ICVA - International Council for Veterinary Assessment Canine Internal Medicine Questions and Answers 1

Question 1

A 7-year-old, male neutered Miniature Schnauzer is presented with a 3-day history of vomiting, anorexia, and lethargy. On physical examination, he displays cranial abdominal pain. Laboratory results show neutrophilia, elevated amylase, and lipase. Which of the following is the most likely diagnosis?

Accepted Answer

Acute pancreatitis

Answer

The signalment (Miniature Schnauzer), clinical signs (vomiting, anorexia, cranial abdominal pain), and laboratory findings (neutrophilia, elevated amylase and lipase) are all highly suggestive of acute pancreatitis. While other conditions can cause similar signs, the combination of findings makes pancreatitis the most probable diagnosis.

Question 2

Which of the following is the most appropriate initial treatment for a dog diagnosed with primary immune-mediated hemolytic anemia (IMHA) presenting with severe anemia (PCV 12%) and autoagglutination?

Accepted Answer

Immunosuppressive doses of corticosteroids and potentially a blood transfusion

Answer

The cornerstone of treatment for primary IMHA is immunosuppression to stop the destruction of red blood cells. Corticosteroids at immunosuppressive doses are the first-line therapy. Given the severe anemia (PCV 12%), a packed red blood cell or whole blood transfusion is often necessary to stabilize the patient and provide oxygen-carrying capacity while waiting for the immunosuppressive drugs to take effect.

Question 3

A 9-year-old spayed female Golden Retriever is diagnosed with chronic kidney disease (CKD). Her initial bloodwork shows: Creatinine 2.8 mg/dL, SDMA 25 µg/dL, and a urine protein:creatinine (UPC) ratio of 0.8. Her systolic blood pressure is 155 mmHg. According to the International Renal Interest Society (IRIS) staging system, what is the correct stage and substage for this patient?

Accepted Answer

IRIS Stage 3, Borderline Hypertensive, Proteinuric

Answer

Based on the IRIS guidelines, a creatinine of 2.8 mg/dL in a dog places it in Stage 3 (2.1-5.0 mg/dL). A UPC ratio of >0.5 makes the dog proteinuric. A systolic blood pressure of 155 mmHg falls into the borderline hypertensive (prehypertensive) category (150-159 mmHg). Therefore, the correct classification is IRIS Stage 3, Borderline Hypertensive, Proteinuric.

Question 4

Which diagnostic test is considered to have the highest sensitivity for diagnosing naturally occurring hyperadrenocorticism (Cushing's disease) in dogs, although it may have lower specificity?

Accepted Answer

Low-Dose Dexamethasone Suppression Test (LDDST)

Answer

The Low-Dose Dexamethasone Suppression Test (LDDST) is widely regarded as the most sensitive screening test for spontaneous hyperadrenocorticism, diagnosing 90-95% of cases. Its drawback is lower specificity, as other non-adrenal illnesses can cause false-positive results. The ACTH stimulation test is less sensitive but more specific, and the UCCR is a screening test that, if negative, makes Cushing's unlikely but if positive requires further testing.

Question 5

A 10-year-old mixed-breed dog presents with polyuria, polydipsia, polyphagia, and weight loss. A blood glucose measurement is 450 mg/dL and the urinalysis reveals glucosuria and ketonuria. What is the most definitive diagnosis?

Accepted Answer

Diabetes mellitus

Answer

The combination of classic clinical signs (polyuria, polydipsia, polyphagia, weight loss) along with persistent hyperglycemia (elevated blood glucose) and glucosuria (glucose in the urine) is diagnostic for diabetes mellitus in dogs. The presence of ketones indicates a more complicated state, often diabetic ketoacidosis, but the underlying disease is diabetes mellitus.

(ICVA) International Council for Veterinary Assessment Practice Test

(ICVA) International Council for Veterinary Assessment Practice Test

ICVA - International Council for Veterinary Assessment Canine Internal Medicine Questions and Answers 1