https://en.wikivet.net/api.php?action=feedcontributions&feedformat=atom&user=Kbaldwin 2026-05-03T02:58:38Z User contributions MediaWiki 1.35.0 https://en.wikivet.net/index.php?title=Malassezia_Dermatitis&diff=98842 2010-11-22T16:29:30Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermitis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with° a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> The most common method of diagnosis is by microscopic examination of a tape stip reveealing an increased number of ''Malassezia pachydermitis''. Clear adhesive tape is applied to the affected area and removed, stained and examined under oil emersion. The yeast can also be cultured on Sabrouraud's dextrose agar at 32-37°C for 3-5 days.<br /> ==Treatment==<br /> Treatment is aimed at reducing the yeast population and treatingany underlying skin conditions. The first choice of treatment is an antifungal medcated shampoo containing miconazole and chlorhexidine. Selenium sulphide in combination with enilconazole or ketoconazole can also be used topically but is less effective.The use of systemic antifungal drugs such as ketoconazole can also be considered. The response to treatment should be measured by clinical response and by a reduction in yeast populations on lsion skin upon microscopic examination. <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> * Bond, R, Hendricks, A. (2008) '''Veterinary Dermatology Integrated Bvetmed course notes''' Department of Veterinary Clinical Sciences and Patology and Infectious Disease. Royal Veterinary College, University of London. <br /> <br /> [[Category: To Do - Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Malassezia_Dermatitis&diff=98841 2010-11-22T16:29:05Z

<p>Kbaldwin: </p> <hr /> <div> {{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermitis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with° a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> The most common method of diagnosis is by microscopic examination of a tape stip reveealing an increased number of ''Malassezia pachydermitis''. Clear adhesive tape is applied to the affected area and removed, stained and examined under oil emersion. The yeast can also be cultured on Sabrouraud's dextrose agar at 32-37°C for 3-5 days.<br /> ==Treatment==<br /> Treatment is aimed at reducing the yeast population and treatingany underlying skin conditions. The first choice of treatment is an antifungal medcated shampoo containing miconazole and chlorhexidine. Selenium sulphide in combination with enilconazole or ketoconazole can also be used topically but is less effective.The use of systemic antifungal drugs such as ketoconazole can also be considered. The response to treatment should be measured by clinical response and by a reduction in yeast populations on lsion skin upon microscopic examination. <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> * Bond, R, Hendricks, A. (2008) '''Veterinary Dermatology Integrated Bvetmed course notes''' Department of Veterinary Clinical Sciences and Patology and Infectious Disease. Royal Veterinary College, University of London. <br /> <br /> [[Category: To Do - Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Malassezia_Dermatitis&diff=98840 2010-11-22T16:26:55Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermidis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> The most common method of diagnosis is via microscopy of a tape strip which will yield an increased number of {{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermitis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with° a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> The most common method of diagnosis is by microscopic examination of a tape stip reveealing an increased number of ''Malassezia pachydermitis''. Clear adhesive tape is applied to the affected area and removed, stained and examined under oil emersion. The yeast can also be cultured on Sabrouraud's dextrose agar at 32-37°C for 3-5 days.<br /> ==Treatment==<br /> Treatment is aimed at reducing the yeast population and treatingany underlying skin conditions. The first choice of treatment is an antifungal medcated shampoo containing miconazole and chlorhexidine. Selenium sulphide in combination with enilconazole or ketoconazole can also be used topically but is less effective.The use of systemic antifungal drugs such as ketoconazole can also be considered. The response to treatment should be measured by clinical response and by a reduction in yeast populations on lsion skin upon microscopic examination. <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> * Bond, R, Hendricks, A. (2008) '''Veterinary Dermatology Integrated Bvetmed course notes''' Department of Veterinary Clinical Sciences and Patology and Infectious Disease. Royal Veterinary College, University of London. <br /> <br /> [[Category: To Do - Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Malassezia_Dermatitis&diff=98838 2010-11-22T16:01:05Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermidis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> ==Treatment==<br /> ==Literature Search==<br /> ==References==<br /> <br /> **Regional lesions: muzzle, ears, interdigital, perianal<br /> **Or generalised disease<br /> **Erythematous, hyperpigmented, [[Skin Glossary - Pathology|lichenified]] and scaly lesions with alopecia<br /> *Microscopically:<br /> **[[Skin Glossary - Pathology|hyperkeratosis, parakeratosis]]<br /> **Spongiotic pustular dermatitis<br /> **[[Skin Glossary - Pathology|Acanthosis]]<br /> **Organisms are usually present, minimum 3-5 yeasts per high-power field must be found to imply cause of disease<br /> <br /> <br /> Grossly, regional lesions may be seen around the muzzle, [[Ear - Anatomy &amp; Physiology|ears]], interdigital, and perianal. Other common signs include erythema, hyperpigmentation, [[Skin Glossary - Pathology|lichenified]] and scaly lesions with alopecia.<br /> <br /> Microscopically, one may see;[[Skin Glossary - Pathology|hyperkeratosis, parakeratosis]], spongiotic pustular dermatitis, [[Skin Glossary - Pathology|Acanthosis]].<br /> <br /> [[Category: To Do - Dermatology]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Malassezia_Dermatitis&diff=98837 2010-11-22T16:00:00Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermitis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.<br /> <br /> ==Pathogenesis==<br /> ''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.<br /> ==Diagnosis==<br /> ===History===<br /> Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed. <br /> ===Clinical signs===<br /> Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.<br /> The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs. <br /> ===Laboratory tests===<br /> ==Treatment==<br /> ==Literature Search==<br /> ==References==<br /> <br /> **Regional lesions: muzzle, ears, interdigital, perianal<br /> **Or generalised disease<br /> **Erythematous, hyperpigmented, [[Skin Glossary - Pathology|lichenified]] and scaly lesions with alopecia<br /> *Microscopically:<br /> **[[Skin Glossary - Pathology|hyperkeratosis, parakeratosis]]<br /> **Spongiotic pustular dermatitis<br /> **[[Skin Glossary - Pathology|Acanthosis]]<br /> **Organisms are usually present, minimum 3-5 yeasts per high-power field must be found to imply cause of disease<br /> <br /> <br /> Grossly, regional lesions may be seen around the muzzle, [[Ear - Anatomy &amp; Physiology|ears]], interdigital, and perianal. Other common signs include erythema, hyperpigmentation, [[Skin Glossary - Pathology|lichenified]] and scaly lesions with alopecia.<br /> <br /> Microscopically, one may see;[[Skin Glossary - Pathology|hyperkeratosis, parakeratosis]], spongiotic pustular dermatitis, [[Skin Glossary - Pathology|Acanthosis]].<br /> <br /> [[Category: To Do - Dermatology]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Flea_allergic_Dermatitis&diff=98836 2010-11-22T14:48:02Z

<p>Kbaldwin: Redirected page to Flea Allergic Dermatitis</p> <hr /> <div>#REDIRECT [[Flea Allergic Dermatitis]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Flea_allergic_Dermatitis&diff=98835 2010-11-22T14:47:31Z

<p>Kbaldwin: Redirected page to XxxxxFlea Allergic Dermatitisxxxxx</p> <hr /> <div>#REDIRECT [[xxxxxFlea Allergic Dermatitisxxxxx]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98834 2010-11-22T14:46:50Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is [[Flea allergic Dermatitis]]('''FAD''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98833 2010-11-22T14:45:55Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is <br /> #REDIRECT [[xxxxxFlea allergic dermatitisxxxxx]]<br /> ('''FAD''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98832 2010-11-22T14:43:55Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is [[Flea allergic dermatitis]] ('''FAD''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98831 2010-11-22T14:43:19Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''[[flea allergic dermatitis]]'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98830 2010-11-22T14:41:41Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98829 2010-11-22T14:40:16Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To_Do_-_Review]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98828 2010-11-22T14:39:02Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> [[Image:miliary dermatitis.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Review]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98827 2010-11-22T14:26:13Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> <br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Review]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98826 2010-11-22T14:19:19Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease the most common of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparasitism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable pruritus and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Cats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair plucks and coat brushings examined micropscopically may show evidence of ectoparasitism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependent on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> <br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Review]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Bibliography&diff=98825 2010-11-22T14:19:13Z

