Digoxin Toxicity and Discospondylitis Overview
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Digoxin Toxicity and Discospondylitis Overview

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Questions and Answers

What condition is most likely associated with abnormal enamel surfaces that accumulate plaque?

  • Hyperbilirubinemia
  • Diastema
  • Dentinogenesis imperfecta
  • Amelogenesis imperfecta (correct)

    • Which of the following is a possible consequence of tetracycline administration during pregnancy?

  • Enhanced dentinogenesis
  • Amelogenesis imperfecta
  • Permanent tooth discoloration in offspring (correct)
  • Increased risk of enamel hypoplasia

    • Which factor is NOT considered age-related concerning dental health?

  • Increased tooth translucence
  • Intrinsic enamel irregularities (correct)
  • Increased plaque accumulation
  • Food debris in diastema

    • What type of stain is associated with tetracycline use?

    <p>Intrinsically developed stain</p> Signup and view all the answers

    Which of the following conditions is considered a differential diagnosis when examining tooth health?

    <p>Calculus buildup</p> Signup and view all the answers

    What laboratory test might show increased bilirubin levels associated with liver disease in dental assessments?

    <p>CBC</p> Signup and view all the answers

    Which of the following is NOT a suggested form of treatment for external stains on teeth?

    <p>Prophy with fluoride</p> Signup and view all the answers

    What condition is characterized by localized red blood cell destruction that may affect dental health?

    <p>Anemia</p> Signup and view all the answers

    What is the recommended digoxin level range to minimize the risk of toxicity?

    <p>0.5 to 1 ng/mL</p> Signup and view all the answers

    Which population is more commonly affected by digoxin toxicity?

    <p>Geriatric patients</p> Signup and view all the answers

    What is a potential consequence of renal impairment in patients receiving digoxin?

    <p>Need for dosage reduction</p> Signup and view all the answers

    What monitoring is recommended for patients on digoxin regarding heart health?

    <p>Regular assessment of ECG</p> Signup and view all the answers

    Which type of rhythm disturbance is commonly associated with digoxin toxicity?

    <p>Atrioventricular block</p> Signup and view all the answers

    What ECG changes might suggest digoxin toxicity?

    <p>ST segment depression</p> Signup and view all the answers

    How often should serum digoxin concentrations be monitored?

    <p>Periodically</p> Signup and view all the answers

    What should be informed to the owner regarding the digoxin effect on appetite?

    <p>A reduction in appetite may indicate toxicity</p> Signup and view all the answers

    What is the most commonly involved disc space in discospondylitis?

    <p>Lumbo-sacral</p> Signup and view all the answers

    Which organism is identified as the most common cause of bacterial discospondylitis?

    <p>Staphylococcus pseudintermedius</p> Signup and view all the answers

    What percentage of patients with discospondylitis typically present with fever?

    <p>30%</p> Signup and view all the answers

    What diagnostic imaging technique is recommended in cases of substantial neurologic deficits due to discospondylitis?

    <p>Myelography</p> Signup and view all the answers

    Which organism is NOT commonly associated with bacterial discospondylitis?

    <p>Clostridium perfringens</p> Signup and view all the answers

    Which of the following is a potential secondary cause of discospondylitis due to foreign bodies?

    <p>Grass awns</p> Signup and view all the answers

    What type of organisms can cause discospondylitis, besides bacteria?

    <p>Fungal and algal</p> Signup and view all the answers

    In cases of discospondylitis, when do radiographic lesions typically become visible?

    <p>3-4 weeks after infection</p> Signup and view all the answers

    What is a common initial therapy recommended for treating dogs with discospondylitis?

    <p>Amoxicillin trihydrate/clavulanate</p> Signup and view all the answers

    Which of the following laboratory tests is indicated for further diagnostics if cultures are positive?

    <p>Sensitivity testing</p> Signup and view all the answers

    What kind of gait may indicate pain in nonambulatory patients?

    <p>Stilted gait</p> Signup and view all the answers

    What should clients do if clinical signs progress or neurologic deficits develop?

