Canine Feline; Final Review - Part I

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Marytaylor
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244187
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Canine Feline; Final Review - Part I
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2013-11-17 10:57:53
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Canine Feline Vet Tech VTHT 2201
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Brucellosis; Bartonellosis; Heartworm; Systemic Mycotic Diseases; Coccidiomycosis; Blastomycosis; Histoplasmosis; Blood types; Fungus like bacterias; West Nile Virus and Cryptococcosis
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  1. How many stains of Brucellosis are there in a dog and in a cow?
    Etiology of Brucellosis:
    What is one animal that you never vaccinate for Brucellosis?
    • Unique in the dog, since there is only one strain; 19 strains of brucella in the bovine
    • Brucella canis
    • Bulls; you can vaccinate other cattle.
  2. Brucella canis is a gram ________.
    Antigenically reactive with ______.
    • negative coccobacillus
    • Brucella ovis
  3. Dogs in contact with livestock can develop rare infections caused by what 3 etiologies? Are cats affected?
    • Brucella abortus, B. suis, and B. melitensis
    • Cats can be infected experimentally, but are resistant with no signs.
  4. Canine Brucellosis 
    Epidemiology: __% of Dogs Nation & __% South US
    • 2%
    • 7%
  5. What are 4 routes of transmission for Brucella canis?
    How does infection occur?
    • infected semen (venereal), vaginal discharge (at estrus, breeding, and post abortion), aborted fetal tissues, and urine. 
    • By penetration of oronasal, conjunctival, and genital mucous membranes.
  6. The shedding of brucella may occur for periods up to ______ following abortion. Milk of infected bitches contains lower concentrations of the organisms and is less important in transmitting infection to _____ but not to ____. Most have already been infected via the ______. Only way to clear up is to __________. Usually in the ____ of the cow not the meat.
    • 6 weeks
    • surviving pups; calves
    • placenta
    • spray the female and neuter the male
    • uterus
  7. Pathogenesis: a _____ disease, with the greatest number of B. canis organisms being found in the _______________________.
    • venereal
    • lymph nodes, spleen and reproductive tissue.
  8. Canine Brucellosis - Name 4 Location of the bacteria:
    • 1. Uterus (during pregnancy primarily) 
    • 2. Testicles and Prostate 
    • 3. Lymphatics
    • 4. Rarely the eye, kidney, or intervertebral discs
  9. Bacteria of brucellosis in the Lymphatics includes what locations?
    • 1. Lymph Nodes, Monocytes & Lymphocytes
    • 2. Spleen 
    • 3. Tonsils and Thymus
  10. Brucella canis is an ______ pathogen that can persist for years within the ________ of the host.
    Brucellosis is characterized by a bacteremia that begins ______ after infection and can last from ___________. 
    Spontaneous recovery has been reported, but it depends on ____________.
    • intracellular; monocytes
    • 1 to 4 weeks; 6 months to over 5 years
    • cell-mediated immunity
  11. Transmission of canine brucellosis:
    Bitch:  
    Dog: 
    Oronasal transmission via ________ is most common by contact with ______ due to the concentration of the bacteria of millions in one mL
    • Bitch: vaginal discharge
    • Dog: via the semen
    • aerosols; aborted materials
  12. As with brucellosis in other species besides canines, infections with B. canis do not interfere with normal ______. Up to __% of bitches that abort may have normal litters subsequently. However, even after having normal litters, some infected bitches experience intermittent ___________.
    • estrus cycles
    • 85%
    • reproductive failures
  13. List 3 treatments for Canine Brucellosis
    • Brucella organisms are refractory to antibiotics because of their intracellular location.
    • 1. Dog – castration 
    • 2. Bitch – Ovario-hysterectomy (OHE)
    • 3. Tetracycline – limited value.
  14. When treating with tetracycline you always treat with what two antibiotics synergistically.
    Traditionally minocycline combined with dihydrostreptomycin on weeks 1 and 4 with other combinations on weeks 2 and 3.
  15. Canine Brucellosis - List 4 General Abnormal Signs of the Bitch
    • 1. Abortion after 30 days of gestation (45 – 59)
    • 2. Early embryonic deaths and termination of pregnancy
    • 3. Generalized lymph node enlargements
    • 4. Occasionally some litters may be born with some pups alive and some pups dead
  16. Canine Brucellosis - List 2 General Abnormal Signs of the Dog
    • 1. Infertility with sperm 30 – 80% abnormal
    • 2. Epididymitis and orchitis often follow by testicular atrophy
  17. Canine Brucellosis - if animal does recover (rare) it is immune to reinfection but are _______ to susceptible females for life.
    carriers
  18. What are 5 ways to diagnose Canine Brucellosis?
    • 1. Rapid Slide Agglutination Test (RSAT) - An inexpensive, in-office screening test used to identify suspects that need more testing.
    • 2. Tube Agglutination Test (TAT) – provides quantitative titer confirmation of positive RSAT. 1:200 are weak positives
    • 3. Agar Gel Immunodiffusion (AGID) AKA Coggins Test – is a sensitive and specific test for antibodies to the B. canis antigen.
    • 4. ELISA and 5. IFA test used in some state and national laboratories.
  19. Clinical Signs of Canine Brucellosis - Most infected animals have no overt clinical signs. 
    List 3 principal manifestations.
