NAVLE COMPREHENSIVE QUESTIONS AND
ANSWERS SET A+
✔✔This 11-year-old spayed female cat is presented with generalized weakness and
unable to lift her head.
The owners have noticed her at the water bowl more often and she seems to be
urinating more in the last month.
Which blood chemistry test would be most likely to diagnose cause of her weakness?
A - Sodium
B - Potassium
C - Chloride
D - Calcium
E - Bicarbonate - ✔✔B
Potassium. This is a classic presentation of a cat with hypokalemic myopathy which is
often due to potassium loss from renal disease.
Other causes of generalized weakness and neck ventroflexion include polymyositis,
organophosphate toxicity, myasthenia gravis.
✔✔Last Fall several malformed calves, that looked like the image below, were born on
this ranch. This Spring, the owner could not deliver feed to the back pasture for 3 days.
Now, 14 days later, heifers on this pasture are losing weight, off feed and lethargic.
Physical exam is unremarkable except for large linear cracks extending to the dermis on
muzzles of affected cows.
Blood chemistry and urinalysis results from a sick cow are below
Na=122 mEq/l...................[N=136-144], K=2.2 mEq/l..[N=3.6-4.9]
Ca=6 mg/dl......................[N=8.4-11.0], ALT=70 u/l..[N=6.9-35]
,CK=150 u/l.......................[N=0-350], SDH=82 u/l..[N=4.3-15.3]
Bilirubin (total)=0.6 mg/dl..[N=0-1.6], BUN=140 mg/dl..[N=10-25]
Creatinine=4.0 mg/dl.........[N=0.5-2.2], Glob=4.4 g/dl..[N=3.0-3.5]
Alb=2.2 g/dl......................[N=2.5-3.8]
USp.G= 1.010...................[N=1.030-1.045] protein +++, blood +++, numerous granular
and hyaline - ✔✔A
Check the pasture for oak trees and acorns. This is a classic case of acorn/oak bud
toxicosis (Quercus spp.).
The sick animals have tubular nephritis evidenced by high urinary protein, casts, low
urine specific gravity, and high BUN and creatinine.
The nephritis is caused by hungry heifers eating green oak leaves that would have
sprouted in the Spring.
The deformed calf is called an "acorn" calf. These calves are the result of a cows on a
low protein diet coupled with acorn ingestion in mid to late pregnancy (in the Fall).
Pigweed (Amaranthus spp) and lamb's quarter (chenopodium) are sources of nitrate
toxicity. Look for a presentation involving hypoxia (muscular tremors, weakness, brown
cyanotic mucous membranes) due to methemoglobinemia.
Lysine deficiency may contribute to necrotic ear syndrome in pigs.
Selenium or vitamin E deficiency is associated with white muscle disease. Look for
stiffness and sudden death due to myocardial lesions in newborn calves.
Think of cerebellar hypoplasia or weak calves born with congenital BVD.
✔✔A 7 year-old intact female poodle is presented. The owner has noted a lot of drinking
and some urinary accidents in the house in the last week and that the dog hasn't
seemed herself either.
Yesterday she vomited twice. On physical exam the dog appears depressed and
listless, has dark injected mucous membranes and a distended tender abdomen.
T=104 F (40 C)..[N=99.5-102.5 F, N=37.2-39.2 C]
HR=100 bpm.....[N=60-120]
RR=30 brpm......[N=15-34]
What diagnosis is of most immediate concern?
A - Pregnancy
,B - Intestinal foreign body
C - Hepato-splenic tumor
D - Diabetes mellitus
E - Pyometra - ✔✔E
The preferred answer is canine pyometra.
Pyometra is a life-threatening emergency which typically requires immediate surgery
(ovariohysterectomy) if the cervix is closed and there is no obvious discharge. Open
cervix pyometras are likely to present with a purulent discharge, simplifying Dx, but
surgical ovariohysterectomy is still recommended.
Pyometra should always be near the top of your DDX when presented with an older
intact female dog or cat with a fever and distended abdomen.
✔✔A 2-week old calf is presented that is dehydrated and almost emaciated from weight
loss. She has a 1 week history of watery, foamy diarrhea and exhibits tenesmus during
examination.
The calf is the only sick one in a mixed group of calves that range from 3 weeks to 2
months of age. What is the diagnosis?
A - Colibacillosis
B - Cryptosporidiosis
C - Coccidiosis
D - Ostertagiasis
E - Coronavirus - ✔✔B
Watery diarrhea in a SINGLE animal (1-4 weeks) in a group, plus emaciation suggests
Cryptosporidiosis.
Expect a more acute, lethal presentation of hemorrhagic diarrhea in 1-4 DAY old calves
with Colibacillosis, and multiple cases with the viral diarrheas like Rotavirus - (5d-2 wks
old, self limiting); Coronavirus, (4-30d).
OLDER-animal diarrheas on this list include Coccidiosis ( Older than 21 days and in
ALL ages, bloody diarrhea, tenesmus) Ostertagiasis (anorexia, poor growth, diarrhea in
less than 2 year olds on pasture- a chronic disease).
