Endocrine Disease
How can regular crystalline insulin be administered?
IV as a CRI
SQ: 6-8 hours duration
IM: 2-6 hours duration
What medications are used to treat an animal in Stage C mitral valve disease in the acute phase and as long term therapy?
Long term: Pimobendan, furosemide, ACE inhibitor
Name 3 anti-emetic drugs for dogs and cats and their mechanisms of actions
What is:
Maripotant- Nk-1 inhibitor (comes in oral and injectable formulations)
Ondansetron-5HT-3 receptor antagonist (USE PARENTERAL FORMULATION BECAUSE ORAL HAS VERY POOR BIOAVAILABLE)
Metaclopramide-
Acepromazine-
What is the first, second, third and fourth line drugs in treating long term seizures?
1st: Phenobarbitoal
2nd: potassium bromide
3rd: Zonisamide
4th: Levetiracetam (aka. Keppra)
What drug class are penicillins, cephalosporins, carbapenams?
What is their mechanism of action?
Beta-lactams
These drugs all target cell wall synthesis by binding to penicillin binding protein.
which ACE inhibitor is safer for patients with renal disease?
Benazepril
What drug is indicated for use to treat life threatening systemic fungal diseases like coccidomycosis, blastomycosis, cryptococcus?
What drug class?
Amophtericin-B-Polyene
What drug is known to cause fatal pulmonary edma in felines?
Cisplatin
What drug class is Bexagliflozin an velagliflozin?
What is the mechanism of action?
SGLT-2 (sodium-glucose co-transportor 2) inhibitors
inhibits function of the proximal tubule SGLT-2 to increase the excretion of glucose in the urine.
Which diuretic is considered "potassium sparing" and what is its mechanism of action?
Spironolactone- aldosterone receptor inhibitor
Cisparide, metaclopramide, erythromycin, ranitidine
What are the first second and third line drugs for status epilepticus?
1st: Benzodiazapines
2nd: Propfol
3rd: Keppra
What antibiotics are considered CONCENTRATION dependent?
FAN-
Floroquinolones, Aminoglycosides, Nitromidazoles (metronidazole)
According to IRIS guidelines, at what stage is a kidney diet recommended?
Stage 1-recommended to change to renal therapeutic diet
What anti-parasitic can be use to treat tritrichomonas and coccidia?
Ronidizole or metronidazole
Doxirubicin causes what type of toxicity in dogs? in cats?
Dogs: cardio toxicity
Cats: nephrotoxicity
What medications is used to treat Cushing's Disease?
Which medication is suppose to cause adrenal necrosis?
Trilostane and mitotane
Mitotane
What medication is a positive inotrope AND vasodilator?
Pimobendan
What antibiotic should be used for antibiotic responsive gastroenteropathy?
What antibiotic should NOT be used?
Tylosin-macrolide should be used for 2 weeks.
Metronidazole should not be used because a lack of efficacy and 100% relapse rate.
What medications is approved for prevention of noise phobias in dogs?
What drug class?
Sileo, Dexmeditomidine.
Alpha-2 agonist
What adverse affects should be clients be warned about when handling chloramphenicol?
Non-regenerative aplastic anemia in humans
What are the first line drugs for hypertension in DOGS and CATS
What are the first line drugs for proteinuria in DOGS AND CATS
Hypertension-
dogs: ACE Inhibitor (benazapril or enalapril), amlodipine (CCB), telmisartan (ARB)
Cats: Telmisartan, amlodipine, or 2x dose of amlodipine,
proteinuria:
Dogs: telmisartan,
Cats: Telemisartan or ACE inhibitor
What topical ear flush/medication can be used for a patient with acute otitis externa secondary to malassezia infection?
Yeast otitis – Acetic acid/boric acid flushes may be effective but can be irritating in some dogs. – Antifungal products (i.e. clotrimazole, miconazole, ketoconazole, thiabendazole, nystatin).
● Use steroid containing products to reduce inflammation.
