CVM Senior Seminars
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This is a collection of fourth-year veterinary student Senior Seminars. Seminars are a DVM-curriculum requirement that enable students to study a disease entity on the basis of a clinical case or series of cases, or conduct a short-term clinically-oriented research project. Seminars involve preparation of a written case report and an oral presentation.
PLEASE NOTE: the Senior Seminars are available only to individuals on the Cornell Campus or those able to log in with Shibboleth. Individuals not affiliated with Cornell should contact the Veterinary Library Reference Services at vetref@cornell.edu.
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Item Transarterial Embolization in a Thoroughbred Gelding with Guttural Pouch MycosisBrown, Darsi (2023-05)An 11-year-old Thoroughbred gelding was referred to Cornell’s Equine & Nemo Farm Animal Hospital for emergency evaluation due to severe epistaxis. The gelding had a month long history of nasal discharge, ranging from mucoid and yellow to small volumes of sanguineous discharge. On presentation, the gelding was bright, alert, and responsive. Physical examination showed evidence of prior sanguineous nasal discharge from the left nostril with no active bleeding, moderate tachycardia and pale mucous membranes. Differentials for the gelding included trauma, guttural pouch mycosis, ethmoid hematoma, and neoplasia. Anemia and hypoproteinemia were identified on intake bloodwork. Upper airway endoscopy revealed extensive clot formation and fungal plaques in the left guttural pouch, confirming guttural pouch mycosis. Transarterial embolization by a minimally invasive surgical technique, involving occlusion with coils and nitinol vascular plugs, was selected as the treatment modality. The gelding was admitted to the hospital and was cross matched with a blood donor in preparation for a transfusion during the procedure. He was started on aminocaproic acid to stabilize clot formation. He was also started on broad spectrum antibiotics to treat any secondary bacterial infection as well as prophylactically for surgery. Under general anesthesia, transarterial embolization was achieved with two Amplatzer ™ nitinol vascular plugs deployed in the internal carotid artery and embolization coils deployed into the maxillary artery and external carotid artery. Two days post-operatively, the gelding’s guttural pouch was fenestrated by a transnasal endoscopic laser surgery to improve access for topical antifungal application as well as to change the guttural pouch environment. The gelding was discharged from the hospital and was reported to be doing well two weeks after the procedure.Item Lead Toxicosis in a Red Tailed HawkBracken, Sophie (2023-05)An adult red-tailed hawk (Buteo jamaicensis) of unknown gender was found down in Franklin, NY. A licensed rehabilitator easily captured the bird, and suspecting vehicular injury, transported the animal to Cornell’s Wildlife hospital. On presentation, the animal was noted to be a large adult red-tailed hawk, likely female due to its size and weight. It was bright, alert, responsive, and mentally appropriate. Physical exam revealed no obvious external injuries and there were no palpable fractures. The animal was knuckling on both feet, and had bilaterally increased extensor tone throughout the pelvic limbs. Two superficial wounds were present on the second digit of both feet, and animal’s tail feathers were encrusted with dried urates. In accordance with hospital protocol, a swab was obtained to test for Avian Influenza, which was not detected. As avian wildlife are highly susceptible to disease at the time of injury, prophylactic antibiotic and antifungal treatments were initiated. One dose of meloxicam was administered for pain control. Blood was drawn for a complete blood count, chemistry, and bench-top lead level. The blood lead was too high to detect on the bench-top analyzer, and a lead level was sent to the laboratory for quantification. The complete blood count was within normal limits, as was the chemistry, outside of an elevation of creatinine kinase of 4910 U/L, which was attributed to muscle injury during the initial insult, capture, or transport. Lead levels were quantified as 91.77 ug/dL. The animal was anesthetized for radiographs, which did not reveal evidence of a foreign metal object. Chelation with calcium EDTA was initiated at 30mg/kg by subcutaneous injection for a course of 5 days. This was followed by chelation with dimercaptosuccinic acid at 30mg/kg by mouth every 12 hours for 9 days. The hawk received supportive care of subcutaneous fluids and B vitamins during its course of chelation, gabapentin for anxiety and suspected lead neuropathy, and fenbendazole to treat gastrointestinal parasitism. The wounds on its feet were monitored and treated with A&D ointment. Lead levels were reassessed throughout