Case Study Quiz: Hypertension and Neurologic Presentation

A 10-year old Golden Retriever presents with a history of unsteady gait. The owner reports she is walking like she is drunk and she has vomited a few times. You are taking a history in the room and notice her tilting her head to the left. Upon closer look at her face you see that her eyes are moving side to side rapidly. The veterinarian asks you to perform a blood pressure. The blood pressure is 200/120 mmHg. Answer the quiz questions, then scroll to the bottom for the answer explanations.


1) What medication may help to treat hypertension (high blood pressure) in this dog?

a) Benazepril

b) Prednisone

c) Phenobarbital

d) Furosemide


2) The condition from which this dog is suffering is also known as which of the following?

a) Vasculitis

b) Vestibular syndrome

c) Disseminated Intravascular Coagulation (DIC)

d) Syncope


3) Which cranial nerve is likely involved in this process?

a) cranial nerve III (oculomotor)

b) cranial nerve VII (facial)

c) cranial nerve VIII (vestibulocochlear)

d) cranial nerve V (trigeminal)


4) Which endocrine disease is often associated with hypertension?

a) Cushing’s disease

b) Addison’s disease

c) Diabetes mellitus

d) Hypothyroidism


5) The eyes moving side to side rapidly is also known as:

a) Vertigo

b) Nystagmus

c) Postural thrust

d) Bupthalmous

Answers: This dog is exhibiting symptoms of vestibular syndrome, which has many possible causes. Because this dog has a very high blood pressure (should be less than 150 systolic in a nervous dog), the likely cause is a vascular accident (a stroke type of event).

Hypertension can be sometimes be associated with Cushing’s syndrome in dogs, and with hyperthyroidism in cats. Hypertension in dogs may be treated with benazepril and/or amlodipine. Amlodipine is the treatment of choice for cats.

Vestibular syndrome is a results of the inflammation or disturbance of cranial nerve VIII (8), the vestibulocochlear nerve which helps with sound in the ear and with equilibrium (balance). Dogs that have vestibular syndrome are often  nauseated and have a history of vomiting. The eyes moving back and forth or side to side is also known as a nystagmus.

For further information on vestibular disease, hypertension, and cranial nerves, please visit our other blog pages on these important topics:

Vestibular Disease Review

The Dangers of Hypertension

Review on Cranial Nerves


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Rabies Exposure Guidelines: New Study from JAVMA

It isn’t all that uncommon. A client has a dog that has been bitten or exposed to a rabies “suspect.” Whether it be a fox, a skunk, coyote, or bat, any wild animal could be a potential hazard for transmitting rabies to our domesticated pets.

State law is very strict regarding pets and exposure to rabies. There was a story in October 2014 that raised some controversy over this issue. A 10-year old Schnauzer was bit by a rabid skunk. The dog’s rabies vaccine had only expired 10 days prior to the attack. The options were to euthanize the dog, or quarantine for 3 months in a kennel with then another 3 months of strict home confinement. The owner was devastated but ultimately chose euthanasia.

For currently vaccinated pets exposed to rabies, they must receive a rabies booster immediately and then be under home confinement for 45 days.

As we know, there is a very high chance that even if the rabies vaccine has lapsed, the animal likely still has immunity. This is why this case is so heartbreaking.

A new JAVMA study, published for January 15, 2015 looks at a Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status.

Full Abstract Here

Findings in this study “supported immediate booster vaccination followed by observation for 45 days of dogs and cats with an out-of-date vaccination status that are exposed to rabies, as is the current practice for dogs and cats with current vaccination status.” 

This is important information to keep in mind for pets that have been vaccinated and exposed to rabies, even if their vaccine has recently expired. While state law will still be in effect, this can provide some additional information to pet owners who find themselves in this predicament.

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Free Sample Questions for VTNE Study via

Please enjoy a few sample questions to help you prepare for the Veterinary Technician National Examination! is the most comprehensive resource you will find on preparation for the VTNE exam. The site covers the categories you will find on the exam, and also includes PowerPages, which are condensed notes on important board review topics.

