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 using Cornell's VPN network. Individuals outside of outside of Cornell should contact the Veterinary Library Reference Services at vetref@cornell.edu.
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Item Insulinoma Diagnosis in a DogManyevitch, Shelly (2019-04-24)An 8-year-old female spayed Golden Retriever was presented with a history of two episodes of weakness within a sixty-second-timespan following periods of brief exercise. Investigative procedures included complete blood counts, serum chemistry profiles, hormone assays, abdominal ultrasound, computed tomography with contrast, exploratory laparotomy and histopathology. Results of these investigations revealed fasting hypoglycemia (blood glucose 47mg/dL, fasting hyperinsulinism (>200 uIU/mL) and an elevated fasting insulin to glucose ratio of>4.65. Abdominal ultrasound revealed numerous nodules in the liver with no visualized pancreatic mass. Computed tomography revealed an ill-defined nodule with heterogenous soft tissue attenuation and mild primarily peripheral contrast enhancement within the left limb of the pancreas. Liver nodules on computed tomography were appreciated but not noted to contrast enhance. Treatment included medical management and exploratory laparotomy. Exploratory laparotomy successfully located the primary pancreatic mass and also revealed numerous presumptive metastatic lesions on the surface of the liver. A partial pancreatectomy, partial liver lobectomy and metastasectomy were performed. These masses were submitted to pathology for histological categorization. A diagnosis of a neuroendocrine carcinoma with liver metastatic lesions was ultimate! y confirmed by histopathology. Medical management in the form of meals every 4 hours with w/d canned diet as well at 10mg of prednisone BID was utilized to maintain euglycemia prior to surgery and for long term management.Item Osteonecrosis of the Jaws in an 8-year-old Mixed Breed DogMassaro, Mark (2019-01-30)An 8-year-old female spayed mixed breed dog was presented to the Cornell Emergency Service for a suspected infection of odontogenic origin ("tooth root abscess"). In December 2017, the owners noticed that the patient was lethargic and had stopped eating dry food. The patient was also seen by an internal medicine specialist who suspected masticatory muscle myositis (MMM) and prescribed mycophenolate 250 mg twice daily and tramadol 50 mg twice daily. On 3/27/18 the patient became anorexic and seemed lethargic. A different internist ruled out MMM through a type 2M autoantibody test and discontinued the mycophenolate. A swelling below the right eye and some masticatory muscle atrophy on the right were noted. Physical examination revealed a painful swelling below the right eye, bilateral masseter and temporal muscle atrophy (more severe on the right than left), and halitosis. Bloodwork was unremarkable. A computed tomography study revealed osteonecrosis of a portion of the right caudal maxilla with a sequestrum of bone. An anesthetized oral exam and targeted dental radiographs also showed necrosis of the soft tissues in this region. Extraction of the right maxillary fourth premolar and first molar teeth, surgical debridement with rinsing of the necrosed tissues of the right caudal maxilla, and removal of necrotic bone and the sequestrum were performed. The patient recovered well and began eating that night. The following morning the patient was discharged on antibiotics (clindamycin 10 mg/kg q12h for 4 weeks) and meloxicam and gabapentin for pain control. Several months later the owner reports that the patient is doing very well at home, eating comfortably.Item Otitis Media /Interna in a 5-year-old Domestic Shorthair CatMilano, Margaret (2018-09-19)A previously healthy 5-year-old male castrated Domestic Shorthair cat presented to the Cornell University Hospital for Animals’ Neurology Service following referral for evaluation of neurological signs. The patient was initially presented to the referring veterinarian for inappetence and “dragging” of the right hind limb. The referring veterinarian noted a right-sided head tilt, absent menace response in the right eye, and postural reaction deficits in the right thoracic and pelvic limbs. Complete Blood Count and Chemistry disclosed a mild hyperproteinemia. The patient was referred to Cornell for further investigation of his neurologic signs. On presentation to the Cornell Emergency Service, the patient was bright, alert, and responsive with normal vital parameters. Physical examination confirmed the abnormalities noted by the referring veterinarian and also disclosed a right sided ear droop and moderate brown discharge in the right ear which contained cocci on ear cytology. Full neurological examination revealed a right sided head tilt, absent menace response in the right eye, increased extensor tone in the right thoracic and pelvic limbs, right-sided postural reaction deficits, and pain on palpation of the head. The patient’s clinical signs neurolocalized to the left forebrain and right vestibular system. An MRI revealed meningoencephalopathy with multifocal intra-axial left forebrain lesions and patchy cerebral and brainstem meningeal enhancement, as well as right otitis media with a possible polyp. Cerebrospinal fluid analysis showed a mixed cell pleocytosis, consistent with inflammation possibly secondary to infection. Extension of otitis media/interna into the cranial cavity was prioritized as the primary differential. The patient underwent right ventral bulla osteotomy and was placed on antibiotics. Ventral bulla biopsy samples were submitted for culture and histopathology. This presentation will discuss the presentation, diagnosis, and treatment of otitis media/interna with intracranial involvement in this patient.Item Degloving injury in a 7-year-old mixed-breed dogRoman, Nicholas (2018-10-17)A previously healthy 