Small Animal Track

Month	Primary Rotation	Concurrent/Elective
July	Small Animal Medicine	Radiology (concurrent)
August	Small Animal Surgery	Anesthesia (concurrent)
September	Emergency & Critical Care	Rotation blocks
October-December	Elective Specialties	Dermatology, Cardiology, Oncology, Neuro
January-February	Additional Electives	Ophthalmology, Dentistry, Advanced cases

Clinical Pearls & Rounds Preparation

🔬 Diagnostic Approach

Problem List Development: Create organized problem lists from signalment, history, physical exam findings, and diagnostics to prioritize differential diagnoses.
Diagnostic Reasoning: Apply systematic approach to narrow differentials based on sensitivity, specificity, and clinical likelihood ratios of diagnostic tests.
Test Selection: Choose diagnostics based on clinical suspicion, cost-benefit analysis, and likelihood of changing management decisions.
Pattern Recognition: Develop pattern recognition for common presentations (polyuria/polydipsia, vomiting, lameness, respiratory distress, etc.)

💊 Medical Management Essentials

Drug Dosing: Master weight-based and body surface area (BSA) calculations; know renal/hepatic adjustments for common drugs.
Chronic Disease: Develop expertise in managing diabetes, heart disease, kidney disease, and other common chronic conditions; focus on quality of life metrics.
Pain Management: Understand multimodal pain control; recognize and manage pain appropriately across all situations.
Medication Interactions: Screen drug interactions and contraindications before prescribing; counsel clients on administration and monitoring.

🏥 Emergency Medicine Skills

Triage Priority: Rapidly assess and triage patients on arrival; recognize immediately life-threatening conditions.
Stabilization: Initiate IV access, fluid therapy, oxygen support, and other stabilization measures before definitive diagnosis.
Shock Management: Understand shock physiology and appropriate supportive care including crystalloids, colloids, and blood products.
Monitoring: Interpret vital signs, blood gas values, lactate, and other hemodynamic parameters to guide ongoing treatment.

🔪 Surgical Competencies

Sterile Technique: Maintain asepsis throughout surgical procedures; understand principles of contamination prevention.
Surgical Anatomy: Know relevant anatomy for common procedures; identify key structures during surgery.
Complication Recognition: Recognize intraoperative and post-operative complications; manage or escalate appropriately.
Recovery Management: Provide appropriate post-operative analgesia, wound care, and monitoring for optimal healing.

⚕️ Communication & Clinical Judgment

Case Presentation: Present cases in organized SOAP format; communicate findings, assessment, and plan clearly to supervisors.
Client Communication: Explain diagnoses and treatment options in language clients understand; address concerns and obtain informed consent.
End-of-Life Care: Support clients making difficult decisions about euthanasia and palliative care with compassion and clinical expertise.
Ethical Decision-Making: Navigate ethical dilemmas (cost, compliance, welfare) with clinical reasoning and professional judgment.

NAVLE-Style Quiz Questions

1. A 7-year-old female golden retriever presents with a 3-day history of polyuria, polydipsia, and anorexia. Physical exam reveals mild dehydration. Blood work shows elevated creatinine (3.2 mg/dL, normal 0.5-1.5), phosphorus (8.5 mg/dL), and potassium (5.8 mEq/L). Urinalysis shows specific gravity of 1.012 (isosthenuria) with proteinuria. Which diagnosis is most likely?

A. Chronic kidney disease (CKD) — The pattern of elevated creatinine with isosthenuria and inability to concentrate urine indicates loss of renal function. Hyperphosphatemia and mild hyperkalemia support this. The elevated protein in isosthenuric urine suggests glomerular disease.

2. A 3-year-old male cat presents for acute onset hind limb paralysis. Spinal reflexes are absent in both hind limbs; pain perception is present. Which spinal cord lesion is most consistent with this presentation?

A. Cauda equina or conus medullaris lesion — Loss of reflex function indicates lower motor neuron (LMN) disease affecting sacral spinal cord or nerve roots. Preserved pain indicates dorsal root ganglia/sensory pathways may be spared. Differential includes IVDD, FIP, lymphoma.

3. A 5-year-old male Labrador in shock (HR 140, systolic BP 85 mmHg, mental depression, pale mucous membranes, prolonged CRT) is brought to emergency. Which type of shock is most likely based on this presentation?

A. Hypovolemic or hemorrhagic shock — Tachycardia with hypotension, poor perfusion (pale mucous membranes, prolonged CRT), and mental depression indicate inadequate tissue perfusion. Assess for bleeding sources; administer IV crystalloids as first-line treatment.

4. A 2-year-old female Siamese cat presents with fever (103.5°F), lethargy, and inappetence for 2 weeks. Bloodwork shows lymphocytosis (8,000/μL, normal 1,500-7,000). FeLV and FIV tests are negative. What is the most appropriate next diagnostic step?

A. Abdominal ultrasound with possible biopsy — Chronic fever with lymphocytosis in a young cat warrants imaging and sampling. Differentials include FIP, chronic infection, neoplasia. Ultrasound can reveal peritoneal effusion, lymph node enlargement, or other changes suggestive of FIP.