    List 2 less common manifestations
    List 2 rare manifestations
    • Generalized  lymphadenopathy, splenomegaly, and reproductive failure
    • Diskospondylitis and uveitis
    • Fever and systemic illness
  20. Primary Signs of Canine Brucellosis
    Male: 
    Bitch:
    • Male: infertility, orchitis & scrotal swelling epididymitis
    • Bitch: abortion and infertility
  21. Female Reproductive Failures - Brucellosis causes abortion of dead, partially autolyzed fetuses at ______ of gestation without any other signs of illness; persistent discharge for _______ after abortion; and failure to conceive (because of _________).
    • 40 to 60 days
    • 1 to 6 weeks
    • early fetal resorption
  22. What is Brucellosis in humans called?
    Undulant Fever – brucella in humans.
  23. Brucella in People - The incubation period for humans is difficult to determine but has been estimated at ________. Most infections typically become apparent within ____. Brucelloses is a multisystemic disease that can have a broad spectrum of symptoms. Asymptomatic infections are common
    • 5 days to 3 months
    • 2 weeks
  24. Brucella in People - In many patients, symptoms can persist for _______ and are followed by a spontaneous recovery. Other patients develop an intermittent fever with other persistent symptoms that typically disappear and reappear at ______ intervals (Undulant Fever)
    • 2 to 4 weeks
    • 2 to 14 day
  25. Infection in Various Animal Types - Brucellosis is maintain in a limited number of reservoir hosts. Maintenance host include: 
    __________ – cattle, bison, water buffalo, elk, camels and feral pigs
    __________ – sheep and goats
    __________ – sheep (antigenically similar to B. canis)
    __________ – dogs
    __________ – rodents
    __________ – pig.
    • Brucella abortus – cattle, bison, water buffalo, elk, camels and feral pigs
    • Brucella melitensis – sheep and goats
    • Brucella ovis – sheep (antigenically similar to B. canis)
    • Brucella canis – dogs
    • Brucella neotomae – rodents
    • Brucella suis – pig.
  26. Brucella suis contains more diverse isolates than any other Brucella species. These include host specificity for ____________.
    swine, caribou, reindeer and very small mammals.
  27. Bartonellosis is no long considered a self-limiting disease, and for some people chronic infection can be as debilitating and hard to diagnose as Lyme disease. (Note: etiology for Lyme disease is ________, but Borrelia is not Bartonella
    Borrelia burgdorferi
  28. Cat-scratch disease (etiology is __________) was recognized nearly 100 years ago.
    Bartonella henselae
  29. List 4 etiologies of Cat-scratch disease
    • Bartonella henselae,
    • B. clarridgeiae,
    • B. vinsonii
    • B. koehlerae,
  30. ___________ is still considered the most common and identified as the primary universal etiological agent plus it the only etiology that is recognized as “Cat Scratch Disease” _______ is today recognized as the most common etiology in the US. ___ have been identified in the last 20 years.
    • Bartonella henselae
    • B. vinsonii
    • 26
  31. How is Bartonellosis Transmitted? Primarily transmission is through ______. The infected _______ of cats are routes of transmission following a bite or scratch. Persistent intravascular infection in some human individuals can result in a cascade of medical conditions like ________.
    • fleas and the inoculation of flea feces
    • nail beds and saliva/gingiva
    • arthritis, endocarditis, and encephalitis.
  32. Bartonellosis - About _______% of cats carry this disease at some point in their lives. ______ is when we see this disease most commonly
    • 14 – 70%
    • Fall and winter
  33. Geographic Distribution of Bartonellosis - In the US it is the most common in the Eastern states where it represents approx. __% of the isolates compared to the western states.
    50%
  34. List 2 myths that recent scientific investigation has challenged
    • Cat-scratch disease is always self-limiting – in other words the problem and the infection just goes away with time. Not true.
    • Bartonella causes chronic bacteremia in immunocompromised people but does not cause persistent bacteremia in immunocompetent people.
  35. __% of healthy people can show a bacteremia to bartonellosis without showing any symptoms at all.
    25%
  36. Is Bartonellosis zoonotic?
    Feline bartonellosis is diagnosed associated with fever, lymphadenopathies, and anterior uveitis. So yes, it is a zoonotic disease transmissible from cat to cat and cat to human.
  37. Up to __% of the vets and RVTs test by investigators were actually infected with one or more Bartonella species. Those tested that did not have extensive contact with the animals (people at the front desk for example) were __% infected.
    • 50%
    • 0%
  38. Bartonellosis Symptoms - People usually experience symptoms ______ after exposure. In most people cat scratch disease cause a mild to severe self-limiting infection. A skin rash is seen in _____% of patents and consists of small pustules or ulcers at the site of the bite or scratch, ______. Lymph nodes can become enlarged and the skin lesions disappear. Enlarged lymph nodes typically last for a few wks to a few months, but some patients the lymph nodes can remain enlarge for up to __
    • 3 – 20 days
    • 25-90%
    • 1 to 4 weeks later
    • 2 years
  39. Complications of cat scratch disease occur in _____% of human pts.
    List 3 complications experienced by Immunosuppressed patients
    • 5 – 16%
    • brain inflammation, heart inflammation, nerve involvement and others.
  40. List 6 symptoms of Bartonella henselae
    This etiology has not been isolated in dogs, list 2 species that appear to be asymptomatic
    • skin inflammation or pustules at the site of infection, fever, lethargy, loss of appetite, muscle pain and enlarged lymph nodes.
