Vetlexicon (Canis, Felis, Lapis, Exotis, Equis and Bovis)

The technique of fetotomy can be used to deliver part(s) of a dead fetus per vaginum in cases of dystocia.

it can be used in conjunction with traction and manual manipulation to deliver calves in cases of abnormal presentation, position and posture.

• Presence of fetal abnormalities (joint ankylosis ie Schmallenberg virus), hydrocephalus or fetal monsters.
• In cases of fetomaternal disproportion.
• In cases of complete uterine inertia (where cesarean section Cesarean section is not an option).

Blindness is a loss of vision in one or both eyes and be central or peripheral:

• Central blindness is associated with lesions within the forebrain. Animals typically present  with a depressed menace response in one or both eyes, while the papillary light reflex (PLR) remains intact.
• In cases of Peripheral blindness, the menace reflex and PLR are absent.

• This podcasts is divided into four episodes giving brief summaries of the conditions listed and is designed to be a useful overview. More detailed information about specific diseases and causal organisms etc can be found by viewing the full articles on each topic on Vetlexicon Bovis.
• This episode covers Acquired unilateral or bilateral blindness: systemic conditions

Blindness is a loss of vision in one or both eyes and be central or peripheral:

• Central blindness is associated with lesions within the forebrain. Animals typically present  with a depressed menace response in one or both eyes, while the papillary light reflex (PLR) remains intact.
• In cases of Peripheral blindness, the menace reflex and PLR are absent.

• This podcasts is divided into four episodes giving brief summaries of the conditions listed and is designed to be a useful overview. More detailed information about specific diseases and causal organisms etc can be found by viewing the full articles on each topic on Vetlexicon Bovis.
• This episode covers Acquired unilateral or bilateral blindness: systemic conditions

Blindness is a loss of vision in one or both eyes and be central or peripheral:

• Central blindness is associated with lesions within the forebrain. Animals typically present  with a depressed menace response in one or both eyes, while the papillary light reflex (PLR) remains intact.
• In cases of Peripheral blindness, the menace reflex and PLR are absent.

• This podcasts is divided into four episodes giving brief summaries of the conditions listed and is designed to be a useful overview. More detailed information about specific diseases and causal organisms etc can be found by viewing the full articles on each topic on Vetlexicon Bovis.
• This episode covers Acquired unilateral or bilateral blindness: systemic conditions 

Blindness is a loss of vision in one or both eyes and be central or peripheral:

• Central blindness is associated with lesions within the forebrain. Animals typically present  with a depressed menace response in one or both eyes, while the papillary light reflex (PLR) remains intact.
• In cases of Peripheral blindness, the menace reflex and PLR are absent.
  

• This Topic is divided into 4 episodes giving brief summaries of the conditions listed and is designed to be a useful overview. More detailed information about specific diseases and causal organisms etc can be found by viewing the full articles on each topic on Vetlexicon Bovis. 
• This episode covers acquired local unilateral or bilateral conditions; and neonatal/congenital conditions.

Cause: Iatrogenic aspiration of material may occur with incorrect drenching, syringe dosing and passage of a nasogastric tube into the trachea and the administration of fluids/ medications/ milk.
Any disease leading to pharyngeal or esophageal dysphagia may lead to aspiration of food, water and saliva into the trachea and the rest of the respiratory tract, eg esophageal obstruction.
Neurological disorders may affect the control of swallowing and lead to pharyngeal paralysis or paresis.

• Signs: see below.
• Diagnosis: see below.
• Treatment: Measures to specifically address the cause of the aspiration and prevent its further occurrence.
  Broad spectrum antimicrobial administration until culture and sensitivity testing reveals any specific medications.
  NSAIDs to control lung inflammation.
  Stress- and dust-free environment, with good ventilation.
  Good nutrition and oral hydration (achieving this can be particularly challenging in these patients).
  Euthanasia.
• Prognosis: Guarded to poor.
  Very variable depending on the severity of the pneumonia, the inciting cause, the ability to resolve the original inciting cause of aspiration, the volume and nature of the aspirated material, the type of bacteria introduced, and the rapidity of treatment. All have an influence on the final outcome.

• Cause: Iatrogenic aspiration of material may occur with incorrect drenching, syringe dosing and passage of a nasogastric tube into the trachea and the administration of fluids/ medications/ milk.
  Any disease leading to pharyngeal or esophageal dysphagia may lead to aspiration of food, water and saliva into the trachea and the rest of the respiratory tract, eg esophageal obstruction.
  Neurological disorders may affect the control of swallowing and lead to pharyngeal paralysis or paresis.
  