    <p>Contact the veterinarian immediately</p> Signup and view all the answers

    What are common clinical signs of discospondylitis in patients?

    <p>Difficulty rising and reluctance to jump</p> Signup and view all the answers

    Which laboratory finding may precede the diagnosis of urinary tract infections in nonambulatory patients?

    <p>Pyuria</p> Signup and view all the answers

    What is an important aspect of care for nonambulatory patients to prevent complications?

    <p>Maintaining a clean, dry environment</p> Signup and view all the answers

    What is the zoonotic potential associated with discospondylitis caused by Brucella canis?

    <p>Uncommon human infection</p> Signup and view all the answers

    What is a primary indication for the use of glucocorticoids in managing fever?

    <p>Fever associated with immune-mediated diseases</p> Signup and view all the answers

    What is considered a life-threatening fever temperature in the context of treatment?

    <blockquote> <p>106 °F</p> </blockquote> Signup and view all the answers

    Which of the following is NOT recommended as a form of antipyretic treatment?

    <p>Corticosteroids for general use</p> Signup and view all the answers

    Which diagnostic test is specifically used for evaluating immune disorders related to fever?

    <p>Coombs’ test</p> Signup and view all the answers

    In which situation should antipyretic treatment be initiated early?

    <p>When the patient has an underlying heart condition</p> Signup and view all the answers

    Which of the following is a potential side effect of antipyretics?

    <p>Gastrointestinal ulceration</p> Signup and view all the answers

    What imaging study is typically recommended for detecting tumors associated with fever?

    <p>Abdominal radiographs</p> Signup and view all the answers

    What method can be employed for topical cooling in cases of severe fever?

    <p>Evaporative cooling with alcohol on foot pads</p> Signup and view all the answers

    What characterizes non-overt disseminated intravascular coagulation (DIC)?

    <p>Consumption of coagulation factors without clear clinical signs</p> Signup and view all the answers

    Which of the following biochemical changes may indicate affected organs in DIC?

    <p>Altered fibrin(ogen)olytic by-products</p> Signup and view all the answers

    What leads to the hypercoagulable state initially observed in DIC?

    <p>Elevation of tissue factor production</p> Signup and view all the answers

    What are common clinical signs associated with overt DIC?

    <p>Spontaneous bleeding and thrombosis</p> Signup and view all the answers

    Which primary condition is NOT commonly associated with DIC?

    <p>Chronic liver disease</p> Signup and view all the answers

    What might result in mild to moderate thrombocytopenia in DIC?

    <p>Excessive consumption of platelets</p> Signup and view all the answers

    What is the typical age range for clinical manifestations of DIC to occur?

    <p>Variable depending on primary disease</p> Signup and view all the answers

    Which symptom is least likely to indicate DIC in feline patients?

    <p>Mild spontaneous bleeding</p> Signup and view all the answers

    Which condition is often confused with intervertebral disc protrusion due to similar clinical signs?

    <p>Spondylosis deformans</p> Signup and view all the answers

    What is a primary characteristic detectable in cases of vertebral fracture or luxation?

    <p>Bony proliferation of adjacent vertebrae</p> Signup and view all the answers

    In which age range is intervertebral disc protrusion most commonly seen?

    <p>4 to 5 years</p> Signup and view all the answers

    Which breed is specifically noted to have a predilection for vertebral disorders?

    <p>German shepherd</p> Signup and view all the answers

    What may be observed in cerebrospinal fluid (CSF) analysis in cases of focal meningomyelitis?

    <p>Increased protein levels</p> Signup and view all the answers

    Which condition does not typically affect adjacent vertebral end plates when considering vertebral neoplasia?

    <p>Spondylosis deformans</p> Signup and view all the answers

    What is the appropriate outpatient treatment approach for mild pain in cases of vertebral disorders?

    <p>Medication management</p> Signup and view all the answers

    What type of radiographic feature is typically associated with spondylosis deformans?