7-year-old castrated male mixed-breed dog was referred to the Cornell University Hospital for Animals (CUHA) Emergency Service for further evaluation of severe trauma secondary to being hit by a vehicle. Immediately after the dog was injured by the vehicle, he was presented to a emergency veterinary clinic and administered intravenous (IV) fluid therapy, pain medication, antibiotics, and analgesics. Referral physical exam revealed extensive degloving wounds to both forelimbs, and crepitus in the right brachial region. Extremity radiographs were obtained and revealed a fracture of the right humerus. The forelimb wounds were lavaged and bandaged, and he was referred for specialist care due to the extent of his wounds. On initial evaluation at CUHA, the dog was unstable with tachycardia, tachypnea, pale mucous membranes, mildly decreased peripheral pulse quality, and a mildly prolonged capillary refill time. He was stabilized treated with IV fluid therapy and full-mu opioid pain medication. Physical exam revealed left brachial instability and crepitus, consistent with a humeral fracture, and a dorsally luxated right maxillary canine tooth. Following stabilization, he was administered broad-spectrum antibiotics. Point-of-care bloodwork showed anemia, hypoproteinemia, and electrolyte derangements (characterized by hyponatremia and hypokalemia). Focused abdominal and thoracic ultrasound were unremarkable. The dog was sedated and evaluation of his wounds revealed degloving wound involving approximately 40% of the circumference of the antebrachium of both forelimbs, with full-thickness soft-tissue loss on the dorsal aspect of the left forelimb and exposure of the carpal bones and metacarpus. This talk will discuss emergency stabilization of the trauma patient and approaches to wound management.Item Molecular Detection of an Adenovirus in Two North American Porcupines (Erethizon dorsatum) with Respiratory DiseaseBalik, Sarah (2019-01-23)Adenoviruses are DNA viruses that are widespread, and depending on the viral species and serotype, can infect a variety of hosts and result in disease involving multiple body systems (Berk 2013). Respiratory disease related to adenoviruses has been reported to affect both humans and a variety of animal species, causing clinical disease ranging from conjunctivitis to pneumonia (Berk 2013). Although necrotizing pneumonia due to an adenovirus has been reported in guinea pigs, which are histricomorph rodents closely related to porcupines, to our knowledge, adenoviruses have not been previously documented in porcupines. This report describes an adenovirus detected by viral isolation and identified via PCR directed sequencing from deep nasal swabs of two North American porcupines exhibiting signs of respiratory disease. The adenovirus identified in these porcupines, skunk adenovirus 1 (SkAdv-1), has only been previously reported in a skunk and African pygmy hedgehogs (Kozak et al. 2015; Needle et al. 2018). Cases 1 and 2 were evaluated at Cornell University’s Janet L. Swanson Wildlife Health Center (WHC) on separate occasions. Case 1 was a young adult male found weak and lethargic in the wild. He was initially treated by a licensed wildlife rehabilitator who removed abundant dried ocular discharge and then transferred the porcupine to the WHC. On physical examination, the porcupine displayed an increased respiratory rate (120 breaths per minute), a markedly increased respiratory effort, bilateral mucopurulent ocular discharge and conjunctivitis, bilateral mucopurulent nasal discharge resulting in occlusion of the nares, and dried mucopurulent discharge on the medial surface of both paws. The remainder of the physical examination was within normal limits. Fluorescein staining of both eyes was negative, and thoracic and abdominal radiographs were normal other than excessive gas accumulation in the stomach and intestines attributed to stasis. A deep nasal swab cultured Staphylococcus aureus. Case 2 was a young adult male porcupine found with signs of an upper respiratory infection and right front limb injury, and was taken to a licensed wildlife rehabilitator. The porcupine was transferred to the WHC after 5 days due to failure of response to ceftiofur crystalline free acid (Excede®). Physical examination found crusted mucopurulent discharge occluding both nares, bilateral mucopurulent ocular discharge, bilateral conjunctivitis, and the right eye had a corneal opacity at the medial canthus that was negative on fluorescein stain. The remainder of the physical examination was within normal limits. Radiographs demonstrated severe diffuse pneumonia throughout the right lung lobes and in the left middle lung lobe. Cytology of a nasal crust revealed neutrophilic inflammation with intracellular gram positive cocci, and aerobic bacterial culture was positive for Staphylococcus aureus. This senior seminar will review adenoviruses reported in wildlife species as well as discuss the epidemiology and clinical significance of the specific adenovirus identified in these two porcupines.Item Mandibular osteomyelitis and fractures in a yearling jersey heiferAlexander, Kerry J (2014-09-24)A yearling Jersey heifer was presented to Cornell University's Farm Animal Hospital for mandibular swellings. Radiographs, ultrasound, and CT revealed fractures, osteomyelitis, and an abscess involving much of the right hemi-mandible. The heifer was treated with drainage of the abscess and systemic antibiotics (oral rifampin and subcutaneous procaine penicillin G). The owner reported improvement in comfort and swelling 10 days after discharge.Item Benign Gastric Polyps in a 15-year-old Male Castrated Domestic Shorthair CatDavis, Lillie L. (2014-02-19)Item Parturition induction in cattle: will performance sufferWall, Chad (2014-01-22)Item Atresia Ani in a 4-month-old PigUnck, Autumn (2014-04-16)Item Feline Idiopathic Pure Red Cell AplasiaSchmoke, Sarah (2014-02-05)