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Formulae for cat and dog dentition, Triadan system (know tooth numbers)
- puppy: 2(3/3I, 1/1C, 3/3PM)=28
- dog: 2(3/3I, 1/1C, 4/4PM, 2/3M)=42
- *kitten: 2(3/3I, 1/1C, 3/2PM)=26
- *cat: 2(3/3I, 1/1C, 3/2PM, 1/1M)=30
- triadan: 100s URQ, 200s ULQ, 300s LLQ, 400s LRQ
- Canines always 04, 4th premolar 08, 1st molar 09. Cats missing 05, 06(1/2), 10, 11
Names and purposes of instruments (periodontal probe, curette, scaler, explorer, elevator)
- Periodontal probe: subgingeval, checking presence and depth of pockets (gingeval sulcus depth)
- curette: subgingeval, removing plaque (scaling and root planing)
- scaler: remove exterior plaque (crown of tooth)
- explorer: hook on end of probe, NOT subgingeval, checking for defects in enamel
- elevator: usually winged, for loosening periodontal attachment of tooth, for extraction (displace tooth from support structures)
Indications for extraction
- periodontal pocket has reached the apex, stage II perio disease when O won’t do home care, can’t do multiple anesthesia, severe systemic or mucogingeval disease, O preference
- Stage IV periodontal disease or teeth with less than 20-30% of normal bone height
What can arise from proximity of max 4th PM and M 1 and 2 to retrobulbar space
damage to optic nerves or exophthalmus from severe periodontitis
Definition of endodontic disease and standard treatments for it
Disease inside the tooth (pulp tissue). extraction, vital pulpotomy, root canal
Definition of and treatment for resorptive lesions
Odontoclastic attack on otherwise normal tooth, extraction or crown amputation based on severity. Body resorbs tooth root, turns into bone.
Definition of and treatment for gingivostomatitis
disease cats get, we don’t know why (immune), ulcerated mouth especially towards throat. Includes mucosa, not just gingeva. inflammation not around teeth, returns immediately after cleaning. Remove all the teeth, fixes 80%, then try cephalosporin or glucocorticoids.
Definition of distoclusion and mesioclusion, buccal, lingual, caries, furcation, enamel hypoplasia
- distoclusion: overbite. Class II.
- mesioclusion: underbite, class III
- buccal: cheek-side surface of tooth
- lingual: tongue-side surface of tooth
- caries: cavities. Show as brown spots on tooth, soft or sticky if a problem. More dogs than cats.
- furcation: where the roots of the tooth meet, important for multi-root extractions and for gingeval/bone loss
- enamel hypoplasia: Loss of production of enamel as a juvenile, often due to high fever (distemper). Tooth is damaged-looking, painful until dentin grows out.
Complications of extraction
- broken and displaced root tips, can go into nasal cavity or mandibular canal
- hemorrhage, intra- or post-operatively. Maxillary, infraorbital and palatine artery all near dental structures, disrupted by disease or surgery.
- jaw fracture, usually mandible. Esp canine and first molar extractions.
- (oronasal fistula, eye issues)
The oral neoplasias Dr. Buelow discussed
- Squamous cell carcinoma and fibrosarcoma in cats, melanoma and fibrosarcoma in dogs
- 6% of malignant tumors in dogs are oral tumors (2.6x more in dogs than cats)
When to use parallel vs. bisecting angle technique in dental radiography (which sections of the dental arcade work with which technique)
Mandibular molars and premolars for parallel technique, all other teeth with bisecting angle
For either scaling or polishing, no more than 5 sec per tooth, or ?
damage to the enamel can occur—it’s like a jackhammer.
Differentiate large bowel from small bowel diarrhea
- lg: increased urgency, hematochezia, straining, normal volume, mucus, no weight loss
- small: no increased urgency, polyphagia, melena, large volumes with no effort, weight loss, no mucus
Difference between regurg and vomiting and what each implies about the location of the problem
- regurg: no effort, comes up immediately after eating, food looks the same as going in. Problem is upper GI, food not making it to stomach, likely esophageal.
- vomit: abdominal effort, can be more time between eating and return, food can be digested, may not vomit food. Problem can be more widespread, lower GI, toxicity, etc.