Scroll down to the very bottom for the correct answers and explanations. For access to the full database of study materials, visit


Question1: Bacteria differ from animal cells in which of the following ways?

a)      They lack ribonucleic acid

b)      They lack cell walls

c)      They are unable to metabolize glucose

d)     They lack a true membrane-bound nucleus

Question 2: A cigar-shaped mite that is seen on a skin scraping from a dog with severe generalized skin lesions is probably what type of mite?


a)      Sarcoptes

b)      Cnemidocoptes

c)      Otodectes

d)     Demodex

e)      Notoedres

Question 3: A patient under anesthesia is hypoventilating and the end-tidal CO2 is rising. The doctor instructs you to give the patient a breath. The pressure on the manometer to which you ventilate the patient is:

a)      20 cm H2O

b)      5 cm H2O

c)      40 cm H2O

d)     60 cm H2O

Question 4: In a pregnant mare, “red bag” delivery implies what situation?

a)   Delivery of a premature foal

b)  Rupture of the amniotic sac

c) Rupture of the chorioallantois

d) Premature placental separation

Question 5: What type of estrous cycle does the cow have?

a)      Estrus every 6 months

b)      Polyestrous in the fall

c)      Non-seasonal polyestrous

d)     Induced ovulation when bred

Question 6: How many upper incisors does a goat have?

a)      Six

b)      Four

c)      Zero

d)     One

e)      Two


Question 1: Correct answer: D

Bacteria are referred to as prokaryotes because they lack a true membrane-bound nucleus. Animals, as well as all multi-cellular organisms, are known as eukaryotes since they have a membrane-bound nucleus. Bacteria do have ribonucleic acids, and several antibiotics target transcription of mRNA. Bacteria are able to metabolize glucose. The type of cell wall that a bacterium has helps us differentiate whether it is a Gram-positive or Gram-negative organism.

Question 2: Correct answer: D

Demodex is the cigar-shaped mite. The other mites are much rounder. The generalized skin lesions are not specific for Demodex as they can also be seen with Sarcoptes.

Question 3: Correct answer: A

When inflating the lungs, the pressure should reach but not exceed 20 cm H2O.
Question 4: Correct answer: D

Red bag is the layman’s term for premature separation of the chorioallantois from the placenta and is a medical emergency. The chorioallantois interfaces with the mare’s endometrium and is the interface that transfers oxygen to the fetus. Under normal circumstances, the fetus breaks through the chorioallantois at the cervical star, and the fetus and amniotic sac are delivered first. In a red bag delivery, the entire fetal-placental unit is being delivered all at once and thus can cut off the oxygen supply to the fetus prior to birth; this can result in death of the fetus if parturition is not facilitated immediately.

Question 5: Correct answer: C

Cows have non-seasonal polyestrous cycles. This means that they have estrus cycles year round. Average estrus is 21 days and lasts for 18 to 24 hours, but heat stress can shorten this window. Estrus is the time of “standing heat” when the cow will stand to be mounted by the bull. Sheep are polyestrous in the fall. Cats are induced ovulators.

Question 6: Correct answer: C

Goats have no upper front teeth (incisors); their upper front mouth is one big gumline. In the back on their mouth they do have both upper and lower teeth. Goats are born with teeth which are replaced by permanent teeth as they age.
The dental formula for permanent teeth in the goat is:
2 ( I 0/3 C 0/1 P 3/3 M 3/3) = 32

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Ebola Virus and Animals

As animal lovers, I think all of us that read about Spanish Ebola patient Teresa Romero‘s dog “Excalibur” being euthanized as a precaution from exposure to Ebola were disheartened. In the veterinary community, our pets are our family members. This disease has caused a lot of fear. I know we were all relieved that they decided to quarantine the U.S. Ebola patient Nina Pham’s dog Bentley for monitoring instead of euthanizing him as a precaution, and were happy to hear he is now safe at home.

Ebola virus, Photo CDC Cynthia Goldsmith

Ebola virus, Photo CDC Cynthia Goldsmith

There is not a confirmed source for Ebola currently, but is thought to be found in fruit bat populations. Humans initially may contract the disease by coming into contact with an infected animal (bat or primate) or infected fruit or meat (bushmeat), and then human to human transmission occurs via bodily fluids or fomites with infected fluid. Those caring for Ebola patients or in close contact are at highest risk.