    • Rodentia and non human primates
  41. Cats are thought to be the only reservoir hosts for ________. Most cats appear to be asymptomatic. When signs are present, they typically appear ______ after exposure.
    • Bartonella henselae
    • 2 – 16 days
  42. List the 7 Feline Bartonella Genus & Species
    • 1. Bartonella henselae 
    • 2. B. vinsonii – most common in humans in dogs now
    • 3. B. clarridgeiae 
    • 4. B. kochlerae
    • 5. B. quintana
    • 6. B. bovis
    • 7. B. elizabethae
  43. All forms Bartonella species have been cultured from people, cats, and dogs although ____________ are considered by far the most common and found definitely more commonly in cats than people or dogs.
    Bartonella vinsonii and B. henselae
  44. Culture: The primary means to diagnose Bartonellosis is via:
    • 1. Polymerase Chain Reaction test 
    • 2. Serology – IgG titer of 1:128 is positive
  45. Most cases of cat scratch disease is self limiting and do not require treatment. If treatment is deemed necessary what are the 2 Primary drugs use to treat
    • 1. Clindamycin 
    • 2. Doxycycline
  46. What are the only products known to block the transmission of Bartonella from flea to flea.
    Imidacloprid (10%) and Moxidectin (1%) 
  47. List in order the 4 areas that Bartonella is cultured on the cat positive for Bartonellosis?
    • 1. blood 
    • 2. skin 
    • 3. clawbed
    • 4. gingiva
  48. Other Bartonella Facts
    The _____ were the 1st to name Bartonellosis “Cat Scratch Disease”.
    Who was the 1st to call the pyrexia of Cat Scratch Disease “Cat Scratch Fever”
    Bartonella moves in the blood via the ____. 
    Bartonella can live in flea dirt for ______.
    • French 
    • Ted Nugent
    • RBC
    • 3-9 days
  49. __% of all __________ fleas (the cat flea) carry Bartonella bacteria at all times.
    • 40%
    • Ctenocephalides felis
  50. Bartonella is associated with flea diseases that can be manifested as:
    • a. skin diseases 
    • b. anemias with hookworms 
    • c. vectors associated with hemoplasma, rickettsia, and FeLV.
  51. Heartworm Disease
    Etiology: 
    Intermediate Host (biological):  
    Test have shown that most mosquitoes that successfully serve as the biological host are of the _____ gender. ____ die or are ineffective.
    • Etiology: Dirofilaria immitis (Nematode)
    • Intermediate Host (biological): Mosquito, commonly some 10 to 15 species primarily Culex, Aedes, and Anopheles spp. 
    • Female
    • Males
  52. Heartworm Disease
    Pathology: 
    Incidence:
    • Pathology: Related to the number of adults only. 
    • Incidence: World Wide & United States: Gulf Coast, East Coast, Great Lakes
  53. Heartworms
    _______ has blunt head,
    _______ tapered head
    • Acanthocheilonema reconditum
    • Dirofilaria immitis
  54. List 4 ways to diagnose a Dirofilaria Infection
    • 1. Blood Sample
    • 2. History 
    • 3. Radiology
    • 4. Echocardiography
  55. List 5 Types of Blood Samples for Dirofilaria immitis and give % of effectiveness
    • 1. Direct Smear of Blood – 64% least eff
    • 2. Modified Knotts Method – 84%
    • 3. Micropore Filtration Method – 84%
    • 4. Microhematocrit (pcv) Tube – least
    • 5. Occult Test – most effective must have at least 3 females todetect antigen
    • 1st 4 types require microfilaria
  56. Occult Test – most effective must have at least 3 females to detect antigen
    a. antigen test of choice for 
    b. antibody test of choice for
    • dogs
    • cats
  57. Occult Test - Antigen Test – the antigen is produced by the ______ only. The antigen is a ______ substance. It takes 3 or more adult females to produce enough of this substance to test positive for the occult using this antigen test.
    • Female Mature Adult
    • Glycoprotein
  58. Antibody Test – this test measures host antibodies that have developed to the adult antigens. Note: this test unfortunately is less specific in that the antibodies of the host can develop in response to ____________.
    intestinal parasites
  59. __% - (10-67%) of all dogs with adult heartworms are negative for microfilaria.
    ___% of all dogs have microfilaria with NO adults in the heart.
    Adults live over _____before death. (__ today)
    Microfilaria live _____ before death. (____ today)
    • 50%
    • 2-5%
    • 5 years; 7 years
    • 1.5 to 2 years; 4-5 years
  60. List 3 products that will react with microfilariae and cause anaphylactic reactions that can result in vomiting to death.
    • Milbemycin oxime (Interceptor or Sentinel)
    • Dichlorvos (Task), or
    • Diethylcarbamazine citrate (Filaribits)
  61. Life Cycle of Dirofilaria
    • Stage 1 (microfilaria) & Stage 5 (adult) are in the dog - mosquito takes a blood meal and picks up S1
    • S1 in mosquito molts to S3 (infective stage) in 1 to 4 weeks depending on temp.
    • Mosquito takes a blood meal from dog and injects S3 into the subcutaneous tissue. S3 molts to S4 in 1 to 2 weeks.
    • S4 stays in the subcutaneous area for 100 days then moves to pulmonary artery and molts to premature S5. S5 stays in pa for 80 days.