✔✔A 7-year old male German shepherd is presented with a history of weakness in the
hind limbs, urinary incontinence and recent obsessive chewing around his tail area.
Dorsiflexion of the tail over the back and extension of the hind limbs elicits a painful
response.
, There is moderate hindlimb ataxia. He does not withdraw each hind leg when a toe is
pinched, but bears weight on the hindlimbs. Patellar reflexes are normal. What is the
clinical diagnosis?
A - Wobbler syndrome
B - Diskospondylitis
C - Hip dysplasia
D - Cauda equina syndrome
E - Radiculoneuritis - ✔✔D
This is a common presentation of Cauda equina syndrome. Look for PAIN in the
lumbosacral area (elicited by tail raise, hindlimb extension), LMN hindlimbs, especially
Sciatic nerve damage at L7-S1 (lack withdrawal), +/- urinary/fecal incontinence, +/-
SELF-MUTILATION of tail, perineum, pelvic limb.
Lesion due to compression of cauda equina at L7-S1 (lumbosacral stenosis). Can be
congenital (abn development dorsal arch L7-S1, small dogs, Border Collies) or acquired
(degenerative changes, big dogs, especially German Shepard, Rottweiler, Boxer).
Wobbler syndrome is a cervical spinal cord disease (also called cervical vertebral
instability/ caudal cervical spondylomyelopathy). In adult form it is an intervertebral disc
disease, usually seen at C5-C6 or C6-C7 in Dobies> 5 yrs, Great Danes < 2 years.
Diskospondylitis is a good second choice on your DDX of a large middle aged dog
presenting with lumbosacral pain. Due to bacterial/fungal infection of intervertebral disk
and adjacent vertebral bodies. Look for systemic signs like fever (1/3 of patients),
weight loss, anorexia. Follow this link to see a Merck image of diskospondylitis.
✔✔Two calves aged 8 weeks are presented that are both down and extremely weak.
They are depressed and lying in pools of foul-smelling brown diarrhea with a small
amount of blood. One other calf died suddenly the night before with no signs at all.
They are found to be dehydrated, with rectal temperatures of 105.2 and 105.6 F (40.7 -
40.9 C)..[N=101.5-103.5F, N=37.8-39.7 C], respectively.
Based on the condition at the top of the differential diagnosis list, what is the treatment
plan?
A - Immunize well and sick calves and adult cattle with MLV vaccine, ABX for sick
calves
B - NSAIDS, ABX in feed & water
C - IV Fluids, NSAIDS, Frequent milk feeding, ABX if septic
D - Cull sick calves, Disinfect feeding areas, Prophylactic ABX and NSAIDs for well
ANSWERS SET A+
✔✔This 11-year-old spayed female cat is presented with generalized weakness and
unable to lift her head.
The owners have noticed her at the water bowl more often and she seems to be
urinating more in the last month.
Which blood chemistry test would be most likely to diagnose cause of her weakness?
A - Sodium
B - Potassium
C - Chloride
D - Calcium
E - Bicarbonate - ✔✔B
Potassium. This is a classic presentation of a cat with hypokalemic myopathy which is
often due to potassium loss from renal disease.
Other causes of generalized weakness and neck ventroflexion include polymyositis,
organophosphate toxicity, myasthenia gravis.
✔✔Last Fall several malformed calves, that looked like the image below, were born on
this ranch. This Spring, the owner could not deliver feed to the back pasture for 3 days.
Now, 14 days later, heifers on this pasture are losing weight, off feed and lethargic.
Physical exam is unremarkable except for large linear cracks extending to the dermis on
muzzles of affected cows.
Blood chemistry and urinalysis results from a sick cow are below
Na=122 mEq/l...................[N=136-144], K=2.2 mEq/l..[N=3.6-4.9]
Ca=6 mg/dl......................[N=8.4-11.0], ALT=70 u/l..[N=6.9-35]
,CK=150 u/l.......................[N=0-350], SDH=82 u/l..[N=4.3-15.3]
Bilirubin (total)=0.6 mg/dl..[N=0-1.6], BUN=140 mg/dl..[N=10-25]
Creatinine=4.0 mg/dl.........[N=0.5-2.2], Glob=4.4 g/dl..[N=3.0-3.5]
Alb=2.2 g/dl......................[N=2.5-3.8]
USp.G= 1.010...................[N=1.030-1.045] protein +++, blood +++, numerous granular
and hyaline - ✔✔A
Check the pasture for oak trees and acorns. This is a classic case of acorn/oak bud
toxicosis (Quercus spp.).
The sick animals have tubular nephritis evidenced by high urinary protein, casts, low
urine specific gravity, and high BUN and creatinine.
The nephritis is caused by hungry heifers eating green oak leaves that would have
sprouted in the Spring.
The deformed calf is called an "acorn" calf. These calves are the result of a cows on a
low protein diet coupled with acorn ingestion in mid to late pregnancy (in the Fall).
Pigweed (Amaranthus spp) and lamb's quarter (chenopodium) are sources of nitrate
toxicity. Look for a presentation involving hypoxia (muscular tremors, weakness, brown
cyanotic mucous membranes) due to methemoglobinemia.