In the current Ebola outbreak in West Africa, animals have not been found to be a factor in ongoing transmission. According to the Centers for Disease Control, the USDA, and the AVMA, pets are not considered to be at a significant risk for Ebola in the United States. This is probably because currently it is still considered low-risk for humans in the U.S. as well, so would be even lower risk for pets. But even in West Africa where Ebola is found, there are no current reports of dogs or cats actually becoming ill from Ebola. That being said, the above organizations are continuing to work to gather more information about Ebola and animals for veterinarians and the public.

There was a study written regarding the outbreak of Ebola in Gabon in 2001-2002. Over 400 dogs were screened for Ebola antibodies (many dogs were thought to have eaten infected dead animals because in this country dogs are scavengers), and approximately 25% of the dogs had detectable Ebola virus- IgG. This shows that these dogs were exposed to the virus. However, none of these dogs were symptomatic. Therein seems to lie the concern then about dogs harboring and transmitting the virus, even if they are asymptomatic. But, the dogs with positive antibodies against the virus tested negative for the disease. So the question is, when they are initially exposed, how long could they be shedding virus if at all? Currently only a few animal species (primates and humans) have demonstrated the ability to actually spread the Ebola virus.

As a vet tech, if you were to be encountered with the rare situation that an owner believed their dog to have Ebola, the best thing to do would be to notify the veterinarian immediately. The veterinarian should take a thorough history, acquire personal protective equipment, quarantine the dog, and contact the CDC and state veterinarian.

Please visit which includes information for veterinarians and a FAQ section for clients. There is also a link to the CDC page regarding Ebola and pets. You may also listen to this podcast by Dr. Ron DeHaven, the VP and CEO of the American Veterinary Medical Association regarding Ebola and Pets.


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Leptospirosis Review

October is Leptospirosis awareness month. Take a moment to review some facts about this zoonotic disease.

What is Leptospirosis? It is a disease caused by a spiral shaped Leptospira bacteria that can infect wildlife, domestic pets, and humans.  Many wildlife are carriers of the bacteria and do not have any clinical symptoms of the disease.

How is it transmitted? The bacteria are passed in the urine to water sources where they can live and reproduce. They can survive for a long time in water (especially stagnant water, ponds, or lakes) and wet soil. Animals become infected by drinking or swimming in water that is contaminated by the bacteria. It can enter the bloodstream through the mucous membranes or through a wound or cut.

Can it be prevented? Vaccinating dogs and livestock for leptospirosis is an important part of prevention, especially in areas where the disease is prevalent. Avoid stagnant water. Practice good hygiene and wash hands frequently- especially if there is contact that may have any urine on it.

What are the symptoms? The symptoms can resemble those of the flu virus. Fever, decreased appetite, vomiting, diarrhea, dehydration, weakness, and lethargy are some symptoms. Some dogs may have jaundice if the liver is severely affected. Bloodwork of a leptospirosis infected dog often has increased kidney and liver values. If a dog is suspected of having leptospirosis, make sure technicians handling the dog and the dog’s urine contaminated bedding, etc. wear gloves and protective clothing. The time between exposure and development of disease is usually 5 to 14 days, but can be as short as a few days or as long as 30 days or more. Cats seem to have some natural resistance and infection is rare in this species.

How is Leptospirosis treated? Treatment for leptospirosis involves supportive therapies including IV fluid diuresis and antibiotics. Leptospirosis is often treated with a combination of antibiotics including amoxicillin and doxycycline. The disease can be fatal, and the best chance for a good outcome is early diagnosis and treatment.

For more information about this disease, please visit and


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Review on Eye Testing

Veterinary technicians commonly perform or assist with ophthalmic examinations. This blog is a review on common eye tests and normal values.

A good eye exam begins with a thorough history and appreciating a patient’s signalment (age, male/female/spay/neuter status, breed). Some particular breeds may be predisposed to certain ocular diseases. Taking a good history may help the veterinarian make a proper diagnosis and treatment plan.

Eye tests should be performed in a certain order. The proper order for the most common ocular tests are Schirmer Tear Test (STT), Fluoroscein stain, and Intraocular pressures (IOP).

