Destistry review for BCSE

• Terminology

Periodontium: include the gum, the tooth root, cementum, the periodontal ligament 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.

Dentin: provides a physical barrier against bacteria.

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.

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.

• Instruments

Sonic dental scalers: NO heat buildup. Do not used in the same spot for more than 5 seconds or
it will damage the tooth and enamel.

Piezoelectric scalers: least traumatic, but builds up heat. Less frequency

Magnetostrictive: more frequency. Heat build up

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

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.

• Technique

Parallel radiograph technique: is used for mandibular premolars and molars.

 Occlusal radiograph technique is best to evaluate nasal disease and identifying tooth remnants.

Bisecting radiograph technique minimizes the image distortion that occurs because of an
inability to place the x ray film parallel to the central axis of a tooth. If not used  tooth appear
artificially foreshortened or elongated. For  maxillary teeth + mandibular canines & incisors

• Physiology

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: 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 is 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. The tooth 109 (first
molar) is the first to erupt between 9-12
months of age.

Sections "cut" parallel to numbered

dashed lines show wear patterns of occlusal
surfaces in terms of approximate horse age.
Labels: E, enamel (white); D, primary dentin
(yellow); I, infundibulum (funnel-shaped,
enamel fold, or infolding, at top of incisor,
mostly filled with cement (C); the part at the
top is unfilled, or filled with food particles
("cup"), lower portion filled with cement
(enamel ring and enclosed cement core
referred to as the "mark"); in transverse
cross section the wall of the infundibulum
appears as an enamel ring, section 9; P, pulp
cavity (filled with secondary dentin to protect
nerves and blood vessels from exposure); S,
dental star (transverse cross section of pulp cavity)

• Pathologies

Periodontal disease: approximately 80% of dogs

and 70% of cats will have periodontal disease by 3
years of age. It is a general term that includes gingivitis
and periodontitis.

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.

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.

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

Fluorosis is the major cause of bovine enamel hypoplasia.

 Physiology Review for BCSE

• Terminology

Pain is an unpleasant sensory and emotional experience caused by actual or potential tissue
damage.

Domain  Kingdom  Phylum  Class  Order  Family Genus  Species. So in Phipecephalus

rossicus, Rhipicephalus is the genus and rossicus is the species.

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.

Plantigrade stance means stand in 2 legs and is done by bears, rabbits kangorroos, raccoons,
mice, opossums, pandas and others.

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.

• Embrionoly

Ectoderm: forms the nervous system, tooth enamel, posterior portion of the vagina, vestibule ,
epidermis, linings of mouth, anus and nostril, sweat glands, hair and nails (hooves). The adrenal gland
if formed from the Rathke’s pouch.

Mesoderm (middle of the 3 germs): Forms the circulatory, skeletal, muscular and urinary systems.
Gives rise to connective tissue, anterior portion of the vagina, notochord, blood, bone
marrow, lymphoid tissue, lymphatic vessels, body cavities, gonads (sex organs), genital ducts and
adrenal cortex.

Endoderm: gives rise to the epithelium (tissue that covers, or lines, a structure) of the pharynx,
the larynx, endocrine organs, trachea, lungs, the gastrointestinal tract (except mouth and anus), liver,
the urinary bladder and the urethra.

• Cell

Nucleus: transcribes DNA

Nucleolus: transcribes RNA

Rough endoplasmic reticulum (RER): used ribosomes to synthesized proteins.

Smooth endoplasmic reticulum (SER): produced lipids and steroids

Goldi 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.

Bacteria: Fimbria is for bacterial attachment and flagella for bacterial motility.
 • Skeletal System

Osteocytes are found within lacunae of mature bone and are derived from osteoblasts.

• Cardiovascular System

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 seminular
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 (remanant of the
fetal ductus arteriosus), 7. Aortic Arch, 9. Brachiocephalic
trunk, 10. Right atrium auricle, 11. Left atrium auricle, 13.
Pulmonary veins.

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 relaxes
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 represent the repolarization period of the atria and can only be seen in horses.

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.

For more information: http://cal.vet.upenn.edu/projects/anestecg/index.html

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 needs 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.

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.
Cat 120–140
Sinus arrhythmias is Dog 70–120
normal in dogs and horses, Chicken (adult) 250–300
abnormal in cats. Heart and Dairy cow 48–84
pulse rate increase slightly Horse 28–40
with inspiration and decrease Ox 36–60
slightly with expiration. Pig 70–120

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

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

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.

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

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 is seen with Sick Sinus Syndrome (SSS).

• Respiratory System

Hemoglobin is the substance is the RBC that attach to oxygen and one it attaches to 4 oxygen
molecules is call Oxyhemoglobin.

Diaphragm: when you exhale the diaphragm relax (high pressure) and when you inhale the
diaphragm contract (low pressure).

Cheyne-stokes breathing pattern: characterized by fast breathing, slowing down and then no
breathing. It happens when there is damage to respiratory centers of the brain.

• Gastrointestinal System

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 secretes
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 (fundus 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 cause the
fundus to relax and increase contraction of the
antrum. Sympathetic stimulation decreases motility.
 The outside layer of the ruminant
compartments of stomach look 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.

The image in the side shows reticulum

and the omasum.

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 mix 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 aminoacids 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. The image in the side is the colon.

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.

• Urinary

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/duck 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.

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

Bladder is made of 3 layer: 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).

• Reproduction (BCSE GOLD)

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.

Gonadotropin release hormone (GnRH): secreted by the brain and starts the estrous cycle.

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.

Luteinizing hormone (LH): release from the anterior pituitary and stimulates testosterone
production by leydig cells. Trigger ovulation in female birds by stimulation of the grafin follicle.

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).

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.

Estrogen: dilate and relax the cervix before labor.

Oxytocin: promoted milk letdown in a lactating animal and promotes uterine contractions.

Induced ovulators: 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 6-7 Zonary and
Canine 62-64
months. Estrus in dogs lasts 9 days. endotheliochorial
Seasonally polyestrous and induced ovulators. Zonary and
Feline 65
Estrus lasts from 6-7 days (range 1-10 days). endotheliochorial
Unseason polyestrus. Cycle every 21 days. Estrus Diffuse and
Swine 114 lasts 2-3 days. Guilts (young female pig that did not Epitheliochorial
give birth) and sow (adult pig).
279 (dairy) Cotyledonary and
Bovine Unseason polyestrus. Cycle every 21 days
292 (beef) Epitheliochorial
Diffuse and
Equine 335-342 Seasonally polyestrous. Estrus cycle lasts 7 days.
Epitheliochorial
Seasonally polyestrous. Cycle every 21 days and Cotyledonary and
Goats 150
estrus last 2-3 days. Epitheliochorial
Seasonally polyestrous. 17 day estrous cycle and Cotyledonary and
Sheep 150
estrus last 1-2 days. 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.
Guinea
65-68 days
Pigs

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 feel at 30-35 days and fremitus can be feed at 90-
120 days.

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 than 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 means 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 for 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. Hippomanes are flattened rubbery masses found free floating in the allantoic cavitiy of mares
and cows. They are not pathologic.

Species Comments
Musculocavernosus penis. Spermatozoa should be more than 80% morphologically
Canine normal and 70-80% 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 descent
Feline
prenatally.
Fibroelastic penis with sigmoid flexure. Barrow is a castrated male pig. Boars are intact.
Swine Have a preputial diverticulum that produces an odor attractive to sows. Boards have
Vesicular gland, Prostate and bulbourethral gland.
Bovine Fibroelastic penis with sigmoid flexure.
Musculocavernosus penis. Equine 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.

Copulary 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 spermhead 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.

Epididymides is where the later maturation of the head, tail and midpiece occur and where
spermatozoon gains motility.

• Endocrinology

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 substanses 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, Prolacting inhibiting factor (PIF) and Growth
hormone-releasing hormone (GHRH). Somatostatin inhibit the secretion of growth hormone,

Pituitary gland is divided into anterior pituitary, posterior pituitary and the pas 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 mesoderma 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 responsable for increase in renal Na reabsoption, K secretion and H
secretion.

Adrenal Medulla produces Noerpinephrine 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.

• Neuro

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).

Sensory nerve receptors: thermoreceptors, photoreceptors, mechanoreceptors, chemoreceptors

and nociceptors (receptors of painful stimuli). Nociceptor are free nerve ending on C and A-delta
type fibers. The other receptors are C-fiber (unmyelinated) with high threshold stimuli. A-beta fibers
respond to tactile stimuli such as, Ruffini’s (stretch), Meissener’s (vibration and motion), Pacini’s
corpuscles (vibration) and Merkel’s disks (light pressure)

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

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.

Innate reflex action is a supper fast motor response to startling stimulus that is controlled by the
spinal cord and is perceived by the brain.

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 is 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.

The PNS include the Cranial nerves (CN) that can have a Sensory (S) function, Motor (M) function
or both (B).

Cranial nerves (CN): 1. Olfactory nerve (S), 2. Optic Nerve (S), 3. Oculomotor Nerve (M), 4.
Trochlear nerve (M), 5. Trigeminal nerve (B), 6. Abducens (M), 7. Facial Nerve (B), 8.
Vastibulocochlear Nerve (S), 9. Glossopharyngeal Nerve (B), 10. Vagus nerve (B), 11. Spinal Accessory
Nerve (M) and 12. Hypoglossal nerve (M).

Hint for the Cranial nerves name: On Old Olympus Towering Tops A Fat Vested German Viewed
Some Hops

Hint for the Cranial nerve function: Some Say Marry Money, But My Brother Says Big Brains Matter
More

Oculomotor nerve controls 4 out of the 6 muscles that moves the eye. The trochlear nerve controls
just 1 muscle of the eye. Trigeminal nerve is the biggest CN and it branches into 3 main strands and
innervates the face and jaw muscle. The abducens stimulates some of the eye muscles. The facial
nerve allows for facial expressions and lacrimal and salivary glands. The vagus nerve controls the heart
and digestive tract among other functions. The Spinal accessory nerve deals with movement of the
head and neck. The hypoglossal nerve allows swallowing and vocalization.

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.

Pyramidal system controls skilled muscle movement.

Extrapyramidal system helps support the body against gravity (posture) and recruits spinal
reflex to initiate voluntary movement.

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.

• Immunology

Type I (immediate hypersensitivity): allergic reaction due to IgE and histamine. Present in atopic
disease and anaphylactic reactions.

Type II: Antigen binds to cell surface and marks it to be destroyed. Present in IMHA,
thrombocytopenia, Babesia infections, streptococcus equi and mycoplasma haemofelis.

Type III: Immune Complex deposition. Present in membranoproliferative glomerulonephritis,

Lupus and hypersensitivity peritonitis.