    <p>Ventral spur formation</p> Signup and view all the answers

    Which condition is least likely to present with hyperthermia in affected dogs?

    <p>Hypothyroidism</p> Signup and view all the answers

    Which of the following drugs is NOT typically associated with causing thrombocytopenia?

    <p>Sulfonamide</p> Signup and view all the answers

    What is the primary purpose of conducting cultures in suspected infectious disease cases?

    <p>To culture an organism for diagnosis</p> Signup and view all the answers

    In cases of fever of unknown origin (FUO), which examination technique may provide valuable insights?

    <p>Retinal examination</p> Signup and view all the answers

    Which symptom is least likely to be associated with infectious disease in dogs?

    <p>Hyperactivity</p> Signup and view all the answers

    Which laboratory test is best suited for identifying the etiology of an infection in a suspected case of septic meningitis?

    <p>Fungal culture from cerebrospinal fluid</p> Signup and view all the answers

    Which of the following fever patterns would be classified as 'intermittent'?

    <p>Temperature that returns to normal between spikes</p> Signup and view all the answers

    What might be the underlying cause of increased lymphocyte counts in a dog?

    <p>Viral infection</p> Signup and view all the answers

    What is the primary purpose of using antipyretics in treatment?

    <p>Reset thermoregulatory set point to a lower level</p> Signup and view all the answers

    Which of the following antipyretics is specifically indicated for use in dogs at a dosage of 10 mg/kg every 12 hours?

    <p>Aspirin</p> Signup and view all the answers

    What is one potential cause of fiber-responsive large bowel diarrhea in dogs?

    <p>Dysbiosis in the gastrointestinal tract</p> Signup and view all the answers

    During a hypoallergenic diet trial for gastrointestinal issues in dogs, what must be strictly avoided?

    <p>Flavored heartworm preventatives</p> Signup and view all the answers

    In treating fever in dogs, which of the following medications is given as a single subcutaneous injection and can also provide IV fluids?

    <p>Flunixin meglumine</p> Signup and view all the answers

    Which dietary strategy is often employed for managing chronic idiopathic large bowel diarrhea in dogs?

    <p>Supplementation with soluble fiber</p> Signup and view all the answers

    What clinical response suggests that a dog with large bowel diarrhea may have abnormal colonic motility?

    <p>Favorable response to dietary fiber supplementation</p> Signup and view all the answers

    Which term refers to a microbial imbalance that could lead to gastrointestinal issues in dogs?

    <p>Dysbiosis</p> Signup and view all the answers

    Which dog breed is commonly associated with lymphocytic plasmacytic colitis?

    <p>German Shepherd</p> Signup and view all the answers

    What is a less common clinical sign associated with colitis in dogs?

    <p>Decreased appetite</p> Signup and view all the answers

    Which condition is known to cause eosinophilic colitis in dogs?

    <p>Food allergy</p> Signup and view all the answers

    What does the histopathologic evaluation of colonic biopsy samples typically show in dogs with colitis?

    <p>Normal limits</p> Signup and view all the answers

    How many biopsy samples are recommended to evaluate colonic conditions in dogs?

    <p>5-6 locations</p> Signup and view all the answers

    What laboratory test is used to detect the presence of whipworms in dogs with diarrhea?

    <p>Fecal flotation</p> Signup and view all the answers

    Which of the following signs is NOT typically associated with chronic colitis in dogs?

    <p>Vomiting</p> Signup and view all the answers

    What primary form of outpatient care is suggested for dogs with mild colitis?

    <p>Dietary fiber supplementation</p> Signup and view all the answers

    Which condition is likely to cause enamel discoloration with black edges?

    <p>Severe dental fluorosis</p> Signup and view all the answers

    What type of staining is characterized by a yellow-brown color due to tooth wear?

    <p>Reparative dentin staining</p> Signup and view all the answers

    What is the potential effect of constant vomiting on dental health?

    <p>Tooth erosion</p> Signup and view all the answers

    Which heavy metal is associated with green discoloration of teeth?

