation of Beta 1 receptors.

Sinus arrhythmias is normal in dogs and horses, abnormal in cats. Heart and pulse rate increase slightly with
inspiration and decrease slightly with expiration. In cats it is due to high vagal tone due to CVS, CNS, respiratory
diseases.

Bradycardia, markedly slower during expiration, is normal in brachycephalic breeds.

In newborn horses heart rate and continuous murmur on left side are normal due to slight opening of the ductus
arteriosus which usually closes within first 4-5 days.

Heart rate: number of beats of heart per minute. In a healthy animal is the same number as the pulse rate.

Cat 120–140 Dog 70–120 Chicken (adult) 250–300 Dairy cow 48–84 Horse 28–40 Ox 36–60 Pig 70–120

Pulse rate: number of palpable or visible arterial waves per minute.

Carotid and aortic bodies are chemoreceptors organs that measure changes in carbon dioxide, oxygen content and
pH of blood. They are sensitive barometers that help regulate respiration and circulation. Sometimes they develop
tumors called Chemodectomas.

Second degree av block is common in horses and is causes by high vagal tone in horses. It disappears when the
sympathetic system kicks in.

Alternating bradycardia and tachycardia are seen with Sick Sinus Syndrome (SSS).

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High protein diet: increase renal blood flow

Kidney: hold 20% of the body blood every minute. Only after 70% loss of kidney function that we will have changes in
the lab work. That is also true for liver function.

Renal pelvis: funnel shaped tube surrounded by smooth muscle that used peristalsis to move urine out of the kidney,
into the ureter and to the bladder.

Nephron: function unit of the kidney composed of glomerulus, proximal convoluted tubule, loop of Henle, distal
convoluted tubule and collecting tubule.

Glomerulus filters fluid and solute materials from blood. Red blood cells and proteins do not pass, and they
leave by the paratubular capillaries (vasa recta). All the filtrate is collected Bowman’s capsule (Glomerular
capsule). Glomerular filtration rate is the amount of filtrate the glomerulus can handle.
Proximal convoluted tubule does the bulk reabsorption of filtered water, solutes (Na, CL, HCO3, glucose,
amino acids) back to the blood. Carbonic anhydrase inhibitor act here!
Loop of Henle creates and maintains the renal medullary hypertonicity gradient so it can absorb water.
Furosemide acts here.
Distal convoluted tubule helps regulate pH, Na and Cl reabsorption and dilution of tubule fluid. Thiazide
diuretics and aldosterone acts here.
Collecting tubule/duct does the final regulation of water, urea, and acid excretion.

Medullary collecting duct is the part of the nephron that comes after the distal convoluted tubule and takes urine to
the ureter.

Collecting ducks regulate water, urea, and acid excretion.

Renal tubular threshold for glucose is higher in cats compared to dogs.


Cat: 240 mg/dl (13,3 mmol/L), Dog: 180 mg/dl (9.9 mmol/L)

Ureter: contain smooth muscle that do peristalsis and push the urine to the bladder.

Bladder is made of 3 layers: inner mucosa, detrusor muscle and outer membrane.

Internal ureteral sphincter is control by the autonomic nervous system. External urethral sphincter is made of skeletal
muscle and controlled voluntarily.

Urethra is the canal where urine passes to leave the body. Hypospadias is abnormal placement of the urethral opening
ventral and caudal to the normal position.

Pontine storage area (inhibits urination) and Pontine micturition center (giver green light).

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Buccal cavity: lips, tongue, teeth, salivary glands (Mandibular, Parotid and sublingual), hard palate, soft palate, and
oropharynx. Occlusal surface: where the teeth touch. Esophagus: the cardia is the sphincter that separates the
esophagus from the stomach. Cardia is too strong in horses and rabbits that is why they do not vomit.

Stomach is divided in 5 areas: cardia, fundus, body, pyloric antrum, and pylorus. Fundus is distensible blind pouch.
Fundus has the gastric glands that have parietal cells, chief cells, and mucous cells. Gastric pits are invaginations of the
glandular gastric mucosa that are lines by columnar, surface mucous cells. Parietal cells secrete hydrochloric acid, Chief
cells secrete pepsinogen and chymosin and mucous cells secrete mucous. Pyloric antrum contains the G cells that
secrete gastrin that can increase the production of HCl and inhibit muscle activity of the fundus. Pylorus is a muscular
sphincter that regulates the movement of chime from the stomach into the duodenum and it prevents back flow.

Mixing of the food is done by fundus and body relaxing while the body contracts, creating the chime. The movements
are propulsion (fund us to pylorus), grinding and retropulsion (a little bit of chime to the duodenum and the rest goes
back to the stomach). Stomach contains mucosal layer, submucosa, muscular layer (longitudinal and circular) and
outer serosa layer. Parasympathetic stimulation causes the fundus to relax and increase contraction of the antrum.
Sympathetic stimulation decreases motility. The outside layer of the ruminant compartments of stomach looks
different, the reticulum is honeycomb, rumen is papillae (side image), and omasum is lamina. Rumen and reticulum
absorb volatile fatty acids. Newborn calves produce renin in their abomasum. Renin is responsible to clothing the milk
and decreasing transit time.

Small intestine is divided in duodenum, jejunum, and ileum. The intestine has inner mucosal layer, submucosal
layer, muscular layer, and outer serosal layer. The mucosa has a lot of villus that contain many microvilli. In between
villus that are crypts that produce new cells and contain Globet cells (shown in the arrow) that produce mucous. In
the duodenum there are crypts of Lieberkühn.

Peristalsis is circular muscle contraction that push it down and is controlled by the myoenteric plexus. Segmental
contraction mixes intestinal content with enzymes. Water, electrolytes, and vitamins are absorbed intact across the
small intestine. Starch is converted into disaccharides by pancreatic amylase. Disaccharides are further digested by
microvilli enzymes resulting in monosaccharides that are absorbed. Protein is partially break by pepsin into
polypeptides and in the duodenum the pancreatic proteases (trypsin, chymotrypsin, elastase, aminopeptidase, and
carboxypeptidase) will partially digest the polypeptides. The proteases from the microvilli will further digest the
peptides into amino acids or dipeptides that will be absorbed. Fat digestion is done by the bile acids that will coat tinny
droplets of fat that then the pancreatic lipase can work to produce glycerol, fatty acids and monglycerides. The
droplets are break into micelles that will be transported to the lymphatic system by the quilomicrons. The image shows
the Duodenum, Jejunum, and Ileum.

Ileocecal sphincter separates the ileum from the cecum. The large intestine is responsible for absorption of water and
electrolyte. The rectum will store small amount of feces. The cecum in equines is responsible for further digestion of
cellulose by microbes.

In birds the GI tract is a little different. It starts in the crop (esophagus), proventriculus (glandular stomach),
ventriculus (gizzard) and bursa of Fabricius (near the cloaca). The crop is a diverticulum of the esophagus used for
temporary feed storage. The ventriculus (gizzard) is a muscular stomach that contains grit and small rocks and helps
the bird grind up hard seeds. The bursa of Fabricius is a dorsal diverticulum of the cloaca and is the side of
Hematopoiesis and B-cell maturation.

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Microscopic characteristics: 1. Motility (decreases quickly, so is the first one to evaluate). Sperm should be kept at 37
Celsius to avoid cold shock that affect motility.

o Gonadotropin release hormone (GnRH): secreted by the brain and starts the estrous cycle.
o Follicle-stimulating hormone (FSH): acts on Sertoli cells in the testis to increase division of primordial
sperm cells and release more sperm cells. FSH also triggers ovule formation and maturation in females.
o Luteinizing hormone (LH): release from the anterior pituitary and stimulates testosterone production
by Leydig cells. Trigger ovulation in female birds by stimulation of the graafian follicle.
o Prostaglandins: are luteolytic and terminate a mature corpus luteum, which can lead to estrus or
termination of a pregnancy. To Lise a CL you can use Fluprostenol or LutalyseA (prostaglanding F2 alpha)
o Progesterone: inhibits contraction of uterus and generally supports healthy pregnancy. Inhibits milk
production during pregnancy. It inhibits the WBC response to bacteria in the endometrium, promotes
endometrial hyperplasia and accumulation of uterine secretions producing a good environment for bacteria
to grow leading to pyometra.
o Estrogen: dilate and relax the cervix before labor.
o Oxytocin: promoted milk letdown in a lactating animal and promotes uterine contractions.

cats, rabbits, ferrets, mink, and South American camelids (llamas, alpacas, vicunas,
guanacos).
Gestation
Species Length Estrous Cycle and Comments Placentation
(days)
Unseasonally monoestrous and cycle once every 6-7months. Estrus in dogs lasts Zonary and
Canine 62-64
9 days. endotheliochorial
Seasonally polyestrous and induced ovulators.Estrus lasts from 6-7 days Zonary and
Feline 65
(range 1-10 days). endotheliochorial
Unseason polyestrus. Cycle every 21 days. Estrus lasts 2-3 days. Guilts (young Diffuse and
Swine 114 female pig that did not give birth) and sow (adult pig). Epitheliochorial
Have grape like ovary with 10-20 follicles.
279 (dairy) Cotyledonary and
Bovine Unseason polyestrus. Cycle every 21 days. Estrus lasts 18 hours.
292 (beef) Epitheliochorial
Diffuse and
Equine 335-342 Seasonally polyestrous. Estrus cycle lasts 7 days.
Epitheliochorial
Seasonally polyestrous. Cycle every 21 days andestrus last 2-3 days. Cotyledonary and
Goats 150
Epitheliochorial
Seasonally polyestrous. 17-day estrous cycle andestrus last 1-2 days. Cotyledonary and
Sheep 150
Epitheliochorial
Chicken 21 No placenta!
Seasonally polyestrous and induced ovulators. Female ferret is name Jill (male is called Hob).
Ferrets 41-42 Pregnancy can be determined at 14 days by palpation or ultrasound.
If not bred, they stay in estrus until bred and die because of hypoestrogenism.
Guinea
65-68 days
Pigs
Chinchilla
111

Rat
22

Hamster
16

Gerbil
25

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The ova in mammals are fertilized in the oviduct, also known as Fallopian Tubes.

For cotyledonary placentas, the cotyledons are the fetal side, and the caruncles are the maternal side. Together they
make the placentome. Primates, humans, and rabbits have a hemochorial and discoid placentation.

Dog cycle: Increase estrogens speed up the turnover of vaginal epithelial cells, which cause progressive
cornification. Keep in mind that during anestrus and proestrus cells are more pink purple. After estrus and diestrus
cells are more blue purple. Parturition happens 58-72 days after breeding at an unknown stage of estrus. Basenji only
have 1 estrous cycle per year. Radiographs can be used after 45 days to count littler size. Abdominal palpation can
reliably detect pregnancy in a dog at about 21 days. Can predict impending parturition in dogs by a transient
temperature drop in the bitch (only). LH surge peaks at behavioral estrus and acceptance of male, ovulation occurs 2
days later.

Feline cycle: Birth will happen 64-69 days from breeding at an unknown state of estrus or 63 days from breeding at
ovulation. Abdominal palpation reliably detects pregnancy at about 21 days. Ultrasound can detect fetal heartbeat at
28 days. Radiographs can be used after 40 days to count littler size. Obvious mammary development can be seen in
the final 2 weeks. Estrus cycle recurs every 2-3 weeks (interestrus interval).

Bovine cycle: Estrus behavior lasts 18 hours. Signs of estrus include standing to be mounted, riding other cows,
restlessness, bellowing, ruffled hair, or hair loss on tail head. A clear vaginal mucus discharge will appear after estrus.
During diestrus a cow will have a soft corpus luteum. Placentomes can be feel from 70-75 days, Membrane Slip can be
felt at 30-35 days and fremitus can be feed at 90- 120 days.

Sheep cycle: fine wool breeds have shorter anestrus. Ovulation rate is a polygenic trait.

Freemartins (XX/XY chimeras) are sterile female calves, born twin to a male, that has underdeveloped ovaries due
to XY antigens crossing the chorionic placenta blood vessels and inhibiting ovarian development. Freemartins have a
short vagina and no cervix.

Bovine reproductive management: Estrus detection rates should be approximately 50-65%. Calving interval
should be around 13 months. First service conception rate 40% or greater. Average days open around 115 days, ideally
in the low 100s. Services per conception is less than 2.5 for pregnant cows and less than 3.5 for all cows serviced.

How many cows should be in estrus on any given day in a pen with X non-pregnant cows? Divide the X number of cows
by 18 and then by 21 and you will have. Example, if X=100, 100/18=5.5 and 100/21=4.7, therefore the answer is
between 4-6 cows.

Equine cycle: estrus signs include raising the tail, everting vulva (winking), urinating and abducting the hind legs.
Waxy teats mean mare is about to foal (in 6-48 hours). Needs long days to ovulate, therefore it is in anestrous in
December in North America (cats also). The embryo is motile for 16 days and that attaches to the base of one of the
uterine horns. Embryo collection for transferring is performed on day 7 or 8 after ovulation. Fetal heartbeat can be
accessed at 25 days and detection of pregnancy can be done in at day 11.

Endometrial cups are formed from cells of the equine fetus that invade the endometrium to form cups with produce
equine chorionic gonadotropin (eCG) between 40-120 days of gestation. eCG is a form of luteinizing hormone.

When llamas are in heat, they lay in sternal recumbency to be breed. The neonatal or very young camelid is called
cria.

Red or dark green vaginal discharge in a pregnant female indicates placental detachment. Lochia refers to normal
post-partum vaginal discharge, containing blood, mucus, and placental tissue. Hippomonas are flattened rubbery
masses found free floating in the allantoic cavity of mares and cows. They are not pathologic.

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Copulatory plug: found after mating in the vagina of guinea pigs, chinchillas, and small rodents. Carnivores, such
as dogs and cats, have an os penis (baculum) which is a penile bone.

Sperm capacitation is a membrane change that allow fertilization. It happens after sperm is deposit in the female
reproductive tract.

Testes are responsible for development of sperm head and positioning of tail and the midpiece. Therefore, head
abnormalities such as macrocephalic, microcephalic or double sperm heads are signs of meiotic failures that occur in
the tests.

Epididymis is where the later maturation of the head, tail and midpiece occur and where spermatozoon gains motility.
Species Comments
Musculocavernosus penis. Spermatozoa should be more than 80% morphologically normal and 70-
Canine 80% progressively motile for optimum breeding fertility. Only has the
prostate. Testes descend after 6-8 weeks.
Musculocavernosus penis. Have the prostate and bulbourethral glands. Testis descentprenatally.
Feline
Fibroelastic penis with sigmoid flexure. Barrow is a castrated male pig. Boars are intact.Have a
Swine preputial diverticulum that produces an odor attractive to sows. Boars have
Vesicular gland, Prostate and bulbourethral gland.
Bovine Fibroelastic penis with sigmoid flexure.
Musculocavernosus penis. Equines have Vesicular gland, Prostate, Ampulla and
Equine
bulbourethral gland.
Goat Goats have Vesicular gland, Prostate, Ampulla, and bulbourethral gland.
Fibroelastic penis with sigmoid flexure. Wether is a castrated male sheep. Sheep have
Sheep
Vesicular gland, Prostate, Ampulla, and bulbourethral gland.

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Glial cells: provide structural support, modulate neural communication, and help produce myelin sheaths. Include
astrocytes, oligodendrocytes, and microglial cells. Neuroglial cells can divide.

Microglial cells: migrate and phagocytize waste products of nerve tissue.


Astrocytes: structural, nutritional support no NC. They form a scar after trauma that can become an epileptic
focus.
Oligodendrocytes: wrap nerve in myelin
Schwann cells: are the neurological cells of the peripheral nervous system. Similar to oligodendrocytes as they
form myelin sheaths.

Myelin: increase the speed of nerve conduction.

Grey matter, also known as substantia grisea, is the part of the brain that is controlled by the nerve cell bodies and
the majority of the true dendrite.

White matter, also known as substantia alba, is a neuron that is made up of extending, myelinated nerve fibers, or
axons. It functions by transmitting the information from the different parts of the body towards the cerebral cortex.
It controls the functions that the body is unaware of, like temperature, blood pressure, heart rate and hormonal
control.

Acetylcholine (Ach) is the primary neurotransmitter for the autonomic nervous system, peripheral nervous system
(PNS) and central nervous system (CNS).

Muscle and tendon spindles sense stretch, and they do not let your muscle to over stretch.

CRANIAL NERVES (12 CNs)


CN1 Olfactory Smell
CN2 Optic Pupil See menacing motion
CN3 Oculomotor
CN4 Trochlear Dorsal obliques muscle of eye
CN5 Trigeminal Mandibular (motor) Blinking
Maxillary (sensory) Jaw tone
Ophthalmic (sensory) Masticatory movement
CN6 Abducent Motor nerve to lateral rectus & retractor
bulbi muscle of eyes
CN7 Fascial Ear, Eyelid, Nose, Mouth Blinking
Lacrimal gland Hypothyroidism cause paralysis
Salivary gland
CN8 Vestibulocochlear Cochlear Auditory
Vestibular Posture, Muscle tone, Equilibrium
CN9 Glossopharyngeal Pharynx & Larynx
CN10 Vagus Pinch hyoid bone to elicit GAG-Reflex Viscera
CN11 Spinal accessory Trapezius, sternocephalicus,
brachiocephalicus
CN12 Hypoglossal Tongue, Geniohyoid muscle Water licking response

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Afferent nerves are sensory nerves, and they bring signal to the CNS via somatic nerves (skin, retina and membranous
labyrinth) and visceral nerves (abdominal organs, olfactory epithelium and taste buds).

Efferent nerves (Exit) are motor nerves that leave the CNS and carry commands to the PNS via somatic nerves to the
skeletal muscle and via visceral nerves to cardiac muscle, smooth muscle, and exocrine glands.

Autonomic Nervous System: divided in sympathetic and parasympathetic nervous system. They require 2 neurons in
order to work (preganglionic and postganglionic) and connect to the ganglia. Ganglia is a cluster is neurons cell bodies
that houses millions of synapses.

Sympathetic Nervous System (SNS): For flight and fight! They originate in the thoracolumbar area and the sympathetic
ganglia is found closer to the spinal cord. Therefore, the preganglionic nerves are short, and the postganglionic nerves
are long. The neurotransmitters and hormones create a stress response characteristic of the SNS. First option:
acetylcholine (Ach) is release by the preganglionic fiber and norepinephrine (neurotransmitter) is release by the
postganglionic fibers. Second option: acetylcholine is releases by the preganglionic fiber to a specific gland that than
will release a hormonal response. If it is the adrenal gland, it will release Epinephrine, Norepinephrine (hormone),
Cortisol and more. This response will increase blood flow to the muscle and decrease blood flow to the TGI.

Parasympathetic Nervous System (PNS): For resting and digesting! They originate in the cervical and in the sacral area
(craniosacral area). The parasympathetic ganglia are found near or inside their effector organs. Therefore, the
preganglionic nerves are long, and the postganglionic nerves are short. The PNS release acetylcholine in the
preganglionic and in the postganglionic fibers.

Pyramidal system controls skilled muscle movement. Extrapyramidal system helps support the body against gravity
(posture) and recruits spinal reflex to initiate voluntary movement. Pyramidal and extrapyramidal system are complex
series of upper motor neurons (UMN) that connect the cerebral cortex to distant body parts and influence muscular
tone and control.

Behavior changes is the most common signs of pain in animals.

Interneurons: Short connecting nerves located in the spinal cord and brain that modulate pain signals from the
periphery. Regulate pain response, increasing or decreasing the release of neurotransmitter as needed and
transferring the signal to other areas for a short distance.

Glutamate is main excitatory neurotransmitter in CNS.

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Hormones: can only work in target cells. Lipid soluble hormones can get across cell membrane and their receptor sites
is inside of the cell. Water soluble hormones (amino acids base) cannot get across the cell membrane and have
receptors on the outside of membrane.

Glands: endocrine glands release hormone into blood. Exocrine glands release hormones into ducts. Paracrine
substances are diffuse locally and act in the nearby tissues such as histamine and clotting factors.

Hypothalamus: Corticotrophin releasing hormone (CRH), Thyroid Releasing hormone (TRH), Gonadotropin-releasing
hormone (GnRH), Somatostatin, Prolactin inhibiting factor (PIF) and Growth hormone-releasing hormone (GHRH).
Somatostatins inhibit the secretion of growth hormone.

Pituitary gland is divided into anterior pituitary, posterior pituitary, and the par intermedia.

Anterior pituitary is responsible for Thyroid Stimulating hormone (TSH), Follicle-stimulating hormone (FSH),
Luteinizing hormone (LH), Growth Hormone (somatotropin), Prolactin, Adrenocorticotropic Hormone (ACTH)
and Melanocyte-stimulating hormone (MSH).
Posterior pituitary is responsible for Vasopressin and Oxytocin. Vasopressin or Anti-diuretic Hormone (ADH)
stimulates water retention and raises blood pressure by contracting arterioles.

Adrenal cortex develops from the mesoderm and contains the zona glomerulosa, zona fasciculata and zona
reticularis. The cells of the z. glomerulosa secretes mineralocorticoids and the cells from the zona fasciculate secrete
glucocorticoids and the z reticularis cells secrete adrenal androgens. The adrenal cortex produces cortisol,
Aldosterone, Dehydroepiandrosterone and androstenedione. Aldosterone is responsible for increase in renal Na
reabsorption, K secretion and H secretion.

Adrenal Medulla produces Norepinephrine and epinephrine

Hypothalamic-Pituitary-Adrenal Axis (HPA Axis): coordinates with Sympathetic Nervous system. CRH goes to the
anterior pituitary and trigger the release of ACTH. The ACTH goes to the adrenal glands and trigger the release of
glucocorticoids and mineralocorticoids.

Thyroid: produces thyroxine (T4), Triiodothyronine (T3) and calcitonin. T4 and T3 increase metabolism, is calorigenic,
increase body temperature, maintain blood pressure and more. Calcitonin is responsible for decreasing renal and
intestinal uptake of calcium and therefore, decreasing in blood serum [Ca].

Hypothalamus-Pituitary-Thyroid Axis (HPT Axis): TRH is released into the blood stream goes to the anterior pituitary
that releases TSH that goes to the thyroid. Thyroid starts producing hormones.

Parathyroid releases parathyroid hormone, which increases serum calcium.

Pancreas: release insulin (beta cells), glucagon (alpha cells) and pancreatic somatostatin (delta cells). The pancreatic
somatostatin that is responsible for regulation of insulin and glucagon. All these hormones are produced in the islet
of Langerhans.

Kidney produces renin. Testes produce testosterone. Ovaries produce estradiol and progesterone.

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Hypersensitivity
Type 1 allergic reaction due to IgE and histamine Vaccine reaction, allergies
Type 2 Antigen binds to cell surface and marks it to Autoimmune hemolytic anemia, Pemphigus, Myasthenia
be destroyed gravis
Type 3 Immune Complex deposition Glomerulonephritis, Hypersensitivity pneumonitis (think
moldy hay), Purpura hemorrhagica (think post-strangles),
anterior uveitis
Type 4 (Delayed hypersensitivity reaction): Cell Lymphocytic choriomeningitis, Keratitis sicca, autoimmune
mediated! thyroiditis, Contact hypersensitivity, transplant rejection,
tumor immunity

Interferon: response to viral infection. Stimulate a response by other host cells to inhibit further infection of host cells.
IgG is the principal antibody of blood. IgM is usually produced during acute infection. IgE is associated with mastocytes
and allergic responses. IgA is found in secretions in the respiratory system and intestinal tract.

Rabies vaccination: antibody titer is reach after 28 days after initial vaccination and immediately after booster
vaccination.

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Vitamin D: (dietary) is crucial as dogs and cats cannot synthesize adequate vitamin D from skin exposure.

Rumen microbiota is crucial for production of dietary protein, essential amino acids, rumen microbial protein, digest
forage and production of volatile fatty acids. Rumen pH around 7.5 is compatible with anorexia.

Volatile Fatty Acids (VFA): Is the product of ruminal fermentation and supply around >70% of dietary energy for a
dairy cow. The 3 main VFAs are: propionic, acetic, and butyric acid. Propionic acid releases more energy than the other
2 – Crucial for beef cattle. Ionophore antibiotics (monesin and lasalocid) cause the rumen microorganism to produce
more propionic. Butyric acid is crucial for butterfat, therefore ionophores are NOT used in dairy cattle.

Bypass protein (UDP): provides Methionine and lysine which allow an increase in milk output. It also helps cows to
conserve body weight during peak lactation.

Grass Tetany is caused by low magnesium levels in the blood and CSF.

Milk fever (post parturient paresis): will be associated with hypocalcemia, which inhibits the insulin secreting letting
the animal hyperglycemic.

Ketosis: cows in early lactation are at risk for ketosis.

Milk urea nitrogen (MUN): measure of nitrogen metabolism (protein) in dairy cattle. Normal value is 14mg/dl. Increase
in MUN can be because an excessive amount of rumen utilizable protein is being fed, there is a low amount of
fermentable carbohydrates or there is an excess fiber.

Ammonium chloride: decrease urine pH and decreases risk of obstruction urolithiasis. Feeding long stem forages
instead of pelleted rations decreases the risk of obstructive urolithiasis in small ruminants by increasing salivary
production and phosphorus excretion in the saliva.

Copper deficiency: can cause neurologic signs such as ataxia in lambs, kids, and piglets. They may also develop
diarrhea.

An egg can be candle 9 days after laying to look for signs of fertile egg with embryo. Candle is just putty the egg under
a light source to see blood vessels and other structures.

Imbalance Calcium: Phosphorus ratio or inadequate dietary vitamin D causes Nutritional secondary
hyperparathyroidism.

Fish that float upside down at the top of the tank likely have a swim bladder disorder. Glodfish are commonly affected.
Keep it off feed for 3-4 days, give it some peas and if does not solve try to create a floating material.

To evaluate the body condition of an adult llama you should palpate over the lumbar vertebrae.

Antigenic drift: combination between hemagglutinin and neuramidase that creates new strains in influenza virus of
all species.

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CRANIAL NERVES (12 CNs)
CN1 Olfactory Smell
CN2 Optic Pupil See menacing motion
CN3 Oculomotor
CN4 Trochlear Dorsal obliques muscle of eye
CN5 Trigeminal Mandibular (motor) Blinking
Maxillary (sensory) Jaw tone
Ophthalmic (sensory) Masticatory movement
CN6 Abducent Motor nerve to lateral rectus & retractor
bulbi muscle of eyes
CN7 Fascial Ear, Eyelid, Nose, Mouth Blinking
Lacrimal gland Hypothyroidism cause paralysis
Salivary gland
CN8 Vestibulocochlear Cochlear Auditory
Vestibular Posture, Muscle tone, Equilibrium
CN9 Glossopharyngeal Pharynx & Larynx
CN10 Vagus Pinch hyoid bone to elicit GAG-Reflex Viscera
CN11 Spinal accessory Trapezius, sternocephalicus,
brachiocephalicus
CN12 Hypoglossal Tongue, Geniohyoid muscle Water licking response

Reflexes
Palpebral reflex: CN V (face sensation) & CN VII (close eyelid)

Pupil light reflex (PLR): Retina, Optic nerve, Optic chiasm, Midbrain, Ciliary ganglia, Parasympathetic fibers via the
oculomotor nerve, Iridial sphincter muscles. Cerebral cortex is not part of PLR.

Menace response test: Retina, CN II, CN VII, Cerebrum, Cerebellum

Dazzle response: Retina, CN II, CN VII, Rostral colliculus

Cutaneous trunci reflex: Actual spinal lesion is generally 2 spinal cord segments in front (cranial) to the line where
cutaneous spinal reflex stops.

If reflex stops at L1 then the lesion will be at T12-T13.

Head tilt: Damage to CN VIII, Inner ear, or parts of the cerebellum.

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Patellar reflex Femoral nerve Stifle should extend
L4-L6
Gastrocnemius & Cranial Tibial muscle Tibial nerve Hock should extend or flex
Peroneal nerve
Lumbosacral plexus
L6-S2
Crossed extensor reflex Above L6 (UMN)
Anal pinching S1-S3
Withdrawal reflex L7-S1 (LMN) Loss of withdrawal reflex
Sciatic nerve
T3-L3 UMN Hind limb signs

Schiff-Sherrington Phenomenon
Trauma to T3-L3 causes interruption of inhibitory neurons input from the lumbar spinal cord.

Rigid forelimb & Hindlimb paresis or paralysis.

Hansen’s type 1 intervertebral disc disease


Thoracolumbar pain, arched back, hind limb hypermetria, ataxia, weakness.

Localize T3-L3 lesion on canine radiograph by looking at the intervertebral foramina. These dark spaces look like a HORSE
HEAD or SNOOPY’S BIRD BUDDY, WOODSTOCK.

Vestibular disease
Head tilt towards the lesion, Circling, Nystagmus

Central vestibular disease: vertical nystagmus & conscious defects. Peripheral vestibular disease: horizontal nystagmus,
conscious defects. Inner ear lesion: horizontal nystagmus. The inner ear is part of vestibular disease.

In one-sided vestibular disease look for head tilt, abnormal nystagmus, circling &, and rolling with proprioception intact.
Vestibular dysfunction may also cause ipsilateral falling. Cerebellar signs might be confused with vestibular signs.

Vestibular ataxia=loss of equilibrium/balance:

Bilateral vestibular disease, see wide head excursions. Vestibular is the only neurologic system involved with movement
where the postural reactions are 100% ok.

Cerebellar ataxia=loss of ability to regulate movement: An exaggerated, jerky spastic gait and head tremors are classic
cerebellar signs. Strength is fine. The resting posture of a cerebellar patient may be a broad-based stance.

Proprioceptive ataxia= loss of awareness of position/movement of body parts.

ROARS/ LARYNGEAL HEMIPLEGIA


Roarers have damage to the recurrent laryngeal nerve (a branch of the vagus) which causes laryngeal hemiplegia - a paralysis
of the abductor muscle (dorsal cricoarytenoid muscle) controlling the glottic cleft in the larynx. This allows the vocal fold
(usually left side) to evert into the lumen of the larynx, obstructing airflow, leading to a roaring sound, and most importantly,
slowing the horse. Mostly in left nerve because it is lengthier.

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Dorsal displacement of the soft palate (DDSP)
Dorsal displacement of the soft palate (DDSP) is thought to be caused by neuromuscular dysfunction of the pharyngeal
muscles that control the soft palate. Follow this link to see an endoscopic image of DDSP.

Epiglottic entrapment may cause inspiratory and expiratory noise. exercise intolerance and is surgically treatable.

Guttural pouch tympany is a young horse disease, seen only up to one year of age, and mostly in fillies.

FIBROTIC MYOPATHIES
Fibrotic myopathy refers to the abnormal gait caused by fibrosis and restriction of action of the semitendinosus muscle, one
of the three hamstring muscles (semitendinosus, semimembranosus, biceps femoris). Occasionally. fibrotic myopathy affects
the semimembranosus, biceps femoris, and gracilis muscles.

The cranial phase of the stride is shortened, and the hoof moves suddenly caudally during the last phase of the stride just
before hitting the ground.

SUPRASCAPULAR NEUROPATHY (SWEENY)


Damage to the suprascapular nerve where it passes cranial to the border of the scapula. Neurogenic atrophy of the
Infraspinatus, Supraspinatus muscles causing prominent scapular spine.

The shoulder is unstable, slips out laterally, and looks dislocated, though technically it is not.

Renal tumors with progressive unilateral lameness in budgerigars.


Sciatic nerve passes through renal parenchyma in birds & budgerigars are more prone to neoplasm in general.

MISCELLANEOUS
Brachial plexus avulsion is one of the causes of Horner’s syndrome due to the damage to the cervical sympathetic innervation
of eyeballs which passes through T1-T2 and upward through the cranial cervical spinal cord.

Spinal cord compression: Ataxia, Tetraparesis, Cervical pain, neck stiffness.

Pendular nystagmus is seen in various breeds of dairy cattle. Pendular nystagmus is caused by a congenital abnormality in
the visual pathway. No other neurologic signs are present, and the condition is nonprogressive and of no clinical significance.

Congenital deafness has rarely been reported in horses and is thought to be pigment-associated. Brain stems auditory

evoked responses (BAER) provide a diagnosis of deafness.

A mature horse is presented because she is bumping into things and is spooking a lot more frequently. She appears to be
blind and is easily surprised when approached. Physical exam reveals normal pupillary light reflexes (PL) bilaterally but
negative menace response bilaterally. No other cranial nerve deficits are noted. Where is the lesion?

This is cortical (a.k.a, central) blindness, due to damage in the occipital cortex of the cerebrum. Cortical blindness is
characterized by loss of vision with normal direct and consensual PLs (because the eyes themselves, optic nerves, and their
pathways are unaffected), and negative menace.

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EPIDURAL ANESTHESIA IN CATTLE
Cd1-Cd2 OR S5-Cd1 (easier to palpate)

Place needle at 45-degree angle or perpendicular to the skin.

Hanging drop technique

Caudal or Low volume epidural

Desensitize sacral nerve.

Do not affect the motor function of the hind limb

Anesthesia to the urethra, rectum, anus, tail, vagina, vulva, and scrotum.

Cranial or Low volume epidural

Lumbosacral space

Analgesia to diaphragm

Hind end ataxia or paralysis

Caudal or high-volume epidural

Same site as caudal

High volume medication

Effects similar to cranial epidural

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This is the hock or tarsus, comprised of 4 synovial joints in the
horse.

The 4 joints are talocrural (or "tibiotarsal"), proximal intertarsal,


distal intertarsal, and tarsometatarsal.

In horses, the talocrural and proximal intertarsal joints


communicate.

It is important to understand which joints communicate when

considering wounds, infections, and medication of these joints.

"A" is pointing to the tarsometatarsal joint of the equine tarsus (hock). The distal
intertarsal joint is also affected (the one just above it).

This is a degenerative joint disease of the tarsus, also called "bone spavin," the
number one hock (tarsus) problem in horses. Seen most in Standardbreds, Quarter
Horses.

If the horse is lame, it tends to drag the toe or have a stabbing gait in the affected
limb. Most often treated with systemic, topical, or intrasynovial anti-inflammatories.
Because this is a low-motion joint, it may arthrodese (fuse) over time and become
less sore (or can be surgically or chemically arthrodesed).

Equine stifle has 3 compartments

Medial & lateral femorotibial pouches (do not communicate) Femoropatellar pouch (communicate).

Femoropatellar connects to the femorotibial by a small slit.

The carpus often called the "knee" in/horses. Try not to confuse the carpus (on the foreleg) with the true anatomic knee on
the hindleg, which is commonly called the stifle.
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The carpus is made up of 3 synovial joints in horses: antebrachiocarpal joint (or "radiocarpal joint"), middle carpal joint, and
carpometacarpal joint. The latter 2 communicate in horses.

The metacarpophalangeal joint is the fetlock. Think of it


as the first place you see an obvious bend in the weight-
bearing leg as you move up the leg phalangeal join from
the hoof.

Horses have four fetlocks- one in each limb.

Cattle and horses have 3 patellar ligaments attaching dorsally to the patella, which act as a part of the "stay apparatus" by
helping the stifle ("knee joint) lock in place. Sometimes horses suffer from a condition called "upward fixation of the patella."
in which the patella gets stuck on the medial femoral trochlear ridge over which it normally "locks." In dogs, remember
rupture of the cranial cruciate ligament when you think of common stifle problems.

Distal sesamoid ligaments are located on the palmar/ plantar aspect of the limb distal to the fetlock. The 4 pairs of ligaments
originate on the ventral aspect of medial and lateral proximal sesamoid bones and attach to the palmar/plantar surface of 1st
or 2nd phalanx.

Fractures of the proximal sesamoid bones in horses are often associated with damage of suspensory ligaments due to its
insertion onto these bones. These are common cause of overextension. These are number one cause of race track death.

Viborg's triangle is a surgical approach to the guttural pouch bounded by the ramus of the mandible, linguofacial vein, and
tendon of sternocephalicus(-mandibularis) muscle.

The deep inguinal ring is bounded by the caudal edge of the internal abdominal oblique muscle, ventromedially by the rectus
abdominis muscle and prepubic tendon, and caudally by the inguinal ligament.

Hunters Bump

Prominences of Tuber Sacrale that can result from luxation, subluxation, or ligamentous injury of the sacroiliac joint. A horse
with a hunter’s bump can be sound if the injury has completely healed but can be observed if the injury is recent or has never
been resolved.

Jugular groove in horse & cattle

It lies between sternocephalicus & brachiocephalicus muscles.

In horses, the Omohyoideus muscle lies deep to the jugular vein in the cranial part of the neck whereas it is the sternomastoid
muscle in ruminants.

Nasal diverticulum

It is a blind cutaneous pouch in dorsal nasal passage which every vet hits at least once while tubing their first couple of horses.
Put thumb while passing tube to avoid this.
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Bone marrow biopsy sites
Horse Sternebrae
Horse less than 4 years Tuber coxae od pelvis
Dog & Cat Iliac crest
Trochanteric fossa of femur
Greater tubercle of the humerus
Biopsy needles: Jamshidi, Illionois

IM Injection sites in Horse

A triangular area of the neck

• Nuchal ligament dorsally


• Cervical vertebra ventrally
• Scapula caudally

Hamstring muscles

Pectoralis muscles

Gluteal muscles

Founder/ laminitis

It is characterized by inflammation, degeneration, and necrosis of the dermal and epidermal laminae in the hoof wall.

The breakdown of the union between the horny and sensitive laminae of the hoof leads to the loss of the suspension

mechanism of the third phalanx, which can result in rotation of the third phalanx within the hoof wall and/or ventral

sinking of the third phalanx through the sole in severe cases.

1) Systemic-inflammatory response syndrome (SIRS)-associated: Laminitis is a common sequel to systemic metabolic


disturbances involving endotoxemia and elaboration of inflammatory mediators, including colonic torsion, grain overload,
enterocolitis, pleuropneumonia, and metritis.

2) Endocrinopathic: horses with insulin dysregulation and equine metabolic syndrome or pituitary pars intermedia
dysfunction (PPID) is at risk of laminitis. Events that can set off a case include grazing lush pasture, corticosteroid
administration, and illness.

3) Support limb: support limb laminitis in one hoof can occur when the limb is excessively loaded after injury on the
contralateral limb. (A fourth, less common cause, is traumatic or "road founder.")

Equine laminitis is often treated with HEART BAR SHOES which distributes the weight-bearing forces from dorsal hoof
wall alone to heel and frog.

Osteochondrosis

Osteochondrosis is a developmental orthopedic disease that begins with a disturbance or failure of endochondral ossification
at the physes and epiphyses (growth plates). The resultant abnormal, thickened cartilage can become fissured, detached, or
form a flap. There is subsequent inflammation in the joint (synovitis) and abnormal wear on the opposing cartilage surface.
The clinical syndrome is termed "osteochondritis dissecans" (OCD) and presents with lameness, reduced range of motion,
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and effusion in the affected joint(s). Typically, a disease of young (4-10 months), male (3x more likely than female), fast-
growing, large breed dogs; and often bilateral (so always take radiographs of the contralateral limb!).

Most common sites of osteochondrosis


Dog shoulder, elbow, stifle, and tarsus (hock).
Horse distal intermediate ridge of the tibia ("DIRT" lesion) and at
the lateral trochlear ridge of the femur (stifle/knee).
Cattle shoulder, elbow, stifle, and hock joints

Chestnut & Ergot

Chestnut Ergot
Variable-sized thorny masses are located on the medial Variable-sized thorny masses located on the Feathers
surface of the forelimb proximal to the carpus and on the (long hairs) at palmar/ plantar fetlock.
hindlimb medial surface or tarus.

Bone spavin

This is an osteoarthritis/degenerative joint disease of the distal hock joints, usually affecting the distal intertarsal and
tarsometatarsal articulations. The number one hock problem (tarsus) in horses. If the horse is lame due to bone spavin, it
tends to drag the toe or have a "stabbing" gait in the affected hindlimb. Occasionally you may see thickening of the soft
tissues over distal hock joints. The problem can be unilateral or bilateral with various degrees of lameness.

Typical Tx: intra-articular steroids and hyaluronic acid, phenylbutazone as needed, continue with work. Over time distal hock
joints are likely to ankylose (fuse) on their own and lameness ends. Additional treatments include shockwave,
bisphosphonates, alcohol arthrodesis, cunean tenectomy, or neurectomy.

Synovitis/Capsulitis (Bog spavin)/ Tarsal hydrarthrosis

Acute or chronic synovitis of the talocrural joint resulting in distention of the joint capsule may occur due to osteochondrosis,
degenerative joint disease, trauma, poor joint conformation, hemarthrosis, or infection, or it may be idiopathic. Radiographs
should be taken to exclude OCD and other radiologically evident pathology, and ultrasonography should be done to assess
the periarticular soft-tissue structures. Synoviocentesis of the talocrural joint should be performed if sepsis or hemoarthrosis
is suspected. Idiopathic synovitis may be diagnosed in the absence of lameness or radiologic change. Idiopathic synovitis
rarely interferes with the use of the horse but may be considered an unacceptable cosmetic blemish. Idiopathic synovitis may
be managed by draining the synovial fluid and medicating the joint with intra-articular corticosteroids. Pressure bandages
should be applied afterward to provide joint compression, and the horse stall rested for 2 wk. However, in approximately half
of horses, effusion will recur, and a persistent cosmetic blemish remains. Intra-articular injection of atropine (8 mg) may
sometimes help.

High ringbone

Pastern joint arthritis is quite common in horses and, with advanced disease, bony swelling due to periosteal proliferation
and enthesiophytosis can be palpated. Horses present with lameness (often variable and responsive to phenylbutazone
therapy at first), are positive to distal limb flexion, and the lameness should improve significantly with an abaxial nerve block.
Additional diagnostics include radiography, ultrasonography (used to determine if soft tissues are involved), and rarely CT or
MRI.

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Common treatments include local (e.g., intraarticular therapies or topical) or systemic anti-inflammatories (e.g., bute or
firocoxib), shockwave therapy, and rest/rehabilitation. The pastern is a relatively low-motion joint so the joint may be
surgically or chemically arthrodesed in severe cases.

Tarsal sheath tenosynovitis ("thoroughpin")

It is distention/effusion/inflammation of the tarsal sheath of the lateral deep digital flexor tendon proximal to/at the tarsus.
Usually, an incidental finding and not associated with any pain or lameness. Esp. common in young horses starting in work.
Occasionally this is due to regional trauma and would be associated with lameness. Tarsal sheath tenosynovitis may be
treated with cryotherapy (ice), rest, and topical/intrathecal/systemic anti-inflammatories.

Similarly, idiopathic synovitis around the metacarpophalangeal or metatarsophalangeal joints are called windgalls or
windpuffs; however, this is more common in older horses.

An acute suspensory breakdown injury results in complete fetlock drop.

Flaccidity of the flexor muscles leads to the digital hyperextension seen in newborn foals. This problem usually corrects in a
few weeks as muscle tone increases.

Rupture of the common digital extensor tendon results in swelling in the tendon sheath at the dorsolateral aspect of the
carpus. Foals are over in the knee and knuckle at the metacarpophalangeal joint while walking and potentially even standing.

Quittor the name for chronic infection of the collateral cartilage(s) of the distal phalanx. Usually secondary to a
wound or sometimes a quarter crack in the hoof. Surgical debridement is necessary, with adjunctive local
or systemic antimicrobials. Prognosis is poor if the distal interphalangeal joint becomes involved. Was
previously more common in draft horses who worked for a living but still seen today in any type of horse.
Sidebone ossification of the cartilages of the third phalanx is thought to be due to repeated concussion of the quarters
of the hooves.
Canker Canker is suppurative hypertrophy of the frog and the sole that is foul-smelling and chronic.
keratoma A keratoma is a benign keratinized mass that develops between the hoof wall and distal phalanx.
Pedal Pedal osteitis is the demineralization of the solar margin of the distal phalanx. usually due to inflammation.
osteitis
Thrush Thrush: sulci of both frogs are moist and contain the thick black malodorous discharge. A bacterial infection
of frog (Fusobacterium necrophorum) due to poor hoof conformation, lack of exercise, moist environment,
and poor hygiene.
Rx: daily tropical astringent (Copper sulfate, Methylene blue, or Chlorine dioxide) and increase exercise in
a dry area. If the frog is really rough use less irritating metronidazole paste with bandage.
curb Thickening or bowing of the plantar tarsal ligament is the curb.
thoroughpin Distention of the tarsal sheath of the DDF tendon proximal to the tarsus is thoroughpin.
pyramidal Avulsion/periostitis of the extensor process of PIII is called pyramidal disease,
disease
Navicular Navicular disease is chronic degeneration of the navicular bursa and bone. It is a syndrome, not a specific
disease disease, resulting in damage to the flexor surface of the navicular bone and the overlying deep digital flexor
tendon.
Sheared Sheared heels refer to the asymmetry of the heels causing a severe imbalance of the foot and one side of
heels the heel contacting the ground before the other. Picture one side of the hoof at the heel is taller than the
other. This causes chronic heel soreness. Typically seen in horses with poor limb/foot conformation causing
abnormal forces on one side of the foot.

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Rx: corrective trimming and shoeing.
Scratches Scratches ("greasy heel") describe a chronic seborrheic dermatitis of the palmar or plantar pastern that can
result from a number of different causes.
carpal A carpal hygroma is a subcutaneous swelling over the cranial/dorsal aspect of the carpus. Typically, a history
hygroma of trauma to the carpus is noted. The swelling is typically aseptic, but the risk of infection can develop after
drainage or injection. Typically, a hygroma is a cosmetic blemish, and lameness is not usually present.
Hygromas can be treated in the early stage with drainage, steroid injections, and bandaging.
bowed "bowed tendon" is the colloquial term for tendinitis in horses, often due to a tear from racing stress. The
tendon most commonly affected tendon is the superficial digital flexor tendon of the thoracic limb. Look for
swelling in the palmar metacarpus.
Treat primarily with stall rest then slow rehabilitation, anti-inflammatories, and bandaging (Additional
therapies are numerous including regenerative therapies (I.e., stem cells injected intralesionally),
shockwave or cold laser therapy, cryotherapy, etc.
Splints Splints describe a periostitis around the 2nd and 4th metacarpal/-tarsals (splint bones); can be associated
with injury of the suspensory ligament.
Bucked Bucked shins" is the term for the dorsal metacarpal disease, an acute periostitis of this region. It can
shins culminate in a dorsal cortical stress fracture of the 3rd metacarpal bone.
club foot A club foot is caused by a contractural deformity of the distal interphalangeal joint, leading to a steep hoof
wall angle and a relatively short toe, eventually leading to the development of a boxy foot. This can be a
congenital deformity or an acquired deformity as a consequence of chronic pain due to a nutritional
imbalance resulting in developmental orthopedic disease, trauma, infection, etc.
Carpal Carpal Valgus (Knock-Kneed) is the Lateral deviation of the forelimbs below the carpus.
Valgus
Carpal Varus Carpal Varus is the medial deviation of the forelimbs originating within the bones of the carpus.
Windfalls Windfalls (windpuffs) are fluid-filled swellings around the metacarpophalangeal and metatarsophalangeal
joints. Usually asymptomatic, a blemish that causes no lameness.
Osselets Osselets are the inflammation of the periosteum of the dorsal distal third metacarpal bone and the
associated
metacarpophalangeal joint capsule.
Aponeurotic Aponeurotic attachments are flat tendinous sheets associated with flat muscles, particularly the abdominal
attachments muscles.
Arytenoid Arytenoid chondritis can cause protrusion of granulation tissue through the axial surface of one of the
chondritis arytenoid
cartilages, resulting in a contact (kissing) lesion on the contralateral arytenoid cartilage. Prominent, nodular
lymphoid
follicles on the pharyngeal roof of young horses are called pharyngeal lymphoid hyperplasia. Usually a
normal finding.
Angular A condition that affects the appendicular skeleton and causes limb deviation.
limb
deformity
Flexure limb It is hyperflexion of joints caused by unequal development of soft tissues and bones.
deformity
Diphyodont Animals have 2 sets of teeth. (Deciduous & Permanent)
animals

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Physitis It is the inflammation and swelling around the growth plates of long bones. It is more common in large,
rapidly growing, young horses especially when the ground is hard.
Abnormal Ca: P, too much exercise, obesity, toxicity, conformational defects.
Slab Slab fracture in the carpus. The most common site is the frontal plane of the radial facet of the 3rd carpal
fracture bone. Common in racehorses. Cause lameness and joint effusion.
Rx: Screw
In racing Thoroughbred horses, the problem presents with lameness, fetlock joint effusion, swelling over the
dorsoproximal fetlock joint, and a positive response to firm flexion of the fetlock.

Villonodular synovitis

This proliferative synovitis is characterized by enlargement of the fibrocartilaginous pad on the dorsoproximal aspect of the
fetlock joint where the joint capsule attaches. It is likely due to repetitive damage from exercise.

Dx: Clinical suspicion based on clinical signs and palpation radiography (lateral view) may reveal associated osteolysis at the
proximal aspect of the dorsal mid-sagittal ridge of the distal third metacarpal bone. Ultrasound may reveal the abnormal or
thickened synovial pad (>4 mm is abnormal.

Rx: Arthroscopy with surgical excision.

Kissing Spines

The dorsal spinous process of the thoracic vertebrae is a frequent cause of back pain in horses due to overriding spinous
processes or "kissing spines " The most common location of kissing spines is between T10 and T18. Different grades can be
identified (grade 1: narrowing of the interspinal space; grade 2: densification of the margins; grade 3: bone lysis adjacent to
the margins; grade 4: severe remodeling).

Clinical signs: back pain, lameness, reluctance to work, and behavioral abnormalities.

Dx: Radiographs show kissing or overriding lesions of the dorsal spinous processes with bony lysis and remodeling, depending
on the severity. Definitive diagnosis can be difficult because radiographic lesions can be seen in horses without back pain and
with normal thoracolumbar mobilization. Local diagnostic analgesia can be helpful.

Rx: Local anti-inflammatory injections (steroids), shockwave therapy, acupuncture, rehab exercises, and surgical resection of
the affected spinous processes /Fistulous withers are inflammation of the supraspinous bursa that can be due to trauma or
Brucella aborts infection. Tx involves complete surgical removal of the bursa.

Fractures

Fractures of the dorsal spinous processes are less common and occur when horses flip over backward. Multiple fractures of
the spinous processes of T4-T10 are sometimes seen in horses that have reared and fallen over backward. The summits and
centers of ossification are fractured and displaced laterally.

Desmopathies

Desmopathies: Acute or subacute desmopathies can be identified ultrasonographically because they demonstrate
dorsoventral or transverse thickening of the ligament, altered echogenicity, and obvious alteration of the linear longitudinal
pattern. In old or chronic injuries, the ligament often remains thicker, with a reduced echogenicity and an irregular
architectural pattern. Hyperechogenic images with or without acoustic shadows are compatible with mineralization or
calcification of the supraspinous ligament.

Bursitis in large animals

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Capped Elbow and Hock are inflammatory swellings of the subcutaneous bursae (acquired bursitis) located over the
olecranon process and tuber calcaneus, respectively, of horses. Frequent causes include trauma from lying on poorly bedded
hard floors, kicks, falls, riding the tailgate of trailers, iron shoes projecting beyond the heels, and prolonged recumbency.

Clinical Findings and Diagnosis: Circumscribed edematous swelling develops over and around the affected bursa.