chelation, and the animal was discharged to a licensed rehabilitator 24 days after intake due to progressive improvement and successful chelation.Item Gastric Perforation and Septic Peritonitis in a Mixed Breed DogAlbarracin, Belen (2023-02)A six-year-old male neutered mixed-breed dog was presented to the Cornell University Hospital for Animals emergency service for muscle fasciculations, stiffness, acute anorexia, and lethargy. The patient had a history of non-steroidal anti-inflammatory drug (NSAID) use for severe wounds. He was treated with antibiotics and oral meloxicam at 0.1mg/kg for approximately two weeks. On presentation, the patient had a kyphotic posture, and was mildly febrile and tachycardic. Physical exam revealed a tensed abdomen and tarry fecal material was evident on rectal palpation. Gastrointestinal-focused abdominal ultrasound identified thickening of the gastric wall as well as free fluid and gas in the abdomen. These findings along with a history of NSAID administration led to a presumptive diagnosis of gastrointestinal perforation.Item Disseminated Bacterial Thromboembolism in a 2 -Year-Old AlpacaFan, Jennifer (Cornell University College of Veterinary Medicine, 2021-04-21)A 2-year-old female Alpaca presented to Cornell’s Equine and Nemo Farm Animal Hospital for hematuria and straining for twelve days. Bloodwork from the referring veterinarian found anemia, eosinophilia and hyperglobulinemia. On presentation, the problem list included a bladder mass, anemia, straining, and hematuria. Differential diagnoses included neoplasia, coagulopathy, hemorrhagic cystitis, pyelonephritis, and idiopathic hematuria. Ultrasonography and radiographs on the patient found additional lung lesions. Surgery was considered but she was euthanized due to poor prognosis. Necropsy found multi-organ lesions due to disseminated bacterial thromboembolism, likely with an original insult to the liver. Further investigation found the patient’s companion also had anemia, hyperglobulinemia, and eosinophilia, with liver lesions consistent with parasite migration tracts. Multiple other members of the herd were also discovered to have anemia and hyperproteinemia. This suggests a herd issue, with differentials including subacute ruminal acidosis, liver flukes, and bacterial infection.Item Senior seminar title: Nasal Abscess and Associated Oronasal Fistula in a MareDiRubio, Mattisen (Cornell University College of Veterinary Medicine, 2021-05-05)A 20-year-old Warmblood broodmare was presented to her primary veterinarian for bilateral nasal discharge, which was treated with sulfamethoxazole and did not resolve although the discharge turned from white to clear. The mare was referred to Cornell’s Equine and Nemo Farm Animal Hospital (ENFAH) in January 2020 after there was no resolution of signs and she began dropping feed without losing weight. Oral exam, radiography, computed tomography (CT), and endoscopy were performed and revealed a left sided nasal abscess filled with feed material due to an associated oronasal fistula between left maxillary third and fourth premolars (207 and 208). The mare underwent standing surgery to establish drainage and debride the abscess. The mare continues to have monthly recheck upper respiratory endoscopies and debridement to improve quality of life, but the prognosis for periodontal health is guarded. This seminar highlights the common causes of nasal discharge in horses, the normal anatomy of the equine paranasal sinuses, and the possible origins of the abscess.Item Senior seminar title: Subcutaneous Ureteral Bypass in a Male Neutered Domestic Shorthair CatD'Argenio, Sara (Cornell University College of Veterinary Medicine, 2021-05-12)A 1.5-year-old male neutered domestic short haired cat was presented to his primary care veterinarian for vomiting and anorexia. He was febrile (104 deg. F) and azotemic with a creatinine of 4mg/dL. He was hospitalized for 4 days and treated with intravenous fluids and an antibiotic. An abdominal ultrasound revealed an enlarged right kidney and serial blood work revealed a progressive azotemia. The cat was sent to a referral hospital where ultrasound examination further revealed the presence of ureteroliths with right hydroureter and hydronephrosis. The right ureteral obstruction did not resolve with further medical management with intravenous fluids, an analgesic, diuretic and antibiotic so he was transferred to Cornell for surgical treatment. A Subcutaneous Ureteral Bypass (SUB) was placed to bypass the occluded right ureter allowing urine to flow from the kidney to the bladder. The following day, his azotemia and hydronephrosis were improved so the patient was discharged to the care of his owners.Item Senior seminar title: Umbilical Abscess in a 6-Year-Old Dairy CowCallaway, Karen (Cornell University College of Veterinary Medicine, 2021-04-28)This paper discusses the diagnosis and treatment of an umbilical abscess in