<p>Kbaldwin: </p> <hr /> <div>This page contains a list of books used on the WikiVet site in the correct referencing format. If your book is not listed, please insert it in alphabetical order of the primary author. All our WikiVet authors can use this page to copy and paste references and thus save time. <br /> <br /> To reference specific information within the text, please use the superscript format as is used on Wikipedia. The explanation of how to use this extension is available here: [[:Extension:Cite|Citation extension]].<br /> <br /> * Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) '''Bovine Medicine''' (Second edition), ''Blackwell Publishing''<br /> * Bertone, J. (2006) '''Equine Geriatric Medicine and Surgery''', ''Elsevier''<br /> * Brown, C.M, Bertone, J.J. (2002) '''The 5-Minute Veterinary Consult- Equine'''', Lippincott, Williams &amp; Wilkins''<br /> * Blood, D.C. and Studdert, V. P. (1999) '''Saunders Comprehensive Veterinary Dictionary (2nd Edition)''' ''Elsevier Science'' <br /> * Cowart, R.P. and Casteel, S.W. (2001) '''An Outline of Swine diseases: a handbook''' ''Wiley-Blackwell''<br /> * Divers, T.J. and Peek, S.F. (2008) '''Rebhun's diseases of dairy cattle''' ''Elsevier Health Scieneces''<br /> * Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''<br /> * Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2)''W.B. Saunders Company''<br /> * Fossum, T. W. et. al. (2007) '''Small Animal Surgery (Third Edition)''' ''Mosby Elsevier''<br /> * Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''<br /> * Fox, M and Jacobs, D. (2007) '''Parasitology Study Guide Part 2: Helminths''' ''Royal Veterinary College''<br /> * Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''<br /> * Jackson, G.G. and Cockcroft, P.D. (2007) '''Handbook of Pig Medicine''' ''Saunders Elsevier''<br /> * Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students''' ''University of Liverpool''<br /> * Knottenbelt, D.C, Pascoe, R.R. (2003) '''Colour atlas of Diseases and Disorders of the Horse''' ''Elsevier Health Sciences''<br /> * Mair, T.S, Divers, T.J, Ducharme, N.G (2002) '''Manual of Equine Gastroenterology''', ''WB Saunders''.<br /> * Mair, T., Love, S., Schumacher, J. and Watson, E. (1998) '''Equine Medicine, Surgery and Reproduction''' ''WB Saunders Company Ltd'' <br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Pasquini, C, Pasquini, S, Woods, P (2005) '''Guide to Equine Clinics Volume 1: Equine Medicine''' (Third edition), ''SUDZ Publishing''.<br /> * Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) '''Veterinary Microbiology and Microbial Disease''' ''Blackwell Publishing''<br /> * Radostits, O.M, Arundel, J.H, and Gay, C.C. (2000) '''Veterinary Medicine: a textbook of the diseases of cattle, sheep, pigs, goats and horses''' ''Elsevier Health Sciences''<br /> * Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders''.<br /> * Reed, S.M, Bayly, W.M, Sellon, D.C. (2004) '''Equine Internal Medicine''' (Second Edition) ''Saunders''.<br /> * Robinson, N.E., Sprayberry, K.A. (2009) '''Current Therapy in Equine Medicine''' (Sixth Edition) ''Saunders Elsevier''<br /> * Rose, R. J. and Hodgson, D. R. (2000) '''Manual of Equine Practice''' (Second Edition) Sauders.<br /> * Straw, B.E. and Taylor, D.J. (2006) '''Disease of Swine''' ''Wiley-Blackwell''<br /> * Sturgess, K. (2003) '''Notes on Feline Internal Medicine''' Blackwell Publishing.<br /> * Tams, T.R. (2003) '''Handbook of Small Animal Gastroenterology''' (2nd edition) Saunders.<br /> * Taylor, D.J. (2006) '''Pig Diseases''' (Eighth edition) ''St Edmunsdbury Press ltd''<br /> * Tilley, L.P. and Smith, F.W.K.(2004)'''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> *Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry''' (3rd Edition) BSAVA <br /> * White, N.A., Edwards, G.B. (1999) '''Handbook of Equine Colic''' ''Reed Educational and Professional Publishing Ltd''</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98824 2010-11-22T14:07:53Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis. <br /> Miliary dermatitis is a manifestation of an underlying pruritic skin disease he most comon of which is ''flea allergy dermatitis'' ('''''FAD''''') which accounts for approximately 85 % of cases. It is also seen in cases of allergic skin disease such as ''atopic dermatitis'' and ''food allergy'' and ectoparatism such as ''Cheyletiellosis'', ''trombiculidiasis'' and ''pediculosis''. Less commonly it is seen as a presentation of ''dermatophytosis'' and bacterial folliculitis.<br /> Miliary Dermatitis should be thought of as a descriptive term rather than a diagnosis. <br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition. The condition occurs in cats.<br /> ==Diagnosis==<br /> ===History===<br /> Affected cats will present with a history of variable prurius and alopecia of the trunk and neck. In cases with an underlying flea allergic dermatitis there may be a history of a flea infestation. <br /> ===Clinical Signs===<br /> Ctats present with small papulocrustous lesions of the skin often on the dorsal neck and trunk which feel like small 'millet seeds' when the coat is groomed. The level of pruritus is variable and may be associated with traumatic alopecia which often has a symmetrical pattern. Eosinophilic plaques may occur concurrently. <br /> ==Laboratory tests==<br /> Laboratory tests are aimed at discovering the underlying cause. Skin scrapes, hair pluck and coat brushing examined micropscopically may show evidence of ectoparatism. Dermatophyte culture or microscopy can be used if dermatophytosis is suspected. Traumatic alopecia can be differentiated from other causes of alopecia via microscopic examination of the hair shaft revealing split or broken distal ends. <br /> ==Treatments==<br /> Treatment is dependant on the underlying cause. As flea allergic dermatitis is the most common underlying cause flea treatment is often initiated whilst investigating other possible causes. <br /> <br /> ==Literature Search==<br /> ==References==<br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Review]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Feline_Miliary_Dermatitis&diff=98823 2010-11-22T13:37:40Z

<p>Kbaldwin: </p> <hr /> <div>[[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]<br /> <br /> {{unfinished}}<br /> <br /> ==Introduction==<br /> Feline Miliary Dermatitis (FMD) is a multifactorial disease of cats characterised by multiple papulocrustous lesions of the skin. The term &quot;miliary&quot; is commonly used to describe the millet-seed like appearance of the typical lesions of miliary dermatitis.<br /> <br /> ==Signalment==<br /> There is no age, breed or sex predilection for the condition.<br /> ==Pathogenesis==<br /> Most cases of FMD occur due to an allergic response, most commonly to fleas. Other conditions such as nutritional deficiencies, ectoparasitism, immune-mediated disease and other allergies may lead to the development of FMD. <br /> <br /> ==Clinical signs==<br /> The characteristic papulocrustous lesions develop<br /> <br /> <br /> [[Category:Allergic Skin Diseases]]<br /> [[Category:To Do - Blood]][[Category:To Do - Clinical]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98607 2010-11-16T17:03:34Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Laboratory findings===<br /> Eosinophilia may be evident on haematology.<br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ===Bronchoscopy===<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying allergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as ''cyclophasphamide''.<br /> <br /> ==Prognosis==<br /> The prognosis is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98606 2010-11-16T17:02:33Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Laboratory findings===<br /> Eosinophilia may be evident on haematology.<br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ===Bronchoscopy===<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying allergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as ''cyclophasphamide''.<br /> <br /> ==Prognosis==<br /> The prognosis is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> ==References==<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98605 2010-11-16T17:01:51Z

<p>Kbaldwin: /* Treatment */</p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Laboratory findings===<br /> Eosinophilia may be evident on haematology.<br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ===Bronchoscopy===<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying allergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as ''cyclophasphamide''.<br /> <br /> ==Prognosis==<br /> The prognosis is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98604 2010-11-16T16:58:03Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Laboratory findings===<br /> Eosinophilia may be evident on haematology.<br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ===Bronchoscopy===<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying alergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as cyclophasphamide. <br /> <br /> ==Prognosis==<br /> The prognosis is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98603 2010-11-16T16:51:03Z