Treatment: Acute early cases may respond well to applications of cold water, followed in a few days by aseptic aspiration

and injection of a corticosteroid.

Fistulous Withers and Poll Evil are rare, inflammatory conditions of horses that differ essentially only in their location in the
respective supraspinous or supra-atlantal bursae

Etiology: The condition may be traumatic or infectious in origin. Agglutination titers support an infectious etiology.

Brucella abortus, Actinomyces Bovis

Clinical Findings: The inflammation leads to considerable thickening of the bursa wall.

Treatment and Prevention: The earlier treatment is instituted, the better the prognosis. The most successful treatment is
complete dissection and removal of the infected bursa. The expense of the protracted treatment required in chronic cases
often exceeds the value of the animal. Brucella vaccines have not proved helpful. Sodium iodide therapy is of limited value.

Congenital patellar luxation

A rare inherited disorder in which foal is unable to stand, crouched position due to quadricep muscle acting as a flexor instead
of an extensor of stifle joint.

Equine congenital luxation is similar to canine patellar luxation.

Cranial Cruciate Ligament Rupture

The dog is presented acutely lame and non-weight bearing on the hind limb. A clinician places the thumb of one hand over
the lateral fabella and the index finger over the patella, stabilizing the femur. The clinician then places the thumb of the
opposite hand caudal to the fibula head with the index finger on the tibial tuberosity. With the stifle first flexed and then
extended, the tibia moves cranially and distally relative to the femur.

Instability in the stifle joint after cranial cruciate ligament damage can cause injury to the medial meniscus, joint effusion,
osteophytosis, and joint capsule fibrosis.

Treatments include medical and surgical therapies. Weight reduction, controlled physical therapy, and NSAIDs alleviate pain
and discomfort from inflammation and degenerative joint disease. Surgical stabilization of the stifle joint is recommended
for active dogs. Extracapsular techniques include fascial suturing, fabella to tibial tuberosity imbrication sutures, cranial
transposition of the fibular head, leveling of the tibial plateau, tibial tuberosity advancement, and synthetic grafts.
Intracapsular techniques include fascia lata or patellar tendon grafts sutured over the top of the lateral femoral condyle.

Radial neuropathy or ulnar of olecranon fracture

Horse unable to fix the carpus in extension.

Spondylosis deformans (increased osteophyte production)

It is a degenerative, old age vertebral change in dogs, cats, bulls caused by the breakdown of the outer annulus fibrous fibers
which stretches the longitudinal ligament. The increased stress of the vertebral attachment of longitudinal ligaments causes
osteophyte production.
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Osteophytes on the ventral and lateral aspects of vertebral bodies may bridge the intervertebral space in severe areas.

Radiographically, these osteophytes appear as spur or bridges at intervertebral spaces.

LIMB NERVE BLOCK

90% of all lameness is in the FOOT & the three LOWEST nerve blocks will help you isolate most lamenesses.

1) PALMAR DIGITAL nerve block (also called heel block, used to help Dx navicular syndrome)

2) ABAXIAL SESAMOID nerve block (also known as basisesamoid nerve block - can use to make a horse with acute laminitis
comfortable).

3) LOW FOUR-POINT block (also called low palmar or volar)

If the horse is still lame after these 3 blocks, continue up the limb with metacarpal/high 4-point, then prox. metacarpal
blocks next.

NERVE DAMAGES IN CATTLE

Ischiatic (sciatic) nerve and/or the obturator nerve is seen most often in post-partum cows (and sometimes horses) living
on slippery surfaces. It is caused by compression of the nerves against the bony pelvic canal as a calf passes through.

Pure obturator paralysis is unusual but more easily managed as animals should be able to stand if a good footing is provided.

When the sciatic nerve(s) are involved, the standing may not be possible, especially if bilateral. Need to arrange for a bedded
stall with good footing, sometimes NSAIDs, turn recumbent animals 6-8 times per day or use a float tank.

With peroneal paralysis, see knuckling at the fetlock, with the dorsal surface of hindfoot scraping on the ground.

Damage to the saphenous nerve would inhibit sensory perception on the medial hind limb and motor innervation to the
sartorius muscle (but probably would not cause knuckling).

Radial nerve paralysis is in the forelimb. High radial paralysis would be non-weight bearing. A low radial paralysis would

knuckle.

Equine sinusitis

In horses it is often due to tooth root infection since the end of the four caudal most cheek teeth extends into the sinus cavity.
Horses have 6 pairs of paranasal sinuses.

Clinical signs: unilateral mucopurulent or bloody discharge often malodorous if associated with tooth root infection or facial
deformity.

Rx: TERPHINATION & LAVAGE.

Nasofrontal suture periostitis is characterized by bony, non-painful swelling over the nasofrontal structure. Secondary to
trauma.

Ethmyoid hematoma are less common in paranasal sinuses but found in conchofrontal sinuses.

Reciprocal & stay apparatus

The reciprocal apparatus consists of the fibularis (peroneus) tertius muscle on the cranial aspect of the crus and the
superficial digital flexor on the caudal aspect. Because of these two opposing cords, flexion, or extension of the tarsus (hock)
or stifle will cause a reciprocal flexion or extension of the other joint.
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STAY apparatus, a combination of non-tiring tendons and ligaments on both the fore and hind limbs that allow muscle bellies
to bypass tension so that a horse may rest while standing with little fatigue.

Rupture of the Fibularis (peroneus) tertius muscles

It disrupts the stay apparatus of the hindlimb & reciprocal apparatus of the stifle & hock joint.

A characteristic feature is EXTENDED HOCK & FLEXED STIFLE.

What is the clinical significance of the femoral triangle in dogs and cats?

The femoral triangle is - rood place from which to take the femoral pulse inside the medial hindleg. The triangle is formed by
the.
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• sartorius muscle cranially
• pectineus muscle caudally
• the body wall dorsally.

Why can't a horse kick sideways as powerfully as a cow?

A horse cannot kick sideways as powerfully as a cow, because horses have an accessory ligament of the hip and femoral
head, (unique to horses) and a deep acetabulum. The accessory ligament connects the prepubic ligament (base of the pelvis)
to the fovea capiitis on the head of the femur, essentially stabilizing the hip. The stabilizing influence of the accessory ligament
is what prevents horses from kicking out to the side to the same degree that cows do. Because of the accessory ligament,
coxofemoral luxation is rare in horses compared to cattle and small animals.

Coxofemoral luxation in cattle may occur when bulls mount cows or cows mount each other on slippery flooring. Hip luxation
in dogs and cats is usually secondary to trauma, like being hit by a car.

What is initially recommended for horses who suffer from the uncomplicated intermittent delayed release of the patella
(blue arrow) from its position over the medial trochlear ridge of the femur?

A controlled conditioning exercise program is often the first recommendation in horses with the intermittent delayed patellar
release (a.k.a. intermittent upward fixation of the patella). Controlled exercise helps strengthen the quadriceps (and biceps
femoris) muscles of the thigh and therefore removal of the patella from its "locked" position over the medial trochlear ridge.

This condition occurs when the medial patellar ligament stays hooked over the medial trochlear ridge of the femur, thereby
locking the reciprocal apparatus with the limb in extension. Horses with intermittent delayed patellar release are slow to
release the patella during limb protraction, which is visible when transitioning from canter to trot. Horses with severe disease
stand with the hind limb in extension and fetlock flexed. Those horses may not be able to move forward, or only do so with
a sudden jerking flexion of that limb.

Rx for horses who do not respond to conservative therapy is lame, or who have severe disease: medial patellar ligament
desmotomy or medial patellar ligament splitting procedures. It is important to provide good farriery care to ensure the foot
is well balanced. Shoes with a beveled edge (and possibly a lateral heel wedge) may be helpful. Arthroscopy would not be an
initial treatment for this condition. The tibial plateau leveling osteotomy is performed in dogs with cranial cruciate injuries.

Why can dog & cat rotate forearm?

Radius and ulna are fused in ruminants and horses which prevents them from supinating or pronating the forearm. They are
not fused in dogs and cats so they can rotate forearm.

Pyriform recess of laryngopharynx in Dogs

It is where bones commonly become lodges leading to Asphyxiation. Also, site for pharyngostomy tube placement. It is the
continuation of the oropharyngeal floor on either side of larynx.

Which animals have incomplete bony orbits?

Dogs and cats (carnivores) and pigs (omnivores) have incomplete bony orbits, which are completed by the orbital ligament.

Horses, cows, goats, and sheep have completed bony orbits.

Fabellae

The fabellae are a pair of sesamoid bones found embedded in the tendons of origin of the heads of the gastrocnemius
muscles.
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There is a rostral bone in the nasal planum of the pig, which aids them in rooting through the soil for food.

Clavicle

Cats have a clavicle, the others listed do not. The thin clavicle is embedded in the shoulder musculature without any direct
bony attachments. Clavicles help anchor the forelimbs to the trunk while allowing the scapulae and shoulder joints to move
relative to the trunk. This increases the mobility of the shoulder joint compared to ball-and-socket joints.

Adrenal Medulla (Chromaffin cells)

The adrenal medulla, although apparently not essential to life, plays an important role in response to stress or hypoglycemia.
It secretes epinephrine and norepinephrine, which increase cardiac output, blood pressure, and blood glucose and decrease
Gl activity. Pheochromocytomas may develop in domestic animals, most often in cattle and dogs. These secrete epinephrine,
norepinephrine, or both. Clinical signs are often absent, and tumors may be incidental findings during evaluation for other
conditions or at necropsy. Chromaffin cells become neoplastic forming Pheochromocytomas.

Typically, intervertebral disc protrusion (IDP) is not seen between T1-T2 because INTERCAPITAL LIGAMENT reinforces the
disk dorsally, preventing it from protruding upward.

Interdigital hyperplasia/ Fibroma is the thickening of skin between the claws of a cow’s foot. More common in the rare foot
due to chronic irritation secondary to trauma or infection. Also called corn.

Choanal atresia in foals causes RESPIRATORY DISTRESS & DYSPNEA. It is the persistence of Bucco nasal membranes resulting
in nasal obstruction at the level of medial canthus of the eye.

Nasal polyps are pedunculated growths that arise from the mucosa of the nasal cavity, nasal septum, or tooth alveolus. They
form in response to chronic inflammation by hypertrophy of the mucous membrane or proliferation of fibrous connective
tissue.

Atresia ani occurs when the dorsal membrane separating the rectum and anus fails to rupture.

Deep digital flexor tendon injury Drooped fetlock + Toe lifted off the ground
Superficial digital flexor tendon injury Dropped fetlock + no change in toe position
Damage to both branches of suspensory ligaments Dropped fetlock + Toes on the ground
Impar ligament damage No fetlock dropped
Long lateral digital extensor tendon damage Inability to protract limb
Intermittent knuckling over fetlock

Tendons, Ligaments, Muscles

Interosseous muscle is an entirely tendinous muscle that is also called the suspensory ligament. It originates from palmar/
plantar aspect of the 3rd metacarpal/ metatarsal bone, branches in the distal 4th of the metacarpus/ metatarsus and inserts
on the abaxial aspect of proximal sesamoid. Suspensory desmitis is a common problem.

Impair ligament reinforces the distal interphalangeal joint distally. It extends from the distal border of the distal sesamoid to
the flexor surface of distal phalanx.

Cunean tendon is synonymous with the medial branch of the cranial tibial muscle and inserts on the middle phalanx.

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Straight sesamoid ligament attaches proximally to the base of sesamoid bones and inserts to the proximal ends of the middle
phalanx.

Inferior check ligament is the continuation of the palmar carpal ligament/ plantar tarsal ligament which originates within the
joint capsule of the carpus/ tarsus and then proceeds distally to insert on the deep digital flexor tendon at about the middle
of the metacarpus/ metatarsus.

Insertion of subscapularis Lesser tubercle of humerus


Insertion of deltoid Deltoid tuberosity of humerus
Insertion of tares major Medial humerus
Insertion of coracobrachialis
Insertion of infraspinatus Epiphysis of the greater tubercle

Longus capitus muscle, one of the ventral straight muscles of the head, inserts on the basisphenoid bone at the skull base.

With traumatic poll injury, rupture occurs at the insertion of the muscle dorsal to the guttural pouch and results in severe
hemorrhages.

A needle inserted in the coronary band (pointing down) reaches the coffin joint.

Disruptions localized to the extensor tendons cause the horse to either "knuckle over" at the fetlock or "flip" his hoof in the
affected leg to avoid knuckling over. Once the hoof is placed on the ground, the horse can bear weight successfully.

A problem localized to the deep digital flexor tendon alone will cause a subtle fetlock to drop when bearing weight along
with a slight toe elevation because it inserts on the palmar/plantar surface of the third phalanx. Pain and lameness are evident
during weight bearing.

Superficial digital flexor tendon disruptions result in a "very


slight" fetlock drop with pain and lameness during weight
bearing.

If both the deep and superficial digital flexor tendons are


damaged, the fetlock will drop more significantly than if either
single structure is cut, and the toe will elevate upon bearing
weight, with prominent lameness.

A disrupted suspensory ligament (with no damage to the


digital flexor tendons) results in a significant fetlock drop when
bearing weight.

Damage to the digital flexor tendons and the suspensory


and/or distal sesamoid ligaments results in the fetlock
dropping to the ground and the toe pointing straight up during
weight bearing.

Long and lateral tendon rupture leads to weight bearing at the


dorsum aspect of the hoof.

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Cryptorchidism: When 1 or 2 testis is located in the abdominal cavity common in dogs and horses. Increases the animal’s risk
to Sertoli cell tumor, feminizing syndrome, and blood dyscrasias. It also increases the risk of seminomas, testicular torsion,
and prostatitis squamous metaplasia. Testes descent prenatally in cats and in 6-8 months in dogs. It has a genetic component,
so breeding is discouraged. Condition is less common in cats (more in Persian).

The process associated with the descent of Testes into Scrotum. The Gubernaculum is a jelly like cord of tissue in the fetus
which extends through the inguinal canal, connecting the teste and tail of the epididymis. As the Gubernaculum regresses
town through the inguinal canal during fetal development, the testis follows it into the scrotum. A key point to remember is
that the developing testes are INSIDE the abdominal cavity and peritoneum and can still communicate with the abdominal
cavity after descent through the inguinal ring, leading to the risk of an inguinal herma, especially common in pigs and horses.
Cryptorchidism is a consequence of undescended testicles, predisposing to sertoliomas, seminomas, and interstitial cell
tumors.

Accessory sex glands


Dog Prostate
Cat Prostate, Bulbourethral
Bull, Boar, Stallion Prostate, Bulbourethral, Vesicular
Vesicular glands of horse are sometimes called seminal vesicles because they have a lumen.
Dog, ruminants, stallions have short, dilated terminal ends of the ductus deference called Ampullae.

Preputial diverticulum: is a pouch in Boars located within dorsolateral aspect of prepuce. It contains a discharge
(desquamated epithelial cells, pheromones, urine) responsible for strong smell. Smell is encouraging to sows to stand to be
mounted during estrus. It also acts as a lubricant during coitus.

Patent urachus: is a tube within the umbilicus through which urine from the unborn foal travels from bladder to allantois.
Risk factor for the development of patent urachus is

Ligation of umbilical cord


Omphalophlebitis
Lifting of foal under abdomen
Prolonged recumbency
Straining due to constipation

I. One umbilical vein: brings nutrient & oxygen rich blood from the placenta to the fetus. It enters the fetal liver to join
portal vein.
II. 2 umbilical arteries: for vascular return from fetus to dam, they originate off of the internal podental artery and pass
ventrally on either side of the bladder.
III. Urachus: is tubular connection present in the fetus between the bladder and the umbilicus. During gestation, urine
flows from the bladder through urachus to allantoic sac.

Hypospadias: is abnormal placement of urethral opening ventral & caudal to normal position. It is a developmental defect
results from failure of fusion of the urethral groove during phallus elongation. Condition is more common in male dogs.

Hippomonas: are flattened rubbery masses found free floating in the allantoic cavity of mares and cows. They are not
pathological. They are thought to be a sort of allantoic calculus formed around a nucleus of cell debris, much like a pearl form
around a grain or sand.

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Ruminants and pigs have a fibroelastic penis (mostly connective tissue) with a sigmoid flexure. Erection is characterized by
substantial increase in length due to straightening of the sigmoid flexure, but no increase in diameter.

Other animals (carnivores, horse, human) have a musculocavernosus penis. Erection is characterized by substantial increase
in length and diameter due to engorgement of erectile tissue with blood.

The sigmoid flexure has clinical significance two reasons:

1. Uroliths may lodge there in cases of urolithiaisis in ruminants and pigs,

2. You must straighten the sigmoid flexure in order to pass a urinary catheter in small ruminants and boars.

You cannot catheterize a bull because of a fold of mucous membrane over the bulbourethral glans called the urethral
diverticulum.

The suburethral diverticulum is present in female domestic ruminants, camelids, and pigs. It is a blind pocket opening

just ventral to the external urethral orifice in the vestibule. It will be inadvertently entered instead of the urethra unless

the practitioner is aware and takes precautions.

Avoid it by using one of two methods:

1. First, place a gloved finger into the suburethral diverticulum and then pass the urinary catheter dorsal to it into the

urethra.

2. Place the urinary catheter into the diverticulum, then gently draw its tip caudally and slightly dorsally until it just

"pops" out at which point it can be directed cranially into the urethra.

This suburethral diverticulum in females should not be confused with the urethral diverticulum present near the pelvis of
male ruminants, which prevents routine retrograde urinary catheterization.

Os-penis: is a bone (baculum) found in the penis of carnivores (Dog & Cats) and other group of mammals. It is absent in
ungulates (stallion, Bull, Ram, Boars). In dogs it facilitates entry into vagina without full erection.

Penile spines: indicate intact tom. Backward projecting cornified spines on glans due to presence of circulating androgens.
Penile spines are absent in neutered male cat. Spines can help to diagnose cryptorchid males. Spines should disappear within
6 weeks of castration. Penile spines help tom fertilizing queen by breaking through copulatory plug. This is helpful in species
in which sperm competition inside female can be fierce.

EQUINE BOVINE
In equine uterine torsion, the cervix Is RARELY involved in In bovine uterine torsion COMMONLY INVOLVE the cervix,
the torsion. and sometimes the vagaina too.
almost all equine cases require rectal palpation because Most bovine uterine torsions can be diagnosed by vaginal
they do not typically involve the cervix examination alone because they usually involve the cervix
In horses, uterine torsions typically occur during the late in cattle, they typically occur during late 1st-stage/early
2nd/early 3rd trimester 2nd- stage parturition.
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Uterine torsion is less common in mares Uterine torsion is more common in BOVINES
Rolling a mare near the tearm is not recommended due to The majority of bovine uterine torsion cases can be
the risk of uterine rupture. Surgical correction via flank corrected non-surgically.
laparotomy is recommended in most cases in mares. Methods include manual detorsion/rotation of the fetus
per vagina, rolling the cow (plank in flank).

Rectal Prolapse: If the tissue is healthy and viable, the prolapse should be washed, reduced, and retained with a loose purse-
string suture. For pigs and sheep, leave a one-finger opening through the purse-string into the rectum (larger for horses and
cattle). Before reduction, you should apply a warm saline lavage and lubrication with water-soluble gel. If the mucosa is
edematous and swollen, topically apply a Hypertonic sugar solution (like 70% mannitol or 50% dextrose) to relieve swelling.
If the everted tissue has obvious necrosis or trauma or is indurated, firm. or cannot be reduced, amputation is indicated.
Expect a higher incidence of post-surgical rectal stricture in pigs after amputation. Rectal prolapse is a common problem of
young straining animals of many species, It is common in pigs, especially due to diarrhea or weak rectal support tissue in the
pelvis. Among pigs raised for food, other predisposing causes include severe coughing or stressors like the cold (piling for
warmth) and transport (piling /crowding in trucks). Rectal prolapse is differentiated from mass lesions, colonic prolapse or
intussusception by the inability to pass anything between the anus and the rectal wall. In females you need to differentiate
from uterine prolapse and vaginal prolapse. Use a Buhner suture to retain a vaginal prolapse, a problem a usually seen in
mature female cattle and sheep (not pies) in the last trimester of pregnancy.

Polled intersex syndrome is a congenital condition associated with hornless goat breeds. Genetically female but exhibit male,
female, or mixed external characteristics. Abnormally protruding vulva.

Persistent hymen: is due to segmental aplasia of paramesonephric duct. (White heifer disease). With persistent hymen
accumulation of uterine secretions may be palpable per vagina as fluctuant swelling. If the segmental aplasia is the cervix,
there may be either mucometra, hydrometra or cystic enlargement of cervix. If site of segmental aplasia is uterus, it may
involve one horn (Uterus unicornis) both horns and only part of a horn. You may be able to palpate or use ultrasound to
detect cystic dilation of uterine horn anterior to area of aplasia.

Horse with cystic calculi show hematuria after exercise. Usually single, large, spiculated stone of calcium carbonate.

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Ptyalism in guinea pigs is usually caused by misalignment of the teeth or subclinical vitamin C deficiency, which leads
to mandibular deformity, and secondary tooth misalignment.
Priapism is a prolonged erection in the absence of sexual stimulation.
paraphimosis is the inability to retract a swollen penis into the prepuce.
phimosis is the Inability to extrude the penis due to constriction at the preputial orifice. Phimosis is usually congenital
(German shepherd, Golden Retriever), but maybe acquired (trauma, post-surgical). In severe cases urine becomes
trapped within the prepuce and urine dribbling and balanoposthitis may be seen. The condition is corrected
surgically.
Balanoposthitis is inflammation of the glans penis and preputial mucosa.
Balanitis is the inflammation of the glans penis only.
Posthitis is inflammation of the preputial mucosa.
Hypospadias is the abnormal placement of the urethral opening ventral and caudal to the normal position.
Ranula is a swelling under the tongue caused by an accumulation of saliva within the tissues under the tongue. It is
a type of mucocele, a salivary gland disorder where saliva accumulates in surrounding tissues after trauma to the
duct or gland.
Necrotic laryngitis (calf diphtheria) is the Infection of the pharynx and larynx with Fusobacterium necrophorum A
young calf disease characterized by fever, ptyalism, nasal discharge, inspiratory dyspnea, and stridor.
Syringomyelia is the development of fluid in the spinal cord.
Hydrocephalus is the accumulation of excess CF fluid in the ventricles of the brain, usually with a distended, bulbous
skull
Hydranencephaly is the loss of cerebral cortigal tissue (brain) with SF filling the resulting cavity and a normal-looking
skull. May see hydranencephaly secondary to in-utero infection with the "3 B's". Bluetongue, Bovine viral diarrhea
(BVD), Border disease, and Akabane virus.
Spina bifida is the failure of the neural arch to fuse.
Syndactyly: is mule footed animal due to fusion of joints.
Dermoid sinus: congenital neural defects.

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GIT
The abomasum is lined with glandular mucosa. It is comparable to a stomach in a non-ruminant. Normally the abomasum
lies more or less along the bottom right side of the lower abdomen, but sometimes it can distend with gas and float upwards
like a balloon, becoming a displaced abomasum (DA). A DA can usually be heard with a stethoscope by flicking your middle
finger over it and listening for a musical ping, much like the sound you get by flicking your finger against a basketball. It makes
50 % of foregut in newborn calf. As calf weaned, abomasum shrinks & ruminoreticulum system becomes active.

The other 3 stomach compartments--the rumen, reticulum, and omasum are non-glandular and lined with stratified
squamous epithelium.

The large rumen contains copious microbes and acts as a fermentation vat. Takes up most of the left side of the animal and
is commonly affected by bloat.

The honey-combed reticulum is a cranioventral pouch contiguous with the rumen. Ingested metallic objects fall directly in,
potentially leading to "hardware disease" (a.k.a. traumatic Reticuloperitonitis).

The omasum contains leaf-like structures and absorbs water and nutrients.

Gastric groove: (reticular groove in ruminants) is a channel through the stomach following the lesser curvature found
in all animals, but most clinically significant in ruminants. When a calf suckle milk with its head up, the lips of groove close
forming a tube that directly connects the esophagus to abomasum by passing the rumen, reticulum, omasum. Calves without
this reflex are called ruminal drinkers. They have a chronic indigestion from the milk that ends up in their rumen.

STOMACH TYPES
Equids (and pigs) have a simple composite stomach comprised of squamous/non-glandular and glandular mucosa.

Dogs and cats & Primates have simple glandular stomachs.

Ruminants (bovine, ovine, caprine) have a complex composite stomach with 4 compartments.

Avian has a 2-compartment stomach comprised of a proventriculus (glandular) and gizzard (muscular).

The capacity of Horse Stomach: Horses are monogastric animals and the stomach is relatively small. An Average-sized horse's
stomach has an approximate normal capacity of 8-10 L, potentially up to 20-25 L when maximally distended. This is clinically
important because the unction between the distal esophagus and the cardia is a functional one-way valve that does not
permit regurgitation or vomiting in most horses. Conditions that prevent the aboral movement of these materials through
the small intestine can lead to gastric dilatation, rupture, and death. Thus, the passage of a nasogastric tube into the stomach
is an important component of every colic examination to rule out gastric dilatation.

Equids have two openings into the cecum - the ileocecal and cecocolic openings.

The ileocecal orifice is susceptible to intussusception - due to parasite damage, Anoplocephala perfoliata infection, or
enteritis.

The other domestic species have only the cecocolic opening.

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CAMEL STOMACH
Hydrochloric acid and proteases are secreted by gastric glands in the caudal 20% of the third compartment (C3) of camelids,
which most closely resembles a monogastric animal's stomach.

Camelids rely on their forestomach for microbial digestion, much like ruminants. They have three compartments- the first 2
(C1 and C2) make up 10-15% of an adult's camelid's body weight and occupy over 50% of the space in the abdomen.
Fermentative digestion occurs both here and in the cranial 80% of the smaller third compartment.

C1 is divided into cranial and caudal sacs by a large transverse pillar. C1 and C2 are lined by stratified squamous mucosa and
C1 contains glandular saccules while C2 contains glandular cells. These specialized structures facilitate rapid absorption of
water, electrolytes, and VAs similar to the function of papillae of the ruminant rumen. It is not well understood how these
saccules facilitate absorption so efficiently.

The remainder of the camelid Gl tract is similar to ruminants - small intestine, relatively small cecum, ascending colon with
spiral loops (centripetal and centrifugal portions), transverse colon with smaller spiral loops, and descending colon to the
rectum.

EQUINE COLON
Sacculated intestine with one broad anti-mesenteric band containing fecal balls is the small colon. small colon impactions are
a relatively uncommon cause of colic in horses (though more common in foals with meconium impaction and miniature
horses with fecaliths).

Various parts of the equine intestine have different descriptions that help with interpreting abdominal palpation per rectum
bands and sacculations are often distinguishable). The small intestine of horses is not sacculated and is comprised of the
duodenum, jejunum, and ileum; the first 2 do not have any anti-mesenteric bands (teniae), while the ileum begins to develop
an anti-mesenteric band that turns into the ileocecal fold. The duodenum is affixed to the right dorsal body wall and then
turns towards midline near the base of the cecum. The small intestine typically sits ventrally, filling up whatever space is
available.

The cecum is a large blind sac on located the right side of the abdomen which gets ingesta from the ileum (ileocecal valve)
and returns ingesta to the right ventral colon (via the cecocolic valve). It is sacculated and has 4 bands. The large colon has
many parts that are contiguous, and it is only affixed to the body at its right dorsal aspect, which
is part of why it can readily displace or twist. The right ventral colon is sacculated (i.e., it has
haustra) with 4 bands, it passes the midline just caudal to the sternum at the sternal flexure to
become the/left ventral colon which also is sacculated with 4 bands. The left ventral colon
narrows significantly and makes a U urn in the left pelvic inlet (called the pelvic flexure) and
then the left dorsal colon heads back cranially, with no sacculations and no anti- mesenteric
bands. The colon again crosses midline near the diaphragm at the diaphragmatic flexure. Here
it becomes the very broad right dorsal colon, which has moderate sacculations and two anti-
mesenteric bands. Back near the base of the cecum the lumen narrows significantly, becoming
the short, well-attached transverse colon.

The traverse colon transverses the abdomen from right to left just cranial to the root of the
cranial mesenteric artery. Then the small colon (descending colon) has a narrow lumen, one
broad anti-mesenteric band, and its sacculations are the site of fecal ball production prior to
their deposition in the rectum.

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Blood Supply to the Gl Tract: The/celiac/and/cranial mesenteric arteries (branches of the abdominal aorta) supply blood to
the Gl tract. The celiac artery supplies arterial blood to the stomach, pancreas, liver, spleen, and the proximal portion of the
duodenum. The cranial mesenteric artery supplies arterial blood to the remaining portion of the duodenum; to all of the
jejunum. ileum, cecum, large colon, and transverse colon; and to the first portion of the descending (small) colon.

Left dorsal displacement of the larger colon (Nephrosplenic entrapment). The large (ascending) colon of horses cam become
dorsally displaced on the left side of the abdomen over the nephrosplenic ligament. Nephrosplenic entrapment is
characterized by moderate or recurrent abdominal pain.

Dx: Abdominal palpation per rectum and/or transabdominal ultrasonography.

Rx: Phenylephrine to contract the spleen, lunging the horse to facilitate the colon "falling" off the ligament, rolling the horse
under general anesthesia, and exploratory laparotomy.

Epiploic foramen incarceration/ entrapment occurs when a loop of small intestine is incarcerated in the epiploic foramen
(bounded by the caudate lobe of the liver, the portal vein, and the caudal vena cava).

Large colon volvulus most commonly occurs clockwise at the junction between the right ventral colon and cecum.

The pelvic flexure of the large colon is a common site of impaction due to the drastic narrowing from the left ventral colon
to the left dorsal colon.

There is no such thing as cecocolic torsion in horses. Cecal torsions are RARE.

Common sites of impaction in equine intestine

1. Pelvic flexure of large intestine


2. Junction of right dorsal colon with transverse colon

Predisposing factors of impaction includes:

Coarse feed
Reduced water intake
Poor dentitioning

Ileal impactions occur mostly in adult horses and associated with feeding of coastal Bermuda grass hay and failure to deworm
with anthelmintics with efficacy against tapeworms.

Intussusceptum: Invaginates into the lumen of an adjacent segment of intestine.

Intussuscipiens: Part of the bowel that receives the intussusceptum.

Splenic torsions: occur concomitantly with GDV. Splenic torsions result from twisting of the spleen on its pedicles, leading to
occlusion of blood flow and subsequent engorgement and thrombosis of the splenic vessels and splenic ischemia.

Peritoneopericardial diaphragmatic hernia is a congenital malformation of diaphragm and most common congenital
pericardial disease in dogs & cats. It is the failure of abdominal & pericardial cavities to separate allowing herniation of
abdominal viscera into pericardial sac. Liver herniates most commonly followed by small intestine, spleen and stomach.

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TEETH TYPE
Horses (and ruminants) have radicular hypsodontic (high crown) cheek teeth. The cheek teeth slowly erupt (about 2-3
mm/year) throughout most of a horse's life to compensate for constant grinding as they eat (think of how a mechanical lead
pencil works).

Hypsodontic teeth have a root structure that allows for continued growth, or continued eruption during all or most of the
animal's life. The roots are divided up into radicular and aradicular.

In radicular teeth, the apices (roots) remain open for a large portion of the animal's life. After these roots close, tooth growth
stops. Very old horses may completely wear down the grinding surfaces and "run out of" cheek teeth

Aradicular teeth lack a true root structure and will grow throughout the animal's entire life. This type of growth helps to
compensate for occlusal wear produced from their high roughage diets. These can be found in rabbits and some rodents.

Dogs and cats have radicular brachyodontic teeth, with a small crown and well-developed roots. The roots are only open for
a short time during eruption and development. These teeth do not continue to erupt or grow.

Stances
Plantigrade: Humans, bears, rabbits, kangaroos, raccoons, mice, opossums, pandas, and others stand and walk in a
plantigrade fashion, on the bottom of their entire foot, from phalanges, metatarsal/metacarpal bones, tarsal
bones/calcaneus, or heel bone. These are 'flat-footed' animals. The calcaneus and tarsal bones= the hock in other animals
that walk on their toes

Digitigrade animals are many carnivores and birds - dogs, cats, wolves, foxes, many birds; all of these walks on all of their
phalanges/toes.

Unguligrade animals have hooves - cows, deer, horses, pigs, hippos, giraffes; walk on the tips of the toes or hooves, on the
last phalanx; except for camelids, a variation of ungulates, that walk on their second and third phalanges.

An abnormal plantigrade posture is seen in patients with injury to the Achilles, injury to the gastrocnemius muscle(s),
weakness from nutritional myopathy or neurologic disease, and in cats with diabetic neuropathy.

Horses are obligate nasal breathers because they have a very long soft palate on which the tip of epiglottis lies ton
form a seal.

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The auricular (left) side of this canine heart is facing you.

Number 3 is the conus of the right ventricle because:

A) You can see the flaccid pulmonary trunk (5), which does not look like the more
rigid, arching aorta (7) above and behind. B) The left ventricle (1) makes up the
apex of the heart. Here are other key parts:

10= right auricle

11=left auricle

6=arterial ligament, the remnant of the fetal ductus arteriosus, which connects
the pulmonary trunk (5) with the Aorta (7)

Patent ductus arteriosus occurs when this vessel does not close properly.

Patent ductus arteriosus (PDA)is a common congenital defect of dogs, and it occurs less commonly in cats. Persistent
flow through the ductus leads to excess blood flow (volume overload) to the pulmonary circulation and left heart chambers,
most commonly leading to left CHF within the first 1-2 years of life. PDA occurs most commonly in small- breed dogs and
causes a continuous murmur loudest over the left base and bounding pulses. Prompt diagnosis and treatment (either by
interventional device occlusion or surgical ligation) before the development of clinical signs is associated with an excellent
outcome. Expect a continuous murmur with patent ductus arteriosus (PDA). The vast majority were detected at first
vaccination visit.

The trabeculae septomarginalis are cords of myocardial tissue inside the right ventricle which connects the outer
heart wall to the interventricular septum. Clinical significance is to Aids right ventricular contraction. Purkinje fibers travel
along with these bands, which act as a shortcut across the chamber of the ventricle and help synchronize contraction and
emptying. Because of its attachments between the outer heart wall to the interventricular septum, the trabeculae
septomarginalis was thought to physically prevent over-distension of the ventricle, and some references still call it the
"moderator band" White muscle disease affects the myocardium and also Purkinje fibers.

HEART SOUNDS

I. The first heart sound (S1) is caused by the closure of the atrioventricular valves (AV valves).
II. The second sound (S2-the "dub" in "lub-dub"') is the closure of the aortic and pulmonic valves.
III. A third sound (S3) is the end of rapid ventricular filling.
IV. The fourth sound (S4) is atrial systole (atrial contraction).

You can often hear all 4 sounds in horses, but typically hear only S1 and S2 in cattle and small animals.

Atrial septal defect (ASD) anomalies can occur when the foramen ovale, normal communication between the right and
left atria in the embryo, fails to close at birth. Frequently Asymptomatic. During fetal life, the foramen ovale is a flapped oval
opening in the interatrial septum. It allows blood to shunt from the right atrium to the left atrium to bypass the nonfunctional
lungs. Holosystolic crescendo-decrescendo murmur may be heard aver left heart base.
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Aortic stenosis (also called sub-aortic stenosis (SAS]), causes a systolic, ejection-type (crescendo- decrescendo)
heart murmur heard most loudly on the left chest between the 2nd and 5th intercostal (IC) space or at the thoracic inlet
(lateral to the trachea). Inherited in Newfoundlands. Predilection in many large breeds - German shepherd, Golden retriever,
Boxer, Rottweiler.

Mitral dysplasia and other mitral valve problems are heard further back on left at 5th-6th IC. More common in CATS.
With pulmonic stenosis see RIGHT ventricular hypertrophy because pulmonic valves block outflow from the R ventricle
(mostly dogs).

Tricuspid dysplasia is heard further back on RIGHT at 5th-6th Inter costal. Uncommon.

About 50 % of patients (horses) withPericardial effusion (PEF) have a pattern of alternating variation in R wave
amplitude called Electrical alternans, caused by swinging motion of the heart within the fluid filled pericardial sac. Most
patients with PEF display normal sinus rhythm to sinus tachycardia. R wave height is often decreased.

Tricuspid insufficiency shows jugular pulse (jugular distension) due to blood backflow.

Right side heart failure cause ascites, pleural effusion & peripheral edema.

Left side heart failure cause pulmonary edema & congestion.

Vascular ring entrapment anomalies occur during embryonic development most commonly due to persistence of
the right fourth aortic arch (PRAA). The right instead of the left aortic arch becomes the aorta, which places the aorta to the
right side of the esophagus.

The esophagus is then entrapped at the heart base by these 4 structures:

I. Right fourth aortic arch


II. Left atrium
III. Pulmonic artery
IV. Ligamentum arteriosum

This vascular ring obstructs food passage, causing subsequent esophageal dilation anterior to the anomaly. Boston Terriers,
German Shepherds, and Irish Setters have higher incidences.

Arrhythmogenic right ventricular cardiomyopathy: Very common in boxers! Clinical signs include syncope,
fainting, collapse, or sudden death due to ventricular tachyarrhythmias. It is uncommon for boxers to show cardiac chamber
enlargement, so radiographs and ultrasound is not very helpful.

Congestive heart failure: in dogs the number one cause is left atrioventricular (mitral) valve insufficiency, usually mitral
valve regurgitation.

Dilated cardiomyopathy (DCM): Most common cardiomyopathy in large breed canines. However, taurine deficiency
can lead to DCM in felines. It is the second most common cause of congestive heart failure in dogs. Clinical signs are usually
acute and include labored breathing, coughing, tiring if Left heart signs or abdominal distension (ascites) and jugular pulse if
right heart signs. Treat it with diuretics, low salt diet and vasodilators (enalapril). Hint: 3D treatment!

Hypertrophic cardiomyopathy (HCM): typically causes left ventricle hypertrophy which gives the heart a valentine’s
heart shape (very tall heart). May see secondary to pulmonary hypertension, systemic hypertension, acromegaly, and

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congenital aortic stenosis. A systolic murmur (left AV, mitral valve) is evident in 80% of cats with HCM. Cats may also present
tachypnea, dyspnea, anorexia, vomiting, lethargy and in more serious cases cyanotic nail beds, cold extremities,
decreased/absent pulses, and aortic thromboembolism. It is the most common cardiomyopathy in felines that are 5-7 years
old.

Shock the most common type of shock in veterinary medicine is hypovolemic shock. Hypovolemic shock happens when the
total circulating blood volume decreases via loss of fluid such as hemorrhage, vomiting, diarrhea, extreme sweating (horses)
and more. Obstructive shock occurs when cardiac output is mechanically impaired, like in GDV, cardiac tamponade and more.
Cardiogenic shock is seen when the heart fails. Distributive shock develops when blood volume is pooled in the peripheral
circulation like in sepsis, anaphylaxis, heatstroke, and snakebite.

Ventricular Tachycardia (VTach): is characterized by ventricular complexes that occur in runs of >30 seconds and
heart rate is high as > 170beats/min. ECG looks like the image in the side. Lidocaine bolus and continuous infusion is used to
treat it. Vtachs are common post GDV surgery.

The Facial artery courses from the inside (medial aspect) of each mandible, over
the ventral aspect, and up the side of the fare just in front of the masseter muscle.
This large artery is commonly palpated to obtain a pulse rate in the horse. Some
references appear to call this vessel the "mandibular" artery, but this is incorrect:
there is no mandibular artery in the horse.

Other locations that can be used to palpate the pulse include the transverse
facial artery just below each eye and a portion of the masseter artery located just
at the caudal angle of the mandible.

The dorsal metatarsal artery can be felt on the lateral aspect of the rear limb
in the space between the cannon bone and the fourth metatarsal bone.

The digital arteries can also be palpated (carefully!) - at the caudolateral and
caudomedial aspects of each fetlock or the medial and lateral aspects of the back of
the pastern. These are used most often during the workup of acute lameness in
horses, especially when laminitis or a foot abscess is suspected.

The palatine artery is located within the soft tissue lining the hard palate just medial to the maxillary teeth. It is easy to
palpate in a sedated or anesthetized horse.

Blood gas analysis: in the dog blood should be collected from the femoral artery and the dorsal metatarsal artery.

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Nasogastric intubation in Horse
Nasogastric intubation should typically be performed via the ventral nasal meats to avoid inadvertently traumatizing the
ethmoid turbinates and causing epistaxis. This can be challenging in horses that do not tolerate the procedure well; most of
the time good technique along with appropriate sedation/restraint minimizes this risk.

Other tips for successful passage of a nasogastric tube: appropriate sedation/restraint, lube, or water on the end of the tube,
make sure the tube is not too cold and stiff, and flex the head/neck when the tube reaches the epiglottis to facilitate
swallowing it into the esophagus instead of the trachea.

Remember that progressive ethmoid hematoma is a hematoma-like non-neoplastic mass of unknown etiology that develops
in some horses. causing intermittent unilateral epistaxis and sometimes stertor. Dx with upper airway endoscopy (Sometimes
skull radiographs). 50% are bilateral so always check the other nasal passage. Treatment is surgical removal or injection with
formalin; expect 30-50% to recur even with surgical Tx.

Left side of neck is the best location where palpation & visualization confirms NG tube placement in horses.

Esophagus runs down the left side of horse neck. It is not possible to see or safely palpate it in the larynx or oropharynx. It is
to confirm proper placement prior to administer fluid or medication.

Other methods to confirm placement:

Blow into end and auscultation of stomach


Coughing if it is in trachea
Negative pressure upon aspiration is a sign of being in stomach

Guttural pouches are paired, symmetric expansions of the eustachian tubes in all equids. They are located just behind &
lateral to pharynx and above & lateral to larynx. Can be affected by empyema, mycosis and tympany which can lead to
damage to the CN 9 (glossopharyngeal), CN 10 (vagus) and internal carotid artery. Aspergillus is the fungus most commonly
associated with guttural pouch mycosis, forming a plaque at the caudodorsal aspect of the medial compartment, and causing
damage to the internal carotid artery and cranial and sympathetic nerves. It can result in epistaxis, dysphagia, and Horner’s
syndrome.

A foal with severe combined immunodeficiency will have little or no visible thymus at necropsy.

Flail chest: Thoracic trauma resulting in more than two fracture sites per rib of three or more adjacent ribs is termed a
"flail chest' The flail segment of the thoracic wall moves paradoxically with respiration because of intrathoracic pressure
changes - so the segment moves inwards at inspiration and outwards at expiration. Flail chest causes hypoxemia secondary
to decreased compliance, increased airway resistance, decreased vital capacity, and decreased functional reserve capacity.
This is due to underlying pulmonary trauma and pain.

Always take orthogonal thoracic radiographs (two views, oriented 90 degrees apart) and closely assess the rib contour for
fractures in cases of thoracic trauma. Place the animal with the affected side of the chest down to stabilize the flail segment
and allow the healthier lung to fully perfuse/oxygenate.

External splinting may be indicated following patient stabilization. After placing the animal under general anesthesia, use
plastic splint material. conformed to the patient's chest, stabilized by sutures around the affected rib segments. Splinting the
flail segment can help control pain, improve ventilation, and prevent further intrathoracic damage. However, it is unclear if
shifting changes prognosis.

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"Papple shape" of a cow with ruminal distention due to vagal indigestion (essentially an outflow failure at the reticulo-
omasal orifice or pyloric sphincter of the abomasum). Look for ruminal distention with ingesta (which causes the papple
shape) and scant stool. Rectally, you may note the characteristic "L-shaped" rumen, with the ventral sac of the rumen
enlarged and palpable to the right of the midline. The left kidney may be pushed to the right of the midline by ruminal
distention. Bradycardia is present in 25-40% of cows with vagal indigestion and is NOT commonly associated with other
conditions in cattle.

The appropriate location to euthanize an adult bovid with a captive bolt/gunshot is at the intersection of two
lines drawn between the outside corner of the eye to the center of the base of the opposite horn (or equivalent spot in polled
animals). Captive bolt or gunshot is an appropriate and common method of euthanasia for cattle. When done properly by a
trained person, this method is rapid, painless, and humane; in this species, it causes less fear and anxiety than most other
available methods (e.g., IV administration of medications).

Mammary gland blood supplies & neoplasia


1. Cranial superficial epigastric artery (arise from internal podental artery)
2. Caudal superficial epigastric artery (emerge from external podental artery near inguinal ring)

The lateral thoracic artery from axillary artery also supplies blood to cranial most mammary gland.

o Cats have 4 pairs of glands while dogs have 5pairs


o Neoplasia is more common in intact females
o More common in dogs than cats
o Dogs 45 % malignant, Cats 90 % malignant
o Dogs: caudal most affected
o Cats: cranial most affected

Cats have a common opening of pancreatic & common bile duct into duodenum. It predisposes to triad of
diseases.

I. Inflammatory bowel disease


II. Extrahepatic bile duct obstruction
III. Cholangitis
Compas placement for Traumatic reticuloperitonitis
When a compass is held near or below the brisket of a cow with a bar
magnet in the reticulum, the compass will point towards the cow and
magnet as you move it.

Traumatic reticuloperitonitis (also called hardware disease) is prevented by


a bar magnet in the reticulum, which stops forward migration of ferrous
metal objects (like nails, baling wire) through the diapraghm and into the
adjacent heart. If you press hard on the ventrum while listening with a
stethoscope on the trachea, you may hear a respiratory grunt. You can also
look for bilaterally distended jugular veins or a washer machine murmur in
cows with hardware disease. Grave prognosis.

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Which structure may be opened following dehorning in older calves and adult cattle?
The cornual diverticulum might be opened during dehorning, increasing the risk of sinusitis (Frontal sinusitis is usually
associated with dehorning, and maxillary sinusitis with infected teeth). It is a diverticulum of the frontal sinus in ruminants
that extends into the proximal aspect of the horns.

Dehorning older calves and adult cattle is associated with the risk of sinusitis, bleeding, local infection, and prolonged wound
healing and should be avoided. Cutting the horns off close to the base but leaving enough horn to prevent opening the sinus
is preferred ("tipping").

Disbudding is the process of destroying the horn-producing cells (i.e., the corum) of the horn bud in very young calves and is
the preferred method of removing the horn completely. This is performed using heat/cautery, chemical agents, and physical
removal. Horn buds attach to the underlying frontal bone periosteum at two months of age.

Proper local anesthesia and analgesia are essential with any of these methods.

The conchofrontal sinus -the joined frontal and dorsal conchal sinus is found in horses, not ruminants.

Horn anatomy and growth in cattle


Horns are special adaptations of the integument (skin). The corium (the area of cells
located at the junction of the horn and skin) is the site of horn production. If the horn
but not the corium is removed, horns will resume growing. Horns begin as buds
within the skin of the poll. At approximately 2 months of age, the horn buds become
attached to the periosteum of the frontal bone overlying the frontal sinus. As the
horns grow, the cornual diverticulum of the caudal portion of the frontal sinus
extends into the most proximal portion of the horn. The cornual nerve, a branch of
the Trigeminal nerve (cranial nerve V), provides sensation to the skin of the
horn/horn bud region. Injection of a local anesthetic around the cornual nerve as it traverses the frontal crest desensitizes
the area.

Nerve blocks
Cow Goat
Cornual nerve block Cornual & Infratrochlear block
It is the branch of trigeminal nerve midway between eye and This is because goat horns lie more rostrally on skull and
base of horn just below the temporal line. close to the bony orbits.
It is not enough to do a ring block only. Cornual nerve is blocked midway between lateral canthus of
eye and lateral base of horn.
Infratrochlear is blocked midway between medial canthus
of eye and medial base of horn.

Birds
The distal ulna is the site most frequently utilized for the placement of an intraosseous catheter in birds. The proximal
tibiotarsal bone is another site often used. The humerus and femur are pneumatic bones and would deliver fluids into the
respiratory tract.

IMPORTANT SITES

Subcutaneous sites: Lateral flank, Inguinal web, Back

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IM Sites: Pectoral muscles

Intraosseous catheters: Proximal Tibiotarsal & Distal Ulna

Indwelling IV Catheters: Right Jugular (it is larger than left), Basilic (wing vein) & Medial Metatarsal vein.

A 10-year-old mare is evaluated for recumbency. The owner notes the mare was a bit depressed for the past week. The
previous day, the mare was seen to be aimlessly wandering, circling, and not eating. The owner reports she looked
"intoxicated" and was very wobbly. The mare has an unknown vaccine history.

Equine arboviral encephalitis is high on the differential list. What is the antemortem test of choice to confirm a diagnosis of
equine arboviral encephalitis?

The antemortem test of choice for equine arboviral encephalitides is the IgM capture ELISA IgG levels (e.g., neutralizing
antibody titers) can be affected by vaccination and take weeks to rise.

Cerebrospinal fluid (CSF) may be abnormal, but no specific findings are pathognomonic for arboviral infections.

Rarely, the virus can be isolated from the CSF of acute cases

Arboviruses are those transmitted by mosquitoes In North America, there are alphaviruses - most commonly, eastern equine
encephalitis (EEE), western equine encephalitis (WEE), Venezuelan equine encephalitis (VEE); and flaviviruses - most
commonly, West Nile virus (WNV).

Bunyaviruses are Main Drain Virus, Cache Valley Virus & Snowshoe hare virus.

Prevention - vaccination (annually or bi-annually depending on the length of the mosquito season) and mosquito reduction
(e.g., topical insect repellants, removing excess standing water/weeds/manure).

These arboviruses can affect humans so proper diagnosis and report to state veterinary authorities is critical.

FISH
What is the main function of the lateral line system in fish, highlighted here with
an arrow in a goldfish (Carassius auratus)?
The lateral line system helps fish detect movement, vibration, and pressure differences
in the water. This sensitivity gives them the spatial awareness and the ability to
navigate.

Fish use the information they receive from the lateral line organs to orient in water,
hunt, hide, and in schooling behavior.

The main functional unit of the lateral line is a mechanoreceptor called the neuromast,
which resembles the hair cells of the inner ear of mammals. Neuromasts sense changes
in water pressure, movement, and vibration. In a way, the lateral line system is the "ear"
of the fish.

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The swim bladder is an internal gas-filled organ that helps many bony fish control their buoyancy. Evolutionarily, it is
analogous to lungs in mammals. Bouyancy control is important to help fish stay at their current water depth without having
to use up energy in swimming. Because the swim bladder is dorsally positioned above the center of mass, it stabilizes a fish
in the water. For some kinds of fish, the swim bladder is also a resonating chamber that can make or receive sound.
Cartilaginous fish, like sharks and rays, do not have swim bladders.

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TESTIS
The entire structure outlined in yellow is a seminiferous tubule. #1 is the lumen
of the tubule.

Leydig cells (#7, also called interstitial cells) are located in the intersitium
between the seminiferous tubules.

The Leydig cells produce most of the body's testosterone in response to


luteinizing hormone secreted from the pituitary.

Sertoli cells are indicated by #5.

Bone
b= Osteocytes

a= Haversian canal

other part= osteon

Bony trabeculae and spicules form the matrix which contains Red bone marrow and
adipocytes.

LIVER
A hepatic portal triad (labeled #1), is made up of the hepatic artery, portal vein, and
bile duct. Blood from the digestive tract comes through the portal vein which then
flows to the central vein.

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SKELETAL MUSCLE (CROSS-SECTION)
Skeletal muscle (when viewed in cross-section) is made up of bundles of myocytes that
appear circular on cross-section. The myocytes can be distinguished by their circular cross-
sections, well-delineated cell junctions, and peripheral nuclei.