• Signs: see below.
• Diagnosis: see below.
• Treatment: Measures to specifically address the cause of the aspiration and prevent its further occurrence.
  Broad spectrum antimicrobial administration until culture and sensitivity testing reveals any specific medications.
  NSAIDs to control lung inflammation.
  Stress- and dust-free environment, with good ventilation.
  Good nutrition and oral hydration (achieving this can be particularly challenging in these patients).
  Euthanasia.
  
• Prognosis: Guarded to poor.
  Very variable depending on the severity of the pneumonia, the inciting cause, the ability to resolve the original inciting cause of aspiration, the volume and nature of the aspirated material, the type of bacteria introduced, and the rapidity of treatment. All have an influence on the final outcome.
  

Bluetongue is an infectious viral disease.

• It is transmitted by adult female Culicoides spp (biting midges).
• Bluetongue can affect domestic and wild ruminants. It can also affect camelids and other herbivores
• The disease causes severe facial swelling, mortality, decreased production, affects fertility and places economic strain on producers.

Bluetongue is a notifiable disease in many countries, including the UK.

Cause: bluetongue virus is a genre of genus Orbivirus in the family Reoviridae.
Diagnosis: clinical and pathological findings. Tests include:

• C-ELISA.
• PCR.
• Isolation of the virus through inoculating an embryonated chicken egg with sub passage onto cell culture.

Treatment: no specific treatments other than supportive care.
Prognosis: poor.

This article discusses Bovine Congenital Erythropoietic Protoporphyria. At the time of publication, there is a lack of substantive literature on this topic and there appears to be some confusion, between publications, as to whether there are two separate disease entities – one type affecting Limousin and Blonde d’Aquitaine cattle and the other affecting Holstein cattle. Both disease presentations are reported to be clinically identical and the management and prognosis of each is also identical, although the pathogenesis is subtly different. Therefore, the Editors have opted to present this as one condition but draw the reader’s attention to the possible differences that may be considered. If and when new evidence comes to light, then this article will be reviewed and updated.

• Bovine congenital erythropoietic protoporphyria presents as photosensitization caused by elevated concentrations of porphyrin precursors and porphyrins.
• Cause: in cattle it is an autosomal recessive trait with heterozygous animals appearing normal but homozygous recessive animals are affected from birth.
• Signs: with increasing exposure to sunlight, affected animals develop classic signs of photosensitization and photophobia. Some Limousin and Blonde d’Aquitaine animals have been reported to suffer neurologic signs and seizures.
• Diagnosis: see below.
• Treatment: symptomatic treatment. Affected animals should be kept indoors and out of direct sunlight.
• Prognosis: guarded.

Causes: Eimeria spp, E. bovis, E. zuiernii, E. alabamensis, E. aubernensis, E. basiliensis, E. bukidnonensis, E. canadensis, E. cylindrica, E. ellipsoidalis, E. pellita,  E. subsherica, E. wyomingensis.

• Signs: most infections are non-pathogenic. Diarrhea and dysentery associated with infections of E. bovis and E. zuernii; watery diarrhea with E. alabamensis.
• Diagnosis: history, clinical signs, identification of oocysts in feces.
• Treatment: diclazuril, toltrazuril, decoquinate.
• Prognosis: most infections asymptomatic. Infections with pathogenic species can cause severe diarrhea, dysentery, dehydration and death.

• Cause: the etiological agent for cutaneous pythiosis is Pythium insidiosum.
• Signs: multifocal, tumor like, chronic, granulomatous masses with draining fistulas, extensive tissue ulceration and secondary bacterial infections of the limb and sometimes ventral regions of the body.
• Diagnosis: RT-PCR, Elisa.
• Treatment: supportive.
• Prognosis: good spontaneous recovery over several weeks to months.

• Tropical and Subtropical regions of the world with cases being reported in South East Asia, South America, Australia, New Zealand and North America.

• All age groups can be infected, but disease is mostly seen in young animals grazing infected flood plains.

• Ill thrift and production losses during the period of infection.

Crimean-Congo hemorrhagic fever (CCHF) does not cause clinical disease in cattle but is included in Bovis as it is a high priority zoonotic disease which can be fatal to people. Cattle play an important role in its transmission to people.

• CCHF is a high priority zoonotic disease; humans acquire CCHFV from either tick bites or exposure to blood or tissue from infected livestock or human patients.
• Slaughtermen, Livestock workers and Veterinarians are high risk occupations for human disease in endemic regions.
• Cattle play an important role in CCHF by playing host to tick vector species, becoming viremic and acting as indirect or direct sources of infection for humans.
• Cause: CCHF is caused by the RNA Crimean-Congo hemorrhagic fever virus (CCHFV) of the family Nairoviridae, order Bunyavirales.
• Signs: CCHF is an asymptomatic disease in cattle, with no overt clinical signs.
• Diagnosis: serological surveillance for antibodies in livestock plays a crucial role in public health measures to prevent human infection and to identify endemic areas where virus is circulating freely. Virus isolation can be undertaken during the period of viremia in cattle, but as the disease is asymptomatic in this species, positive samples may be difficult to obtain.
• Treatment: not required, as clinical signs are not evident in livestock species.
• Prognosis: excellent.