<p>Kbaldwin: /* Prognosis */</p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ==Bronchoscopy==<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying alergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as cyclophasphamide. <br /> <br /> ==Prognosis==<br /> The prognosis is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98602 2010-11-16T16:50:14Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease - Eosinophillic Pulmonary Granulomatosis'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincical signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnoea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. ''Eosinophilic Pulmonary Granulomatosis'' results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ==Bronchoscopy==<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features of malignancy which may represent potential antigenic sources. Diagnosis may be complicated by the presence of a bacterial secondary infection resultng in a neutrophillic inflammation and a positiove culture on tracheal wash. Once the bacterial infection has been controlled, a second tracheobronchial wash may harvest eosinophils. <br /> ==Treatment==<br /> Any underlying disease needs to be treated directly. Eliminating the source of the antigen that may the triggering the excessive immune response may result in a cure. The most effective management consists of ''corticosteroids''. When PIE is secondary to heartworm disease or pulmonary parasites, treatment with prednisolone before or during treatment antihelmintic treatment controls the pulmonary signs. Prolonged therapy is often needed when the underlying alergen is unknown starting at a high dose and gradually tapering down. When severe bronchoconstriction is suspected, ''bronchodilators'' or ''b2-agonists'' may be helpful.<br /> &lt;br&gt; ''Eosinophilic Pulmonary Granulomatosis'' requires treatment with corticosteroids and a cytotoxic agent such as cyclophasphamide. <br /> <br /> ==Prognosis==<br /> The prognoss is fair to good although there is a wide spectrum of disease severity. Some dogs require long term corticosteroid therapy. ''Eosinophillic Pulmonary Granulomatosis'' carries a guarded prognosis.<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98601 2010-11-16T16:35:57Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincial signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorexia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Radiography===<br /> The most common radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. Eosinophilic Pulmonary Granulmatosis results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ==Bronchoscopy==<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearance. Tracheobronchial washes may show evidence of eosinophillic inflammation. Pulmonary specimens shouldbe carefully examined for the presence of infectious agents and for features od malignancy which may represent potential antigenic sources. <br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98599 2010-11-16T16:22:44Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincial signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance, wheezing and occasionally haemoptysis may be seen.The cough may be mild or severe, productive or nonproductive, and progressive or nonprogressive. Systemic signs are rarely present but may include anorecia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> &lt;br&gt; Severely affected animals may exhibit moderate to severe dyspnea and cyanosis at rest.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Radiography===<br /> The most comon radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. Eosinophilic Pulmonary Granulmatosis results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ==Bronchoscopy==<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearannce<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98598 2010-11-16T16:20:04Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia (PIE) is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors.<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> ==History &amp; Clincial signs==<br /> Eosinophillic lung diseases are seen in young and older dogs. It is rare in the Cat.<br /> &lt;br&gt; Affected dogs usually present because of slowly progressive respiratory signs such as a cough, increased respiratory effort and exercise intolerance. Systemic signs are rarely present but may include anorecia and weight loss. There may be a history of a recurring cough which is unresponsive to antibiotics but often responsive to corticosteroid therapy. The clinical signs may be seasonal in appearance.<br /> ==Diagnosis==<br /> ===Physical examination===<br /> Physical examination is largely normal. Thoracic auscultation may reveal crackles or expiratory wheezes. <br /> ===Radiography===<br /> The most comon radiographic finding is a diffuse ''Interstitial lung pattern'', a bronchial and/or alveolar pattern may also be visible. Eosinophilic Pulmonary Granulmatosis results in the formation of nodules, usually with indistinct borders. Consolidation of lung lobs and a hilar lymphadenopathy may also be seen. <br /> ==Bronchoscopy==<br /> Bronchoscopy may reveal increased amounts of mucous in the airways which may have a greenish appearannce<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98597 2010-11-16T16:08:03Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia is a broad term describing an inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a hypersensitivity reaction to an unidentified allergen such as microfilariae of heartworms, lungworms, chronic bacterial or fungal infections (eg, histoplasmosis, aspergillosis), viruses, external antigens, and unknown precipitating factors<br /> &lt;br&gt; '''Eosinophillic pulmonary granulomatosis''' is a severe type of PIE seen in dogs and is characterzied by the development of nodules and hilar lymphadenopathy. It is most often associted with a hypersensitivity reaction to microfilarie in heartworm infection. <br /> <br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To_Do_-_KatieB]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Pulmonary_Infiltration_with_Eosinophilia&diff=98595 2010-11-16T15:59:32Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> Also known as : '''''PIE - Eosinophillic Lung disease'''''<br /> <br /> ==Introduction==<br /> Pulmonary Infiltration with Eosinophilia is a broad term describing inflammatory lung disease in which the predominant infiltrating cell is the eosinophil. It is thought to be an immune mediated condition where the airway abnormalities are a consequence of a reaction to an unidentified allergen. <br /> <br /> *A group of small animal diseases in which there is a predominance of eosinophils in the airways<br /> *Generally considered that there is underlying hypersensitivity to allergens<br /> <br /> [[Category:Allergic Respiratory Diseases]][[Category:To Do - Blood]][[Category:To Do - Clinical]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Degenerative_Mitral_Valve_Disease&diff=98594 2010-11-16T15:21:57Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> Also known as: '''''MVD — Mitral Valve Disease — Mitral insufficiency — Mitral endocardiosis — Myxomatous Mitral Valve Disease (MMVD) - Endocardiosis'''''<br /> <br /> ==Introduction==<br /> [[Image:AV valve dysplasia cat.jpg|right|thumb|200px|&lt;small&gt;&lt;center&gt;'''Mitral dyplasia'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> Mitral valve dysplasia is a congenital malformation or degeneration of the mitral valve leaflets and its supporting structures (chordae tendinae, papillary muscles, valvular leaflets, annulus) resulting in valvular regurgitation (insufficiency). It is common in dogs and cats and rare in other species.<br /> <br /> Chronic mitral regurgitation leads to volume overload of the left heart, which results in dilatation (eccentric hypertrophy) of the left ventricle and atrium. When mitral regurgitation is severe, cardiac output decreases, which results in signs of left sided cardiac failure (LCHF) and pulmonary venous congestion. Dilatation of the left-sided chambers predisposes affected animals to [[:Category:Arrhythmia|arrhythmias]]. In some cases, malformation of the mitral valve complex causes a degree of valvular stenosis as well as insufficiency.<br /> <br /> In advanced cases, signs of right sided congestive heart failure may follow due to an increased pressure load on the right ventricle as a result of long standing pulmonary congestion. <br /> <br /> ==Signalment==<br /> Typically in middle aged to older small breed dogs. Genetically predisposed breeds include Cavalier King Charles Spaniel, Bull Terriers, German Shepherds, and Great Danes.<br /> <br /> ==Diagnosis==<br /> ===History===<br /> Animals may remain asymtomatic for years. Typical reported signs include exercise intolerance and dyspnoea as a result of reduced cardiac output and a ventilation perfusion mismatch due to pulmonary oedema. A progressive cough often during rest or recumbancy is frequently seen and needs to be distinguished from primary respiratory disease. Sudden death is possible due to a left atrial tear or advanced pulmonary oedema. <br /> <br /> ===Clinical Signs===<br /> * Left apical systollic murmur<br /> * Left sided congestive heart failure<br /> **Resting Tacchycardia<br /> **Pale Mucous membranes<br /> ** Prolonged Capillary refill time (CRT)<br /> ** Prolonged Jugular filling time<br /> ** Pulmonary crackles / evidence of pulmonary oedema<br /> ** Cool extremities<br /> ** Loss of sinus arrhythmia<br /> ** Cardiac arrhythmias e.g. Atrial fibrillation, Atrial premature complexes<br /> ===Diagnostic imaging===<br /> ====Radiography====<br /> Left Lateral, right lateral and ventrodorsal views of the thorax are needed. The key radiographic signs associated with mitral valve dysplasia and resulting left sided congestive heart failure are cardiomegaly, pulmonary venous congestion (enlarged pulmonary arteries and veins) and pulomary oedema. Cardiomegaly may lead to dorsal displacement of the trachea. <br /> <br /> Evidence of Right sided congestive heart failure maybe evident in severe cases e.g. distended caudal vena cava, hepatomegaly, ascites, pleural effusions.<br /> <br /> ====Echocardiography====<br /> Evidence of left atrial and left venrticular enlargement is visible on echocardiography. The 'fractional shortening' is also increased which is measured as the percentage change in the left ventricular diameter during systole and is used as a measure of systollic function. It is also possible to see structural changes in the valve leaflets in some cases. The regurgitant jet of blood can be detected using colour doppler and evidence of turbulent flow.<br /> <br /> ===Electrocardiogram (ECG)===<br /> A resting ECG trace may show evidence of an enlarge left atrium (Wide P Wave), an enlarged left ventricle (Tall R wave, wide QRS complex, shift of mean electrical axis to the left) and rhythm disturbances such as sinus tacchycardia, atrial fibrillation, atrial premature complexes and atrial Tacchycardia.<br /> <br /> ===Laboratory Tests===<br /> Pro-brain natriuretic peptide (N-BNP) is a newly described cardiac hormone considered to be an effective marker of severity and prognosis of acute coronary syndromes and congestive heart failure. Circulating levels of the hormone increase in peripheral blood with increased myocardial stress. Commercial assays are not currently available.<br /> <br /> ==Treatment==<br /> No treatment is recommended prior to the onset of heart failure. Once there is evidence of congestive heart failure, treatment is aimed at its management through a combination of drugs. <br /> <br /> The aims of treatment are to:<br /> <br /> 1. '''Reduce Preload''' <br /> ::Diuretics to reduce circulating fluid volume (Frusemide, Benzofluazide, Spironolactone, Amiloride)<br /> ::Vasodilators to reduce venous return (Nitrates, ACE inhibitors, Alpha antagonists)<br /> 2. '''Reduce Afterload <br /> ::Vasodilators to decrease systemic vascular resistance <br /> :::ACE inhibitors e.g. Enalapril, Benzapril, Imidopril , <br /> :::Pimobendan<br /> :::Calcium channel blockers e.g. Amlodipine<br /> :::Nitrates e.g. Nitroprusside<br /> 3. '''Enhance Systolic function<br /> ::Positive Inotropes to increase cardiac contractility and increase cardiac output.<br /> :::Pimobendan<br /> :::Digoxin<br /> :::Dobutamine<br /> :::Xanthines<br /> 4. '''Improve Diastolic function<br /> ::Negative Chronotropes to increase the length of diastole (digoxin, atenolol)<br /> ::Calcium channel blockers to improve relaxation (amlodipine)<br /> 5. '''Control cardiac arrhythmias using anti-arrhythmic drugs<br /> <br /> ==Prognosis==<br /> Mitral Valve Dysplasia can remain asymptomatic for many years (average 4 years). Once congestive heart failure has developed, the progression of the diseae can be monitored by the severity of the clinical signs (cough, exercise intolerance) and radiographically looking at caridac size, the degree of pulmonary oedema and the size of the left atrium. Cardiac size can be measured objectively using the Vertebral Heart Score method. <br /> Mean survival of 200-300 days once in overt cardiac failure with standard treatment protocols.<br /> <br /> ==Literature Search==<br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley, L.P. and Smith, F.W.K.(2004)'''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams &amp; Wilkins''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> <br /> [[Category:Cardiovascular_System_-_Developmental_Pathology]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98593 2010-11-16T15:20:45Z