KIDNEY
1= Glomerulus

2= Convoluted tubules

The convoluted tubule has proximal and distal sections connected by the loop of
Henle. It is difficult to differentiate the different sections of the tubule on H and E
histology. Click here to see a diagram of the nephron.

The proximal is about twice as long as the distal. In addition, the proximal tubule
has a slightly larger outside diameter and a distinct brush border.

ADRENAL GLAND
The external portion of the adrenal gland is called the cortex. It develops from the
mesoderm and contains the zona glomerulosa, zona fasciculata, and zona
reticularis.

The cells of the z. glomerulosa secrete mineralocorticoids. The cells of the z.


fasciculata secrete glucocorticoids and the z. reticularis cells secrete adrenal
androgens.

LYMPH NODES
Only the lymph node has Capsule & Subscapular sinus. A lymph node is a kidney-shaped organ of the lymphatic system and
the adaptive immune system. They are major sites of lymphocytes that include B and T cells. Lymph nodes are important for
the proper functioning of the immune system, acting as filters for foreign particles including cancer cells, but have no
detoxification function. In the lymphatic system, a lymph node is a secondary lymphoid organ. A lymph node is enclosed in a
fibrous capsule and is made up of an outer cortex and an inner medulla. Lymph nodes become inflamed or enlarged in various
diseases, which may range from trivial throat infections to life- threatening cancers. The condition of lymph nodes is very
important in cancer staging, which decides the treatment to be used and determines the prognosis. Lymphadenopathy refers
to glands that are enlarged or swollen. When inflamed or enlarged, lymph nodes can be firm or tender.

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OPTHALMIC CONDITIONS
Glaucoma occurs when the normal outflow of aqueous humor
is impaired.

May occur from primary eye disease, like closed filtration angle
or goniodysgenesis. Primary glaucoma is a BILATERAL disease:
the other eye will typically develop glaucoma in 2.5 years even
with Prophylactic TX.

Can also see glaucoma secondary other diseases, like lens


luxation, hyphema, anterior uveitis, or intraocular tumors.

Orbital cellulitis: Presents in large and hunting breed of dogs. Look for acute pain when opening mouth, eyelid swelling,
unilateral prolapse of nictitating membrane, eye protrusion and conjunctivitis. The dogs face looks swollen.

An inclusion body inside of a cell from conjunctival discharge


suggests Chlamydia (Chlamydophilia (Chlamydia) psittaci).

Rx: Tetracyclines
Chlamydophila felis infections cause conjunctivitis and rhinitis.
Clinical signs include serous to purulent naso-ocular discharge
and marked chemosis. Inclusion bodies on the conjunctival
scrape in the side image. Treat with tetracyclines, both ocular
and systemic.

This is ectropion (everted lid margin, eyelid rolled outward).


Think of droopy dogs (i.e.: too much extra skin on the face).

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Entropion

Distichiasis looks like this (note eyelashes touching, irritating


cornea).

Cherry eye

Pannus looks like this. Also called chronic superficial keratitis, think of herding dogs-
German Shepherds, Belgian Tervurens, Border Collies, Australian Shepherds. Also,
Greyhounds, Siberian Huskies.

Anisocoria is having pupils of different sizes. It is tested first in a light room then in a dark room. In well-lighted room
abnormally dilated pupil is more obvious because pupil constricts normally. In a dark room abnormally constricted pupil is
more obvious because normal pupil dilates.

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HORNER’S SYNDROME
Remember "My 3rd Sunken Toe" = Miosis, 3rd eyelid protrudes, Sunken eye, Ptosis (& "sweaty horses"). Horner's is a
syndrome, not a disease per se. Can see 4 things with

Horner's, ALL associated with the eye:

I. MIOSIS (constricted pupil-lose sympathetic innervation)


II. PROTRUSION of 3rd eyelid (nictitans)
III. ENOPHTHALMOS (sunken eye)
IV. PTOSIS (drooped eyelid), +/- anisocoria

Anhidrosis (dry, decreased sweating ipsilaterally) occurs in all animals EXCEPT horses, but can be difficult to observe.
PARADOXICALLY, horses can show profuse sweating ipsilaterally due to loss of peripheral vasoconstriction.

Corneal ulcers are a common injury in horses, dogs & cats.

This is a lens cataract, following the lines of the lens sutures. Often
see cataracts form bilaterally in older dogs and cats and in diabetic
dogs.

Cataracts are an opacity of the lens or its capsule.

LENS PROBLEM

This is a cataract in the LENS, a common problem of older dogs.

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A cataract is a lens opacity and can be inherited; traumatic; age-related; or secondary to diabetes mellitus, uveitis,
glaucoma, retinal disease, or lens luxation. Cataracts are common and are classified by age of onset (congenital, juvenile,
or senile), location (capsule, cortex, or nucleus), and severity (incipient, immature, mature, or hypermature).

Progressive retinal atrophy (PRA) is an example of a condition that affects the funds (retina) and leads to a progressive
loss of photoreceptor cells, resulting in blindness. It would be difficult to diagnose based on this photograph.

Ophthalmoscopic lesions include an increase in the reflectivity of the tapetal funds bilaterally with decreased
pigmentation of the nontapetal fundus, a decrease in the number of retinal vessels, and atrophy of the optic papillla.

Glaucoma is an example of a condition that is caused by decreased aqueous outflow through the iridocorneal drainage
angle or uveoscleral network.

Abnormalities visible with the naked eye might include buphthalmos (big eye), corneal edema, fixed/dilated pupil, and
conjunctival venous congestion.

Keratoconjunctivitis sicca (KCS) and corneal ulcerations are examples of conditions of the cornea. KCS, or "dry eye
syndrome. results from insufficient tear production. Clinical signs of KCS include significant ocular mucus production,
conjunctival hyperemia. corneal edema, and corneal ulcers.

Uveitis is an example of a condition affecting the anterior uvea. It can be caused by trauma, cataracts, infectious disease,
or be idiopathic. Visible clinical signs include corneal edema, conjunctival hyperemia, epiphora, and blepharospasm.

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Formalin and fumes can damage blood smear, therefore do not ship blood smears with formalinfixed tissue samples.

Crenation, Punched-out cells, and Smudge cells are usually artifacts caused by errors during preparation of blood films.

Bovine RBCs are smaller and take longer to pack down, so it is necessary to run the centrifuge longer for cattle than for
cats.

Lipemia is lipedemic serum (milk-colored, fatty) that usually happens after a recent meal. It affects many biochemical
tests.

Hyperlipidemia (high blood lipids) can be caused by sudden metabolic changes (pregnancy, stress) or decrease in feed
quality in horses. If the serum is left sitting too long, then the RBC bicarbonate and glucose can decrease, and phosphorus
and potassium can increase.

Packed cell volume (PCV): is another name for a hematocrit. Is given in percentage. The hemoglobin (Hb, g/dl) correspond
to 1/3 of the PCV. So, if an animal has 30% PCV, it has 10g/dl of Hb.

Red Blood Cells (RBC): Hemosiderin (and ferritin) are a storage form of iron.

Tubes Chemical Important points


Purple top EDTA It lyses RBC of birds and reptiles. EDTA is a calcium total chelate, therefore it inhibits
Ca from activating coagulation factors and platelet aggregation. It does not stain the
cells and doesn’t interfere with blood cell morphology.
Green Top heparin Used for RBC of birds and reptiles. Inhibits thrombin that converts fibrinogen in fibrin.
Blue top Sodium Citrate Reversible calcium chelate. PT & APTT
Red Top coagulation Serum chemistry
accelerator
Yellow top separating gel
gray top sodium fluoride Inhibit glucose breakdown, so it is used to measure glucose and lactate.

Birds and reptiles have nucleated RBC.

Camelids (llamas, camels, and alpacas) have ellipsoid RBC without a central parlor.

Increase the angle between slides of anemic animals.

Romanowsky stains include Wright’s and DiffQuik that are used to stain blood smears.

Reticulocytes (retics): In case of anemia small animals will release reticulocyte and metarubricyte. Ruminants rarely
release reticulocyte. Horses NEVER release reticulocyte and metarubricyte. Reticulocytes can be punctate (mature, single
dot) or aggregate (immature strand). In felines punctate retics can last for 7-10 days, therefore we only count aggregate
retics in felines. In other species, you count both the punctate and aggregate. Use Methylene blue to look for reticulocyte.
If you use Wright’s stain the reticulocytes will appear polychromatic.

New Methylene blue (NMB) is used to stain blood smear to look for reticulocytes.

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Anisocytosis: Different sizes in between RBC of the same blood smear. Microcytosis (small cells) is sometimes seen in
dogs with congenital liver problems like portosystemic shunts.

Polychromasia: different color in between RBC of the same blood smear. It is an indicative of regenerative anemia.

Poikilocytosis: difference in shape and size between RBC that is physiological in goats.

RBC index are blood tests that provide information about the hemoglobin content and size of red blood cells. They are
calculated from RBC measures like erythrocyte count, packed cell volume and hemoglobin concentrations. MCHC is the
most accurate RBC index because is calculated based on packet cell volume. MCH is the least accurate because it is
calculated based on RBC count.

MCHC = hb/PCV
MCH = hb/ RBC
MCV = PCV/ RBC

Mean Corpuscular Hemoglobin Concentration (MCHC): color of the RBC and is recorded in g/dL. Reticulocytes have 40%
less hemoglobin and so they are less pigmented.

Mean Corpuscular Volume (MCV): size of the RBC that is recorded in femtoliters (fL). Reticulocytes are bigger; therefore
a macrocytic anemia is regenerative. Normocytic tends to be non-regenerative. Microcytic is a non-regenerative anemia.

Anemia: 3 causes: Loss, destruction or decrease production, so Hemorrhage, Hemolysis and Decrease in production. After
a severe hemorrhage, you can detect bone marrow response in 2 to 3 days, but maximum response takes around 1 week.
Lack of iron and complex B vitamins will result in a microcytic and hypochromic anemia that is nonregenerative.

Horses that suffered acute blood loss do not have an alteration in PCV and protein in the first 12 hours. Shifts of
extracellular fluid usually takes 12 to 24 hours, and then you have a decrease in PCV and plasma protein.

Polycythemia: Increase in the RBC. Secondary polycythemia is when RBC are increased due to an underlying cause such
as dehydration and splenic contraction. Polycythemia Vera is when you have a disease that makes the bone marrow to
produce more RBC.

Rouleau Formation: piling of erythrocytes that is physiological in felines and horses. It is present during inflammatory
circumstances.

Target Cell: Bad distribution of hemoglobin in RBC due to hepatopathy, hemolytic anemia and iron deficiency.

Spherocyte: is a ball-shaped RBC that was damaged, but it can be caused by auto-hemolytic anemia.

Metarubricyte: nucleated RBCs

Schistocytes: are produced by mechanical fragmentation of erythrocytes on intravascular fibrin strands. Most commonly
a result of DIC, heartworm, Hemangiosarcoma and glomerulonephritis.

Basophilic stippling is the aggregation of ribosomes in the cytoplasm of a RBC, giving it a basophil look. You can see in
animals suffering from lead poisoning.

Acanthocytes: RBC with membrane abnormality that causes numerous, irregularly spaced projections. They occur due to
fragmentation injury, liver disease, DIC or congenital defects. It is a normal finding in young ruminants (calves and kids
with less than 3 months of age). However, it should be differentiated from crenation.

Crenation: is an artifact during making of blood smear that results in RBCs with rounded regularly placed projections
around cell membrane. It occurs if the film is dried too slowly or at high temperature.

Smudge cells are cells that have been damaged when excessive pressure is used during the process of creating a blood
smear.
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Inclusion Bodies
Howell Jolly Heinz bodies
indicative of regenerative anemia, common in felines. can be seen in ghost cells after the damaged Hb is
denatured. It is also evidence of oxidant induced hemolytic
anemia caused by acetaminophen in cats and red maple in
horses. Can be seen in hepatic disease.

BLOOD SMEAR
Body Cells are densely packed. It is the are closest to where blood drop is placed.
Counting area Morphologically evaluated & counted
Feathered edge Examine large abnormal cells, platelet clump, microfilaria

Leukocytosis means an increase in WBC number. Leukopenia means decrease in number of WBC (leukocytes).

Polymorphonuclear cells Family (PMNs): include the eosinophils, neutrophils, and basophils. All WBC are phagocytic,
except thrombocytes (platelets) and lymphocytes.

Neutrophils: Neutrophilia is the increase in neutrophils due to bacterial infection (commonly), recent systemic
inflammatory response, tissue necrosis, autoimmune disease, and corticoid usage for long period of time. Neutropenia
means low levels of neutrophils. Healthy neutrophils may have barr bodies.

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Eosinophils: stain red. Eosinophilia is the increase in eosinophils and happens due to tissue lesion (fleas and ticks), allergic
disorders and parasitism. Eosinopenia means low levels of eosinophils.

Basophils: stain dark blue. It has a similar function to mast cells.

Monocytes: when they migrate to the tissue, they are called macrophages. Play a significant role in intracellular pathogens
such as fungi, virus, and some bacteria (brucellosis and mycobacterium). Monocytosis is an increase in the number of
monocytes and monocytopenia is a decrease in monocytes. Macrophages in the liver are known as Kupffer cells, in the
bones are osteoclasts, in the connective tissue histiocytes and in the nervous tissue microglial cells.

Lymphocytes: responsible for immunologic activity. It is not possible to differentiate a T and a B lymphocyte in a blood
smear. Lymphocytosis is a high lymphocyte count and Lymphopenia is low levels of lymphocytes. High nuclear/ cytoplasm
ratio, chromatin is coarse, clumped & dark staining and sky-blue cytoplasm.

Hyper segmented Neutrophil: neutrophils with more than 5 segmentations. It is an indicative of vitamin deficiency (B9
and B12), chronic inflammation and megaloblastic anemia. Exogenous or endogenous steroid can cause hyper segmented
neutrophils.

Left shift: indicates that immature (no segmented) neutrophils have been released from the bone marrow into circulation
prior to maturation to segmented cells. These immature neutrophils are also known as band cells. (U- shaped)

Toxic Change: are indicative of inflammation. They will include Dohle bodies (pale blue irregularly shaped cytoplasmic
inclusions), increased cytoplasmic basophilia, and foamy/vacuolated cytoplasm. Toxic change indicates accelerated
production of neutrophils by the bone marrow.

Stress Leukogram: is characterized by neutrophilia, lymphopenia, eosinopenia, and potentially Monocytosis. It occurs
primarily in dogs in response to stress, bacterial infection and hyperadrenocorticism. The term stress denotes the presence
of increased cortisol released from the adrenal gland secondary to severe disease (e.g., diabetic ketoacidosis, renal
failure), high body temperature, pain, dehydration, or hyperadrenocorticism.

Inflammatory Leukogram: may be characterized by neutrophilia, or in some instances neutropenia, with or without a left
shift or toxic change.

Fibrinogen is markedly increased (hyperfibrinogenemia) in most cases of chronic inflammation.

Platelets are produced by megakaryocytes. 1/3 of platelets are stored in the spleen, therefore animals that had a
splenectomy will have higher concentration of platelets in the blood.

Coagulation cascade: The extrinsic pathway (factor 7), intrinsic pathway (factor 12, 11, 9 and 8) and common pathway
(factor 10, 5, 2 and 1) together create thrombin that transform fibrinogen into fibrin.

Feline platelets clump easily, so take that in consideration while counting.

Thrombocytosis: increase in number of platelets. Usually due to dehydration, but it can be pathological such as in FeLV
cases.

Thrombocytopenia: decrease in platelets number. Occurs due to: Destruction, Consumption and decrease production.
Consumption can happen due to DIC (Disseminated Intravascular Coagulation), neoplasia or splenomegaly. Destruction
can be due to parasites (Anaplasma) and immune mediated. Decrease platelet function happens due to uremia, hepatic
disease (no production of coagulating factors), antibiotics such as penicillin and cefazolin, NAIES and calcium blocking
drugs (some cardiac drugs and barbiturates).

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Buccal mucosal bleeding time (BMBT): Evaluate primary hemostasis, therefore it only evaluates platelet plug formation
and NOT fibrin formation.

Prothrombin time (PT): measures the overall speed of the extrinsic and common pathways.

Activated Partial thromboplastin time (aPTT): measures the overall speed at which blood clots by means of two
consecutive series of biochemical reactions known as the intrinsic (contact activation pathway) and common coagulation
pathways. It is used in conjunction with another measure of how quickly blood clotting takes place called the prothrombin
time (PT).

Thrombin time (TT): is a blood test that measures the time it takes for a clot to form in the plasma of a blood sample
containing anticoagulant, after an excess of thrombin has been added. It evaluates how long it takes to convert fibrinogen
to fibrin.

Fibrin degradation products (FDP): It evaluates how long it takes to dissolve the clot into plasmin.

Protein Induced by Vitamin K Antagonist (PIVKA): It measures the precursors to the coagulation proteins that accumulate
when vitamin K is absent. Is the most sensitive test for anticoagulant rodenticide toxicity.

DIC: think diseases with H: Heartworm, Heart failure, Hemolytic anemia, Hemangiosarcoma, Hemorrhagic gastroenteritis
and Hepatic disease. Other causes include: Gastric Dilatation Volvulus and pancreatitis.

Blood Transfusion
Major crossmatch Minor crossmatch
determines the presence of preexisting isoantibodies in determines the presence of preexisting isoantibodies in
recipient plasma that could produce adverse reactions. donor plasma. This test is important for animals that have
naturally occurring isoantibodies such as cats and some
dog breeds (German shepherd), in patients that have
already had a transfusion and in multiparous mares.

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TOTAL BLOOD VOLUME
Animals 7-9 %
Horse 8%
Cats 6.5 %

The enzymes AST, ALT, SDH and LDH are indicative of hepatocellular leakage.

AST (aspartate aminotransferase): indicative of rhabdomyolysis (skeletal muscle of large animals) or hepatocellular
leakage (small animals). Great marker for bird hepatic disease.

ALT (Alanine transaminase): only exists inside of hepatocytes and is an indicator of liver damage in small animals.

ALP or AP (Alkaline Phosphate): It has 5 isoenzymes in dogs. Increase with excess osteoblastic activity, therefore may be
increased in growing puppies. It also increased in pregnant animals, high stress levels, cholestasis, intestinal disease, and
steroid therapy.

Liver-ALP
Placenta-ALP
Bone-ALP
Leukocyte-ALP
Corticosteroid-ALP (Occurs in dogs only)

GGT: inducible enzyme that increase in cholestasis but is present in other tissues. High in neonates due to colostrum
absorption and in animals that are treat with anticonvulsants and glucocorticoids. Go to enzyme for hepatic disease in
horses. However, in large animals is also present in the liver, pancreas, and kidneys.

SDH (Sorbital dehydrogenase): very useful for evaluation of acute hepatitis in large animals.

CK (Creatine Kinase): indicative of rhabdomyolysis. It will also be increased in horses with ionophore toxicity.

LDH (Lactate dehydrogenase): indicated hepatocellular leakage enzyme evaluates in large animals but can be increased
in muscle injury.

Bile acids: to evaluate liver function and possible shunt.

Bilirubin increases in hemolytic diseases. Cholestasis may increase bilirubin.

Serum Albumin: more than half of total blood protein. Increase value may be due to dehydration. Decrease values can be
by decrease production (hepatopathy), low dietary protein and loss of protein (enteropathy or renal disease).

Potassium (K): hypokalemic myopathy caused paralysis and the neck has a ventroflexion and is stiff. Hyperkalemia is
cardiotoxic and causes bradycardia, large, spiked T waves, flat or absent P waves, wider QRS complex and S-T segments
depression.

Calcium (Ca): Hypercalcemia is usually idiopathic. Because of renal disease (hypocalcemia), eclampsia (hypocalcemia),
phosphate enemas (hypocalcemia). Hypercalcemia in Neoplasia (lymphoma).

Pancreatic Specific lipase: great to diagnose pancreatitis, but it can give a false positive with renal lesions.

Amylase: Hyperamylasemia is often seen in dogs with exocrine pancreatitis.

Trypsin-like immunoreactivity: tests pancreatic function.

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Chylothorax is an obstruction of the thoracic duct that leads to accumulation of chyle in the thorax. It is a modified
transudate, white, pink in colour typically opaque. It is the accumulation of chyle (triglyceride) fluid resulting from
lymphatic drainage of GIT into pleural cavity. Normally chyle returns to the cranial vena cava via thoracic duct and it can
be secondary to thoracic duct trauma, CHF, or a cranial mediastinal mass or idiopathic.

Anion Gap (AG): Positive cations (Na++K+) minus negative anions (Total CO2 - + Cl-). Total CO2 - can be replaced by
bicarbonate (HCO3 -). Anion gap increases with diabetic ketoacidosis, renal insufficiency, Ethylene glycol toxicity, grain
overload and strenuous exercise.

Metabolic acidosis: caused by decreased concentration of bicarbonate (HCO3 -). It can happen due to loss of bicarbonate
by diarrhea or saliva loss (ruminants) or Titration of Bicarbonate during grain overload, diarrhea, ketosis, diabetic
ketoacidosis, renal disease, and some toxins such as ethylene glycol.

Total bicarbonate deficit is calculated: Total bicarbonate deficit (in mEq) = base deficit ×0.3×Body weight (in kg). Typically
1/3 to ½ of the calculated deficit is administered over 5-10 min and then the remaining is administered over following 12-
24 hours.

Metabolic Alkalosis: caused by decrease concentration of HCl. (Vomiting, displaced abomasum)

Respiratory alkalosis and acidosis are caused by changes in pCO2. Hyperventilation and reduction in pCO2 caused
respiratory alkalosis, while hypoventilation causes an increase in pCO2 and respiratory acidosis.

Urinalysis should be done as soon as possible. Use a drop or 3 of re-suspended sediment after removal of supernatant
from centrifuged urine for examination. Perform tests within 30 minutes.

Herbivores have alkaline urine and carnivores have normally acidic urine. Anorexic animals have acidic urine. Cats & goats
have pungent urine. Horses have cloudy urine.

Cystocentesis is contraindicated in animals with bleeding disorders, ascites, peritonitis, dyspnea, or pain that would cause
distress in dorsal recumbency.

Glomerular filtration rate (GFR) is measured ml/min/kg or by ml/min/square meter. Azotemia: excess of nitrogenous
compounds in the blood. Pre-renal azotemia signs include increase BUN and dehydration. Uremia is the clinical
manifestation of azotemia. Urinary specific gravity (SG) evaluates the kidney capacity of concentrating urine. Classified
in hyposthenuria (less or equal to 1.007), isosthenuria (1.008-1.012) and hypersthenuria (>1.013). Isosthenuria means the
urine osmolality is the same as that of plasma. Bilirubin gives the urine a brownish-greenish color and it usually precedes
icteric signs.

Blood Urea Nitrogen (BUN): suffers influence of hepatic production, diet, gastrointestinal hemorrhage and is reabsorbed
by renal tubules.

Creatinine: constant daily production, suffers small dietary influence, excreted only by glomerular filtration, and does not
suffer reabsorption or secretion. However, it can be bigger in animals with high muscle mass. Creatinine is more sensitive
indicator for acute renal failure than BUN in large animals.

Leukocytes: less than 5 leukocytes per high power field in the urine is normal, more than that is a sign of urinary tract
infection and can be classified as pyuria. Degenerated neutrophils in the urine are known as pyocytes.

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URINARY CRYSTALS
Struvite crystals These are magnesium ammonium phosphate crystals,
also known as triple phosphate crystals or coffin lids.
Often found in alkaline urine.

Calcium oxalate Dihydrate look like square diamonds and can be found in normal
crystals urine.
Calcium oxalate Monohydrate look like lozenges and sometimes can be seen in
crystals antifreeze toxicity (ethylene glycol)

Calcium carbonate wheel-like shape and often appears in healthy horse


urine.

Uric Acid crystals found in Dalmatians as they lack a liver enzyme.

Amorphous phosphate granular precipitate, found in alkaline urine.

Ammonium biurate crystals Found in animals with portosystemic vascular anomaly


(shunts)

Casts: made of Tamm-Horsfall proteins! It may indicate tubular damage.


Hyaline casts if clear or semitransparent they are an indicative of mild glomerular leakage.
Cellular casts like sloughed epithelial cells or RBC with renal hemorrhage or WBC with pyelonephritis.
Waxy casts Older version of granular casts and may indicate severe renal tubular degeneration. They are
wide, blunt, or squared ended and opaque.

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Round cell tumors include Mast cell, Histiocytoma, Lymphoma, Plasmacytoma, Melanoma, basocellular tumors and TVT.
Mast Cell Tumor think cytoplasmic granules

Histiocytoma occurs only in the dog and is the most common skin tumor in this species.
Occurs in young animals (50% are less than 2 years old). Rapidly growing,
dome shaped, often ulcerated lesions approximately 2 cm in diameter. Skin
of the head is the most common site. Do not metastasize and may
spontaneously regress.
Plasmacytoma Round, eccentric nuclei with dense chromatin; bi- and trinucleate cells are
common and characteristic. Image bellow. Marked pleomorphism.

Transmissible Abundant cytoplasm contains distinct clear vacuoles.


Venereal Tumor
(TVT)

Lymphoma Originates in solid tissue (spleen, lymph nodes and thymus) and bone
marrow
Leukemia Originates from blood circulation and bone marrow. They arise from
myeloid cells (monocytes, basophils, eosinophils, megakaryocytes and
erythrocytic precursor cells).

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Daily testing for the LH surge is the most accurate method of ovulation timing as LH surge becomes day 0.

Anestrus has a predominance of parabasal


and intermediate cells with only a few
neutrophils and bacteria. The cellularity is
low (A).

Proestrus (early estrogen influence): From


early to late proestrus, a gradual shift from
parabasal and intermediate cells (small then
larger) and finally superficial cells occurs (B).
Typically, red blood cells are present in large
numbers (C)

Estrus think about corn flakes! Look for more


than 90% cornified superficial cells with
angular, sharp edges and tiny pyknotic nuclei
or no nuclei (D, E). Full cornification usually
coincides with receptivity. The image in the
side shows cornification of cells which is a
sign that estrogen is decreasing, and LH
surge is imminent or just happened.

Diestrus (the luteal phase): Onset of diestrus


is marked by a precipitous decline in the
number of superficial cells and
reappearance of intermediate and parabasal
cells within 1 to 2 days. Neutrophils are
commonly observed (F), and large numbers
of bacteria are also often present (G).

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Gram positive: Blue/purple. Has teichoic acids. Gram Negative: Red. Has an outer membrane and LPS (endotoxemia).

Acid-fast staining is done primarily to detect mycobacteria, which causes bovine tuberculosis (mycobacterium bovis) and
Johne’s disease (Mycobacterium avium subspecies paratuberculosis).

Catalase test that evaluates the presence of catalase enzyme that breaks down hydrogen peroxide producing water and
oxygen.

Coombs test: Used for IMHA and neonatal isoerythrolysis. Direct Coombs test is used to detect the antibodies or
complement proteins that are bound to the surface of red blood cells and is used for autoimmune hemolytic anemia. A
blood sample is taken, and the RBCs are washed (removing the patient's own plasma) and then incubated with anti-human
globulin (Coombs reagent). If this produces agglutination of RBCs, the direct Coombs test is positive. Indirect Coombs test
detects antibodies against RBCs that are present unbound in the patient's serum. In this case, serum is extracted from the
blood sample taken from the patient. Then, the serum is incubated with RBCs of known antigenicity and anti-human
globulin is added. If agglutination occurs, the indirect Coombs test is positive.

Bacterial culture media examples


G+ Phenyl ethyl alcohol agar
G- MacConkey agar
Anaerobic Brucella blood agar
Salmonella Selenite broth
Staphylococcus Mannitol salt agar
Enterobacteriaceae Citrate test media
Show how an organism use Glucose, Sucrose, Lactose and Triple sugar ion slant agar
whether it produces Hydrogen sulfide

Dermatophyte test media (DTM) is used to identify fungal pathogens like ringworm. If it is a positive fungal culture, the
DTM will change color. Another technique is the toothbrush, used specially in cats, as you scrub the hair and then tap it
into the DTM media.

Direct smear technique is preferred for detecting some types of protozoa in feces because they do not survive other
techniques.

PCR: can not distinguish between dead & live organisms. It makes millions of copies of specific DNA section. It is extremely
sensitive & rapid (4 hours).

ELISA: is used in bench top SNAP test. Antigen of interest bind to specific antibody then a substrate is added to see colour
change.

Immunohistochemistry: is similar to ELIS but can be performed on tissue samples not the fluids.

Fungal culture media: DTM, Sabouraud

Fungal staining: PAS, gomori’s methenamine silver and Gridley’s

Rivalta’s test: distilled water mixed with a drop of acetic acid in a clear tube. Then a drop of effusion fluid is carefully
layered on top. If the effusion fluid does not dissolve into the solution or form into a ball shape you have a positive reaction
for Feline Infectious Peritonitis (FIP).

Antimullerian hormone assay: is used to diagnose ovarian remnant. It is also used to diagnose a cryptorchid male.

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Helicobacter spp is a spirochete bacteria present in almost 100% of dogs and cats, but Helicobacter pylori is rarely found
in cats and was not reported in dogs.

Proteus bacteria: does not form discrete colonies when grown on blood agar and tends to swarm, spreading all over the
culture media which may obscure or inhibit other colonies. Use a selective media, like phenylethyl alcohol, to minimize
the effect.

Salmonellosis: Confirmed by isolate from enlarged mesenteric lymph nodes.

Staphylococcus aureus: gram-positive, catalase positive, coccus. Part of the normal flora, especially in birds and humans.
S. pseudointermedius is main in dog.

Streptococci: gram-positive, catalase-negative, non-motile, round and ferment sugars.

Leucocytozoonosis: infect the lymphocytes of birds. Signs of the disease are nonspecific such as lethargy, decreased
production, and death. Treatment is clopidol in feed.

Treponema paraluiscuniculi: causes rabbit syphilis (vent disease) Venereal disease. Similar to hutch burn.

Neorickettsia risticii: causes equine monocytic eherlichiosis or Potomac horse fever. It is transmitted by trematodes
(flukes).

Babesia bovis is a red blood cell protozoon of cattle.

Anaplasma spp. is an obligate intraerythrocytic bacteria, a tick-borne in the order of rickettsials.

Babesia Anaplasma
Feline Leukemia Virus (FeLV): from the family Retroviridae. Diagnosis is done by IFA and/or ELISA. A positive IFA means
the animal is FeLV positive. A positive ELISA alone means presence of antigen, not necessarily infection and therefore,
needs an IFA to confirm it. If ELISA is positive and IFA is negative the animal has an unknown status (regressive or
progressive infection) and should be retested in 30-60 days. Keep in mind that ELISA (highly sensitive) and IFA (high
specificity) measure antigen and are not affected by vaccination status. If you see a regenerative anemia (polychromasia,
reticulocytosis and anisocytosis) in a FeLV positive cat suspect coinfection with Mycoplasma haemofelis.

Feline Immunodeficiency Virus (FIV): from the family Lentiviridae. A positive ELISA in an animal younger than 6 months
should be repeated in 8 to 12 months. If the animal still positive in the ELISA, it should be followed by a western blot
antibody test.

Feline Infectious Peritonitis (FIP): from the family Coronaviridae. Lab work shows hyperglobulinemia and low
albumin/globulin ratio on serum or effusion. The only way to diagnose FIP is histopathology, detection of FCoV antigen in
macrophages by immunofluorescence or immunohistochemical staining. However, you can do a Rivalta’s test (91% sen
and 65% spec) and if positive you have an animal that is likely positive for FIP.

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Tracheal wash with a few neutrophils and macrophages is normal. Too many is abnormal and an
indicative of respiratory infection. In addition, Simonsiella (in the side image) is bacteria normally
inhabit the pharynx and have a large and ladder-like appearance. Presence of Simonsiella indicates
bacterial contamination.

Schirmer’s tear test (STT) strip evaluated the amount of moisture in the eye. A normal eye
should have 18-25mm. Keratoconjunctivitis sicca is one disease that causes dry eye, in cats STT
Simonsiella would be around 10mm and in dogs it would be around 15mm.

Endometrial biopsy predicts the mare’s ability to carry a foal to term. The mare is categorized
in I (80-90 %), IIA (50-80 %), IIB (10-50 %) and III (10 %). III is the worst and the mare should not be used for breeding.
Most mares are category IIA. (Kenny scoring)

The mucin clot test (JOINT FLUID EVALUATIN) is a way to evaluate joint fluid viscosity. Normal joint fluid is very viscous
because it contains mucin. Joint fluid might be evaluated for signs of infectious, inflammatory, or neoplastic arthritis in
cases of lameness, joint swelling. Add equal volumes of 2.5% glacial acetic acid and joint fluid and watch for formation of
a tight white clot in the tube. If no good clot forms (i.e., it is not obvious or soft), the mucin has been degraded by
infectious agents or diluted by effusion in the joint.

Another subjective determination of joint fluid viscosity is the wooden stick applicator test. A wooden applicator stick is
placed into the joint fluid sample and slowly pulled out, forming a strand (normal strand is 2-3 cm long).

Myasthenia gravis: result of autoantibodies binding to the acetylcholine receptors, preventing neurotransmission.
Therefore, the animal cannot walk properly. Diagnosis with an acetylcholine receptor antibody assay (best available) or
a tensilon (edrophonium) test. A muscle biopsy is needed to quantitate acetylcholine receptors for a definitive diagnosis
of congenital myasthenia gravis.

Nosocomial infection: It is a hospital-acquired infection. Examples include parvovirus, kennel cough or salmonella
typhimurium (horses).

Diabetes Mellitus: Clinical finds include high blood sugar and glycosuria. It leads to diabetic cataracts in dogs, but not in
cats! It can also cause pancreatitis (more in dogs than in cats).

Diabetes insipidus: to differentiate diabetes Insipidus (DI) from psychogenic polydipsia (PPD) you need to do a Water
deprivation test and ADH response test.

Water deprivation test: due to medullary washout (loss of the gradient between renal medullary intersitium and urine)
you must deprive the animal from water before ADH test.

ADH response: to differentiate Central DI (lack of ADH due to a problem in the posterior pituitary gland or the
hypothalamus) or Nephrogenic DI (kidney not responding to ADH).

If USG after ONLY the urine concentration test is great than 1.025-30 think PPD or atypical hyperadrenocorticism.

If USG is less than 1.025, perform the ADH test. If the urine concentrates to greater than 1.025-30 think central diabetes
Insipidus. If not concentrate after BOTH tests, think nephrogenic diabetes insipidus.

Cushing’s (Hyperadrenocorticism): In dogs, usually toy breeds, clinical signs include obesity, increased cholesterol,
comedones, panting, increased ALP and sometimes you can see a mild increase in glucose and decrease in BUN. In cats
you see hyperglycemia, concurrent diabetes mellitus (80% of cases), increase cholesterol and increase ALT. Diagnostic test
include Low-dose dexamethasone suppression test (LDDST) and ACTH stimulation test. LDDST is more sensitive (few false
neg), while ACTH stimulation test can identify iatrogenic causes. When you hear the 4 Ps (Panting, Potbelly, PU/PD, and
polyphagia) think Cushing’s. Can use mitotane as treatment.

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Addison’s (Hypoadrenocorticism): Evident when Na:K ratio is less than 27! Look for low sodium, high potassium,
bradycardia, low Cl, high Ca, azotemia, increased PCV and anemia. There is a high incident of Addison’s in Standard
Poodles. Keep in mind that in felines a low Na:K ratio may be associated with other diseases and definitive diagnosis is an
ACTH stimulation test.

Hypothyroidism: can cause facial nerve paralysis. More common in dogs, usually large breeds, and leads to tail alopecia
and tragic facial expression. Other areas of bilateral alopecia are common and include the lateral trunk, caudal thighs,
ventral neck, and dorsum of the nose. Treatment includes thyroxin supplementation.

Hyperthyroidism it is the most common feline endocrine and geriatric disorder usually caused by a functional thyroid
adenoma (adenomatous hyperplasia). In roughly 70% of cases, both thyroids’ lobes are enlarged. Thyroid carcinoma is the
primary cause of hyperthyroidism in dogs, but it is rare in cats (1-2% of cases). Clinical sings include thin, big appetite and
hyperactive cat. Lab finding include high AP. Diagnostic test of choice is serum total T4 (TT4). T3 suppression and TRH
stimulation tests are useful to diagnose mild hyperthyroidism. If left untreated hyperthyroidism can lead to hypertension.
Palliative treatment includes Methimazole (block thyroid hormone synthesis). Curative treatment includes surgical
removal of the affected gland or radioactive iodine therapy to destroy the gland.

Total body water: is 60% of body weight. Is divided into intracellular fluid (inside of cells), extracellular fluid (outside of
the cell) and third space fluid (pericardial, pleural, and peritoneal fluid). The extracellular fluid compose has 1/3 of the
body water and is divided into interstitial tissue fluid (16% of Body weight) and plasma (4% of body weight). The
intracellular fluid has 2/3 of the body water and compose around 40% of body weight. Keep in mind that a 10%
dehydration means 10% decrease of body weight in a non-obese animal.

Sensible losses are the fluid the animal loses by urination. (Hint: sensible losses make sense). Insensible losses are fluid
the animal loses that are hard to measure, like vomiting, diarrhea, and breathing.

Shock the most common type of shock in veterinary medicine is hypovolemic shock. Hypovolemic shock happens when
the total circulating blood volume decreases via loss of fluid such as hemorrhage, vomiting, diarrhea, extreme sweating
(horses) and more. Obstructive shock occurs when cardiac output is mechanically impaired, like in GDV, cardiac
tamponade and more. Cardiogenic shock is seen when the heart fails. Distributive shock develops when blood volume is
pooled in the peripheral circulation like in sepsis, anaphylaxis, heatstroke, and snakebite.

Hypobiosis: is a stage of parasitic life with arrested development. (T. canis, Cyathostomes, Ostertagia)

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Aspergillosis: narrow, hyaline, septate and branching hyphae. Usually a nasal presentation in
dogs.

Coccidioidomycosis by Coccidioides immitis also known as Valley fever is seen in the arid and
semiarid southwestern US (think dusty desert). Clinical signs include fungal pneumonia.

Blastomycosis: animals affected usually come from the river valleys of the central US. Look for lymphadenopathy, draining
cutaneous nodules, pyogranulomatous lesions on various tissues and signs of respiratory
disease (cough and fever).

Histoplasmosis: differential for blastomycosis as it has a


similar distribution if the river valleys in central US. However, clinical signs include chronic
diarrhea and respiratory disease in dogs and respiratory disease in cats. On the smear, the
Histoplasma is much smaller and harder to detect.

Dermatophytosis (Ringworm): Zoonosis! Ringworm is more common in cats and 98% are caused by Microsporum canis.
In dogs it is caused mainly by Microsporum canis (70% of cases), but it can also be by M gypseum (20%) and Trichophyton
mentagrophytes (10%). In cattle the most common is Tricophyton verrucosum and it usually happens in the winter. Clinical
sings include focal or multifocal, sometimes circular regions of alopecia, scaling and crusting with variable amounts of
inflammation and pruritus. Fungal culture of hair stubbles and skin scale can confirm infection. Treatment can be local or
systemic. Itraconazole is the drug of choice for felines but can be expensive for dogs. Ketoconazole can be used in dogs,
but not in cats due to hepatoxicity and anorexia issues.

Dermatophyte culture plates should be incubated in a loosely sealed plastic bag at room temperature kept in a darkened
area for up to 3 weeks.

Trichophyton
Microsporum canis

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Hyperthyroidism Mild increase in ALP & ALT in felines
Stress & Glucocorticoids Increased ALP in dogs only
Feline idiopathic hepatic lipidosis Increase bilirubin & ALP but normal GGT
Cholangiohepatic syndrome Increased GGT
Extra hepatic bile duct obstruction
Hyperadrenocorticism Increased cholesterol & ALP
Horse with acute colitis & Diarrhea Leukopenia and Hypoalbuminemia
Displaced abomasum Metabolic alkalosis
Multiple myeloma Hyperglobulinemia

Ruminal PH
Normal 6
High grain diet 5.5
High roughage diet 6.5
Anorexia 7.5
Prolonged anorexia 7-7.5
Carbohydrate overload 4.5
Urea overfeeding 8.5

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Posology: dosage with therapeutic purposes and a set amount and frequency.
Frequency: SID (once a day), BID (twice a day), TID (three times a day), QID (four times a day), PRN (according
to need), QXH (every X hours) and QXD (every X days).
Pharmacodynamics: biochemical and physiological effects of the drug in the body. Drugs can have an additive,
synergistic or antagonistic effect.
Additive effect is when one drug may add to the effects of the other. Synergism is one drug will potentiate
(intensify) the other. Antagonistic effect means one drug can block the effects of another, it can be physical,
chemical, physiological (functional) or pharmacological.
Pharmacokinetic: pathway of the drug inside the body, from absorption, distribution, metabolism, and
excretion.
Bioavailability: proportion of an administered drug that reaches systemic circulation and is available to have
an effect on the body.
Lipophilic and unchanged drugs are absorbed rapidly.
Distribution describes how a drug moves to various parts and tissues of body after absorption. Blood brain
barrier is on of the most important physical barrier to drugs. Collies have genetic mutation in P-glycoprotein
pump to BBB that renders it non-functional. This allows drugs like ivermectin to readily cross to CNS & cause
toxicity.
Free drug: not bound to albumin and is able to leave the vasculature.
Dose Response relationship: is the relationship between the amount administered and the intensity of the
response produced.
Biotransformation: defined as the enzymatic alteration of drug structure so the drug can be excreted. It
usually happens in the liver, but it can also happen in the kidneys and other organs. The first biotransformation
reaction include oxidation, reduction and hydrolyses, then the drug can be conjugated with other products so
it can be excreted.
Prodrugs: is inactive when taken and once metabolized it becomes active.
Half-life: the time it takes for half of that drug in the plasma to be broken down (metabolized).
Minimum effective concentration (MEC): the minimum amount of drug needed for a response.
Potency: the amount of drug needed to produce a desired effect.
Factors that impact intensity of drug response include prescribed dose, administered dose, concentration at
site of action and intensity of response.
Routes of administration: enteral (PO) or parenteral (IV, IM or SQ). Can also be done intraosseous (IO),
inhalation, suppositories (rectal), intradermal (under the skin), transdermal and topical.
4 primary receptor families: Kinase-linked receptor, Ligand-gated ion channel, G protein-couple receptor
system and Nucleus receptor.
Non-specific drugs: can act in any type of tissue. Examples include ice baths.
Nonselective drugs: works on several difference receptors.
Agonist: molecules that active receptors and mimic the actions of endogenous regulatory molecules.
Antagonists: prevent activation of receptors.
Affinity: the strength of the attraction between a drug and its receptor.
Therapeutic index (TI): measure of drug safety. Is the ratio between the lethal dose (LD) to an effective dose
(ED). High/wide TI the safer the drug. Low/narrow TI the less safe the drug.
Lethal dose (LD): necessary dose to kill 50% of patients.
Drug interaction: have an interaction with another drug or food.
Drug incompatibility: drugs that cannot mix together before entering the body.
Side effects: non-desired effects
Adverse drug reaction: more harmful effect a drug can have.
Allergic reaction: immune system part of response to a drug.
Idiosyncratic effect: when an individual has a unique response to a drug.
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Tachyphylaxis: When a drug is administered a few times and the patient stops responding to it.
Tolerance: reduced action of a drug following repeated use.
Nutraceutical: is a pharmaceutical-grade and standardized nutrient
Compounded medication: example of extra-label drug use. Involves the manipulation of federally approved
drug by a licensed veterinarian or pharmacist to meet the specific needs of a veterinary patient. This include
adding flavoring, suspension or mixing different drugs together.

Autacoid
3 types of autacoids: amines (histamine, serotonin, and antagonists), peptides (angiotensin and cyanine) and lipids
(prostaglandins).

Histamine: stores 90% in cellular compartment (basophils and macrophages) or produced and released by non-cellular
compartment. There are 2 histamine receptors: H1 (IgE receptor) or H2 (histamine related gastric secretion).

Antihistamine

Antagonist of H1, H2, H3 and H4 receptor. Side effects: sedative (1st generation drug). Drugs: 1st generation:
Diphenhydramine, Promethazine, Hydroxyzine, and 2nd generation: Loratadine and astemizol.

Anti-acids

Antagonist of H2. Decrease the absorption of drugs that need an acid pH to be absorbed, such as antifungals. Side
effects: nausea, diarrhea, constipation, CNS effects (IV). They also affect the drugs: diazepam (anti-seizure), warfarin
(blood finer) and theophylline (bronchodilator). Drugs: 1st generation: Cimetidine, 2nd generation: Ranitidine (also a
prokinetic) and 3rd generation: Famotidine.

Serotonin: 5-HT receptor that is related to sleep regulation, pain perception, depression, bronchoconstriction, GI
motility and platelet function. Ondansetron is a serotonin antagonist used as an antiemetic in small animals. Cisapride
is a serotonin agonist that works as a prokinetic as it acts in the myenteric plexus.

Peptides: usually control the blood pressure as they interact with the Renin-AngiotensinAldosterone system. The
drugs usually are Angiotensin-converting Enzyme (ACE) inhibitors or Angiotensin II receptor blockers (ARBs). ACE
inhibitors include: Benazepril, Enalapril and Captopril. ARBs inhibit include: Losartan, telmisartan, valsartan, and
candesartan.

Enalapril is used as a vasodilator for hypertension and CHF. Decrease aldosterone induced fluid retention.

It mimics the cortisol produced by the body. Corticoids are produced by the cortical part of the adrenal gland.
Biotransformation is 70% hepatic and excretion are almost 100% renal. These drugs effects include
immunosuppression (phospholipase A2 inhibition), membrane stabilizing, hyperglycemia (increase of
gluconeogenesis), increase protein catabolism, sodium retention, potassium elimination, increase of total white blood
cell count, lymphopenia, and birth induction. All those effects together make the classical “potato” dog with Cushing’s
(hyperadrenocorticism) that has very thin legs (protein catabolism) and big belly (increased liver due to
gluconeogenesis).

short acting hydrocortisone and cortisone. (<12h)


Intermediate action: prednisone and prednisolone. (12-36h)
Long action: betamethasone, dexamethasone and flumethasone. (>36h)

Budesonide is a glucocorticoid used in inhalant preparations for asthma or orally in prednisoloneintolerant patients.
Other glucocorticoids include Triamcinolone. Budesonide is used to trat IBD & diabetes mellitus.

Cats do not have a bunch of liver enzymes, therefore try to use prednisolone, which is the active form of prednisone.

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Overdose of dexamethasone causes anorexia, melena, anemia, and ulcerations. It is 8-10 times more potent than
prednisolone. Calculate prednisolone dose and divide by 8 to get dexamethasone dose.

Acute equine laminitis should not be used with corticosteroids & ACTH because they decrease protein synthesis and
increase tissue insulin resistance.

Used against inflammation (especially muscle related), somatic pain, fever, thromboembolism and endotoxemia.

Monito BP if giving NSAIDS before surgery because renal flow can be impaired by hypotension.

Side effects usually happens due to prolonged usage and include gastritis, gastric ulcers, nephritis, and renal failure.
Misoprostol, a synthetic prostaglandin E1 analog, may be given concurrently with NSAIDs to decrease gastric acid
secretion.

Cats have a deficiency of the glucoronyl transferase enzyme in the liver; therefore they cannot process NSAIDs as well
as dogs. Therefore, be careful at dosing.

Derivatives of acetylsalicylic acid: anti-inflammatory, antipyretic, inhibit platelet aggregation and analgesic (minor).
Drugs: Aspirin. Aspirin is toxic to cats.

Derivatives of Acetic acid: anti-inflammatory (elevated), analgesic (elevated) and chondroprotective. Drugs:
Diclofenac. Diclofenac is toxic to dogs.

Derivatives of Propionic Acid: Ibuprofen, Naproxen (potent anti-inflammatory, antipyretic, and analgesic), ketoprofen
and Carprofen (potent anti-inflammatory, mild analgesic). Carprofen is the go-to drug for dogs after orthopedic
surgery, is very well tolerated and can be used for 2 weeks without risk. However, carprofen can lead to hepatopathy.
Contraindicated in patients with bleeding disorders.

Derivatives of Amino nicotinic acid: Flunixin meglumine (potent anti-inflammatory, antipyretic, analgesic and
endotoxemic).

Derivatives of Enolic Acid: Include the pyrazolones (phenylbutazone) and oxicams (meloxicam, piroxicam etc.).
Phenylbutazone potent anti-inflammatory, antipyretic, analgesic, and antispasmodic (minor), but it can cause necrosis
if done perivascular. Meloxicam is anti-inflammatory (more COX-2 selective), analgesic and chondroprotective.

Phenylbutazone can cause stimulation of CNS, seizures, collapse, and death if done intra-arterial in horses. When the
drug is used for long term it can cause ulcer in the right dorsal colon, recurrent colic, and oral ulcers.

Dimethylsulfoxide (DMSO): potent anti-inflammatory and analgesic, especially for acute pain. Go to drug for horses.

Cox-1 inhibitors: aspirin, phenylbutazone, flunixin meglumine: cause GIT ulcerations

Cox-2 inhibitors: carprofen, meloxicam, Robenacoxib, firocoxib

Firocoxib is least likely to cause GIT ulcerations & renal diseases in horses.

For cat use: Robenacoxib & Meloxicam

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β-Lactam antibiotics
Penicillins: Procaine, Penicillin G (Na+ or K+), Penicillin, Ampicillin, Amoxicillin, Oxacillin, Ticarcillin and Imipenem

Cephalosporins: 1st: Cefadroxil, Cefazolin, Cephalothin and Cephalexin, 2nd: Cefoxitin and Cefuroxime, 3rd Ceftiofur,
cefotaxime, Ceftazidime and Cefovecin and 4th cefepime and ceftazidime.

Mode of action: β-Lactams impair the development of bacterial cell walls by interfering with transpeptidase enzymes
responsible for the formation of the cross-links between peptidoglycan strands. β-Lactam antibiotics have little
influence on formed bacterial cell walls, and even susceptible organisms must be actively multiplying or growing.

Resistance: Bacterial resistance is related to the permeability barrier, β-lactamase resistance (most important one),
specific bacterial-binding proteins and cell wall-deficient microbes, such as Mycoplasma. The permeability barrier
happens in Gram-negative bacteria that have a restricting sieving mechanism (porins) in their outer membranes
(external cell wall), which reduces the penetration of several types of antibiotics. β-lactamase resistance is related to
enzymatic inactivation by β-lactamases (penicillinases) by cleavage of the 4-member β-lactam ring, which results in
the inability of the drugs to bind to the target PBPs. β-Lactamases are produced by both gram-positive (Staphylococcus
aureus, S epidermidis, S pseudintermedius but generally not enterococci) and gramnegative organisms.

Clavulanate-potentiated amoxicillin is an excellent example of such a synergistic association.

Sulfonamides and Sulfonamide Combinations


Effective against gram-positive, some gram-negative and some protozoa (toxoplasma gondii, Isospora and Eimeria).
Hepatic biotransformation and renal secretion. These drug pass the blood brain barrier and the placenta. These drug
needs the acid stomach pH to be fully absorbed so should not be associated with antiacids. It should also not be
associated with B9 supplementation (folic acid precursor).