    • After 80 days in the pa it will mature to S5 and begin mating and produce S1
  62. We tell owners that it takes 6 months for S1 to show up in the blood, implying a 6 month infection. Today it is called the _______ since we now know that S5 immature (2-5 cm in length) is in the Pa for 80 days before maturing to the adult S5 and thus starting its reproduction. So the cardiac vascular system is effected for approximately 3 months prior to our diagnosis and treatment.
    3 month disease
  63. Generally we say two to three weeks for the S1 to molt into S2 and then into S3. In reality it is all controlled by the temperature.
    Celsius                        Days
    30o C(86F)                            
    26o C                                                 
    22o
    18o C                                                  
    12o C (53.6F)
    • 8
    • 12
    • 17
    • 29
    • death
  64. 10 dogs exposed to 100 S3 = __dogs infected
    Worms mature in each dog? = __ S5 immature adult of those S5 immature develop to __ S5 mature adults __% of developed in mature adults
    Average dog only has __ adults in its heart post mortem
    • 10
    • 8
    • 7
    • 70%
    • 14
  65. 10 cats exposed to 100 S3 = __ cats infected 
    Worms mature in each cat? = __ S5 immature adult of those S5 immature develop to ___ mature adults
    Average cat only has ______ in its heart pst mortem. Need 3 female adults that is why we use the antibody test
    • 7
    • 7
    • 0 to 1
    • 1 to 2 adults
  66. Dog – ______% of all immature S5 will develop to the mature S5 in pa.
    75% to 80%
  67. If 80% of all immature S5 will develop to mature S5, and if the average mosquito will carry 8 S3 (can carry up to 13 without dying), then why is 14 the average number of adults in the post mortem dog?
    Immune Recognition - Give 100 S3 to a dog, and then repeat in 3 month, you will have less heartworms survive due to protein recognition and antibody production by the host dog.
  68. List 3 of the most common mosquito species that are definitive host for Dirofilaria immitis.
    • The Culex
    • Aedes
    • Anopheles
  69. ______ is considered a ________ in that it feeds on both dogs and cats and is the most commonly found in door mosquito in the US
    • Culex
    • dual mosquito
  70. What are the 4 Classification of Heartworm Severity
    • Three classes are defined that correlate to clinical signs and pulmonary arterial and lung parenchymal disease.
    • Class 1 – asymptomatic or mild signs 
    • Class 2 – moderate clinical and radiographic abnormalities
    • Class 3 – severe clinical and radiographic abnormalities, including right sides CHF Left side mitral valve insufficiency, right side= heartworm infection
    • Class 4 – is often included to identify the class 3 patients that also have caval syndrome.
  71. What are 2 Kinds of Blood Work-up for Dirofilaria immitis?
    • Complete Blood Count
    • Serum Biochemistries
  72. Complete Blood Count for Heartworms
    __________ are the most common abnormalities noted on CBC.
    ___________ almost always is seen with pulmonary thromboembolisms.
    ___________ is commonly seen with arterial and lung associated disease.
    ___________ usually is seen with caval syndromes and pulmonary disease.
    • Eosinophilia and Basophilia
    • Neutrophilic leukocytosis
    • Thrombocytopenia
    • Hemoglobinuria
  73. Serum Biochemistries for Heartworms - Hepatic insufficiencies with elevated _______ hepatic enzyme levels up to 10 times normal 
    _______ and increases in ___________ is noted due to microfilaria complications in the nephrons. Elevation here is a contraindication for treat.
    • ALT and ALP 
    • Proteinuria
    • Blood urea nitrogen (BUN)
  74. List 6 Preventions of Dirofilaria immitis
    • 1. Diethylcarbamazine Citrate – Pfizer 
    • 2. Ivermectin (Heartgard) – Merial
    • 3. Milbemycin oxime (Interceptor) Novartis
    • 4. Selamectin (Revolution) – Pfizer
    • 5. Moxidectin (Advantage Multi) - Bayer
    • 6. Thiacetarsamide Sodium (Caparsolate) old adulticide
  75. Which Dirofilaria preventative is no longer available in this country, but can be found in Asia?
    Thiacetarsamide Sodium (Caparsolate) old adulticide
  76. __% of heartworm market is for the canine an amount estimated at ____________.
    • 99%
    • 331 million dollars/year 
  77. Known as Filaribits from Pfizer this product killed S3 and thus require a daily dose especially during the warmer months of the yr. Today this product is rarely seen in the US but is used extensively in _______.
    Dosage is _____. In TX this medication had to be given ____.
    • Europe and Asia
    • 3-5mg/kg
    • daily
  78. ___________ following administration of diethylcarbamazine has been reported in dogs with large number of circulating microfilariae.
    DEC has also been incriminated as a possible cause of _________________.
    • Irreversible shock and death
    • sterility in some breeding animals
  79. What is the “off label use” drug of choice in the treatment of positive heartworm dogs in the illumination of microfilaria?
    Ivomec 1% (ivermectin dewormer for cattle) with the dose being ¼ mL p/40 lbs orally.
  80. Milbemycin oxime Interceptor by Novartus and Sentinel (added Luferon) like Heartgard, is administered ____ every 30 days since it kills the S3 and S4.  It is also very effective in the control of ______________. 
    • orally
    • ancylostoma and ascarids without any other additives.
  81. Selamectin Revolution by Pfizer another member of _________ like ivermectin was the first FDA approved topical medication that protects against heartworm disease and fleas, plus has a unique spectrum of other internal and external parasites 
    Like Ivermectin and milbemycin oxime, selamectin is applied _______ once a month
    • Avermectins
    • topically
  82. Selamectin can be control _________. It can also control _____________.
    • ascarids and ancylostoma parasites in cats
    • ear mites and treat and control sarcoptic mange in the dog. 