<p>Kbaldwin: /* Treatment */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Common underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseminated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation.<br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension of the inflammatory focus to invlove the myocardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a prolonged course (&gt;4 weeks) of oral medication. <br /> &lt;br&gt;Common Protocols use Ampicillin in combination with a Fluoroqunilone such as Enrofloxacin.<br /> &lt;br&gt;Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed.<br /> <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98592 2010-11-16T15:19:06Z

<p>Kbaldwin: /* Electrogcardiogram (ECG) */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Common underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseminated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation.<br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension of the inflammatory focus to invlove the myocardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98591 2010-11-16T15:18:04Z

<p>Kbaldwin: /* Physical examination */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Common underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseminated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation.<br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98590 2010-11-16T15:16:48Z

<p>Kbaldwin: /* Species differences */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Common underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98589 2010-11-16T15:16:02Z

<p>Kbaldwin: /* References */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98588 2010-11-16T15:15:27Z

<p>Kbaldwin: /* References */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.<br /> * Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.<br /> * Elwood, C.M., Cobb, M.A., Stepien, R.L., (1993) Clinical and echocardiographic findings in 10 dogs with vegetative bacteria endcarditis. '''Journal of small animal practice'''. 34, pp420-427.<br /> <br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98587 2010-11-16T15:10:58Z

<p>Kbaldwin: /* Prognosis */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs.<br /> <br /> ==References==<br /> <br /> <br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98586 2010-11-16T15:01:44Z

<p>Kbaldwin: /* Prognosis */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, [[Disseminated Intravascular coagulation]], [[congestive heart failure]] and embolisation to other organs.<br /> <br /> ==References==<br /> <br /> <br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98585 2010-11-16T15:01:14Z

