NAVLE Canine Internal Medicine 2 — Questions and Answers
Question 1: A 7-year-old Labrador Retriever presents with polyuria, polydipsia, and bilateral cataracts. Fasting blood glucose is 420 mg/dL. Which insulin type is most commonly used for initial management of canine diabetes mellitus?
- Glargine (Lantus)
- NPH insulin (Correct answer)
- Regular insulin
- Detemir (Levemir)
Correct answer: NPH insulin
NPH insulin is the first-line choice for canine diabetes mellitus due to its intermediate duration matching the dog's twice-daily feeding schedule.
Question 2: A 5-year-old intact male Cocker Spaniel presents with acute vomiting, fever, and a painful cranial abdomen. Serum lipase is markedly elevated. Which dietary fat level is most appropriate during recovery?
- High fat (>25% DM)
- Moderate fat (15-20% DM)
- Low fat (<10% DM) (Correct answer)
- Fat-free diet
Correct answer: Low fat (<10% DM)
Dogs recovering from pancreatitis should receive a low-fat diet (<10% DM) to minimize pancreatic stimulation and reduce recurrence risk.
Question 3: A 9-year-old Golden Retriever is diagnosed with protein-losing nephropathy. UPC ratio is 4.8. Which antihypertensive class is considered first-line therapy to reduce proteinuria?
- Beta-blockers
- Calcium channel blockers
- ACE inhibitors (Correct answer)
- Loop diuretics
Correct answer: ACE inhibitors
ACE inhibitors (e.g., enalapril, benazepril) reduce glomerular capillary pressure and proteinuria and are first-line therapy for PLN.
Question 4: A 4-year-old Boxer presents with episodic syncope. ECG reveals a wide, bizarre QRS complex occurring at a rate of 180 bpm with no preceding P waves. What is the most likely diagnosis?
- Atrial fibrillation
- Second-degree AV block
- Ventricular tachycardia (Correct answer)
- Supraventricular tachycardia with aberrant conduction
Correct answer: Ventricular tachycardia
Wide bizarre QRS complexes with no preceding P waves at a rapid rate are characteristic of ventricular tachycardia, common in Boxers with ARVC.
Question 5: A 6-year-old German Shepherd has chronic small bowel diarrhea, weight loss, and hypocobalaminemia. Serum folate is elevated. What is the most likely diagnosis?
- Inflammatory bowel disease
- Exocrine pancreatic insufficiency
- Small intestinal bacterial overgrowth (SIBO) / dysbiosis (Correct answer)
- Lymphangiectasia
Correct answer: Small intestinal bacterial overgrowth (SIBO) / dysbiosis
Elevated folate (produced by bacteria) combined with low cobalamin (consumed by bacteria) is the classic pattern for small intestinal bacterial overgrowth/dysbiosis.
Question 6: A 10-year-old intact female dog presents with vaginal discharge, PU/PD, and leukocytosis with a left shift. Radiographs show a fluid-filled uterus. Which finding would support a closed-cervix pyometra over an open-cervix pyometra?
- Presence of vaginal discharge
- Lower white blood cell count
- More severe azotemia and toxemia (Correct answer)
- Lower serum progesterone
Correct answer: More severe azotemia and toxemia
Closed-cervix pyometra prevents drainage, leading to greater systemic toxemia, azotemia, and more severe clinical signs compared to open-cervix cases.
Question 7: A 3-year-old Beagle presents with seizures and a serum ammonia of 280 µmol/L. Abdominal ultrasound reveals a single extrahepatic portosystemic shunt. Which amino acid supplementation is MOST important in this patient's management?
- Branched-chain amino acids
- Arginine (Correct answer)
- Taurine
- Methionine
Correct answer: Arginine
Arginine is essential for the urea cycle; dogs with PSS may develop arginine deficiency, worsening hyperammonemia, so supplementation is important.
NAVLE Canine Internal Medicine 2
A 7-year-old Labrador Retriever presents with polyuria, polydipsia, and bilateral cataracts.
Fasting blood glucose is 420 mg/dL.
Which insulin type is most commonly used for initial management of canine diabetes mellitus?