Type IV (delayed hypersensitivity reaction): Cell mediated! Granulomatous reactions, allergic

contact hypersensitivity, keratitis sicca and autoimmune thyroiditis or adrenalitis.

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.

• Canine and Feline

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

• Bovine

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.

Volatil 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 (postparturient 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 are an excess fiber.

• Small Ruminants

Ammonium chloride: decrease urine pH and decreases risk of obstruction urolithiasis.

Feeding long stem forages instead of pelleted rations decreases the rist 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.

• Chickens

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.

• Exotics

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. https://www.youtube.com/watch?v=6xamxeKSQUU

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

• Viral Physiology

Antigenic drift: combination between hemagglutinin and neuramidase that creates new strains in
influenza virus of all species.
 Pharmacology Review for BCSE
• Terminology

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.

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.

Tachyplaxis: 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).

× Anti-histamine

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 astemizole

× 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-Angiotensin-
Aldosterone system. The drugs usually are Angiotensin-converting Enzyme (ACE) inhibitors or
Angiotensin II receptor blockers (ARBs). ACE inhibitors include: Benazepril, Enalapril and Captopril.
ARBs inhibits include: Losartan, valsartan and candesartan.

• Steroidal anti-inflammatory drugs

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 is 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).
 Drugs: short action (<12h): hydrocortisone and cortisone, Intermediate action (12-36h)
prednisone and prednisolone and Long action (>36h): betamethasone, dexamethasone and
flumethasone.

Budesonide is a glucocorticoid used in inhalant preparations for asthma or orally in prednisolone-

intolerant patients. Other glucocorticoids include Triamcinolone.

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

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

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

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.

Derivatives of Aminonicotinic 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.

• Antiparasitics

3 types: Ectoparasiticides, Endoparasiticides and Endectoparasiticides

Endoparasiticides include Benzimidazoles, Imidazothiazoles, Tetrahydropyrimidines, Piperazine,

Praziquantel and Epsiprantel.

Endectoparasiticides include Avermectin and Milbemycin.

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.

× 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 (eg, vomiting, diarrhea, salivation,
bronchoconstriction, increased bronchial secretions), nicotinic signs (eg, muscle tremor and twitching),
and CNS signs (eg, 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

× Formamidines

Amitraz is the only formamidine used as an ectoparasiticide. Toxic effects can be reversed with
Atipamezole. It should not be used in toy breeds.

Mode of action: act by inhibition of the enzyme monoamine oxidase (MAO) and as an agonist at
octopamine receptors. Monoamine oxidase metabolizes amine neurotransmitters in ticks and mites,
and octopamine is thought to modify tonic contractions in parasite muscles. Therefore, amitraz causes
nervous system depression and it inhibits egg laying activity.

Amitraz has a relatively wide safety margin in mammals; the most frequently associated adverse
effect is sedation, which may be associated with an agonist activity of amitraz on α2-receptors in
mammalian species. In horses it inhibits the P substance causing ileum and large intestine gas bloat.

Amitraz is available as a spray or dip for use against mites, lice, and ticks in domestic livestock. It
controls lice and mange in pigs and psoroptic mange in sheep. In cattle, it has been used in dips,
sprays, or pour-ons for control of single-host and multi-host tick species. In dipping baths, amitraz can
be stabilized by the addition of calcium hydroxide and maintained by standard replenishment methods
for routine tick control. An alternative method involves the use of total replenishment formulations in
which the dip bath is replenished with full concentration of amitraz at weekly intervals before use.
Amitraz is contraindicated in horses.

Amitraz can cause hyperglycemia so use carefully in DIABETICS. Maybe toxic to cats and rabbits.
Must be used with caution in TOY breeds not GIANT breeds.

× 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.

× Neonicotinoids

Drugs of interest: dinitrofuran, imidacloprid, and nitenpyram.

Mode of action: act as agonists on the postsynaptic acetylcholine receptors in insects. This inhibits
cholinergic transmission, resulting in paralysis and death.

× 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.

× Isoxazolines

New class! They have a potent insecticidal and acaricidal activities.

Mode of action: specifically block arthropod ligand-gated chloride channels.

Afoxolaner and fluralaner are currently the only two compounds approved for use in veterinary
medicine. Both are unique in that they were the first oral flea and tick products. The compounds are
readily absorbed after oral administration and provide 4–12 wk of insecticide and acaricide activity.

× Spinosyns

Drug of interest is Spinosad that is used to control a wide variety of insects, including flies and
fleas.

× Insect Growth Regulators (IGR)

These compounds inhibit the development of immature stages of insects. They are generally
classified as either juvenile hormone mimics (insect growth regulators) or as chitin synthesis inhibitors
(insect development inhibitors). Juvenile hormone mimics include Methoprene, fenoxycarb, and
pyriproxyfen. Chitin inhibitors include lufenuron.

× Diminazene Aceturate

Antiprotozoal drug that is very effective against babesiosis (B bigemina and B bovis). Highly toxic
effects such as salivation, muscle tremors, hepatic, renal and cardiac degeneration

Mode of action: it interferes with the DNA synthesis of the parasite.

× Imidocarb Dipropionate

Antiprotozoal that is very effective against anaplasmosis (A. marginale) and babesiosis.

Mode of action: Causes vacuolization of parasitic cytoplasm, reduction of ribosomes and nucleus
dilation.

× Nitroimidazoles

Nitroimidazoles is a group of drugs that have both antiprotozoal and antibacterial activity.
Nitroimidazoles with activity against trichomonads and amebae include metronidazole, tinidazole,
nimorazole, flunidazole, and ronidazole.

Metronidazole and nimorazole are effective in treatment of giardiasis, whereas dimetridazole,

ipronidazole, and ronidazole control histomoniasis in poultry. Several nitroimidazoles have activity
against trypanosomes. Metronidazole, ronidazole, and other nitroimidazoles are active against
anaerobic bacteria. Extra-label use of nitroimidazoles is prohibited in food animals in the USA.

× Miscellaneous
 Amprolium: used to treat coccidiosis, most commonly used in cattle, pigs and chickens. Prolonged
usage can cause Thiamine deficiency.

• Antibiotics

× β-Lactam antibiotics

Include the penicillins and the cephalosporins.

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.

Bactericidal and time dependent. Works in gram positive, gram negative and anaerobes (broad
spectrum antibiotic).

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 gram-
negative organisms.

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

- Penicillins

Penicillins are divided into subclasses based on chemical structure (eg, penicillins, monobactams,
and carbapenems), spectrum (narrow, broad, or extended), source (natural, semisynthetic, or
synthetic), and susceptibility to β-lactamase destruction.

Narrow Spectrum Broad Spectrum Extended Spectra

Active against anaerobic
organisms and many
β-lactamase- gram-positive, but only a
sensitive limited number of gram-
Penicillins negative bacteria. Eg:
Penicillin G
(benzylpenicillin)
Oxacillin, Cloxacillin,
β-lactamase-
Dicloxacillin,
protected
Flucloxacillin, Methicillin,
penicillins
Nafcillin And Temocillin
Carbapenems
Active against many gram-
Carbenicillin,
positive and gram-negative
Ticarcillin, Piperacillin,
bacteria. Include
Azlocillin and
aminopenicillins, such
Mezlocillin
as ampicillin and amoxicillin
Clavulanate-potentiated
amoxicillin, ticarcillin,
Sulbactam-potentiated
Ampicillin and Tazobactam-
potentiated Piperacillin.
Imipenem, meropenem and
Aztreonam.

- Cephalosporins and Cephamycins

Generation Drugs Spectrum Susceptibility

Cephaloridine, Active against many gram-
Susceptible gram-negative
Cephapirin,Cephradine, positive bacteria, but are
1st bacteria include Escherichia
Cefadroxil, Cefazolin only moderately active
coli and Proteus, Klebsiella,
and Cephalexin against gram-negative
 organisms. Ineffective Salmonella, Shigella and
against enterococci. Enterobacter spp
Ineffective against
Cefamandole, Active against both gram-
enterococci, Pseudomonas
Cefotiam, Cefachlor, positive and gram-negative
2nd aeruginosa, Actinobacter spp,
Ceforanide, Cefoxitin bacteria. They are relatively
and many obligate anaerobes
and Cefuroxime resistant to β-lactamases.
(cefoxitin is an exception).
Ceftiofur,Cefotaxime, Active against many gram- Ineffective against
3rd Ceftazidime and positive bacteria and are Pseudomonas or other
Cefovecin moderately active against problematic coliforms
gram-negative organisms.
Cefepime and Associated with culture
4th They are relatively resistant
Ceftazidime results.
to β-lactamases.

× 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 anti-
acids. 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 keratoconjuntivitis sicca, type 1 and 3 hypersensitivity, hepatitis, hemolytic anemia,
urticaria, hematuria and bone marrow depression in dogs.

Sulfonamides for standard use include: Sulfathiazole, Sulfamethazine (Sulfadimidine),

Sulfamerazine, Sulfadiazine, Sulfapyridine, Sulfabromomethazine, Sulfaethoxypyridazine,
Sulfamethoxypyridazine, Sulfadimethoxine, and Sulfachlorpyridazine

Sulfonamides for Urinary tract infection (highly soluble) include: Sulfafurazole and Sulfasomidine.
They can cause crystalúrea.

Sulfonamides for intestinal infection (poorly soluble) include: Sulfaguanidine, Phthalylsulfathiazole,

Succinylsulfathiazole and Salicylazosulfapyridine (Sulfasalazine).

× 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, eg, Brucella spp. However, it
can cause damaged cartilage in young animals.

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

Orbifloxacin.

× Aminoglycosides
 Bactericidal and concentration dependent. Does not suffer biotransformation and is eliminated
in its active form in the urine. Not well absorbed in the GIT (strong base).

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 gram-
negative aerobic bacteria. Gentamicin, tobramycin, amikacin (synthesized from kanamycin),
sisomicin, and netilmicin are aminoglycosides with extended spectra that include Pseudomonas
aeruginosa.

Resistance occurs by impaired transport, impaired ribosomal binding, enzymatic modification of

aminoglycosides, increased concentration of divalent cations (especially Ca2+ and Mg2+), which act to
repel ionized drug from the microbe, and increased production by P aeruginosa mutants of the outer
cell membrane protein, H1, resulting in resistance to gentamicin.

Toxic effects are rare as mammals have 40S and 60S subunits. However, high IV doses can cause
bradycardia, nephrotoxicity, ototoxic and neuromuscular blockage.

In cases of botulism, avoid Gentamicin due to neuromuscular blockage.