<p>Kbaldwin: /* Electrogcardiogram (ECG) */</p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected.<br /> <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs. <br /> ==References==<br /> <br /> <br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98584 2010-11-16T14:59:49Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> Structural abnormalities and vegetations may be visible on the valves although it is difficult to differentate from [[endocardiosis]]. <br /> ===Radiography===<br /> Radiography is often unremarkable. There may be evidence of cardiomegaly or congestive heart failure if valvular damage is chronic or severe. Evidence of a focus of infection such as discospondylitis may be visible.<br /> ===Electrogcardiogram (ECG)===<br /> ECG may be normal. Arrhythmias detectected are often ventricular in origin (e.g. ventricular premature complexes) and represent extension fo the inflammatory focus to invlove the moycoardium. 3rd degree heart block may be present if the AV node is affected. <br /> ==Treatment==<br /> Antibiotic treatment with either a broad spectrum antibiotic or an appropriate antibiotic based on cultre and sensitivity results. Antibiotics should be administered intravenously for the first 5 days of therapy followed by a proloned course (&gt;4 weeks) of oral medication. <br /> Common Protocols use Ampicillin in combination with fluoroqunilone such as enrofloxacin.<br /> Secondary problems such as septic shock, D.I.C., congestive heart failure and embolisation need to be managed. <br /> ==Prognosis==<br /> Long term prognosis is guarded to poor. Possible complications include septic shock, Disseminated Intravascular coagulation, congestive heart failure and embolisation to other organs. <br /> ==References==<br /> <br /> <br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98583 2010-11-16T14:47:20Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> Endocarditis is rare in dogs but males and large breeds (e.g. german Shepherds) are most affected. Very rare in cats.<br /> The disease mainly affects adult cattle and young pigs. In Horses, males are more comonly affected than females. <br /> ==Histroy &amp; Clinical Signs==<br /> Clinical signs are often vague and rarely referable to congestive heart failure. The folowing clinical signs are seen related to sepsis:<br /> * Pyrexia<br /> *Lameness<br /> *Neck Pain<br /> *Lethargy/Anoexia<br /> *Weight loss<br /> *Epistaxis<br /> Signs of embolisation to other organs may also be seen and those of congestive heart failure (dyspnoea, poor pulses, pale mucous membranes, tacchycardia, pulmonary crackles)<br /> ==Physical examination==<br /> A variable murmur depending upon the valve affected. It may be noted that murmur has recently arisen or changed. Other clincial examination findings include joint effusions, lymphadenopathy, pyrexia and in advanced cases signs associated with disseinated intravascular coagulopathy (D.I.C) such as bleeding diathesis and petichiation. <br /> <br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> '''Blood profiles''': Not all cases will have altered blood changes. Possible changes include:<br /> ::Haematology - Neutrophilia, left shift, monocytosis, Thrombocytopaenia and prolonged clotting times if developing D.I.C.<br /> ::Biochemistry - Hypoalbuminaemia and hypoglycaemia.<br /> '''Urinalysis''' : may have proteinuria, casts, pyuria. A uniary tract infection may be present with the same organism as is responsible for the endocarditis. <br /> '''Blood cultures''' : Requires 3-4 sterile samples colected from the jugular vein at least 1 hour apart over a 24 hour period. Negative cultures do not rule out the possibility of bacerial endocarditis. <br /> ===Echocardiography===<br /> ===Radiography===<br /> ===Electrogcardiogram (ECG)===<br /> ==Treatment==<br /> ==Prognosis==<br /> ==References==<br /> <br /> <br /> =from clinical=<br /> <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> =====Laboratory Findings=====<br /> <br /> -'''Urine analysis'''<br /> <br /> *If UTI is present, could be (+/-) for the same bacteria that caused endocarditis<br /> <br /> *Proteinuria<br /> <br /> *Casts<br /> <br /> *Pyuria<br /> <br /> *Hematuria<br /> <br /> <br /> -'''Blood Culture'''<br /> <br /> *collect blood from the jugular vein<br /> <br /> *3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media <br /> <br /> *Positive culture (Rare)<br /> <br /> *Negative culture is not diagnostic<br /> <br /> <br /> -'''Blood Profiles:'''<br /> <br /> *Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged<br /> <br /> *Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli<br /> <br /> <br /> =====Radiography=====<br /> <br /> -Usually normal unless severe damage is present<br /> <br /> -Left atrial and ventricular enlargement (Mitral Valve Incompetence)<br /> <br /> -Right atrial and ventricular enlargement (Aortic Valve Incompetence)<br /> <br /> -Signs of congestive heart failure with chronic/severe valve damage<br /> <br /> <br /> =====Electrocardiography (ECG)=====<br /> <br /> -Usually normal<br /> <br /> -Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)<br /> <br /> <br /> =====Echocardiography=====<br /> <br /> -Vegetative lesions on valves and/ mural surfaces<br /> <br /> <br /> ====Treatment====<br /> <br /> -Antibiotic given I/V for at least five days and then given orally for at least six weeks<br /> (Broad Spectrum or Culture/Sensitivity) <br /> <br /> -Manage secondary problems:<br /> <br /> (e.g. septic shock, congestive heart failure, embolization, D.I.C.)<br /> <br /> <br /> ====Prognosis====<br /> <br /> -Guarded <br /> <br /> (Possibility of recurrent infections, embolic complications, congestive heart failure)<br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98582 2010-11-16T14:29:36Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> {{dog}}{{cat}}{{horse}}{{cow}}{{pig}}<br /> Endocarditis is defined as an inflammation of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ===UlcerativeEndocarditis===<br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> ==Signalment==<br /> <br /> ==Clinical Signs==<br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> ===Echocardiography===<br /> ===Radiography===<br /> ===Electrogcardiogram (ECG)===<br /> ==Treatment==<br /> ==Prognosis==<br /> ==References==<br /> <br /> <br /> =from clinical=<br /> <br /> ===Infective Endocarditis=== <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> ====Signalment====<br /> <br /> '''Present in small animals:'''<br /> <br /> Dogs: (uncommon); Males &amp; Large Breeds (e.g. German Shepherd) most affected<br /> <br /> Cats: (rare) <br /> <br /> <br /> '''Present in large animals:'''<br /> <br /> Cattle: (common); Adult cattle<br /> <br /> Swine: (very common); Young pigs<br /> <br /> Horse: (uncommon); Males more affected<br /> <br /> <br /> <br /> ====Diagnosis====<br /> <br /> =====History &amp; Clinical Signs=====<br /> <br /> -Sings of Embolization:<br /> *sudden death<br /> *lameness<br /> *seizure<br /> *arrhythmias<br /> *cold extremities<br /> <br /> -Signs of Sepsis:<br /> *Pyrexia<br /> *Neck Pain<br /> *Joint Pain<br /> *Muscle Pain<br /> *Anorexia<br /> *Lethargy<br /> <br /> -Signs of Cardiac Involvement:<br /> *Syncope<br /> *Weakness<br /> *Exercise Intolerance<br /> *Heart Failure<br /> *Pulmonary edema<br /> *Pulse deficits<br /> <br /> <br /> =====Physical Exam=====<br /> <br /> -Systolic Murmur (Mitral Valve Affected)<br /> <br /> -Diastolic Murmur (Aortic Valve Affected)<br /> <br /> -Pulmonary crackles (If edema is present)<br /> <br /> <br /> =====Laboratory Findings=====<br /> <br /> -'''Urine analysis'''<br /> <br /> *If UTI is present, could be (+/-) for the same bacteria that caused endocarditis<br /> <br /> *Proteinuria<br /> <br /> *Casts<br /> <br /> *Pyuria<br /> <br /> *Hematuria<br /> <br /> <br /> -'''Blood Culture'''<br /> <br /> *collect blood from the jugular vein<br /> <br /> *3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media <br /> <br /> *Positive culture (Rare)<br /> <br /> *Negative culture is not diagnostic<br /> <br /> <br /> -'''Blood Profiles:'''<br /> <br /> *Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged<br /> <br /> *Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli<br /> <br /> <br /> =====Radiography=====<br /> <br /> -Usually normal unless severe damage is present<br /> <br /> -Left atrial and ventricular enlargement (Mitral Valve Incompetence)<br /> <br /> -Right atrial and ventricular enlargement (Aortic Valve Incompetence)<br /> <br /> -Signs of congestive heart failure with chronic/severe valve damage<br /> <br /> <br /> =====Electrocardiography (ECG)=====<br /> <br /> -Usually normal<br /> <br /> -Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)<br /> <br /> <br /> =====Echocardiography=====<br /> <br /> -Vegetative lesions on valves and/ mural surfaces<br /> <br /> <br /> ====Treatment====<br /> <br /> -Antibiotic given I/V for at least five days and then given orally for at least six weeks<br /> (Broad Spectrum or Culture/Sensitivity) <br /> <br /> -Manage secondary problems:<br /> <br /> (e.g. septic shock, congestive heart failure, embolization, D.I.C.)<br /> <br /> <br /> ====Prognosis====<br /> <br /> -Guarded <br /> <br /> (Possibility of recurrent infections, embolic complications, congestive heart failure)<br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98580 2010-11-16T14:23:06Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> <br /> Endocarditis is defined as an inflammation of one or more of the cardiac valves. It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Needs sustained or recurrent bacteraemia. Some bacteria have particular adherence properties and may only need a single episode of bacteraemia to set up an endocarditis. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> <br /> <br /> ===UlcerativeEndocarditis===<br /> <br /> Commonly seen along with renal failure in dogs.Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the subendocardial tissue with deposition of glycosaminoglycans. This may progress to a necrotising endocarditis and, in extreme cases, left atrial rupture. If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> ==Species differences==<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. COmmon underlying causes include Liver abcesses, traumatic reticulitis, metritis, mastitis, navel ancesses and 'joint ill'. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Horse: Lesions occur mainly on the mitral valve. The site of sepsis is often not identified but may be a sequale to septic jugular thrombophlembitis. <br /> *Pig and dog: Lesions occur particularly on the mitral valve (71% of cases in dogs), perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> <br /> Contributing factors include:<br /> *Trauma: haemodynamic turbulence.<br /> *Valve tissue ageing.<br /> *Avascularity of valves; poor healing capacity.<br /> *Tissue exposure; constant contact with blood-borne<br /> <br /> pathogens.<br /> ==Signalment==<br /> ==Clinical Signs==<br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> ===Echocardiography===<br /> ===Radiography===<br /> ===Electrogcardiogram (ECG)===<br /> ==Treatment==<br /> ==Prognosis==<br /> ==References==<br /> <br /> <br /> =from clinical=<br /> <br /> {{dog}}{{cat}}{{horse}}{{cow}}{{pig}}<br /> ===Infective Endocarditis=== <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> ====Signalment====<br /> <br /> '''Present in small animals:'''<br /> <br /> Dogs: (uncommon); Males &amp; Large Breeds (e.g. German Shepherd) most affected<br /> <br /> Cats: (rare) <br /> <br /> <br /> '''Present in large animals:'''<br /> <br /> Cattle: (common); Adult cattle<br /> <br /> Swine: (very common); Young pigs<br /> <br /> Horse: (uncommon); Males more affected<br /> <br /> <br /> ====Description==== <br /> <br /> *Infective endocarditis is a bacterial infection of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). <br /> <br /> <br /> *Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Pieces of the vegetative lesions can detach as emboli. Most often these emboli travel to the kidneys and spleen. <br /> <br /> <br /> ====Diagnosis====<br /> <br /> =====History &amp; Clinical Signs=====<br /> <br /> -Sings of Embolization:<br /> *sudden death<br /> *lameness<br /> *seizure<br /> *arrhythmias<br /> *cold extremities<br /> <br /> -Signs of Sepsis:<br /> *Pyrexia<br /> *Neck Pain<br /> *Joint Pain<br /> *Muscle Pain<br /> *Anorexia<br /> *Lethargy<br /> <br /> -Signs of Cardiac Involvement:<br /> *Syncope<br /> *Weakness<br /> *Exercise Intolerance<br /> *Heart Failure<br /> *Pulmonary edema<br /> *Pulse deficits<br /> <br /> <br /> =====Physical Exam=====<br /> <br /> -Systolic Murmur (Mitral Valve Affected)<br /> <br /> -Diastolic Murmur (Aortic Valve Affected)<br /> <br /> -Pulmonary crackles (If edema is present)<br /> <br /> <br /> =====Laboratory Findings=====<br /> <br /> -'''Urine analysis'''<br /> <br /> *If UTI is present, could be (+/-) for the same bacteria that caused endocarditis<br /> <br /> *Proteinuria<br /> <br /> *Casts<br /> <br /> *Pyuria<br /> <br /> *Hematuria<br /> <br /> <br /> -'''Blood Culture'''<br /> <br /> *collect blood from the jugular vein<br /> <br /> *3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media <br /> <br /> *Positive culture (Rare)<br /> <br /> *Negative culture is not diagnostic<br /> <br /> <br /> -'''Blood Profiles:'''<br /> <br /> *Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged<br /> <br /> *Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli<br /> <br /> <br /> =====Radiography=====<br /> <br /> -Usually normal unless severe damage is present<br /> <br /> -Left atrial and ventricular enlargement (Mitral Valve Incompetence)<br /> <br /> -Right atrial and ventricular enlargement (Aortic Valve Incompetence)<br /> <br /> -Signs of congestive heart failure with chronic/severe valve damage<br /> <br /> <br /> =====Electrocardiography (ECG)=====<br /> <br /> -Usually normal<br /> <br /> -Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)<br /> <br /> <br /> =====Echocardiography=====<br /> <br /> -Vegetative lesions on valves and/ mural surfaces<br /> <br /> <br /> ====Treatment====<br /> <br /> -Antibiotic given I/V for at least five days and then given orally for at least six weeks<br /> (Broad Spectrum or Culture/Sensitivity) <br /> <br /> -Manage secondary problems:<br /> <br /> (e.g. septic shock, congestive heart failure, embolization, D.I.C.)<br /> <br /> <br /> ====Prognosis====<br /> <br /> -Guarded <br /> <br /> (Possibility of recurrent infections, embolic complications, congestive heart failure)<br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98579 2010-11-16T14:12:51Z