1)   Schirmer Tear Test- The STT tests for dry eye or kerratoconjunctivitis sicca (KCS). This is a decrease in tear production. A small piece of paper made for this test is inserted under the lower eyelid and held in place for 60 seconds. Normal tear production should be greater than 15 mm in 60 seconds. Most normal dogs will produce more tears than this but this is a guideline to follow.



2)   Fluoroscein stain- This is a yellow dye which is applied to each eye to look for a corneal abrasion or ulcer. The abrasion or ulcer is seen when highlighting the stained eye with a fluorescent blue light.



3)   Intraocular pressure (IOP) – This is the test for glaucoma. Glaucoma is increased pressures in the eyes. The pressure in the eyes is tested using a device called a tonometer (the most commonly used one is the TonoPen). A drop of proparacaine is applied to each eye to numb the surface of the eye. The tonometer is gently touched to the surface of the eye and a proper or good reading should be with less than 5% error. Normal values are less than 20 mmHg (typical normal range 10-20 mmHg). Again, this is only a basic guideline and should be interpreted based on the rest of the exam and clinical signs. A low pressure may be due to uveitis (inflammation). It is important to note: DO NOT put any pressure around the neck region while holding the pet for IOP. This can falsely elevate the readings.



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Rodenticide Toxicity

Anticoagulant rodenticide, otherwise most commonly known as “rat bait” poisoning, is a serious and potentially fatal toxicity that requires treatment. Coumarins such as warfarin and brodifacoum are the most commonly known examples. D-Con is a common rodenticide that pets ingest in the home in cases of toxicity.

Anticoagulant rodenticide is a vitamin K1 antagonist. Vitamin K is required for synthesis of clotting factors II, VII, IX, and X (2, 7, 9, and 10). Factor VII has the shortest half-life of these and will be depleted first.

Prothrombin time (PT) measures the extrinsic clotting system which contains factor VII and it becomes prolonged first.  Therefore, PT measurement is helpful in determining clotting status in a pet that may have been exposed to anticoagulant rodenticide. Platelet counts in these animals are usually normal. Any time there is a history of potential exposure or an animal is showing evidence of bleeding, coagulation should be checked.

Pets that have been exposed to anticoagulant rodenticide are at risk for bleeding. They may bleed spontaneously or if they receive an injury could bleed due to their inability to clot. They can bleed from anywhere and symptoms may include melena, epistaxis, bleeding from gums, blood in urine or vomit, lameness or joint swelling, etc. Clinical signs may be seen initially  within 4 to 6 days after ingestion.

If an animal is known to have recently ingested this toxin (within the last 8 hours), induction of emesis (vomiting) is recommended, followed by activated charcoal to prevent further absorption of the toxin, and supplemental Vitamin K 1 (phytonadione). It is given daily for 3 to 4 weeks. Vomit of this type of toxin is very commonly a green/blue color.



Animals that are actively bleeding will need supportive care which may include IV fluid therapy and blood products to provide clotting factors in addition to the Vitamin K1 supplementation.


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Updates to VetTechPrep

We recently changed our program to reflect the new changes in the VTNE blueprint! The new categories you will find are:

Pharmacology, Surgical Nursing, Dentistry, Laboratory, Animal Care and Nursing, Diagnostic Imaging, Anesthesia, Critical Care, and Analgesia.

Take a quick 3 minute tour to see if VetTechPrep is right for you!








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Anesthesia Safety

To ensure a safe workplace for pets and employees, remember a few key points regarding anesthesia safety.

For General Anesthetic Procedures:

  • Always remember to ask for assistance when moving large pets from one place to another. Moving a heavy dog by yourself could cause you or the pet injury.
  • Patients that are recovering from anesthesia need to be closely monitored. Sometimes they may thrash around or make sudden movements and could injure themselves or others.
  • Watch for the swallowing reflex during recovery and remove the deflated endotracheal tube when the patient begins to swallow.