5. A 10-year-old golden retriever with stage B2 (asymptomatic with systolic murmur) mitral insufficiency has just been diagnosed with heart failure (elevated NT-proBNP, pulmonary edema on radiographs). Which medication class should be initiated FIRST?

A. ACE inhibitors — ACE-I (enalapril, lisinopril) reduces afterload and is the foundational therapy for chronic heart failure in dogs. Once stable, may add diuretics, beta-blockers, or pimobendan based on clinical response.

6. An 8-year-old cat with chronic gingivitis and halitosis requires full mouth extraction. Which is the most important consideration for post-operative pain management in this patient?

A. Multimodal analgesia including opioids and local anesthetics — Oral pain is significant in cats post-extraction. Combine NSAIDs (with caution re: renal function), opioids, and local blocks. Pain control is critical to encourage eating and healing.

7. A 4-year-old male boxer presents with acute onset coughing and respiratory distress. Thoracic radiographs show a soft tissue mass in the cranial mediastinum with pleural effusion. What is the most likely diagnosis?

A. Lymphoma or thymoma — Cranial mediastinal masses in dogs are typically lymphoma, thymoma, or granulomatous disease. Pleural effusion may be exudative. Cytology via effusion or fine needle aspiration is indicated.

8. A 6-year-old dachshund with acute paraparesis/paraplegia is suspected IVDD. Clinical signs suggest T3-L3 lesion. What is the most appropriate emergency management before advanced imaging?

A. Strict cage rest, corticosteroids (if within 8 hrs), and MRI — Acute IVDD is a surgical emergency. High-dose corticosteroids (methylprednisolone) may help if given acutely. MRI is required to confirm diagnosis and assess candidacy for emergency surgery.

9. A 3-year-old male cat presents with a history of sneezing, nasal discharge, and poor appetite. Bloodwork shows hyperglobulinemia. Serology is positive for feline coronavirus (FCoV). What should you communicate to the owner regarding prognosis?

A. FCoV seropositivity alone does not confirm FIP; clinical signs, bloodwork, and effusion analysis are needed — Many cats are FCoV-seropositive. FIP (wet or dry form) requires compatible clinical signs, bloodwork abnormalities (hyperglobulinemia, anemia), and typically effusion analysis. Prognosis depends on FIP confirmation and form.

10. A 5-year-old female golden retriever with a history of allergic dermatitis now presents with severe pruritus unresponsive to NSAIDs. Which medication is most appropriate as next-line therapy?

A. Cyclosporine or oclacitinib (Apoquel) — Both JAK inhibitors (oclacitinib) and calcineurin inhibitors (cyclosporine) are effective for allergic dermatitis refractory to NSAIDs. Oclacitinib works faster; cyclosporine is less expensive long-term.

11. A 2-year-old standard poodle is presented 4 hours post-op following routine spay. The patient is tachycardic (HR 160), has pale mucous membranes, and abdominal pain on palpation. What is your primary concern?

A. Internal hemorrhage/hypovolemic shock — Acute post-operative tachycardia with poor perfusion (pale mucous membranes) and pain suggests hemorrhage from ovarian pedicle or uterine artery. Immediate IV access, fluid therapy, and possible return to surgery for exploration.

12. A 7-year-old cat with suspected diabetes mellitus (clinical signs: polyuria, polydipsia, weight loss) has fasting glucose of 280 mg/dL. Which initial management is most appropriate?

A. Insulin therapy (typically starting with intermediate-acting insulin BID) — Cats are insulin-dependent diabetics in most cases. Start insulin (e.g., Lantus or NPH), adjust based on glucose curves, and implement dietary management (high-protein, low-carb). Some cats may achieve remission with diet alone.

13. A 1-year-old Boston terrier presents with an acute abdominal crisis. Radiographs show a gas-filled, dilated small intestine with haustra. Owner reports recent access to a toy. What is the most likely diagnosis?

A. Small intestinal obstruction (linear foreign body or impaction) — Young dogs with acute abdominal signs and radiographic evidence of small intestinal dilation should be suspected of obstruction until proven otherwise. Surgery is indicated after stabilization. Confirm with ultrasound/CT if stable.

14. A 4-year-old golden retriever presents with bilateral, symmetrical alopecia along the trunk and hindquarters. Skin cytology is unremarkable; fungal culture is negative. Which is the most likely diagnosis?

A. Sebaceous adenitis or pattern alopecia — Bilateral symmetrical alopecia with negative infectious work-up suggests immune-mediated (sebaceous adenitis) or endocrine disease. Consider thyroid panel, melatonin (may help pattern alopecia), and dermatology referral.

15. A 6-year-old female Cavalier King Charles Spaniel has a grade III/VI systolic murmur and is now showing exercise intolerance. Echocardiography reveals left atrial enlargement with mild mitral regurgitation. What stage of heart disease does this represent?

A. Stage C (symptomatic heart disease) — ACVIM stages: B1 (murmur, no enlargement), B2 (murmur with enlargement), C (symptomatic/evidence of HF), D (end-stage/refractory). This patient is Stage C and requires medical management.

Core Rotations

Small Animal Medicine

Small Animal Surgery

Emergency & Critical Care

Anesthesia

Radiology

Elective Rotations

Dermatology

Ophthalmology

Cardiology

Oncology

Neurology

Dentistry

Suggested Rotation Timeline