Mode of action: They inhibit the PABA activity and therefore the formation of folic acid, which inhibit the formation
of new DNA chains. It is not effective in bacteria that use the host’s folic acid, such as Leptospira.

Sulfas should be associated with trimethoprim, which also effects the folic acid pathway in the formation of DNA and
other proteins. Sulfonamides by themselves are bacteriostatic but associated with trimethoprim they are bactericidal.

Toxicity: Trimethoprim sulfa can cause GI distress at high doses or after oral administration. It can also cause
keratoconjunctivitis sicca, type 1 and 3 hypersensitivity, hepatitis, hemolytic anemia, urticaria, hematuria and bone
marrow depression in dogs.

Quinolones
Bactericidal and concentration dependent. Effective against gram-negative, gram-positive aerobes and Pseudomonas
aeruginosa. Partially biotransform by the liver and excreted in active form in the urine and bile.

Mode of action: inhibit bacterial enzyme topoisomerases, including topoisomerase II (DNA gyrase) and topoisomerase
IV. Therefore, they inhibit DNA conformation and by that, its function.

Quinolones also have significant activity against Mycoplasma and Chlamydia spp. Quinolones should not be associated
with anti-acids or iron supplements as both decrease its bioavailability in the body. It should also not be associated
with NSAIDs as it causes CNS excitation. Fluoroquinolones are active against intracellular pathogens, including, e.g.,
Brucella spp. However, it can cause damaged cartilage in young animals.

Fluoroquinoles of interest include: Enrofloxacin, Ciprofloxacin, Difloxacin, Marbofloxacin and Orbifloxacin.

Aminoglycosides
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Used for salmonella (G -)

Mode of action: they attach to the 30S ribosome subunit (sometimes binds to 50S), which stops protein production
or make them defective, killing the bacteria.

Narrow-spectrum aminoglycosides include: streptomycin, which are mainly active against aerobic, gram-negative
bacteria.

Expanded-spectrum aminoglycosides include: Neomycin, framycetin (neomycin B), paromomycin (aminosidine), and
kanamycin have broader spectra than streptomycin that includes many gramnegative aerobic bacteria. Gentamicin,
tobramycin, amikacin (synthesized from kanamycin), sisomicin, and netilmicin are aminoglycosides with extended
spectra that include Pseudomonas aeruginosa.

Toxic effects:

Bradycardia
nephrotoxicity (dose dependent)
ototoxic
neuromuscular blockage (In cases of botulism, avoid Gentamicin due to neuromuscular blockage.)

Macrolides
Mode of action: Interfere with protein synthesis by reversibly binding to the 50S subunit of the ribosome

Drugs on interest include erythromycin, azithromycin, and clarithromycin, tylosine & tilmicosin.

Adult horses and swine may present with GI problems.

Lincosamides
They are bacteriostatic or bactericidal depending on the concentration and the time. Effective against gram positive
anaerobes.

Mode of action: bind exclusively to the 50S subunit of bacterial ribosomes and suppress protein synthesis.

Drugs of interest include: Lincomycin and Clindamycin.

Can cause GI disturbances or skeletal muscle paralysis. Clindamycin is contraindicated for use in some horses, guinea
pigs, hamsters, rabbits, chinchillas, and ruminants. Lincosamides are contraindicated in horses, because severe and
even fatal colitis may develop. Basically, use Lincosamides only in dogs and cats.

Tetracyclines
Bacteriostatic and time dependent. Effective against both aerobic and anaerobic gram-positive and gram-negative
bacteria, mycoplasmas, rickettsiae, chlamydia, and even some protozoa (amebae).

These group divided between short-acting (tetracycline, oxytetracycline, chlortetracycline), intermediate-acting


(demethylchlortetracycline and methacycline), and long-acting (doxycycline and minocycline)

Mode of action: Reversible binding to the bacterial 30S ribosomal subunit, and specifically at the aminoacyl-tRNA
acceptor ("A") site on the mRNA ribosomal complex, thus preventing ribosomal translation.

Resistance: Mutant strains that do not have the necessary transport system, plasmid- or transposon-mediated
acquisition of active efflux pumps or production of protective protein.

Side effects: Vomiting! Tetracyclines chelate calcium in teeth and bones, inhibit calcification (e.g., hypoplastic dental
enamel), and cause yellowish then brownish discoloration. At extremely high concentrations, the healing processes in
fractured bones is impaired. Rapid IV injection of a tetracycline can result in hypotension and sudden collapse. It can
be nephrotoxic and cause GI upset.
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Doxycycline, when compared to oxytetracycline and tetracycline, is less likely to cause skeletal abnormalities, can be
given in patients with renal insufficiency, injection is safe in horses, can be used with niacinamide to treat certain
inflammatory dermatoses and has high penetration in the cerebral spinal fluid. It can cause esophageal stricture in
cats if not given with food. Should not be given with anti-acids or iron as it decreases its absorption.

Polymyxin B at low doses can bind to endotoxins in horses’ circulation. It also has an anti-tumor necrosis factor
activity.

Chloramphenicol: Binds to 50S ribosomal subunit and interferes with protein. Bone marrow depression in
humans. DO not use in food animals. Cause aplastic anemia.

Vancomycin: Interferes with cell wall synthesis. Usage is limit to organism resistant to other antimicrobials.

Rifampin: Main indication is R. equi pneumonia in foals.

Metronizadole: Neurologic side effects (weakness, ataxia, vestibular signs) and anorexia. Treat IBD, Giardia & other
protozoans.

Factors that contribute to fungal infection include necrotic tissue, a moist environment, and immunosuppression.
Fungal infections can be primarily superficial and irritating (e.g., dermatophytosis) or systemic and life threatening
(e.g., blastomycosis, cryptococcosis, histoplasmosis, coccidioidomycosis).

Imizadoles
Imidazoles may have antibacterial, antifungal, antiprotozoal, and anthelmintic activity. Clotrimazole, miconazole,
econazole, ketoconazole, itraconazole, and fluconazole are the most clinically important members of this group.
Hepatic biotransformation and bile excretion. The imidazoles are rapidly but sometimes erratically absorbed from the
GI tract. An acidic environment is required for dissolution of the imidazoles, and a decrease in gastric acidity can reduce
bioavailability after administration PO, therefore give it with food and do not associate anti-acids.

Mode of Action: Imidazoles alter the cell membrane permeability by blocking the synthesis of ergosterol, the primary
cell sterol of fungi, causing cell membrane and internal organelle disruption and cell death.

Fluconazole does not react the CSF. Ketonazole is a known teratogenic.

Amphotericin B
Amphotericin B is used in progressive or disseminated deep mycosis. It is poorly absorbed from the GI tract and must
be given parenterally

Mode of action: binds to sterols (especially ergosterol), causing increased permeability and leakage of nutrients and
electrolytes. Side effects: nephrotoxicity, fever, vomiting and nausea.

Griseofulvin
Teratogenic & Bone marrow suppression

Drugs that target viral processes must penetrate host cells; further, because viruses often assume direction of cell
division, drugs that negatively impact a virus are also likely to negatively impact normal pathways of the host. For

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these reasons, particularly compared with antibacterial drugs, antiviral drugs are characterized by a narrow
therapeutic margin.
Drug Mechanism of Action Spectrum Comments
DNA virus: Herpes
Unable to eliminate latent
Acyclovir Inhibitor of viral DNA polymerase. virus and Equine
infections
Binding to DNA polymerase is sarcoid
irreversible and DNA chain is Prodrug is Famcyclovir.
Peniciclovir terminated. DNA virus Less potent than
acyclovir.
Specific inhibition of viral- Toxicity is manifest by
associated enzymes, inhibition of anorexia, weight loss,
Ribavirin the capping of viral mRNA, and RNA and DNA virus. bone marrow depression
inhibition of viral polypeptide and anemia, and GI
synthesis. disturbances.
The shared mechanism of action
is inhibition of RNA-dependent
Granulocytopenia and
DNA polymerase (reverse
Zidovudine Variety of anemia are the major
transcriptase). Therefore, it is
(AZT) Retroviruses adverse effects of AZT in
incorporated into DNA
human patients
transcription, preventing viral
replication.
Act on an early step of viral
replication, which leads to
inhibition or delay of the
uncoating process that precedes Side effects are CNS
Amantadine Influenza Virus.
primary transcription. Therefore, related.
It also interfere with the early
stages of viral mRNA
transcription.
Ocular herpesvirus
Inhibits many viral and human and systemically for
Bone marrow suppression
Vidarabine DNA polymerases and thus DNA herpetic encephalitis
and CNS signs.
synthesis. and neonatal herpes
viral infection.

Interferon is an immune modulator that activates macrophages and stimulates cytotoxic and phagocytic activity from
different cells, therefore helping defeat viral infections.

Furosemide, a loop diuretic, can be administered intravenously to dogs and cats to treat life threatening pulmonary
edema caused by CHF. Oral furosemide is also the first-line diuretic for the long-term management of CHF. Improve
the race performance by lowering exercise induced pulmonary hemorrhages.

Hydrochlorothiazide and Chlorothiazide are thiazide diuretics that works on the distal convoluted tubule. They
are considered a rescue diuretic and can provide additional diuresis in patients with furosemide resistance.

Spironolactone or Amiloride, potassium-sparing diuretics, are weak diuretics that should never be used as a
sole treatment for patients with CHF. Spironolactone is typically used in patients with right side CHF, those with
hypokalemia from other diuretics, or as adjunctive therapy. It is an aldosterone antagonist.

Torsemide, a potent loop diuretic, works similarly to furosemide but is only available commercially as an oral tablet.

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Inotropic effect is related to cardiac strength of contraction. Chronotropic effect (is the frequency of cardiac
contraction (chronologic= time).

Cardiac drugs include positive inotropes, ACE inhibitors, vasoactive drugs, antiarrhythmics, hematinics, hemostatics,
anticoagulants and drugs used to prevent and treat heartworm.

Increase the strength of the heart muscle by increasing the amount of calcium available for binding to muscle proteins.
There are 3 classes of positive inotropes: cardiac glycosides, beta-adrenergic agonists, and phosphodiesterase
inhibitors.

Positive inotropes & negative chromotropes

Mainly used to treat supraventricular tachyarrhythmia by suppression of AV node.

Cardiac glycosides
Drug of interest: Digoxin and digitoxin.

Mode of action: inhibition of the membrane-bound Na+/K+-ATPase pump; when this occurs, Na+ increases in the cell,
the exchange of Na+ for Ca2+ via the Na+/Ca2+ exchange pump is augmented, and there is a small increase in calcium
influx.

β -Adrenergic Agonists
They cause a positive inotropic effect by activating β-receptors with subsequent stimulation of adenylate cyclase and
increased cAMP. Drugs on interest include dopamine, dobutamine, epinephrine and Isoproterenol.

Dopamine is an endogenous catecholamine precursor with selective β1 activity. However, it also stimulates release of
norepinephrine. At low doses, it stimulates renal dopaminergic receptors, which causes increased renal blood flow
and diuresis. Indications include cardiogenic or endotoxic shock and oliguria.

Dobutamine is a more effective positive inotrope than dopamine with less chronotropic effects, although it does not
dilate the renal vascular bed. It does not cause release of norepinephrine.

Epinephrine with its β1 and β2 effects causes the greatest increase in the rate of energy usage and myocardial oxygen
demand. This increase in oxygen need may be detrimental to the failing heart, but epinephrine is used in CPR to
increase coronary circulation via peripheral vasoconstriction. Epinephrine also causes vasoconstriction and
bronchodilation. Cannot be done PO.

Isoproterenol is a nonspecific β-agonist that, like epinephrine, increases myocardial oxygen demand. Tachycardia and
the potential for other arrhythmias excludes its use in a cardiac patient except for short-term therapy of
bradyarrhythmia’s (e.g., AV block). It is typically used as a CRI to effect based on the heart rate desired.

Phosphodiesterase (PDE) inhibitors


Also known as inodilators. Mechanism of action is by blocking the breakdown of cAMP and therefore increase
intracellular cAMP concentrations. The result is an increase in myocardial contractility and peripheral vasodilation.
Drugs of interest include Milrinone, Amrinone, Theophylline and Pimobendane.

Theophylline (Methylxanthine derivatives) have significant CNS, renal, and smooth muscle effects, including on
bronchial smooth muscle. The use of methylxanthines in cardiac disease is limited to conditions that would benefit
from bronchodilation.

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Pimobendane is a positive inotrope and balanced systemic arterial and venous dilator. Causes minor increase
intracellular calcium concentration and myocardial oxygen consumption. It has largely replaced digoxin.

Phosphodiesterase 5 (PDE 5) Inhibitor


Sildenafil works through the inhibition of PDE 5 in the small arterioles of the lung (and corpus cavernosum of the
penis) leads to dilation that is more significant than dilation of the systemic arterioles. Go to drug for pulmonary
hypertension.

There are 4 classes of antiarrhythmics, grouped according to how they affect the heart cells.

Class I agents comprise the group of agents generally known as "membrane-stabilizing drugs" such as quinidine,
procainamide, and lidocaine. These agents work by selectively blocking a proportion of the fast sodium channels
in cardiomyocytes, leading to depression of phase 0 of the action potential and subsequent reductions in conduction
velocity. Other drugs include Mexiletine, Tocainide and Phenytoin.

Class II antiarrhythmic drugs are the β-adrenergic receptor blocking agents that also have cardioprotective
effects. Drugs of interest include Propranolol (do not use in animals with asthma), Atenolol and Carvedilol.
Propranolol must be gradually tapered down prior to discontinuation because it leads to upregulation of beta
receptors and possible fatal cardiac arrhythmias.

Class III drugs is potassium channel blockade leading to prolongation of the cardiac action potential and its
refractory period. Drugs of interest include Sotalol and Amiodarone.

Class IV antiarrhythmic drugs is blockade of the slow calcium channels in cardiac cells and vascular
smooth muscle. The most commonly used drugs are Diltiazem and Amlodipine, verapamil. Diltiazem is a calcium
channel blocker, antiarrhythmic and have negative inotropic effects. Overdose of calcium channel blockers (diltiazem,
amlodipine, and verapamil) can cause hypotension, bradycardia, and pulmonary edema.

Amlodipine is the only calcium channel blocker used in veterinary medicine that has potent arterial dilatory effects
with negligible effects on inotropy and conduction. Used to treat hypertension in dogs and cats.

Hematinics are drugs that increase the amount of hemoglobin (the portion of the red blood cell that carries oxygen
throughout the body) and the number of red blood cells in the blood. Are used to treat anemia.

Hemostatics Used to help the blood clot. Lyophilized concentrates are applied to the skin or to a particular area to
help control capillary (small blood vessel) bleeding. Astringents are used directly at the site of bleeding to control
bleeding. They constrict the blood vessels and tissue to help slow and stop the blood flow. Epinephrine and
norepinephrine are used to constrict the blood vessels and decrease blood flow to the tissues. Systemic hemostatics
include fresh blood or blood components that are given to animals that cannot clot correctly.

Anticoagulant drugs are used to stop or minimize the clotting process, usually by inactivating the body’s natural
clotting factors or increasing the rate at which the body dissolves clots.

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Prevention of heartworm in dogs and cats: macrolide drugs (ivermectin, milbemycin oxime, moxidectin, and
selamectin). For dogs infected with heartworms, melarsomine dihydrochloride is the only available drug to kill the
adult worms. Ivermectin can be used to kill microfilariae and immature heartworms, before giving melarsomine.
Macrolides can also be prescribed to treat microfilariae in infected dogs, although they are not approved by the US
Food and Drug Administration for this purpose.

Appetite Stimulant: Cyproheptadine (antihistamine and antiserotonin), Mirtazapine, Buclizine, diazepam (cats) and
Elfazepam (ruminants). Diazepam as an appetite stimulant can cause hepatotoxicity.

Emetic drugs: Xylazine (cats) and apomorphine.

Anti-emetics: Metoclopramide, Maropitant (serenia), Ondansetron and Diphenhydramine (cats). Metoclopramide can
cross the BBB and cause extrapyramidal neurologic side effects (movement disorders and aggression).

Adsorbents (inhibit absorption): Caolin-pectin formulas, activated charcoal, and bismuth subsalicylate are popular
therapies for diarrhea.

Prokinetic drugs: metoclopramide, domperidone and neostigmine.

Antacids: Famotidine, Ranitidine and Omeprazole (proton pump inhibitor). Omeprazole decreases gastric acid
secretions by inhibiting H/K- ATPase proton pump at luminal surface of parietal cells.

Antidiarrheal: Opioids such as Lomotil and loperamide.

Laxative (Cathartic) drugs: mineral oil, Methylcellulose, Magnesium Salts, Anticholinergic drugs, and lactulose.
Lactulose is the go-to drug for megacolon.

Enemas: Sodium phosphate and Sodium biphosphate. Do not do a Sodium phosphate enema in cats, dogs under 10kg
and in patients with renal disease, hypernatremia, hyperphosphatemia, and hypocalcemia. Docusate is a stool softer.

Treatment of chronic constipation: low residue, high fiber diet, prokinetics, laxatives.

Sulfonylurea (oral hypoglycemic agent) for uncomplicated diabetic animals with no history of ketoacidosis.

Regular (fastest acting, shortest duration), NPH, Lente, Ultralente, Glargine and PZI.

Intermediate duration, remember N so NPH and Lente.

For longest duration remember the end of the alphabet: ultralente, Glargine and PZI. Glargine is usually given in cats
and Lente or NPH in dogs. Insulin usually lasts less in cats.

Glipizide is a human oral hypoglycemic agent sometimes used in dietary therapy to manage cats with uncomplicated
type 2 diabetes.

Detemir insulin starting dose is LOWER in dogs. Canine insulin receptors are 4X more sensitive to detemir than are
human receptors. Detemir is human insulin analog. Higher risk of hypoglycemia with detemir. Administered SC every
12 hours.

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Calcitonin decreases bone resorption and decreases the amount of calcium available to move from bone to plasma. It
also promotes renal excretion of calcium and phosphorus.

Pergolide: treatment drug for EQUINE Cushing’s, which is caused by pituitary intermedia dysfunction secondary to
loss of dopaminergic inhibition.

Trilostane inhibits 3- beta hydroxysteroid dehydrogenase, an enzyme in the pathway of cortisol synthesis.

Mitotane: use to treat hyperadrenocorticism (Cushing’s) in dogs. It causes necrosis of the cortisol producing zones of
adrenal gland.

Methimazole: use to treat hyperthyroidism in cats.

Loklivetmab: is a dog specific monoclonal antibody that neutralize interleukin-31. It is labeled to treat allergic & atopic
dermatitis in dogs and given monthly SQ injection.

Alprazolam: is GABA potentiation drug used to treat behavior issues. Usually used to moderate anxiety in the urine
spraying cat.

Phenobarbital: mostly used drug. Should not be used in hepatotoxicity.

Potassium bromide: 2nd most used but not used in cats.

Levetiracetam: is a well-tolerated anticonvulsant in dog & cat. One of the few that is cleared by kidney.

Gonadotropin-releasing hormone (GnRH): used to treat follicular cystic ovarian disease. It initiates the release of LH.

Prostaglandin F2-alpha (PGF2-alpha): treatment of luteal cysts.

Estradiol: teratogenic in pregnant animals and is associated with cystic endometrial hyperplasia, pyometra, bone
marrow suppression and potentially fatal aplastic anemia in dogs and cats.

Chorionic gonadotrophin in aquaculture for fishes improves spawning function in males and females.

Ionophore: antibiotic used in beef cattle (in feed) to increase the production of propionic volatile fatty acid, decrease
bloat and acidosis. Toxic to horses.

Tilmicosin: is a macrolide contraindicated in pigs (injection may kill them and us). Should only be used in food.

Azathioprine: inhibit T cell proliferation. Toxic to cats causing bone marrow suppression. It can also cause vomiting
and diarrhea.

Doxorubicin HCL: most common drug use for carcinomas and sarcomas. Can be myelosuppressive and cardiotoxic
in breeds that are pre-disposed to DCM such as Dobermans, great Danes, boxers, and Rottweilers.
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Carboplatin: interrupts replication of DNA tumor cells. Side effects include vomiting and nephrotoxicity.

Cisplatin; interrupts replication of DNA tumor cells. Side effects include vomiting and nephrotoxicity, pulmonary
toxicosis in cats, potassium wasting and depletion of magnesium. Cyclophosphamide: bone marrow toxicity, vomiting
and diarrhea.

Lomustine

Chlorambucil: cytotoxic agent. Can cause diarrhea and anorexia. Go to drug for inflammatory bowel disease.

Isotretinoin: keratinization-stabilizing drug that is a known powerful teratogens. Keep in a separate place of human
medicine and pregnant women should avoid. Adverse effects include focal calcification in the heart and muscle.

Oclacitinib: Janus kinase inhibitor; used for allergic dermatitis. Common side effects include gastrointestinal upset,
vomiting, inappetence, diarrhea, lethargy, and polydipsia.

Cyclosporine (Atopica) is frequently used to treat feline atopic dermatitis. However, is contraindicated in cats, FeLV,
FIV, toxoplasma and in cats with malignancies.

Euthyroid Sick Syndrome: Drugs usage for non-thyroidal illness causes a decrease in T3/T4 hormones. Drugs that
can depress T3/T4 include: Glucocorticoids, anabolic steroids, anticonvulsants, phenylbutazone, Ipodate (radiographic
contrast agent), Furosemide, Anesthetic agents (methoxyflurane, halothane) and Mitotane.

Tyzzer’s disease: is caused by clostridium piliforme and is predisposed by sulfonamide antibiotics.

8%= 80mg/ml

1mEq/L=1 mmol/L

How much sterile water to add to a 25g bottle to make it 8%?

80mg – 1Ml 25000mg – Xml X = 321.5ml

30cc = 1oz

1cc=1ml

1kg=2.2lb

How much an animal should eat? Formula Kcal/day= (30× body weight in kg) + 70

What is the concentration of a solution containing 1mEq/L of NaCl in mg/L if the molecular weight of sodium (Na+) is
23g and the molecular weight of Chloride (Cl-) is 35.5g? Mg = (mEq × atomic weight)/valence mg= (1 × (23+35.5))/1,
so mg=58.5mg/L Valence is 1 because Na is +1 and of Cl is -1.

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o Lots of toxic effect, remember TWO TOXIC T’s – Tetracycline and Trimethoprim-Sulfa (TMS).
o Drugs that are ok to use in Hamsters, guinea pigs and rabbits are: Trimethoprim Sulfa, Chloramphenicol and
Enrofloxacin (remember ETC).
o Rabbits, hamsters, and other rodents are very sensitive to enterotoxaemia, so antibiotics that mess with the
gut flora can be lethal.
o Naloxone antagonize OPIOIDS.
o Metoclopramides antagonize dopamine.
o Tilmicosin (Milcotil): use in feed only! Injection may kill you and the animal.
o Sulfamethazine cannot be used in lactating dairy cattle.
o Fat soluble, small molecules like Enrofloxacin, Doxycycline rapidly cross BBB.
o Epinephrine is used to trat pulse less electrical activity.
o Pentobarbital is used for euthanasia.
o Doxycycline: can cause esophageal stricture in feline patients
o Atropine and Glycopyrrolate: cause mydriasis
o Pilocarpine and Demecarium bromide: cause miosis.
o Drugs that cannot be used in farm animals: Chlorphenicol, Furazolidone, Diethylstilbesterol and Estradiol
cypionate. Fluorquinolones, Glycopeptides and Cephalosporins (not including Cephapirin).
o Atropine is a muscarinic antagonist of acetylcholine and may be dangerous to use after administration of
alpha-2 agonists. This is because alpha-2 agonists cause marked vasoconstriction and high afterload on the
heart. Giving atropine and increasing the heart rate can place further stress on the heart. You do not want to
set in motion peripheral vasoconstriction and compensatory bradycardia brought on by the alpha 2, then
increase the heart rate against that high afterload. This could make for an unhappy heart in the event
underlying subclinical heart disease is present.
Drug Receptor Drug Receptor
Phenylephrine Alpha-1 agonist Norepinephrine Alpha-1 agonist
Acepromazine Alpha-1 blocker Atropine Block muscarinic
Dobutamine Beta-1 agonist Diazepam GABA agonist
Detomidine Alpha-2 agonist Atipamezole Alpha-2 blocker
Ketamine NMDA antagonist Butorphanol Activated K, blocks Mu
Lidocaine Sodium channel blocker Vasopressin Vasopressin receptor agonist
Diltiazem calcium channel blocker

Phenylpropanolamine: is used to treat urinary incontinence associated with urethral sphincter mechanism
incompetence (USMI) in dogs & cats. It is a sympathomimetic drug.

Levetiracetam: is a well-tolerated anticonvulsant in dog & cat. One of the few that is cleared by kidney.

Acepromazine: is a phenothiazine that causes vasodilation while acting as an e=anti-emetic, sedative, muscle
relaxant, anti-arrhythmic. Do not provide analgesia. Contraindicated in organophosphate toxicity.

o Block alpha 1: vasodilation & hypotension


o Block dopamine: Cause sedation, anti-emetic, muscle relaxant, anti-arrhythmic.

Alpha 2 agonists: xylazine, medetomidine, dexmedetomidine, amitraz.


o They inhibit release of norepinephrine from presynaptic a-2 sites.
o Medetomidine cause profound sedation and muscle relaxation.

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o Amitraz cause lethargy and sedation in almost a third of canines and is used to treat generalized demodicosis
as a drip.

Fomepizole: is used to treat ethylene glycol toxicity.

o Buprenorphine: can be absorbed transmucosal in cats due to unique ph of vat. Preferred narcotic for pain in
cats.
o Butorphanol: kappa receptor agonist & mu receptor antagonist.
o Fentanyl: is very lipophilic so absorbed and eliminated very quickly. So it is not useful for pain control by a
single dose. However, it produces good analgesia when given continuous iv infusion or transdermal pouch.
Absorption is affected by temperature and heating blanket can increase its level.

Opiates decrease the intestinal motility and constipation.

o Lidocaine: onset is 3-5 minutes and lasts for 1-1.5 hours.


o Mepivacaine: onset is 5-15 minutes and lasts for 2 hours.
o Bupivacaine: onset is 5-15 minutes and lasts for 6-8 hours.

o Endoparasiticides include Benzimidazoles, Imidazothiazoles, Tetrahydropyrimidines, Piperazine, Praziquantel


and Epsiprantel.
o Endectoparasiticides include Avermectin and Milbemycin.
o Ectoparasiticides include Organochlorine, organophosphates, carbamates, pyrethrins, synthetic pyrethroids,
Formamidines and more.

Benzimidazoles Used to treat nematode and trematode infections but has limited activity against cestodes.
Hepatic biotransformation and biliary excretion. Do not use in pregnant animals, as it can cause teratogenic effects.
Drugs of interest: mebendazole, flubendazole, fenbendazole, oxfendazole, oxibendazole, albendazole, albendazole
sulfoxide, thiabendazole, thiophanate, febantel, netobimin, and triclabendazole. Mode of action: depolarizing the
tubulin, therefore stopping vital processes like mitotic function and nutrient transport. They also inhibit the fumarate
reductase enzyme, therefore stopping mitochondrial reactions.

Imidazothiazoles The anthelmintic activity drug that is commonly used in cattle, sheep, pigs, goats, and poultry to
treat nematode infections. It has no activity against flukes and tapeworms. Hepatic biotransformation and renal
excretion. Efficacy is related to plasmatic peak, not duration of effect. Drugs of interest: tetramisole and levamisole.
Mode of action: agonist of cholinergic receptors and it tempers with neuromuscular coordination causing a spastic
paralysis. It is not teratogenic and can have an immunostimulant effect if given in higher dosage. However, it should
not be given to lactating animals (passes to milk) and it may cause cholinergic side effects (SLUD).

Tetrahydropyrimidines Anthelmintic drug that is effective against adult gut worms and larval stages that dwell
in the lumen or on the mucosal surface. It is not recommended for use in severely debilitated animals, and it can also
cause vomit and diarrhea. Its action depends on the acid pH of the stomach, therefore, should not be given with anti-
acids. Drugs of interest: Morantel and Pyrantel Mode of action: Nicotinic action over the neuromuscular junction,
causing a flaccid paralysis that will cause the parasite to detach from the gut wall.

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Praziquantel and Epsiprantel: Praziquantel PO is highly effective against cestodes of ruminants, horses, dogs,
cats, and poultry. Epsiprantel is used specifically to treat the common tapeworms of dogs and cats. Mode of action:
promotes the entrance of calcium ions into the cell, which causes muscle contraction, vasodilation, and destruction of
helminthic tegument. It also affects the carbohydrate metabolism of the parasite.

Macrocyclic Lactones (Avermectin and Milbemycin) Avermectin drugs of interest: Ivermectin, Doramectin and
Abamectin Milbemycin drugs of interest: Moxidectin and Milbemycin oxime Mode of action: acts as a GABA agonist,
causing a flaccid paralysis in susceptible arthropods and nematodes. Ivermectin is used in small animals for treatment
of Sarcoptes scabiei, Otodectes cynotis, Cheyletiella blakei, C yasguri, and Demodex canis; in cattle for psoroptic
mange, lice, and Hypoderma larvae; in horses for equine filarial dermatitis from Onchocerca cervicalis; and in swine
for Sarcoptes scabiei. Keep in mind that some dog breeds (Collies, Shetland Sheepdogs, Old English Sheepdogs,
Australian Collies, and their crosses) have an abnormality in the blood-brain barrier associated with a mutation of the
multiple drug resistance gene MDR1 (affects drug distribution), which allows increased ivermectin into the CNS and
results in toxicity.

Organophosphates Mode of action: inhibit the action of acetylcholinesterase (AChE) at cholinergic synapses and
at muscle endplates. The compound mimics the structure of acetylcholine (ACh); when it binds to AChE, it causes
transphosphorylation of the enzyme. The transphorylated AChE is unable to break down accumulating ACh at the
postsynaptic membrane, leading to neuromuscular paralysis. Organophosphates used topically include coumaphos,
diazinon, dichlorvos, malathion, tetrachlorvinphos, trichlorfon, phosmet, and pirimiphos. Ear tags containing
chlorpyrifos, coumaphos, diazinon, or pirimiphos are available. These compounds are generally active against fly
larvae, flies, lice, ticks, and mites on domestic livestock, although activity varies between compounds and differing
formulations. Toxicity: Acute toxicity clinical signs include muscarinic signs (e.g., vomiting, diarrhea, salivation,
bronchoconstriction, increased bronchial secretions), nicotinic signs (e.g., muscle tremor and twitching), and CNS signs
(e.g., behavioral change, seizures). The intermediate toxicity is primarily manifest as generalized muscle weakness due
to accumulation of acetylcholine at the nicotinic neuromuscular junction, causing a depolarizing block. Cats are
especially prone to this form of toxicity, most commonly due to chlorpyrifos. Delayed form of toxicity is associated
with degeneration of distal axons in the peripheral and central nervous systems. Signs develop several weeks after
exposure and are characterized by weakness and ataxia of the pelvic limbs

Pyrethrins and Synthetic Pyrethroids Mode of action: they interfere with sodium channels of the parasite
nerve axons, resulting in delayed repolarization and eventual paralysis. Synthetic pyrethroids can be divided into two
groups (types I and II). Type I compounds have a mode of action similar to that of DDT, involving interference with the
axonal Na+ gate leading to delayed repolarization and repetitive discharge of the nerve causing incoordination,
imbalance, weakness and paralysis. Type II compounds also act on the Na+ gate but do so without causing repetitive
discharge. Drugs on interest: β-cyfluthrin, bioallethrin, cyfluthrin, cypermethrin, deltamethrin, fenvalerate, flumethrin,
lambda cyhalothrin, phenothrin, permethrin, prallethrin, and tetramethrin Pyrethroids are generally safe in mammals
and birds but are highly toxic to fish and aquatic invertebrates. Permethrin is toxic to cats.

Phenylpyrazoles Drug of interest: Fipronil and pyriprole. Mode of action: these compounds bind to γ-aminobutyric
acid and glutamate-gated receptor sites of insect nervous systems, inhibiting the flux of Cl– into nerve cells, which
results in hyperexcitability. These compounds have broad-spectrum activity against fleas, ticks, mites, and lice. Fipronil
is toxic to rabbits.

Amprolium: used to treat coccidiosis, most commonly used in cattle, pigs, and chickens. Prolonged usage can cause
Thiamine deficiency.

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Balanced anesthesia: Is the use of 2 or more drugs to achieve the desired level of anesthesia.

Tank color: nitrous oxide tank in blue, oxygen tanks are white or green.

Room air: 21% O2, 78% N, 1& others.

Electrical defibrillation: shock stops all cells in the heart simultaneously which allows the pacemakers cells to regain
control of myocardial contraction. Heart is put into asystole to allow peacemaker cells to regain control of cardiac rhythm.

Akinesis Motor paralysis


Allodynia Pain response to stimuli that are not normally painful
Dysphoria Signs include restlessness, agitation, vocalization, and lack of response to surrounding or interaction
with caretakers.
Hyperalgesia Heightened response to painful stimuli
Hypoalgesia Decreased response to normally painful stimuli
Hypercapnia Means excess carbon dioxide (CO2) in blood
Hypoxemia low blood oxygen
Hypertension MAP above 160mmHg small animals and 150mmHg in large animals.
Hypotension MAP is bellow 65mmHg and caused by deep anesthesia

PAIN
Nociception: is the physiological mechanism in pain perception.
First order neuron: are sensory neurons that receive signals transform them into electric impulse and transmit to
spinal cord.
In spinal cord signal is passed to INTERNEURONS for amplification.
2nd order neuron: receive signal from peripheral nerves and transmit to brain.
In Thalamus signal meets 3rd order neuron that projects into cerebral cortex for perception & response to pain.
STEPS NAME PARTS INVOLVED Types
1 Transduction nerve ending Alpha delta & C Noxious/ painful stimuli
Alpha beta Non noxious stimuli
Alpha alpha Skeletal muscles
B fibers ANS
2 Transmission nerve body
3 Modulation dorsal horn of the spinal cord
4 Projection thalamus and brainstem
5 Perception cerebral cortex
Neuropathic pain: Caused by damage to neural tissue and is usually present in chronic cases of pain.
Example: Horse with chronic laminitis
You can use gabapentin to treat NP.
Side effects of Gabapentin: Sleepiness. It contains xylitol and cause hypoglycemia and seizures.
Pathologic pain: response that is heightened beyond that needed to protect the patient from injury.
Physiologic pain: Protective response to an actual or potentially damaging insult. Also called nociceptive pain.
Visceral pain: Stretching, tension or inflammation of viscera.

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Wind up: Sensibilization of nociceptors and pain pathways in response to intense bombardment of painful sensory
impulses in the phenomenon of Wind-up, which greatly amplifies the pain response. NMDA receptors in the spinal cord
are activated in the wind-up phenomenon. Ketamine, an NMDA receptor antagonist, is used to help prevent the
development of wind-up. Other NMDA antagonists include methadone, amantadine, and dextromethorphan.

PAIN ASSESSMENTS
Colorado state university pain scale Acute pain
The health-related quality of life cycle Chronic pain
Preemptive scoring system Estimate of expected pain
Visual analog scale Evaluate intensity of pain
World small animal veterinary association Pain level in dog and cats

PRE-ANESTHETICS
Drug Group Drug Name Action Adverse effects Do not use / Reverse
With
Phenothiazine (GABA Acepromazine, Mild tranquilization, Vasodilation, ↑CO Decompensated
potencialization) Chlorpromazine reduction of motor (comp), ↓RR, ↓ ST, cardiac patients,
Methotrimeprazine activity, mild ↓ Temp animals with sepsis or
sedation, antiemetic hypothermic patients
and antiarrhythmic.
Benzodiazepines Diazepam Anxiolytic, Not analgesic, Flumazenil Do not use
Midazolam myorelaxant, agitation, paradoxical diazepam in patients
hypnosis (LA) and effect with liver failure.
anticonvulsive.
Α-2 agonists Dexmedetomidine, Deep sedation,
↓ CO, ↓ HR, Yohimbine or
Xylazine analgesic hypotension, ↓RR, Atipamezole
bradycardia, vomit,
and salivation
Anticholinergic Atropine, ↓ salivary and Decrease GI motility Atropine in horses.
(Blocks muscarinic) Scopolamine respiratory secretion, Scopolamine in cats.
Glycopyrrolate ↑ HR, mydriasis Animals with KCS
Opioids Morphine, Fentanyl, Analgesia, sedation, ↑ Histamine release, Naloxone
Tramadol, ↓ HR, ↓ RR vomit, and
Butorphanol, constipation
Methadone

Acepromazine: Antagonizes dopamine receptors in the brain. Causes mild sedation, vasodilation (alpha-1 blocker) and
hypotension (Dopamine blocker). Causes penis protrusion in large animals (especially horses). If using in geriatric patients,
decrease dose. Side effects include significant hypotension. Do not use in animals with organophosphate toxicity as it may
exacerbate its toxic effect. Least cardiac & respiratory depression.

Xylazine: Cause significant bradycardia, reduction of cardiac output, hypotension, cardiac arrhythmias, and respiratory
depression. Is revered with Yohimbine. Cow dose is 20 less than dogs or horses. Pretreatment with atropine can decrease
bradycardia and hypersalivation in cattle. Swine do not respond well to xylazine. Chemical restrain in cattle. Cause
vomiting in cats.

Opioids: like hydromorphone can cause dysphoria is healthy patients. Dysphoria is treated with tranquilizer or sedatives
such as acepromazine or dexmedetomidine, respectively.
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Morphine: should not be used in geriatric, severely debilitated patients and in patients with hypothyroidism, renal
insufficiency and/or adrenocortical insufficiency. Morphine increases the intracranial pressure and should not be given to
an animal with head trauma. Bolus of morphine can cause high histamine release, vasodilation, and anaphylaxis.

Dexmedetomidine: Cause significant bradycardia, reduction of cardiac output, hypotension, cardiac arrhythmias, and
respiratory depression. Do not give atropine for these patients, reverse it with Atipamezole.

Butorphanol: Cause respiratory depression.

Glycopyrrolate: Great for pregnant animals. Can cause ileus in horses and it causes thickening of bronchial secretions so
avoid in patients with pneumonia. (Not cross BBB).

Injectable Anesthesia
Group of Drug Names Effects Adverse Effects Do not Use
Drugs
Alkylphenol Propofol ↓ intracranial pressure, ↓ Significant respiratory Not analgesic! Pregnant
(GABA) CNS metabolism depression, apnea, animals as it causes fetal
bradycardia and decreased depression.
cardiac contractility
Etomidate CNS depression, Not analgesic Fetal depression,
(GABA) maintenance of adrenocortical
hemodynamic parameters depression, and immune
system depression.
Animals with sepsis or
pregnant.
Barbiturates Thiopental Peripheric vasodilation, cause heart arrhythmias Perivascular injection
Methohexital ↑HR (transitory) and ↓ AP (usually ventricular causes necrosis. Causes
bigeminy), temporary ileum in horses
apnea after injection and
respiratory depression.
Pentobarbital Euthanasia drug! Causes respiratory depression
Phenobarbital Control epilepsy/ seizures

Thiopental: extremely fat soluble and is metabolized by the liver! Do not use in fat patients or greyhounds (not enough
fat and horrible liver)

Methohexital: best barbiturates to do in fat patients and greyhounds because it does not absorb into fat and quickly
induces anesthesia.

Propofol: should be discarded after 6 hours, is rapidly cleared and is not particularly irritating to tissues if it goes outside
of the vein accidentally. Cause Heinz body anemia in cats. Cause spontaneous movements with opisthotonos, nystagmus,
paddling and apnea. CRI of propofol (Total intravenous anesthesia) is used for procedures where good muscle relaxation
is required.

Orthopedic foundation of America pelvic radiograph


Suturing skin laceration
Ear cleaning

Alfaxazolone: schedule 4 iv drug. Not analgesic. Used for induction.

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Dissociative anesthesia Drug:

Ketamine and Tiletamine (more potent). Characteristics: IV or IM, great for wild animals due to broad therapeutical
margins. Effects: Analgesia (little), amnesia, ↑ AP, ↑ RR (Short and fast), bronchodilator, ↑ HR and ↑ Cardiac output.
Can cause seizures and respiratory depression at high doses. Ketamine provides a good superficial analgesia, but poor
visceral analgesia. (Often used in snakes for non-painful procedures).

Neuromuscular blocker

Act in the neuromuscular junction (at the motor plate) leading to muscle relaxing and causes respiratory paralysis.

Depolarizing agents (competitive): Decamethonium and succinylcholine

Non-depolarizing agents (non-competitive): Pancuronium, vecuronium, rocuronium and dacuronium.

Sequencing of blocking: 1. Face and tail, 2. Limbs, 3. Neck, 4. Abdomen, 5. Thorax (intercostal muscle) and 6. Diaphragm.
Recovering is in the opposite sequence.

General Anesthesia Drugs


Minimal Alveolar Concentration (MAC): amount of anesthetic necessary to abolish pain response to painful stimuli in 50%
of patients. Higher the MAC, less potent is the gas. (1.5 X MAC is used to reach surgical plane of anesthesia)

Desflurane: Extremely low solubility, has the fasted induction and recovery. (Highest MAC)

Halothane: ↓ CO, arrhythmogenic potential, dose dependent respiratory depression and hepatic lesion in predispose
animals. The most soluble gas, therefore it has a slower induction and recovery.

Isoflurane: ↓ AP (dose dependent), ↑ HR and ↓ CO. High doses lead to ileus, decrease cardiac output, vomiting, nausea,
and respiratory depression. Go to drug for patients with kidney and liver problems as only 0.2% of the gas is removed via
metabolism. Sevoflurane: Create a Substance A that can lead to kidney damage, ↓ AP (dose dependent) and ↓ CO.
(Lowest MAC)

Methoxyflurane: no one uses it anymore due to high solubility (higher than halothane).

Nitrous Oxide: Causes oxygen depletion! ↑ AP (discrete), ↑ HR, ↑ intracranial pressure. Not useful alone. It dissipates to
gas compartment. Do not use in horses as it can cause post-operative colic.

Neither sevoflurane nor isoflurane provides any analgesia after surgery.

Refill the anesthetic machine when fewest people are in the clinic.

Ceiling effect when using anesthetic medication

No further analgesia is produced above this level. Higher doses may increase the duration but may increase the side effects
too. Butarphenol & Buprenorphine both exhibit this effect.

Anesthesia for dogs having cardiac issues to remove local mass: Opioid + benzodiazepines + local anesthesia

Spay procedure dog & cats: Analgesic + anxiolytic + inhalant anesthetic

Tricaine methane sulphonate (MS 222, Tricaine mesylate) is the only anesthetic licensed in US for food fish for human
consumption. At high doses can cause euthanasia in fish and amphibians. (Metomidate causes sedation & anesthesia in
ornamental fish.

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Anesthesia Monitoring
Pain response: ↑ AP (main), ↑ HR, mydriasis, ↑ temperature and ↑ RR (rarer).

Stage 1: Voluntary movement.

Stage 2: delirium, involuntary movement. Pass by it as quick as possible.

Stage 3: surgical plane of anesthesia. Ideal is Stage 3 medium. Observe palpebral reflex, eye and pupil position, muscular
tonus, tracheal reflex, and corneal reflex. Corneal reflex should never be absent in a proper anesthesia plane. You should
see eyes rolled ventrally, pupils dilated and no palpebral response.

Hypoventilation leads to respiratory acidosis that shows as increase PaCO2 and increased HCO3 (renal compensation). It
can develop ATELECTASIS.

Hyperventilation indicates inadequate plane of anesthesia.

Anesthetic Breathing Circuit


A typical circular anesthetic circuit is composed of: Pressure regulator, flowmeter, vaporizer, patient, CO2 canister.

Oxygen tanks: Both H & E types are same that contains pressurized O2 to 2200 psi but differ in volume. (E=660L & H=
6600L)

Pressure regulator decreases the pressure of gas leaving the pressured gas cylinder. Decrease pressure from 2200 to 40-
50 psi.

Flowmeter controls the amount of carrier gas flow. Flowmeter fall during anesthetic event indicates O2 tank being empty
or turned off. Decrease pressure from 40-50 psi to 15 psi. Flow meter is used to increase oxygen volume in pressurized
bag. If flush valve is used only O2 is used to fill reservoir bag with no anesthetic gas and patient will go under lighter planes
of anesthesia.

Vaporizer convert the volatile liquid anesthetic into vapor and then mixes it with carrier gas.

CO2 canister contains soda lime granules that absorb carbon dioxide. Fresh soda lime is white and can be crushed.
Exhausted soda lime is off-white color and is hard. Color usually changes to purple or violet. Granules contain a PH sensitive
dye. Colour itself is not so important as colour changes.

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Change soda lime every 6-8 hours of use (30 days if unused). Dispose soda lime in general trash and wear gloves to prevent
irritation.

Scavenging system: is designed to help remove waste anesthetic gases from breathing circuit to either outside building
or into charcoal canister. Change charcoal when it increases 50 g weight.

Chemical exposure monitor is used to detect waste anesthetic gases.

Oxygen flush bottom: sends pure oxygen into the breathing circuit, bypassing the vaporizer. The patient will start to wake
up. If pushing it in a non-rebreathing system, you can cause barotrauma.

One-way valve: keeps exhaled gasses moving away from the patient in a circular rebreathing anesthetic delivery system.
Semi-closed: Semi-closed or partial rebreathing systems are the same thing! It flows at intermediate flow rates where
fresh gas is delivered in excess of metabolic consumption. During induction and recovery the flow is 100ml/kg/min (small
animals). During maintenance of anesthesia the flow is 10 ml/kg/min (large animals) or 30-50 ml/kg/min (small animals).

Closed anesthetic Rebreathing System: Closed anesthetic rebreathing system only provides enough flow of fresh gas to
meet an animal’s metabolic needs, about 5 to 10 ml/kg/min. Never use nitrous oxide in this type of system!

Non-rebreathing system: No remixing of inhaled and exhaled gasses and has the highest gas glow rates (100-
300ml/kg/min). Used for small animals under 7kg (15lb).

Bain System (tube inside tube): Can run at a high flow rate of 200-300 ml/kg/min, than it does not allow rebreathing of
exhaled gasses and it does not allow mixing of gases. At a flow rate of 130- 200ml/kg/min or less the Bain functions as a
partial rebreathing system.

Best time to stop oxygen flow during recovery from inhalant anesthetic: At the end of procedure turn off vaporizer and
continue O2 for 5-10 minutes to allow patient to exhale any remaining anesthetic gas.

Best way to detect leakage in O2 deliver system:

High pressure system: from anesthetic machine to flowmeter.

Low pressure system: flowmeter to patient. This includes vaporizer, flutter valve, soda lime, ET tube, rebreathing bag,
delivery hoses & pop off valve.

Things that cause reservoir bag to overinflate

o Pop off valve is closed


o High flow rate
o Inadequate scavenging

INSTRUMENTS
Pulse Oximeter used primarily to measure the oxygen saturation (SaO2) of hemoglobin in arterial blood and
pulse rate. (95-100 is normal)
Capnography measures CO2. Normal is around 35-45mmHg.
Electrocardiogram records heart rate and rhythm.
(ECG)
Doppler monitor detects the flow of blood through small arteries and can be used to measure blood pressure.
Endotracheal tube Cuffed in adult dogs. Uncuffed (coole tubes) in ferrets, small animals (puppies and kitten) and in
birds as they have a complete tracheal ring.
Measure tube from nares to thoracic inlet.
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Enter between vocal folds of trachea.
Intubating Positions:
Dog, Cat, Small ruminants: sternal recumbency
Horse: Lateral recumbency
ET tube placement confirmation
1. Neck palpation: 1 hard structure is ok; 2 hard structure means tube is in esophagus.
2. End tidal CO2 monitor: normal waveform indicates exact placement.
3. Breath feeling from out of tube
Important points to remember
o Insert ET tube when Pedal reflex & swallowing are absent.
o Remove ET tube when Gag reflex has returned, and patient is swallowing.
o If the stylet is used to stiffen the ET tube, it should never pass the end of tube. It can
increase chance of trauma to the laryngeal folds, oropharynx, and trachea.
o Leakage of air around ET tube at 20 cm H2O helps to ensure that cuff is nor under or
over inflated during anesthesia.
o If an ET tube is blocked with mucous the patient will start to wake up because the
anesthetic gas flow can not flow. Secondary hypoxia can develop if ET is blocked.
o If ET tube is too long, it will inflate one lung.
Orogastric tube From point of nares to xiphoid.
Supraglottic airway It is helpful in animals where direct visualization is not possible (Rabbits) and laryngospasm is
device common (cats).
Oscillometric blood senses the motion of the arterial wall as a blood pressure
pressure monitor
Esophageal Amplifies the sound of heart to measure at a distance.
stethoscope

Local Anesthesia Drugs


DRUGS ONSET DURATION USE
Lidocaine 3-5 minutes 60-90 minutes
Mepivacaine 5-15 minutes 2 hours
Bupivacaine 5-15 minutes 6-8 hours oral surgery

Guaifenesin: Also known as Guaiacol glyceryl ether (GGE). NOT ANESTHETIC! Anti-tussive (anti cough) and decongestant
med that also works as a muscle relaxant and leads to immobilization. Used to support excitement-free anesthesia
induction and recovery in horses. Effects include decrease respiratory rate. Can lead to inflammation if done perivascular
and high concentration (>15%) cause hemolysis.

Pentobarbital: EUTHANASIA DRUG. Like all barbiturates it causes respiratory depression. If you can’t get an IV, euthanasia
can be done by intraperitoneal injection of pentobarbital with lidocaine.

Phenobarbital: Anti-seizure drug. Dobutamine: increase blood pressure

Phenylephrine: increase blood pressure and a urinary tract analgesic.

Amiodarone: use for treatment of persistent ventricular tachycardia following cardiac arrest.

Magnesium Sulfate: use for treatment of persistent ventricular tachycardia following cardiac arrest.
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Nerve Blocks
Auriculopalpebral Prevents the horse from blinking but not prevent sensory function. Provides innervation
to the upper orbicularis oculi muscle. For corneal scraping use Auriculopalpebral nerve
block and tropical proparacaine.
Supra orbital nerve block Upper eyelid
Retrobulbar Enucleation
Frontal Branch of trigeminal and provides sensory innervation to upper eyelid.
Cornual block is necessary for dehorning of cattle. For goats you should also do the infratrochlear block
for dehorning.
Proximal paravertebral placement of local anesthetic just off the midline and caudal to the transverse processes
block (Farquharson of T13, L1 and L2 vertebrae. Block nerves T12, L1 and L2.
method)
Distal paravertebral block placed above and below the ends of the transverse processes of L1, L2 and L4 vertebrae.
Block nerves T12, L1 and L2.
Palmar digital nerve block blocks the palmar third of the foot, including navicular bone. In some horses it blocks 70%
(PD or Heel block) of the hoof.
Abaxial Sesamoid block when suspecting of laminitis. It blocks the whole hoof and the proximal interphalangeal
joint.
Low four point blocks the entire metacarpophalangeal (fetlock) joint and structures distal to this joint.
High four-point (sub carpal desensitizes the metacarpal region along with the entire metacarpophalangeal (fetlock)
block) joint and structures of the digit.

