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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. - CORRECT ANSWERS 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.
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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. - CORRECT ANSWERS 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".
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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. - CORRECT ANSWERS 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.
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Refs: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 1164-5 and the Merck
Veterinary Manual online edition. - CORRECT ANSWERS 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.