  83. Etiology of ear mites in dogs and cats?
    Etiology of sarcoptic mange mite of dogs and cats
    • Otodectes cynotis
    • Sarcoptic scabei & Notoedres cati
  84. Moxidectin Proheart by Fort Dodge was the 1st to date to develop an _________ for the prevention of D. immitis
    injectable med
  85. Bayer bought the rights to moxidectin and incorporated its flea preventative (Advantage) with it and renamed the combination Advantage Multi or ________ as it is known in Europe. Not approved by FDA but used constantly in Europe this product is very effective “off label” for the treatment of ________.
    • Advocate
    • demodectic mange.
  86. What are the 5 Treatments for Dirofilaria immitis - Microfilaria
    • 1. Ivermectin 1% Cattle Dewormer still drug of choice -  ¼ mL/40# body weight oral Drug of Choice (not approved FDA) 
    • 2. Selamectin (Revolution) 
    • 3. Dithiazine Iodide (Dizan) *Approved FDA 
    • 4. Levamisole 
    • 5. Fenthion 
  87. _____________ is contraindicated due to its reaction with L1.Shock
    Melarsomine hydrochloride (Interceptor)
  88. What are the 4 Adults treatments for Dirofilaria immitis?
    • 1. Milarsomine dihydrochloride (Immiticide) Drug of Choice Merial Corp 1 IM/subc. Injection wait 30 days repeat 
    • 2. Thiacetarsamide sodium (Caparsolate) More dangerous and not available 
    • 3. Levamisole HCl 
    • 4. Fenthion (Talodex)
  89. Immiticide like Caparsolate is an arsenic compound and thus need to check 
    kidney function (BUN) & liver function (ALT & ALP)
  90. List 4 Other Drugs With Adult Heartworm Treatments?
    • 1. Aspirin – reduces pulmonary arterial lesions and improves blood flow. Use for only the most severe Class 3 cases. 
    • 2. Heparin – also for the most severe cases. It also reduces pulmonary arterial lesions and improves blood flow. 
    • 3. Corticosteroids – designed to reduce parenchymal disease in lungs but can promote thrombosis and reduces pulmonary arterial blood flow if used too long. (2 weeks) 
    • 4. Oxygen – this is the only way to dilate the pulmonary arteries in emergencies and severe cases. Such as Class 3 associated with dyspnea or congestive heart failure. 
  91. Routine for Dirofilaria Treatment includes what 6 steps?
    • 1. Office Visit With Diagnosis (antigen/ab) 
    • 2. Schedule Laboratory Test ex. BUN, Alk Phos, ALT,CBC, Radiology 
    • 3. Initiate microfilaria treatment/preventative Note use selamectin or ivermectin (no interceptor)
    • 4. Treatment for adults - Immiticide – 1 IM/subc/wait 1 mo./ no ex./2 IM/subc/wait 1 mo./no ex.
    • 5. Check for microfilaria even if it occurred before 
    • 6. Treat for L1 if positive, and check for antigen 4 months post treatment.
  92. Why is there no documented correlation between the severity of the illness of heartworm disease and the number of adult Dirofilaria found in the heart on post
    mortem?
    Exercise produces more Pulmonary Vascular Resistance (PVR) in dogs with few adults (14) for 6 months as compared to non-exercising dogs with 50 heartworms for 18 months.
  93. List 4 Post Adult Heartworm Treatment Complications
    • 1. Dyspnea and severe coughing 
    • 2. Acute lung injury due to the absorption of treated adults being absorbed by the macrophages in the lungs.
    • 3. Pulmonary Thromboembolisms – clot moved and blocking 
    • 4. Disseminated Intravascular Coagulation
  94. Post Adult Heartworm Treatment - Critical time is ______. Post treat Most severe reactions occur in what 2 groups of animals?
    • 1-3 wks
    • Class 3 infections and those associated with high antigen concentrations at the time of diagnosis.
  95. Adult Infection Facts - Post Infection but Prior to Treatment
    Blood pressure will increase in all dogs _____ after infection
    Right side congestive heart failure can be seen at _______ post infection
    • 9 months
    • 10-17 month
  96. Post Heartworm Treatment: _________ are more severe affected by infective stage HW and dead HW that have moved to the lungs for reabsorption
    It will take _______ to kill adult HW after Immiticide administration.
    It may take up to _____ for the worms to be totally removed from the lungs. The lungs are never the same.
    • Caudal lung lobes (diaphragmatic)
    • 21 – 28 days
    • 6 month
  97. _________ is uncommon except in highly endemic regions, like Houston.
    Diagnosis generally employs the use of an _______.
    Routine treatment with Immiticide will produce __________.
    What is the only recommended acute treatment?
    • Vena cava syndrome (Class 4)  
    • Echocardiography
    • acute cardiovascular collapse and shock.
    • Surgical retrieval of the worms using minimal sedation, local anesthetics, and long flexible alligator forceps
  98. Most fungal infections results from the _______ of fungal spores (_______) or from wound contamination. The fungi, found as inhabitants of the animal’s environment, damage the host cells by releasing _______. They kill, digest, and invade surrounding cells. Some fungi produce toxins.