    <p>Nickel</p> Signup and view all the answers

    Which dietary component may cause green discoloration of teeth?

    <p>Chlorophyll-rich foods</p> Signup and view all the answers

    What condition results from the breakdown of hemoglobin leading to green staining of teeth?

    <p>Hemolytic disorders</p> Signup and view all the answers

    What is a common characteristic of dental discoloration related to age?

    <p>Increased yellowing and decreased translucency</p> Signup and view all the answers

    Which food-related issue can lead to enamel pitting?

    <p>Excessive iron and iodine intake</p> Signup and view all the answers

    Which type of enamel is described as bluish-white and translucent?

    <p>Translucent enamel</p> Signup and view all the answers

    What condition results in grayish discoloration and can lead to hypocalcification of enamel?

    <p>Dentinogenesis imperfecta</p> Signup and view all the answers

    Which extrinsic factor is primarily associated with black-brown stains on teeth?

    <p>Bacterial sulfide interaction</p> Signup and view all the answers

    In cases of extrinsic discoloration associated with systemic infections, which of the following agents is mentioned?

    <p>Parvovirus</p> Signup and view all the answers

    What is the characteristic appearance of hypoplasia associated with affected enamel?

    <p>White lesions with horizontal stripes</p> Signup and view all the answers

    What is the primary pigment responsible for the formation of intrinsic stains within enamel?

    <p>Endogenous factors</p> Signup and view all the answers

    Which of the following factors is least likely associated with the formation of plaque-related stains?

    <p>Development of dentinogenesis imperfecta</p> Signup and view all the answers

    What enhances the risk of bacterial 'creeping' around restoration margins?

    <p>Surface accumulation of plaque</p> Signup and view all the answers

    What characterizes overt disseminated intravascular coagulation (DIC)?

    <p>Clinical signs of hemorrhage, thrombosis, and organ failure</p> Signup and view all the answers

    Which of the following biochemical changes is commonly associated with non-overt DIC?

    <p>Decreased production of clotting factors</p> Signup and view all the answers

    What might mimic the clinical presentation of DIC in a patient?

    <p>Hepatic insufficiency</p> Signup and view all the answers

    Which condition is least likely to result in the hypercoagulable state observed in DIC?

    <p>Severe dehydration</p> Signup and view all the answers

    What is an unusual sign of DIC associated with feline patients?

    <p>Uncommon bleeding tendencies</p> Signup and view all the answers

    Which of these factors does NOT typically contribute to the initial phase of DIC?

    <p>Endogenous fibrinolysis</p> Signup and view all the answers

    During the assessment of a patient believed to have DIC, which laboratory finding is most likely to be used for diagnosis?

    <p>Low platelet count</p> Signup and view all the answers

    What is the typical age range for clinical manifestations to appear in cases of DIC?

    <p>Varies depending on the primary disease</p> Signup and view all the answers

    What dental condition is characterized by enamel hypoplasia or irregular surfaces that predispose to plaque accumulation?

    <p>Amelogenesis imperfecta</p> Signup and view all the answers

    Which of the following conditions can be exacerbated by medications like tetracycline during critical developmental periods?

    <p>Enamel hypoplasia</p> Signup and view all the answers

    In relation to the formation of dental abscesses, which factor is commonly considered as a key contributor?

    <p>Diastema</p> Signup and view all the answers

    What metabolic disorder is indicated by a specific enzyme deficiency leading to signs of dental issues such as tooth discoloration?

    <p>Tyrosinemia</p> Signup and view all the answers

    Which of the following conditions is least likely to cause direct dental complications?

    <p>Asthma</p> Signup and view all the answers

    What is a potential clinical outcome of systemic infections on dental health?

    <p>Dental abscessation</p> Signup and view all the answers

    Which of the following systemic factors is often correlated with tooth resorption?

    <p>Chronic renal failure</p> Signup and view all the answers

    What effect does hyperbilirubinemia typically have on dental health perception?