Anesthetic Gas Precautions:

The goal is to keep the amount of waste gas low in the hospital environment. When using gas machines and administering gas anesthesia:

  • Always perform a leak check prior to using the machine. Check the hoses, lines, and scavengers for any leaks and ensure that the soda lime canister is properly secured to the machine.
  • Make sure the the antesthesia machines receive regular service maintenance and keep record of the maintenance and service to the machines.
  • Make sure the scavenger for the waste gas is connected prior to turning on the machine.
  • When the machine is not in use, the machine vaporizer and oxygen should be turned off.  It should never be turned on unless the patient is connected to the machine. Oxygen can be used without connecting to the patient when blow-by oxygen is needed in emergency cases. Otherwise, a mask or connection directly to the ET tube is needed.
  • The endotracheal tubes should be the correct size for the patient. A tube that is too small puts a patient at risk of aspiration and causes anesthetic gas to leak out around the tube.
  • Inflate the endotracheal tube properly after placement but DO NOT OVERINFLATE. Ask for assistance if you are unsure how much to inflate the tube. If you overinflate the tube this could cause a tear of the trachea and could be life-threatening. Check for leaks after the patient is connected to the anesthetic machine.
  • When you turn the gas off after a procedure, leave the patient hooked up to oxygen for a couple of minutes. This will allow time for the anesthetic gas to pass out of the patient’s lungs and into the scavenger.
  • Make sure that the soda lime is changed regularly (every 12 hours of use or so), and keep a log of when it was changed.

If you are ever in doubt about how to properly hook up an anesthesia machine, or are unsure about cuff size, etc., ALWAYS ASK! Better to be safe and ensure that you are doing the right thing, and protecting yourself and your patients.

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Discussing Anesthesia With Clients

Dental Cleaning

One of the most common reasons owners neglect dental care or other procedures for their pet is fear of anesthesia. In fact, many owners have either had a negative experience surrounding anesthesia with a previous pet or with themselves, or have a friend who had a bad experience. Veterinary medicine has come a long way in terms of standards of care and many people do not realize how advanced our anesthesia protocols and procedures have become.

It is crucial to communicate with clients regarding the doctor’s recommendations and to communicate with them about their fears of anesthesia. Most owners don’t even know what anesthesia entails. They just think the pet goes to sleep and may never wake up. Tell them the precautions you take at your hospital to make sure that their pet is a good anesthesia candidate. They should have a full physical exam by the doctor and bloodwork to check their liver and kidney status prior to anesthesia.


1) Tell the client about how long their pet will be under anesthesia. (i.e. Let them know that to clean their pet’s teeth and to perform the extraction will take about 30-45 minutes, or the spay should take about 15 minutes for the procedure but about 30 minutes total of anesthesia to include the shave and scrub the abdomen and get “Sophie” hooked up to the monitoring equipment.) Use the pet’s name when talking about these procedures.

2) Talk about the monitoring equipment when you mention it as above. Let them know you monitor the ECG and blood pressure. Let them know you constantly monitor their oxygenation and CO2 and keep record of their values. Discuss that you keep them on heat support so they stay nice and warm during the procedure and they will be on IV fluids to keep their blood pressure stable. They will have a tube placed in their trachea so that their airway is controlled. Sometimes it helps to give clients a tour of the surgery or anesthesia suites. It helps them to visualize where their pet will be and may help them to feel more confident.

3) Discuss specifics of anesthetic drugs. When they drop off the pet, let them know they will receive a pre-medication so they will be nice and relaxed and so you can get the IV placed and start the fluids. Depending on which anesthetics you use, let them know what recovery time is to be expected. Let them know that the anesthetic plan is tailored to each individual patient, and that the doctor will calculate the specific medications just for “Sophie”.

4) Do pre and post-op calls to the owner. Some people want to be called before and after while others just want to be called after. Ask them what they would like. It is always a relief to the client to know when the procedure is finished and hear that their pet is extubated and awake. Many times there are multiple procedures scheduled. It is helpful to give them an approximate time as to when their pet may be having their procedure. You don’t want them to call at 1 pm and wonder why their pet hasn’t had their dental yet. Keep open communication and if the procedure is pushed back due to an emergency, let them know! They should feel that their pet is a priority.

5) Tell them you will take great care of their pet. If there were to be any complications arrise they would be contacted immediately. Make sure to get a phone number and make sure they will be available at that number in case they need to be reached.

6) Ask them if they have any questions about anesthesia or the scheduled procedure. Make sure you answer all of their questions. If they have questions and you don’t know how to answer, have the doctor answer them. The doctor should go over the more serious risks of anesthesia or their procedure and discuss risk vs. benefit of the procedure to be performed. This is best done at the time of the physical exam.


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