<p>Kbaldwin: </p> <hr /> <div>{{unfinished}}<br /> <br /> ==Introduction==<br /> <br /> Endocarditis is defined as an inflammation of one or more of the cardiac valves. It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Needs sustained or recurrent bacteraemia. Some bacteria have particular adherence properties and may only need a single episode of bacteraemia to set up an endocarditis. Progression to rupture of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium. Valves may become stenotic, incompetant or both. Death usually results from either embolisation of the vegetative material or congestive heart failure due to significant valvular damage.<br /> <br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> <br /> <br /> ===UlcerativeEndocarditis===<br /> <br /> Commonly seen along with renal failure in dogs.<br /> Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the sunendocardial tissue with deposition of glycosaminoglycans. <br /> <br /> Healing may occur by fibrosis or the lesion may progress to a necrotising endcarditis and, in extreme cases, left atrial rupture.<br /> If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> <br /> <br /> <br /> ''Species differences:''<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Pig and dog: Lesions occur particularly on the mitral valve, perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> <br /> Contributing factors include:<br /> *Trauma: haemodynamic turbulence.<br /> *Valve tissue ageing.<br /> *Avascularity of valves; poor healing capacity.<br /> *Tissue exposure; constant contact with blood-borne pathogens.<br /> <br /> <br /> ==Signalment==<br /> ==Clinical Signs==<br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> ===Echocardiography===<br /> ===Radiography===<br /> ===Electrogcardiogram (ECG)===<br /> ==Treatment==<br /> ==Prognosis==<br /> ==References==<br /> <br /> <br /> =from clinical=<br /> <br /> {{dog}}{{cat}}{{horse}}{{cow}}{{pig}}<br /> ===Infective Endocarditis=== <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> ====Signalment====<br /> <br /> '''Present in small animals:'''<br /> <br /> Dogs: (uncommon); Males &amp; Large Breeds (e.g. German Shepherd) most affected<br /> <br /> Cats: (rare) <br /> <br /> <br /> '''Present in large animals:'''<br /> <br /> Cattle: (common); Adult cattle<br /> <br /> Swine: (very common); Young pigs<br /> <br /> Horse: (uncommon); Males more affected<br /> <br /> <br /> ====Description==== <br /> <br /> *Infective endocarditis is a bacterial infection of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). <br /> <br /> <br /> *Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Pieces of the vegetative lesions can detach as emboli. Most often these emboli travel to the kidneys and spleen. <br /> <br /> <br /> ====Diagnosis====<br /> <br /> =====History &amp; Clinical Signs=====<br /> <br /> -Sings of Embolization:<br /> *sudden death<br /> *lameness<br /> *seizure<br /> *arrhythmias<br /> *cold extremities<br /> <br /> -Signs of Sepsis:<br /> *Pyrexia<br /> *Neck Pain<br /> *Joint Pain<br /> *Muscle Pain<br /> *Anorexia<br /> *Lethargy<br /> <br /> -Signs of Cardiac Involvement:<br /> *Syncope<br /> *Weakness<br /> *Exercise Intolerance<br /> *Heart Failure<br /> *Pulmonary edema<br /> *Pulse deficits<br /> <br /> <br /> =====Physical Exam=====<br /> <br /> -Systolic Murmur (Mitral Valve Affected)<br /> <br /> -Diastolic Murmur (Aortic Valve Affected)<br /> <br /> -Pulmonary crackles (If edema is present)<br /> <br /> <br /> =====Laboratory Findings=====<br /> <br /> -'''Urine analysis'''<br /> <br /> *If UTI is present, could be (+/-) for the same bacteria that caused endocarditis<br /> <br /> *Proteinuria<br /> <br /> *Casts<br /> <br /> *Pyuria<br /> <br /> *Hematuria<br /> <br /> <br /> -'''Blood Culture'''<br /> <br /> *collect blood from the jugular vein<br /> <br /> *3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media <br /> <br /> *Positive culture (Rare)<br /> <br /> *Negative culture is not diagnostic<br /> <br /> <br /> -'''Blood Profiles:'''<br /> <br /> *Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged<br /> <br /> *Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli<br /> <br /> <br /> =====Radiography=====<br /> <br /> -Usually normal unless severe damage is present<br /> <br /> -Left atrial and ventricular enlargement (Mitral Valve Incompetence)<br /> <br /> -Right atrial and ventricular enlargement (Aortic Valve Incompetence)<br /> <br /> -Signs of congestive heart failure with chronic/severe valve damage<br /> <br /> <br /> =====Electrocardiography (ECG)=====<br /> <br /> -Usually normal<br /> <br /> -Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)<br /> <br /> <br /> =====Echocardiography=====<br /> <br /> -Vegetative lesions on valves and/ mural surfaces<br /> <br /> <br /> ====Treatment====<br /> <br /> -Antibiotic given I/V for at least five days and then given orally for at least six weeks<br /> (Broad Spectrum or Culture/Sensitivity) <br /> <br /> -Manage secondary problems:<br /> <br /> (e.g. septic shock, congestive heart failure, embolization, D.I.C.)<br /> <br /> <br /> ====Prognosis====<br /> <br /> -Guarded <br /> <br /> (Possibility of recurrent infections, embolic complications, congestive heart failure)<br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Endocarditis&diff=98577 2010-11-16T14:08:11Z