What is a known and predictable effect to an animal being treated with carboplatin?
Delayed and DOUBLE nadir
What medication is used for replacement therapy for patient's with hypothyroidism?
Levothyroxine (synthetic T4)
What are the four sympathomimetics?
Epinephrine
norepinephrine
dopamine
Dobutamine
What medication can be used to treat steroid responsive enteropathy?
(Hint: not pred!)
Budesonide- glucocorticoid with less systemic effects
What Drug class is Clonidine ?
Hint: you don't get one.
centrally acting Alpha-2 agonist- used to treat behavioral disorders, particularly anxiety or phobia-related, in dogs (e.g., separation anxiety, noise phobias, such as fireworks or thunderstorms, veterinary visits, hospitalization, and travel). It is frequently used as supplemental therapy in pets that do not respond to conventional therapies.
Which antimicrobial drugs can be used to treat Ehrlichia canis, Rickettsia rickettsii, AND Upper respiratory tract infections?
What electrolyte/chemistry abnormalities should be monitored for patients with CKD?
Hypokalemia
hyperphosphatemia
Hypocalcemia
Azotemia- increased creatinine
Increased SDMA
What chemo drugs cross the blood brain barrier?
CCNU
5-FU
Cyclophosphamide
cytosine arabinoside
What endocrine disease can lead to HCM in felines? What medication do you treat this endocrine disease?
Hyperthyroidism- Methimazole can be given orally or transdermally
What is an adulticide used to treat heart worm disease?
Melarsamine
What can be used an emetic in dogs? Cats?
Ropinerole, apomorphine, hydrogen peroxide
xylazine, dexmedetomidine
What drug glass is used to treat separation anxiety?
(Hint: MOA=inhibits re-uptake of seritonin, norepinephrine and other neurotransmitters)
Tricyclic antidepressants- clomipramine (AKA Clomicalm), amitryptaline, Imipramine, nortriptyline
Selective seritonin Re-uptake Inhibitor: Fluoxetine, Setraline, peroxitine, fluvoxamine
What is the first line drug for canine bacterial prostatitis?
What adverse effect does this drug cause? (hint: think about young animals and in cats)
Enrofloxacin
Can cause cartilage damage and a dose dependent blindness in cats
What are the three phases of AKI?
What is the treatment for AKI?
Latent
Maintenance
Recovery
Treat with supportive care and aggressive fluid therapy
Which antifungal in the Azole drug class has the most adverse effects associated with it?
Ketoconazole
What supportive care techniques can be used for patients with osteosarcoma?
Manage obesity :
exercise
Inactivity can cause muscle weakness and stiff joints, causing OA clinical signs to be exacerbated. Over exercise can also worsen OA clinical signs. Generally, exercise ensures flexibility, muscle strength, joint mobility, and cardiovascular health. Passive movement, active assisted exercise, active restricted exercise
Other Physical Therapies
What insulin is FDA approved for dogs? Cats?
Dogs are FDA approved for Lente insulin (aka Vetsulin) *U-40*
but can also NHP (aka humulinN) *U-100* since it is cheaper
Cats are FDA approved for PZI (aka Prozin) *U-40*
But can also use Glarginine (aka Lantus) *U-100*
What are the four classes of antiarrhthmatics?
Class 1 -sodium channel blockers (lidocaine, mixiletine)
class 2 - beta blockers (Atenolol)
class 3 - potassium channel blocker (sotalol)
class 4 - calcium channel blockers (diltiazem)
Match a drug that antagonize each receptor.
What does oral diazpeam cause to cats?
Fatal hepatic failure
What can be used to treat feline Tritrichomonas?
Ronidazole
what micro organism is most commonly found in patient bacterial cystitis?
What micro organism is most commonly found in patients with struvite stones?
E. coli
Staph
What drugs are used in the "CHOP" protocol?
Doxirubicin
Vinncristine
cyclophosphamide
Diabetes mellitus is a common secondary disease in felines due to over production of growth hormone. What disease is this and how is it treated?