Home care for megaesophagus
Put food up so gravity helps it go down, frequent small meals, wet food
Slide on causes and treatment of ulcer
- Parasites, NSAIDS, metabolic (uremia). Sucralfate, omeprazole, famotidine, d/c
GDV: what it stands for, typical patient, treatment
Gastric dilitation and volvulus, large, deep-chested breeds like greyhound and Great dane. Can try to insert gastric tube and VERY GENTLY attempt to untwist, if not, surgery to revolve and gastropexy to prevent recurrence. Raise food dish, small frequent meals, canned food.
Signs of enteric disease
- vomiting, diarrhea, anorexia or polyphagia, melena (parasites like toxocara,
- ancylostoma, diplydium, coccidia, giardia, parvo, bacteria)
Cause and treatment of SIBO
- small intestinal bacterial overgrowth, EPI, ileus, prolonged enteritis.
- caution with Abx, acidophilus and possibly cobalamine.
Causes and signs of colitis
- caused by: (acute) diet change/indiscretion
- parasites (trichuris, ancylostoma)
- fungal (histoplasma)
- (chronic) lymphocytic/plasmacytic, eosinophilic; megacolon;
- signs: hemochezia,mucus
Causes and treatment of constipation/obstipation
- causes: Inflammatory, dietary, dehydration, megacolon, neoplasia, trauma
- tx: RADIOGRAPHS, then (if not obstructed), enema (emolient like dactyl sodium
- sulfosuccinate) and hydrate/repeat, laxative (laxatone or pumpkin), pro kinetic (cisapride), careful deobstipation if necessary, colectomy if necessary (resect abnormal section)
Causes of liver disease
CAV (canine adenovirus 1 and 2), ICH (infectious canine hepatitis), FIP (feline infectious peritonitis), bacterial cholangiohepatitis (usu secondary), platynostonum (liver fluke), copper-storage disease (Westies and Bedlingtons), Feline cholangiohepatitis (triaditis?)
Signs of hepatic lipidosis
anorexia, weight loss, vomiting, icterus
primary or secondary, fatty acid metabolism/mobilization issue
What PSS is and what it causes
Portosystemic shunt. Abnormal connection between portal blood and systemic circulation, liver bypassed, liver atrophies or malfunctions, toxins like ammonia go into circulation
Neuro signs, encephalitis
Signs and treatment of pancreatitis
pain in upper right quadrant (not cats), hunched posture, anorexia, vomiting, diarrhea, dehydration, electrolyte issues. Middle aged or older overweight dogs.
24h fast, fluids, abx, analgesia
Causes of prolonged estrus
too much estrogen, from wherever. ovarian cyst, iatrogenic
Causes of reproductive failure
- glucocorticoids, fluoroquinolones, brucella, canine herpesvirus, feline: herpes,
- panleukopenia, FIP, FeLV
Definition of eclampsia
hypocalcemia, often tetany and fever. treat with calcium gluconate
Know the two transmammary parasites we talked about
- ancylostoma (hookworm)
- toxocara (roundworm)
Types of pyometra, signs of each, treatment
open or closed. Open has vaginal discharge/draining and fever. Closed does not. 1-2 months post estrus, septicemia, shock. abdominal pain in both. tx: fluids, abx sensitive to e coli. Then OHE.
Signs and location of scrotal hernia
abdominal contents protude through inguinal ring. sx. Goes back in if pressed on.
Type of pathogen brucella is, and species it’s seen in most
- bovine and canine
- b. canis, B. abortus. Causes abortion storms in cow herds. Bacteria.
- gram - coccobacilli
Cryptorchidism: most common type, how the surgery is prepped, what the
consequences of ignoring it are
- unilateral most common,
- prep for exploratory surgery, similar to spay. Shave and scrub up to xiphoid. Ignoring will likely cause it to become cancerous, also it will continue to pump out testosterone and possibly make reproduction possible. Sertoli Cell Tumor.
Causes of ARF (general, not specifics, EXCEPT please know the infectious causes)
ischemia, toxic injury, immune-mediated, infectious (leptospirosis, baterial disease like ascending infection, lyme (acute or chronic)
Signs of ARF vs. CRF
ARF: emesis, kidneys normal on palpation, K normal to high, metabolic acidosis (severe)
CRF: PUPD, weight loss, kidneys atrophic on exam, K levels decline over time, anemic, retinal hemorrhage with hypertension
Treatment for hyperkalemia
Saline, insulin, dextrose/glucose, possibly calcium gluconate to protect heart.