× Macrolides

Bacteriostatic and time dependent, but can be bactericidal at high concentration. Active against
most aerobic and anaerobic gram-positive bacteria.

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.

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, chlamydiae, 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 (eg,
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.

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.

× Miscellaneous

Polymyxin B at low doses can bind to endotoxins in horses circulation. It also has an anti-tumor
necrosis factor activity.

Mechanism of Cidal or Time or

Drug Spectrum Comments
Action Static Concentration
Chloramphenicol Binds to 50S Gram Static Time Bone marrow
ribosomal positive, depression in
subunit and Gram humans. DO not use
interferes with negative in food animals.
protein and
synthesis. Anaerobes
Vancomycin Interferes with Gram Cidal Time Usage is limit to
cell wall positive organism resistant
synthesis to other
antimicrobials
Rifampin Inhibits RNA Gram Cidal Concentration Main indication is R.
polymerase Positive equi pneumonia in
foals.
Metronizadole Breakage of Anaerobes Cidal Concentration Neurologic side
DNA and effects (weakness,
protozoa ataxia, vestibular
signs) and anorexia

• Antivirals

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 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
Zidovudine Variety of Granulocytopenia and
is inhibition of RNA-dependent
(AZT) Retroviruses anemia are the major
DNA polymerase (reverse
 transcriptase). Therefore, it is 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.

• Antifungals

Factors that contribute to fungal infection include necrotic tissue, a moist environment, and
immunosuppression. Fungal infections can be primarily superficial and irritating (eg, dermatophytosis)
or systemic and life threatening (eg, 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.

More information: http://www.merckvetmanual.com/pharmacology/systemic-

pharmacotherapeutics-of-the-integumentary-system/antifungals-for-integumentary-disease

• Diuretics

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
longterm management of CHF.
 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.

• Cardiac drugs

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.

× Positive inotrope drugs

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.

- 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 bradyarrhythmias (eg, 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 Pimobendan.
 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.

Pimobendan is a positive inotrope and balanced systemic arterial and venous dilator. Causes
minor increase intracellular calcium concentration and myocardial oxygen consumption.

× Vasoactive drugs

Divided between arterial dilators and venous dilators.

- Arterial Dilators

Hydralazine directly relaxes the vascular smooth muscle in systemic arterioles by inhibiting
calcium fluxes into the cell or by increasing local prostacyclin concentrations. Hydralazine has no effect
on systemic venous tone.

Calcium channel blockers are also class IV antiarrhythmics, negative inotropes (an adverse
property), and positive lusitropes (drugs that improve relaxation of cardiomyocytes).

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.

- Arterial and Venous Dilators

Nitroglycerin, an organic nitrate, relaxes vascular smooth muscle. However, the dosage
of nitroglycerin used clinically results in predominantly venous dilation and preload reduction.

Nitroprusside is one of the most potent vasodilators available as it reduces preload (venous
dilation) and afterload (arterial dilation) in a dose-dependent manner. Advantages
of nitroprusside include potency, rapid onset of action, and short half-life. The main disadvantage is
that it must be administered by CRI.

- 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.

× Antiarrhythmics

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 (see above).
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.

× Hematinics
 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.

× Anticoagulants

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.

× Heartworm drugs

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.

• GI tract Drug

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).

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.

• Endocrine Drugs

Sulfonylurea (oral hypoglycemic agent) for uncomplicated diabetic animals with no history of
ketoacidosis.

Insulin drugs: 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.

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.

Mitotane: use to treat hyperadrenocorticism (Cushing’s) in dogs

Methimazole: use to treat hyperthyroidism in cats.

• Antianxiety drugs

Alprazolam: is GABA potentiation drug used to treat behavior issues. Usually used to moderate
anxiety in the urine spraying cat.

• Reproductive drugs

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.

• Feed Drugs

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.

• Chemotherapies

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.

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.

• Dermatologic Drugs

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 includes focal
calcification in the heart and muscle.

Oclacitinib: Janus kinase inhibitor; used for allergic dermatitis. Common side effects include
gastrointestinal upset, vomiting, inappetance, 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.

• Diseases caused by Wrong drug usage

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,
phenulbutazone, 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.

• Drug Calculations (BCSE)

1. 8%= 80mg/ml
2. 1mEq/L=1 mmol/L
3. How much sterile water to add to a 25g bottle to make it 8%?
80mg – 1Ml
25000mg – Xml
X = 321.5ml
4. 30cc = 1oz
5. 1cc=1ml
6. 1kg=2.2lb
7. How much an animal should eat? Formula Kcal/day= (30× body weight in kg) + 70
8. 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.

• BCSE GOLD
1. Lots of toxic effect, remember TWO TOXIC T’s – Tetracycline and Trimethoprim-Sulfa (TMS).
2. Drugs that are ok to use in Hamsters, guinea pigs and rabbits are: Trimethoprim Sulfa,
Chloramphenicol and Enrofloxacin (remember ETC).
3. Rabbits, hamsters and other rodents are very sensitive to enterotoxemia, so antibiotics that
mess with the gut flora can be lethal.
4. Tilmicosin (Milcotil): use in feed only! Injection may kill you and the animal.
5. Sulfamethazine cannot be used in lactating dairy cattle.
6. Doxycycline: can cause esophageal stricture in feline patients
7. Atropine and Glycopyrrolate: cause mydriasis
8. Pilocarpine and Demecarium bromide: causes miosis.
9. Drugs that cannot be used in farm animals: Chlorphenicol, Furazolidone, Diethylstilbesterol and
Estradiol cypionate. Fluorquinolones, Glycopeptides and Cephalosporins (not including
Cephapirin).
10. Drugs and receptors

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

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.
 Clinical Pathology
• Hematology

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

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

Bovine RBC 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.

Complete Blood Count (CBC): Is the red blood cells (RBC) and White Blood Cell (WBC).

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.

Test Tubes: Purple top (EDTA), Green Top (heparin), Blue top (Sodium Citrate), Red Top
(coagulation accelerator), Yellow top (separating gel) and gray top (sodium fluoride)

EDTA: It lyse 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.

Sodium Fluoride: Inhibit glucose breakdown, so it is used to measure glucose and lactate.

Sodium Citrate: Reversible calcium chelate.

Heparin: Used for RBC of birds and reptiles. Inhibits thrombin that converts fibrinogen in fibrin.

Serum protein: calculated by globulins (like antibodies) plus albumin.

Chronic inflammation in large animal is shown as hyperfibrinogenemia, hypergammaglobulinemia

and hyperglycemia.

• Erythrogram

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.
 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.

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. It can be seen in the side image! 

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.
Seen in the side image.

 Smudge cells are cells that have been damaged when
excessive pressure is used during the process of creating a blood
smear.

Inclusion Bodies:

1. Howell Jolly: indicative of regenerative anemia, common

in felines.

2. Heinz bodies: can be seen in ghost cells after

the damaged Hb is denaturated. 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.

• Leukogram

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.

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.
 Hypersegmented Neutrophil: neutrophils with more than 5 segmentations. It is an indicative of
vitamin deficiency (B9 and B12), chronic inflammation and megaloblastic anemia.

Left shift: indicates that immature (nonsegmented) 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.

Toxic Change: are indicative of inflammation. They will

includes 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 (eg, 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 (Thrombocyte)

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).

Blood coagulation test include PT and PTT (aPTT)

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 cross-match: determines the presence of preexisting isoantibodies in recipient plasma

that could produce adverse reactions.

Minor cross-match: determines the presence of preexisting isoantibodies in 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.

Total Volume of Blood: Dogs (77-78ml/kg), cats (62-68ml/kg), horses (62-108ml/kg) and
ruminants (66-78ml/kg). An animal can safely donate 20% of its blood total volume.

Total volume of blood: 8% of Body weight in horses.

• Chemistry

EDTA and Sodium citrate cause enzymatic reactions that affect the chemistry tests. Therefore, you
should use a red top tube for chemistry.

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.

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 increase 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.

• Blood Gas Analysis

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.

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

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.

Herbivores have alkaline urine and carnivores have normally acidic urine. Anorexic animals have
acidic 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.

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

Calcium oxalate Dihydrate

crystals: look like square
diamonds and can be found in
normal urine.
 Calcium oxalate MONOhydrate crystals: look like lozenges and
sometimes can be seen in 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.

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.
Ammonium biurate crystals: Found in animals with portosystemic vascular anomaly (shunts)
 • Cavity Fluids

Chylothorax is an obstruction of the thoracic duct that leads to accumulation of chyle in the
thorax.

Characteristics Transudate Modified Transudate Exudate

Clarity Clear Clear to slightly opaque Opaque
Color Clear to faint amber Variable Variable
Odor Odorless Odorless Variable
pH Alkaline Alkaline – Acid Acid
Protein <2.5g/dl 2.5-3g/dl >3g/dl
Density <1.014-1.018 >1.018-1.025 >1.025
Coagulation Negative Variable Usually positive
Until 1500cell/µl in dogs >1500-5000 cell/µl (dogs) >5000cell/µl (dogs) and
Cell Count
and 5000cell/µl in horses. and >5000-10000 (horses) >10.000cell/µl (horses).
Neutrophils,
Mesothelial and Variable including
Predominant macrophages, some
mononuclear. Up to 60% mesothelial, macrophages,
Cell Types mesothelial and
neutrophils in horses. neutrophils and neoplastic
neoplastic.
Bacteria Absent Absent Usually present
-Portal hypertension -Right sided congestive -Septic Inflammatory
Common secondary to hepatic heart failure -Aseptic inflammation
Causes insufficiency -Intestinal disturbances in -Intestinal disturbances
-Severe hypoalbuminemia equines in equines

• Vaginal Smear

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 signs 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).
 • Tumors

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.
Seen in the side image.

Lymphoma: Originates in solid tissue (spleen, lymph nodes and

thymus) and bone marrow. Image in the side/corner.

Plasmacytoma: Round, eccentric nuclei with dense

chromatin; bi- and trinucleate cells are common and
characteristic. Image bellow. Marked pleomorphism.

Transmissible Venereal Tumor (TVT): Abundant

cytoplasm contains distinct clear vacuoles.

Spindle cell tumors of the skin and subcutis include:

Fibroma/equine sarcoid/fibrosarcoma,
Hemangioma/Hemangiosarcoma,
Lymphangioma/lymphangiosarcoma, Hemangiopericytoma,
Melanocytoma/benign dermal melanoma/malignant
melanoma, Lipoma/liposarcoma and Myxoma/myxosarcoma

Leukemia: Originates from blood circulation and bone marrow. They arise from myeloid cells
(monocytes, basophils, eosinophils, megakaryocytes and erythrocytic precursor cells).
 • Bacteria, Virus and Parasites

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).