<p>Kbaldwin: </p> <hr /> <div>{{unifinished}}<br /> <br /> ==Introduction==<br /> <br /> Endocarditis isdefined as an infection and resulting inflammation of one or moreof the cardiac valves. It is usually a result of a bacteraemia or pyaemia, spread from adjaent myocardium is rare. It occurs in all species and is more common in cattle, pigs and sheep than dogs and cats. <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> Organisms commonly isolated include:<br /> *Cattle: [[Actinomyces pyogenes]]<br /> *Pigs: [[Erysipelothrix_rhusiopathiae|Erysipelothrix spp.]]<br /> *Sheep: [[:Category:Streptococcus species|Streptococci.]]<br /> ==Pathophysiology==<br /> ===Vegetative Endocarditis===<br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Needs sustained or recurrent bacteraemia. Some bacteria have particular adherence properties and may only need a single episode of bacteraemia to set up an endocarditis.<br /> ===UlcerativeEndocarditis===<br /> <br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ''Pathophysiology:''<br /> <br /> Loose thrombi of platelets and fibrin form which build up to larger vegetations. Bacterial colonies are found within the mass. Attempts to organise the vegetation occur but complete healing very rarely occurs. The mass may become ulcerated. Progression to rupure of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium.<br /> Valves may become stenotic, incompetant or both.<br /> <br /> Death usually results from either embolisation of the vegetation or congestive heart failure due to significant valvular damage.<br /> <br /> ''Species differences:''<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Pig and dog: Lesions occur particularly on the mitral valve, perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> <br /> Contributing factors include:<br /> *Trauma: haemodynamic turbulence.<br /> *Valve tissue ageing.<br /> *Avascularity of valves; poor healing capacity.<br /> *Tissue exposure; constant contact with blood-borne pathogens.<br /> <br /> <br /> ==Signalment==<br /> ==Clinical Signs==<br /> ==Diagnosis==<br /> ===Laboratory findings===<br /> ===Echocardiography===<br /> ===Radiography===<br /> ===Electrogcardiogram (ECG)===<br /> ==Treatment==<br /> ==Prognosis==<br /> ==References==<br /> <br /> <br /> ===Vegetative endocarditis===<br /> <br /> Predisposed by valvular damage as thrombi occur on the surface of the valves exposed to blood flow. Needs sustained or recurrent bacteraemia. Some bacteria have particular adherence properties and may only need a single episode of bacteraemia to set up an endocarditis.<br /> [[Image:vegetative endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Vegetative endocarditis (dog)'''. Courtesy of T. Scase&lt;/center&gt;&lt;/small&gt;]] <br /> <br /> ''Pathophysiology:''<br /> <br /> Loose thrombi of platelets and fibrin form which build up to larger vegetations. Bacterial colonies are found within the mass. Attempts to organise the vegetation occur but complete healing very rarely occurs. The mass may become ulcerated. Progression to rupure of the chordae tendinae is possible, along with spread of the infection to the adjacent mural endocardium.<br /> Valves may become stenotic, incompetant or both.<br /> <br /> Death usually results from either embolisation of the vegetation or congestive heart failure due to significant valvular damage.<br /> <br /> ''Species differences:''<br /> *Cattle: predominantly affects the tricuspid valve, perhaps due to bacteria arising in the GI tract and liver. Congestive right sided failure is manifested as ascites (including '''bottle jaw''') and embolisation to the lungs. Anaemia is often present as the red blood cells are damaged as they pass through the vegetation.<br /> *Pig and dog: Lesions occur particularly on the mitral valve, perhaps due to the higher pressure blood flow on the left side of the heart leading to more valvular damage. Left sided heart failure and pulmonary oedema are seen clinically, as are emboli in various organs, particularly the kidney.<br /> <br /> ===Ulcerative endocarditis===<br /> <br /> Commonly seen along with renal failure in dogs.<br /> Uraemia irritates and damages the endocarium, particularly in the left atrium. Oedema is seen in the sunendocardial tissue with deposition of glycosaminoglycans. <br /> <br /> Healing may occur by fibrosis or the lesion may progress to a necrotising endcarditis and, in extreme cases, left atrial rupture.<br /> If renal sufficieny is re-established then healing of the endocardial lesion is possible.<br /> <br /> <br /> =from clinical=<br /> <br /> {{dog}}{{cat}}{{horse}}{{cow}}{{pig}}<br /> ===Infective Endocarditis=== <br /> <br /> [[Image:Bacterial endocarditis.jpg|right|thumb|125px|&lt;small&gt;&lt;center&gt;'''Bacterial endocarditis'''. Courtesy of A. Jefferies&lt;/center&gt;&lt;/small&gt;]]<br /> <br /> ====Signalment====<br /> <br /> '''Present in small animals:'''<br /> <br /> Dogs: (uncommon); Males &amp; Large Breeds (e.g. German Shepherd) most affected<br /> <br /> Cats: (rare) <br /> <br /> <br /> '''Present in large animals:'''<br /> <br /> Cattle: (common); Adult cattle<br /> <br /> Swine: (very common); Young pigs<br /> <br /> Horse: (uncommon); Males more affected<br /> <br /> <br /> ====Description==== <br /> <br /> *Infective endocarditis is a bacterial infection of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis). <br /> <br /> <br /> *Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Pieces of the vegetative lesions can detach as emboli. Most often these emboli travel to the kidneys and spleen. <br /> <br /> <br /> ====Diagnosis====<br /> <br /> =====History &amp; Clinical Signs=====<br /> <br /> -Sings of Embolization:<br /> *sudden death<br /> *lameness<br /> *seizure<br /> *arrhythmias<br /> *cold extremities<br /> <br /> -Signs of Sepsis:<br /> *Pyrexia<br /> *Neck Pain<br /> *Joint Pain<br /> *Muscle Pain<br /> *Anorexia<br /> *Lethargy<br /> <br /> -Signs of Cardiac Involvement:<br /> *Syncope<br /> *Weakness<br /> *Exercise Intolerance<br /> *Heart Failure<br /> *Pulmonary edema<br /> *Pulse deficits<br /> <br /> <br /> =====Physical Exam=====<br /> <br /> -Systolic Murmur (Mitral Valve Affected)<br /> <br /> -Diastolic Murmur (Aortic Valve Affected)<br /> <br /> -Pulmonary crackles (If edema is present)<br /> <br /> <br /> =====Laboratory Findings=====<br /> <br /> -'''Urine analysis'''<br /> <br /> *If UTI is present, could be (+/-) for the same bacteria that caused endocarditis<br /> <br /> *Proteinuria<br /> <br /> *Casts<br /> <br /> *Pyuria<br /> <br /> *Hematuria<br /> <br /> <br /> -'''Blood Culture'''<br /> <br /> *collect blood from the jugular vein<br /> <br /> *3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media <br /> <br /> *Positive culture (Rare)<br /> <br /> *Negative culture is not diagnostic<br /> <br /> <br /> -'''Blood Profiles:'''<br /> <br /> *Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged<br /> <br /> *Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli<br /> <br /> <br /> =====Radiography=====<br /> <br /> -Usually normal unless severe damage is present<br /> <br /> -Left atrial and ventricular enlargement (Mitral Valve Incompetence)<br /> <br /> -Right atrial and ventricular enlargement (Aortic Valve Incompetence)<br /> <br /> -Signs of congestive heart failure with chronic/severe valve damage<br /> <br /> <br /> =====Electrocardiography (ECG)=====<br /> <br /> -Usually normal<br /> <br /> -Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)<br /> <br /> <br /> =====Echocardiography=====<br /> <br /> -Vegetative lesions on valves and/ mural surfaces<br /> <br /> <br /> ====Treatment====<br /> <br /> -Antibiotic given I/V for at least five days and then given orally for at least six weeks<br /> (Broad Spectrum or Culture/Sensitivity) <br /> <br /> -Manage secondary problems:<br /> <br /> (e.g. septic shock, congestive heart failure, embolization, D.I.C.)<br /> <br /> <br /> ====Prognosis====<br /> <br /> -Guarded <br /> <br /> (Possibility of recurrent infections, embolic complications, congestive heart failure)<br /> <br /> <br /> [[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]<br /> [[Category:To_Do_-_Cardiovascular]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Bovine_Immunodeficiency_Virus&diff=98571 2010-11-16T13:45:42Z

<p>Kbaldwin: /* Pathogenesis */</p> <hr /> <div>{{Unfinished}}<br /> <br /> ==Description==<br /> Bovine Imunodeficiency Virus (BIV) is a Lentivirus (non-oncogenic), a genus of the ''Retroviridae'' family. BIV causes a persistent viral infection in cattle, and has been reported in the US, Canada,Europe, Pakistan, Korea, Japan, New Zealand, Australia and several other countries. The virus is morphologically, antigenetically and genetically related to HIV. It was first isolated in 1969 from a cow with a wasting syndrome.<br /> <br /> ==Pathogenesis==<br /> BIV has a broad cell tropism and causes a mild lymphoproliferative disorder with low viral titres and no reproducible disease sequelae. As a lentivirus it is able to integrate into the host genome and replicate within macrophages. It is associated with a long uncubation period. The mechanism of transfer is not well known,but the following possibilites are being researched :<br /> * Transplacental<br /> * Transmammary<br /> * Vertical transfer through infected Semen (e.g. Artificial insemination)<br /> <br /> ==Clinical Signs==<br /> The virus was originally isolated in 1969 from an 8 year old Holstein cow in the US with lymphocytosis and lymphadenopathy. <br /> Bovine immunodeficiency Virus has been associated with the folowing signs:<br /> * Decreased milk yield <br /> * Clinical immunodeficiency <br /> * Encephalitis<br /> * Bovine paraplegic syndrome <br /> * Skin infections <br /> * Emaciation<br /> Immunocompromised cattle, arising from BIV infection, can develop secondary diseases associated with stress (e.g. parturition or environmental conditions) or sytemic disease. It may also be responsible for a poor antibody response to viral vaccines in calves. <br /> <br /> ==Diagnosis==<br /> There are difficulties in the isolation of BIV from clincial cases. Serological tests such as immunoflorescence and western blot have ben used to identify the virus although virus isolation from these cases has been unsuccessful. Diagnosis by PCR remains the most sensitive test at present. <br /> <br /> ==Treatment and Control==<br /> The Incidence of Bovine immunodeficiency virus appears to be low (1%) although can reach &gt;15 % in some herds. Due to the unkown prevelance of the virus in most herds, prevention and control methods are not widely practiced. Treatment is symptomatic. <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) '''Veterinary Microbiology and Microbial Disease''' ''Blackwell Publishing''<br /> *Marie-Claude St-Louis, Mihaela Cojocariu and Denis Archambault (2004). The molecular biology of bovine immunodeficiency virus: a comparison with other lentiviruses. '''Animal Health Research Reviews''' 5, pp 125-143<br /> *Walder R, Kalvatchev Z, Tobin GJ, Barrios MN, Garzaro DJ, Gonda MA. (1995). Possible role of bovine immunodeficiency virus in bovine paraplegic syndrome: evidence from immunochemical, virological and seroprevalence studies.'''Research in Virology''' 146(5) pp 313-23.<br /> <br /> [[Category:Secondary Immunodeficiency]][[Category:Cattle]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Bovine_Immunodeficiency_Virus&diff=98567 2010-11-16T13:41:16Z