Reason for association of PUPD with dehydration
Tubules not resorbing water from urine, so even though animal keeps drinking, body is not getting the water it needs. Thirst center continues to be activated by hyperosmolarlity of blood, P keeps drinking.
decreased renal blood flow
Need for gastroprotectants in renal disease – why, which ones
acidemia and uremia can cause gastric ulcers. Sucralfate if already ulcerated, famotidine, omeprazole
Why hypertension associated w/ renal disease
- hyperkalemia caused by urine not being excreted or not exchanging Na for K causes
- bradycardia, which causes hypotension, which causes sympathetic stimulation causing vasoconstriction and tachycardia, causing
- hypertension. Dehydration causes lowered blood volume, also causing sympathetic stimulation.
causes of renal tubular disease
tubular disease: toxins (ethylene glycol), Hereditary (Fanconi syndrome), Inflammatory (glomerular disease lets large molecules through tubules), secondary (abrnomal urate crystals cause uroliths/cystoliths
causes of UTI
UTI: Ascending infection (e coli), urinary stasis (obstruction, neuro, spay incontinence), incontinence (spay), damage to mucosa (uroliths, neoplasia), immune factors (Cushings, DM, renal failure, chemotherapy, FeLV/FIV), Iatrogenic (steriods, trauma from catheter), urachal diverticulum, uroliths
Disorders of micturition
detrusor muscle dysfunction (UMN disease/trauma), ectopic ureter (most common in dogs), sphincter muscle insufficiency/spay incontinence, trauma
Pathogenesis and treatment of blocked cat
- crystals or mucus/sludge gets trapped in bend of male cat’s narrow urethra, block urine from going past. This causes urine to back up, causes kidney damage, azotemia, hyperkalemia, then cardio issues and/or neuro problems if it gets bad enough. MUST unblock, emergency.
- Gently insert tomcat catheter, try to expel plug, then flush and flush and flush. Catheter in 2+ days, pain and fluids. Penile urethrostomy if frequent
Treatment of FLUTD
canned food, increase water, extra litter boxes, anti-inflammatories, pheromones
3 types of renal/urinary cancer, and usual location of transitional cell carcinoma
transitional cell carcinoma (neck of urinary bladder into trigone), lymphoma (kidney), renal cell carcinoma
Causes of respiratory diseases (general)
infection, inflammation, FB, sinusitis, dental disease, neoplasia, fungus, virus (FVR, Calici, virulent calici)
Signs of upper vs. lower respiratory disease
URD: stertor, stridor, sneeze, increased inspiratory effort, slow deep breaths, tracheal palpation cough
LRD: increased effort including abdominal effort, shallow, rapid breathing
nursing considerations of respiratory disease
- humidifier/nebulizer, harness not collar, antihistamines/antitussives, monitor RR and
Causes, clinical signs and nursing re: pleural effusion
- causes: fluid overload, infection, lymphatic obstruction, coagulation disorders, cardiovascular disease
- clinical signs: respiratory distress or effort, decreased lung or heart sounds
- tx: thoracocentesis (pending rads), c/s, supplement/monitor O2, CAGE REST
Things to watch for in lower respiratory disease
- electrolyte/acid-base abnormalities
- hypoxemia (arterial blood gas)
- ventilation/perfusion mismatch
- tissue oxygenation less than 95% (atelectasis)
3 factors in determining inpatient feeding methods
- route (oral, enteral, parenteral)
- amount fed (MRE, RER)
- How food is offered (free choice, food-restricted, time-restricted)
What AAFCO is and what letters stand for
- Association of American Feed Control Officials
- evaluate how food has been formulated, approve FOOD, not snacks/treats/supplements. Statement must appear on commercial foods.
Nutrient profile vs. feeding trial (ie, what each one is)
when new foods want to come on the market, have to prove that they provide complete nutrition. Can do so by chemical testing and proving exactly what nutrients are in the food (nutrient profile) or feeding trial, where at least 8 animals get ONLY that food for 6 months with constant monitoring and blood tests for “signs of deficiency”.
What has to be on a food label (8)
- product name
- manufacturer name and phone number
- statement of intent
- net weight of bag/can
- ingredient statement
- guaranteed analysis
- nutritional adequacy statement (AAFCO)
- feeding guidelines
What RER and MER are, how they relate to each other, how to calculate RER
- Resting energy requirement vs maintenance energy requirement. Resting is how many calories the animal needs per day just to exist. Maintenance adds in energy for movement/activity.
- RER = 30(kg) + 70 (for 2-45 kg animals) = KCals OR 70(kg)^0.75
- MER can be 2 or 3 times that, etc.