    <p>Causes intrinsic tooth staining</p> Signup and view all the answers

    What is a significant cause for monitoring patients showing predisposing conditions for disseminated intravascular coagulation (DIC)?

    <p>Monitoring laboratory values every 24–48 hours.</p> Signup and view all the answers

    Which of the following is a typical laboratory finding that suggests non-overt DIC?

    <p>Prolongation of activated partial thromboplastin time (APTT).</p> Signup and view all the answers

    What is a common initial approach to managing discospondylitis?

    <p>Cautious use of nonsteroidal anti-inflammatory drugs (NSAIDs).</p> Signup and view all the answers

    Which statement about the incidence of disseminated intravascular coagulation (DIC) is accurate?

    <p>DIC is predominantly observed in dogs with severe systemic inflammatory disease.</p> Signup and view all the answers

    Which factor does NOT have a direct association with the development of disseminated intravascular coagulation (DIC)?

    <p>Mild dehydration.</p> Signup and view all the answers

    Which intervention is recommended when utilizing nonsteroidal anti-inflammatory drugs (NSAIDs) for vertebral infections?

    <p>Assess the effectiveness of antibiotic therapy after discontinuation.</p> Signup and view all the answers

    What is a distinguishing feature of overt disseminated intravascular coagulation (DIC)?

    <p>Significant clinical signs such as organ dysfunction and bleeding.</p> Signup and view all the answers

    What role does acute thrombocytopenia play in the context of disseminated intravascular coagulation (DIC)?

    <p>It suggests a heightened risk of hemorrhage.</p> Signup and view all the answers

    What is the recommended serum digoxin level range to minimize the risk of toxicity?

    <p>0.5 to 1.0 ng/mL</p> Signup and view all the answers

    Which arrhythmia is commonly associated with digoxin toxicity?

    <p>Atrioventricular block</p> Signup and view all the answers

    In which patient demographic is digoxin toxicity most commonly seen?

    <p>Geriatric patients</p> Signup and view all the answers

    What monitoring procedure is essential for patients receiving digoxin?

    <p>Serum digoxin concentration</p> Signup and view all the answers

    What effect does digoxin generally have on appetite?

    <p>Reduces appetite</p> Signup and view all the answers

    What is an important laboratory consideration in patients treated with digoxin, especially the elderly?

    <p>Electrolyte balance</p> Signup and view all the answers

    Which cardiovascular change should be monitored periodically in patients on digoxin?

    <p>ST segment changes</p> Signup and view all the answers

    What is a common symptom indicative of digoxin toxicity in affected patients?

    <p>Severe lethargy</p> Signup and view all the answers

    What is a primary consideration for plasma or whole blood transfusion in patients with coagulation issues?

    <p>To restore clotting factors before surgery</p> Signup and view all the answers

    Which factor may limit patient activity in cases of bleeding disorders?

    <p>Severity of the underlying disease</p> Signup and view all the answers

    What potential complication should be monitored during plasma transfusions?

    <p>Volume overload</p> Signup and view all the answers

    What is a common misconception about the use of corticosteroids in relation to coagulation?

    <p>They impair mononuclear phagocyte function</p> Signup and view all the answers

    What is a critical precaution to consider in patients receiving heparin therapy?

    <p>Possible hemorrhage risk</p> Signup and view all the answers

    Which of the following should NOT be anticipated in patients with uncontrolled bleeding prior to surgery?

    <p>Immediate surgery without stabilization</p> Signup and view all the answers

    Which condition is least likely to warrant the use of fresh frozen plasma transfusion?

    <p>Mild dehydration symptoms</p> Signup and view all the answers

    In what situation might surgery be delayed due to bleeding concerns?

    <p>When clinical signs of DIC are present</p> Signup and view all the answers

    What is the primary goal of daily lab testing in severe cases of DIC?

    <p>To identify positive or negative trends in coagulation</p> Signup and view all the answers

    In which circumstance is heparin the preferred choice of treatment?

    <p>In patients with overt thrombosis and normal coagulation times</p> Signup and view all the answers

    Which of the following factors is commonly involved in the diagnosis of non-overt DIC?