• Cause: epizootic hemorrhagic disease is caused by a Reoviridae, genus Orbivirus.
• Signs: ulcerative stomatitis, pyrexia, dysphagia, respiratory distress, milk drop and production losses.
• Diagnosis: virus Isolation. RT-PCR.
• Treatment: supportive.
• Prognosis: good.

• EHV is a vector borne disease and its distribution is limited to that of its vector, the culicoides biting midge
• EHV has been reported between latitudes 35°S and 49°N with clinical disease reported in North America, Australia, Asia, Africa and more recently in those countries surrounding the Mediterranean basin such as Morocco, Israel, Tunisia, Jordan and Turkey.

The major salivary glands are the parotid, mandibular, sublingual and zygomatic glands

They are made up of Acini glands that secrete a fluid containing mainly water, bicarbonate, electrolytes, mucin and the enzymes amylase and lipase.
The mandibular ducts enter the oral cavity on the ventral surface of the sublingual caruncles.
The parotid gland ducts enter the oral cavity on the cheek opposite the upper 2nd molar.

• Cattle produce around 110-180L of saliva per day, with a key role in buffering rumen pH
• Saliva is normally produced in response to stimulation of the mouth, esophagus and reticulo-rumen
• Excessive salivation or ptyalism can be due to hypersialosis (hypersecretion of saliva) or pseudoptyalism (secondary to disorders in cows producing a normal quantity of saliva).
• It can be identified by observation of the cow:
  • Drooling, foam around lips, wet appearance around and underneath the muzzle 
• It can be caused by multiple disorders and diseases (as detailed in this podcast and in the text article linked below).

• Butterfat and protein concentrations in milk can both be significantly affected by nutrition.
• Nutritional problems may be identified by examination of milk quality, eg using milk recording data available through milk recording organizations such as DHI.
• Butterfat and protein levels may be manipulated by dietary methods, to increase the milk price paid to farmers based on constituent contracts, eg cheese production.

M. wenyonii is an incompletely understood organism which might contribute to a range of clinical signs.

Omphalitis is inflammation of the umbilical structures and may include the umbilical arteries, umbilical vein, urachus and/or tissues immediately surrounding the umbilicus.Omphalophlebitis is inflammation and/or infection of the umbilical vein.
Omphaloarteritis is inflammation and/or infection of the umbilical arteries (both or singly).

• Cause: acquired or congenital infection and/or trauma of umbilicus and associated structures.
• Signs: enlarged umbilicus, possible purulent discharge, pain on palpation, systemically ill/septic calves.
• Diagnosis: clinical examination and palpation, ultrasonography, bacteriology.
• Treatment: antimicrobials and surgery.
• Prognosis: dependent upon extent and severity of infection.Localized infections in clinically well calves can carry a good prognosis.
  Prognosis would be more guarded in systemically ill neonates

Mycotoxicoses are diseases caused by secondary toxic metabolites produced by molds.

• Cause: important mycotoxin-producing molds, include Penicillium spp, Claviceps spp, Phomopsis leptostromiformis, Rhizoctonia leguminicola.
• Signs: vary depending on toxin and species. Mycotoxins affect almost all organ systems. Ergot and some Penicillium spp produce indole tremorgens which affect the nervous system.
• Diagnosis: difficult. Mycotoxin isolation from feed, clinical signs and history, feeding trials.
• Treatment: removal of toxin source; supportive therapy.
• Prognosis: depends on toxin, dose and clinical course.

The obturator nerve is predisposed to traumatic damage, as it passes from the origin in the lumbar region of the spinal cord to the obturator foramen in the floor of the pelvis, medial to the ilium of the pelvis, on each side.

• Direct trauma to the nerve is most likely to occur at parturition or through poor management and movement of cows leading to injuries involving sudden abduction of one or more hindlimbs (ie ‘doing the splits’ in the collecting yard.
• The calf can injure the nerve by extended pressure (due to dystocia) or tearing as it passes through the pelvic canal, causing a temporary or permanent paralysis of the muscles that are innervated.
• The nerves innervate the adductor muscles of the hind limb, and so paralysis is evident as an inability to adduct one or both hind legs.
• In most cases, the paralysis is temporary, but the inability to use the adductor muscles can lead to traumatic damage to other structures of the hind limb (particularly the hip joint) or permanent recumbency.

Severe Fever with Thrombocytopenia Syndrome is NOT a disease of cattle. It is a human disease, but is included within Bovis as cattle, although unaffected themselves, play a role in this significant human disease and as such those working with cattle should be aware of this condition.