    • inhalation 
    • saprophytes
    • enzymes
  99. Mycotic diseases are found worldwide but in the United States are endemic along the
    eastern seaboard, the Great Lakes, and the river valleys of the Mississippi, Ohio, and the St. Lawrence waterways
  100. Are Fungal Diseases (Systemic) Diseases Infectious?
    How are infections usually contracted?
    • These diseases are NOT thought to be contagious.
    • Via inhalation of infected spores or mycelial fragments and rarely via skin penetration or ingestion
  101. All the fungi involved (except Cryptococcus) are ________ (having properties of both sexes)
    A. being ___________ at ____ and
    B. ______________ at __________
    • dimorphic
    • mycelial (thread like hyphae); 25° C
    • yeast like (rounded fungi that produce a budding); 37° C (warm)
  102. Who is Affected Most Commonly - All of these fungi (except Cryptococcus neoformans) cause death in what species. What species appears to be resistent? Why? Most veterinarians believe that systemic mycoses become established more easily in what animals?
    • dogs and humans are affected more commonly than cats
    • debilitating, immunodeficient or immunosuppressed animals
  103. Systemic Fungal Diseases
    The lesions caused by these infections are characterized by ______________.
    Most infections develop slowly and the course is almost always __________.
    Produces a _____________.
    • abscessation, ulceration’s and nodular formations
    • chronic
    • chronic cough and persistent fever
  104. Systemic fungal infections are _________.
    List 4 Systemic Mycotic Diseases
    • saprophytic
    • Blastomycosis - North and South American
    • Coccidioidomycosis - San Joaquin Valley
    • Cryptococcosis
    • Histoplasmosis
  105. North American Blastomycosis
    Synonym:
    2 Etiologies:
    • Gilchrist’s Disease
    • Blastomyces dermatitis – N. American
    • Paracoccidioides brasiliensis – S Am.
  106. _________ is the most common systemic disease seen in all animals in SE TX although all systemic mycotic infections diagnosed at veterinary school in College Station
    Blastomycosis 
  107. Blastomycosis - 
    ____ – dogs and __ – cats infected in 5 years 
    ______ infected more, _______ more likely to survive treatment.
    • 324; 3
    • Males; female
  108. Blastomycosis is a chronic ___________. Most common site of infection is the ____________. 
    Dogs with blastomycosis usually have clinical signs that include ______________.
    Signs of disease usually have been present for a few days to a week but may have been
    apparent for up to a year
    • wasting disease
    • lungs (like all systemic mycotic infections) plus the bronchial and mediastinal lymph nodes
    • anorexia, wt loss, cough, dyspnea, ocular disease, lameness or skin lesions of purulent exudate
  109. Blastomycosis
    __% - lung lesions with dry, harsh lung sounds
    __% - ocular lesions of anterior uveitis 
    _____% - w/pustular skin lesions
    __% - have bone involvement and lameness
    • 85%
    • 40%
    • 20-50%
    • 30%
  110. Genetic analysis of isolates from soil and human patients has resulted in what 3 distinctive isolates of blastomycosis? _______ is the common type seen in SE Texas, Louisiana, Arkansas, and the Mississippi Valley
    • A, B, and C isolates and each have numerous sub-types.
    • Isolate A
  111. Modes of Infection for Mycotics - The spores enter the ________ and establish a primary infection in the ______. When the yeast grows at body temperature, it is too large to enter the terminal airway in an aerosol, therefore transmission by ______ is very likely. This is why systemic mycotics are not considered contagious.
    • terminal airway
    • lungs
    • coughing
  112. Inoculation of Blastomyces into a wound from the soil appears to be uncommon in the dog, but in dogs with __________ without systemic disease provides the possibility of direct inoculation cannot be excluded. Because of the rarity of disease restricted to a focal skin area, cutaneous blastomycosis in the dog should be considered a manifestation of __________.
    • solitary skin infections
    • disseminated disease
  113. Histoplasmosis
    Etiology: 
    Note: Saprophytic like Blastomycosis, but found more often in
    • Histoplasma capsulatum 
    • dung of chickens and bats, as it grows best and accelerates its sporulation in soil containing nitrogen-rich organic matter such as excrement.
  114. What are the 2 clinical signs (forms) of Histoplasmosis?
    • 1. Intestinal Form – bloody diarrhea
    • 2. Lymphoid Form – general lymphadenopathy. Swollen lymph nodes bilaterally.
  115. Histoplasma capsulatum is found in soil in ___ of the 48 states; however in Texas the endemic zone for histoplasmosis is from ________. Following inhalation, the Histoplasma spores convert to their active yeast phase at the body temperature and proliferate in the tissues. 
    • 38 
    • San Antonio eastward
  116. Histoplasma capsulatum is endemic throughout large areas of the temperate and sub tropical regions of the world. Although infection have been document from every continent except ____ they are most prevalent in the _______.
    • Antarctica 
    • Americas
  117. Histoplasmosis - 
    Frequent site of infection is the _______
    Dogs are affected at any age from ______
    2 forms are _________________
    ___________ are more susceptible here and some feel just as likely to come into contact with Histoplasmosis as ____. Most authorities disagree. Age range is about the same for dogs.