    <p>Prolonged coagulation times</p> Signup and view all the answers

    What is a key feature of the relationship between inflammation and coagulation?

    <p>Inflammation can lead to a hypercoagulable state</p> Signup and view all the answers

    Which parameter often normalizes more rapidly than FDPs in DIC patients?

    <p>Fibrinogen levels</p> Signup and view all the answers

    What might a timely detection of non-overt DIC facilitate?

    <p>Implementation of appropriate prophylactic therapies</p> Signup and view all the answers

    What is a common trend observed in laboratory findings related to DIC?

    <p>Fibrinogen usually decreases while FDPs increase</p> Signup and view all the answers

    Which of the following is NOT a recommended approach for DIC in pets?

    <p>Immediate anticoagulation therapy for all patients</p> Signup and view all the answers

    What is the recommended course of action if a patient's condition is deteriorating rapidly?

    <p>Start combination antibiotic therapy after culture specimens are obtained.</p> Signup and view all the answers

    Which diagnostic procedure is considered a last resort if all other tests fail to determine the cause of the patient's condition?

    <p>Exploratory laparotomy.</p> Signup and view all the answers

    For young animals presenting symptoms of infection, which treatment approach is most appropriate?

    <p>Perform arthrocentesis for culture and cytology.</p> Signup and view all the answers

    What factor does not influence the prognosis for cases of osteomyelitis?

    <p>Presence of neurologic signs.</p> Signup and view all the answers

    What is the importance of performing a lymph node biopsy in veterinary diagnostics?

    <p>It helps determine the presence of myelodysplasia or malignancy.</p> Signup and view all the answers

    Which of the following antibiotics would be appropriate in an emergency setting after culture specimens have been obtained?

    <p>Cephalothin 20 mg/kg IV q6–8h.</p> Signup and view all the answers

    What is a significant risk of extending antibiotic treatment beyond 1-2 weeks if it proves ineffective?

    <p>Development of antibiotic resistance.</p> Signup and view all the answers

    In the context of evaluating myelodysplasia, which diagnostic procedure might be employed?

    <p>Bone marrow aspirate and biopsy.</p> Signup and view all the answers

    Which diagnostic test is commonly performed to identify underlying causes of colitis in dogs?

    <p>Colonic biopsy samples</p> Signup and view all the answers

    What laboratory finding is occasionally observed in dogs with eosinophilic colitis?

    <p>Peripheral eosinophilia</p> Signup and view all the answers

    In which age range are dogs most commonly affected by chronic diarrhea associated with colitis?

    <p>Dogs of all ages up to 14 years</p> Signup and view all the answers

    Which condition is least likely to present with classic signs of chronic diarrhea and tenesmus in dogs?

    <p>Cecal inversion</p> Signup and view all the answers

    What is the recommended approach for managing mild cases of colitis in dogs?

    <p>Outpatient dietary fiber supplementation</p> Signup and view all the answers

    Which type of imaging is indicated in evaluating the abdominal area during colitis diagnosis?

    <p>Abdominal radiographs</p> Signup and view all the answers

    Which breed is commonly associated with colitis according to the given findings?

    <p>German shepherd</p> Signup and view all the answers

    What characterizes the typical presentation of diarrhea due to colitis in dogs?

    <p>Episodic alternating with periods of normal stool</p> Signup and view all the answers

    Study Notes

    Digoxin Toxicity

    • Digoxin toxicity is uncommon, but can happen in patients treated with digoxin, especially geriatric patients.
    • The therapeutic index for digoxin is narrow, and patients with serum concentrations >1.5 ng/mL often show signs of toxicity (even some with normal ranges).
    • Digoxin toxicity is a risk factor for renal impairment, so monitor renal function and electrolytes regularly.
    • Digoxin dosage should be reduced if renal disease develops.

