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NAVLE Questions2 And Answers.
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NAVLE Questions2 And Answers.This is Sacrococcygeal dysgenesis, an inherited trait in Manx cats. Look for dysgenesis,
agenesis of sacrum or other spinal column abnormalities.
May present asymptomatic or with palpable lumbosacral abnormalities and LMN hind
limb signs. (Hopping or crouched gait). May see nonprogressive urinary or fecal
incontinence, chronic constipation.
Sequelae include recurrent urinary tract infections, megacolon.
NO treatment.
Follow this link to see the original Merck image.
Refs: Pasquini's, Tschauner's Guide to Small Animal Clinics, vol 1, 2nd ed. p. 537, and
the Merck Veterinary Manual online edition. -
\What is wrong with this picture?
A - Pelvic fracture
B - Tail root avulsion
C - Left acetabular fracture
D - Megacolon
E - Sacrococcygeal dysgenesis
This is the clinical picture of Pericardial effusion. Note the spherical "Balloon heart".
Follow this link to see a DV view of pericardial effusion. RX of choice is
pericardiocentesis.
Ascites, distended jugulars suggests RIGHT congestive heart failure (CHF), more than
left CHF (pulmonary edema, crackles, wheezes, cough).
Cor pulmonale is just another name for right CHF due to pulmonary hypertension.
Dilated cardiomyopathy (DCM) should be on your DDX. More likely to hear systolic
murmur, arrhytmias, less likely to be muffled heart sounds. ECHOCARDIOGRAPHY
resolves DDX between pericardial effusion, DCM and Peritoneopericardial hernia.
Refs: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 288-9, 1052-3,
Tschauner/Pasquini's Guide to Sm An Clinics, 2nd ed. pp. 230-32 and the Merck
Veterinary Manual online edition. -
\An 8-year old German shepherd is presented with a 1-month history of cough, labored
breathing and lethargy. He has fainted a few times after exertion.
,Upon physical exam pallor and a slow capillary refill time is noted. The dog has jugular
distension, diminished, quiet heart sounds, ascites and weak, variable femoral pulses.
T=102.0 F (38.9 C)..[N=99.5-102.5 F]
HR=140 bpm...........[N=80-120]
RR=24 brpm...........[N=15-34]
A thoracic radiograph reveals the following.
What is the clinical diagnosis?
A - Peritoneopericardial hernia
B - Dilated cardiomyopathy
C - Congestive heart failure (left)
D - Pericardial effusion
E - Cor pulmonale
These are ventricular premature complexes (VPCs).
You had better be thinking the dog is in early stages of Dilated Cardiomyopathy (DCM).
According to Merck, 9th ed. "...ventricular premature contractions on a routine ECG in a
presumed healthy DOBERMAN Pinscher or BOXER is HIGHLY SUGGESTIVE of
CARDIOMYOPATHY".
Echocardiography is the test of choice for definitive diagnosis of DCM.
Remember this mnemonic for DCM breed predispositions: "DCM in a BOX" (ie:
"D_obes, C_ockers, M_assive dogs (giant breeds), in a BOX_er"
ALWAYS FATAL. Death usually in 6 to 24 months after Dx. WORSE Prognosis in
DOBES, generally survive less than 6 months from Dx.
Ref: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 210-1 and the Merck
Veterinary Manual online edition. -
\During a routine dental cleaning under isoflurane anesthesia on an 8-year old male
neutered Doberman, the ECG monitor shows the following pattern.
The dog is stable and doing fine. What is this pattern?
A - Atrial fibrillation
B - Ventricular premature complexes
C - Atrioventricular (AV) block
D - Accelerated idioventricular rhythm
E - Sinus arrhythmia
,The preferred answer is canine pyometra.
Pyometra is a life-threatening emergency which typically requires immediate surgery
(ovariohysterectomy) if the cervix is closed and there is no obvious discharge. Open
cervix pyometras are likely to present with a purulent discharge, simplifying Dx, but
surgical ovariohysterectomy is still STRONGLY recommended.
Pyometra should always be near the top of your DDX when presented with an older
intact female dog or cat with a fever and distended abdomen.
Follow these links to see a pyometra radiograph in a Norwegian Elkhound and to see a
pyometra ultrasound in a cat.
Refs: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 1164-5 and the Merck
Veterinary Manual online edition. -
\A 7 year-old intact female poodle is presented. The owner has noted a lot of drinking
and some urinary accidents in the house in the last week and that the dog hasn't
seemed herself either.
Yesterday she vomited twice. On physical exam the dog appears depressed and
listless, has dark injected mucous membranes and a distended tender abdomen.
T=104 F (40 C)..[N=99.5-102.5 F]
HR=100 bpm.....[N=110-120]
RR=30 brpm......[N=15-34]
What diagnosis is of most immediate concern?
A - Pyometra
B - Intestinal foreign body
C - Hepato-splenic tumor
D - Diabetes mellitus
E - Pregnancy
Antihelminthics are the treatment of choice.
This is ascarid (roundworm) infestation and these are classic "milk spots"- liver scars
left by migrating ascarid larva traveling to the lungs. In heavy infestation, larvae can
cause pulmonary edema, consolidation, severe respiratory distress. May see icterus.
Follow this link to see another image of milk spots. A fecal exam would show eggs that
look like this.
Rx with antihelminthics, like benzimidazoles, ivermectin, pyrantel, levamisole. May need
antibiotics to treat secondary bacterial pneumonia, but primary Rx is antihelminthics.
Lincomycin is a lincosamide antibiotic used in pigs against mycoplasma pneumonia.
, Clorsulon is used to treat liver flukes in cattle and sheep. Click here to see an adult
ruminant liver fluke, Fasciola hepatica.
Click here to see a fluke egg.
Refs: Plumb's Vet Drug Handbook, 7th ed. pp. 753-60, 809-12, 778-9, 1183-4, 1520
and the Merck Vet -
\If the following image is seen on necropsy, what would be recommended as a
treatment plan for the remaining group of pigs?
A - There is no effective treatment
B - Clorsulon PO, all animals
C - Lincomycin IM, underweight animals
D - Decrease non-protein nitrogen in diet
E - Antihelminthics
This puppy has a laryngeal foreign body near the far left edge of the images. A small,
round, mineral opacity is observed within the larynx ventral to C2 on the first lateral
projection. This is a good example of why a radiographic review must encompass the
ENTIRE image, including the periphery.
The patient became dyspneic at this point and was administered oxygen.
There is a second round mineral opacity within the descending colon.
A small seed was removed from the upper airway using endoscopy.
Click here to see normal canine thoracic radiographs.
Refs: Cote, Clin Vet Advisor 2nd ed. pp. 1295-97 and the Merck Veterinary Manual
online edition. Radiographic interpretation and images courtesy, Dr. A. Zwingenberger
and Veterinary Radiology. -
\A 3-month-old French bulldog is presented with respiratory distress and vomiting.
Based on the radiographs shown below, which of the following choices is the most likely
diagnosis?
A - Laryngeal foreign body
B - Normal radiographs
C - Cranio-ventral aspiration pneumonia
D - Vascular ring anomaly
E - Hiatal hernia with gastric displacement
12-18 months after the initial outbreak, sows are usually no longer transmitting the
Porcine reproductive and respiratory syndrome (PRRS) virus, so segregated early
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