Why we calculate DMB (not how to do it, just what it’s used for)
Dry matter basis. To compare different foods, especially to compare wet to dry food.
The definitions of the basic nutrients (6)
- water - most necessary, needed for hydrolysis, temp, tissue shape and resilience
- carbohydrates - monosaccharides, disaccharides and polysaccharides that break down into glucose. Quick glucose source. Dogs need more than cats. Turn into starch or fiber
- proteins - chain of amino acids, needed to make more amino acids, enzymes, tissues, antibodies, hormones, organs
- lipids - energy production and fat soluble vitamin (ADEK) absorption, essential fatty acids
- minerals - any inorganic element in food, macro and micro.
- vitamins - diagnosis of exclusion. Organic necessary material in diet that isn’t anything else.
What IS the deal with taurine?
Essential amino acids that cats don’t make on their own. If they don’t get enough of it, they get DCM. Used to be common, but since we figured it out much less common.
Definitions of pre-biotics and pro-biotics
- pre-biotics are non digestible ingredient that influences that growth and activity of bacteria in colon in a way that helps the animal. Esp fructose/carbs
- probiotics supplies beneficial microorganisms. Acidophilus.
5 things you would recommend for an obese patient
- calculate calories
- palatable food
- transition gradually
- no human food/treats
- increase water intake and exercise
Qualities of an ideal food for dog/cat with digestive disease, renal disease, cystoliths
- digestive disease: varies by species. D/C - digestible protein, low fat, antioxidants. Equine high protein forage.
- renal disease: increase water, decrease Phosphorus, low protein, adjust K as needed, 1.1-1.4 (RER) for cat, 1.1-1.6 (RER) for dog.
- cystoliths: pH neutral diet, high water (watch for dalmation/urate, Ca oxalate = toxicity). Not all will respond
How nutritional secondary hyperparathyroidism relates to the lizard’s diet
Lizards MUST receive Ca supplementation to avoid bone problems like rubberjaw. They do not get enough calcium in their diet, so they are always hypocalcemic (without supplementation), so the parathyroids pump out hormone to resorb calcium and phosphorus from the bones, causing the bones to become weak and mobile.
What cecotropes are and why they’re important
cecotropes are the night feces of rabbits, which need to be reingested for added nutrients. They come out of the cecum.
"to sort". evaluation and prioritizing of patients based on severity of condition to maximize survivors.
Quick assessment for triage
- Respiratory, cardiovascular, CNS
- determines stability. Perfusion/O2 delivery a priority.
neurologic order of assessment of consciousness
- obtunded (minimally responsive)
- stupor (responds to pain only)
- coma (unresponsive)
ER managment: shock
supplemental O2, fluid resuscitation to optimize preload
ER managment: cardiovascular
- auscult, ECG/radiograph/Echo
- minimize stress, O2, diuretics(furosimide), vasodilator (nitro), positive inotrope (dobutamine)
ER managment: respiratory upper airway
O2, decrease stress, sedation, ET tube, PPV
ER managment: CNS, seizures
- seizures, head trauma, spinal cord injury
- catheter, fluids, correct metabolic issues, anticonvulsants, cooling
- watch perfusion, O2/aspiration, deterioration of neuro status
Brain injury assessment
- level of consciousness (alert vs stupor etc.)