    • lungs, bronchial and medastinal lymph nodes
    • 2 months to 14 years
    • 1) Intestinal form w/bloody diarrhea - most common and 2) Lymphoid form w/lymphadenopathy
    • Cats, unlike with blastomycosis, dogs
  118. Coccidioidomycosis
    Synonyms: 
    Etiology:
    This is a soil bourne fungus like the others; however it is a ________ organism with no known sexual state
    • Valley Fever or San Joaquin Valley Fever
    • Coccidioides immitis
    • haploid (not a diploid with myclelium and yeast forms)
  119. Coccidiomycosis Epidemiology: the mycelial phase has been found in nature only in a specific ecologic region, the lower ______ zone. This zone is within the _____________. This zone is sandy alkaline soil, high environmental temperatures, low annual rainfall, and low elevations. This perfectly describes the San Joaquin Valley of California hence the name.
    • Sonoran life
    • southwestern US, Mexico and Central and S. America
  120. Valley Fever - Clinical Signs: the most common site of infection are the ________. And like all systemic funguses, __________ prevails. If this disease disseminates to other areas of the body, ________ are the most common example generally occurring at _______ after a primary respiratory disease. _______ is the owners complaint.
    • lungs, bronchial and the mediastinal lymph nodes. 
    • chronic cough and persistent fever
    • bone lesions
    • 3-5 weeks
    • Lameness
  121. What is the most commonly mentioned system mycotic infection in people?
    What group of people is it routinely diagnosed?
    • San Joaquin Valley Fever
    • In migrant farm workers that till the soil and hand pick fruits and vegetables in the valley region of California.
  122. Why is the soil is perfect in this area for San Joaquin Valley Fever?
    It is sandy, alkaline, low rainfall, low elevation and it is exposed to high temperatures.
  123. What are 2 Classic Symptoms for all Systemic Mycotics?
    • a. Persistent Temperature
    • b. Chronic Cough
  124. Genetic analysis of isolates from soil and human patients has resulted in what 3 distinctive isolates of blastomycosis.
    Isolate ___ is the common type seen in SE Texas, Louisiana, Arkansas, and the Mississippi Valley
    • A, B, and C are the isolates and each have numerous sub-types.
    • A
  125. Modes of Infection for Mycotics - The spores enter the _________ and establish a primary infection in the ______. When the yeast grows at body temperature, it is too large to enter the terminal airway in an aerosol, therefore transmission by ______ is very likely. This is why systemic mycotics are not considered contagious.
    • terminal airway; lungs
    • coughing 
  126. What is the scientific name for Histoplasmosis?
    List the 2 most common etiological systemic fungus in southeastern Texas
    • Histoplasma capsulatum var. capsulatum 
    • N. American Blastomycosis
    • Histoplasma capsulatum
  127. Clinical signs and sites of infection for Blastomycosis and Histoplasmosis are similiar - List one difference
    Cats, unlike with blastomycosis, are more susceptible here and some feel just as likely to come into contact with Histoplasmosis as dogs
  128. Valley Fever - Pathogenesis: not typically contagious, the major route of infection is by _________. It takes very few ________ to produce disease.
    • inhalation; 
    • “arthroconidia” inhaled
  129. What are the 2 primary etiologies of Cryptococcosis (European Blastomycosis)?
    • Cryptococcosis neoformans (common)
    • Cryptococcosis gatti
  130. What is the most common systemic blastomycosis that we see in cats and also is the only systemic fungal infection that is prevalent in cats.
    Cryptococcosis (European Blastomycosis)
  131. Cryptococcosis (European Blastomycosis) is an infection common in what 10 animals?
    How many subspecies types are recognized?
    • cats, dogs, ferrets, horses, goats, sheep, cattle, dolphins, birds and even marsupials.
    • 5
  132. Cryptococcosis is found with _________ are often cited as a source of infection remaining viable for ______.
    • pigeon excreta
    • 2-5 years
  133. Pigeons are not infected naturally but their excreta acts as a good nutritional medium for the fungus ___________. The pigeon is the _______ – it doesn't get the disease, but it spreads it to the cat.
    • Cryptococcosis neoformans
    • reservoir 
  134. What are the Clinical Signs of Cryptococcosis?
    Effects CNS as well as respiratory tract and the ophthalmic areas. Sneezing is common with nasal discharge. Chronic cough and persistent fever.
  135. What are 2 etiologies that do not respond to antibiotics? 
    • Fungus
    • Protozoan
  136. Cyptococcosis is most commonly seen in what dogs?
    young immunosuppressed dogs less than 4 years
  137. What are the 2 Major Sites Effected with Crytococcosis? 
    • Upper respiratory tract and Central Nervous System (CNS) although cutaneous lesions
    • have been seen. 
  138. What are 3 ways to Diagnose a Fungal Infection?
    • Skin Test Antigens intradermal injections of 1/10 mL solution  
    • Serology- determination of titers of circulating antibodies 
    • Microscopic Identification of Fungi - Common from pus subcutaneous extractions on blastomycosis
  139. What are 6 Treatments for Fungal Infections?  
    • 1. Amphotericin B (Fungizone PN) - IV Most commonly used - Must be mixed with 5% dextrose - Toxicity: Kidney failure will precipitate
    • 2. Ketoconazole (KTZ) - oral/ Commonly used in humans for years nt approved for use in animals Formulated as 200mg – can be reformulated at drug store as “off-label”
    • 3. Itraconazole (ITZ) - Oral. Also considered a favorite oral regiment for dogs with dermatophytes (ringworm). Be careful using with older dogs because it is toxic and can cause liver damage.
    • 4. Fluconazole – (triazole) most effective for cryptococcosis
    • 5. Flucytosine – used jointly to improve effect of other drugs
    • 6. Enilconazole – is not necessarily a drug for systemic infections but is a favorite for dermatophytes in Europe. 