    Discospondylitis

    • Discospondylitis is an infection usually caused by bacteria (like Staphylococcus pseudintermedius, Streptococcus, Brucella canis, and Escherichia coli) or fungi.
    • The infection happens in the intervertebral end plates, discs, and adjacent vertebral bodies. It can also be caused by migrating foreign bodies.
    • The most common area affected is the lumbosacral space.
    • The lumbar spine is most likely to be affected.
    • Signs of discospondylitis include pain, difficulty rising, reluctance to jump, stilted gait, ataxia, paresis, and lameness.
    • Diagnose discospondylitis with spinal radiographs, urine cultures, and blood cultures.
    • Myelography should be performed with substantial neurologic deficits to determine the location of the lesion.
    • Treatment with antibiotics should be tailored to the specific organism causing the infection.
    • Treat patients with supportive care, including comfortable bedding to prevent decubital ulceration.

    Fever

    • Fever is often caused by infectious diseases like FIV, FeLV, Toxoplasmosis, Borrelia, Mycoplasma, Bartonella, Anaplasma, Ehrlichia, Rickettsia, FIP, and systemic mycoses.
    • Fever can also be caused by non-infectious diseases such as immune-mediated disease and certain tumors (e.g., lymphoma).
    • Glucocorticoids should be used with caution and should only be utilized to treat fever after infectious causes have been ruled out.
    • Glucocorticoids can mask clinical signs, immunosuppress the patient, and interfere with diagnosis and treatment.
    • Antipyretics should be used with caution in patients with impaired organ function and only when fever is prolonged and life-threatening.
    • Antipyretics can cause emesis, diarrhea, gastrointestinal ulceration, and renal complications.

    ### Fiber-Responsive Large Bowel Diarrhea in Dogs

    • Occurs in dogs of all ages, with median age of 6 years
    • More common in German shepherd, miniature schnauzer, cocker spaniel, miniature or toy poodle
    • Diarrhea is chronic, soft to liquid, often with mucus, blood, increased frequency, and urgency
    • Can be episodic, alternating with periods of normal stool
    • 25% of dogs have continuous diarrhea
    • Other signs include occasional vomiting, decreased appetite during episodes
    • Cause likely unknown, may be related to stress, abnormal personality traits, motility and/or dysbiosis
    • Responds to dietary soluble fiber supplementation

    Pathophysiology

    • Dysbiosis is defined as microbial imbalance in the gastrointestinal tract
    • In dogs, soluble fiber is a prebiotic that is fermented by colonic bacteria, altering microbial composition or activity
    • Causes
    • Clostridium perfringens
    • Lymphocytic plasmacytic colitis
    • Eosinophilic colitis
    • Miscellaneous types of colitis
    • Irritable bowel syndrome
    • Colonic neoplasia (adenocarcinoma, lymphoma, adenoma)
    • Cecal inversion

    Diagnosis

    • No consistent or specific abnormalities in CBC, Biochemistry, or Urinalysis
    • Multiple fecal flotations by zinc sulfate to rule out parasites
    • Abdominal radiographs are usually within normal limits
    • Colonoscopy can also be performed, but usually within normal limits or only mild nonspecific findings

    Treatment

    • Treatment focuses on dietary fiber supplementation
    • Hypoallergenic diet trial for 2-3 weeks
    • If no improvement in stool quality, further investigation needed
    • During food trial, no other supplements/nutrients should be given

    Other Key Points

    • Pathologic findings
    • Histopathologic evaluation of colonic biopsy samples usually within normal limits
    • Multiple biopsy samples should be taken from the cecum to the rectum
    • Activity level does not have to be modified during treatment

    Disseminated Intravascular Coagulation (DIC)

    • DIC is an acquired hemostatic defect resulting from various inciting causes that leads to intravascular activation of coagulation and consumption of clotting factors.
    • The disorder results in widespread formation of microthrombi with clinical manifestations of thrombosis and/or hemorrhage.
    • Non-overt DIC is the early, compensated form of DIC, featuring consumption of coagulation factors and generation of microthrombi without clear clinical signs.
    • Overt DIC is the classic phenotype associated with hemorrhage, thrombosis, and organ failure.

