Companion Animal Advanced Clinical Management WEEK 2

The efficacy of some chemotherapy drugs depends on whether the target cells are in a sensitive phase of the cell cycle. This can almost always be predicted by their mechanism of action/cellular target molecule. Which of the following drugs is cell cycle phase-dependent?

The dose of chemotherapy a clinician may select relies on several pharmacokinetic and pharmacodynamic considerations. Which of the following regarding chemotherapy dose considerations is TRUE?

Which of the following pairing of drug, species and side effect is INCORRECT?

A 7-year-old MN Labrador Retriever presents to your clinic 7 days after his first doxorubicin chemotherapy. He was feeling well yesterday, but this morning did not want to eat his breakfast and seems to be feeling worse since then. What is your top differential?

There are some forms of lymphoid cancer (such as chronic lymphocytic leukemia, or T-zone lymphoma) that act in a more indolent fashion. They are thus characterized by slower progression of the disease, and slower cell turnover/proliferation than seen in the more clinically aggressive forms of lymphoid cancers. Which of the following would be the MOST appropriate treatment option for a cancer that has a lower rate of proliferation?

What are the 3 most common general adverse effects associated with chemotherapy?

Which of the following chemotherapies crosses the blood-brain barrier and causes hepatotoxicity?

Doxorubicin can cause __________ in cats.

Which of the following drugs is an opioid that is commonly used as an antitussive in dogs with chronic bronchitis?

Which of the following chemotherapy drugs is a microtubule inhibitor, causes a peripheral neuropathy due to inhibition of microtubules that promote normal signaling along the axon, and can also cause a thrombocytosis due to alterations in microtubule management of megakaryocytes?

A 7-year-old castrated male domestic medium haired cat is presented in respiratory distress. Which of the following would be the best clinical finding to differentiate cardiac from non-cardiac causes of respiratory distress in this cat?

In patients with pulmonary edema secondary to left-sided congestive heart failure, what therapeutic intervention will help improve blood oxygen levels the most rapidly?

A 12-year-old DSH cat with a previous diagnosis of hypertrophic cardiomyopathy is presented in respiratory distress – pale mucous membranes, open-mouth breathing, eyes bulging. A brief point-of-care ultrasound identifies a large amount of pleural effusion, concerning for CHF. Sedation with butorphanol and a ½ dose of dexmedetomidine is given IM, an IV catheter is placed, and propofol is given to perform thoracocentesis. During the procedure, the patient goes into cardiopulmonary arrest. What would you have done differently for this patient?

A 13-year-old poodle mix is presented to you for a recheck exam and prescription refill of furosemide (your colleague at the practice has recently retired). You are reviewing the record and note the dog has had a grade III/VI left apical murmur first noted when he was 10 years old. He was brought in for a dry, honking cough when he was 11 years old, and a furosemide trial was prescribed (2 mg/kg twice daily (standard starting dose for CHF)). In the record it is noted that the cough mildly improved so the furosemide was continued. Radiographs have not been performed since he was 10 years old, and no abnormalities were noted at that time. Since the last visit, the owner says the cough is “about the same as it’s always been,” and the dog is otherwise doing fine. What is the problem with the current furosemide treatment plan?

Referring to the poodle mix in the previous question:

A 13-year-old poodle mix is presented to you for a recheck exam and prescription refill of furosemide (your colleague at the practice has recently retired). You are reviewing the record and note the dog has had a grade III/VI left apical murmur first noted when he was 10 years old. He was brought in for a dry, honking cough when he was 11 years old, and a furosemide trial was prescribed (2 mg/kg twice daily – standard starting dose for CHF). In the record it is noted that the cough mildly improved so the furosemide was continued. Radiographs have not been performed since he was 10 years old, and no abnormalities were noted at that time. Since the last visit, the owner has decreased the dose to once daily and says the cough is “about the same as it’s always been.” And he is otherwise doing fine.

Of the following choices, what would be your single best recommendation for this patient today?

