ACVN
Benchmark #1An 8-year old spayed female cocker spaniel dog is presented to the primary care veterinarian for a 2 day history of lethargy, hyporexia, and vomiting. The dogs is up-to-date on vaccinations, has no travel history outside of the North East of North America and the only pertinent medical history is a bout of otitis externa which is well managed. The dog has no history of toxin exposure, is not on any current medications and normally eats a commercial diet (Purina Dog Chow Complete Adult with Real Chicken Dry). There was no history of dietary indiscretion or change in diet recently. The dog weighs 19 kg and has a body condition score of 7/9 and a normal muscle condition score.Physical examination includes 7% dehydration, mild dental disease, dry mucous membranes of normal color, normal lymph nodes, heart rate of 130/min, respiratory rate of 20/min with normal thoracic auscultation. The dog exhibits cranial abdominal pain but no masses are palpated in the abdomen. No other abnormality is noted. Given this dog’s presentation and initial examination, acute pancreatitis is a reasonable differential. Describe the pathophysiology of acute pancreatitis. 2. The diagnostic work-up for dogs with suspected acute pancreatitis is typically exhaustive and usually includes pancreatic-specific assays. Discuss the main assays (i.e., in current clinical use) thought to be useful in characterizing this condition. 3. In addition to assays of pancreatic lipases, there is experimental and some early clinical use of newer biomarkers for assessing acute pancreatitis. Discuss the utility of the following biomarkers:A. Trypsinogen Activation PeptideB. C-reactive protein4. Like many diseases, there is a desire to stratify the condition in hopes of improving prognostication. Describe the 2 scoring systems for canine acute pancreatitis and discuss their performance. 5. One of the common biochemical changes encountered in dogs with acute pancreatitis is hypocalcemia. This occurs due to chelation of calcium in the saponification of peri-pancreatic fat. Describe the physiology of calcium regulation. 6. The dog in this case was noted to be hyporexic. Describe the pathophysiology of hyporexia.7. The dog in question was consuming a commercial diet. Tabulate the nutritional analysis of the diet and compare to the NRC Recommended Allowance for Adult Dogs. 8. Nutritional management of dogs with acute pancreatitis has changed in the past several year. Present arguments for and against the institution of early enteral nutrition. 9. In recent years, there has been an interest in modulation of disease processes via nutrients. In the context of acute pancreatitis, discuss the potential benefits of glutamine, arginine and probiotics in this disease. 10. In devising a nutritional plan, meeting the energy needs of an animal is an important aspect. Discuss methods for measuring energy expenditure and estimation of energy expenditure via formulas. 11. Fill in the table with the indications/benefits and contraindications/limitations of nasoesophageal/nasogastric tubes, esophagostomy tubes, gastrostomy tubes and jejunostomy tubes. ADDIN EN.REFLIST ................
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