Important Points
Atropine in horses causes ileus.
Atropine in febrile patients since is crosses the Blood brain barrier and it may interfere with temperature
regulation in the hypothalamus.
Atropine causes thickening of bronchial secretions, so avoid in patients with pneumonia.
Acepromazine, Ketamine and xylazine in seizure patients.
Thiopental in animals with asthma (cases apnea)
Thiopental in Sighthounds (Grey Hounds) because they have low body fat and less efficient liver, which increases
recovery times.
Morphine or Ketamine in animals with high intracranial pressure
Nitrous oxide (N2O) in horses. Nitrous oxide causes distention of the intestines and may result in postoperative
colic in horses.
Ultra-short barbiturates can cause severe tissue irritation and sloughing if they get outside the vein when injected.
1-2% Lidocaine spray in cats before intubating to prevent laryngospasm. Laryngospasm in animals cause cyanosis,
hypoxia, increased CO2. Benzocaine in cats causes methemoglobinemia. Methemoglobinemia reduces the ability
of the RBC to release oxygen to tissues leading to tissue hypoxia. Pigs are also prone to laryngospasm.
Xylazine makes cats vomit, so be careful! It also causes muscle tremors, bradycardia and reduced respiratory rate
in cats.
Ketamine in cats should be associated with ophthalmic ointment, as the eyes stay open when using this drug.
Ketamine in dogs with increase intraocular pressure (like glaucoma).

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Bovines and Camelids continue to salivate under sedation of anesthesia. Put the nose own so the saliva can drain
away from the pharynx.
Indirect and direct blood pressure measures DO NOT correlate well in reptiles.
Surgical plane of anesthesia usually results in loss of the righting reflex (less reliable in turtles and tortoises).
Corneal and palpebral reflexes cannot be elicited in snakes (they do not have eyelids)
Pulse oximetry values are not absolute reliable in reptiles BUT can be useful for anesthesia monitoring.
Reptiles should be kept upper limit of their normal temperature range during induction, surgery, and anesthetic
recovery to optimize anesthetic metabolism and recovery.
Chelonians tent to have long period between breaths, making induction of anesthesia via inhalants difficult.
Anesthesia is usually induced with injectables.
Fasting before Anesthesia: animals less than 2kg or with low glucose should not be fasted more than 2 hours.
Diabetic animals should be fasted 2-4 hours before anesthesia.
During anesthesia normal patient is monitored every 5 minutes
During pre-anesthetic phase classification for risks of adverse effects assigned.
Drug dose is calculated on the basis of lean body weight.
Hypothermia (below 98 F) during anesthesia can prolong the recovery.

Porcine Stress Syndrome (PSS): adverse reaction to halothane. Use ice packs and alcohol to decrease body temperature
and administer dantrolene (ryanodine receptor antagonist) and lidocaine (for cardiac arrhythmias). Calcium and
potassium chloride are contraindicated. PSS is also known as malignant hyperthermia.

Oculo-cardiac Reflex: Stows the heart rate when intraocular pressure increases. This may occur when the globe is
manipulates during any eye surgery but is more common during enucleation.

Marey’s reflex or Baroreceptor response: is one of the body's homeostatic mechanisms that helps to maintain blood
pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood
pressure reflexively causes the heart rate to decrease and also causes blood pressure to decrease.

Vago-vagal response: brief loss of consciousness due to a neurologically induced drop in blood pressure.

Drug categories by FDA


1 Heroine, Marijuana Not currently accepted for medical use
2 Hydromorphone, Cocaine High potential for abuse
3 Ketamine, Testosterone, Anabolic steroids
4 Diazepam, Alfaxazolone Low potential for abuse
5 Narcotics Lowest potential for abuse

DRUG CONTRAINDICATIONS
Ketamine Seizures
Xylazine
Acepromazine
Thiopental Asthma, Greyhounds
Morphine High intra cranial pressure, head injury, hit by car
Dexmedetomidine Congestive heart failure

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Atrial depolarization= 1-2

Ventricular depolarization= 3-5

Ventricular repolarization= 6-7

mean arterial pressure (MAP)=

= 77+ (126-77)/3

= 77+16

= 93

This dog has a second-degree AV block which is a failure of


conduction through the AV node. Atropine may initially cause a
transient slowing of heart rate (HR) and AV block as low doses
stimulate presynaptic inhibitory receptors. As drug level
increases, muscarinic blockade predominates and HR increases.
The ECG is characterized by occasional P waves without a QRS that
follows. There is a 'dropped beat' as the ventricles do not contract.
This rhythm is heard as a pause equal to 2X the normal R-R
interval.

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A cardiac arrhythmia is auscultated during a preoperative
examination in a three-year-old Thoroughbred gelding. The
heart rate is 32 beats/minute [N=28-42] and the rhythm is
regularly irregular. A representative ECG strip is shown
below.

This is 2nd degree atrioventricular (AV) block.

2nd degree AV block is more common in horses at rest, when the


heart rate is low, as it is associated with increased vagal
(parasympathetic) tone. When sympathetic tone increases, as
with exercise, excitement, pain, etc., the heart rate increases,
and AV block disappears. 2nd degree AV block can be diagnosed
without an ECG. The rhythm is regularly irregular, the pause is
equal to 2X the normal interval between contractions, the 4th heart sound (S4) is audible during the pause, and the
irregularity disappears when the HR increases.

A three-day-old Quarterhorse foal is anesthetized for cerebrospinal fluid (CSF) tap, joint lavage, and removal of an
infected umbilicus. Just as the doctor begins the CSF tap, the heart rhythm becomes irregular, as seen on this
electrocardiogram. The foal appears deeply anesthetized, but blood pressure and heart rate are normal.

Which of the following correctly identifies this arrhythmia?

There are 2 premature ventricular contractions (PVCs) on this ECG.

There is no P wave, the R-R interval before each PVC is shorter


than normal, and the QRS-T is 'wide and bizarre' in shape.
PVCs seen under anesthesia are caused by hypercarbia
(hypercapnia), deep or light anesthesia, some anesthetic
drugs, electrolyte abnormalities, hypoxemia, cardiac disease,
and increased sympathetic tone Inhalant aesthetics sensitize
the myocardium to arrhythmias and suppress ventilation. The
vaporizer setting was decreased, mechanical ventilation was
instituted, the PVCs disappeared and did not return.

A six-year-old mixed breed dog is anesthetized for an exploratory laparotomy/splenic mass removal with isoflurane in
oxygen. Anesthetic monitoring includes an electrocardiogram (ECG), direct arterial blood pressure, end-tidal carbon
dioxide levels, oxygen saturation, anesthetic gases, and temperature.

A recording of the ECG and the arterial pressure waveform is shown in the image below.

What is the pulse rate?


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The pulse rate is 80 beats per minute. This case is
just one example of why it is important to palpate
the pulse periodically during anesthesia, rather
than just following the monitors (because here
the ECG says the heart rate is 160). At a paper
speed of 25 mm/second (= 5 big boxes per
second), there are 16 depolarizations in a 6
second period. To calculate the rate, 60 sec/6 sec
= 10. 10 X16 = 160 depolarizations per minute from this strip. However, the blood pressure (BP) wave shows that there
were only 8 ventricular contractions that actually produced blood flow (a pulse) in the same 6 seconds. Therefore, the
pulse rate is 60/6 = 10 X8 = 80 contractions per minute in this patient.

This patient has a pulse deficit caused by a cardiac arrhythmia – a premature ventricular contraction (PVC) follows each
sinus beat, so this is ventricular bigeminy. There are "pairs" of each - each sinus beat/one PVC. hence a "bigeminy." Note
that the PVCs do not generate enough cardiac output to produce a separate blood pressure waveform, hence the pulse
deficit. The PVCs probably contribute a small amount of flow seen as the extra "bumps" on the bp waveform.

Numerous pauses are heard on the Doppler of a dog


anesthetized with isoflurane. The veterinary technician
monitoring the dog is having trouble evaluating the heart
rhythm from this electrocardiogram.

Which of the following is the main problem?

Respiratory motion has distorted the recording, causing the undulating wave-like baseline seen.

To correct this, move the lead attachments further away from the chest, or select a different lead (Lead I or Ill) to see if
this artifact remains. This is a good example of one advantage of using a Doppler blood pressure monitor - since cardiac
pulsations are continuously audible, it is obvious when an arrhythmia occurs.

A four-year-old male Great Dane recovering from emergency surgery to


correct a gastric dilatation-volvulus (GDV) is still quite weak and depressed
after 24 hours. Auscultation of the heart reveals a cardiac arrhythmia, seen on
the electrocardiogram shown below.

Which of the following correctly identifies this rhythm?

This dog has ventricular tachycardia (VTach), which is common in dogs with GDV Tach = high heart rate, no P waves are
associated with QRSTs, the QRSTs are wide and bizarre. The decrease in venous return caused by gastric distension and
the effects of inflammatory mediators cause heart damage that results in arrhythmia. Lidocaine is used to treat VTach.
Most dogs with GDV are kept on a lidocaine infusion to help prevent or minimize the occurrence of this dysrhythmia.

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Perilla ketone toxicity (purple mint toxicity) 4-Ipomeanol toxicity (moldy sweet potato): clinically indistinguishable from
Acute Bovine Pulmonary Emphysema and Edema (ABPEE, also known as Fog Fever). Fog fever is associated with L-
Tryptophan in lush pastures which is converted to pneumotoxic compound (3-methylindole) that damage respiratory
epithelium. Other disease is Feedlot acute interstitial pneumonia.

Acer rubrum (red maple) toxicity: Unknown toxic principle(s) in wilt leaves. Causes methemoglobinemia, Heinz body
anemia, and intravascular hemolysis, weakness, polypnea, tachycardia, depression, icterus, cyanosis, brownish
discoloration of blood and urine. Affect horses!

Acetaminophen: toxic to cats and it causes hemolysis and formation of methemoglobin. Clinical signs include salivation,
depression, pale mucous membranes, cyanosis, brown blood (methemoglobinemia) and urinating dark brown urine.
Treatment includes emesis, activated charcoal (within 2 hours), ascorbic acid, n-acetylcysteine, and Cimetidine for dogs
only! Most common cat toxicity. n-acetylcysteine provide sulfhydryl source to hepatocytes & erythrocytes and prevent
oxidative damage.

Aflatoxicosis: toxigenic strains of Aspergillus flavus and A. parasiticus on peanuts, soybeans, corn (maize), and other cereal
grains. Clinical signs in acute cases include liver damage, widespread hemorrhages, icterus, and death. Subacute signs
include depression, weakness, anorexia and unthriftness. Treatment: take animals off feed and provide an effective binder
for aflatoxins, such as hydrated sodium calcium aluminosilicates (HSCAS).

Fescue mycotoxicosis: Ergot–like mold (neotyphodium coenophialum) present on tall fescue grass can cause lameness
and hyperthermia in cattle and horses. It also causes abdominal fat necrosis (lipomatosis) in adult cattle and some deer.
On RP masses feel like floating carks similar to cotyledons.

Fumonisin: a toxin from Fusarium Spp causes Equine leukoencephalomalacia and porcine pulmonary edema (PPE).

Ergotism: caused by ingestion of alkaloids in a parasitic fungus Claviceps purpurea that infects small grains and forage.
Clinical signs include vasoconstriction, necrosis of extremities, gangrene, CNS effects and pituitary effects (decrease
prolactin leading to agalactia) or potent oxytocic action.

Mycotoxicosis: Aflatoxins and fumonisins can cause hepatic injury and failure in ruminants, swine, and horses. Fusarium
toxicosis is the most common mycotoxicosis causing liquefactive necrosis and degeneration in the cerebrum as well as
hepatic congestion and necrosis in horses. However, aflatoxins only sporadically cause hepatic failure in this species.

Zearalenone toxicosis: leads to reproductive dysfunction such as estrogenism and vulvovaginitis. Produced by Fusarium
spp mold on corn, barley, and wheat. A secondary mycotoxin called Deoxynivalenol is also produced which causes
decreased feed intake.

Trichothecenes: group of related cytotoxic mycotoxins associated with many fungi. Causes vomiting and
immunosuppression. Refusal to eat and taste aversion. Macrocyclic Trichothecenes related diseases have several specific
names --- stachybotryotoxicosis.

Slaframine toxicosis: causes profuse salivation, oral irritation, retching and sometimes vomiting, primarily in horses and
occasionally in cattle. Happens due to Rhizoctonia leguminicola fungus (black patch disease) on red clover, esp. in wet cool
years.

Alkaloid toxicity: present in Delphinium spp. (larkspur), Rhododendron Spp (azaleas) or Solanum spp. (nightshade). It
causes both cardiac arrhythmias and severe gastric distress. Falling, bloat, salivation, constipation.

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Alsike clover (Trifolium hybridum): also known as “dew poisoning” causes two syndromes in horses: photosensitivity
(trifobiasis) and Alsike clover poisoning (“big liver disease”). The toxic principle is an unidentified phytotoxin.
Photosensitivity has been reported in horses, sheep, cattle, and pigs. Clinical signs include reddened skin after exposure
to sun, followed by dry necrosis of the skin or edema and serous discharge. The muzzle, tongue, and feet are frequently
affected. If the stomatitis is severe, anorexia and weight loss develop. If not treated it can be fatal due to hepatic failure
and neurologic disturbances. Colic, diarrhea, and other signs of GI disturbances have been noted. Affected horses may be
markedly depressed or excited. Diagnosis: serum chemistry alterations include increased GGT and AST activities and
hyperbilirubinemia, with direct bilirubin frequently being ≥25% of the total, history, and multiple animals on a farm or in
an affected area.

Anticoagulant rodenticides: include warfarin, brodifacoum, bromdialone and diphacinone. They inhibit vitamin K
dependent factors (II, VII, IX and X). Clinical signs: hemorrhage (usually hemoabdomen), pale and dry mucous membrane,
tachycardia, and weak pulse. Diagnosis: markedly prolonged prothrombin time (PT). Treat with emesis, activated charcoal
+/- sorbitol and vitamin K1 for 4 weeks PO.

They inhibit action of vit k1 reductase that is required to convert vitk1 epoxidase to active vit k1. Factor vii is shortest.

Bromethalin rodenticides: inhibit ATP production in neurons, which causes tremors, seizures, hyperexcitability and
hyperthermia. Treatment: emesis, activated charcoal, diazepam, mannitol to reduce cerebral edema and inclined plane
30 degrees to improve venous return.

Cholecalciferol Rodenticide: increases intestinal absorption of calcium leading to hypercalcemia, hyperphosphatemia,


and organ injury. Clinical signs usually take 36 hours and include acute renal failure and cardiac arrhythmias. Diagnosis is
presence of hyperphosphatemia (12h post ingestion), hypercalcemia (24h post ingestion) and azotemia (36-48h post).
Treatment: emesis, activated charcoal, loop diuretics (furosemide) or saline diuresis, corticosteroids (decrease Ca
intestinal absorption and urinary retention) and bisphosphonates (pamidronate) to inhibit osteoclast activity.

Arsenic: commonly found in ant bait, wood preservatives or pesticides. Expect GI presentation such as vomiting, diarrhea,
hematochezia, weakness, and prostration. Treatment of choice: Succimer (Dimercaptosuccinic acid).

Nitrate Toxicity: present on Pigweed, Nightshade (solanum), Oat hay, Sorghum, Rye, and Alfalfa. Primarily problem in
cattle. Nitrate causes methemoglobinemia, leading to dark brown or chocolate colored blood, gray mucous membranes,
dyspnea, tremors, and convulsion. Treatment: 1% methylene blue.

Cyanide: seeds of apples, apricots, cherries, peaches, plums, the jetberry bush, Sorghum (Johnson grass) and Prunus
species (fruit tree) contain cyanogenic glycosides. Ruminants and reptiles are more sensitive. Clinical signs include
excitement, rapid respiration, dyspnea, salivation, muscle fasciculation, spasms, staggering, collapse, and death. Key
finding includes bright red blood (cherry color), bright red mucous membranes and rumen gas smelling like bitter almond.
Treatment include Sodium nitrite and Sodium Thiosulfate.

Avocado (Persea Americana): contains Persin, toxic to rabbits, mice, and caged birds. Can cause myocardial necrosis (in
mammals and birds) or sterile mastitis (in lactating mammals). Dogs are relatively resistant to these effects. However
ingestion of avocado pit may cause intestinal obstruction.

Black walnut toxicity: Horses are more susceptible. When used as bed, black walnuts can cause acute onset laminitis,
which may progress to necrosis of dorsal laminae, distal limb edema and fever.

Blue-green Algae: hepatotoxic after the ingestion of cyanobacteria.

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Bracken Fern (Pteridium aquilinum): poisonous to cattle, sheep, pigs, and horses.
Contains thiaminase, which cleaves vitamin B1 and Ptaquiloside that is
carcinogenic and leads to bone marrow suppression. Thiamine (B1) deficiency
leads to polio encephalomalacia. Clinical signs in large animals include
incoordination, standing with legs apart, depression, muscle tremors, ataxia,
blindness, retinal degeneration, and staggers in horses. Ptaquiloside in ruminants
leads to bone marrow destruction, hemorrhage, anemia, enzootic hematuria, and
tumors in the bladder. Treatment includes discontinue exposure, thiamine
supplementation and blood transfusion.

Poliencephalomalacia is due to low thiamine and high sulfur (Molasses-urea diet, sugercane byproducts, alfalfa, kanda
thistle, kochia, Lambsquarter.

Cantharidin toxicity: from blister beetle (Epicauta spp.) that swarm in alfalfa hay. Cantharidin is a potent irritant causing
colic, renal disease, hematuria, hemorrhagic gastritis, dark injected mucous membranes and per acute death. Horses

Carbamates: SLUD clinical signs as they inhibit the acetylcholinesterase at nerve synapses and neuromuscular junction.
SLUD: Salivation, Lacrimation, Urination and Defecation.

Organophosphate toxicity: same clinical signs as carbamate. Remember SLUDDE: salivation, lacrimation, urination,
defecation, dyspnea, and emesis. Treatment includes emesis, activated charcoal, seizure control (diazepam), pralidoxime
chloride (2-PAM) and atropine.

Carbophenothion: used to control parasites on sheep and a single dose is lethal to cats.

Cardiotoxic plants: Oleander (nerium oleander), Foxglove (digitalis purpurea) and Lily of the valley (Donfallaria majalis)
contain cardiac glycosides that affects sodium channels in the cardiac and skeletal muscle. The Yew (Taxus sp.) contains
alkaloids A and B, which inhibit cardiac depolarization. Azalea (Rhododendron) contains andromedotoxins which binds to
sodium channels. Clinical sings include: salivation, nausea, vomiting, hematochezia, weakness, bradycardia, hypotension,
AV block, collapse, and possible death. No antidote, only treat the clinical symptoms.

OLENDER FOXGLOVE

Olender & Foxglove contains cardiac glycosides and toxicity cause arrhythmias or asystoles, hyperkalemia vomiting,
diarrhea. Effects include AV block, increase vagal tone and decrease membrane potential and pacemaker activity.

Foxgloves are used to make digoxin so seru digoxin can confirm toxixity.

Other cardiotoxic plants that contain Graynotoxins are Azalea, Rhododendron, Rosebay, Laurals.

Chlorinated Hydrocarbons: present in insecticides and cause CNS depression or stimulation (convulsive seizures).

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Centaurea Spp (yellow star thistle or Russian Knapweed): causes nigropallidal encephalomalacia in
horses, which is basically the liquefactive necrosis of the neurons in the globus pallidus and substantia
nigra. Ruminants are not affected. Affected horses cannot properly chew (chewing disease) and show
involuntary twitching and curling of lips.

Brain damage is irreversible and euthnazia is preffered.

Copper toxicity: Sheep is most affected. Acute copper poisoning causes severe gastroenteritis, abdominal pain, diarrhea,
anorexia, dehydration, and shock. Hemolysis and hemoglobinuria may develop after 3 days if the animal survives the GI
disturbances. Chronic exposure leads to depression, lethargy, weakness, recumbency, rumen stasis, erosions and
ulcerations in the abomasum, anorexia, thirst, dyspnea, pale mucous membranes, hemoglobinuria, jaundice and acute
liver or kidney failure. Treatment is not successful. Usually associated with Molybdenum deficiency. Necropsy will find
gun-metal gray kidneys and port-wine colored urine. Copper deficiency in kids, lambs and piglets affects the nervous
system.

Molybdenum toxicosis (copper deficiency): also causes secondary deficiency in copper. signs such as Achromotrichia
(depigmented hair especially around the eyes), speckles, rough coat, decreased milk yield, lameness, peat scours and
teart (severe scours with gas bubbles). Presents as Enzootic ataxia or Swayback in lambs less than one month old leading
to ataxia, stiffness of hind limbs.

Cottonseed Toxicity: also known as Gossypol toxicity. Iron helps to inactivate free gossypol pigment. Gossypol is
cardiotoxic for cattle, sheep, and pigs. High iron, Ca hydroxide, proteins are protective.

Ethylene glycol: (Renal damage) present in antifreeze. Stage I (30min-12h post) – neurological
phase with knuckling, ataxia, vomiting and drunken behavior. Stage II (12-24h post) –
cardiovascular phase with tachypnea and tachycardia. Later signs also include renal failure and
elevated osmolar gap (>20mOsm/kg). Diagnosis is done by clinical signs, rapid test kit and
Calcium Oxalate Monohydrate crystals in urine sediment.

Treatment with Fomepizole (4-methylpyrazole or 4-MP) until 3 hours after ingestion & 20%
ethanol IV after 3h post ingestion and is the treatment of choice for cats. Both ethanol and
fomepizole slow the metabolism of ethylene glycol by competitively inhibiting alcohol
dehydrogenase (ADH).

Lead toxicity: causes CNS signs, encephalopathy, head pressing, maniacal excitement and blindness, but you can also see
diarrhea or constipation. Blood work shows basophilic stippling. Common in birds due to paint in old houses, lead curtain
weights or in stained glass.

Fishmeal: can be potentially toxic and allergenic. Ethoxyquin is a preservative in fishmeal that may have toxic hepatic
effects. Fish meal also contains mercury, which can cause neurological disturbances.

Ester Lilly or Tiger Lilly: can cause acute renal failure in cats. Clinical signs include azotemia, weakness, ataxia, and
abdominal pain. Lab work shows very high creatinine, hyperkalemia, and hyperphosphatemia.

Halogeton Spp and Rumex sp. (dock) toxicosis: leads to oxalate calculi in small ruminants and cattle.

Hemlock poison: in conium maculatum and clinical signs include hind limb weakness, weak pulse, irregular heart rate,
recumbency, coma and death. Mousy odor from urine & breath.

Household Cleaners: acids and alkalis that cause caustic or corrosive lesions respectively. Treatment administers milk or
water, GI protectants for several days and monitor for ulcers. Do not induce vomit or administer activated charcoal.
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Hypocalcemia: also known as milk fever or parturient paresis. Clinical signs include acute to per acute, afebrile, flaccid
paralysis of mature dairy cows that occurs most commonly at or soon after parturition (within 72h). It is manifest by
changes in mentation, generalized paresis, and circulatory collapse due to tachycardia. Treatment include IV Ca.

Hypoiodinemia: caused by goitrogenic plants (soybeans, cabbage, rape, kale, and turnips) that do not allow iodine uptake
by the body. Pregnant dams that eat goitrogenic plants may birth foals with hyperplastic goiter and hypothyroidism

Hypomagnesemia: in cattle is present as tetany along with hyperexcitability, ataxia, convulsion, and death. Treatment is
IV Ca/Mg combo (like in Milk fever – hypocalcemia).

Locoweed toxicosis: due to Astragalus and Oxytropis ingestion leads to Swainsonine toxicity and causes neurological signs
(locoism) such as aggression, ataxia, depression, circling, and vision loss. Ingestion worsens the High Mountain Disease
(LOCO = High). High mountain disease has a genetic component and prognosis is good if the disease is catch early. The
plants are also known as vetches or milk vetches.

Lupine Spp: contain a quinolizidine alkaloid that has nicotinic effects leading to salivation,
incoordination, head pressing, excitement, muscle tremors and dyspnea. Most commonly affect
sheep. It has a teratogenic effect in cattle only, if dam eat the plant between 40-70 days of gestation
causing Arthrogryposis (Crooked calf syndrome). There is no specific treatment.

LUPIN

Imidacloprid: is a neonicotinoid insecticide that can be applied in dogs and cats.

Ionophore: Horses are the most sensitive affecting the heart. It leads to abnormal transport of specific ions across cell
membrane to damage myocardium and fibrosis. This cause decrease performance and heart failure. Clinical signs include
anorexia, colic, stiffness, tachycardia, posterior paresis and increase CK. Other clinical signs include colic, myoglobinuria.
In cattle toxicity affects multiple organs, leading to cardiomyopathy and heart failure. On postmortem see pale
myocardium, hemopericardium, epicardial hemorrhages & fluid accumulation in body cavities. There is no antidote.

Marijuana: prolonged sedation, hypotension, bradycardia, hypothermia, and mydriasis.

Metaldehyde: active ingredient in molluscicides (snail baits) that causes clinical neurological signs such as seizures. Treat
with diazepam.

Methylxanthine alkaloids: such as theobromine, theophylline, and caffeine. Present in chocolate! See excitement,
seizures, and arrhythmias.

Mothball toxicity: caused by naphthalene-containing mothballs or from paradichlorobenzene containing cakes. Clinical
signs include GI signs, hemolytic anemia, and Heinz bodies. Single mothball is toxic for 14 kg dog.

Paradichlorobenzene: organochloride insecticide that mainly causes CNS signs and is found in deodorant cakes.

Oxalate toxicity: found in Sarcobatus vermiculatus (greasewood), Oxalis (sorrel), Rumex (dock), Halogeton, Amaranthus
(pigweed) and Chenopodium (lambsquarter). It is also produced by Aspergillus niger in molds. Oxalate binds to calcium in
the rumen or in the body fluids, leading to death attributed to hypocalcemia or kidney failure by calcium oxalate crystals
in the renal tubules. Sheep is most affected.

Painting and Varnishing products: Treatment administer milk or water, GI protectants for several days and monitor for
ulcers. Do not induce vomit or administer activated charcoal.
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Penitrem A: present in moldy garbage containing Aspergillus spp. Clinical signs include panting, restlessness,
hypersalivation, incoordination, fine motor tremors and seizures. Treatment includes gastrointestinal decontamination
(emesis if possible), activated charcoal, methocarbamol (Robaxin) for muscle tremors, diazepam (for seizures) and GI
protectants (sucralfate or H2 blockers).

Permethrin: found in some brands of topical flea treatments for dogs, but highly toxic to cats. Treat it with methocarbamol

Photosensitization: primary photosensitization is when the component becomes photo dynamic like photosensitization
by St. John’s wort. Secondary sensitization is when a component damages the liver leading to photosensitization. The
components can be Pyrrolizidine alkaloids and others. The plants that can cause secondary photosensitization are: Rape
(Brassica sp), Blue-green algae, Wooly Groundsel (senecio sp), Rattle weed (Crotalaria retusa) and Yellow starweed
(Amsinckia intermedia). Ragwort (senecio jacobea).

Ponderosa pine: needles and bark contain the toxin isocupressic acid, which causes vasoconstriction and ischemia to the
uterus and other tissues. Causes abortion 2-21 days after exposure. Cattle is most sensitive to it. In cattle cause late term
abortion. Ischemic necrosis of CL results in lack of progesterone and causes abortion. Edema of vulva and udder and bloody
mucosal vaginal discharge occurs just before the abortion. Retained placenta after the abortion. Calves that are not
aborted are born weak. Affected dams do not produce colostrums and calves may die from starvation or infection.

Quercus spp (oak) toxicity: happens consumption of large amounts of buds, leaves or acorns over 2-3 days. Cattle are
most commonly affected and pregnant cows may birth calves with congenital abnormalities (acorn calf). Damage is
primary found in kidneys (leading to pale swollen kidneys and peri-renal edema), liver and gastrointestinal tracks. Goats
are more resistant to oak toxicity. These contain certain tannins that cause GIT, renal, liver damage and death. Toxic
principle is Gallotannin, a combination of Tannin & Gallic acid. Goats and wild ruminants have proteins in saliva that binds
tannins and may have greater level of tannase enzymes in rumen mucosa. Oak must comprise over 50% of diet to cause
toxicity.

Salt toxicosis: sheep is most resistant, and pigs are most sensitive. Most common in swine, cattle, and poultry.

Sago palm: ingestion causes acute hepatic necrosis and is lethal. Hepatic encephalopathy, icterus, and seizures.

Sorghum (Sudan Grass, Johnson grass, Milo): can cause neurologic toxicity, primarily in horses.
Clinical signs include posterior incoordination (swaying rear limb gait, knuckling) and urinary
incontinence, secondary to a lower motor neuron myelomalacia of the nerve roots. It can also
cause cyanide toxicity.

S0tringhalt gait: caused by Hypochoeris radicata (flatweed) and Lathyrus (sweet pea).

Teratogenic effect: Griseofluvin (antifungal), Ketoconazole (antifungal) and Doxorubicin (chemotherapic) are teratogens,
especially for cats and horses. Oak toxicity (acorn calf) and Lupinea (arthrogryposis in calves) and skunk cabbage (cyclopia
in lambs).

Urea toxicity: causes wildly aberrant behavior (bovine bonkers), tremors and acute death. Carcasses appear to bloat and
decompose quickly. Treat with vinegar (5% acetic acid) & cold water. Slow the absorption by lowering the stomach PH.

Veratrum spp (false hellebore, skunk cabbage): associated with cyclopia, early embryonic death and defects of the limbs
in lambs if dam ingest it during early gestation. Sheep mainly.

Zinc Deficiency: causes a non-pruritic parakeratosis and may resemble exudative dermatitis (greasy pig disease –
Staphylococcus hyicus). However, exudative dermatitis is in young suckling piglets. Decrease Zn absorption due to high
Ca, phytase & other chelating agents.
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RX: Zn supplementation (Starter: 125 ppm, Grower: 75 ppm, Finisher: 50 ppm)

Zinc toxicity: common in puppies that ate pennies or in birds with galvanized cage wire.

White Muscle Disease: sudden death and endocardial plaques in young calf, lamb, or kid with history of recent vigorous
exercise. To try to prevent it, treat animals with vitamin E and Selenium.

White snakeroot (Eupatorium rugosum): contains trematone that cause cardiac & skeletal muscle damage.

Hypericum perforatum (klamathweed): contain hypericin.

Hordeum spp. (foxtail): cause physical injury.

Primary photosensitization: Photodynamic substances in the plant itself. For example, Hypericin from Hypericum
perforatum (St. John’s wort) and fagopyrin, Fagopyrum esculentum (Buckwheat).

Secondary photosensitization: causes include common bile duct occlusion, facial eczema (pithomycotoxicosis) and
mycotoxic lupinosis.

Calla Lillies & Philodendrons: contain excess calcium oxalate, toxic to kidneys and oral tissues causing swelling and
inflammation when ingested.

Prunus virginiana (chokecherry): contains CYANIDE.

Horse brush (tetradymia): causes photosensitization, hepatic damage, and “big head”.

Materials for tubing in an Amphibian enclosure: Polyethylene, polypropylene & Nylon. Do not use Zn, Cu, Lead or Acrylic
plastics.

Mare reproductive loss syndrome (MRLS) is caused by eating wild cherry tree, Eastern tent caterpillars and wheatear
changes that affect pastures.

Gas bubble disease is caused by over saturation (Nitrogen) and cause buoyancy problems, visible bubbles in foot webbing
of frogs.

Onion or Garlic toxicity: can be caused from chronic overconsumption of garlic powder e.g. cat food on exclusive diet of
baby food. Excessive consumption of plants from Allium genus can cause methemoglobinemia with Heinz body anemia.

Smoke inhalation cause Cyanide + CO toxicity. Birds are the most susceptible.

Pumpkin is safe to eat for pets.

Tod poisoning: mostly cause local irritation, profuse salivation. Head shaking, pawing at mouth, retching, vomiting. The
marine Tod ( Buff marinus) have highly toxic venom causing life threatening CNC & Cardiac effects with 20-100% mortality.

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POSITIONINGS
Lateral recumbency Animal is lying on the side
Right lateral recumbency Animal lies on its right side down
Left Lateral recumbency Animal lies on its left side down
Dorsal recumbency Animal lying belly up
Sternal recumbency Animal lying belly down

STERILE METHODS & TECHNIQUES


Instruments A double wrapped muslin or crepe paper wrapped surgical pack will last 3 weeks on an open shelf,
sterility but it can last for 6 weeks if kept in a clear, closed, dust-free cabinet.
Surgeon The surgeon must put cap, mask, and foot covers before scrubbing.
preparation Scrubbing should last 5 min or 10-25 brush strokes on each skin surface.
Antiseptic Povidone-iodine Povidone-iodine causes acute contact dermatitis in 50% of dogs and in many
agents horses.
Glutaraldehyde Glutaraldehyde is toxic and irritating. It is usually used to sterile instruments
in cold trays (cold sterilization) and exposure time should be at least 3 hours.
It is the most appropriate way to sterilize an endoscope. After using
glutaraldehyde, you would double rinse it with sterile water.
Chlorhexidine Typically, it is recommended to do 3 scrubs. Sterile saline or isopropyl alcohol
wipes can be used to clean the surgical site between 3 scrubs.
Chlorhexidine is superior to Povidone-iodine because it is not inactivated by
alcohols or organic matter and is non-irritating to the skin.
Incision site Start the surgical scrub at the site of the proposed incision and then work outward only in
scrubbing concentric circles. Use a new gauze sponge for each pass of the area ensuring that all areas within
the surgical field are cleaned. Repeat this procedure for three antiseptic cycles or until there is no
dirt visible on the sponge.
Instruments Distilled water Clean surgical instruments with distilled water if possible
cleaning Ethylene oxide Endotracheal tube & Meltable materials
Radiation Gloves & Sutures
Heat Gowns, Drapes, Surgical instruments
Autoclaving The minimum safe standard for autoclave sterilization of surgical packs is
121C (250F) for 13 min.
Sterilization strip Change color to indicate that pack is sterile.
Surgical Milk A solution that works as a lubricant and rust inhibitor used on surgical
instruments with working action.

INSTRUMENTS
FORCEPS USES
DeBakey Has multiple delicate teeth and is good for vascular surgery.
Brown-Adson Have intermeshing teeth and are used for suturing and wound closure, therefore are
used to hold tissue.
Allis tissue forceps that have teeth on the gripping and can cause trauma to delicate tissue.
Doyen Long and flat-bladed that is used to hold the bowel.
Rat tooth Have large interlocking teeth and are used for tough connective tissue and fascia
Russian Thumb Good for needle handling and are hard on tissue
Rochester Carmalt commonly used in stump and pedicle ligation during an ovariohysterectomy surgery.
Great for large vessels.
Rochester Pean commonly used in stump and pedicle ligation during an ovariohysterectomy surgery.
Babcock least traumatic and best for delicate tissue.
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Roeder looks like Backhaus clamps, but they have a metal ball welded to the points of the jaws
to prevent tissue penetration.
Cooley forceps Vascular clamps
Lorna Non-perforating clamps are used to secure tubing or lines to drapes.
Retractors Manual Senn Used to improve the field of view during soft tissue or
orthopedic surgeries.
Self-retaining Gelpi Muscle retractors
Weitlaner
Balfour Abdominal cavity
Finochietto Finochietto rib spreader. (thoracic surgery)

Needle Holders
Olsen-Hager needle holder has a scissor to cut sutures
Mayo-Hager normal needle holder
Mathieu Does not have rings and the surgeon uses finger pressure to close or open them
Castroviejo Does not have rings and the surgeon uses finger pressure to close or open them

SURGICAL NEEDLES
Taper Have pointed ends. Sub-cut, fascia, intestines
Cutting Tough tissue, skin
Blunt Friable organs, liver, kidney

Hemostats
Kelly & Crile Use to clamp off intermediate size blood vessels
Halsted “mosquito” clamp small bleeding vessels

SCALPEL
Bard-Parker is a handle Blade size
Handle 3 10, 11, 12, 15
Handle 4 20, 21, 22

SCISSORS
Mayo Heavy-duty to cut hard tissues
Metzenbaum Cut soft tissues & have blades with blunt points for opening up tissue planes
Lister bandage scissors one blunt-ended blade (for slipping under a bandage without cutting the patient)
one sharp-pointed blade (which goes above the bandage)
Spencer/ Littauer Suture cutting scissors
White scissor Nail trimming
Iris/ Tenotomy scissor Eye surgery
Abeli Corneal surgery

SUCTION TIPS
Frazier tips Low bleeding areas (Neurological & orthopedic)
Has a finger control for suction pressure that is useful in smaller.
Belluci Ear, Nose, Throat surgeries
Poole Has a protective outer sleeve that prevents it from clogging with tissue on fat.
Used for abdominal & thoracic surgeries.
Yaunkauer Multi-purposed tip.
Lack outer protective sleeve.
Adson Neurosurgery in humans.
Jackson- Pratt drain: Closed suction device used postoperatively to collect body fluid.

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OTHER INSTRUMENTS
Electrocautery A unit that stops bleeding by cauterizing cut blood vessels
Jacob’s chuck a handle with a drill bit head used to grip and place intramedullary bone pins (IM pins, also
called Steinmann pin) when fixing broken bones
Kirschner wire A smaller version of the Steinmann pin is used to pin small bone pieces.
Rongeur forceps Used to break up and remove the bone. Inside of each half of the nose is scooped out and
has a sharp edge for biting away chunks of bone
Trocar opens a hole for an arthroscope
Periosteal elevator lifts muscle of bone
Osteotome used with a mallet to cut bone
Curette like a tiny, sharp ice cream scooper used to scrape hard tissue, like bone and cartilage
Spay hook Lifts the uterine horn out of the abdomen
Ophthalmoscope An instrument used to examine the eyes
Otoscope used to look into the ears
Frick Speculum a blunt-ended metal tube inserted into the cow’s mouth to prevent it from chewing on the
plastic orogastric tube.
Gigli Wire saw
Trephine A T-shaped tube with sharpened hollow tube-end usually used to remove a bone core for
biopsy.
Trocar used to puncture the rumen in bloat cases. It is also called a cannula
Flutter valve A one-way valve is used in respiratory medicine to prevent air from back along a chest
tube.

SUTURE PATTERNS
Types Patterns Usage
Appositional Cruciate Skin
Gambee intestinal anastomosis
Simple interrupted Skin
Simple continuous Skin, uterus
Intradermal/subcuticular
Inverting Connell Hollow organs
Cushing
Parker-Kerr
Purse-string
Everting Ford interlocking Commonly used in areas under tension such as skin, subcutis,
(Reverdin) fascia, and tendons.
Horizontal mattress
Vertical mattress
Near and far
Three loop pulley Commonly used in areas under tension such as skin, subcutis,
fascia, and Flat tendons.
Kessler (locking loop) Recommended for the repair of Round tendons
Krackow

FEATURES OF THE SUTURE MATERIALS


Absorbable Synthetic Dexon Polyglycolic acid Multifilament
Vicryl Polyglactin Multifilament
PDS Bladder Polydioxanone Monofilament
Maxon Polyglyconate Monofilament
Monocryl Monofilament
Non-synthetic Catgut Sheep intestine Multifilament
Non-Absorbable Non-synthetic Silk Multifilament
Steel
Synthetic Prolene Polypropylene Monofilament
Ethilon Nylon 6 Monofilament
Vetafil Polymerized caprolactam Monofilament
Fluorofil Monofilament
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SUTURING/ SIZES/ SELECTION OF MATERIAL/ HISTORY
Catgut Originally it was LIT GUT in German which means fiddle strings because of its use in
stringed musical instruments.
Gutta-percha Original natural latex, a product of the tree.
It was used to insulate telegraph wires.
Golf ball.
Dentists fill teeth during the root canal. (today)
Vascular anastomosis Monofilament, Non-absorbable, small
Urinary bladder Monofilament, absorbable, small
Corneal suturing 6-0
Equine linea alba 2
Skin closure 2-0 Monofilament, Non-absorbable, remove after 14 days
Rumen suturing 2 (chromic catgut)
Uterine suturing Simple continuous (single or two layers)
2nd layer may be Cushing/ lambert.
Gastrostomy Cushing over-sewn with lambert

Wound Healing
First Intention Healing Second Intention Healing Third intention healing
(Appositional Healing or Primary
Wound Closure)
Suture fresh, the clean wound Used for dirty, traumatized wounds If decided you can close the wound
closed within 6 to 8 hours (golden where the injury is cleaned and after 3 to 5 days (delayed closure,
hour) post-injury. allowed to contract and epithelialize also called third intention healing).
on its own until closed. The wound
should be left open to contract and
granulate.
STAGES OF WOUND HEALING
Inflammation Neutrophils migrate to new wound within 30 minutes. Neutrophils
phagocytose bacteria and die off leaving monocytes to become predominant
cell type for the next phase of inflammation: wound debridement.
3-5 days
Proliferation Fibroblasts dominate in this phase.
Remodeling During maturation collagen fibers produced by fibroblasts remodel along lines
(Maturation) of tension in wound and gain their final length. This may take 2 years.
After 3 weeks

WOUND CONTAMINATION
ENDOGENOUS EXOGENOUS
Bowel content, dermatitis, gingivitis, blood Air, surgical team, instruments, supplies

Proud Flesh: excessive growth of cauliflower-like granulation tissue around a healing wound. Hygroma: inflammation
of an acquired bursa that developed usually due to trauma. Villonodular synovitis: inflammation of the synovial
membrane of the dorsoproximal aspect of the forelimb fetlock joint. Ulceroproliferative faucitis: progressively
worsening gingivitis and stomatitis in cats.
Onychectomy (Declawing): Is the removal of the distal phalanges (3rd phalanx) by severing the digital extensor and
elastic tendons dorsally, digital flexor tendon ventrally and collateral ligaments laterally between P2 and P3. This is a
painful procedure and requires significant post-operative multimodal analgesia. Pain management is NECESSARY, not
elective! Declawing is controversial and illegal in Brazil.
Ovariohysterectomy (spay): ovarian pedicle bleeding in the right you should retract proximal duodenum to the left. If
it is in the left, you should retract the mesocolon (descending colon) to the right.
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Tail Docking: Cutting the animal’s tail is done between 3 to 5 days of age in dogs. Laparotomy: Incision into the
abdominal cavity. Right Flank pyloric omentopexy: Used to correct left displaced abomasum.
Modified Whitehouse, Viborg’s Triangle and Hyovertebrotomy: Guttural pouch approach
Caslick’s operation: Vulvar suturing that is used to treat Pneumovagina. Ingluviotomy: surgical opening into the crop
of a bird. It is usually done to remove the foreign body. Colpotomy: incision of the vagina.
Post-operative care Methylcellulose: has anti-adhesion effects and is recommended for use in animals post
laparotomy in order to reduce the incidence of adhesive peritonitis.
Penrose drain: thin, floppy latex rubber tube used as a passive drain.

COMMON PROBLEMS & THEIR SOLUTIONS


Hip dysplasia Triple pelvic osteotomy
Pectineal myotenectomy
Luxated shoulder Velpeau bandage
Hip luxation/ coxofemoral luxation Ehmer sling
Cranial cruciate ligament tear Robert jones sling
Fracture distal to knee & elbow Thomas splint
Avascular necrosis of femoral head (leg-Perthes) Femoral head & neck excision
Degenerative joint disease Transverse intertrochanteric osteotomy
Enteroplication surgeries Risk of intussusception reoccurrence
Prevent uterine cancer (adenocarcinoma) OVH in non-breeding Rabbits (4–6-month age)
Make opening into urethra at perineum Penile urethrostomy

Which choice is the recommended intervention for correction of the left displaced abomasum in dairy
cattle?
Right flank pyloric omentopexy.

The abomasum is normally located in the right ventral abdomen, but because it is loosely suspended by the greater
and lesser omenta, it can potentially move out of this position to the left side of the abdomen (most common) or to a
more caudal position on the right side of the abdomen lateral to the liver. Both surgical and closed (percutaneous)
techniques can be used to correct displacements, with a right flank pyloric omentopexy generally recommended, if
possible. Surgery is in preference to blind techniques due to the greater risk of complications and higher recurrence
rate seen with closed techniques. The etiology of abomasal displacement is multifactorial, including abomasa
hypomotility, genetic predisposition correlated with high milk veld, decreased rumen fill, and low-roughage, high-
concentrate diets. Right displacement of the abomasum can lead to rotation of the abomasum on its mesenteric axis,
resulting in abomasal volvulus. Clinical findings of abomasal displacements include anorexia, ketosis, and decreased
milk and fecal production; cows with abomasal volvulus display more severe signs including depression, weakness,
toxemia, dehydration, and shock.

Acute Abdomen
An acute abdomen refers to the sudden onset of clinical signs attributable to the abdomen. Gastric distention and
volvulus, peritonitis, and ruptured bladder are all potential causes of an acute abdomen.

Which is the best method of abdominal closure being most appropriate for OVH patient?
The best choice for abdominal closure would be Rectus fascia: Simple continuous; subcutis: Simple continuous; skin:
Cruciate. The abdomen is closed in three layers: Rectus fascia, subcutis, and skin using appositional patterns. Simple
interrupted or continuous patterns may be used. The Connell and Lambert patterns are inverting suture patterns, used
to close a hollow viscus. The Gambee is used for intestinal surgery to prevent mucosal version. The Halstead is an
uncommonly used suture pattern, that is used for skin apposition. Remember that the holding layer of the abdomen
is the rectus fascia, not the muscle!

Which process is appropriate when opening an instrument sterilized in a plastic peel pouch?
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The pouch should be slowly peeled open while facing the opening away from the assistant's body and towards the
surgeon or sterile field. The surgeon can either take the item directly from the opened package (for smaller or awkward
items) or the contents can be dropped onto the sterile field. Instruments should always be opened with the handle
towards the surgeon.

What is the treatment of cherry eye condition?


This is a classic image of the cherry eye (prolapsed accessory lacrimal gland of the third eyelid (nictitans)) and the most
appropriate treatment is surgical replacement of the third eyelid gland. This gland provides 30-50% of the aqueous
tear film (varies depending on demand and the individual). Eversion of third eyelid cartilage is inherited in giant-breed
dogs, such as mastiff breeds, Great Danes, and German shorthair pointers. This condition can also be seen in cats but
is less common. Cherry eye is seen most commonly in young dogs (6 mos-2 yrs.), usually unilateral. Warn owner that
other glands may prolapse in the future, and this cannot be prevented. Perform a full ophthalmic examination to rule
out concurrent conditions such as keratoconjunctivitis sicca (KCS), corneal ulceration, and Horner syndrome. There
are multiple options for surgical repair of the prolapsed third eyelid gland. Rapid intervention reduces the risk of
ongoing inflammation and subsequent KCS. Avoid excision of the gland or entire nictitans with the gland due to the
high risk of developing KCS. Even if you surgically replace the gland, there is a 20% risk of subsequently developing
KCS.

A surgical gown should always be folded so which part is at the top of the sterilization package?
Surgical gown packs should always have neck ties on the top. This allows the surgeon to easily pick up the gown
without compromising sterility. Depending on surgeons’ preferences, a sterile towel may be placed on top of the gown
for drying their hands. Gowns are fan or accordian folded to allow them to easily unfold after being picked up.

Which parts of a surgical gown are considered sterile once the gown and gloves have been donned (put
on)?
Once a gown is on, it is considered sterile from just below the shoulders to the waist or tabletop. The neck is not
considered sterile. The sleeves are considered sterile because they are below the shoulder. To maintain sleeve and
glove sterility, your hands should never drop below the level of the table. Hands can be clasped together above the
level of the waist and sterility is maintained but arms should not be folded since armpits are not sterile. The back of
the gown is treated as non-sterile. A gowned and gloved person should never turn such
that the back faces a sterile area.

When wrapping a surgical pack or gown, how should the pack be placed on the
wrap?

The pack is placed diagonally on the wrap to allow the corners to fold up over the pack
like an envelope. The final corner is tucked into the previous wraps with a folded tab to
allow easier opening. A piece of autoclave tape secures the entire package.

Lavage Solutions
Neutral, isotonic solutions are generally used as lavage fluid (0.9% saline and lactated ringer's solution are common).

Hypotonic edema
Hypertonic dehydration
glucose food for bacteria
Acidic or basic stimulate bacterial growth
Antibiotics and disinfectants irritate tissues
Blood Pressure Monitor
An oscillometric blood pressure monitor sense the motion of the arterial wall as a blood pressure cuff deflates. The
arterial wall tends to 'oscillate' up and down as pulsatile blood flow is restored, this oscillation is transferred to the

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blood pressure cuff. The oscillations change as flow and pressure change. The signals are interpreted by the monitor
and systolic. mean, and diastolic pressures are calculated.

The tails of lambs are typically "docked" or shortened. Which one of the following adverse outcomes has
an increased risk if a lamb's tail is docked too short?
Tails of lambs are docked to reduce fecal soiling and flystrike but making it too short is associated with an increased
risk of rectal prolapse. Flystrike occurs when blowflies lay eggs on sheep. When the maggots then burrow into the
sheep, they secrete ammonia and poison the sheep. It's a self-perpetuating cycle because the skin irritation attracts
additional flies. It is very painful, and death can ensue within 3-6 days. Tail docking has welfare implications because
it is painful for the lambs. Reported benefits include increased weight gain, feed efficiency, reproductive capacity, and
improved tolerance of heat. The AVMA notes that excessively short docking is inappropriate from a welfare point of
view. Appropriate docking at the level of the distal end of the caudal tail fold, using analgesia and appropriate
procedures, is recommended.

Strike-Through
Strike-through is when a gown or drape becomes completely soaked through with blood or saline rinse. Once soaked
through, a gown and drape are no longer impermeable to bacteria. This increases the chances of surgical field
contamination. Any soaked items should be removed from the surgical field and replaced with fresh sterile ones. A
soaked gown should be changed (along with the gloves). There are gowns specifically designed with an impermeable
front to help prevent this from happening.

Which of the following is a common break in aseptic technique during small animal surgery?
The anesthetist is typically not wearing sterile gloves and may not be wearing a sterile gown, and therefore should
not reach over a sterile field. The sleeves, hands, and front of the surgeon and assistant are sterile, they are included
in the sterile field and can safely reach over the instrument tray.

When is the best time to spay a dog to decrease the chances of developing malignant mammary gland
tumors later in life?
Spay before the first estrus.

A horse is in dorsal recumbency under general anesthesia maintained with isoflurane to perform an
exploratory laparotomy for colic. The surgeon says she is going to perform a pelvic flexure enterotomy.
Which group of items are all needed for the procedure?
You will need to prepare the enterotomy tray, a sterile drape, fluids to rinse the colon, a sterile
"suture pack" " (typically includes scalpel handle, needle drivers, forceps), and suture, and
usually hoses to help rinse the contents out of the colon. Pelvic flexure enterotomy is a common
procedure performed during exploratory laparotomy in horses. It involves placing the large
colon onto a draped enterotomy tray at the right side of the abdomen, then an assistant makes
an incision into the pelvic flexure Hoses are used to gently flush out the colon, it is sutured up,
rinsed thoroughly, then placed back into the abdomen. Colloquially called "dumping the colon"
"- it can be done to remove an impaction such as an enterolith or sand, or just to empty the
colon so that it's easier for the horse to resume normal Gl motility after anesthesia.

A tourniquet was placed at mid cannon bone on this cow's leg. Lidocaine is being injected in the dorsal
pedal vein. What is expected to happen?