<p>Kbaldwin: /* References */</p> <hr /> <div>{{Unfinished}}<br /> <br /> ==Description==<br /> Bovine Imunodeficiency Virus (BIV) is a Lentivirus (non-oncogenic), a genus of the ''Retroviridae'' family. BIV causes a persistent viral infection in cattle, and has been reported in the US, Canada,Europe, Pakistan, Korea, Japan, New Zealand, Australia and several other countries. The virus is morphologically, antigenetically and genetically related to HIV. It was first isolated in 1969 from a cow with a wasting syndrome.<br /> <br /> ==Pathogenesis==<br /> The mechanism of transfer is not well known,but the following possibilites are being researched :<br /> * Transplacental<br /> * Transmammary<br /> * Vertical transfer through infected Semen (e.g. Artificial insemination)<br /> ==Clinical Signs==<br /> The virus was originally isolated in 1969 from an 8 year old Holstein cow in the US with lymphocytosis and lymphadenopathy. <br /> Bovine immunodeficiency Virus has been associated with the folowing signs:<br /> * Decreased milk yield <br /> * Clinical immunodeficiency <br /> * Encephalitis<br /> * Bovine paraplegic syndrome <br /> * Skin infections <br /> * Emaciation<br /> Immunocompromised cattle, arising from BIV infection, can develop secondary diseases associated with stress (e.g. parturition or environmental conditions) or sytemic disease. It may also be responsible for a poor antibody response to viral vaccines in calves. <br /> <br /> ==Diagnosis==<br /> There are difficulties in the isolation of BIV from clincial cases. Serological tests such as immunoflorescence and western blot have ben used to identify the virus although virus isolation from these cases has been unsuccessful. Diagnosis by PCR remains the most sensitive test at present. <br /> <br /> ==Treatment and Control==<br /> The Incidence of Bovine immunodeficiency virus appears to be low (1%) although can reach &gt;15 % in some herds. Due to the unkown prevelance of the virus in most herds, prevention and control methods are not widely practiced. Treatment is symptomatic. <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) '''Veterinary Microbiology and Microbial Disease''' ''Blackwell Publishing''<br /> *Marie-Claude St-Louis, Mihaela Cojocariu and Denis Archambault (2004). The molecular biology of bovine immunodeficiency virus: a comparison with other lentiviruses. '''Animal Health Research Reviews''' 5, pp 125-143<br /> *Walder R, Kalvatchev Z, Tobin GJ, Barrios MN, Garzaro DJ, Gonda MA. (1995). Possible role of bovine immunodeficiency virus in bovine paraplegic syndrome: evidence from immunochemical, virological and seroprevalence studies.'''Research in Virology''' 146(5) pp 313-23.<br /> <br /> [[Category:Secondary Immunodeficiency]][[Category:Cattle]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Bovine_Immunodeficiency_Virus&diff=98563 2010-11-16T13:34:17Z

<p>Kbaldwin: /* Description */</p> <hr /> <div>{{Unfinished}}<br /> <br /> ==Description==<br /> Bovine Imunodeficiency Virus (BIV) is a Lentivirus (non-oncogenic), a genus of the ''Retroviridae'' family. BIV causes a persistent viral infection in cattle, and has been reported in the US, Canada,Europe, Pakistan, Korea, Japan, New Zealand, Australia and several other countries. The virus is morphologically, antigenetically and genetically related to HIV. It was first isolated in 1969 from a cow with a wasting syndrome.<br /> <br /> ==Pathogenesis==<br /> The mechanism of transfer is not well known,but the following possibilites are being researched :<br /> * Transplacental<br /> * Transmammary<br /> * Vertical transfer through infected Semen (e.g. Artificial insemination)<br /> ==Clinical Signs==<br /> The virus was originally isolated in 1969 from an 8 year old Holstein cow in the US with lymphocytosis and lymphadenopathy. <br /> Bovine immunodeficiency Virus has been associated with the folowing signs:<br /> * Decreased milk yield <br /> * Clinical immunodeficiency <br /> * Encephalitis<br /> * Bovine paraplegic syndrome <br /> * Skin infections <br /> * Emaciation<br /> Immunocompromised cattle, arising from BIV infection, can develop secondary diseases associated with stress (e.g. parturition or environmental conditions) or sytemic disease. It may also be responsible for a poor antibody response to viral vaccines in calves. <br /> <br /> ==Diagnosis==<br /> There are difficulties in the isolation of BIV from clincial cases. Serological tests such as immunoflorescence and western blot have ben used to identify the virus although virus isolation from these cases has been unsuccessful. Diagnosis by PCR remains the most sensitive test at present. <br /> <br /> ==Treatment and Control==<br /> The Incidence of Bovine immunodeficiency virus appears to be low (1%) although can reach &gt;15 % in some herds. Due to the unkown prevelance of the virus in most herds, prevention and control methods are not widely practiced. Treatment is symptomatic. <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) '''Veterinary Microbiology and Microbial Disease''' ''Blackwell Publishing''<br /> *Marie-Claude St-Louis, Mihaela Cojocariu and Denis Archambault (2004). The molecular biology of bovine immunodeficiency virus: a comparison with other lentiviruses. '''Animal Health Research Reviews''' 5, pp 125-143<br /> <br /> [[Category:Secondary Immunodeficiency]][[Category:Cattle]][[Category:To_Do_-_Review]]</div>

Kbaldwin https://en.wikivet.net/index.php?title=Bovine_Immunodeficiency_Virus&diff=98562 2010-11-16T13:32:39Z

<p>Kbaldwin: </p> <hr /> <div>{{Unfinished}}<br /> <br /> ==Description==<br /> Bovine Imunodeficiency Virus (BIV) is a Lentivirus (non-oncogenic), a genus of the ''Retroviridae'' family. It causes a persistent viral infection in cattle worldwide and was first isolated in 1969 from a cow with a wasting syndrome. BIV causes a persistent viral infection in cattle, and has been reported in the US, Canada,Europe, Pakistan, Korea, Japan, New Zealand, Australia<br /> and several other countries. The virus is morphologically, antigenetically and genetically related to HIV.<br /> ==Pathogenesis==<br /> The mechanism of transfer is not well known,but the following possibilites are being researched :<br /> * Transplacental<br /> * Transmammary<br /> * Vertical transfer through infected Semen (e.g. Artificial insemination)<br /> ==Clinical Signs==<br /> The virus was originally isolated in 1969 from an 8 year old Holstein cow in the US with lymphocytosis and lymphadenopathy. <br /> Bovine immunodeficiency Virus has been associated with the folowing signs:<br /> * Decreased milk yield <br /> * Clinical immunodeficiency <br /> * Encephalitis<br /> * Bovine paraplegic syndrome <br /> * Skin infections <br /> * Emaciation<br /> Immunocompromised cattle, arising from BIV infection, can develop secondary diseases associated with stress (e.g. parturition or environmental conditions) or sytemic disease. It may also be responsible for a poor antibody response to viral vaccines in calves. <br /> <br /> ==Diagnosis==<br /> There are difficulties in the isolation of BIV from clincial cases. Serological tests such as immunoflorescence and western blot have ben used to identify the virus although virus isolation from these cases has been unsuccessful. Diagnosis by PCR remains the most sensitive test at present. <br /> <br /> ==Treatment and Control==<br /> The Incidence of Bovine immunodeficiency virus appears to be low (1%) although can reach &gt;15 % in some herds. Due to the unkown prevelance of the virus in most herds, prevention and control methods are not widely practiced. Treatment is symptomatic. <br /> ==References==<br /> * Merck &amp; Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''<br /> * Quinn, P.J., Markey, B.K., Carter, M.E., Donnelly, W.J., Leonard, F.C. (2007) '''Veterinary Microbiology and Microbial Disease''' ''Blackwell Publishing''<br /> *Marie-Claude St-Louis, Mihaela Cojocariu and Denis Archambault (2004). The molecular biology of bovine immunodeficiency virus: a comparison with other lentiviruses. '''Animal Health Research Reviews''' 5, pp 125-143<br /> <br /> [[Category:Secondary Immunodeficiency]][[Category:Cattle]][[Category:To_Do_-_Review]]</div>

Kbaldwin