    Causes

    • DIC is a complication of a variety of primary conditions.
    • It begins with a hypercoagulable state that leads to production or embolization of microthrombi in small vessels.
    • Common causes include:
      • Gastric dilatation-volvulus
      • Heart failure
      • Heartworm disease
      • Heat stroke

    Signalment

    • Primarily diagnosed in dogs.
    • More common in dogs than cats.
    • No significant breed predilection.
    • Age and sex are dependent on underlying disease.

    Signs

    • Vary with primary disease and DIC-associated organ dysfunction.
    • May include:
      • Petechiae
      • Bleeding from venipuncture sites, mucosa, or into body cavities.
      • Bleeding is infrequent in cats.

    Incidence/Prevalence

    • Associated with severe systemic inflammatory disease.
    • Suspect DIC any time thrombocytopenia and prolonged clotting tests are seen together.

    Diagnosis

    • Laboratory monitoring every 24-48 hours is recommended for patients with predisposing conditions.
    • A sudden drop in platelet count and a 20-30% prolongation in APTT is suspicious for non-overt DIC.
    • CBC/biochemistry/urinalysis may show:
      • Inflammatory leukogram, often with a stress component.
      • Mild to moderate thrombocytopenia (40-100 × 103/μL); less reliable in cats.
      • Anemia is possible.
      • Red blood cell (RBC) fragmentation is a supportive finding.
      • Biochemical changes reflect affected organs; acute kidney injury may result in increased FDP values.

    Differential Diagnosis

    • Hepatic insufficiency may mimic DIC.
    • Mild idiopathic thrombocytopenia may also be seen.
    • Spontaneous bleeding is uncommon unless DIC is present.

    Treatment

    • Early intervention is critical to prevent progression to overt DIC.

    Prognosis

    • Variable, depending on the etiology and response to treatment.
    • Mortality rate can be high, especially in cases of overt DIC.

    Digoxin Toxicity

    • Digoxin toxicity is not uncommon in patients treated with digoxin due to its narrow therapeutic index and prevalence of renal impairment in elderly patients with cardiac disease.
    • Target digoxin levels to be between 0.5 and 1 ng/mL, this minimizes the risk of toxicity.
    • Monitor ECG periodically to assess for conduction disturbances (AV block, arrhythmias, and ST segment depression).

    Disseminated Intravascular Coagulation (DIC)

    • DIC is a serious condition with a guarded to poor prognosis.
    • Usually there is no specific pharmacologic therapy for DIC itself.
    • Key positive findings for DIC are clinical improvement and arrest of bleeding.
    • Daily lab testing (coagulation tests, fibrinogen, platelet counts) is warranted in severe cases.
    • Heparin may be used in patients with overt thrombosis or those at high risk of thrombosis, with normal coagulation times.

    Colitis

    • Colitis is a common condition in dogs of all ages, with a median age of 6 years.
    • German Shepherd, Miniature Schnauzer, Cocker Spaniel, and Miniature or Toy Poodle breeds are commonly affected.
    • Chronic diarrhea (soft to liquid) with large bowel characteristics, tenesmus, excess fecal mucus, hematochezia, increased frequency and urgency, and periods of normal stool are key clinical signs.
    • No consistent or specific abnormalities are found in CBC/BIOCHEMISTRY/URINALYSIS, although peripheral eosinophilia may be seen in some cases.
    • Multiple fecal flotations are essential for diagnosis and to rule out other causes, such as whipworms and other parasites.
    • Dietary fiber supplementation and appropriate activity levels are key components of treatment.
    • Multiple biopsies from throughout the colon are necessary for accurate histopathologic evaluation.

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    Canine and Feline Digoxin Toxicity PDF

    Description

    Explore the key aspects of digoxin toxicity and discospondylitis in this quiz. Digoxin toxicity is particularly concerning in geriatric patients due to its narrow therapeutic index, while discospondylitis is an infection impacting the vertebral bodies. Understand the risks, signs, and necessary monitoring for both conditions.

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