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Anesthesia distal to tourniquet. This is an example of intravenous regional
anesthesia, the anesthetic method of choice for most bovine digital
surgical procedures. It has similar results to a nerve block. but is easier to
do with reliable results. You need only one injection and no special
knowledge of anatomy. 2% Lidocaine infuses down the venous system
and anesthetizes the entire lower limb distal to the tourniquet within
about 10 minutes. The amount of lidocaine needed is typically 10-30 ml
and should not exceed a total dose of 9 mg/kg. Do not keep a tourniquet
in place for more than one hour. Some references call this a "Bier" block,
after the pioneering German physician August Bier, who reported on this
form of anesthesia in 1908.

Horse having paraphimosis & hair ring.


General anesthesia to remove the ring of hair, perform a partial penectomy and orchiectomy. Paraphimosis is a
medical emergency. Early recognition and treatment is essential to prevent permanent damage to the penile and
urethral tissue.

In this case, blood supply to the penis was obstructed for too long. causing ischemic necrosis of the penile tissue and
damage to the urethra. A penectomy and castration are required to salvage the remaining tissue. The most common
cause of paraphimosis is a smaller than normal preputial orifice (congenital, traumatic, or post-surgical). Other causes
include spinal lesions, foreign bodies (awns, long hair) in/around the prepuce, chronic balanoposthitis, trauma or
fracture of the os penis.

A dog is anesthetized for enucleation of the right eye. During surgery, the heart rate slows down as the
surgeon retracts the globe to access the structures behind the eye. At this time, the blood pressure
begins to drop as the heart rate gets slower and slower. Which one of the following choices is the best
next step in this case?
The best course of action when the heart rate slows during eye surgery is to ask the surgeon to relax the tension on
the eye and prepare a dose of atropine. If the HR increases when tension on the eye is relaxed, this confirms that the
oculocardiac reflex (OCR) occurred. Administration of an anticholinergic (e.g., atropine) will usually resolve the OCR.
Pressure on the globe or traction on the extraocular muscles increases intraocular pressure (lOP). This stimulates
cranial nerve V (CNV), the trigeminal nerve, which relays information to the brain. Here, the vagus, CN X, increases
output and slows the heart rate. Cardiac arrest may (rarely) occur. A pre-operative retrobulbar block is useful but may
not always prevent the reflex.

For what condition in dogs is the parotid duct sometimes translocated to the lateral canthus of the eye?
Parotid duct translocation is indicated for chronic, nonresponsive cases of keratoconjunctivitis sicca (KCS). The parotid
gland then lubricates the eve with saliva. KCS is due to aqueous tear deficiency in dogs (and less so, cats and horses).
Causes in dogs: Autoimmune dacryoadenitis (most common), distemper, idiopathic (removal of nictitans), drug
induced (NSAIDs and sulfonamides), neurogenic, traumatic, or congenital. Clinical signs: Persistent, painful
mucopurulent conjunctivitis with corneal ulceration and scarring. Corneas look dull. Medical Tx: Topical artificial tears
and antibiotic-corticosteroid combinations (if no corneal ulceration): increase tear production with topical
cyclosporine A, tacrolimus, or pimecrolimus. Can give enteral pilocarpine for neurogenic KCS and topical
acety|cysteine to lvse excess mucus and allow other topical medications to spread. Lifelong TX typically necessary.

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Ballottement is a physical exam technique most often used in ruminants to see if the animals is in the late stages of
pregnancy (right side) or to get a feel of the rumen content (left side).

Succussion is a similar technique to ballottement, but you listen to the animal with a stethoscope while you do it for
sound of splashing in the gut.

Primary survey (triage) helps determine how critical emergent patients are and identifies the need for resuscitation.
Than animals are sorted into groups depending on the need for immediate intervention. Always evaluate ABCD:
Airway, Breathing, Circulation and Disability. Then, evaluate for external evidence of disease of injury such as
hemorrhage, laceration, swellings and more.

Secondary survey does a complete physical exam, thorough history, and minimum database. Where more thorough
diagnostics and therapy are instituted.

Infection and Inflammation


Angioedema Characterized by a locally extensive swelling, predominately on the head. It is different from
urticaria that is multiple small wheals. Both are caused by hypersensitivity reactions.
Antibody titer Measures the level of antibody in a serum.
Enzootic disease Endemic. It is seen from time to time and affects a few animals at a time.
Epizootic disease Epidemic. It is not seen often and develops suddenly in many different animals at once and
it spreads.
Inflammatory Mediators Bradykinin, Phospholipase A2, Cox1, Cox2
Nosocomial infection It is a hospital-acquired infection. Examples include parvovirus, kennel cough or
salmonella typhimurium (horses).
Omphalophlebitis Umbilical infection
Prodromal period It is the period of disease where only mild symptoms are present.
Seroconversion It is the production of antibody in response to an antigen, so the animal goes from
seronegative to seropositive
Urticaria Also known as hives. Can be immunologic or not and is characterized by small wheals of elevated,
swollen skin.

Ophthalmology
Blepharitis Lid swelling, which is different from the swollen conjunctivae of chemosis.
Chemosis Swelling (or edema) of the conjunctiva.
Cherry eye Prolapse of the nictitating membrane
Distichiasis Eyelashes touching the cornea
Ectropion Everting lid margin, so eyelid is rolled outwards
Entropion Inverting lid margin, so eyelid is rolled inwards
Epiphora Excessive watering of the eye.
Intraocular Pressure Measurement of the eye pressure. In dogs and cats the normal IOP is between 15-
25mmHg.
Keratomalacia “Eye melting” that involves drying and clouding of the cornea. Usually due to vitamin A
deficiency.
Nyctalopia Night blindness
OD on the right eye (O. Dexter)
OS on the left eye (O. Sinister)
Pannus Bilateral, progressive, chronic, superficial keratitis common in German Shepherds.
Superficial keratitis Vascularization of the cornea.

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Synechia: Adhesions formed between adjacent structures within the eye usually as a result of inflammation.
Ophthalmoscope Used examine the eye. GT6VBNµ

Neurology
Anisocoria Having pupils of different sizes
Ataxia General neurologic term that refers to an inability to coordinate muscle movements or loss of balance
because the animal doesn’t know where its feet are in relation to the ground.
Flaccid (limp) The limb is flaccid.
Head tilt Laying the head sideways. Happens with damage to CN8, to the inner ears, floculonodular node or
to parts of the cerebellum.
Hydranencephaly Loss of cerebral cortical tissue (brain) with CSF filling the resulting cavity and normal-looking
skull.
Hydrocephalus Accumulation of excess CSF in the ventricles of the brain, usually with distended/bulbous skull.
Knuckling Is a deficit of conscious proprioception where the animal does not know where its foot is in space.
Miotic Pupil abnormally constricted
Mydriasis Pupil abnormally dilates
Nystagmus Normal, involuntary twitching movement of both eyes that occurs when an animal’s head is
moved from side to side. However, it can also be abnormal due to disease processes such as otitis media, otitis
interna and damage the cranial nerves of the inner ear.
Paralysis Unable to move
Paresis Weak movement, but still able to move
Patellar Reflex Monosynaptic reflex that tests the integrity of the femoral nerve and the L4-L5 spinal segments.
Syringomyelia Development of fluid cavities in the spinal cord Tetanic (Stiff) The limb is rigid.
Withdrawal Reflex Tests the sciatic nerve at L7-S1.

Cardiorespiratory
Advanced Life Support Involved the administer of medical therapies to patients in cardiac arrest.
Basic Life Support Initiate immediately! Cardiac compression and ventilation that are started during the initial
phase of CPCR.
Bradypnea Decrease respiratory rate. It can also be due to increase intracranial pressure.
Cheyne-stokes Breathing Characterized by fast breathing, slowing down and then no breathing. Occurs most
often as a result of abnormal CO2 regulation associated with increased intracranial pressure or damage to
respiratory centers of the brain.
Crackles Bubble sound in the lungs associated with pulmonary edema
Ecchymosis Discoloration of skin resulting from bleeding underneath (bruising)
Hematomas Solid swelling of clotted blood within the tissue
Hemoptysis Blood spotted cough
Kussmaul Breathing Characterized by slow, deep respiratory pattern. Typically indicated respiratory
compensation for metabolic acidosis.
Petechiae Small pinpoint hemorrhages on the skin or mucus membranes
Restrictive breathing Fast and shallow breaths typically indicated pleural space disease, such as pleural
effusion or rib fractures.
Silver nitrate Is used to chemical cauterization to stop bleeding.
Suppuration Pus forming process.
Synchronous Diaphragmatic Flutter Also known as Thumps is a respiratory pattern due to hypocalcemia.
Tachypnea Rapid breathing pattern usually in response to hypoxemia and shock.
Wheezes Associated with collapse airway lumen

Gastroenterology
Dyschezia Constipation associated with a defective reflex for defecation

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Gastric Tubes When tube feeding is necessary for weeks to months, usually between 8 to 12 months.
Hematochezia Fresh blood in the feces
Icterus Also known as, Jaundice and it is characterized by a yellow-colored skin. It is caused by the
accumulation of bilirubin, which is the intermediate breakdown product from the heme molecule in
hemoglobin and myoglobin.
Intussusceptum Invaginates into the lumen of an adjacent segment of intestine.
Intussuscipiens Part of the bowel that receives the intussusceptum.
Large bowel Diarrhea Small stool volume, increase frequency of bowel movements, tenesmus, dyschezia,
hematochezia and mucus. Patients are usually of normal weight.
Melena Dark, tarry stools containing decomposing blood, which is usually an indicative of bleeding in the
upper GI such as esophagus, stomach, and duodenum.
Small bowel diarrhea large stool volume, normal defecation frequency, weight loss, often watery or soft,
odoriferous with flatulence. May be associated with melena or vomiting.
Mucocele Disorder where saliva accumulates in the surrounding tissues after trauma to the duct of gland.
Nasogastric tubes Short-term feeding solution for small animals. According to Fossum they can stay for several
weeks, but according to Merck you can leave them in 1-7 days. Usually they can be left for 1 to 3 weeks.
Obstipation Chronic constipation so severe that the patient is unable to defecate on its own. More common
in elderly and infirm patients. Can be a result of foreign bodies, trauma, neoplasia, and megacolon.
Papple shape When a cow is with an apple shape (left side) and a pear shape in the right side.
Ptyalism Excess production of saliva
Ranula Sublingual swelling, usually part of a salivary mucocele (sialocele).
Tenesmus Ineffective and painful straining to defecate and urinate.
Brachygnathism Also known as overbite or overshot jaw. It is when the upper jaw (maxilla) is longer than the
mandible.
Prognathism Elongated lower jaw. Common in bulldogs. (brachycephalic)

Parasitology
Cestode Tapeworm. They release proglottid into the feces. Dipylidium caninum is the most common cestode
in dogs and cats. Intermediate hosts are fleas, and the definitive hosts are dogs and cats.
Life cycle Definitive host has the mature form of the parasite, and the intermediate host has the immature
form.
Nematode Round worm. Intermediate host are mosquitoes, and the definitive host are dogs. (HW)
Pediculosis Infestation of lice
Protozoa Diverse group of unicellular eukaryotic organisms
Schizonts Multi-nucleated structures that are part of the asexual reproductive cycle of coccidia. An infected
oocyst ingested from the environment releases sporozoites. These invade cells in the large intestine, enlarge
and become multi-nucleated (schizonts). Each nucleus becomes the next stage, called merozoite. Merozoite
are released in the lumen of the intestine, invade another intestinal cell, and then reproduce sexually to
produce more oocysts.
Strongyle
Ticks The mouthpart that penetrates the skin is called the hypostome and it enables the parasite to suck blood
from the host.
Trematodes Flukes. Most trematode eggs are too dense to float, and sedimentation procedures are necessary
to identify them. Intermediate host are snails, and the definitive host are sheep.

Skeletal System
Ankylosis Stiffness in a joint, either from injury or disease
Kyphosis Excessive outward curvature of the spine, causing hunching of the back
Lameness

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Laminitis Inflammation of the laminae that connect the hoof wall to the coffin bone.
Valgus Lateral deviation of the forelimb.
Varus Medial deviation of the forelimb.

Nephrology
Azotemia Excess of nitrogenous compounds in the blood. Can be pre-renal, renal, or post renal.
Common Pathogens G+: Staph, Strep and Enterococcus G-: E. coli, Proteus, Klebsiella, Pseudomonas and
Enterobacter.
Dysuria Difficulty during micturition
Nephrotic Syndrome Is the pathologic presence of hypoalbuminemia, proteinuria, hypercholesterolemia, and
edema. It is a complication of glomerular disease.
Periuria Urinating in abnormal or inappropriate locations
Pollakiuria Increase frequency of urination
Polyuria Increase in the amount of urine
Stranguria Difficulty and painful micturition in which the urine usually dribbles (straining)
Uremia Clinical manifestation of azotemia.

Reproduction
Balanoposthitis is inflammation of the glans penis and preputial mucosa
Cryptorchidism When 1 or 2 testis is located into the abdominal cavity.
Paraphimosis inability to retract a swollen penis into the prepuce
Phimosis Inability to extrude the penis due to constriction at the prepucial orifice. Makes urine dribble after
urination. Animals with congenital phimosis should not be bred Posthitis inflammation of the prepucial
mucosa
Priapism prolonged erection in the absence of sexual stimulation
Salpingitis Inflammation of the fallopian tubes

Dermatology
Comedomes Clogged hair follicle (pore) in the skin known as a black head in humans.
Dermatomyositis Thick scaling alopecia of the face, ears, tails, and digits.
Epidermal collarette When around a lesion is formed a crusty surrounding.
Melanoderma Darkening of the skin Nail dystrophy Generalized nail deformities caused by congenital
malformation
Onychorrhexis Brittle nails that are split and easily broken
Onychomadesis Sloughing of the nail off the nail bed and can occur with most nail bed diseases.
Onychomycosis Fungal infection on the nail bed.
Paronychia Swelling around a single nail bed that can be caused by neoplasia, infection, or immune-mediated
disease.
Scleroderma Denotes shiny areas of thick alopecic skin. Warts Caused by papilloma virus.

Tests
Blood gas analysis: in the dog blood should be collected from the femoral artery and the dorsal metatarsal
artery.
Bone marrow aspiration: in dogs and cats should be done in the iliac crest, the trochanteric fossa of the femur,
the tibial crest and greater tubercle of the humerus. In horses it should be done in the Sternebrae. If the horse
is less than 4 years of age, you can collect from the tuber coxae of pelvis. Illinois or the Jamshidi are the needles
often used.

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Central venous pressure (CVP) is measured via a long catheter placed into the jugular vein and positioned just
outside of the right atrium in the cranial vena cava. It is useful to evaluate volume status and response to fluid
therapy.
Coggins Test: gold standard test for equine infectious anemia.
Drawer sign: sign is felt in the stifle (often called the knee) when there has been a rupture of the cranial
cruciate ligament.
Endometrial biopsy predicts the mare’s ability to carry a foal to term. The mare is categorized in I (best), IIA,
IIB and III. III is the worst and the mare should not be used for breeding. Most mares are category IIA. (Kenny
scoring)
Fecal floatation examination should be performed to identify parasitic causes of acute colitis in a young dog.
Direct smear is also useful to look for Giardia and other protozoans.
Gender Identification of Snakes is done by probing for the hemipenis with a blunt, lubricated probe. In males,
the probe will enter the hemipenis (depth of 6-14 subcaudal scales). In females, it enters the cloacal gland
(depth of 3-6 scales).
Grunt Test: press the xiphoid or pinching the animal’s back in the top of the reticulum. If the animal refuses
to move the back up or down, it is a positive grunt test. Traumatic Reticulopericarditis usually has a positive
grunt test.
Schirmer’s tear test (STT) strip evaluated the amount of moisture in the eye. A normal eye should have 18-
25mm. Keratoconjunctivitis sicca is one disease that causes dry eye, in cats STT would be around 10mm and
in dogs it would be around 15mm
Tracheal wash with a few neutrophils and macrophages is normal. Too many is abnormal and an indicative of
respiratory infection. In addition, Simonsiella (in the side image) is a bacteria normally inhabit the pharynx and
have a large and ladder-like appearance. Presence of Simonsiella indicates bacterial contamination.

Vaginal Cytology: To look for signs of ovarian remnant syndrome.

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FLUID THERAPY

BODY WEIGHT & WATER

WATER= 60% of body weight Others= 40%

EXTRACELLULAR= 1/3 of Body Water (20% body weight) INTRACELLULAR = 2/3 of Body Water
(40% body weight)
PLASMA= 4% of B. Weight INTERSTITIAL= 16% of B. Weight
10% dehydration means a 10%decrease in body weight in a non-obese animal.
Fluid deficit calculation: Bodyweight (kg) × % dehydration = volume (L) to correct

Blood transfusion volume (ml) = [Weight (Kg) × Blood volume (ml/kg) × (desired PCV-actualPCV)]/ Donor PCV.

o Sensible losses are the fluid the animal loses by urination. (Hint: sensible losses make sense).

o Insensible losses are fluid the animal loses that are hard to measure, like vomiting, diarrhea, and
breathing.
Determining the Route of Fluid Administration
Per os GIT tract is functional, and no contraindications exist (e.g., vomiting)
Subcutaneous Anticipated dehydration or mild fluid volume disturbances in an outpatient setting
Hospitalized patients not eating or drinking normally, anesthetized patients, patientswho need
IV or
rapid and/or large volume fluid administration (e.g., to treat dehydration,
intraosseous
shock, hyperthermia, or hypotension)
Critical care setting. Used in patients with a need for rapid and/or large volume fluid
Central IV administration, administration of hypertonic fluids and/or monitoring of central
venous pressure

o Subcutaneous route should only be used for isotonic crystalloids. Do not use dextrose, hypotonic(i.e.,
D5W), or hypertonic solutions. Subcutaneous fluids are best used to prevent losses and are not adequate
for replacement therapy in anything other than very mild dehydration

o Intraosseous catheter can be placed for fluid therapy in neonatal patients and birds. In birds, it should
be placed in the distal ulna or in the proximal tibiotarsal bone. Remember that the humerus andfemur
are pneumatic bones and would deliver fluid to the respiratory system.

o TPN: Total parenteral nutrition.


Recommended Maintenance Fluid Rates (mL/kg/hr.)
Cats Dogs
Formula: 80 × body weight (kg)0.75 Formula: 132 × body weight (kg)0.75
Rule of thumb: 2–3 mL/kg/hr. Rule of thumb: 2–6 mL/kg/hr.

o Clinical signs of dehydration include skin tenting, slow capillary refill time, dry mucous
membranes, hypothermia, and tachycardia.

Dehydration Assessment
Dehydration Physical exam findings
Euhydrated Normal.
Mild (around 5%) Minimal loss of skin turgor, semidry mucous membranes, normal eye
Moderate loss of skin turgor, dry mucous membranes, weak rapidpulses,
Moderate (around 8%)
enophthalmos
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Considerable loss of skin turgor, severe enophthalmos, tachycardia, extremely dry
Severe (>10%) mucous membranes, weak/thready pulses, hypotension,
and altered level of consciousness.

o Solution types include Colloid and Crystalloid. Colloids have bigger molecules that cannot get out of the
vessel and pull water intravascularly being used during hypovolemic shock. Crystalloids can be absorbed
into the interstitial space and are usually cheaper.
Solutions
Hypotonic 0.45% saline, 5% dextrose
Isotonic Lactate ringer, Normosol-R, 0.9% solution
Hypertonic Hetastarch, Vetstarch, 7.5% saline (HSS)
Solutions
Crystalloids Sodium Chloride0.9% (Physiological saline), Lactate
ringer, 5% dextrose and 7.5% saline (HSS)

Colloids plasma, RBC, hetastarch, vetstarch, dextrans,


Hydroxyethyl starch (HES).

o Sodium: in cases of Hypernatremia the decrease in serum sodium concentration does not exceed1mEq/L/h
and does not exceed 24mEq/L/day.

o Potassium: should never be supplemented IV at a rate over 0.5mEq/Kg/hour. Adverse cardiac


effects can occur above this rate.

o Total bicarbonate deficit is calculated: Total bicarbonate deficit (in mEq) = base deficit ×0.3×Body weight (in
kg). Typically, 1/3 to ½ of the calculated deficit is administered over 5-10 minand then the remaining is
administer over following 12-24 hours.

o In severe dehydrated patients or those that suffered blood loss, lactate is the best way to measure
blood perfusion.
Animal Disease Fluid
IV fluid with sodium bicarbonate at100ml/kg for
Diarrhea (often hypersecretory with great loss ofwater and
Calf first 4-6 hours.
bicarbonate)
Dextrose maybe added.
Urethral obstruction: patient is usually
IV saline. Avoid Lactate ringers andNormosol-R.
General hyperkalemic, hyponatremic, hypochloremic andacidotic.

General Resuscitation 7% saline (hypertonic solution)


Vomiting patients with low chloride andmetabolic
General 0.9% saline
alkalosis
Blood Transfusion Blood transfusion volume (ml) = [Weight (Kg) × Blood volume (ml/kg) × (desired PCV-actual PCV)]/
Donor PCV

Ischemia and reperfusion injury (IRI) is the most important cause of myocardial damage in the post-cardiac arrest
patient. When oxygen returns, some is converted to oxygen radicals and peroxides, which cause further cell damage.
Chemical mediators of inflammation and products of WBC produced in the heart exacerbate the IRI damage. To
minimize damage, oxygen supplementation is provided at normal range.

There are 5 drugs that can be given intratracheal (IT) and they: Naloxone, Atropine, Vasopressin, Epinephrine and
Lidocaine. Remember NAVLE!

Anaerobic bacteria: Chloramphenicol, Cephalexin, Clindamycin and Metronidazole.

Gram-negative: Enrofloxacin and Aminoglycosides (Gentamicin, Amikacin and Neomycin).

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Generalized conditions
Allergic reaction: If associated with respiratory signs treatment should include epinephrine IV and prednisolone IV. If
the patient becomes hypotensive or bradycardic use atropine IM and if becomes severely dyspneic use aminophylline
IM or slow IV. If the case is not as severe use epinephrine SC. Usually small reaction can be treated with antihistamine
(diphenhydramine or Loratadine).

Anthrax: caused by Bacillus anthracis and leads to sudden death in humans and animals. Reportable disease and
Federal Veterinarian should be called! Do not do necropsy as the spores may infect the veterinarian and the
environment. Carcass should be buried with lime or incinerated. Clinical signs include sudden death and carcass with
absence of rigor mortis and dark blood coming out of orifices. Treat remaining animals with penicillin. Vaccinate in
high-risk areas.

Aortic Stenosis: is a systolic, ejection type (crescendo decrescendo) heart murmur, which may be heard most loudly
on the left chest between the 2nd and 5th intercostal space.

Pulmonic stenosis: usually a systolic murmur heard mostly in the left side between the 2nd and 4th intercostal space.
It can cause right ventricular hypertrophy. It is genetic link in beagles, but miniature Schnauzers, Chihuahuas, Cockers,
and Boxers have also a predilection.

Arrhythmogenic right ventricular cardiomyopathy: Very common in boxers! Clinical signs include syncope, fainting,
collapse, or sudden death due to ventricular tachyarrhythmias. It is uncommon for boxers to show cardiac chamber
enlargement, so radiographs and ultrasound is not very helpful.

Dilated cardiomyopathy (DCM): Most common cardiomyopathy in large breed canines. However, taurine deficiency
can lead to DCM in felines. It is the second most common cause of congestive heart failure in dogs. Clinical signs are
usually acute and include labored breathing, coughing, tiring if Left heart signs or abdominal distension (ascites) and
jugular pulse if right heart signs. Treat it with diuretics, low salt diet and vasodilators (enalapril). Hint: 3D treatment!

Hypertophic cardiomyopathy (HCM): typically causes left ventricle hypertrophy which gives the heart a valentine’s
heart shape (very tall heart). May see secondary to pulmonary hypertension, systemic hypertension, acromegaly, and
congenital aortic stenosis. A systolic murmur (left AV, mitral valve) is evident in 80% of cats with HCM. Cats may also
present tachypnea, dyspnea, anorexia, vomiting, lethargy and in more serious cases cyanotic nail beds, cold
extremities, decreased/absent pulses and aortic thromboembolism. It is the most common cardiomyopathy in felines
that are 5-7 years old.

Congestive heart failure: in dogs the number one cause is left atrioventricular (mitral) valve insufficiency, usually
mitral valve regurgitation.

Mitral valve dysplasia: heard further back on the left 5th to 6th intercostal space. More common in cats but can be
present in dogs with tracheal collapse.

Mitral valve regurgitation or insufficiency is common in small breed dogs, especially Dachshund, Cockers and Cavalier
King Charles Spaniels.

Disseminated Intravascular Coagulation (DIC): think diseases with H such as Heartworm, Heart failure, Hemolytic
anemia, Hemangiosarcoma, Hemorrhagic gastroenteritis and Hepatic disease. It can also be associated with Gastric
Dilatation volvulus, septic shock, and pancreatitis. It is characterized by concurrent thrombosis and bleeding that can
lead to Multiple organ dysfunction syndrome (MODS).

Bronchogenic cysts (congenital bullae) are multiple thin-walled air filled lucencies throughout the lungs. Rupture can
cause pneumothorax. Differentiate from emphysema and infectious.

Brucellosis: also known as undulant fever. Reportable and zoonotic disease that affects all domestic animals. It is
transmitted through ingestion of contaminated milk, food, water, and secretions. Abortion only once, at second half
of gestation (around 7 months) and with a thickened, leathery placenta is very characteristic. Other clinical signs
include stillborn, weak calves, retained placentas and reduced milk yield. Can survive 2 months in cool/moist

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environment and hours under direct sunlight. Vaccination should be done in all heifer calves between 4-12 months of
age. Vaccine increases resistance but does not protect 100%. Males are usually not vaccinated. Vaccine Strain RB51 is
a live vaccine that is less virulent in humans, is less abortigenic in cattle and does not generate antibodies that cause
positive response in serological tests. Strain 19 vaccine is more virulent and result in antibodies that may confuse
diagnostic testing. Brucellosis ring test (BRT) is a dairy-herd test for screening that has a high false positives. If BRT is
positive, the vet needs to draw blood from each individual animal and do serological tests. Market cattle testing (MCT)
is an individual beef cow test. Positive animals should be tracked to herd of origin and the entire herd is tested.
Serology agglutination at dilution of 1:100 (nonvaccinated) and 1:200 (vaccinated between 4-12months) is considered
positive animals. Positive animals are culled.

Candida albicans is a normal member of the flora of the digestive system of many animals. It only causes disease when
the normal flora is disrupted by the presence of another pathogen, from prolonged antibiotic therapy or when
immunosuppression occurs.

Cataracts: occurs in the lens and is classified by age of onset, location, and severity. Common problem in older dogs.
Can be triggered by uveitis in horses.

Cheyletiella (walking dandruff) is identified by the prominent hook-like mouth parts as seen in the side
images. It infects dogs, cats, and rabbits. It is highly contagious disease that is characterized by scaling
lesion on the dorsum and pruritus. Treatment includes permethrin dust for animal and bedding.

Chorioptic mange (leg mange) also known as scratches, greasy heel, and dermatitis verrucosa is
seen in the image in the side. It usually affects cattle but can be found in horses (most common
mite) and small ruminants. Clinical signs in cattle include pruritus and crusts around the caudal
thighs and perineum. In draft horses’ clinical signs are usually hyperkeratosis and scaling on the
caudal aspect of the pastern. Treatment include ivermectin pour-on, 0.25% crotoxyfos spray or
lime-sulfur dips weekly for 4-6 weeks.

Chronic Renal disease: Typically see hypertension, uremia, hyperphosphatemia, hypokalemia and isosthenuria.
Hyperphosphatemia is due to decrease renal excretion, which inhibits activation of vitamin D and therefore the gut
absorption of calcium. Low blood calcium triggers the parathyroid hormone (PTH) which mobilizes calcium from the
bones leading to renal secondary hyperparathyroidism and osteoporosis (rubber jaw). In advanced cases you may see
non regenerative anemia (decrease of erythropoietin). Hypokalemia is usually associated with hypokalemic myopathy
and causes generalized weakness and neck ventroflexion. Azotemia can be renal or pre-renal, you can differentiate it
by giving IV fluid and rechecking BUN and creatinine after 12/24 hours. Pre-renal azotemia signs include increase BUN
and dehydration.

Corneal Ulcers: simple and uncomplicated should be treat with triple antibiotic ointment TID, 1% atropine SID,
Autologous serum TID and an anti-inflammatory. Use antibiotics to fight infection, atropine to dilate pupil and
minimize pain of iridocyclitis, decrease synechia risk and stabilize the blood-aqueous barrier. Serum is an antiprotenase
to prevent keratomalacia. In horses use flunixin meglumine which is an analgesic and anti-inflammatory.

Cryptorchidism: When 1 or 2 testis is located in the abdominal cavity common in dogs and horses. Increases the
animal’s risk to Sertoli cell tumor, feminizing syndrome, and blood dyscrasias. It also increases the risk of seminomas,
testicular torsion, and prostatitis squamous metaplasia. Testes descent prenatally in cats and in 2-6 months in dogs. It
has a genetic components, so breeding is discouraged.

Cystic calculi (bladder stones): in horses is associated with hematuria after exercise. Struvite urolithiasis in dogs is
associated with bacteriuria, high WBC count and high protein. Acidifying the diet prevent struvite-related tract disease
by dissolving the crystals. However, it is not recommended for kittens and older cats. Urate crystals are present
Dalmatians and animals with portosystemic vascular anomalies. In small ruminants it is a common problems that can
be avoided by not feeding grain and leaving mineral blocks to increase water intake.

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Dermatophilosis (rainrot): caused by Dermatophilus congolensis in horses, cattle, small ruminants and rarely in dogs
and cats. The bacteria colonize wet and macerated skin. Under the microscope it will look like railroad tracks. Clinical
signs include areas of alopecia (infects hair), lesions with crust or scab formation, hair matted together in a paint-brush
formation and in severe cases lesions with cutaneous keratinized material (wart-like). Treatment includes antibacterial
shampoo and environmental management. Severe affected horses can be treated with penicillin. The image in the
side shows the rainrot.

Disk spondylitis: vertebral infection from hematogenous spread of bacteria or fungi from another site. Typically seen
a middle-aged dog breeds, especially German Shepherds and Great Dane. Usually caused by Staphylococcus aureus,
but it can also be caused by Brucella canis. Look for spinal pain, sometimes kyphosis, bacteremia, pyuria in 50% of
cases and positive blood cultures (75%).

Echinococcus granulosus: cestode whose definitive hosts are carnivores (dogs, wolves, etc.) and is seen especially in
sheep, but can infect all domestic animals and humans. Cysts are found in the lungs and liver. The cysts are seen in the
side image.

Fibrotic myopathy: refers to the abnormal gait caused by fibrosis and restriction of action of the semitendinosus
muscles.

Foot mouth Disease: Reportable! Family Picornaviridae and it usually affects pigs and cattle. Virus is resistant in the
environment, can be spread by aerosol or fomites and has a high mutation rate. It is not zoonotic and clinical signs
resolve in 2 weeks. Great economic impacts! Clinical signs include fever, pustules in the foot and mouth.

Glaucoma: occurs when the normal outflow of aqueous humor is impaired. Primary causes include closed filtration
angle or goniodysgenesis. It can also be secondary to lens luxation, hyphema, anterior uveitis or intraocular tumors.
Clinical signs include corneal edema, episcleral hyperemia, sluggish to absent pupillary light response, dilated pupils,
decreased vision, ocular pain and enlarged globe. Diagnosis is done by tonometry and if confirmed if IOP is >25mmHg
in horses and above 30mmHg in dogs and cats. Glaucoma needs surgical intervention as only 10% of animals with only
medical management can see in the affected eye after 1 year. However, 40% or more will be blind in the affected eye
no matter the treatment. Avoid atropine!! Medical management include the use beta blockers (Timolol) or carbonic
anhydrase inhibitors (dorzolamide) to decrease aqueous humor production and prostaglandin analogues
(lantanoprost) to increase aqueous humor outflow. Timolol side effects include hypotension, bradycardia, and
bronchoconstriction.

Hansen’s Type I Intervertebral disc disease: is characterized by extrusion of nucleus pulposus through ruptured
annulus fibrosis into the spinal canal. Expect thoracolumbar pain, arched back, hindlimb hypermetria, ataxia and
weakness. Very common in chondrodystrophic breeds such as Dachshunds.

Schiff-Sherrington syndrome (spinal shock): combination of forelimb extensor rigidity and hind limb flaccid paralysis,
in an animal that had just had major spinal trauma. With severe trauma between T2-T13, inhibitory pathways
(especially around L2-L4) are interrupted, and cervical intumescence neurons (C6-T2) are “released” causing extensor
hypertonia in the forelimbs.

Heartwater disease: affects ruminants. It is caused by Ehrlichia ruminantium, a tick-borne (Ambyloma spp) foreign
disease characterized by high fever, lung edema and hydropericardium.

Horner’s Syndrome: Can also be caused by brachial plexus avulsion (damage to the cervical sympathetic innervation
of the eyeball). The signs and symptoms occur on the same side as the lesion of the sympathetic trunk. It is
characterized by miosis (a constricted pupil), partial ptosis (a weak, droopy eyelid), apparent anhidrosis (decreased
sweating), protruding nictitans membrane with or without enophthalmos (inset eyeball).

Hypostatic pneumonia is found in older or debilitated (often hospitalized) patients. The lack of movement cause fluid
to build up in the lungs which leads to dyspnea, cyanosis, and wet, productive cough. Animals should be repositioned
hourly to avoid it and to treat it.

Intervertebral disc protrusion: It is rare between T1-T10 because the intercapital ligaments reinforce the disc dorsally,
preventing it from protruding upwards.
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Keratoconjuctivitis Sicca (KCS or Dry Eye): think bilateral goopy eyes. This is a common problem that is quickly
diagnosis in-house with a Schirmer tear test. Normal dogs should be around 15mm/min of wetting. Dogs with KCS
should have less than 10mm/min wetting. It can be caused by atopy, trimethpim-sulfas, immune mediated adenitis,
post proptosis and after complete removal of cherry eye (hypertrophy and prolapse of gland of nictitating membrane).

Malignant Edema caused by Clostridium septicum and affects many species. Infection occurs through contaminated
wounds and turns affected muscle dark brown and black.

Mannheimia haemolytica pneumonia typically affects ruminants and is also known as shipping fever. It has a
cranioventral distribution and is characterized by a hepatized lung (dark red, liver-like) just like in the side image.
Mannheimia haemolytica is a commensal in the upper airway of sheep, along with Pasteurella multocida. The infection
is usually triggered by stress situations such as movement, weaning and mixing of different animals.

Megaesophagus can affect any breed, but it is more common in dogs. Is associated with myasthenia gravis and can
lead to aspiration pneumonia. Other causes include esophagitis, esophageal stricture or diverticulum, heavy metal
toxicity, polymyositis, lupus and hypoadrenocorticism. Neurological examination, complete blood work, adrenal
testing and contrast studies should be done. Regurgitation is a common clinical finding.

Meningitis is characterized by head pressing due to central nervous system disease, fever, hyperesthesia, a stiff painful
neck and paraspinal muscle spasms. With diffuse meningoencephalitis, may see blindness, progressive weakness,
ataxia (vestibular or cerebellar), opisthotonus, seizures, agitation and mental dullness or coma. Causes of meningitis
include Colisepticemia (calves), TEME (Histophilus somni) in cattle, Haemophilus parasuis (Glasser’s disease of swine)
and listeriosis in ruminants. Think bacterial meningitis in a calf less than a week old with stiffness, inducible nystagmus,
and intermittent tonic clonic convulsions.

Methicillin-resistant Staph aureus: commonly found in humans who transmit to their pets.

Nutritional myodegeneration: due to dietary deficiency of vitamin E and selenium.

Occipitoatlantoaxial malformation (OAAM): is due to a congenital C1-occipital malformation particularly in Arabian


foals. In dogs is mostly common in toy breeds. Look for foals ataxic from birth or shortly thereafter and with clinical
signs such as paresis in all 4 limbs and frequently standing in weathervane stance, with head and neck extended. The
animal will be bright, alert, responsive, with normal cranial nerves, normal body condition and no evidence of muscle
atrophy.

Pasteurella multocida: causes Fowl cholera and Progressive atrophic rhinitis

Plague: Reportable and zoonotic disease caused by Yersinia pestis (safety pin shaped with bipolar staining).
Transmission by flea bites from infected rodents and rabbits. Among pets think septic cats with abscesses in western
US (Arizona, New Mexico, California, Colorado) and Hawaii.

Pure red blood cell aplasia (PRCA): low hematocrit with no reticulocyte and normal WBC count. Bone marrow aspirate
will show myeloid: erythroid ratio of 75:1

Q Fever: caused by gram-negative bacteria named Coxiella burnetti. It affects primarily parturient ruminants, although
cats and wild animals can also be infected. Zoonotic! It can be transmitted by tick bites, unpasteurized milk, birth fluid,
placenta, feces, and urine. It is extremely heat resistant.

Rabies: Zoonotic and reportable that can affect any mammal! It has 2 forms the furious and the paralytic. Bovines
usually have a more prominent paralytic form. Tests include: look for the Negri corpuscle, biological proof and direct
immunofluorescent. Animal bite animal cases: Exposed and unvaccinated animals should be euthanized or vaccinated
and keep on isolation quarantine for 4 months (dogs and cats) or 6 months (ferrets). Animals that have a document,
but overdue vaccination should receive an immediate booster and be keep under owner control for 45 days under
observation. Animal bite Human cases: confine 10-day observation and vaccinate at 11th.

Rocky Mountain Spotted Fever (Tick Fever) caused by Rickettsia rickettsiae that is transmitted by Dermacentor
variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick). It is common in the eastern
coast, the Midwest and plain states of the US and is seen most often in dogs and humans.
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Ruminal parakeratosis in cattle and sheep is characterized by hardening and enlargement of the rumen papillae due
to constant aggression, usually secondary to acidosis due to high concentrate and low roughage diet.

Slab fracture in the carpus is usually in the frontal plane of the radial facet of the third carpal bone. It is seen in the
side image.

Shock the most common type of shock in veterinary medicine is hypovolemic shock. Hypovolemic shock happens when
the total circulating blood volume decreases via loss of fluid such as hemorrhage, vomiting, diarrhea, extreme sweating
(horses) and more. Obstructive shock occurs when cardiac output is mechanically impaired, like in GDV, cardiac
tamponade and more. Cardiogenic shock is seen when the heart fails. Distributive shock develops when blood volume
is pooled in the peripheral circulation like in sepsis, anaphylaxis, heatstroke, and snakebite.

Spondylosis deformans is a degenerative disease characterized by osteophyte production in old vertebra in an attempt
to stabilize it.

Streptococcus equi zooepidemicus: cause endometritis/infertility/mastitis in horses and cervical lymphadenitis in


guinea pigs, mortality in poultry and disease in other animals.

Tetanus: Caused by Clostridium tetani when the spores get inside of a wound and find an anaerobic environment
(usually necrotic tissue) where the bacteria develop, multiplied and release 2 toxins tetanospasmin and tetanolysin.
The tetanospasmin blocks the release of the inhibitory neurotransmitters GABA and glycine, which produces a spastic
paralysis. The tetanolysin is a hemolysin that causes destruction of tissues. The incubation period varies from 10 days
to a couple of weeks depending on the wound. Clinical signs in horses include saw-horse stance, very rigid four limbs,
alert and quivering of nictitating membranes in response to loud unexpected sounds. Treatment includes penicillin
and antitoxin, muscle relaxants, supportive care in a dark, minimally stimulating environment. Prevention with
vaccination and proper wound care is critical.

Ventricular Tachycardia (VTach): is characterized by ventricular complexes


that occur in runs of >30 seconds and heart rate is high as > 170beats/min.
ECG looks like the image in the side. Lidocaine bolus and continuous infusion
is used to treat it. Vtachs are common post GDV surgery.

Vesicular Stomatitis: family Rhabdoviridae. Occurs in horses, pigs, and cows. Clinical signs include vesicles in the
mouth, tongue, teats, and coronary band of the hoof. Very similar to FMD, therefore it is a reportable disease!!
Transmitted by mosquitos, Lutzomyia spp (sand flies) and Simulidae (black flies). Diagnosis is by ELISA.

West Nile virus (WNV): a flavivirus transmitted by Culex spp. mosquitoes that affects horses and birds. Clinical signs
in birds include recumbency to leg and wing paralysis, reluctant or unable to move when disturbed, incoordination,
torticollis and opisthotonus. Clinical signs in horses include neurologic abnormalities, colic, lameness, anorexia, fever,
azotemia, and peripheral lymphopenia. Initial systemic signs include a mild fever, feed refusal, and depression.
Diagnosis by PCR and ELISA.

Wooden Tongue is caused by Actinobacillus ligniersi and is seen mostly in cattle, but can also affect sheep, horses,
pigs and dogs. Look for a hard, swollen tongue with tumorous abscesses, swelling and pyogranulomatous lesions in
soft tissue of head, neck, and limbs.

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Dog conditions
Benign prostatic hypertrophy can lead to constipation, ribbon stool, tenesmus, and urinary obstruction. Treatment
can be surgical (orchiectomy) or medical which include Finasteride or Medroxyprogesterone. Finasteride is expensive
but decreases prostate size by interfering with testosterone synthesis.

Borreli burgdorferi: causes Lyme disease. Use western blot or C6 peptide ELISA test to differentiate between
vaccinated dogs from naturally infected dogs.

Canine Distemper (Hardpad disease): caused by a paramyxovirus and spread via aerosol. Necropsy finding include
intracytoplasmic eosinophilic inclusion bodies, catarrhal enteritis and mucopurulent oculonasal discharge. Clinical
signs include hyperkeratosis of the footpads or nasal planum, catarrhal illness and neurological signs in an
unvaccinated dog.

Canine Parvovirus: Necropsy will show intestinal crypt necrosis, lymphoid depletion of payer’s patches, shortened,
blunt villi and collapse of the lamina propria.

Cognitive Dysfunction syndrome: can be treated with donepezil (Alzheimer’s drug)

Cranial Cruciate ligament tear: leads to instability of the stifle joint. It usually also damages the medial meniscus.
Diagnosis by positive drawer sign.

Crotalus Atrox vaccine provided protection against Western Diamondback rattlesnake envenomation, found in the
southwestern US and Northern Mexico. Should be only administered in dogs with risk of exposure.

Degenerative valve disease: Endorcardiosis is characterized by nodular thickening of the mitral valve margins and is
the most common cardiac disease of dogs (75%).

Demodicosis: is caused by demodex canis (side image), leading to alopecia, deep folliculitis, scaling, and secondary
infection. Demodex canis is part of the normal flora and the animal needs to be immunocompromised for it to become
a disease. In young animals it is usually local and self-limiting. Treatment include ivermectin, local baths with amitraz
or 1 fluralaner pill will solve it.

Dermoid Sinus: tubular skin lesion from a congenital neural tube defect on the dorsal midline of dogs.

Eclampsia (hypocalcemia or puerperal tetany) is an emergency medical condition associated with post-partum
hypocalcemia in dogs. Animal become stiff or tetanic. Treatment include IV calcium gluconate and animal should be
monitored for arrhythmias.

Ehrlichiosis: caused by Ehrlichia canis. Clinical signs include fever, generalized lymphadenopathy, splenomegaly, and
thrombocytopenia. May see stiffness, reluctance to walk, limb, scrotum edema, coughing or dyspnea.

Elbow dysplasia: there are 3 components for it: ununited anconeal process, fragmentation of the medial coronoid
process of the ulna and Osteochondrosis of the medial aspect of the humeral condyle.

Flea bite hypersensitivity or flea allergy dermatitis is seasonal type 1 & 3 immune hypersensitivity reaction caused by
flea bites. The affect skin can be alopecic, erythematous, edematous and with some excoriation (from itching) in the
tail base, caudo-dorsal area and both hind legs. The animal will have pruritus. Keep in mind that intense reaction can
be caused by small amount of fleas.

Heartworm disease: caused by Dirofilaria immitis, a nematode transmitted by mosquito and can affect dogs and cats.
See enlarged heart touching the sternum and pulmonary knob as the parasite likes to live in the pulmonary artery.
Diagnostic tests for felines use Heartworm antigen test as positive test is diagnostic (very specific). For other species,
you can use heartworm antibodies where a negative test is good to rule out ongoing infection (very sensitive). The
modified Knott’s, the capillary hematocrit tube test and the fresh blood-saline preparation test can be used to find
heartworm microfilariae. Canine heartworm is classified in 4 parameters: Class I is asymptomatic-tomild case with no
radiographic signs and no lab abnormalities. Class II is moderate, with occasional coughing and mild to moderate
exercise intolerance. On physical exam there may be slight loss of body condition and increased lung sound with mild-

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to-moderate radiographic changes and lab results may show anemia and proteinuria. Class III is severe and
characterized by weight loss, exercise intolerance, tachypnea at rest, severe or persistent coughing, dyspnea,
hemoptysis, fainting and ascites. There will be severely abnormal radiographs, enlarged main pulmonary artery and
diffuse pulmonary density. Lab work will indicate marked anemia, thrombocytopenia, and proteinuria. Class IV (also
called post-caval or caval syndrome) is an acute, shocklike presentation where there are worms in the vena cava.
Clinical signs include collapse, hemoglobinuria, respiratory distress and require surgery to physically remove worms.
Treatment for dogs include first stabilize the patients if it’s having Right side CHF with diuretics, cage rests and anti-
thrombotic agents (aspirin or heparin) or corticoids in cases of pulmonary failure. Then, macrocyclic lactone at day 1,
30 and 60, 28 days of doxycycline starting on day 1 and at day 60 begin a 3-dose melarsomine, 1 dose IM at day 60
then 2 doses IM 24 hours apart at least one month later. Use ivermectin, Milbemycin and others as preventive. For
cats there is no definitive treatment.

Hypertrophic osteodystrophy (HO) is more typically an older animal disease with periosteal proliferation (swollen
distal limbs) and secondary to thoracic or abdominal neoplasia.

Inflammatory bowel disease: Common sequela of moderate to severe IBD is cobalamin (B12) deficiency due to
intestinal malabsorption. Cobalamin absorption happens in the ileum and needs an intrinsic factor produced by the
pancreas. Therefore, exocrine pancreatic insufficiency can lead to B12 deficiency. Diagnosis is by measuring serum B12
levels. Treatment is parenteral administration of high doses of cyanocobalamin.

Infectious tracheobronchitis (Kennel cough) can caused by Bordetella bronchiseptica (more common), parainfluenza
virus, adenovirus 2 and distemper virus. It is highly contagious and spreads via aerosol, therefore pets should not be
in the hospital unless they have severe bronchopneumonia. Most uncomplicated cases recover within 7-14 days.

Legg-perthes disease: another name for aseptic necrosis of the femoral head. It is a disease of miniature and small
dogs.

Leptospirosis: Clinical signs are usually a combination of hepatic signs with renal signs and systemic infection signs.
Look for icterus, increased liver enzymes, bilirubinuria, isosthenuria in dehydrated patients, increased BUN and
Creatinine, neutrophilic leukocytosis, pyuria, and fever. Diagnosis is done by microscopic agglutination test (MAT). In
bovines it causes abortion in the last trimester, 2-6 weeks after maternal infection.

Metritis: is a common complication of retained placenta in a bitch.

Orbital cellulitis: Presents in large and hunting breed of dogs. Look for acute pain when opening mouth, eyelid
swelling, unilateral prolapse of nictitating membrane, eye protrusion and conjunctivitis. The dogs face looks swollen.

Osteochondrosis in dogs is usually in the shoulder or in the elbow. Usually in young, male, fast growing, large breed
dogs and is usually bilateral (51%). Differentials include panosteitis (think shifting leg lameness) and Hypertrophic
osteodystrophy (lameness and swollen long bones).

Portosystemic vascular anomalies (portosystemic shunt): can happen in any animal but is more common in dogs.
Clinical signs include vomiting, polyuria, polydipsia, weakness, head-pressing, disorientation, and stumbles right after
a meal and unthriftness. Hypersalivation is common in cats. Sometimes you can see hematuria, pollakiuria, stranguria
or urethral obstruction via ammonia biurate urolithiasis. Lab work shows microcytosis, target cells and mild non-
regenerative anemia and ammonium biurate urolithiasis. Treatment is surgical as medical management is often
ineffective.

Progressive retinal atrophy (PRA) leads to worsening of night blindness (nyctalopia). It is common in young dogs with
bilateral retinal abnormalities.

Pyometra: is a uterine infection that can happen in any species, but usually happens in dogs. It is a life-threatening
emergency which typically require immediate surgery (ovariohysterectomy). It can be open, and the owner usually
notice a purulent, malodorous or bloody discharged coming out of the vagina. Alternatively, it can be closed pyometra
and there is no evident vaginal discharge. It should be a top differential for an intact dog, with fever and distended
abdomen. Some animals may develop kidney problems due to inflammation and deposition of immune complex.

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Sarcoptes Mange: seen in the side image, usually affects dogs, but can be found in cats, swine and humans. The mite
has shot legs, but long unsegmented pedicles. Look for intense pruritus!

Small Intestine Bacterial overgrowth (SIBO): occurs primarily in dogs. The causes are unknown, but it causes decrease
cobalamin and increase folate. It is usually a complication of exocrine pancreatic insufficiency.

Tracheal collapse: think honking cough that is usually chronic, without fever and that can be stimulated by touching
the tracheal area. Heart murmurs (mitral valve insufficiency/dysplasia) are usually also concurrent.

Wobbler’s syndrome: also known as cervical spondylomyelopathy (CSM) is a disease of the cervical spine that is
commonly seen in large and giant-breed dogs. CSM is characterized by compression of the spinal cord and/or nerve
roots due to cervical bone or ligament malformation, which leads to neurological signs and/or neck pain. The term
wobbler syndrome is used to describe the characteristic wobbly gait (walk) that affected dogs have.

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Cat conditions
Alopecia: caused usually by flea allergy dermatitis.

Bite abscess is usually caused by Pasteurella multocida (facultative aerobic), but it can be caused by anaerobic bacteria
such Streptococcus spp. and Staphylococcus spp. Treatment include lancing, debridement and empiric antimicrobial
treatment with cefazolin or amoxicillin.

Cat scratch disease is causes by Bartonella genus, especially Bartonella henselae and Bartonella clarrideiae.

Chlamydophila felis infections cause conjunctivitis and rhinitis. Clinical signs include serous to purulent naso-ocular
discharge and marked chemosis. Inclusion bodies on the conjunctival scrape in the side image. Treat with tetracyclines,
both ocular and systemic.

Cryptococcus is a fungus that causes a granulomatous rhinitis and sinusitis in felines. It can also be seen in cows and
dogs. They appear as a thick capsule and narrow-necked budding on DiffQuik-stained cytology just like in the second
side image.

Feline acquired symmetric alopecia: the most common cause is flea allergy dermatitis and eosinophilia may be
present. It is usually pruritic.

Feline infectious anemia is caused by Mycoplasma haemofelis. It is basically an immune-mediated anemia as the body
destroys RBC when trying to destroy the M. haemofelis. Treatment includes tetracycline, usually doxycycline and
prednisolone (decrease erythrophagocytosis).

Feline Leukemia Virus (FeLV): from the family Retroviridae. Diagnosis is done by IFA and/or ELISA. A positive IFA means
the animal is FeLV positive. A positive ELISA alone means presence of antigen, not necessarily infection and therefore,
needs an IFA to confirm it. If ELISA is positive and IFA is negative the animal has an unknown status (regressive or
progressive infection) and should be retested in 30-60 days. Keep in mind that ELISA (highly sensitive) and IFA (high
specificity) measure antigen and are not affected by vaccination status. If you see a regenerative anemia
(polychromasia, reticulocytosis and anisocytosis) in a FeLV positive cat suspect coinfection with Mycoplasma
haemofelis.