Bacterial culture media examples: MacConkey, Trypticase soy, Triple sugar, Blood agar,
Chocolate agar.

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.

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.

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).

× General

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.

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

× Exotics

Leucocytozoon spp.: 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

× Small Animals

Babesia canis, Ehrlichia canis and Mycoplasma haemofelis in the images bellow.
 × Equine

Neorickettsia risticii: causes equine monocytic eherlichiosis or Potomac horse fever. It is

transmitted by trematodes (flukes).

× Ruminants

Babesia bovis is a red blood cell protozoa of cattle.

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

 Internal Medicine
• Terminology

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. Than, 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

Characterized by a locally extensive swelling, predominately on the head.
Angioedema 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.
Epidemic. It is not seen often and develops suddenly in many different
Epizootic disease
animals at once and it spreads.
Inflammatory
Bradykinin, Phospholipase A2, Cox1, Cox2
Mediators
It is a hospital-acquired infection. Examples include parvovirus, kennel
Nosocomial infection
cough or salmonella typhimurium (horses).
Omphalophlebitis Umbilical infection
Prodromal period It is the period of disease where only mild symptoms are present.
It is the production of antibody in response to an antigen so the animal
Seroconversion
goes from seronegative to seropositive
Also known as hives. Can be immunologic or not and is characterized by
Urticaria
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 Measurement of the eye pressure. In dogs and cats the normal IOP is between
Pressure 15-25mmHg.
“Eye melting” that involves drying and clouding of the cornea. Usually due to
Keratomalacia
vitamin A deficiency.
Nyctalopia Night blindness
OD on the right eye (O. Dexter)
OS on the left eye (O. Sinister)
Bilateral, progressive, chronic, superficial keratitis common in German
Pannus
Shepherds.
Superficial
Vascularization of the cornea.
keratitis
Adhesions formed between adjacent structures within the eye usually as a result
Synechia
of inflammation.
Ophthalmoscope Used examine the eye. GT6VBNµ
 Neurology
Anisocoria Having pupils of different sizes
General neurologic term that refers to an inability to coordinate muscle
Ataxia movements or loss of balance because the animal doesn’t known where its feet
are in relation to the ground.
Flaccid (limp) The limb is flaccid.
Laying the head sideways. Happens with damage to CN8, to the inner ears,
Head tilt
floculonodular node or to parts of the cerebellum.
Loss of cerebral cortical tissue (brain) with CSF filling the resulting cavity and
Hydranencephaly
normal-looking skull.
Accumulation of excess CSF in the ventricles of the brain, usually with
Hydrocephalus
distended/bulbous skull.
Is a deficit of conscious proprioception where the animal does not know where
Knuckling
its foot is in space.
Miotic Pupil abnormally constricted
Mydriasis Pupil abnormally dilates
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
Nystagmus
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
Monosynaptic reflex that tests the integrity of the femoral nerve and the L4-L5
Patellar Reflex
spinal segments.
Syringomyelia Development of fluid cavities in the spinal cord
Tetanic (Stiff) The limb is rigid.
Withdrawal
Tests the sciatic nerve at L7-S1.
Reflex

Cardiorespiratory
Advanced Life
Involved the administer of medical therapies to patients in cardiac arrest.
Support
Initiate immediately! Cardiac compression and ventilation that are started
Basic Life Support
during the initial phase of CPCR.
Decrease respiratory rate. It can also be due to increase intracranial
Bradypnea
pressure.
Characterized by fast breathing, slowing down and then no breathing.
Cheyne-stokes Occurs most often as a result of abnormal CO2 regulation associated with
Breathing 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
Characterized by slow, deep respiratory pattern. Typically indicated
Kussmaul Breathing
respiratory compensation for metabolic acidosis.
Petechiae Small pinpoint hemorrhages on the skin or mucus membranes
Restrictive Fast and shallow breaths typically indicated pleural space disease, such as
breathing pleural effusion or rib fractures.
Silver nitrate Is used to chemical cauterization to stop bleeding.
Suppuration Pus forming process.
Synchronous
Diaphragmatic Also known as Thumps is a respiratory pattern due to hypocalcemia.
Flutter
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
When tube feeding is necessary for weeks to months, usually between 8 to 12
Gastric Tubes
months.
Hematochezia Fresh blood in the feces
Also known as, Jaundice and it is characterized by a yellow-colored skin. It is
Icterus 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 Small stool volume, increase frequency of bowel movements, tenesmus,
Diarrhea dyschezia, hematochezia and mucus. Patients are usually of normal weight.
Dark, tarry stools containing decomposing blood, which is usually an indicative
Melena
of bleeding in the upper GI such as esophagus, stomach and duodenum.
Disorder where saliva accumulates In the surrounding tissues after trauma to
Mucocele
the duct of gland.
Short-term feeding solution for small animals. According to Fossum they can
Nasogastric
stay for several weeks, but according to Merck you can leave them in 1-7 days.
tubes
Usually they can be left for 1 to 3 weeks.
Chronic constipation so severe that the patient is unable to defecate on its own.
Obstipation 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).
Small bowel Large stool volume, normal defecation frequency, weight loss, often watery or
diarrhea soft, odoriferous with flatulence. May be associated with melena or vomiting.
Tenesmus Ineffective and painful straining to defecate and urinate.
Also known as overbite or overshot jaw. It is when the upper jaw (maxilla) is
Brachygnathism
longer than the mandible.
Prognathism Elongated lower jaw. Common in bulldogs. (brachycephalics)

Parasitology
Tapeworm. They release proglottid into the feces. Dipylidium caninum is the
Cestode most common cestode in dogs and cats. Intermediate hosts are fleas and the
definitive hosts are dogs and cats.
Definitive host has the mature form of the parasite and the intermediate host
Life cycle
has the immature form.
Round worm. Intermediate host are mosquitoes and the definitive host are
Nematode
dogs. (HW)
Pediculosis Infestation of lice
Protozoa Diverse group of unicellular eukaryotic organisms
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
Schizonts
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
The mouthpart that penetrates the skin is called the hypostome and it enables
Ticks
the parasite to suck blood from the host.
Flukes. Most trematode eggs are too dense to float and sedimentation
Trematodes 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
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
Excess of nitrogenous compounds in the blood. Can be pre-renal, renal or post-
Azotemia
renal.
Common G+: Staph, Strep and Enterococcus
Pathogens G-: E.Coli, Proteus, Klebsiella, Pseudomonas and Enterobacter.
Dysuria Difficulty during micturition
Nephrotic Is the pathologic presence of hypoalbuminemia, proteinuria,
Syndrome 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 prepucial mucosa
Cryptorchidism When 1 or 2 testis is located into the abdominal cavity.
Paraphimosis inability to retract a swollen penis into the prepuce
Inability to extrude the penis due to constriction at the prepucial orifice. Makes
Phimosis
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
When around a lesion is formed a crusty surrounding.
collarette
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.
Swelling around a single nail bed that can be caused by neoplasia, infection or
Paronychia
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.

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 (BCSE): 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 categorize 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. Keratoconjunctivits 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.

• Fluid Therapy

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.

Determining the Route of Fluid Administration

Per os Gastrointestinal 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,
IV or
patients who need rapid and/or large volume fluid administration (e.g., to treat
intraosseous
dehydration, shock, hyperthermia, or hypotension)
Critical care setting. Used in patients with a need for rapid and/or large volume
Central IV fluid administration, administration of hypertonic fluids and/or monitoring of
central venous pressure

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

Intraosseous catheter can be placed for fluid therapy in neonatal patients and birds. In birds it
should be place in the distal ulna or in the proximal tibiotarsal bone. Remember that the humerus and
femur are pneumatic bones and would deliver fluid to the respiratory system.
 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

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 rapid
Moderate (around 8%)
pulses, enophthalmos
Considerable loss of skin turgor, severe enophthalmos, tachycardia,
Severe (>10%) extremely dry mucous membranes, weak/thready pulses, hypotension,
and altered level of consciousness.

Fluid deficit calculation: Body weight (kg) × % dehydration = volume (L) to correct

Solution types include Colloid and Crystalloid. Colloid have bigger molecules that cannot got 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.

Crystalloids include Sodium Solutions

Chloride 0.9% (Physiological saline), Hypotonic 0.45% saline, 5% dextrose
Lactate ringer, 5% dextrose and 7.5% Isotonic Lactate ringer, Normosol-R, 0.9% solution
saline (HSS). Hypertonic Hetastarch, Vetstarch

Colloids include plasma, RBC, hetastarch, vetstarch, dextrans, Hydroxyethyl starch (HES).

Lactate ringer solution (LRS) is an isotonic, balanced, electrolyte crystalloid solution useful for
patients with metabolic acidosis as it has an alkalizing effect. The osmolality and concentration of
sodium, chloride and potassium are similar to plasma.

Sodium: in cases of Hypernatremia the decrease in serum sodium concentration does not exceed
1mEq/L/h and does not exceed 24mEq/L/day.

Potassium: should never be supplemented IV at a rate over 0.5mEq/Kg/hour. Adverse cardiac

effects can occur above this rate.

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 administer over following 12-24 hours.

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 at
Diarrhea (often hypersecretory with great loss of
Calf 100ml/kg for first 4-6 hours.
water and bicarbonate)
Dextrose maybe added.
Urethral obstruction: patient is usually
IV saline. Avoid Lactate ringers and
General hyperkalemic, hyponatremic, hypochloremic and
Normosol-R.
acidotic.
General Resuscitation 7% saline (hypertonic solution)
Vomiting patients with low chloride and
General 0.9% saline
metabolic alkalosis
• Blood Transfusion
 Blood transfusion volume (ml) = [Weight (Kg) × Blood volume (ml/kg) × (desired PCV-actual
PCV)]/ Donor PCV

• CPR

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.

• General Treatment

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).

• General Diseases

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.

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.

Bronchogenic cysts (congenital bullae) are multiple thin walled air filled lucencies throughout
the lungs. Rupture can cause pneumothorax. Differentiate from emphysema and infectious.

Brucellosis (BCSE): 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 positives. If BRT is positive, the vet need 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) are 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 cause 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 include 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 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 trigger 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.

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

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 increase 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.

Dermatophilosis (rainrot) (BCSE): 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 include antibacterial
shampoo and environmental management. Severe affected
horses can be treated with penicillin. The image in the side shows
the rainrot.

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!

Diskospondylitis: 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%),

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).

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 (BCSE): 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 (BCSE): 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.

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 (BCSE): 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).

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.

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.

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 (BCSE) 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.

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.

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.

