ICVA Canine Internal Medicine 3 — Questions and Answers
Question 1: A 9-year-old intact male dog presents with preputial discharge, lethargy, and PU/PD. Prostatic wash cytology shows septic suppurative inflammation. What is the most appropriate initial treatment?
- Finasteride alone
- Broad-spectrum antibiotics and castration (Correct answer)
- Urethrostomy
- Radiation therapy
Correct answer: Broad-spectrum antibiotics and castration
Bacterial prostatitis requires antibiotics that penetrate the blood-prostate barrier (e.g., fluoroquinolones, trimethoprim-sulfa), and castration reduces recurrence.
Question 2: Which finding on thoracic radiographs is most consistent with left-sided congestive heart failure in a dog?
- Generalized megaesophagus
- Pulmonary venous distension and perihilar interstitial pattern (Correct answer)
- Pleural effusion only
- Right-sided cardiomegaly with hepatomegaly
Correct answer: Pulmonary venous distension and perihilar interstitial pattern
Left-sided CHF causes pulmonary venous congestion, leading to interstitial and alveolar patterns beginning perihilarly.
Question 3: A dog is diagnosed with hypothyroidism. Which serum test is considered the gold standard for confirming the diagnosis?
- Total T4 (TT4)
- Free T4 by equilibrium dialysis (fT4ED) (Correct answer)
- TSH stimulation test
- Reverse T3
Correct answer: Free T4 by equilibrium dialysis (fT4ED)
Free T4 measured by equilibrium dialysis is the most specific and sensitive single test for canine hypothyroidism.
Question 4: A 4-year-old Boxer presents with episodic weakness and syncope. A Holter monitor reveals paroxysmal ventricular tachycardia. Which drug is first-line therapy for this arrhythmia in dogs?
- Digoxin
- Diltiazem
- Sotalol (Correct answer)
- Atropine
Correct answer: Sotalol
Sotalol is the preferred antiarrhythmic for ventricular arrhythmias in Boxers, with both class II and class III activity.
Question 5: Which parameter is most useful for differentiating prerenal azotemia from intrinsic renal failure in a dog?
- BUN:creatinine ratio alone
- Response to IV fluid challenge and urine specific gravity (Correct answer)
- Serum phosphorus concentration
- Urine sediment RBC count
Correct answer: Response to IV fluid challenge and urine specific gravity
Prerenal azotemia resolves with fluid therapy and is associated with concentrated urine (USG >1.030), whereas renal failure shows isosthenuria and persistent azotemia.
Question 6: A dog with small intestinal disease has a serum cobalamin (B12) of 98 ng/L (reference 251–908). Which intestinal segment is responsible for cobalamin absorption?
- Duodenum
- Jejunum
- Ileum (Correct answer)
- Colon
Correct answer: Ileum
Cobalamin is absorbed exclusively in the ileum via cubilin receptors; ileal disease or resection causes cobalamin deficiency.
Question 7: Which condition is characterized by episodic hemolytic anemia triggered by oxidative stress in dogs and is associated with a G6PD-like enzyme deficiency in certain breeds?
- Hereditary elliptocytosis
- Phosphofructokinase deficiency (Correct answer)
- Pyruvate kinase deficiency
- Methemoglobinemia
Correct answer: Phosphofructokinase deficiency
Phosphofructokinase deficiency in English Springer Spaniels and American Cocker Spaniels causes compensated hemolytic anemia that crises with alkalosis from panting or excitement.
ICVA Canine Internal Medicine 3
A 9-year-old intact male dog presents with preputial discharge, lethargy, and PU/PD.
Prostatic wash cytology shows septic suppurative inflammation.
What is the most appropriate initial treatment?