Feline lower urinary tract disease (FLUTD): is usually caused by idiopathic cystitis. It is a life-threatening hyperkalemia
due to anuria! It tends to cause metabolic acidosis, hyponatremia, hyperglycemia, and post renal azotemia. ECG shows
tall T waves and bradycardia.

Feline Panleukopenia: from the family Parvoviridae and is known as Feline Distemper or Feline parvo. Clinical sings
include bone marrow suppression and gastrointestinal disease. It will cause cerebellar and retinal damage in newborn
kittens born to queens infected during pregnancy. Lab work shows generalized leukopenia. Think: Depression,
Dehydration and Diarrhea for panleukopenia.

Feline Syncytial virus: Retroviridae

Feline Infectious Peritonitis (FIP): from the family Coronaviridae. Lab work shows hyperglobulinemia and low
albumin/globulin ration on serum or effusion. The only way to diagnose FIP is histopathology, detection of FCoV
antigen in macrophages by immunofluorescence or immunohistochemical staining. However, you can do a Rivalta’s
test (91% sen and 65% spec) and if positive you have an animal that is likely positive for FIP.

Feline Immunodeficiency Virus (FIV): from the family Lentiviridae. A positive ELISA in an animal younger than 6 months
should be repeated in 8 to 12 months. If the animal still positive in the ELISA, it should be followed by a western blot
antibody test.

Idiopathic Hepatic lipidosis in felines is characterized by hyperbilirubinemia, high ALT, high AP, but normal GGT
(sometimes mildly increased). Poikilocytosis is also common. It can be secondary to inflammatory bowel disease,
diabetes mellitus and pancreatitis. Treatment includes nutritional support (tube feeding) with high calorie and high
protein diet, vitamins K1 supplementation (prevent coagulopathy) and blood chemistry every 2 weeks. Animal typically
recover in 3-6 weeks.
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Injection site sarcomas are primarily linked to rabies and FeLV vaccines.

Megacolon is most common seen in Manx cats with an underlying dysautomia, as the etiology for prolonged
constipation and reduced defecation. Think of palpable firm tubular density in the caudal abdomen and a history of
straining to defecate.

Notoedres cati is a feline scabies mite.

Nutritional deficiency: thiamine (B1) deficiency and taurine deficiency can cause cervical ventroflexion in cats
(hypokalemia too).

Otodectes cynotis is seen in the side image. Remember black brown coffee ground debris in the ear canal of a cat with
pruritic ears and headshaking. High contagious to other cats, has a low zoonotic risk and can infect dogs. Treatment
include cleaning the ear canals with cerumitic and apply acaricidal. Systemic treatment with ivermectin or selamectin
is usually not necessary.

Retinal detachment: caused by hypertension usually secondary to kidney disease. It can also be caused by FIP, FELv,
FIv, Toxoplasmosis and trauma.

Rhinotracheitis is caused by feline herpesvirus and typically causes serous ocular and nasal discharge with possible
ulcerative keratitis. Later secondary bacterial infections may lead to purulent exudate.

Sacrococcygeal dysgenesis: inherited trait in Manx cats. Look for dysgenesis, agenesis of sacrum and other spinal
column abnormalities. Animal may present urinary and fecal incontinence, chronic constipation, recurrent urinary
tract infections and megacolon.

Spumavirus: Retroviridae

Toxoplasmosis: caused by Toxoplasma gondii. In humans it causes birth defects and that is why pregnant women
should not clean a cat’s litter box, should was raw vegetables and only eat well cooked meats. Treatment includes
clindamycin, sulfadiazine or pyrimethamine combination.

Urethral obstruction looks for hyperkalemia, hyponatremic, hypochloremic, acidosis, hyperphosphatemia and
bradycardia.

Vaccinations: FeLV vaccinate Low, Lateral and Left hind bellow the stifle joint. Rabies vaccine Low, Lateral on the Right
side bellow the stifle joint. Hint: FeLV = Left hind and Rabies = Right hind.

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Bovine conditions
Abomasal displacement in dairy cattle: cause include abomasal hypomotility.

Abortion: Bovine viral diarrhea (BVD), Campylobacter fetus sp. venerealis and trichomoniasis (occasionally) can cause
early abortion in the first half of pregnancy. Trueperella and listeria cause abortion at any time of pregnancy.
Chlamydiosis and Ureaplasma diversum are both associated with late term abortion in cows. Brucellosis have a late
term abortion with thickened leathery placenta. Aspergillus cause fungal placentitis leading to a dehydrated fetus with
ringworm-like lesion in the head and shoulders primarily.

Bacillary Hemoglobinuria (Redwater disease): Clostridium novyi group D (Clostridium hemolyticum) is found naturally
in the GI tract of cattle and survives long periods of time in soil and bone carcasses. Latent spores set in the liver and
when the migration of liver flukes (Fasciola hepatica) happens it occurs a localized infectious necrotic hepatitis which
becomes a site of spore germination. Clinical signs include sudden death with necrotic foci in the liver.

Blackleg caused by Clostridium chauvoei (feseri). Look for per acute febrile disease, acute lameness and great muscle
areas that are edematous and crepitant (popping and crackling sound/feel). No wound is visible, but bruising may
precipitate the disease. Death occurs within 12-48 hours. Beef animals are mostly affected.

Bottle jaw is edema that occurs due to hypoproteinemia under the lower jaw. Can be caused by Haemonchus spp and
Trichostrongylus spp, and rarely by Ostertagia spp.

Bovine Genital Campylobacteriosis: primarily cause a venereal disease that leads to infertility and early embryonic
death. Occasionally it can cause late abortions between 4 to 8 months of gestation (???). Older bulls that are positive
should be culled. Vaccination should be instated in the herd.

Bovine Leukosis Virus (BLV): most animals do not have clinical signs. 1/3 of infected cattle develop a persistent benign
lymphocytosis and <5 % develop lymphosarcoma (enzootic bovine leukosis). More common is dairy animals, is not
zoonotic and there is no treatment. Enzootic bovine leucosis usually makes a heart mass lesion in the right atrium
which leads to carcass condemnation.

Bovine respiratory disease (BRD) complex: usually caused by Pasteurella multocida, Histophilus somni and
Mannheimia haemolytica (normal inhabitant of the tonsillar crypts).

Bovine Spongiform Encephalopathy (BSE) is a reportable prion disease discovered in 1985-6 in the UK. It was caused
by feeding cattle concentrates of meat and bone meal of sheep origin. It causes a CNS lesion that looks like
vacuolization. Every animal positive should be euthanized and incinerated.

Bovine viral diarrhea: family Flaviviridae that can cause immunosuppression, respiratory, gastrointestinal, abortion,
in utero infection and birth defects in cattle. Clinical signs include early embryonic death, fetal death, abortion, calves
with congenital defects (cerebellar hypoplasia, hydranencephaly, microphthalmia and arthrogryposis) and if the dam
is infected between 20 to 125 days of pregnancy, she will birth a persistent infected (PI) calf. PI calves are
seronegative!! Mucosal disease happens during a flare of BVD, and the animal have ulcerating mucosa from mouth to
anus and usually dies. Diagnosis by ELISA or Serology. For BVD think oral erosions, diarrhea and early abortion and
differentials should include Rinderpest and Malignant Catarrhal Fever.

Calf diphtheria (Necrotic laryngitis): caused by Fusobacterium necrophorum and is generally seen in calves between
6-18 months old in unsanitary conditions or feedlots. Mixed upper respiratory infections such as IBR, parainfluenza-3,
Mycoplasma, Pasteurella, Haemophilus may predispose the animal. Necropsy findings include mucopurulent nasal
discharge and necrotic ulcers on the larynx.

Enteritis: usually caused by Salmonella spp.

Enterotoxaemia in calves is caused by Clostridium perfringens type B or C. Think of sudden death in a 2-week-old calf,
especially the fastest growing, healthiest one in the group.

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Epizootic bovine abortion (foothill abortion) is caused by a Myxobacterium named Pajaroellobacter abortibovis, a
gram-positive rod, transmitted by argasid tick (Ornithodoros coriaceus). Clinical signs include late term abortion (first
6 months of pregnancy) and is very common in California and Eastern Sierra Nevada.

Fusobacterium necrophorum: causes foot rot in cattle, necrotic stomatitis of calves and calf diphtheria.

Frothy bloat: is caused by a stable foam produced by fermentation of legumes and lush cereal grasses. Animals may
present open mouth breathing and abdominal distention. Treatment includes anti-foaming agents such as vegetable
oil, mineral oil, or surfactants such as dioctyl sodium sulfosuccinate, poloxalene or even dish detergent can be given
to break up the foam. Ionophore can be added to the diet of sheep, cattle, and beef cattle to reduce the incidence of
frothy bloat.

Grain Overload: rumen fluid pH of 4.5 due changes in bacterial population in favor of gram-positive bacteria that
produce lactic acid. As the acid level increases, the normal flora dies, and the rumen mucosa is damaged. Fluid shifts
occurs and systemic acidosis develop (high plasma lactate). Without treatment dehydration, shock and cardiovascular
collapse will happen followed by death. Keep in mind that normal pH of rumen fluid is around 6 depending on the diet
can be a 5.5 (high grain) to 6.5 (high forage). To prevent it farmers should introduce dietary changes slowly.

Grass Tetany: is caused by hypomagnesemia from eating pasture grasses and cereal crops low in magnesium. Problem
is primarily seen in lactating animals. It is usually associated with hypocalcemia. Infectious Keratoconjuctivitis (pink
eye): In cattle is caused by Moraxella bovis, but other less common causes include Mycoplasma spp. and Neisseria spp.

Infectious Bovine Rhinotracheitis (IBR or Red nose): non reportable disease caused by a Bovine herpesvirus 1 (BoHV1),
therefore it created latency. Not zoonotic. Clinical signs include rhinotracheitis, hyperemia of nares and surrounding
muzzle (red nose), early embryonic death, temporary infertility, low conception rates, balanoposthitis and
vulvovaginitis. Viral infection with IBR alone may not be life-threatening but predispose to secondary bacterial
pneumonia which may kill the cow. Diagnosis during clinical signs include PCR and serology. During latent phase ELISA
and Western blot. Interdigital hyperplasia (fibroma) is a thickening of the skin between the digitals of cattle feet.

Johne’s disease: caused by mycobacterium avium ss. Paratuberculosis and is reportable. It leads to debilitation,
emaciation and watery diarrhea that looks like pea soup. Primary means of transmission is fecal-oral, but
transplacental and milk can also happen. There is no treatment.

Listeriosis: affects humans, cattle, and small ruminants (animals that eat silage). Clinical signs include CNS disease
(circling), septicemia (microabscesses) and abortions (any time). Clinical signs also include swelling of cheek due to
accumulation of food in the buccal space, drooling, unilateral cranial nerve signs such as ptosis (lowered eyelid),
drooping ears, collapsed nostril, flaccid lip on the affected side, fever, depression, circling and leaning. Antemortem,
CSF has an increased protein and a mild pleocytosis of large monocular cells. Serology isn’t used because healthy
animal may have high titers. At necropsy look for microabscesses in the brain and gram-positive pleomorphic
coccobacilli on impression smears. Listeriosis is usually caused by not-properly fermented silage. Treatment includes
high dose tetracycline or penicillin, +/- IV fluids and take animals off silage.

Lumpy jaw is caused by Actinomyces bovis which is bacteria in the normal mouth flora. It enters the soft tissue after
damage from a traumatic feed then causes damage/granulomatous abscess in the mandible, maxilla or other bony
structures. (Hint: lumpY = mYces)

Mastitis: Contagious mastitis-causing bacteria include Staphylococcus aureus, Streptococcus agalactiae,


Streptococcus dysgalactiae, Corynebacterium bovis and Mycoplasma bovis. They are spread when cows are milked
and are long lived within the udder. Control of contagious mastitis is done by teat dipping, milking hygiene, dry cow
antibiotic therapy and initiation of proper milking machine function. Environmental mastitis-causing bacteria include
gram-negative coliforms (E. coli, Klebsiella spp. and Pseudomonas) and Streptococcus uberis. They are transmitted
when cows are not milking, like when they lay in their beds. Infections are usually short-lived within the udder.
Staphylococcus aureus, Streptococcus uberis and Streptococcus dysgalactiae overlap both categories and may be
environmental or contagious. Severe clinical mastitis in cattle is usually caused by coliforms like E. coli and Klebsiella.
Coliform mastitis can result in cow’s death or agalactia-related culling. Flabby bag mastitis or Milk Drop Syndrome is
caused by Leptospira and leads to fast drop in milk production and the udder becomes soft and flabby. Mycoplasma
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sp., especially M. bovis mastitis is rarer, but spreads rapidly in the herd. It leads to drastic decrease in production, fine
granular or flaky sediment in the milk and serous or purulent exudate.

Malignant catarrhal fever: reportable and fatal lymphoproliferative disease caused by a virus from the Herpesviridae
family. Clinical signs include fever, depression, ocular and nasal discharge, lesions in the mouth and muzzle, opacity of
the corneas, inappetence and diarrhea. Some animals may develop neurological signs. Diagnosis by ELISA or PCR. No
vaccines available.

Milk fever (Parturient paresis): expect tachycardia and weak pulse in cows with milk fever. As you administer calcium
gluconate IV (treatment) expect the heart to slow down and pulse to increase in strength and do not forget to monitor
for bradycardia and arrhythmias (and cardiac arrest) as IV calcium can be cardiotoxic.

Mycobacterium bovis or Mycobacterium tuberculosis: causes tuberculosis (TB), which is reportable disease. Animal
will appear emaciated, debilitation and caseous necrosis in the lungs and regional lymph nodes. Zoonotic that can be
transmitted through milk.

Pediculosis (lice infestation) caused by Linognathus vituli (in the pictures) which is
a blood sucking louse and Damalinia bovis is a chewing lice. Stressor such as health
problems, high stocking density, poor feed quality and gestational status
contribute to susceptibility and degree of infestation. It can cause severe lesions
in the hide and alopecia. L. vituli can act as a mechanical vector for Anaplasma
marginale. Treatment includes pour-on (for biting and blood sucking lice) or
injectable (for blood sucking lice) formulations of Pyrethroids, macrocyclic
lactones and organophosphates.

Polioencephalomacia (PEM) is a nutritional disease due to high sulfur and low thiamine (B1) diets that can occur in all
ruminants. Thiamine is necessary for production of glucose in the brain. Think dorsomedial strabismus (stargazing)
that is pathognomonic. Other clinical signs include recumbency, blindness, tonic-clonic seizures, coma, and death.
Necropsy will show cerebrocortical necrosis under UV light.

Pulmonary abscesses: frequently isolate is Trueperella pyogenes.

Pyelonephritis in ruminants is usually caused by Trueperella spp. and Escherichia coli. These bacteria are everywhere
in the environment and common inhabitants of the vagina and prepuce. Pyelonephritis is usually triggered by stress
situation that allows ascending infection, such as, parturition. The first clinical signs may be passage of blood-stained
urine (hematuria) in an otherwise normal animals. Then the animal will show frequent attempts to urinate, anorexia,
slight fever, loss of production, colic, restlessness, tail switching, polyuria, more hematuria, and pyuria. In chronic cases
the animal may show colic, diarrhea, polyuria, polydipsia, stranguria and anemia.

Right displaced abomasum (RDA) is very difficult to clinically differentiate from abomasal volvulus on physical
examination. Both have tympanic resonance (pings) on the right side of the cow, are confined to an area under the
last 5 ribs in the upper half of the abdomen. Cows with abomasal volvulus are usually more dehydrated and more
systemically ill. Surgical treatment is required for both conditions.

Rinderpest: mainly affects cattle. Eradicated globally, but they want vets to know. Clinical signs include fever, diarrhea,
and oral erosions (stomatitis) with a nearly 100% mortality rate. Necropsy findings include necrotic Peyer’s patches.

Ruminal Acidosis: associated with overgrowth of Streptococcus bovis.

Spastic paresis (Elso heel): look for an animal with stiff hind leg or legs in full extension, whether walking or standing.
It is heritable animals affected should not be used in reproduction.

Stephanofilariasis is characterized by a plaque-like dermatitis along the ventral midline of cattle. Transmitted by horn
flies. Diagnosis by deep skin scraping.

Syndactyly (mule foot) is when the claws are fused and only one claw is weight-bearing. One or all feet may be
affected.

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Thrombotic meningoencephalitis (TEME): caused Histophilus somni. Think recent feedlot entry, high fever,
respiratory, CNS and septic joint signs. Treatment include high dose Tilmicosin or Oxytetracycline and Thiamine.

Traumatic Reticuloperitonitis (hardware disease): is prevented with a magnet in the reticulum. You can check the
magnet placement with a compass near or below the brisket of a cow. Look for off feed animals with abducted elbows,
arched back, reluctant to move, with bottle jaw and bilateral jugular distension. A washing machine murmur and pain
points to hardware disease!

Umbilical hernias are common finding in neonatal foals and calves (Holstein breed is more affected). Usually you can
reduce the content of an umbilical hernia. However, when associated with umbilical abscessation or infection
reduction may be difficult or impossible. An infected umbilicus will cause heat in the area, drainage, fever, inappetence
and ill thrift. Treatment involves surgical repair of the hernia and antibiotics (if infected).

Vagal indigestion has many causes, but it is effectively an outflow failure at the reticulo-omasal orifice or pyloric
sphincter of the abomasum, leading to delayed passage of ingesta. Look for papple shape (pear+apple) and scant stool.
Some causes of vagal indigestion include traumatic Reticuloperitonitis, abomasal impaction and late pregnancy.

Winter dysentery: etiology not clear, but a bovine coronavirus is implicated.


Diarrhea
E. Coli Less than 4 days old, multiple cases
Rotavirus 5 days to 2 weeks, self-limiting and multiple cases
Early diarrheas Coronavirus 4 to 30 days, multiple calves
Enterotoxaemia (C. 2 weeks, healthiest, fast growing, hemorrhagic diarrhea with
perfringens type c) sudden death
Cryptosporidium 1-4 weeks, diarrhea, tenesmus, and emaciation.
1-2 months, with fever, diarrhea, septicemia, suddendeath
Salmonella
Later diarrheas
Older than 21 days and all ages, bloody diarrhea,tenesmus
Coccidiosis

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Conditions of small ruminants
Bluetongue: Family Reoviridae and is an arbovirus transmitted only by Culicoides mosquitoes named C. varipennis
(biting midge). Clinical signs include inflammation of the capillaries leading to edema in the face, neck and brisket,
hemorrhage, thrombosis, and infarctions. The lesions at the oronasal cavity look like vesicular disease and foot mouth
disease. In-utero infection can cause hydranencephaly and arthrogryposis (crooked) in lambs. Diagnosis is done by
ELISA or PCR.

Brucella melitensis: vaccine Rev-1 or Strain H38 (killed vaccine). Causes Malta fever in humans that had contact with
infected placental and fetal tissues, ingested unpasteurized milk and cheese, or ate undercooked meat.

Botulism (Lamziekte) in sheep and cattle! In the US it is usually caused by silage contaminated with rodent or bird
carcass and poultry litter.

Caprine arthritis encephalitis (CAE): It is related to lentiviruses, family retroviridae, and is a RNA virus. No vaccine or
cure. Vertical and horizontal transmission by milk (primarily) and copulation. In adults it causes the deposition of
immunocomplex in the joints (carpus and tarsus) leading to a swollen and painful joint causing lameness, hard
udder/agalactia at parturition and subsequent decrease in milk production. Kids may have neurological presentation
such as ataxia, hindlimb deficits, paraparesis, +/- head tilt, opisthotonus and circling. Diagnosis by ELISA and PCR.

Caseous lymphadenitis (CLE): caused by Corynebacterium pseudotuberculosis (gram-positive and intracellular


bacteria) that creates an onion looking abscess. High environmental contamination if the abscess ruptured. Abscesses
should be drained, and the material burned and properly disposed. In goats the abscesses are usually in the
submandibular, parotid and prescapular lymph nodes as they contaminate themselves while eating abscess content
in the feed bunks. However, the abscesses can appear in other places like the mesenteric lymph node, which is very
hard to diagnose, the animal will lose weight progressively and then die. In sheep the abscess tends to be in the body.
As the sheep are sheared the blades can cut abscesses open or get contaminated with abscess content. Differential
diagnosis for Wattle Cysts, which are a benign lymphatic drainage abnormality occur at the base of the wattle and is
filled with lymphatic fluid.

Contagious ecthyma: also known as Orf or Sore mouth is caused by a parapoxvirus. Zoonotic and common!!! It leads
to crusty lips and ears in goats and sheep as seen in the side image. You can see papules, pustules and thick friable
scabs on the lips, mouth, nose, ears, feet and on the udders of lactating does and ewes.

Infectious Footrot is caused by Dichelobacter nodosus in sheep. Previous infection with Fusobacterium necrophorum
may predispose the animal to development of D. nodosus.

Infectious keratoconjunctivitis (Pink eye): Chlamydophila pecorum is the most common cause of pink eye in sheep.

Maedi-Visna: economically important viral disease of sheep that occasionally infect goats. Is a lentivirus that infects
its host for life. Clinical signs include encephalitis and chronic pneumonitis in sheep. Ovine progressive pneumonia
(OPP): related to lentiviruses

Ovine encephalomyelitis (Louping ill) is caused by a tick-transmitted ovine encephalomyelitis virus (Flavivirus).
Affected sheep may bound or leap in a characteristic louping manner.

Peste des Petits Ruminants (PPR) is a reportable viral disease that causes fever, emaciation, dyspnea, diarrhea,
conjunctivitis, and stomatitis on the corner of the mouth. Is related to Rinderpest, Canine distemper and Measles.

Polled intersex syndrome is a congenital condition associated with hornless goat breeds.

Pregnancy toxemia: common in ewes with multiple lambs. Treatment depends on the severity of symptoms. If early
diagnosed, supportive care, dietary changes, oral propylene glycol and IV glucose may resolve the issue. Once
recumbent with signs of severe ketosis emergency cesarean section is crucial to save the dam. Lambs born more than
7 days premature rarely survive.

Psoroptic mange: reportable disease caused by Psoroptes ovis (seen in the side image) also known as sheep scab.
Clinical sings include scaly, crusty very itchy lesions in wooly parts with no neurological signs.
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Scrapie: Reportable disease caused by prions. Antemortem test is rectal mucosa biopsy test. Postmortem test is
immunohistochemistry of obex tissue.

Sheep Keds (Melophagus ovinus) are dipterans (flies) that have no wings. It is an important external parasite of sheep
and goats as they spend their entire life cycle in the animal. Clinical signs include pruritus and sometimes anemia. Seen
in the side image.

Ulcerative posthitis and vulvitis (pizzle rot) is an irritation of penis, prepuce, and surrounding skin due to infection
with Corynebacterium renale. C. renale hydrolyzes urea which leads to high ammonia concentrations and thought to
irritate the surrounding genital tissue. Common in male castrated sheep (wethers), goats and occasionally in cattle.

Urolithiasis in small ruminants: sodium chloride (increase water intake) and ammonium chloride (decrease urine pH)
and increase dietary calcium (inhibit struvite crystals).

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Pig conditions
Atrophic Rhinitis is caused by Bordetella bronchiseptica, Pasteurella multocida (types A and D). High ammonia and
dust environments. Is divided into 2 forms: Nonprogressive and Progressive form. Nonprogressive is causes by B.
bronchiseptica is a mild, transient rhinitis with little effect on growth. Progressive form is cause by B. bronchiseptica
and Pasteurella multocida and cause severe, permanent damage and poor growth.

Classical Swine fever (Hog Cholera): viral disease from the flaviridae family and is reportable. Related to BVDV and
Border disease. Vertical and horizontal transmission through placenta, blood, semen, and bodily secretions. Clinical
signs include high fever, abortion, cyanotic ears, red marks in the skin (as seen in the side image), hemorrhage,
thrombocytopenia, pinpoint lesions in the kidneys (turkey egg kidneys), convulsion, congenital malformation
(microcephaly and pulmonary hypoplasia) and weak pigs that die after a few months. Diagnosis by PCR and ELISA from
urine and blood (live animals) and kidney, lymphatic tissue, and tonsil (dead animals). Positive animals should be
culled, incinerated, and buried. Cannot be differentiated from African swine fever (reportable) based on clinical signs
and postmortem symptoms alone.

Clostridium difficile is the second most common cause of diarrhea in neonatal swine. It causes a mesocolonic edema
that is very characteristic.

Edema disease is caused by E. Coli (STEC). Clinical signs include marked swelling of the periocular region, forehead and
submandibular area follow infection along with possible CNS involvement with ataxia, paralysis and recumbency.
Piglets may die per acutely. Definitive diagnosis is by isolation and strain determination (producing F18 pili and Shiga
toxin 2e).

Enzootic pneumonia: caused by Mycoplasma hyopneumoniae. It is common to have a secondary infection with
Pasteurella multocida. Treatment for mycoplasma includes Lincomycin.

Exudative dermatitis (greasy pig disease) is caused by Staphylococcus hyicus, and it affects pigs of different ages. On
necropsy, you see marked dehydration, lung congestion, peripheral lymph nodes inflammation and distension of
kidneys, ureters with mucus, cellular casts, and debris.

Glasser’s disease is caused by Haemophilus parasuis. Clinical signs include high fever, respiratory signs such as cough,
abdominal breathing, fibrinous polyserositis, arthritis, swollen joints, lameness, and CNS signs (meningitis, trembling
and paddling) in young pigs typically 6 to 8 weeks old.

Hemorrhagic bowel syndrome is caused by intestinal volvulus leading to sudden death without clinical signs in rapidly
growing 4–6-month-old pigs.

Hypothermia is common in piglets because they have no fur and low subcutaneous body fat.

Metastrongylus spp lungworm whose infection in pigs require an earthworm intermediate host. Usually seen in pigs
with pasture access. Clinical signs include chronic cough, dyspnea and unthriftness.

Necrotic enteritis of piglets is caused by Clostridium perfringens type C. It leads to hemorrhagic intestines with severe
hemorrhagic necrotizing diarrhea in piglets up to 3 weeks of age. High mortality rate!

Necrotic Rhinitis in swine is caused by Fusobacterium necrophorum.

Nephrotic syndrome: hypoalbuminemia, proteinuria, hypercholesterolemia, and edema. It is a common complication


of glomerular disease.

Parakeratosis (zinc deficiency) can resemble exudative dermatitis but tend to see in pigs older than 6 weeks.

Pityriasis rosea: differential diagnosis for exudative dermatitis. It only affects pigs with less than 10 months of age and
resolves spontaneously.

Pseudorabies (Aujeszky Disease or Mad Itch): basically a pig herpesvirus, as it is lethal to other species. Clinical
presentation varies with the pig’s age and can be neurologic, respiratory, and gastrointestinal. Clinical signs include

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anorexia, hyperthermia, neurological signs such as convulsions and tremors and nystagmus, nasal discharge, abortion,
still born, mummies, congenital defects and weak piglets. Diagnosis is done by viral isolation, ELISA, and PCR.

Porcine Circo Virus 2 (PCV2): It is a multifactorial disease that is associated with Mycoplasma hyopneumoniae, swine
influenza, swine parvovirus and others. Horizontal transmission through semen, saliva, feces, urine, and bodily
secretions. PCV2 is associated with Porcine Dermatitis and Nephropathy Syndrome (PDNS), Pneumonias, enteritis,
reproductive failure, and subclinical infections. The Porcine Dermatitis and Nephropathy Syndrome (PDNS) leads to
hemorrhagic and necrotizing cutaneous lesions and at necropsy the kidneys appear with petechiae. Associated
Pneumonias leading to respiratory insufficiency and dyspnea usually associated with M. hyopneumoniae, P. multocida,
S. suis and B. bronchiseptica. Associated enteritis leads to diarrhea, granulomatous enteritis, and depletion of payer’s
patch. Reproductive failures include abortion, mummies, and irregular estrus return. Vaccination is usually at 21 days
of age.

Porcine proliferative enteritis/adenomatosis is hemorrhagic diarrheal disease caused by Lawsonia intracellularis


common in growing-finishing pigs or younger breeding pigs.

Salmonellosis: fever and hemorrhagic diarrheas of growing pig and can cause death by septicemia. Infection of
Salmonella typhimurium is associated with rectal strictures in growing pigs caused by an ulcerative proctitis that
damages the rectal tissue.

Streptococcus suis: causes septicemia and meningitis in weaners and growing pigs.

Swine dysentery (bloody scours): is caused by Brachyspira hyodysenteriae, a treponemal spirochete parasite. Clinical
signs include mucoid-hemorrhagic diarrheas of the large intestines in pigs between 6-20 weeks old (growing pig).

Swine Influenza: Zoonosis! Can do reassortment of hemeagglutinin and neuraminidase which creates different strains.
Pigs have the sialic acid receptors α2,3 and α2,6 which makes them susceptible for the human and poultry viruses. It
spreads through aerosol, and it has high morbidity and low mortality. Clinical signs include anorexia, prostration,
tachypnea, cough, and weight loss. Diagnosis by PCR real time and ELISA from deep nasal and oral fluids. Necropsy will
show lung consolidation like a chess board.

Swine Parvovirus: Horizontal and vertical transmission through semen, placenta, during parturition and bodily fluids.
Clinical signs include small litter size, mummies, increase estrus return, stillborn and some normal piglets. Vaccination
for gilts at 150-160 days and then 170-180. Sows should be vaccinated 15 days before breeding. Boars should be
vaccinated annually. Diagnosis PCR, ELISA and Hemagglutination.

Transmissible gastroenteritis (TGE): is a diarrheal disease of pigs caused by a coronavirus that spreads fast in the herd.
Vomiting is an early signs of epidemic from TGE in non-immune herds. It is characterized by high mortality in neonatal
piglets with less than a 1 week and clinical signs include dehydration and profuse watery diarrhea. Sows will have
vomiting, diarrhea and agalactia.

Porcine Reproduction and Respiratory Syndrome virus (PRRS): Is caused by an arterivirus. Clinical signs in neonates
includes anorexia, lethargy, fever, respiratory distress, and secondary bacterial pneumonia. In sows with PRRS have
delayed or abnormal estrous cycles with increased numbers of stillborn/mummies and/or abortions. Diagnosis is done
by serology, virus isolation and PCR (most commonly used in the US). Necropsy finding include severe necrotizing
interstitial pneumonia. Treatment includes supportive care and treat secondary bacterial infections. To control we can
state a closed herd, do depopulation of infected animals, and instate a PRRS vaccine protocol for pre-breeding and in
neonates.

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Equine conditions
Acute colitis and diarrhea cause leukopenia (neutropenia) and hypoalbuminemia due to protein losing enteropathy.

Acute renal failure in horses is usually caused by toxic medication, such as aminoglycosides and NSAIDS. Dehydration
and endotoxemia can both exacerbate the renal damage caused by the medications.

African Horse Sickness: mainly spread by Culicoides mosquitoes. Clinical signs include respiratory and cardiac such as
swelling of the supraorbital fossa, hydropericardium, endocardial and epicardia petechiae and ecchymoses, flaccid or
edematous lungs and yellow gelatinous infiltration of the subcutaneous and intramuscular tissue. Disease is endemic
of Africa.

Arytenoid chondritis: can cause protrusion of granulation tissue through the axial surface of one of the arytenoid
cartilages, resulting in a contact lesion on the contralateral arytenoid cartilage.

Bacterial folliculitis is usually caused by Staphylococcus aureus, S. intermedius and Corynebacterium spp. Clinical signs
include alopecia, crust lesions and epidermal collarettes. Diagnosis is done by culture, cytology, and histopathology.
Treatment is by cleaning and topical therapy with antimicrobials. If severe, systemic antimicrobials are indicated.

Bone spavin: number one hock problem usually affecting the distal intertarsal and tarsometatarsal articulations. It is
a chronic synovitis that is characterized by a stabbing gait in the limb and suddenly abducts it just before the hoof hits
the ground.

Bowed tendon is another name for tendinitis.

Chestnut: is a variably sized horny mass located on the medial surface of the forelimb proximal to the carpus. An Ergot
Is a variable sized mass of horny material found in the long hair of the palmar/plant fetlock and is lower than a
chestnut.

Contagious equine metritis is caused by infection of Taylorella equigenitalis. Not common in the US, but common in
Europe and Japan. Clinical signs include a copious, mucopurulent vaginal discharge 10-14 days after mating. Mares
and stallions may remain chronically infected.

Contractural deformity: is when the tendons are shooter than they are supposed to. A contractural deformity of the
distal interphalangeal joint can lead to a club foot or boxy foot.

Dorsal displacement of the soft palate (DDSP): When the soft palate covers part of the epiglottis. Look for the classic
gurgling expiratory noise and exercise intolerance. DDSP can be caused by upper respiratory inflammation, congenital
epiglottic hypoplasia or be idiopathic. Treatment can be surgical which include epiglottic augmentation or tie-forward
procedure or conservative with rest, anti-inflammatories topically and systemic.

Dourine is a chronic venereal disease caused by Trypanosoma equiperdum. Not found in North America, is reportable
and has a 50-75% mortality rate. Enzootic calcinosis: causes by ingestion of plants, such as Cestrum diurnum (day
blooming jessamine) containing calcitriol-like glycosides resulting in excessive absorption of calcium and soft tissue
calcification.

Epiploic foramen incarceration/entrapment occurs when a loop of small intestine is incarcerated in the epiploic
foramen, which is an opening into the omental bursa.

Equine arboviral encephalitides: antemortem test of choice is the IgM capture ELISA. The most common Togaviridae
family virus in the US is: Eastern equine encephalitis (EEE), Western equine encephalitis (WEE), Venezuelan equine
encephalitis (VEE). The most common flaviridae family virus is the West Nile Virus (WNV).

Equine Chronic uveitis: most common cause of blindness in horses and can lead to glaucoma and cataracts. Can be
treated by suprachoroidal cyclosporine implant (last 3 years), core vitrectomy where the vitrous is removed and
replaced with saline or daily topical medication.

Equine Coital Exanthema caused by equid herpesvirus-3 and results in the development of papules, ulcers and
depigmented scars on vulva, perineum, penis, and prepuce.
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Equine degenerative myelopathy/encephalomyelopathy is a diffuse degeneration of axons, myelin and neurons in
the spinal cord and brainstem thought to be caused in part by vitamin E deficiency. It is a common cause of symmetrical
ataxia of all 4 libs in your horses (6-8 months old). The animal will be bright, alert, responsive, no muscle atrophy and
with normal cranial nerves and body condition. The disease is incurable, but treatment with vitamin E can slow
progression.

Equine granulocytic ehrlichiosis (EGE): caused by Anaplasma phagocytophilum.

Equine Rhinopneumonitis: caused by equine Herpesvirus 1 and creates latency. Clinical signs in adults include abortion
and sometimes neurological signs such as tongue protrusion and head turn. In young foals clinical sings include
conjunctivitis, snots, anorexia, and submandibular edema.

Equine infectious anemia (EIA): family retroviridae. Infect equines and donkeys. It causes fever, hemolytic anemia,
depression, edema, weight loss and icterus. Can be transmitted directly or indirectly by semen, secretion, needle and
transplacentally.

Equine Influenza: caused by a RNA virus from the family Orthomyxoviridae. Clinical signs include coughing, weakness
and tachypnea.

Equine Protozoal Myeloencephalitis (EPM) caused by Sarcoystis neurona and, rarely, Neospora hughesi. Principal rule
out for a multifocal, asymmetric, neurological disease in horses 1-6 years of age. It can mimic any neurological disease,
but is typically characterized by multifocal asymmetric gait abnormalities, muscle atrophy and down horses.

Equine viral arteritis (EVA): another name is epizootic cellulitis and equine typhoid. It is a reportable disease in some
states and requires quarantine. It is caused by a virus that leads to limb edema, abortions, conjunctivitis, and
respiratory disease. Stallions can transmit it during breeding. Vaccine can be used during outbreaks expect in pregnant
mares and foals.

Exuberant granulation tissue (Proud Flesh) is most likely to develop on equine would over high motion areas and/or
distal to the carpus or hock. It is characterized by the excessive development of granulation tissue over the wound
instead of the epithelialization and contraction process that occurs during normal healing.

Fistulous withers: Actinomyces bovis and Brucella abortus are the common organisms responsible for fistulous
withers. Also blunt trauma can lead to infection and inflammation resulting in fistulous withers. The hair-like parasite
Onchocerca cervicalis has also been implicated in the early stages of the disease.

Gastric colic: Horse stomach can hold 8-10L normally and 20-25L at max.

Glanders (Farcy): caused by Burkholderia mallei. Ulcerating mucopurulent nodules in the upper respiratory tract,
lungs, and skin! Reportable and zoonotic! Don’t treat, confirm diagnosis with ELISA or Mallein test, cull, and report if
positive.

Glaucoma: Primary glaucoma is unusual in horses, but it can be secondary to chronic equine recurrent uveitis. Horses
with glaucoma have mydriatic pupils and horses with uveitis have miotic pupils!

Gonitis: inflammation of the stifle leading to degenerative joint disease.

Granulosa Cell Tumors in mares secrete inhibin which leads to increase serum testosterone. That causes aggressive,
stallion-like behavior and prolongs estrous cycles or alternatively anestrus.

Guttural pouch: can be affected by empyema, mycosis and tympany which can lead to damage to the CN 9
(glossopharyngeal), CN 10 (vagus) and internal carotid artery. Aspergillus is the fungus most commonly associated with
guttural pouch mycosis, forming a plaque at the caudodorsal aspect of the medial compartment, and causing damage
to the internal carotid artery and cranial and sympathetic nerves. It can result in epistaxis, dysphagia, and Horner’s
syndrome.

Hunter’s bumps: are prominences of the tuber Sacrale that can result from luxation or subluxation of the sacroiliac
joint.

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Hyperkalemic periodic paralysis (HyPP): autosomal dominant trait resulting in a defect in a voltage dependent skeletal
muscle sodium channel. More common in quarter horses and clinical signs include fasciculation, sweating, prolapse of
the third eyelid and weakness of variable severity. Lab work shows hyperkalemia (slows the heart). Treatment during
crisis required 5% Na Bicarbonate IV (drives K back into the cell by pulling H out) and 23% Ca borogluconate IV.
Dextrose IV may support movement of K into cells and diuresis. Treating with diuretics such as acetazolamide and
hydrochlorothiazide can reduce episodes in affecting horses. Stress situation, sudden changes in diet, fasting and high
potassium diets may trigger episodes.

Inflammatory airway disease (IAD): clinical signs include mucoid to mucopurulent nasal discharge and chronic cough.
Differential diagnosis for recurrent airway obstructions (Heaves).

Intermittent delayed patellar release: If uncomplicated, you should recommend a controlled conditioning exercise
program which will strengthen the biceps femoris and decrease the amount of episodes. If the animal has a
complicated case, do a medial patellar ligament desmotomy or medial patellar ligament splitting procedure.

Intestinal impaction: the pelvic flexure of the large colon is a common site for it in a horse.

Lameness: 90% of all lameness is in the foot!

Laminitis (founder): Chronic laminitis can be treated with a heart bar shoe which supports the distal phalanx by
pressing up the frog. Heart bar shoe helps the treatment as supports distal phalanx with upward pressure on frog.
Over conditioned horses with abnormal subcutaneous fat deposits that are allowed unrestricted grazing may show
hoof changes (wavy hoof wall) characteristic of chronic laminitis.

Large Colon volvulus: most commonly occurs clockwise at the junction between the right ventral colon and cecum.

Laryngeal hemiplegia: the neurogenic atrophy of the cricoarytenoideus dorsalis muscle due to recurrent laryngeal
nerve (a branch of the vagus) damage. The loss of control of the abductor muscle leads to collapse of the arytenoid
cartilage and vocal fold, leading to airway resistance. The horse produces a roaring sound while running. It is usually
in the left side.

Lymphoma: is the most common internal neoplasia in horses. It can be multicentric (spleen, liver, kidneys, and
intestine), alimentary, mediastinal, solitary, or cutaneous. Multicentric is most common in horses (1-5 years) and
Alimentary is more common in older horses (around 16 years). Abdominocentesis sometimes show neoplastic cells.
The animal may be mild anemic, hypoalbuminemia and acute to moderate colic.

Monday Morning Sickness: also known as Sporadic Exertional Rhabdomyolysis or Tying up. Usually happens when the
animal isn’t working for a period of time and then goes through extreme exercise. Look for dark urine in some cases
(myoglobinuria) with possible renal damage. See also increase muscle enzymes (CK and AST), hyperkalemia and
hyperphosphatemia.

Navicular syndrome (heel pain): involves the navicular bone (distal sesamoid) Nephrosplenic entrapment happens
when the large (ascending) colon of horses can become dorsally displaced on the left side of the abdomen over the
nephrosplenic ligament.

Nutritional secondary hyperparathyroidism results from an absolute or relative calcium deficiency. Typically caused
by an excess dietary phosphorus or, less commonly, a lack of vitamin D. Facial bones in particular respond with
osteodystrophia fibrosa, which lends the disorder its name “Bighead disease”.

Osselets (periostitis): refers to a traumatic arthritis of the fetlock. Specifically, look for inflammation of the periosteum
on the dorsal distal epiphyseal surface of the third metacarpal bone and joint capsule of the fetlock joint. Usually
bilateral.

Osteochondrosis dissecans: developmental disorder of articular cartilage in horses. Causes are multifactorial, including
rapid growth rate, high energy diets, mineral imbalances (copper deficiency and excessive zinc), genetics, large size
and articular trauma. If non-surgical approach is chosen, you should reduce energy content in the diet. The most
common site is cranial aspect of the Distal Intermedia Ridge of the Tibia (DIRT lesion). Usually bilateral!

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Osteochondrosis: result of a focal disturbance in endochondral ossification. Associated with rapid growth, over
nutrition, mineral imbalance, genetic influences, and cartilage trauma.

Peroneus tertius muscle rupture disrupts the stay apparatus of the hindlimb. The ability to simultaneously extend the
hock and flex the stifle is the characteristic diagnostic feature (seen in the side image). They are usually weight bearing
on the affected hind limb but have a jerking motion.

Persistent corpus luteum: primary cause of anestrus in mares. Use prostaglandin F2 alpha to lyse it. The animal will
knuckle the hind foot.

Physitis is inflammation and swelling around growth plates (physes) of long bones. Especially common in large, rapidly
growing young horses. Usually affects the forelimbs.

Potomac horse fever is an acute enterocolitis syndrome caused by Neorickettsia risticii and transmitted by a
trematode. It produces colic, fever, laminitis, and diarrhea. It resembles salmonellosis, but it occurs in June through
October in the east of Mississippi and in California.

Pyramidal disease (buttress foot): avulsion or periostitis of the extensor process of the third phalanx.

Quittor is caused by Fusobacterium necrophorum

Recurrent Airway obstruction (RAO or Heaves): neutrophilic airway inflammation due to allergic reaction. It is part of
the equine asthma complex. Clinical signs include no fever, increased respiratory rate, crackles, wheezes, coughing,
snot-nosed and flared nostrils. Treatment is to decrease exposure to allergen and dust, bronchodilators
(albuterol/clenbuterol), corticoids and outside housing (if possible). Should be differentiated from inflammatory
airway disease (IAD)! Animals with Heaves have increased respiratory rates at rest, while horses with IAD do not!

Rickets: failure of bone calcification, especially in the metaphysis of long bones, due to dietary insufficiency of vitamin
D in young, growing animals.

Sand enteropathy: Horses eat sand from sandy pastures or when feed is offered on the ground. The accumulated sand
physically irritates the lining of the large intestine, resulting in inflammation, pain, and diarrhea. You can hear an
“ocean-like” sound in the ventral abdomen. Treatment includes psyllium. Differentials include cyathostomiasis, right
dorsal colitis, bacterial enterocolitis, coronavirus, rapid diet change and primary infiltrative or inflammatory intestinal
disease.

Scratches (greasy heel) describes a chronic seborrheic dermatitis of the palmar or plantar pastern that can result from
a number of different causes.

Sheared heels refer to asymmetry of the heels causing severe imbalance of the foot.

Sidebone: ossification of the cartilages of third phalanx seen most often in heavy working horses.

Strangles (Streptococcus equi): Most carriers horses have guttural pouch empyema due to a poorly drained abscess
and are subclinical. Strangles should be treated with antibiotics in cases of intra-abdominal abscess (bastard strangles),
guttural pouch empyema or other complications. It is a highly contagious disease that causes abscesses of
submandibular and retropharyngeal lymph nodes. Fever develops 2-3 days before shedding occurs in horses, so in
case of fever the animal should be isolated immediately to prevent further spread of disease. Clinical signs include
fever, anorexia, depression and nasal discharge. Antibiotics are not typically administered to routine cases until after
the abscesses have opened and drained.

Stringhalt: myoclonic disease characterized by spasmodic hyperflexion of one of both hindlimbs.

Subsolar abscess: the most common cause of acute/severe lameness in horses. Trim the sole of the hoof, drain abscess
and place poultice on foot.

Sweeney: damage to the suprascapular nerve that leads to atrophy in the infraspinatus and supraspinatus muscle.
Look for prominent scapular spine.

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Synchronous Diaphragmatic Flutter (Thumps) is respiratory pattern due to hypocalcemia that makes the phrenic
nerve hyperexcitable. Thumps is not uncommon in horses, and they usually are concurrent hypochloremic,
hyponatremic, hypokalemic, hypomagnesemic and with metabolic alkalosis due to losses in sweat. Treatment include
IV calcium.

Theiler’s disease (Idiopathic Acute Hepatic disease): may have multiple etiologies, but it is suggestive of a Flaviviridae
virus. It is the most common cause of acute hepatitis in horses. 20% of cases happens 4-10 weeks after vaccination of
equine-origin biologic material, such as tetanus antitoxin.

Thoroughpin occurs in the tarsal sheath of the deep digital flexor tendon proximal to the tarsus and is characterized
by effusion, distension and inflammation.

Thrush: Looks like thick, black and malodorous discharge. It is caused by bacterial infection of the frog by
Fusobacterium necrophorum. Treat with daily topical astringent (copper sulfate, methylene blue or chlorine dioxide)
and increasing exercise in a dry area. If the frog is really raw use less irritating metronidazole paste with bandage.

Villonodular synovitis: common condition in thoroughbred racehorses that presents with lameness, fetlock joint
effusion, firm swelling over the dorsoproximal fetlock joint and positive response to firm flexion of the fetlock.

Quidding: act of picking up feed, forming a bolus and then dropping the bolus out of the mouth. Classic clinical sign of
dental disease.

Western equine encephalitis (WEE): affects horses, crows, humans, and cats (oral transmission by infected prey).

Windgalls (also called windpuffs): are fluid filled swellings around the metacarpophalangeal and metatarsophalangeal
joints, basically synovitis at the fetlock. Other idiopathic synovitis includes Thoroughpin (tarsal sheath of the deep
digital flexor tendon proximal to the tarsus) and Bog spavin (tibiotarsal joint).

Foal conditions
produce small amounts of IgM in utero, but significant response only happens about 2 months of age. No
transplacental transfer of immunoglobulins occurs in horses, therefore they need to eat colostrum.

A continuous murmur on the left side is normal in neonatal horses due to a slight opening of the ductus arteriosus,
which usually closes within 4-5 days.

Acute bronchointerstitial pneumonia is a multifocal, sporadic disease seen in foals from 1 week to 8 months of age.
Clinical signs include sudden severe respiratory distress, fever, hypoxemia, and cyanosis. Heat stress and recent
antimicrobial use have been identified as risk factors. At necropsy look for severe, diffuse, necrotizing bronchiolitis
and alveolitis. Treatment include IV fluid, anti-inflammatory, environmental cooling, broad-spectrum antimicrobials,
bronchodilators, corticosteroids, and supplemental oxygen.

Alloimmune hemolysis (neonatal isoerythrolysis) is seen in neonatal foals. Clinical signs include yellow foals who drink
maternal colostrum containing antibodies to the neonatal own blood group.

Choanal atresia leads to respiratory distress. It is caused by a persistence of the bucconasal membranes resulting in
nasal obstruction.

Congenital lateral luxation of Patella in foals is characterized by a lateral displacement of the patella and the animal
adopts a crouched position due to the quadriceps muscle acting as a flexor instead of the extensor of the stifle joint.

Foal Heat Diarrhea: mild and self-limiting and occurs in foals about 4-14 days of age, coinciding with alterations of
intestinal microflora, diet and coprophagy.

Patent Urachus: is common problem and can be congenital or acquired (more common). Acquired patent urachus is
associated with excessive handling and foals that spend a lot of time recumbent. That is why patent urachus develops
high % of foals in neonatal intensive care units. Omphalophlebitis can also be associated.

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Rhodococcus equi pneumonia occurs in foals around 3 months old. Clinical signs include depression, nasal discharge,
cough, inappetence and diarrhea. Diagnosis is confirmed by tracheal wash with gram-positive, pleomorphic rods that
resemble Chinese letters and culture. Treatment include erythromycin, clarithromycin or azithromycin are individually
paired with rifampin to treat foals.

Rotavirus is the most commonly identified caused of diarrhea in foals from 2 days to 5 months old. Transmitted by a
fecal-oral route and diagnosis is done by immunoassay kit for human rotavirus. Clinical sign is basically an osmotic
diarrhea. Prevention involves vaccinating the mare.

Severe combined immunodeficiency (SCID): the foal will not have a visible thymus tissue at necropsy.

Shaker foal syndrome or toxic infectious botulism occurs when Clostridium botulinum sporulates in the tissue of a
living animal and elaborates toxins. Foals demonstrate signs of progressive symmetric motor paralysis, including stilted
gait, muscular tremor, recumbency and expect mortality rate above 90%.

Transient hypogammaglobulinemia is a disorder in which neonates have delayed production of immunoglobulin, for
as long as 3 months after birth. Recurrent episodes of bacterial and viral infections, most often respiratory tract
infection, are seen in these foals before they can produce good amounts of their own antibody.

Tyzzer’s disease caused by Clostridium piliforme. Think hepatitis and suddenly dead yellow foals at 7 to 40 days of age.
Dogs, cats, and calves can also be infected. On necropsy you will find a huge liver with disseminated, multifocal areas
of necrosis, thick, congested intestinal and focal myocarditis.

Uroperitoneum can be seen in neonatal foals as a result of tearing of the bladder or urachus during parturition,
congenital defects, prematurity, and cystitis. Lab finding include hyponatremia, hypochloremia, hyperkalemia, and
azotemia. Clinical signs include stranguria, abdominal distension, depression, poor nursing, and cardiac arrhythmias
as a result of electrolyte imbalance.

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Poultry conditions
Avian Influenza: vary pathogenicity and is caused by orthomyxovirus. High pathogenicity avian influenza is known as
Fowl plague. No clinical signs with subclinical infections. Clinical signs include sinusitis, respiratory signs, fulminating
multisystemic and hemorrhagic signs. At necropsy see edema, cyanosis of head, wattle and comb, hemorrhagic
discoloration of feet and legs and petechial hemorrhages on visceral organs.

Avian liver disease: increase ALT and bile acids, with normal creatinine phosphokinase. GGT, SDH, ALP and AP are not
good indicators.