Pulmonic stenosis: usually a systolic murmur heard mostly in the left side between the 2nd and
4 intercostal space. It can cause right ventricular hypertrophy. It is genetic link in beagles, but
th

miniature Schnauzers, Chihuahuas, Cockers and Boxers have also a predilection.

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 burnetii. 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 (BCSE): 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.

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.

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.

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 (BCSE): 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 a anaerobic
environment (usually necrotic tissue) where the bacteria develops, 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 include 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 (BCSE): 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.

• Canine

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 (bravecto) 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 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 (BCSE): 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-to-mild 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-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. Labwork will indicate marked anemia,
thrombocytopenia and proteinuria. Class IV (also called post-caval or caval syndrome) is an acute,
shock-like 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 unthriftiness. 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 nightblindness (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 animal
may develop kidney problems due to inflammation and
deposition of immune complex.

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.

• Feline

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
include tetracycline, usually doxycycline and predinosolone (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 (high 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 Syncytical virus: Retroviridae

Feline Infectious Peritonitis (FIP): from the family Coronaviriae. 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, diabetis mellitus and pancreatitis. Treatment include 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.

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 (BCSE) is seen in the side image. Remember black-brown coffee ground
debris in the ear canal of a cat with pruritic ears and head-shaking. 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. Example:
http://www.merckvetmanual.com/multimedia/zk/v4739218

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 include clindamycin, sulfadiazine or pyrimethamine combination.

Urethral obstruction look 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.

• Equine

Acute colitis and diarrhea causes 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 Culicoide 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
tarsometartarsal 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 veneteral 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 (BCSE): antemortem test of choice is the IgM capture ELISA.
The most common Togaviridae family virus in the US are: 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.

Equine degenerative myelopathy/ecephalomyelopathy 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 (BCSE): 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) (BCSE): 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.

Hock has 4 compartments: tibiotarsal, proximal and distal intertarsal and tarsometatarsal. The
tibiotarsal and proximal intertarsal almost always communicate and the distal intertarsal and
tarsometartarsal rarely communicate. The stifle has 3 compartment. The equine carpus (aka Knee)
has 3 compartments.

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 treat 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
produce 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!

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) (BCSE): 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 include
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.
Example:
https://www.youtube.com/watch?v=gVaQqQp7OhQ

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.
 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.

Tendon damage (BCSE):

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 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 sesamoidian
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.

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 include
Thoroughpin (tarsal sheath of the deep digital flexor tendon proximal to the tarsus) and Bog spavin
(tibiotarsal joint).

× Foals

Foals as immunologically naïve, but are capable of producing antibodies at birth. Normal foals
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.

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 toxicoinfectious 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.

Uroperitonium 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.

• Bovine

Abomasal displacemement 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 peracute 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 veneral 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 (BCSE): 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.

Diarrhea
E. Coli Less than 4 days old, multiple cases
Rotavirus 5 days to 2 weeks, self-limiting and multiple cases
Coronavirus 4 to 30 days, multiple calves
Early diarrheas
Enterotoxemia (C. 2 weeks, healthiest, fast growing, hemorrhagic
perfringens type c) diarrhea with sudden death
Cryptosporidia 1-4 weeks, diarrhea, tenesmus and emaciation.
1-2 months, with fever, diarrhea, septicemia, sudden
Salmonella
death
Later diarrheas
Older than 21 days and all ages, bloody diarrhea,
Coccidiosis
tenesmus

Enteritis: usually caused by Salmonella spp.

Enterotoxemia 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.

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 include 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 die 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
of 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) (BCSE): 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 (BCSE): 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 include
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 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, inappetance 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 (BCSE): 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 include 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.
 Thrombotic meningoencephalitis (TEME) (BCSE): 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, inappetance and ill thrift. Treatment involve 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.

• Small Ruminants

Bluetongue (BCSE): 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)

(BCSE): 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 tend 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 encephalomyelitis (Louping ill) is caused by a tick-transmitted

ovine encephalomyelitis virus (Flavivirus). Affected sheep may bound or leap in a
characteristic louping manner.

Ovine progressive pneumonia (OPP): related to lentiviruses

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 depend 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.

Scrapie (BCSE): 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).

• Swine

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, pin point 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 peracutely. 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
unthriftiness.

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 vary with the pig’s age and can be neurologic, respiratory and
gastrointestinal. Clinical signs include 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 payers 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 stillborns/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 include 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.

• Poultry

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 animals 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 alphaherpesvirus. 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 alphaherpesvirus 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

• Exotics

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 hyperstrogenism and bone marrow suppression too.

Hyperestrogenism: 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.

Lead and zinc toxicity in caged birds leads to biliverdinuria, hepatic disease, urates stain lime-
green 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 include 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 include 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.

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.

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 include 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.

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 dino-flagellate that causes serious health
problems in marine fish and leads to high mortality. It gives fish a gold-brown color.

Vitamin A deficiency in turtles is common and leads to swollen eye, nasal discharge, necrotic
stomatitis, anorexia and ear infections (box turtles). Treatment include 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.

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 include formalin or copper sulfate every 2-3
days for at least 3 weeks.

• Congenital Diseases

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.

• Autoimmune Disease

Immune
Diseases
Hypersensitivity
Type I Vaccine reaction, allergies
Type II Autoimmune hemolytic anemia, Pemphigus, Myasthenia gravis
Glomerulonephritis, Hypersensitivity pneumonitis (think moldy hay), Purpura
Type III
hemorrhagica (think post-strangles), anterior uveitis
Lymphocytic choriomeningitis, Keratitis sicca, autoimmune thyroiditis, Contact
Type IV
hypersensitivity, transplant rejection, tumor immunity

Pemphigus: rare, autoimmune skin disease characterized by varying presentation of ulceration,

crusting, pustules and vesicles. Type II reaction where antibody binds to antigen on a cell which activates
complement, causing cell damage. Can be Pemphigus foliaceus, phemphigus vulgaris and bullous
pemphigoid.

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.
Tensilon test example: https://www.youtube.com/watch?v=k7YX9kuWrxA

• Endocrine diseases

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:

1.1. Water deprivation test: due to medullary washout (loss of the gradient between renal
medullary interstitium and urine) you must deprive the animal from water before ADH
test.
1.2. 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, Pot-belly, 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 include 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 include Methimazole (block thyroid hormone synthesis). Curative treatment include 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.

• Neurological Diseases

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 reflex 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
veneral tumor (TVT). HINT: they all are present in the skin and can be easily identified by cytology.

Ameloblastomas 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.

Chemodectoma: tumor of the carotid and aortic bodies.

Histiocytoma 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.

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 trigger 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.

• Bacterial Disease

Gram Positive Gram Negative

Listeria, Streptococcus, Bacillus, Staphylococcus, E. Coli, Pseudonomas, Brucella, Pasteuralla,
Nocardia Coxiella burnetii

• Parasitic Diseases

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.

× General

Coccidiosis (BCSE): 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-coccidials 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 host-specific than other types and are usually associated with dog and
cat infestations. (Side image side/bellow).

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.

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 Tse-Tse flies or other biting flies. Seen in the side image.
 × Small animals

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 is 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 (Amblyoma 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 include a combination of atovaquone and
azithromycin, but some animals remains persistently infected. Seen in side image.

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. Seen in side image.

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 dog develop spondylitis or enlargement of the extremities characteristic of
hypertrophic osteopathy. The infection is usually asymptomatic, but it may cause esophageal
obstruction. Seen in side image in red.

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. Seen in side image bellow.

Taenia taeniaformis: cats can acquire it from eating wild rodents.

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.

× Equine

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.

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).

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.

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. Seen in side image.

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
is 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.
 × Bovine

Cryptosporidium: clinical signs include emaciation and watery diarrhea in a 1-4 week old calf. Stain
red with Ziehl-Neilson stain. Seen in side image.

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 swin out into the fluid and
settle to the bottom.Treated with ivermectin family, fenbendaole, albendazole and levamisole. Seen in
side image.

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: (seen in side image) 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 unthriftiness. Seen in side image.

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

Argas persicus (fowl ticks or poultry tick): 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.

• Fungi

Aspergillosis (BCSE): narrow, hyaline, septate and

branching hyphae. Usually a nasal presentation in dogs.
Seen in the side image.

Blastomycosis (BCSE): 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). Seen in corner
image.

Coccidioidomycosis (BCSE) 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. Seen in the
bottom image.
 Dermatophytosis (Ringworm) (BCSE): 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.

Microsporum canis: spindle-shaped, thick,

walled, more than 6 cells present, with
paintbrush-like structures at their ends seen in
the side image.

Tricophyton verrucosum seen in the

bottom picture.

Histoplasmosis (BCSE): 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.
Smear in seen in the side image.

Sporothrix schenckii (sporotrichosis) results from direct inoculation from skin wound or
inhalation. Clinical signs include lymphocutaneous, cutaneous or disseminated form of disease. Highly
zoonotic.
 Radiology Review
• Technique

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.

Key components of x-ray exposure include: focal-film distance, Milliampere-seconds and

kilovoltage.

X-ray films should be stored at vertical position, in a cold room with low humidity.

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

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

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.)

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 relatively low contrast
between viscera and adipose tissue.

Thorax x-ray: high kVp

Bone x-ray: lower kVp and higher mAs setting. (Not so sure).

Blurring: might be caused by poor film-screen contact, patient movement or poor centering of
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 fall 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 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 bubble in 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.

Hair clip: should be done to decrease ultrasound reflection, because hair traps air.
 • Machinery

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 produces radiograph 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.

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. 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 decrease production of scatter radiation. It improves

safety and image quality.

Low voltage electrical circuits: provide 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

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 wave line across the screen, is used for echocardiography.

Linear array ultrasound probe for rectal palpation.

• Terminology

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: structure that produce 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 appear black in the radiograph. Air is radiolucent.

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

Radiology Finding and Treatment

• Thorax

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

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

silhouettes.

Alveolar pattern: air bronchograms.

Vascular pattern: can suggest either hypervascularity or hypovascularity.

Hypovolemia: 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.

Pneumothorax: notice dark airspace below the lungs, between them and the chest wall. 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 (BCSE): 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 VD view.

http://www.merckvetmanual.com/multimedia/v4730657 : Shows tortuous pulmonary arteries and

increased sternal contact.

http://www.merckvetmanual.com/multimedia/v4730666 : Reverse D

• Abdomen

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.

• Skeleton

Ringbone: is exostosis (bone growth) in the pastern or coffin joint of a horse, associated with
periostitis and osteoarthritis. High ringbone occurring on the lower part of the large pastern bone or
the upper part of the small pastern bone. 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.

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).

Fracture straight across cartilage of physis. Also known as capital physeal

S Straight
fracture.
A Above Fracture above physis
 L Lower Fracture below physis in the epiphysis
T Through Fracture through metaphysis, physis and epiphysis
R 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 non-uniform appearance of the image.