Lysine deficiency may contribute to necrotic ear syndrome in pigs.
Selenium or vitamin E deficiency is associated with white muscle disease. Look for
stiffness and sudden death due to myocardial lesions in newborn calves.
Think of cerebellar hypoplasia or weak calves born with congenital BVD.
✔✔A 7 year-old intact female poodle is presented. The owner has noted a lot of drinking
and some urinary accidents in the house in the last week and that the dog hasn't
seemed herself either.
Yesterday she vomited twice. On physical exam the dog appears depressed and
listless, has dark injected mucous membranes and a distended tender abdomen.
T=104 F (40 C)..[N=99.5-102.5 F, N=37.2-39.2 C]
HR=100 bpm.....[N=60-120]
RR=30 brpm......[N=15-34]
What diagnosis is of most immediate concern?
A - Pregnancy
,B - Intestinal foreign body
C - Hepato-splenic tumor
D - Diabetes mellitus
E - Pyometra - ✔✔E
The preferred answer is canine pyometra.
Pyometra is a life-threatening emergency which typically requires immediate surgery
(ovariohysterectomy) if the cervix is closed and there is no obvious discharge. Open
cervix pyometras are likely to present with a purulent discharge, simplifying Dx, but
surgical ovariohysterectomy is still recommended.
Pyometra should always be near the top of your DDX when presented with an older
intact female dog or cat with a fever and distended abdomen.
✔✔A 2-week old calf is presented that is dehydrated and almost emaciated from weight
loss. She has a 1 week history of watery, foamy diarrhea and exhibits tenesmus during
examination.
The calf is the only sick one in a mixed group of calves that range from 3 weeks to 2
months of age. What is the diagnosis?
A - Colibacillosis
B - Cryptosporidiosis
C - Coccidiosis
D - Ostertagiasis
E - Coronavirus - ✔✔B
Watery diarrhea in a SINGLE animal (1-4 weeks) in a group, plus emaciation suggests
Cryptosporidiosis.
Expect a more acute, lethal presentation of hemorrhagic diarrhea in 1-4 DAY old calves
with Colibacillosis, and multiple cases with the viral diarrheas like Rotavirus - (5d-2 wks
old, self limiting); Coronavirus, (4-30d).
OLDER-animal diarrheas on this list include Coccidiosis ( Older than 21 days and in
ALL ages, bloody diarrhea, tenesmus) Ostertagiasis (anorexia, poor growth, diarrhea in
less than 2 year olds on pasture- a chronic disease).
✔✔A 7-year old male German shepherd is presented with a history of weakness in the
hind limbs, urinary incontinence and recent obsessive chewing around his tail area.
Dorsiflexion of the tail over the back and extension of the hind limbs elicits a painful
response.
, There is moderate hindlimb ataxia. He does not withdraw each hind leg when a toe is
pinched, but bears weight on the hindlimbs. Patellar reflexes are normal. What is the
clinical diagnosis?
A - Wobbler syndrome
B - Diskospondylitis
C - Hip dysplasia
D - Cauda equina syndrome
E - Radiculoneuritis - ✔✔D
This is a common presentation of Cauda equina syndrome. Look for PAIN in the
lumbosacral area (elicited by tail raise, hindlimb extension), LMN hindlimbs, especially
Sciatic nerve damage at L7-S1 (lack withdrawal), +/- urinary/fecal incontinence, +/-
SELF-MUTILATION of tail, perineum, pelvic limb.
Lesion due to compression of cauda equina at L7-S1 (lumbosacral stenosis). Can be
congenital (abn development dorsal arch L7-S1, small dogs, Border Collies) or acquired
(degenerative changes, big dogs, especially German Shepard, Rottweiler, Boxer).
Wobbler syndrome is a cervical spinal cord disease (also called cervical vertebral
instability/ caudal cervical spondylomyelopathy). In adult form it is an intervertebral disc
disease, usually seen at C5-C6 or C6-C7 in Dobies> 5 yrs, Great Danes < 2 years.
Diskospondylitis is a good second choice on your DDX of a large middle aged dog
presenting with lumbosacral pain. Due to bacterial/fungal infection of intervertebral disk
and adjacent vertebral bodies. Look for systemic signs like fever (1/3 of patients),
weight loss, anorexia. Follow this link to see a Merck image of diskospondylitis.
✔✔Two calves aged 8 weeks are presented that are both down and extremely weak.
They are depressed and lying in pools of foul-smelling brown diarrhea with a small
amount of blood. One other calf died suddenly the night before with no signs at all.
They are found to be dehydrated, with rectal temperatures of 105.2 and 105.6 F (40.7 -
40.9 C)..[N=101.5-103.5F, N=37.8-39.7 C], respectively.
Based on the condition at the top of the differential diagnosis list, what is the treatment
plan?
A - Immunize well and sick calves and adult cattle with MLV vaccine, ABX for sick
calves
B - NSAIDS, ABX in feed & water
C - IV Fluids, NSAIDS, Frequent milk feeding, ABX if septic
D - Cull sick calves, Disinfect feeding areas, Prophylactic ABX and NSAIDs for well