A 9-year-old Maine Coon cat is hospitalized for treatment of acute left-sided congestive heart failure secondary to hypertrophic cardiomyopathy characterized by respiratory distress and severe hypoxemia. He has been receiving supplemental oxygen and 4 mg/kg of furosemide every 6 hours for the last 24 hrs.

His respiratory rate, heart rate, and mentation have greatly improved in the last 8 hours, but your astute technicians alert you that he has lost 5% of his body weight since admission and his urine production has decreased. You are concerned that he has mild but clinically obvious dehydration (likely 5% dehydrated (delayed skin tent, dry mucous membranes)) on exam. What would be your best recommendation for this patient?

Why has spironolactone been added to the recommended initial therapy for dogs in congestive heart failure?

What is the most important nutritional treatment goal for all patients in Stage B2 thru Stage D heart disease?

Why is moderate salt restriction recommended in patients (who are eating well!) in Stage C and Stage D heart disease?

Sassy is a 10-year-old female Schnauzer mix who is presented for increased thirst and urination, polyphagia, and a pot-bellied appearance. She has a historical diagnosis of MMVD and had an episode of congestive heart failure six months ago. She has been doing well on the medications (furosemide, enalapril, pimobendan, spironolactone) so far. An arterial blood pressure (Doppler method, average reading) is measured and is 200 mmHg. Initial lab work findings are highly suggestive of Cushing’s disease. Testing for Cushing’s disease is pending, and the veterinarian elects to start amlodipine in the meantime. Why is starting amlodipine a good treatment decision for this patient?

Where should the needle be placed when performing a thoracocentesis?

Which of the following is the MOST appropriate therapy for a patient with a hemothorax due to a coagulopathy from rodenticide ingestion?

Which of the following can be safely used and is most effective to induce emesis in a cat?

Why is ingestion of raw bread dough potentially toxic to dogs? SELECT ALL THAT APPLY. a. dyspnea b. ethanol toxicosis c. gastric distension d. pancreatitis

Why is placement of a urinary catheter or frequent walks important in patients with chocolate toxicosis?

In dogs, xylitol toxicosis can lead to which of the following? SELECT ALL THAT APPLY. a. hepatic necrosis b. hypoglycemia c. renal failure d. seizure activity

Which of the following is the preferred antidote for ethylene glycol toxicity?

Paintball ingestion can lead to which of the following?

A dog that has been playing with a Bufo toad and is now hypersalivating and has brick red mucous membranes. Which of the following is the most important thing to do first?

Match the toxin with the appropriate antidote therapy.

1. Amphetamine A. pamidronate

2. Selective serotonin reuptake inhibitor B. cyproheptadine

3. Cholecalciferol C. vitamin K1

4. Warfarin D. acepromazine

A ferret presents to your clinic with pyrexia, anorexia, and a mucopurulent nasal discharge. On examination you find a papular dermatitis on the chin and hyperkeratosis of the foot pads. Which of the following is the most accurate regarding treatment of this disease in ferrets?

What are the two most common causes of feline upper respiratory infections?

True or false: Most upper respiratory infections in cats are self-limiting and do not require treatment beyond supportive care.

In addition to lethargy, anorexia, or fever, what clinical sign is an indication that antibiotic therapy may be required for a cat with an acute upper respiratory tract infection?

Why is placement of a urinary catheter or frequent walks important in patients with chocolate toxicosis?

A 2-year-old Miniature Lop rabbit presents with mucopurulent nasal discharge, discolored forelimbs and a history of sneezing. You suspect the rabbit has ‘snuffles’, also known as pasteurellosis. Which of the following is true about this condition?

What type of drugs are terbutaline and albuterol?

Which of the following is an inhaled glucocorticoid that is used in the long-term management of feline asthma?

Which of the following drugs is an opioid that is commonly used as an antitussive in dogs with chronic bronchitis?

All of the following may be indicated in the treatment of bacterial pneumonia EXCEPT which of the following?