Overexposure causes disappearance of soft tissues surrounding bones.

 Anesthesiology Review for BCSE
• Terminology

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.

Electrical defibrillation: shocks stops all cells in the heart simultaneously which allows the
pacemakers cells to regain control of myocardial contraction.

Pre-emptive analgesia: to intervene prior to an expected event or consequence of pain.

Akinesis Motor paralysis.

Allodynia Pain response to stimuli that are not normally painful
Signs include restlessness, agitation, vocalization and lack of response to
Dysphoria
surrounding or interaction with caretakers.
Hyperalgesia Heightened response to painful stimuli
Hypercapnia Means excess carbon dioxide (CO2) in blood.
Hypertension MAP above 160mmHg small animals and 150mmHg in large animals.
Hypoalgesia Decreased response to normally painful stimuli
Hypotension MAP is bellow 65mmHg. Usually caused by deep anesthesia.
Hypoxemia Mean low blood oxygen.
Neuropathic Caused by damage to neural tissue and is usually present in chronic cases of pain.
pain You can use gabapentin to treat NP.
Transduction (nerve ending), transmission (nerve body), modulation (dorsal horn of
Pain the spinal cord), projection (thalamus and brainstem) and perception (cerebral
cortex).
Pathologic
response that is heightened beyond that needed to protect the patient from injury.
pain
Physiologic Protective response to an actual or potentially damaging insult. Also called
pain nociceptive pain.
Visceral pain Stretching, tension or inflammation of viscera.
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
Wind up
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.

• Pre Anesthetic Medication (PAM) (BCSE)

Adverse Do not use /

Drug Group Drug Name Action
effects Reverse With
Mild
Decompensated
tranquilization,
cardiac patients,
Phenothazine Acepromazine, reduction of motor Vasodilation,↓AP,
animals with
(GABA Chlorpromazine, activity, mild ↑CO (comp),↓RR,
sepsis or
potencialization) Methotrimeprazine sedation, ↓ ST, ↓ Temp.
hypothermic
antiemetic and
patients.
antiarrhythmic.
RW: Flumazenil
Anxiolytic, Not analgesic,
Do not use
Benzodiazepines Diazepam, myorelaxant, agitation,
diazepam in
midazolam hypnosis (LA) and paradoxical
patients with liver
anticonvulsive. effect
failure.
↓ CO, ↓ HR,
hypotension,
Α-2 agonists Dexmedetomidine, Deep sedation, RW: Yohimbine or
↓RR, bradycardia
Xylazine analgesic (DD) Atipamezole
,vomit and
salivation.
 Atropine in
↓ salivary and
Anticholinergic Atropine, horses.
respiratory Decrease GI
(Blocks Scopolamine, Scopolamine in
secretion, ↑ HR, motility
muscarinic) Glycopyrrolate cats.
mydriasis,
Animals with KCS.
Morphine, ↓ HR, ↓ RR (DD),
Fentanyl, ↑ Histamine
Analgesia,
Opioids Tramadol, release, vomit RW: Naloxone
sedation,
Butorphanol, and
Methadone, constipation.

Meaning: Reverse with (RW), Arterial Pressure (AP), Cardiac output (CO), Respiratory Rate (RR), Heart
Rate (HR), Seizure threshold (ST), Temperature (Temp), Compensatory (Comp), Large animals (LA),
Dose Dependent (DD), KCS (Keratoconjunctivitis sicca).

Acepromazine: Antagonizes dopamine receptors in the brain. Causes mild sedation, vasodalition
(alpha-1 blocker) and hypotension. 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.

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.

Opioids: like hydromorphone can cause dysphoria is healthy patients. Dysphoria is treated with
tranquilizer or sedatives such as acepromazine or dexmedetomidine, respectively.

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.

• Injectable Anesthesia

Group of Drug Names Effects Adverse Effects Do not Use

Drugs
Significant respiratory
↓ intracranial Pregnant
depression, apnea,
Propofol pressure, ↓ animals as it
Alkylphenol bradycardia and decreased
(GABA) CNS causes fetal
cardiac contractility. Not
metabolism, depression.
analgesic!
CNS
Not analgesic! Fetal
depression, Animals with
Etomidate depression, adrenocortical
- maintenance of sepsis or
(GABA) depression and immune
hemodynamic pregnant.
system depression.
parameters.
Perivascular
Peripheric Can cause heart arrhythmias
injection
vasodalition, (usually ventricular
Thiopental, causes
↑HR bigeminy), temporary apnea
Barbiturates Methohexital necrosis.
(transitory) after injection and
Causes ileum
and ↓ AP . respiratory depression.
in horses.
Pentobarbital Euthanasia drug! Causes respiratory depression.
 Thiopental: extremely fat soluble and is metabolized by the liver! Do not use in fat patients or
greyhounds (not enough fat and horrible liver)

Methohexidal: 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.

• 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), broncodilator, ↑ HR and ↑ Cardiac
output. Can cause seizures and respiratory depression at high doses. Ketamine provides a good
superficial analgesia, but poor visceral analgesia.

• 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: Desflurane, Sevoflurane, Isoflurane and Halothane.

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.

Desflurane: Extremely low solubility, has the fasted induction and recovery.

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.

Methoxyflyrane: 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 dissipate to gas compartment. Do not use in horses as it can cause post-operative colic.

Refill the anesthetic machine when fewest people are in the clinic.

• Anesthesia Monitoring

Pain response: ↑ AP (main), ↑ HR, midriasis, ↑ temperature and ↑ RR (more rare).

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).

• Anesthetic Breathing Circuit

More detail: http://www.capnography.com/new/breathing-circuits/anesthesia-breathing-circuits-

functionality

A typical circular anesthetic circuit is composed of: Pressure regulator, flowmeter, vaporizer,
patient, CO2 canister. Pressure regulator decreases the pressure of gas leaving the pressured gas
cylinder. Flowmeter controls the amount of carrier gas flow. 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.

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 animals metabolic needs, about 5 to 10 ml/kg/min. Never use
nitrous oxide in these 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.

BREATHING SYSTEMS WITH CO2

BREATHING SYSTEMS WITHOUT CO2 ABSORPTION
ABSORPTION.
Unidirectional flow:
Unidirectional flow
a) Non rebreathing systems.
B) Circle systems. Circle system with absorber.
Bi-directional flow:

a) Afferent reservoir systems.

Mapleson A
Mapleson B
Mapleson C
Lack’s system.

B) Enclosed afferent reservoir systems

Bi-directional flow
Miller’s (1988)
To and Fro system.
c) Efferent reservoir systems

Mapleson D
Mapleson E
Mapleson F
Bain’s system

d) Combined systems

Humphrey ADE

Pulse Oximeter: used primarily to measure the oxygen saturation (SaO2) of hemoglobin in
arterial blood and pulse rate.

Capnography: measures CO2. Normal is around 35-45mmHg.

Electrocardiogram (ECG): records heart rate and rhythm.

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 in ferrets, small animals (puppies and kitten)
and in birds as they have a complete tracheal rings.

Oscillometric blood pressure monitor senses the motion of the arterial wall as a blood pressure
cuff deflates.

• Local Anesthesia Drugs

Drugs: lidocaine, bupivacaine, prilocaine, procaine, tetracaine and ropivacaine

Only the non-ionizing form of the drug is effective. The form is pH dependent, therefore is the area
is very acidic (inflammation) you can add a little bit of bicarbonate.

Adrenalin (vasoconstrictior) can be used to decrease absorption.

Intoxication: IV, high doses, increase absorption or wrong application. Clinical signs: irregular
respiration, opisthotonus, bradycardia and PEDALADA.

Lidocaine: Lasts for 1.5-2 hours.

 Bupivacaine: lasts from 4 to 10 hours. Most frequently used for oral surgery.

• Nerve Blocks

Auriculopalpebral: Prevents the horse from blinking. Provides innervation to the upper orbicularis
oculi muscle.

Supraorbital:

Ocular:

Zygomatic:

Frontal:

Cornual block: is necessary for dehorning of cattle. For goats you should also do the
intratrochlear block for dehorning.

Proximal paravertebral block (Farquharson method): placement of local anesthetic just off the
midline and caudal to the transverse processes of T13, L1 and L2 vertebrae. Block nerves T12, L1 and
L2.

Distal paravertebral block: placed above and bellow the

ends of the transverse processes of L1, L2 and L4 vertebrae. Block
nerves T12, L1 and L2.

Palmar digital nerve block (PD or Heel block): blocks the

palmar third of the foot, including navicular bone. In some horses
it blocks 70% 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 (subcarpal block): desensitizes the metacarpal region along with the entire
metacarpophalangeal (fetlock) joint and structures of the digit.

• Other Drugs

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.

• DON’T DO (BCSE GOLD)

1. Atropine in horses causes ileus.
2. Atropine in febrile patients since is crosses the Blood brain barrier and it may interfere with
temperature regulation in the hypothalamus.
 3. Atropine causes thickening of bronchial secretions, so avoid in patients with pneumonia.
4. Acepromazine, Ketamine and xylazine in seizure patients.
5. Thiopental in animals with asthma (cases apnea)
6. Thiopental in Sighthouds (Grey Hounds) because they have low body fat and less efficient liver,
which increases recovery times.
7. Morphine or Ketamine in animals with high intracranial pressure
8. Nitrous oxide (N2O) in horses. Nitrous oxide causes distention of the intestines and may result
in postoperative colic in horses.
9. Ultra-short barbiatuates can cause severe tissue irritation and sloughing if they get outside the
vein when injected.
10. Benzocaine in cats causes methemoglobinemia. Methemoglobinemia reduces the ability of the
RBC to release oxygen to tissues leading to tissue hypoxia.
11. Xylazine makes cats vomit, so be careful! It also causes muscle tremors, bradycardia and
reduced respiratory rate in cats.
12. Ketamine in cats should be associated with ophthalmic ointment, as the eyes stay open when
using this drug.
13. Ketamine in dogs with increase intraocular pressure (like glaucoma).

• Things that can mess with the Anesthesia

Porcine Stress Syndrome (PSS): adverse readtion 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

• Species specific Trades

1. 1-2% Lidocaine spray in cats before intubate to prevent laryngospasm.
2. Pigs are also prone to laryngospasm.
3. Bovines and Camelids continue to salivate under sedation of anesthesia. Put the nose own so
the saliva can drain away from the pharynx.
4. Indirect and direct blood pressure measures DO NOT correlate well in reptiles.
5. Surgical plane of anesthesia usually results in loss of the righting reflex (less reliable in turtles
and tortoises).
6. Corneal and palpebral reflexes cannot be elicited in snakes (they do not have eyelids)!
7. Pulse oximetry values are not absolute reliable in reptiles, BUT can be useful for anesthesia
monitoring.
8. Reptiles should be kept upper limit of their normal temperature range during induction, surgery
and anesthetic recovery to optimize anesthetic metabolism and recovery.
9. Chelonians tent to have long period between breaths, making induction of anesthesia via
inhalants difficult.
Anesthesia is usually
induced with injectables.