Acromegaly-
Dopamine agonists or somatostatin analogues
Radiotherapy
Hypophysectomy
High-dose insulin therapy to combat insulin resistance
What breeds/species are predisposed to DCM? HCM?
Dogs: large breed dogs like dobermans, german shepherds, great danes.
Cats: maine coons, ragdolls, sphinx
What is a synthetic prostaglandin used for prevention of gastric ulcers associated with NSAID toxicity?
Misoprostol
What does KBr cause in cats?
fatal penuomonitis
What is the first line drug of choice for a patient with uncomplicated urinary tract infection? How long should it be used for?
Amoxicillin can be safely used because higher concentrations can be achieved in the urine than in the tissues. Treatment should be 3-5 days
what stones can and cannot be seen on radiographs?
Which ones can be treated through conservative medical dissolution?
Calcium oxalate and struvites can be seen on radiographs
Cystein and urates cannot be seen on radio graphs
I CANT C-U
dissolution of Cystein and struvites can be attempted in stable animals without urethral obstruction. No dissolution protocol for CaOx calculi exists-surgery is usually indicated,
What is a an appropriate treatment for a patient diagnosed with otodectes cynotis?
revolution can be applied
ivermectin drops
What are first line, second line, and third line immunosuppresive drugs for dogs?
Cats?
Immunosuppressive that interfere with nucleotide synthesis:
Cytotoxic immunosuppressives:
Second line immunosuppressive drugs:
Note. The best second line immunosuppressive medications in cats are chlorambucil and cyclosporine.
Third line immunosuppressive drugs
Note. If you add a third line drug, it will commonly replace the second line drug.
Treating with more than one adjunctive immunosuppressive drug causes significant immunosuppression and increases the risk of infection.
What medication can be given to a patient with Addison's disease to supplement glucocorticoids and mineralcorticoids?
Prednisone and DOCP can be used together
or
Fludrocortisone can be used
What is the ONLY way to diagnose pulmonary edema in a patient who is in CHF? What medications/treatments should be instituted immediately?
Thoracic radiographs
oxygen supplementation and IV furosemide should be used to treat a patient who is in respiratory distress secondary to pulmonary edema
What medication is used to treat hepatic encephalopathy?
Lactulose enemas
What breed of dog is predisposed to developing degenerative myelopathy?
What supportive care/treatments are used to manage these cases?
German Shepherd dogs, but also boxers, chesapeake bay retrievers, Rhodesian Ridgebacks, pembroke welsh corgis
There is no proven effective treatment. Vitamins (i.e., vitamin E, vitamin B complex, vitamin C), omega-3 fatty acids, and antioxidants have been suggested to help but conclusive evidence is lacking. Exercise and physiotherapy may help in slowing progression of disease.
What antimicrobial can be used empirically for cats with suspected acute bacterial upper respiratory URI?
Doxycycline- beware of esophageal strictures !
"The Working Group believes that doxycycline is a good first choice because it is well tolerated by cats; most B. bronchiseptica isolates from cats are susceptible to doxycycline in vitro (by unapproved standards for testing), despite resistance to other agents such as beta-lactams and sulfonamides,29–31 and doxycycline is effective in vivo for the treatment of cats with C. felis infections,27,32–34 and Mycoplasma spp. infections.35 Doxycycline is also effective for the treatment of a variety of chlamydial and mycoplasma infections in cats"
What medication should be given for patients with ethylene glycol toxicity?
Fomepizole is used as an antidote in confirmed or suspected methanol or ethylene glycol poisoning. Fomepizole is a competitive inhibitor of alcohol dehydrogenase, the enzyme that catalyzes the initial steps in the metabolism of ethylene glycol and methanol to their toxic metabolites.
ONLY EFFECTIVE in the FIRST 3 HOURS for cats! (8-12 hours in dogs)
Ethanol can also be used
What chemotheraputic drugs are alkalyzing agents?
Azathioprine
Chlorambucil
cyclophosphamide