  140. List 2 Fungus-Like Bacteria
    • Nocardiosis
    • Actinomycosis 
  141. Nocardiosis
    List 2 Etiologies: 
    How do you Diagnose? 
    Is it Zoonotic?
    • Nocardia asteroides
    • Nocardia braziliensis
    • Thoracic exudate characterized by “tomato soup like” appearance
    • Not likely but reported
  142. What are the Clinical signs of Nocardiosis?
    The infection via inhalation and subcutaneous inoculation and ingestions.
  143. What are the 3 Forms of Nocardiosis?
    • 1. Systemic Form – looks like canine distemper in dogs with pyrexia, anorexia, coughing, dyspnea, and neurological signs
    • 2. Primary Respiratory Form – pus in the chest (pyothorax) or pleural fusions can be tomato soup like.
    • 3. Cutaneous Form pus under the skin, abscess or ulcerations.
  144. Actinomycosis is also known as “__________” 
    What is the Etiology?
    What are 3 clinical signs?
    How do you diagnose?
    • Wooden Tongue
    • Actinomyces bovis
    • 1. Respiratory – inhale grass spears; 2. Penetrating – mandibular osteitis with pyrexia and draining wounds; 3.Foreign objects will penetrate the hairless underside with cellulitis.
    • Exudate = “sulfur granules” (yellow)
  145. List the eight types of recognized canine erythrocyte antigens (DEA) including the old naming
    • DEA – 1; A1
    • DEA – 2; A2
    • DEA – 3; B
    • DEA – 4; C
    • DEA – 5; D
    • DEA – 6; F
    • DEA – 7; Tr
    • DEA – 8; He 
  146. Blood Groups in Dogs
    Highest Incidence = 
    Lowest Incidence = 
    Most Reactive = 
    • DEA 4 and DEA 6 (98%)
    • DEA 3
    • DEA 1 & DEA 2 = these two produce severe hemolytic reactions. Donor dogs should be blood typed to insure they do not have DEA 1 or 2.
  147. Random transfusions should be avoided: WHY?
    • 1. risk of sensitizations & subsequent severe transfusion reactions. 
    • 2. transfused RBCs will have a SHORTENED life span
  148. Normal RBC lifespan for
    dogs 
    cats
    • about 110 days
    • 120 days 
  149. West Nile Virus is a potentially serious illness that causes _________ as its primary location of infection. ________ spread the virus by feeding on ___________. West Nile Virus was first discovered in the United States in ____ and has been found/identified in Texas since ____.
    • encephalitis
    • Mosquitos
    • infected birds and then biting humans, animals and other birds. 
    • 1999; 2002
  150. At least ___ species of mosquitos in North America are susceptible to the WNV infection, but _______ species, the most common mosquitos seen in households in US appears to be the most common vector in the US. Infections have been documented in ______, but their role in transmission is still not known.
    • 43
    • Culex
    • ticks
  151. What is the primary reservoir host for West Niles Virus? 
    Birds 
  152. What are 2 reasons why the WNV is more common in human transmission than dogs and cats?
    • 1. a lot of dogs and cats go undiagnosed 
    • 2. because of the hair cover on dogs and cats they are less susceptible to being transmitted to those animals by mosquitos.
  153. _________ can cause the virus to spread north to Dallas, Denton etc.
    Eastern and Western encephalitis nickname is _________.
    Nickname for EIA is ___________-. 
    • Hurricanes
    • sleeping sickness
    • swamp fever
  154. What are the symptoms of WNV in dogs?
    West Nile Virus has been recovered from the _________ of a cat with ______, 2 other fatally ill cats and ___________.
    The incubation period in species other than equine is unknown. Incubation period in equine is about _______.
    • fever, depression, spasms, seizures, muscle weakness and paralysis.
    • brain; neurological signs
    • dead squirrels
    • 6 months
  155. List 10 birds in North America that are commonly affected by the WNV
    crows, blue jays, ravens, magpies, robins, eastern bluebirds, chickadees, tufted titmice, wrens and geese
  156. Most people infected with West Nile Virus are asymptomatic. When symptoms do occur they typically have mild fever, headache, muscle aches, nausea, vomiting with occasionally a mild skin rash appearing _____ after the person was bitten. Symptoms can last for a few days to several weeks.
    _____ can occur if the symptoms become more pronounced and persistent with persons becoming disoriented, coma, convulsions, vision and paralysis. A lot of this has to do with the immunosuppression in humans.
    • 3-14 days
    • Death
  157. What are the 3 types of blood groups for cats?
    Which type is considered the universal recipient?
    Which type may have a fatal transfusion reaction after only 1 mL of incompatible blood?
    • Type A, Type B and Type AB.
    • Type AB (very rare) = 
    • Type B cats receiving Type A blood 
  158. Domestic shorthairs (most common in the United States) are almost always what blood type?
    1 to 4% maybe what blood type?  
    • Type A
    • Type B. 
  159. Between 2000-2004 in London, UK, 156 cats were included in a study. ____% were pedigree, ___% non-pedigree.
    Pedigree – Type A = ___%, Type B = ___%, and Type AB = ___%.
    Non-pedigree – Type A = ___%, Type B = ___%, and Type AB = ___%.
    • 32.7 %; 67.3%
    • 82.4%; 13.7%; 3.9
    • 67.6%; 30.5%; 1.9%

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