• Calculations and
Interpreatation

× ECG in a horse

That animal shows a PVC.

 × Pulse Pressure (PP)

Seen in the side image! 

× Mean Arterial Pressure

(MAP) – Side image

A low MAP results in ischemia

and organ damage if present too
long. Hypotension is MAP bellow
65mmHg

MAP = 80+ (125-80)/3= 95mmHg

Note the dip in BP waveform very close to the mean pressure line on the illustration. This is the
dicrotic notch, which is produced by change in blood flow in the large vessels when the aortic valve
closes.

× Systolic Arterial Pressure (SAP)

SAP is 125-127mmhg

× Diastolic Arterial Pressure (DAP)

DAP is 76-80

× Pulse Rate (PR)

Paper speed is 25mm/sec. Each box has 5mm, therefore the speed is 5 big boxes/sec. There
patient has 16 depolarization (big spikes).

However, there were only 8 ventricular contraction that actually produced a blood flow (a pulse) –
Red arrow.

To calculate the pulse rate you divide the number of sec in 1 min by the amount of seconds in the
paper, and than multiply it by the number of ventricular contractions that created a pulse. Therefore,
Pulse rate= (60/6)*8=80.

These animal has ventricular bigeminy, which is a premature ventricular contraction (PVC) follow
by a sinus beat.
 Surgery Review

• Positioning

× Lateral recumbency: means the animal is lying on the side.

1. Right lateral recumbency: animal lies on its right side. Right side DOWN!!
2. Left Lateral recumbency: Animal lies on its left side. Left side DOWN!!

× Dorsal recumbency: Animal lying belly up

× Sternal recumbency: Animal lying belly down.

• Sterile Technique
1. A double wrapped muslin or crepe paper wrapped surgical pack will last 3 weeks in open shelf,
but it can last for 6 weeks if kept in a clear, closed, dust-free cabinet.
2. Surgeon must put cap, mask and foot covers before scrubbing.
3. Scrubbing should last 5 min or 10-25 brush strokes on each skin surface.
4. Chlorhexidine or povidone iodine solution can be used for scrub disinfectant solution. Typically it
is recommended to do 3 scrubs. Sterile saline or isopropyl alcohol wipes can be used to clean
surgical site between 3 scrubs.
5. Glutaraldehyde is toxic and irritating. It 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.
6. Ethylene oxide (gas sterilization) would be the best way to resterilize suture.
7. Povidone-iodine causes acute contact dermatitis in 50% of dogs and in many horses.
8. Clean surgical instruments with distilled water if possible.
9. The minimum safe standard for autoclave sterilization of surgical packs is 121C (250F) for 13
min.

• Terminology
1. Sterile: Only for instruments
2. Aseptic: skin prepared for surgery. Basically means that the number of bacteria is significantly
reduced to the point where they cannot overwhelm patient’s immunity mechanisms.

• Pre-operative exams
1. Ortolani test: Done to diagnose hip dysplasia.
2. Drawer movement: Indicate cranial cruciate rupture.
3. Thumb test: for coxofemoral luxation. Place thumb in the groove between greater trochanter
and ischial tuberosity and externally rotate femur. If the thumb is pushed OUT of the groove
with normal hip, but stays in groove with luxated hip or fractured femoral head.

• Technique

The holding layer when you are closing the abdomen in dogs and cats after surgery is the external
rectus sheath, because it has connective tissue. The rectus sheath is composed of the aponeuroses of
the 3 flat abdominal muscles (the external and internal abdominal oblique muscles and the transversus
abdominis muscle) as they pass the rectus abdominus muscles.

The linea alba is the cord formed where the aponeuroses from each side join on the ventral midline.
It extends from the pelvic symphysis to the xiphoid cartilage.

The recommended suture patterns to repair tendons include: three loop pulley, Kessler (locking
loop) and Krackow.

• Suture Pattern
1. Cruciate: Appositional suture pattern
2. Gambee: Appositional suture pattern. It is commonly used for intestinal anastomosis.
3. Intradermal/subcuticular: Appositional suture pattern
4. Simple continuous: Appositional suture pattern
5. Simple interrupted: Appositional suture pattern
6. Connell: Inverting suture pattern
7. Cushing: Inverting suture pattern
8. Halsted: Inverting suture pattern
9. Lembert: Inverting suture pattern
10. Parker-kerr: Inverting suture pattern
11. Purse-string: Inverting suture pattern
12. Ford interlocking (Reverdin): Commonly used in areas under tension such as skin, subcutis,
fascia and tendons.
13. Horizontal mattress (U deitado): Everting suture pattern. Commonly used in areas under
tension such as skin, subcutis, fascia and tendons.
14. Vertical mattress (U em pé): Everting suture pattern. Commonly used in areas under tension
such as skin, subcutis, fascia and tendons.
15. Near and far: Commonly used in areas under tension such as skin, subcutis, fascia and
tendons.
16. Three loop pulley: Commonly used in areas under tension such as skin, subcutis, fascia and
tendons.
17. Kessler (locking loop): recommended for repair of tendons
18. Krackow: recommended for repair of tendons
 • Suture Material (BCSE)

Dexon Synthetic absorbable suture made of polyglycolic acid.

Vicryl polyglactin acid
Absorbable PDS Polydioxanone
Maxon Polyglyconate
Catgut Nonsynthetic and is made of sheep intestines.
Silk Nonsynthetic
Steel Nonsynthetic
Non-absorbable Prolene Polypropylene
Ethilon Nylon 6
Vetafil Polymerized caprolactam

PDS and MAXON: retain strength in urine and are recommended for bladder closure surgery.
Vicryl and Dexon are rapidly degraded in alkaline environments and dissolve faster in urine.

• Forceps
1. DeBakey: Has multiple delicate teeth and are good for vascular surgery
2. Brown-Adson: Have intermeshing teeth and are used for suturing and wound closure,
therefore are used to hold tissue.
3. Allis: tissue forceps that have teeth on the gripping and can cause trauma to delicate tissue.
4. Doyen: Long and flat-bladed that is used to hold the bowel.
5. Rat Tooth: Have large interlocking teeth and are used for tough connective tissue and fascia
6. Russian Thumb: Good for needle handling and are hard on tissue
7. Rochester Carmalt: commonly used in stump and pedicle ligation during an
ovariohysterectomy surgery. Great for large vessels.
8. Rochester Pean: commonly used in stump and pedicle ligation during an ovariohysterectomy
surgery.
9. Babcock: least traumatic and best for delicate tissue.
10. Roeder: looks like backhaus clamps, but they have a metal ball welded to the points of the
jaws to prevent tissue penetration.

• Needle Holders
1. Olsen-Hager: needle holder have a scissor to cut sutures.
2. Mayo-Hager: normal needle holder
3. Mathieu: needle holder used for large animals. Does not have rings and the surgeon uses finger
pressure to close or open them.
4. Castroviejo: Needle holder. Does not have rings and the surgeon uses finger pressure to close
or open them.

• Hemostats (Type of Forceps)

1. Kelly: Use to clamp off intermediate size blood vessels
2. Crile: Use to clamp off intermediate size blood vessels
3. Helsted “mosquito” hemostats: are tiny hemostats used to clamp small bleeding vessels.

• Scissors
1. Mayo: Heavy-duty!
2. Metzenbaum: is a dissection scissors that have blades with blunt points for opening up tissue
planes.
3. Lister bandage scissors: have one blunt-ended blade (for slipping under a bandage without
cutting the patient) and one sharp-pointed blade (which goes above the bandage).
4. Spencer scissors: Suture cutting scissors. (Littauer scissors)

• Scalpel
1. Bard-Parker is a handle for disposable scalpel blades.

• Other Instruments
1. Electrocautery: unit that stops bleeding by cauterizing cut blood vessels.
 2. Jacob’s chuck: is 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.
3. Kirscnher wire: smaller version of the Steinmann pin used to pin small bone pieces.
4. Rongeur forceps: Used to break up and remove bone. Inside of each half of the nose is scooped
out and has sharp edge for biting away chunks of bone.
5. Trocar: opens a hole for an arthroscope
6. Periosteal elevator: lifts muscle of bone
7. Osteotome: used with a mallet to cut bone.
8. Curette: like a tiny, sharp ice cream scooper used to scrape hard tissue, like bone and cartilage.
9. Spay hook: Lifts the uterine horn out of the abdomen.
10. Ophthalmoscope: instrument used to examine the eyes.
11. Otoscope: Device used to look into the ears.
12. Frick Speculum: blunt ended metal tube inserted into the cow’s mouth to prevent it from
chewing on the plastic orogastric tube.
13. Surgical Milk: solution that works as a lubricant and rust inhibitor used on surgical instruments
with a working action.
14. Trephine: T shaped tube with sharpened hollow tube-end usually used to remove a bone core
for biopsy.
15. Trocar: used to puncture the rumen in bloat cases. It is also called cannula.

• Wound Healing

First Intention Healing (Appositional Healing or Primary Wound Closure): Suture fresh, clean
wound closed within 6 to 8 hours (golden hour) post injury.

Second Intention Healing: Used for dirty, traumatized wounds where the injury is cleaned and
allowed to contract and epithelialize on its own until closed. The wound should be left open to contract
and granulate. If decided you can close the wound after 3 to 5 days (delayed closure, also called third
intention healing).

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.

• Surgical Procedures

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 to the right.

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 foreign body.

Colpotomy: incision of the vagina.

Triple pelvic osteotomy or Incision of Pectineus Muscle: done for hip dysplasia.

Gastrostomy: should be closed with Cushing over-sewn with lambert.

• 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.

Velpeau bangage: Used for luxated shoulder.

Ehmer Sling: Conservatively treat for hip luxation and is seen in the side image. It is used to
stabilize reduced anterior dorsal coxofemoral luxations in the dog and cat. The sling has the advantage
that it does not immobilize the hip joint, but places the femoral head into a position within the
acetabulum in which it is most stable.
 Robert Jones (with or without fiberglass splint) and typically wrap a repaired cranial cruciate
ligament tear.