- pupilary evaluation (miotic, anisicoria, mydirasis, PLR)
ER managment: CNS, brain injury
- maintain airway/ventilation
- maintain cerebral perfusion
- minimize intracranial pressure (elevate head/neck)
spinal cord function assessment
- 1. conscious proprioception
- 2. voluntary movement (paresis or paralysis)
- 3. pain sensation (not withdrawal reflex)
ER managment: CNS, spinal cord
- function assessment
- medical vs surgical managment. Meds: pain mgmt, sedatives, steroids
- patient mgmt: recumbent care, urine output monitoring
ER managment: GDV
- abd rads (rt lateral), assess severity of hypoperfusion
- O2, fluid resuscitation, gastric decompression (if possible)/gastrocentesis, surgery
- IVF, analgesia, ECG (arrhythmias), monitoring
ER managment: addisonian crisis
- VDA, weight loss, weakness, lethargy, bradycardia, shock
- ACTH stim, BW (no stress, electrolyte), rads (decreased heart), urinalysis (dilute)
- tx: IVF, glucocorticoids
ER managment: DKA
- signs: PUPD, dehydration, weakness, lethargy, VDA
- tx: IVF (dehydration and acid/base), insulin (humulin R), concurrent disease
ER managment: hypocalcemia
- signs: muscle tremors, twitching, seizures
- tx: Ca gluconate, ECG monitoring (prolonged Q-T), parental Ca
ER managment: feline urinary obstruction
- alert to obtunded, vocalizing, vomiting, distended painful bladder, shock, stranguria
- O2 for shock, IVF, drugs (insulin, Ca gluconate, dex)
- diuresis, MONITOR INS VS OUTS
ER managment: dystocia
- prolonged gestation (>65d), unproductive straining for 30-60m, >2h between deliveries, stuck, foul odor
- decrease stress, oxytocin and Ca gluconate, surgery (C-section)
ER managment: pyometra
- 4-5 weeks post-heat, VDA, depression, PUPD, vaginal discharge, fever (dehydration, sepsis, shock, death)
- OHE, medical mgmt with antibiotics and PGF2 for contractions
- treat electrolyte/shock
tx for external toxin
- remove gross contaminate from fur/skin
- protect eyes with ophthalmic
- protect airway
- bathe with mild detergent and lots of water
- monitor temp
tx for inhalation toxicology
- protect airway
- humidified O2
- nebulize and coupage
- intubate and ventilate
tx for GI toxins
- Most common route of poisoning
- emesis (within <1.5h, not with corrosive, coma)
- gastric lavage (rapid removal, caustic ok, gives charcoal, needs general anesthesia)
- adsorbents (activated charcoal, stops entero absorption, repeated doses safe, not for metals, acids, alkalis, alcohols)
- cathartics (decrease GI transit time to limit resorption)
rodenticide toxicity, 2 kinds
- 2 kinds, dif tx times
- 1st gen: warfarin and dicumarol (4-6 days)
- 2nd gen: brodifacoum and bromadiolone (3-4 weeks)
- 3-5 days post ingestion, bleeding from anywhere, petechia, ecchymosis
- tx: emesis if possible, vitK PO for 4-6d or 3-4w, blood products
- rodent bait that doesn't cause bleeding. causes CNS because of decrease in ATP production.
- 12-24h post ingestion, CNS signs, seizures, weakness, ataxia
- tx: emesis, activated charcoal, anticonvulsants/mannitol, IVF
- cats get glutathione deficiency, can't replenish, in cytochrome P450 pathway.
- signs: VD, lethargy, abd. pain, coma, METHEMOGLOBINEMIA (brown mm, facial/paw edema)
- decontamination, supportive care, N-acetylcistine to replace glutathione, ascorbic acid (breaks down methemoglobin)
- VD, pain, lethargy, melena, anemia, shock, ARF
- tx: emesis, gastric lavage, activated charcoal, support/correct ulceration
- VD, agitation, tremors, PUPD, ataxia, tachycardia, arrhythmias
- tx: emesis, activated charcoal, IVF, anticonvulsants, beta blockers
- VD, lethargy, dehydration, weakness
- tx: emesis, diuresis, supportive care
- anemia, pallor, tachycardia, tachypnea, lethargy
- Heinz body anemia
- tx: emesis, supportive care. No antidote
- triggers insulin release, hypoglycemia, liver enzymes
- weakness, seizures
- emesis, activated charcoal, IVF with dextrose, denosyl for hepatocytes
Lily toxicity (TEDS)
- tiger, easter, day and star of bethlehem lillies
- Star toxic to both, others cat
- v/d and death
- flea/tick. sodium channels
- salvation, tremors, ataxia, vomiting, anorexia
- bathe, emesis, activated charcoal, cathartics, diazepam
- HYPERNATREMIA, metabolic acidosis
- v/d, ataxia, tremors
- decontaminate, NO ACTIVATED CHARCOAL (sorbitol), correct electrolytes
- pennies after 1982
- irritates gastric mucosa
- v/d, anorexia, lethargy, intravascular hemolysis (ANEMIA WITH BASOPHILIC STIPPLING and nRBC), hematuria, hemoglobinuria, jaundice, death
- supportive tx, chelation, h2 blockers
ethylene glycol toxicity
- antifreeze, biphasic
- phase 1: ataxia, nausea, stupor (1-2h)
- phase 2: metabolic acidosis, CNS depression, calcium oxalate in kidney
- CNS or GI
- URINE - CA OXALATE CRYSTALURIA
- WOOD'S LAMP - PHOSPHORESCE
- emesis < 1h, IVF, hemodialysis, activated charcoal, FOMEPAZOLE (4-MP) = antidote