a 6-year-old dairy cow. The patient was medically managed for a presumptive diagnosis of an umbilical abscess by the referring veterinarian (rDVM) with antibiotics and wound flushing but the draining tract did not improve. The cow presented to Cornell’s Large Animal Hospital on November 15th, 2020, and was taken to surgery in dorsal recumbency for removal of the abscess on November 18th, 2020. She was unstable under anesthesia and the procedure was aborted. Aggressive medical management in hospital for 5 weeks failed to resolve the draining tract. A second surgery in lateral recumbency on December 23rd, 2020, allowed subtotal resection and debridement of the umbilical abscess. Postoperative cellulitis and edema developed and the wound was treated with flushing and packing with Kerlix-soaked gauze. The cow was discharged before complete healing, but updates from the rDVM indicated she recovered well.Item Cleft Palate Repair in a 1-Year-Old Miniature SchnauzerCaligiuri, Lisa (2021-02-10)A 1-year-old neutered male, Miniature Schnauzer was referred to Cornell’s Dentistry and Oral Surgery service for repair of a cleft palate. The preoperative evaluation, which included a conscious orofacial examination and a head computed tomography (CT) scan confirmed the presence of a congenital palatal defect. As the CT revealed the presence of a complete and bilateral cleft of the secondary palate, a staged reconstruction was planned. Consequently, several teeth were first extracted to allow for additional soft tissue utilization and mobilization, and to decrease overall soft tissue tension. Approximately 8 weeks later, the surgical repair of the cleft palate was performed utilizing releasing incisions and undermining for the soft palate and a mucoperiosteal flap and a releasing incision for the hard palate. The patient recovered uneventfully, but did develop a small oro nasal fistula as a result of a focal dehiscence. After a discussion with the owner, it was elected to proceed without any further surgery. This paper reviews this patient’s case, as well as the suspected etiologies, patho-anatomy, clinical signs, surgical treatments, and prognosis for patients with cleft palate.Item Surgical Correction of Traumatic Sacral and Humeral Fractures in a 5-month-old Golden DoodleBourgeois, Alexandria (Cornell University College of Veterinary Medicine, 2021-03-17)A five-month-old, female intact, Golden Doodle presented to Cornell University's Hospital for Animals (CUHA) Emergency Room with multiple fractures after being hit by a car. She was assessed and stabilized at primary and secondary hospitals, where radiographs confirmed the presence of a right distal humeral fracture and multiple pelvic fractures. On physical examination, the patient was quiet, but alert and responsive. Her vital signs were within normal limits. She was non-ambulatory without assistance, but when held in a standing position, her left pelvic limb was flexed and non-weightbearing, and a lateral splint bandage was present on her right thoracic limb. There was significant swelling noted of her left pelvis, with pain on manipulation. A complete orthopedic examination was unable to be performed. On brief neurologic examination, proprioception was unable to be assessed in affected limbs but was normal in remaining limbs. Spinal reflexes and motor function were present in all four limbs, but voluntary urination was unable to be assessed. A rectal examination elicited pain and was unable to be fully completed. This presentation will discuss the presentation, diagnostic imaging, surgical fixation options and treatment, and post-operative management of sacral and humeral fractures.Item Alimentary Small-Cell Lymphoma in a CatBociulis, Samantha (Cornell University College of Veterinary Medicine, 2021-05-01)This case study will focus on the presentation, diagnosis, and treatment of feline alimentary small-cell lymphoma in a 14-year-old Maine coon cat. The patient presented for a history of chronic vomiting and diarrhea, weight loss, muscle atrophy, and hyporexia. Major physical examination abnormalities included bilateral entropion, feline tooth resorption lesions, grade III/VI left parasternal systolic heart murmur, and a firm structure in the mid-abdomen. An ultrasound confirmed mesenteric lymphadenopathy with adjacent hyperechoic mesentery and diffusely thickened intestinal loops. An aspirate of the enlarged mesenteric lymph node and a polymerase chain reaction for antigen receptor rearrangement both were consistent with a small cell alimentary lymphoma. Full thickness biopsies were not pursued. The patient was treated with chlorambucil and prednisolone and eventually euthanized approximately 6 months later. Small cell alimentary lymphoma is a very common feline neoplasm that is a slowly progressive disease with variable extra-intestinal involvement and wide reported ranges for survival times (Moore 2012 and Paulin 2018).