The bandage can be used as a temporary dressing for immobilization of fractures and is especially
useful for traumatized extremities with a great deal of swelling or edema. The dressing is also used as
a way of partially immobilizing
joints following reconstructive
surgery of the knee, such as
cruciate or patella surgery. The
principle involved in the fixation
is that of a large bulky dressing
wrapped very tightly to the
extremity, providing supreme
comfort and relative immobility
of the injured site. It is seen in
the image below.

Application of a Robert Jones

dressing. (A) The tape stirrup is
applied to the foot before the
bandage is started. (B) Cotton
roll is wrapped around a
forelimb after the application of
a tape stirrup (see Fig. 15-1 )
(C) Elastic gauze is then applied
to firmly bind the cotton to the
leg. (D) Elastic tape is then used
to complete the dressing.

Schroeder-Thomas Splint

The Schroeder-Thomas splint

can be used to immobilize any
fracture distal to the midfemur
or midhumerus. It is also a useful device for immobilization of joints distal to and including the knee
and distal to and including the elbow. The indications for use of this splint can be extended in the
hands of some veterinarians but to do so requires constant and careful supervision of the animal and
its splint.

A pelvic limb Schroeder-Thomas splint. The finished splint is shown with flattened tilted groin bar.
Tape is applied to keep the traction members from slipping.

Application of a Schroeder-Thomas splint. (A) The bottom sling is placed first, as shown. Following
completion, the combine roll material is taped in place. (B) The process is reversed to apply the top
combine roll to pull the femur forward, thereby applying traction to the tibia. (c) Medial support is
applied to the tibia by continuation of the bandage medial to the tibia.

• Pathologies related to Surgery

Legg-Perthes: Another name is avascular/aseptic necrosis of the femoral head. Usually happens
in young animals (4-11months), small/miniature breed problem presenting with hind lameness.

Paraphimosis: Medical EMERGENCY! The most common cause of paraphimosis is a smaller than
normal prepucial orifice (congenital, traumatic or post-surgical), therefore the penis can’t retract after
mating and the penis will be exposed and constricted. The penis may be dry, swollen, red, cyanotic,
ulcerated and necrotic.
 Preventive Medicine Review for BCSE
• Regulations

United States Department of Agriculture (USDA) has a section called Animal and Plant health
inspection service (APHIS) that enforces the animal 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 and Use Committee (IACUC): self-regulating entity that must be
established by institutions that use laboratory animals. They oversee the care and use of laboratory
animals.

Food animal residue Avoidance Databank (FARAD): have guidelines on withdrawal times in
food-producing animals.

Pasteurization: 140 Celsius or 284 F for 4 seconds (UHT pasteurization).

• Behavior

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 interreption 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.

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 others cats. They are not adequately socialized and may
not know when to stop being aggressive.

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.

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 theirs
handlers.

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.

Carcass from BSE should not be disposed by rendering because the prions are still infective and
rendered material may be used as animal feed.

• Epidemiology

TP = True Positive Diseased Non-Diseased Total

FP = Fake Positive Test Positive A (TP) B (FP) A+B
FN = False Negative Teste Negative C (FN) D(TN) C+D
TN = True Negative 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 (eg: BSE), 2. Diseases where early diagnosis
improved prognosis (eg. HIV in people) and 3. The disease is highly lethal and with severe
consequences for missing (eg. 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)

× Practice Exercise (BCSE)

You screen 1000 cows with a new blood test for bovine spongiform encephalopathy (BSE). You also
send brain tissue to the lab for confirmation (The gold standard). 200 cows were confirmed to have
BSE based on the gold standard test.

- Of the 200 cows with BSE, 190 teste positive on your new test.
- Of the 800 cows without BSE, 4 tested positive.
Calculate the sensitivity, specificity, prevalence, positive predictive value and negative predicted
value. Diseased Non-Diseased Total
Sensitivity: 190/200 = 0.95 Test Positive 190 4 194
Specificity: 796/800 = 0.995 Test Negative 10 796 806
Prev: 200/1000 = 0.2 Total 200 800 1.000
PPV: 190/194 = 0.98
NPV: 796/806 = 0.9875

Therefore, the test will detect 95% of cows with BSE and will miss 5% of cows with BSE. However,
the test will correctly rule out BSE in 99.5% of healthy cows but will diagnose 0.5% of healthy cows
with BSE.

With 98% PPV and 99% NPV, this test is probably a pretty good screening test for the herd. So,
98% of the cattle that test positive truly had the disease and 99% of the cattle that tested negative
were truly disease free.
 • Veterinary Inspection at Slaughter

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.
 Toxicology Review for the BCSE

4-Ipomeanol toxicity (moldy sweet potato): clinically indistinguishable from Acute Bovine
Pulmonary Emphysema and Edema (ABPEE, also known as Fog Fever).

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 (BCSE): 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 include
emesis, activated charcoal, ascorbic acid, n-acetylcysteine and Cimetidine for dogs only! Most
common cat toxicity.

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
unthriftiness. Treatment: take animals off feed and provide an effective binder for aflatoxins, such as
hydrated sodium calcium aluminosilicates (HSCAS).

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.

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
phototoxin. 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. NO
ZUKU

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.

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).

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. NO ZUKU

Benzene hexachloride: highly toxic to cats. NO ZUKU

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. You can see a picture in the side! 

Blue-green Algae: hepatotoxicosis after the ingestion of

cyanobacteria.

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 polioencephalomalacia. 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 include discontinue exposure,
thiamine supplementation and blood transfusion. Picture aside 

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.

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 peracute death.

Carbamates (BCSE): SLUD clinical signs as they inhibit the acetylcholinesterase at nerve
synapses and neuromuscular junction. SLUD: Salivation, Lacrimation, Urination and Defecation.

Carbophenothion: used to control parasites on sheep and a single dose is lethal to cats. NO ZUKU

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 signs
include: salivation, nausea, vomiting, hematochezia, weakness, bradycardia, hypotension, AV block,
collapse and possible death. No antidote, only treat the clinical symptoms.

In the image below we

have Azalea, Lilly of the Valley and Yew, followed by Oleander and foxglove.
 Centaurea spp (yellow star thistle or Russian Knapweed) (BCSE):
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. 

Chlorinated Hydrocarbons: present in insecticides and cause CNS

depression or stimulation (convulsive seizures). NO ZUKU

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.

Copper toxicity (BCSE): 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.

Cottonseed Toxicity: also known as Glossypol toxicity. Iron helps to inactivate free gossypol
pigment. Glossypol is cardiotoxic for cattle, sheep and pigs.

Cyanide (BCSE): 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 include bright red blood (cherry
color), bright red mucous membranes and rumen gas smelling like bitter almond. Treatment
include Sodium nitrite and Sodium Thiosulfate.

Ergotism (BCSE): 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.

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.
 Ethylene glycol (BCSE): 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 8 hours after ingestion or it
is not effective. 20% ethanol IV can also be given within 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).

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.

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.

Fumonisin: a toxin from Fusarium spp causes Equine leukoencephalomalacia and porcine
pulmonary edema (PPE).

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.

Household Cleaners: acids and alkalis that cause caustic or corrosive lesions respectively.
Treatment administer milk or water, GI protectants for several days and monitor for ulcers. Do not
induce vomit or administer activated charcoal.

Hypocalcemia (BCSE): also known as milk fever or parturient paresis. Clinical signs include acute
to peracute, 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 (BCSE): in cattle is present as tetany along with hyperexcitability, ataxia,

convulsions and death. Treatment is IV Ca/Mg combo (like in Milk fever – hypocalcemia).

Kleingrass (Panicum coloratum): produce toxicosis in horses and

ruminants. Sapogenin content (toxic principle). Clinical signs include
icterus, photosensitivity, intermittent colic and fever, weight loss, and
hepatic encephalopathy. Diagnosis: Bilirubin, γ-glutamyl transpeptidase
or transferase (GGT), and blood ammonia concentrations are increased,
history of exposure to plants and multiple affected animals on a farm or
in an area. Affected animals should be removed from the Klein grass
source, fed good-quality hay, and protected from sunlight. Local
treatment of the photodermatitis with antimicrobial or softening creams
may be needed in severe cases. NO ZUKU
Kleingrass 

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.

Locoweed toxicosis (BCSE): 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 worsen the High
Mountain Disease (LOCO = High). High mountain disease has a genetic component and prognosis is good
if the disease is caught early. The plants are also known as vetches or milk vetches.

Lupine spp (BCSE): 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.

Imidacloprid: is a neonicotinoid insecticide that can be applied in dogs and cats. NO ZUKU

Ionophore: Horses are the most sensitive affecting the heart. Clinical signs include anorexia,
colic, stiffness, tachycardia, posterior paresis and increase CK. In cattle toxicity affects multiple
organs, leading to cardiomyopathy and heart failure. There is no antidote.

Marijuana: prolonged sedation, hypotension, bradycardia, hypothermia and mydriasis.

Metaldehyde: active ingredient in molluscicides that causes clinical neurological signs such as
seizures. Treat with diazepam.

Methylxanthine alkaloids (BCSE): such as theobromine, theophylline and caffeine. Present in

chocolate! See excitement, seizures and arrhythmias.

Molybdenum toxicosis (copper deficiency) (BCSE): also causes secondary deficiency in

copper. See ADR (ain’t doin’right) 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).

Mothball toxicity: caused by naphthalene-containing mothballs or from paradichlorobenzene

containing cakes. Clinical signs include GI signs, hemolytic anemia and Heinz bodies.

Mycotoxicoses: 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.

Nitrate Toxicity: present in 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.

Organophosphate toxicity (BCSE): same clinical signs as carbamate. Remember SLUDDE:

salivation, lacrimation, urination, defecation, dyspnea and emesis. Treatment include emesis, activated
charcoal, seizure control (diazepam), pralidoxime chloride (2-PAM) and atropine.
 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 mostly
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.

Paradichlorobenzene: organochloride insecticide that mainly causes CNS signs and is found in
deodorant cakes.

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 (BCSE): 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. 

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 primarily found in kidneys (leading to pale swollen
kidneys and peri-renal edema), liver and gastrointestinal tracks.
Goats are more resistant to oak toxicity. No renal damage in
horses.

Salt toxicosis (BCSE): 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. Sago Palm 

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.

Sorghum (Sudan Grass, Johnson grass, Milo)

(BCSE): 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.
 Stringhalt 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 Lupine
(arthrogryposis in calves) and skunk cabbage (cyclopia in lambs).

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.

Urea toxicity: causes wildly aberrant behavior (bovine bonkers),

tremors and acute death. Treat with vinegar.

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. You can see a picture of the plant in the side.

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.

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.

Zinc toxicity: common in puppies that ate pennies or in birds with galvanized cage wire.

White Muscle Disease (BCSE): 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”.