Botulism (Limberneck or Western Duck Sickness): affects ducks and chickens. Causes floppy neck (neck flaccid
paralysis), animals unable to ambulate and massive death. Campylobacter jejuni: Chickens do not show any clinical
signs, but humans get severe enterocolitis.

Fowl cholera: caused by Pasteurella multocida. Fowl typhoid: caused by Salmonella gallinarum.

Infectious Bursal disease (IBD): causes by a Birnavirus and affects hematopoiesis and B-cell maturation (immune
function).

Infectious bronchitis: caused by a Coronaviridae and leads to wrinkled eggs.

Infectious coryza is a milder respiratory disease, with swelling around the eye and head, sneezing and nasal discharge.
Haemophilus paragallinarum.

Infectious enterohepatitis (also called blackhead) is causes by the protozoan Histomonas meleagridis, transmitted in
eggs of the cecal nematode Heterakis gallinarum. Expect depression, diarrhea, and blackheads in the animal’s head.
On necropsy the bulls-eye lesions on liver and cecal changes (yellowish green, caseous exudate, ulceration and
thickening of cecal wall) are pathognomonic. It can also affect turkeys. Hint: Turkeys are from the genus Meleagridis.
So, if you need to guess a turkey disease, guess something meleagridis.

Infectious Laryngotracheitis (ILT): reportable disease caused by an enveloped alpha herpesvirus. Look for gasping and
coughing animals with blood-stained beaks, rales, and severe dyspnea. Look for blood occluding trachea on necropsy.

Marek’s disease: caused by an alpha herpesvirus where you see depression followed by death. Some birds have a
characteristic unilateral paresis (one leg forward and one leg back). Necropsy will show never enlargement, distortion
of the pupil and enlargement of feather follicles (skin leucosis=condemnation of carcass).

Newcastle Disease: Caused by Paramyxovirus (PMV1) and is characterized by respiratory signs. Viscerotropic
Velogenic Newcastle disease (VVND) is reportable and causes GI hemorrhage.

Psittacosis: reportable.

Riboflavin (B2) deficiency: causes decrease egg production, decrease hatching eggs, curled toe paralysis and
paraparesis with splayed legs.

Salmonella gallinarum: Fowl typhoid

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Conditions of exotic animals
Turtle diseases:

o Septicemic cutaneous ulcerative disease (scud) is a severe shell disease characterized by irregular caseated
cratered ulcers, especially on the ventral surface of the shell. As lesions progress, the animal become anorexic,
lethargic, septicemic, paralytic and may die. At necropsy you can see hepatic necrosis. The lesions are seen in
the side image.
o Shell rot: is a chronic bacterial infection on the shell of aquatic turtles that give a whitish appearance to the
shell. It is usually due to poor husbandry and a dirty environment. Treatment includes separating affected
turtles, removing affected tissue and cleaning, maintain clean water, good airflow and provide basking area
with light where each turtle can dry off.
o Vitamin A deficiency in turtles is common and leads to swollen eye, nasal discharge, necrotic stomatitis,
anorexia, and ear infections (box turtles). Treatment includes 200IU/kg vitamin A, once every 2 weeks and no
more than 2 injections. Oral vitamin A is preferred if is a mild-moderate cases because too much vitamin A is
toxic.

Aleutian disease is a chronic immunosuppressive wasting disease caused by a parvovirus in mink (more) and ferrets.
Minks will show poor production, gradual weight loss, or/and GI bleeding, renal failure, uremia, and high mortality.
Look for enlarged, pitted, tan kidneys on necropsy.

Bumblefoot (pododermatitis) in guinea pigs usually occurs secondary to poor sanitation, obesity and wire cage floors
or rough bedding. Staphylococcus aureus is most commonly isolated.

Bordetella bronchiseptica is highly pathogenic in guinea pigs, but rabbits are subclinical carriers. Therefore, guinea
pigs and rabbits should not be kept together. Clinical signs in guinea pigs include inappetence, oculonasal discharge
and dyspnea.

Cervical lymphadenitis (lumps) in guinea pigs is usually caused by streptococcus zooepidemicus.

Chromodacryorrhea (red tears) occurs in stressed or diseased rats when the Harderian glands, behind the eyes,
secrete increased porphyrins.

Chronic mechanical self-trauma on the cage is associated with alopecia and dermatitis.

Chronic wasting syndrome: reportable and affects deer and elk.

Hamster: the female is usually larger, dominant, and more aggressive.

Hepatopathy in Birds: lab work shows increase AST, normal creatinine phosphokinase (to rule out muscle disease) and
increased bile acids. GGT and glutamate dehydrogenase are specific, but not sensitive. Keep in mind that bilirubin is
not produced by birds they use biliverdin instead.

Hyperadrenocorticism in ferrets think hair loss beginning on tail/rump, progressing to flank and head. In females may
see swollen vulva and enlarged mammillae. Males become aggressive, develop stranguria secondary to prostatic
enlargement. Enlarged adrenal glands are often palpable cranial to kidneys. Can cause hypoestrogenism and bone
marrow suppression too.

Hypoestrogenism: leads to estrus-induced aplastic anemia and clinical signs include extremely pale skin, swollen vulva,
and severe anemia. Common in unspayed female ferrets.

Infectious Salmon Anemia is a reportable disease caused by an orthomyxovirus. Clinical signs include high mortality,
pale gills, hemorrhage in the anterior chambers, dark and hemorrhagic livers, and ascites. Diagnosis is by
immunofluorescent antibody testing of kidney.

Insulinoma: are common in ferrets with >2-3 years. Look for weakness, lethargy, posterior paresis, drooling, teeth
grinding and seizures due to severe hypoglycemia.

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Lead and zinc toxicity in caged birds leads to biliverdinuria, hepatic disease, urates stain limegreen to yellow. Clinical
signs also include history lethargy, weakness, polydipsia, and regurgitation.

Moist dermatitis: can develop in areas that have contact with water or saliva, especially with ptyalism secondary to
malocclusion. In female rabbits it usually occurs in the dewlap which is a skin fold under the chin.

Psoroptes cuniculi: ectoparasite that infect the ears of rabbits. It creates an accumulation of a serum brown crust and
untreated infestation can cause secondary infections which can damage the inner ear. Treatment includes cleaning of
the crust with cotton soaked in dilute hydrogen peroxide and ivermectin can be used to treat the mites.

Ptyalism in guinea pigs is usually caused by misalignment of the teeth or subclinical vitamin C deficiency, which leads
to mandibular deformity, and secondary tooth misalignment.

Red spot is reportable disease is caused by Aphanomyces invadans a species of


water mould. Clinical signs include an epizootic ulcerative syndrome in fish.

Renal tumor with progressive unilateral lameness in budgerigars is common because the sciatic nerve passes through
the renal parenchyma in birds and Budgerigars are prone to neoplasia in general.

Scurvy (Vitamin C deficiency) can cause subcutaneous hemorrhages in guinea pigs. Look for swollen joints (source of
lameness), anorexia, diarrhea and weakness. Affected animals may be thin with rough hair coat. Treatment includes
daily vitamin C 5- 10mg/kg, PO or IM, for 1-2 weeks. However, avoid multivitamins as can cause vitamin overdose.

Sea lice (Lepeophtheirus salmonis) are an important problem of farmed salmon and is seen in the side image. They
cause damage to the skin and in high number can result in death. Treatment is difficult and you
should consult a specialist. Lumpfish and wrasse (cleaner fish) have been used to control see lice.

Sucking louse (Polyplax spinulosa) is parasite that causes pruritus, excoriations (from screeching), mild alopecia and
lethargy in mice. They look like white speckles attached to hair and can be captured by acetate tape imprints. Seen in
the image in the next page.

Tularemia is caused by Francisella tularensis and humans can be infected from rabbits or rodents when eating
undercooked meat. Tularemia in humans varies from localized illness to fulminant septicemia. Necropsy in infected
rabbits shows starry sky, pale, necrotic foci on the dark congestive liver.

Velvet (coral disease) is caused by Amyloodinium spp a dinoflagellate that causes serious health problems in marine
fish and leads to high mortality. It gives fish a gold-brown color.

Whirling disease is caused by Myxosoma cerebralis and is characterized by rapid tail-chasing behavior in fingerling
when startled. The parasite infects cartilage in the vertebral column and skull causing skeletal deformities in fish.

White spot disease is caused by Ichthyophthirius multifiliis which an obligatory


parasite of fish that is highly contagious and common. It invades epithelial tissue,
leaving white spots where it encysts. Treatment includes formalin or copper sulfate
every 2-3 days for at least 3 weeks.

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Congenital conditions
Chediak’-Higashi syndrome: due to a congenital platelet and white cell defect. Associated with dilute hair color in
smoke blue Persian cats and beige mice. Not seen in dogs!

Glycogen branching enzyme deficiency: leads to defects in muscle glycogen storage.

Pelger-Huet anomaly: is a thrombocyte and white cell defect where granulocytes, especially neutrophils are stuck in
band form. CBC shows apparent left shift with normal WBC count.

Von Willebrand’s disease: is coagulation factor deficiency. Von willebrand’s factor is needed for the first step in clot
formation. Normally von Willebrand’s factor circulates in a complex with coagulation Factor 8 and facilitates adhesion
of platelets to subendothelial surfaces. Usually happens in dogs! Lethal in homozygotic animals. Heterozygotes have
normal cell function.

Severe combined immunodeficiency (SCID): the foal will not have a visible thymus tissue at necropsy.

Immune conditions

Hypersensitivity
Type 1 allergic reaction due to IgE and histamine Vaccine reaction, allergies
Type 2 Antigen binds to cell surface and marks it to Autoimmune hemolytic anemia, Pemphigus, Myasthenia
be destroyed gravis
Type 3 Immune Complex deposition Glomerulonephritis, Hypersensitivity pneumonitis (think
moldy hay), Purpura hemorrhagica (think post-strangles),
anterior uveitis
Type 4 (Delayed hypersensitivity reaction): Cell Lymphocytic choriomeningitis, Keratitis sicca, autoimmune
mediated! thyroiditis, Contact hypersensitivity, transplant rejection,
tumor immunity

Myasthenia gravis: result of autoantibodies binding to the acetylcholine receptors, preventing neurotransmission.
Therefore, the animal cannot walk properly. Diagnosis with an acetylcholine receptor antibody assay (best available)
or a tensilon (edrophonium) test. A muscle biopsy is needed to quantitate acetylcholine receptors for a definitive
diagnosis of congenital myasthenia gravis.

Endocrine conditions
Diabetes Mellitus: Clinical finds include high blood sugar and glycosuria. It leads to diabetic cataracts in dogs, but not
in cats! It can also cause pancreatitis (more in dogs than in cats).

Diabetes insipidus: to differentiate diabetes Insipidus (DI) from psychogenic polydipsia (PPD) you need to do a Water
deprivation test and ADH response test:

o Water deprivation test: due to medullary washout (loss of the gradient between renal medullary intersitium
and urine) you must deprive the animal from water before ADH test.
o ADH response: to differentiate Central DI (lack of ADH due to a problem in the posterior pituitary gland or the
hypothalamus) or Nephrogenic DI (kidney not responding to ADH).

If USG after ONLY the urine concentration test is great than 1.025-30 think PPD or atypical hyperadrenocorticism.

If USG is less than 1.025, perform the ADH test. If the urine concentrates to greater than 1.025-30 think central
diabetes Insipidus. If not concentrate after BOTH tests, think nephrogenic diabetes insipidus.

Cushing’s (Hyperadrenocorticism): In dogs, usually toy breeds, clinical signs include obesity, increased cholesterol,
comedones, panting, increased ALP and sometimes you can see a mild increase in glucose and decrease in BUN. In
cats you see hyperglycemia, concurrent diabetes mellitus (80% of cases), increase cholesterol and increase ALT.

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Diagnostic test include Low-dose dexamethasone suppression test (LDDST) and ACTH stimulation test. LDDST is more
sensitive (few false neg), while ACTH stimulation test can identify iatrogenic causes. When you hear the 4 Ps (Panting,
Potbelly, PU/PD, and polyphagia) think Cushing’s. Can use mitotane as treatment.

Addison’s (Hypoadrenocorticism): Evident when Na:K ratio is less than 27! Look for low sodium, high potassium,
bradycardia, low Cl, high Ca, azotemia, increased PCV and anemia. There is a high incident of Addison’s in Standard
Poodles. Keep in mind that in felines a low Na:K ratio may be associated with other diseases and definitive diagnosis
is an ACTH stimulation test.

Hypothyroidism: can cause facial nerve paralysis. More common in dogs, usually large breeds, and leads to tail alopecia
and tragic facial expression. Other areas of bilateral alopecia are common and include the lateral trunk, caudal thighs,
ventral neck, and dorsum of the nose. Treatment includes thyroxin supplementation.

Hyperthyroidism it is the most common feline endocrine and geriatric disorder usually caused by a functional thyroid
adenoma (adenomatous hyperplasia). In roughly 70% of cases, both thyroids lobes are enlarged. Thyroid carcinoma is
the primary cause of hyperthyroidism in dogs, but it is rare in cats (1-2% of cases). Clinical sings include thin, big
appetite and hyperactive cat. Lab finding include high AP. Diagnostic test of choice is serum total T4 (TT4). T3
suppression and TRH stimulation tests are useful to diagnose mild hyperthyroidism. If left untreated hyperthyroidism
can lead to hypertension. Palliative treatment includes Methimazole (block thyroid hormone synthesis). Curative
treatment includes surgical removal of the affected gland or radioactive iodine therapy to destroy the gland.

Glucocorticoids: excess GCC and stress in dogs can cause elevated AP.

Neuro conditions
Gray matter lesion between C6 and T2 spinal cord segments: no withdrawal reflex in forelimbs.
If the lesion is above, withdraw will be present.
Lesion at L4-L5 causes depressed or absent patellar reflexes because that is where the femoral nerve cell
bodies are. The animal will sometimes have normal withdrawal reflex.
L7-S1 with damage to the sciatic nerve leads to loss of hind limb withdrawal.
Cauda Equina Syndrome happens when you have a L7-S1 lesion. Clinical signs include delayed CP in both pelvic
limbs, poor anal tone, normal patellar reflexes, and poor withdrawal reflexes of the pelvic limbs.
Hydranencephaly: usually caused by Bluetongue, Bovine viral diarrhea (BVD), Border disease and Akabane
virus.
Vestibular disease: head tilt towards the lesion, circling towards the lesion and nystagmus fast phase away
from the lesion.
Spina bifida: is a failure of the neural arch to fuse.

Tumors
Round cell tumors include: Mast cell tumors, histiocytomas, cutaneous lymphoma, and transmissible venereal tumor
(TVT). HINT: they all are present in the skin and can be easily identified by cytology.

Ameloblostoma are the most common benign tumor of dogs. They are tumors of the periodontal ligament cells that
often aggressively invade local tissues, bone included, but generally do not metastasize. Surgical excision is curative if
done with full 1cm margin of clinically normal tissue to prevent recurrence.

Benign mammary tumors (fibroadenomas) are the most common subcutaneous tumors in rats. Can happen from
inguinal areas to the neck due to extensive mammary tissue.

Chemodectomas: tumor of the carotid and aortic bodies.

Histiocytomata are benign tumors from connective tissue that resolve in 3 months but may mimic a mast cell tumor.

Lipoma: static subcutaneous fat tissue tumor. They can grow at slow rates and are usually not problematic.

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Mastocytoma look like any lump, but it can grow bigger and red and go back to normal after. That happen because
degranulation of histamines granules triggers local inflammation. Low grade mast cell tumors (I and II) are treatable
and less than 10% metastasize. Grade III has a poorer prognosis as >50% metastasize. Dogs usually have
gastroduodenal ulceration (>25%) due to histamine-induced stimulation of HCl from gastric parietal cells, therefore
the main complains are vomiting, diarrhea, weight loss, melena. These dogs need Diphenhydramine (H1 blocker),
Ranitidine or Famotidine (H2 Blockers) or Omeprazole (proton pump inhibitor).

Melanoma: a malignant melanoma has a high mitotic figure and pleomorphism of the nucleus and nucleolus.

Osteosarcoma: common, aggressive bone tumor typically found in the appendicular skeleton, especially distal radius.
Usual locations remember: “Away from the elbow, near the knee”. Does not cross the joint, which helps differentiate
from osteomyelitis that usually cross the joint. Look for tissue swelling, periosteal proliferation, sunburst periosteal
reaction (33%) and possible pathologic fractures.

Pheochromocytoma: adrenal gland tumor that affects the chromaffin cells of the adrenal medulla and affects the
secretion of catecholamines (epinephrine and norepinephrine). Seen in cattle, dogs, and lab rats.

Sarcoid: most common tumor in equine and is thought to be associated with bovine papilloma virus.

Sertoli cell tumors: usually are estrogen-secreting tumors that can cause feminization syndrome in male dogs and lead
to gynecomastia (enlargement of mammary glands), penile atrophy, pendulous prepuce, attraction of other males,
blood dyscrasias, +/- bone marrow depression and bilateral alopecia.

Squamous cell carcinoma (SCC): oral SCC is the most common oral neoplasia.

Transitional cell carcinoma is usually found in the trigone of the bladder and very aggressive. Due to its location
excision is hard. Clinical signs include hematuria, pollakiuria, abdominal pain and bacterial cystitis in an older dog.

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Fungal conditions
Aspergillosis: narrow, hyaline, septate and branching hyphae. Usually a nasal
presentation in dogs.

Coccidioidomycosis by Coccidioides immitis also known as Valley fever is seen in the arid
and semiarid southwestern US (think dusty desert). Clinical signs include fungal pneumonia.

Blastomycosis: animals affected usually come from the river valleys of the central US. Look for lymphadenopathy,
draining cutaneous nodules, pyogranulomatous lesions on various tissues and signs of
respiratory disease (cough and fever).

Histoplasmosis: differential for blastomycosis as it has a


similar distribution if the river valleys in central US. However, clinical signs include chronic
diarrhea and respiratory disease in dogs and respiratory disease in cats. On the smear,
the Histoplasma is much smaller and harder to detect.

Dermatophytosis (Ringworm): Zoonosis! Ringworm is more common in cats and 98% are caused by Microsporum
canis. In dogs it is caused mainly by Microsporum canis (70% of cases), but it can also be by M gypseum (20%) and
Trichophyton mentagrophytes (10%). In cattle the most common is Tricophyton verrucosum and it usually happens in
the winter. Clinical sings include focal or multifocal, sometimes circular regions of alopecia, scaling and crusting with
variable amounts of inflammation and pruritus. Fungal culture of hair stubbles and skin scale can confirm infection.
Treatment can be local or systemic. Itraconazole is the drug of choice for felines but can be expensive for dogs.
Ketoconazole can be used in dogs, but not in cats due to hepatoxicity and anorexia issues.

Dermatophyte culture plates should be incubated in a loosely sealed plastic bag at room temperature kept in a
darkened area for up to 3 weeks.

Trichophyton
Microsporum canis

Sporothrix schenckii (sporotrichosis) results from direct inoculation from skin wound or inhalation. Clinical signs
include lymphocutaneous, cutaneous, or disseminated form of disease. Highly zoonotic.

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Parasitology
Nematodes are the most common encountered intestinal parasite of all species. They usually cause diarrhea and
weight loss. In all ruminants, the most important parasites are Haemonchus, Ostertagia, Trichostrongylus and
Nematodirus.

Coccidiosis: is caused by a protozoa that can lead to diarrhea and depression at 3 to 4 weeks
(older than 21 days) of age. Coccidiosis in calves, kids and lambs is usually by Eimeria spp
and causes a bloody diarrhea with tenesmus. If animal is asymptomatic no treat is needed
as coccidian lives in the normal gut of chickens, cows, goats, and sheep. Treatment is sulfas
(water) tetracyclines (feed) or amprolium (water). Control with anti-coccidias include
ionophores, amprolium and chlortetracycline in feed.

Cochliomyia hominivorax (screwworm myiasis): reportable as it has been eliminated from North
America. Causes an obligatory myiasis as it primarily invades normal flesh.

Culicoides spp bite can cause a hypersensitivity reaction. It is usually dorsally distributed, pruritic and it happens in
warm weather areas. It is also known as Sweet Itch and Queensland Itch. The lesions of alopecia, crusting and scaling
may be from self-inflicting trauma.

Cuterebra spp: also known as bot fly larva or Berne (Portuguese). Causes verminous myelitis in felines. Rabbit
cuterebrae are less hostspecific than other types and are usually associated with dog and cat infestations.

Dermacentor spp. are vector for Babesia caballi in horses, Anaplasma marginale in cattle, Rickettsia rickettsiae (Rocky
Mountain spotted fever), Powassan virus as well as the agents of Q fever (Coxiella burnetti) and tularemia among
other infectious.

Dipterans (two-winged flies) are called period parasites because they do not live on their host, but return frequently
to feed.

Echinococcus granulosus tapeworm larvae is associated with sheep and dogs. Humans can be contaminated by eating
food contaminated with dog feces, which causes hydatid cysts in the liver, brain, and lugs.

Eurytrema pancreaticum: also known as pancreatic flukes. They are parasites of the pancreatic ducts and occasionally
of the bile ducts of sheep, pigs, and cattle in Brazil and Asia.

Facultative myiasis: invades damaged tissue. Flies that participate in facultative myiasis typically have free-living
larvae (maggots) that can invade wound or moist flesh of debilitated animals.

Haematobi irritans (Horn Flies): transmit Stephanofilaria stilesi, the causative agent of stephanofilariasis.
Stephanofilariasis is characterized by a plaque-like dermatitis along the ventral
midline of cattle. Diagnosis by deep skin scraping. Control by insecticide
impregnated ear tags, pour on insecticides and feed-through insect growth
regulators or insecticides.

Hypoderma spp leads to the formation of warbles, larval cysts in the subdermal tissue on the back of cattle and
sporadically in horses kept near cattle.

Neospora caninum: cause bovine protozoal abortion between 4 to 6 months of gestation. In canines it causes an acute
ascending paralysis in puppies and young dogs under 6 months of age. The paralysis is usually progressive and leads
to rigid contracture of muscles of affected limbs, dysphagia, incontinence, and muscle atrophy. Transmission
unknown.

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Sticktight fleas (Echidnophaga gallinaceae): affects multiple hosts

Thelazia gulosa is an eyeworm. Thelazia californiensis is a zoonotic eyeworm that can affect dogs. Clinical signs include
keratitis with corneal opacity and ulceration, hyperemia and occasionally blindness. Treatment involves manually
removing the worms, subcutaneous ivermectin, spot on moxidectin, oral milbemycin oxime, ocular moxidectin or
levamisole ocular solutions.

Tritrichomonas foetus affects the urogenital system.

Trypanosomes sp infect all domestic animals and humans causing trypanosomiasis. Transmitted by
Tsetse flies or other biting flies. Seen in the side image.

Ancylostoma caninum (hookworms): found in the small intestine. Can be transmitted to puppies via colostrum and
milk. Ancylostoma braziliense can cause cutaneous larva migrans in people that look like raised, pruritic, tortuous red
tracts.

Ctenocephalides spp.: flea found in dogs and cats. Usually the Ctenocephalides felis is the most prevalent flea on both
dogs and cats. The larvae are shown below. Remember that fleas do not spend their entire life cycle on their host,
therefore disinfecting the environment is crucial.

Cytauxzoon felis is a protozoa that causes Cytauxzoonosis in cats. It is transmitted by the lone
start tick (Ambyloma Americanum) and the American dog tick (Dermacentor variabilis). Clinical
signs include depression, lethargy, anorexia, fever, pallor, icterus, and death if not treated.
Diagnosis by aspirates of lymph nodes, spleen, or bone barrow. Treatment includes a
combination of atovaquone and azithromycin, but some animals remain persistently infected.

Dioctophyma renale: kidney worm of dogs.

Dipylidium caninum (tapeworms): typically attach their scolices to the small intestinal
wall. Transmitted by flea bites and is the most common cestode in dogs and cats.
Proglottids (segments of tapeworm) in the feces are an evidence of tapeworm infection.

Giardiasis: sad looking parasite that causes a watery diarrhea. Fecal flotation will be
negative, but direct fecal smear with Diff-quick will show the parasite. Seen in the side image
bellow. Ollulanus tricuspis infects several species, but mostly seen in cats. Clinical signs
include vomiting few minutes or hour after eating due to mild erosive gastritis.

Oslerus (filaroides): lungworm of dogs.

Paragonimus kellicotti is the lung fluke of dogs and cats and the first and second internment host is crayfish. Treat it
with fenbendazole twice a day for 10-14 days.

Spirocerca lupi: makes reactive granulomas in the esophageal, gastric, or aortic walls. Common
in Southern U.S. and tropical climates. Large granulomas may become neoplastic (osteosarcoma
or fibrosarcoma) and some dogs develop spondylitis or enlargement of the extremities
characteristic of hypertrophic osteopathy. The infection is usually asymptomatic, but it may
cause esophageal obstruction.

Toxocara canis (roundworms): found in small intestine of canines. Can be transmitted to puppies via
colostrum, milk, and placenta (primary form of transmission). Can cause visceral and ocular larva
migrans in people.

Taenia taeniaformis: cats can acquire it from eating wild rodents.

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Trichuris spp (whipworms): typically found in the cecum and large intestine in dogs (rare in cats). Clinical sings include
large bowel diarrhea (frequent urgent defecation of loose watery feces, possibly with mucus or fresh
blood). Can be associated with hypoadrenocorticism-like syndrome showing hyponatremia,
hyperkalemia, azotemia, and metabolic acidosis. It can also cause cecocolic intussusception. Treatment
include fenbendazole, febantel, praziquantel or pyrantel pamoate. Seen in image below.

Equines
Anoplocephala perfoliata: tapeworm that can lead to colic due to cecal motility dysfunction
and intussusception. Life cycle include: egg in feces eaten by oribatid mites → larvae form in
mites → mites eaten by grazing horses → mite digested, release larvae and mature to adults.

Cyathostomes (small strongyles): develop in the wall and lumen of the intestine. At necropsy it can be felt in the
intestinal wall like tiny gritty nodules the side of sand grains. They live in the lumen of intestine and can be easily killed
by anthelmintics (avermectins). Eggs are not found on fecal exam, but the bright red stage larvae can be easily seen in
the feces. Clinical signs include recent history of moderate colic, diarrhea and weight loss coinciding with warmer
spring weather.

Draschia megastoma: caused catarrhal gastritis.

Habronema spp: is a stomach worm of horses that can lead to catarrhal gastritis. Cutaneous habronemiasis (summer
sores) happens when the larvae of the stomach worms are deposited in wound or around mucocutaneous junctions,
usually by flies. The aberrant migration of these larva causes a granulomatous reaction. Lesions are typically in the
lower limbs, medial canthus of the eye or urethral process. Lesions are ulcerative, nodular with yellow, necrotic foci
known as sulfur granules.

Onchocerca cervicalis live in calcified nodules in the ligamentum nuchae and produce microfilaria that migrate to
specific areas, including the ventral midline, face, neck, and chest. The migrating result in a hypersensitivity reaction
leading to dermatitis. The accumulation of microfilaria in the eye may also lead to conjunctivitis and uveitis. Culicoides
mosquitoes carry the onchocerca microfilaria

Gasterophilus intestinalis: The botflies lay eggs on the hair of the horse
forelimbs or shoulders. The horse licks it stimulating it to hatch and then it
goes to the stomach where it stays all winter and cause few problems (mild
gastritis sometimes).

Oxyuris spp (pinworms): found in horses. The adult female equine Oxyuris equi (pinworm) resides in the terminal
colon of the horse and emerges to deposit egg on the anus and perianal area. The eggs are embedded in sticky material
that is irritating to the host, causing pruritus! You can use a cellophane tape (clear tape/Scotch) at the perianal area
and look for eggs.

Parascaris equorum: migrating parascaris larvae can cause respiratory signs (verminous pneumonia) sometimes called
summer colds. Foals with heavy intestinal infections may be unthrifty, lethargic, and sometimes display colic.
Occasionally see intestinal perforation or obstruction.

Strongyloides spp are found in the small intestine of foals.

Strongylus vulgaris: can cause thrombosis and arteritis. Causes pain in equines when the larvae are migrating and can
end up in spine causing verminous myelitis or verminous arteritis. Verminous arteritis is characterized by dilation,
swelling and small mass of fibrinous debris and can be found in the aorta and cranial mesenteric artery. Aneurisms,
swelling and thrombotic debris can also be found as a result of Strongylus vulgaris infection. It causes colic due to
ischemia.
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Bovines
Cryptosporidium: clinical signs include emaciation and watery diarrhea in a 1–4-week-old calf. Stain
red with Ziehl-Neilson stain.

Dicrocoelium dendriticum is found in the bile ducts.

Dictyocaulus viviparous: lungworsm of cattle, deer, donkeys, and horses. It causes a parasitic pneumonia (Husk)
characterized by coughing, mostly in yearling cows on pasture during summer and fall. Diagnosis with Baermann
sedimentation technique as the lung larvae will swim out into the fluid and settle to the bottom. Treated with
ivermectin family, fenbendazole, albendazole and levamisole.

Haemonchus spp: causes anemia, hypoproteinemia (bottle jaw) and weakness. It lives in the abomasum. Barber pole
appearance. Seen in corner image.

Fasciola hepatica (liver flukes): lives in the liver. It is more clinically relevant in sheep, especially
with infectious necrotic hepatitis (black disease, clostridium novyii). Seen in below image.

Ostertagia ostertagi: Clinical signs include anorexia, poor growth, diarrhea in less than 2-year-
old animals on pasture. Lives in the abomasum causing nodules with a “Moroccan leather”
appearance. It is usually chronic.

Paramphistomum cervi: known as rumen flukes. Immature paramphistomes attach to ileum and duodenum.

Taenia saginata: small cysts can be found in undercooked beef.

Trichostrongylus spp. is an abomasum parasite of ruminants.

Swine
Ascaris suum: lives in the liver and sometimes in the bile ducts and stomach, but hatch in the large
intestine. Damage in the liver is known milk spots. Clinical signs include severe respiratory distress, icterus,
and sometimes pulmonary edema. Large infestation can cause intestinal obstruction and permanently
stunt growth of young pigs. Treatment include ivermectin, pyrantel, levamisole and Benzimidazoles.

Metastrongylus (lung worms): have an earthworm intermediate host. Infected pigs usually have
pasture access. Clinical signs include chronic cough and unthriftness.

Stephanurus dentatus: swine kidney worm.

Taenia solium can be get by ingestion of undercooked pork containing the larvae (taeniasis) or eggs (cysticercosis).

Trichinella spiralis: Reportable disease of swine. Can be transmitted by undercooked pork or bear.
Treatment is not practical. Cysts are killed by cooking (137F or 58C) or freezing (-30C for 6 days).
Seen in bottom side image. Use ELISA to confirm it.

Poultry
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Argas persicus (fowl ticks or poultry ticks): causes anemia and can serve as a vector for fowl spirochetosis (Borrelia
anserina).

Chicken Mite (Dermanyssus gallinae): Feed only at night and drops during the day.

Northern Fowl Mite (Ornithonyssus sylviarum): animal will lay less eggs and seem listless. You can see tiny blackish
brown specks moving around the vent.

Scaly-leg mites (Knemidocoptes mutans): lives on distal extremities

Exotics
Cnemidocptes pilae (Scaly face mite) creates a scale like lesion in the bird’s beak. It should be treated with ivermectin
topically or orally. Beak deformity may persist after treatment and immunocompetent birds are not usually affected
therefore look for an underlying cause.

Hymenolepis (Rodentolepis) nana is a tapeworm of rodents that can also infect humans, causing mild abdominal
distress and sometimes nausea and vomiting.

Parelaphonstrongylus tenuis: nonpathogenic parasite of neurologic tissue of white deer. In aberrant host, such as
camelids or small ruminants, it causes severe neurological disease.

Lamanema chavezi: intestinal parasite in South America.

Encephalitozoon cuniculli is a protozoan that sometimes causes neurologic disease in small mammals, small animals,
and humans.

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REGULATORY AUTHORATIES
United States Department has a section called Animal and Plant health inspection service (APHIS) that enforces the animal
of Agriculture (USDA) welfare act that sets the minimal standard of care of laboratory animals, pet trades, animal
transportation and exhibition and licensure of animal dealers. It is also responsible for
prohibiting animal fighting.
Institutional Animal Care self-regulating entity that must be established by institutions that use laboratory animals. They
and Use Committee (IACUC) oversee the care and use of laboratory animals.
Food animal residue have guidelines on withdrawal times in food-producing animals.
Avoidance Databank
(FARAD)
Quality assurance program helps sheep and goat farmers to produce safe and wholesome food products under HACCP
principles.

OIE World organization of Animal Health (Office international des epizooties)

Feline aggression: use selective serotonin reuptake inhibitors (SSRIs – fluoxetine and paroxetine) or tricyclic
antidepressants (amitriptyline, clomipramine) combines with desensitization and counter conditioning exercises are
the most effective way to manage feline aggression. Benzodiazepines such as diazepam, can help some timid cats that
are victims of aggression. Treatment for up to a year or more is often necessary. Play aggressive kittens should be
given suspended toys.

Re-directed aggression: when an interruption of an aggressive event between 2 animals results in re-direction of the
aggression to the one who intervened or to a third uninvolved animal.

Petting-induced aggression should be dealt by gradually increasing petting time and associated with food rewards.
Vocalizing, chasing, attacking, and biting a new cat in the house is considered an act of overt, active and offensive
aggression on the part of the resident cat.

Facial pheromones are though to act at level of the hypothalamus to decrease anxiety and effectively decrease urine
spraying in felines. Examples include Feliway and Felifriend. However, some cats may not respond well to pheromones
or may become even worse.

Add litter boxes 1 for each cat and one extra. Place litter box at good place, uncovered, daily scooping and unscented.

Punishment-based negative reinforcement may increase fear and anxiety in cats and male aggression among cats
worse.

Kittens who are weaned early, hand raised, or bottle fed exclusively by people may never learn to modulate their play
aggression responses to other cats. They are not socialized and may not know when to stop being aggressive.

Inappropriate elimination: provide litter boxes.

Flehmen reflex is common in males. In females it is an indicative of testosterone-producing granuloma cell tumor that
leads to stallion-like behavior along with aggression and mounting.

Always do a gradual introduction of a new pet to prevent aggression episodes.

To promote breeding, the queen should go to the tom’s territory. Minimize interruption of the 2 cats. Allow mating
with the queen so they can breed multiple times but separate them regularly to allow the male to rest and prevent
fighting.

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Llamas will lay in sternal recumbency when in heat.

Berserk llama syndrome occurs when an orphaned crias, usually male, imprint with human handlers and then treat
them as another llama. Llamas are very aggressive among themselves and head butt and bite to establish dominance.
If they imprint on humans, they will do that to their handlers. Minimize contact to avoid this.

South American camelids defecate and urinate on a communal dung pile, and they do not graze near or downstream
from the dung piles.

Preventive Medicine
Organisms transmitted by milk include mycobacterium bovis (TB), listeria monocytogenes, Brucella abortus and
Coxiella burnetti (Q fever).

Animal diarrheas with public health/zoonotic significance: cryptosporidiosis (protozoa in drinking water),
salmonellae and E. coli

Sentinel animals are typically susceptible to a particular disease and are used in laboratories and in the wild to monitor
the environment and determine if that disease is on the rise. (chicken: west Nile virus & Dog: rocky mountain spotted
fever).

Carcass from BSE should not be disposed by rendering because the prions are still infective and rendered material may
be used as animal feed.

Rectal temperature for slaughter: 106 (41C) for pigs and 105 (40.5C) for cattle, sheep, goats, horses and mules.

In the US it is illegal to consume lungs (TB), brain (rabies, BSE), laryngeal muscles (rabies) and thyroid gland (thyroid
hormone).

Temperature for pasteurization is set by Coxiella burnetti, which is extremely heat resistant and causes Q fever (1957).

Pasteurization: 140 Celsius or 284 F for 4 seconds (UHT pasteurization)

EPIDEMIOLOGY
Actual positive Actual negative TOTAL
POSITIVE A (true +ve) B (false +ve) A+B
Your tests NEGATIVE C (false negative) D (true negative) C+D
TOTAL A+C B+D A+B+C+D
Sensitivity: A/(A+C). High sensitivity means you can trust a Negative test (few false negative). You want a sensitive test
for 1. Diseases that are rare (e.g.: BSE), 2. Diseases where early diagnosis improved prognosis (e.g. HIV in people) and
3. The disease is highly lethal and with severe consequences for missing (e.g. Rabies, Brucellosis, BSE).

Specificity: D/(B+D). High specificity means you can trust a Positive test (few false positives). High specificity is
important in diseases with high prevalence (kennel cough) and where early diagnosis or treatment does not improve
prognosis. Sensitivity and specificity are inherent to the test and are not affected by the population.

Prevalence: (A+C)/(A+B+C+D)

Positive predictive value (PVP): A/(A+B)

Negative predictive value (PVN): D/(C+D)

INCIDENCE: Number of new cases over a period of time


PREVALENCE: Number of cases currently present at a particular time.
Morbidity is another term for illness.

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Mortality is another term for death

TAIL ALTERATIONS

Tail alteration for cosmetic purposes is NOT ethical according to the American Association of Equine
Practioner's (AAP) Ethical and Professional Guidelines and is illegal in some states.
Raised tail Saddlebred This raised tail appearance is typically achieved by
horses cutting the ventral Sacro caudal muscles that depress
the tail. The tail is then put into a "tail-set" device that
keeps it elevated; the device is then removed when
showing.
Caustic substances Arabian horses lift the tail up
Alcohol block or cutting Quarter, hunter- horse cannot lift the tail
the dorsal Sacro caudal class horses
Docking Draft horses enhance visualization of the hindquarter muscling

AVMA & CVMA allows the use of mares to collect urine from which estrogen is extracted.

Molting: reduce light and changing feed ingredients.

Sow housing systems

Gestation stalls (individual pen, sow cannot turn around)


Group housing: (Indoor pens housing 5 to hundreds of pigs)
free-range housing: (indoor/outdoor)

5 serious REPORTABLE diseases:

Malignant catarrhal fever (MCF)


Bluetongue (more a sheep disease)
Vesicular stomatitis (VS)
Rinderpest
Foot and mouth disease (FMD)

Veal calves Housing requirements

Group housing, balanced diet including grain. Veal calves (bulls’ calves from dairy farms) are now raised similarly to
dairy heifer replacement calves, which are also transitioning to group housing. Click here to see the American Veal
Producers Veal producers’ statement of principles. Iron deficiency used to be common in veal calves who were raised
in small individual pens and fed iron deficient diets to produce pale, soft meat. In 2007 the American Veal Association
adopted a resolution calling for all U.S. veal producers to transition to group housing methods by December 31, 2017.
Changes were made to provide balanced diets including grain. The veal industry follows the Veal Quality Assurance
program which is based on the same principles as beef, pork, milk, and poultry quality assurance programs. The
American Veterinary Medical Association through its Position Statement on Veal Calf Management supports current
industry initiatives to move to group housing of veal calves. Calves should be housed in groups at the earliest age
practicable to facilitate normal behaviors, including social interaction.

Soring

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Soring is an unethical and illegal practice of intentionally causing pain to exaggerate the leg motion of horses. The
outcome is a chest- high stride called the "big lick;' which unfortunately is desired in many competitions of gated
horses (esp. Tennessee Walkers). Soring is achieved by application of chemical irritants to the lower limb, +/- use of
"action devices" that make the horse pick up the leg faster, or mechanical/physical measures that make the feet
incredibly sore. The special shoes seen on this horse are called "stacks" - and they make the foot heavy to exaggerate
the movement; unfortunately, they can also hide application of items that cause pain/pressure on the bottom of the
hoof. The Horse Protection Act (HPA) of 1970 made soring illegal. The USDA enforces the HPA by having Designated
Qualified Persons and/or Veterinary Medical Officers inspect horses at events. Any suspect cases should be reported
to the USDA.

Antler removal

This must be done in deer and elk of ages 55 to 65th day. It must be done humanely under proper analgesia.

High mountain disease

Avoid breeding animals affected with high mountain disease (due to genetic component) and try to avoid pastures
with locoweed in mountains over six thousand feet. Do not return animals that have been affected to high altitudes -
it will recur. The prognosis is guarded to poor once signs of cardiac failure have begun. Animals should be moved to
lower altitudes with minimal stressors. The single most useful treatment is thoracocentesis and drainage of pleural
effusion. Prevention is preferable: use genetic screening via measurement of pulmonary arterial pressure (PAP) to
choose cattle resistant to the effects of hypoxia. This is mostly performed on breeding bulls and valuable cows.

Biopsy samples for scrapie

sample of obex tissue is the Post-mortem test of choice for scrapie.


A rectal mucosa biopsy for antemortem

DISEASES SPECIES AFFECTED


FMD Pigs, Cattle
RHINDERPEST Cattle
BLUE TONGUE Sheep
ANTHRAX Cattle, Sheep
VESICULAR STOMATITIS Horse, Cattle, Pig
PSEUDORABIES Pigs

Ancylostoma caninum found in the small intestine. Can be transmitted to puppies via colostrum and milk.
(hookworms) Ancylostoma braziliense can cause cutaneous larva migrans in people that look like raised,
pruritic, tortuous red tracts
Toxocara Visceral & Ocular larval migrans in humans.
(roundworms) found in small intestine of canines. Can be transmitted to puppies via colostrum, milk and
placenta (primary form of transmission). Rx: fenbendazole
Baliscaris procynosis Visceral & neural larval migrans
(Racoon roundworm)
Habronema It is a stomach worm of horses that can lead to catarrhal gastritis. Cutaneous
habronemiasis (summer sores) happens when the larvae of the stomach worms are
deposited in wound or around mucocutaneous junctions, usually by Muscid flies. The
aberrant migration of these larva causes a granulomatous reaction. Lesions are typically in
the lower limbs, medial canthus of the eye or urethral process. Lesions are ulcerative,
nodular with yellow, necrotic foci known as sulfur granules.

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Trichuris (whipworm) typically found in the cecum and large intestine in dogs (rare in cats). Clinical sings include
large bowel diarrhea (frequent urgent defecation of loose watery feces, possibly with
mucus or fresh blood). Can be associated with hypoadrenocorticism-like syndrome
showing hyponatremia, hyperkalemia, azotemia, and metabolic acidosis. It can also cause
cecocolic intussusception. Treatment include fenbendazole, febantel, praziquantel or
pyrantel pamoate
Spirocerca lupi makes reactive granulomas in the esophageal, gastric, or aortic walls. Common in
Southern U.S. and tropical climates. Large granulomas may become neoplastic
(osteosarcoma or fibrosarcoma) and some dogs develop spondylitis or enlargement of the
extremities characteristic of hypertrophic osteopathy. The infection is usually
asymptomatic, but it may cause esophageal obstruction.
Gasterophilus The botflies lay eggs on the hair of the horse forelimbs or shoulders. The horse licks it is
intestinalis stimulating it to hatch and then it goes to the stomach where it stays all winter and cause
few problems (mild gastritis sometimes).
Trichinella spiralis Reportable disease of swine. Can be transmitted by undercooked pork or bear. Treatment
is not practical. Cysts are killed by cooking (137F or 58C) or freezing (-30C for 6 days). Seen
in bottom side image. Use ELISA to confirm it.
Plague caused by Yersinia pestis and carried by Fleas who transmit from wild rodents. Among
pets, think cats with septic abscess. More common in west America.
Cat scratch disease Cat scratch disease is causes by Bartonella genus, especially Bartonella henselae.
Taenia saginata small cysts can be found in undercooked beef.
Taenia solium can be get by ingestion of undercooked pork containing the larvae (taeniasis) or eggs
(cysticercosis).
East coast fever Caused by Theleria parva (Tick borne). Hemiparasite in cattle causing high fever,
lymphadenopathy, dyspnea & death.
Caprine arthritis It is related to lentiviruses, family retroviridae, and is an RNA virus. No vaccine or cure.
encephalitis (CAE) Vertical and horizontal transmission by milk (primarily) and copulation. In adults it causes
the deposition of immunocomplex in the joints (carpus and tarsus) leading to a swollen
and painful joint causing lameness, hard udder/agalactia at parturition and subsequent
decrease in milk production. Kids may have neurological presentation such as ataxia,
hindlimb deficits, paraparesis, +/- head tilt, opisthotonos and circling. Diagnosis by ELISA
and PCR.
Toxoplasmosis It is caused by Toxoplasma gondii. In humans it causes birth defects and that is why
pregnant women should not clean a cat’s litter box, should was raw vegetables and only
eat well cooked meats. Treatment includes clindamycin, sulfadiazine or pyrimethamine
combination
Heartworm caused by Dirofilaria immitis, a nematode transmitted by mosquito and can affect dogs
and cats. See enlarged heart touching the sternum and pulmonary knob as the parasite
likes to live in the pulmonary artery. Diagnostic tests for felines use Heartworm antigen
test as positive test is diagnostic (very specific). For other species, you can use heartworm
antibodies where a negative test is good to rule out ongoing infection (very sensitive). The
modified Knott’s, the capillary hematocrit tube test and the fresh blood-saline preparation
test can be used to find heartworm microfilariae.
No symptoms in humans.
Echinococcus cestode whose definitive hosts are carnivores (dogs, wolves, etc.) and is seen especially in
granulosus sheep, but can infect all domestic animals and humans. Cysts are found in the lungs and
liver.

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Cuterebra spp known as bot fly larva or Berne (Portuguese). Causes verminous myelitis in felines. Rabbit
cuterebrae are less hostspecific than other types and are usually associated with dog and
cat infestations.
Hypoderma Leads to the formation of warbles, larval cysts in the subdermal tissue on the back of cattle
and sporadically in horses kept near cattle.
Cochliomyia reportable as it has been eliminated from North America. Causes an obligatory myiasis as
hominivorax it primarily invades normal flesh.
(screwworm myiasis)
Chorioptic mange Chorioptic mange (leg mange) also known as scratches, greasy heel, and dermatitis
verrucosa is seen in the image in the side. It usually affects cattle but can be found in Draft
horses (most common mite) and small ruminants. Clinical signs in cattle include pruritus
and crusts around the caudal thighs and perineum. In horses’ clinical signs are usually
hyperkeratosis and scaling on the caudal aspect of the pastern. Treatment include
ivermectin pour-on, 0.25% crotoxyfos spray or lime-sulfur dips weekly for 4-6 weeks.
Calci virus Contact transmission
Pthiris pubis Non reportable human public lice
Tularemia Tularemia is caused by Francisella tularensis and humans can be infected from rabbits or
rodents when eating undercooked meat. Tularemia in humans varies from localized illness
to fulminant septicemia. Necropsy in infected rabbits shows starry sky, pale, necrotic foci
on the dark congestive liver.
Campylobacter jejuni No symptoms in poultry
Enterocolitis in humans
Necrotic rhinitis By swine needle teeth.
Fusobacterium necrophorum
West Nile virus Cats (and alligators!) can get West Nile virus by eating infected prey. Since introduction to
the U.S. in 1999, West Nile Virus (WNV) has been seen in horses, corvid birds (crows), and
humans. WNV is most commonly spread by the bite of an infected mosquito (vector). Cats
can be infected by eating infected prey (small mammals, birds).
Horses, humans, and most other mammals are considered "dead-end" hosts - i.e., they do
NOT develop sufficient viremia to pass the infection back to another mosquito. The CDC
has a nice image of the transmission cycle of WNV.
There have been a limited number of reported cases of WNV in dogs, camelids, sheep,
farmed alligators, and wild squirrels. Interestingly, alligators are susceptible to oral
transmission and develop a sufficient viremia to amplify the virus and serve as reservoir
hosts.
Dorsal displacement of When the soft palate covers part of the epiglottis. Look for the classic gurgling expiratory
the soft palate noise and exercise intolerance. DDSP can be caused by upper respiratory inflammation,
congenital epiglottic hypoplasia or be idiopathic. Treatment can be surgical which include
epiglottic augmentation or tie-forward procedure or conservative with rest,
antiinflammatories topically and systemic
Rabies Zoonotic and reportable that can affect any mammal! It has two forms the furious and the
paralytic. Bovines usually have a more prominent paralytic form. Tests include: look for
the Negri corpuscle, biological proof and direct immunofluorescent. Animal bite animal
cases: Exposed and unvaccinated animals should be euthanized or vaccinated and keep on
isolation quarantine for 4 months (dogs and cats) or 6 months (ferrets). Animals that have
a document, but overdue vaccination should receive an immediate booster and be keep
under owner control for 45 days under observation. Animal bite Human cases: confine 10-
day observation and vaccinate at 11th.

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Brucellosis: also known as undulant fever. Reportable and zoonotic disease that affects all domestic animals. It is
transmitted through ingestion of contaminated milk, food, water, and secretions. Abortion only once, at second half
of gestation (around 7 months) and with a thickened, leathery placenta is very characteristic. Other clinical signs
include stillborn, weak calves, retained placentas and reduced milk yield. Can survive 2 months in cool/moist
environment and hours under direct sunlight. Vaccination should be done in all heifer calves between 4-12 months of
age. Vaccine increases resistance but does not protect 100%. Males are usually not vaccinated. Vaccine Strain RB51 is
a live vaccine that is less virulent in humans, is less abortigenic in cattle and does not generate antibodies that cause
positive response in serological tests. Strain 19 vaccine is more virulent and result in antibodies that may confuse
diagnostic testing. Brucellosis ring test (BRT) is a dairy-herd test for screening that has a high false positive. If BRT is
positive, the vet needs to draw blood from each individual animal and do serological tests. Market cattle testing (MCT)
is an individual beef cow test. Positive animals should be tracked to herd of origin and the entire herd is tested.
Serology agglutination at dilution of 1:100 (nonvaccinated) and 1:200 (vaccinated between 4-12months) is considered
positive animals. Positive animals are culled. Brucella melitensis: vaccine Rev-1 or Strain H38 (killed vaccine). Causes
Malta fever in humans that had contact with infected placental and fetal tissues, ingested unpasteurized milk and
cheese, or ate undercooked meat.

Brucella vaccine details


RB51 Live Brucella abortus Less virulent, less antigenic
Strain 19 Live Brucella abortus More virulent, more antigenic
Rev 1 Live Brucella melitensis
Strain H38 Killed Brucella melitensis

Anthrax: caused by Bacillus anthracis and leads to sudden death in humans and animals. Reportable disease and
Federal Veterinarian should be called! Do not do necropsy as the spores may infect the veterinarian and the
environment. Carcass should be buried with lime or incinerated. Clinical signs include sudden death and carcass with
absence of rigor mortis and dark blood coming out of orifices. Treat remaining animals with penicillin. Vaccinate in
high-risk areas.

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VENOMOUS SNAKES
coral snake • Hemolysis
• lower motor neuron paralysis
• mental depression
Clinical signs can progress extremely rapidly (within minutes)
to the point of respiratory paralysis, necessitating mechanical
ventilation. But the onset of clinical signs can be delayed up
to 36 hours!
Coral snake bites are far less common than pit vipers
(rattlesnakes, copperheads, cottonmouths) due to their
limited geographic distribution.
Onset 36 hours
Pit viper coagulopathy
rapid, severe swelling around the bite.
Onset 15 minutes

Pit viper coagulopathy


rapid, severe swelling around the bite.

Pit viper coagulopathy


rapid, severe swelling around the bite.

Rattlesnakes can be found almost anywhere in the U.S.

Think "Red-on- yellow, kill a fellow. Red-on-black, a friend of Jack" to remember which shakes are poisonous.

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