• Cause: severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne hemorrhagic viral disease of humans. It is believed to be caused by a tick borne Phlebovirus of the family Bunyviridae, transmitted by the tick Haemaphysalis longicornis, and it can be fatal to affected people. Cattle, and other domestic and wild animals, are believed to be amplification vectors for this disease, although they do not suffer the disease themselves. Research into this emerging condition and the role of cattle in the transmission of this disease is ongoing.
• Signs: SFTS is an asymptomatic disease in livestock.
• Diagnosis: RT-PCR, IgG ELISA and virus isolation have demonstrated circulating virus in domestic livestock species during epidemiological investigations in regions where human cases of SFTS have occurred.
• Treatment: none, no clinical signs have been reported in livestock.
• Prognosis: good, no clinical signs have been reported in livestock.

• Cause: traumatic from calving, intramuscular (IM) injection,  ischemic myopathy, compression from abscess, neoplasia, or fractured sacrum, pelvis or proximal femur and associated inflammation/fibrosis.
• Signs: those associated with LMN dysfunction including pain, paresis, paralysis, muscle atrophy, hyporeflexia and analgesia in severe cases.
• Diagnosis: history and clinical signs plus the ruling out of other causes.
• Treatment: analgesia, nursing and physiotherapy.
• Prognosis: variable.

• The sciatic nerve is the largest nerve in the body. It is formed by fibers originating from spinal cord segments L6-S2.
• The fibers emerge together at the sciatic foramen as the large, wide, flat sciatic nerve (approx. 4cm wide and 0.5cm thick).
• It is consistent in size and shape as is progresses caudally towards the coxo-femoral joint which it wraps behind as it changes direction, down the hind limb. At this point the sciatic nerve becomes more rounded before splitting into the tibial and common fibular branches .Common fibular (peroneal) nerve – runs down anterior part of leg giving this area sensation and controlling hock flexion and digit extension
  Tibial Nerve – runs down the posterior part of leg giving this area sensation and controlling hock extension and digit flexion.
  Cause: traumatic from calving, intramuscular (IM) injection,  ischemic myopathy, compression from abscess, neoplasia, or fractured sacrum, pelvis or proximal femur and associated inflammation/fibrosis.
• Signs: those associated with LMN dysfunction including pain, paresis, paralysis, muscle atrophy, hyporeflexia and analgesia in severe cases.
• Diagnosis: history and clinical signs plus the ruling out of other causes.
• Treatment: analgesia, nursing and physiotherapy.
• Prognosis: variable.

• Cause: ingestion of bracken (Pteridium species).
• Signs: hemorrhage, pyrexia, loss of condition, intermittent hematuria.
• Diagnosis: based on clinical signs, history of exposure and post-mortem findings.
• Treatment: supportive, but generally ineffective.
• Prognosis: poor.

• Bracken is one of the most abundant plants in the world.
• It is a fern growing throughout the world (except where it is very cold or very dry) and is abundant in woods, heaths, sand dunes, neglected pastures, hedgerows, moors and even in walls, and often dominant over large areas mainly on light well-drained acid soils.

• Younger animals may be more at risk, but older animals are likely to have had a longer exposure and are therefore more likely to develop enzootic bovine hematuria.

• Humans may be exposed to the toxic compounds in bracken through the ingestion of milk or meat from animals that have fed on bracken, although young fronds of bracken are eaten in some countries.
• Bracken is a potential public health concern; in some studies, high exposure has been associated with an apparent increased risk of gastric and esophageal cancers.

• There may be high stock losses acutely and loss of condition and productivity in the long-term.
• There are costs associated with clearing bracken-infested land.

“Edema” is defined as an abnormal accumulation of fluid in the interstitial spaces of tissues or in body cavities.

All fruit products of Vitis vinifera(a perennial woody climbing vine) should be considered potentially toxic to dogs. Anecdotal evidence of poisoning exists in cats, but this has not been well documented.

• Signs: gastrointestinal effects, anorexia, and lethargy. In many cases renal failure characterized by oliguria or anuria, and accompanying elevation in levels of calcium, phosphorus, urea and creatinine.
• Diagnosis: signs and case history.
• Treatment: no antidote. Gastric decontamination, aggressive fluid therapy and supportive management.
• Prognosis: fatal cases are common, particularly in animals that develop oliguria or anuria.

• The adder, or viper (Vipera berus ), is the only venomous snake in UK.
• Snake bite envenomation occurs in approximately 50% of bites.
• Cases of envenomation generally occur between February and October, peaking in June to August, and should always be treated as an emergency.
• Adder bites can be life-threatening where systemic envenoming occurs.

• Cause: most likely a toxin produced by Clostridium perfringens.
• Signs: peracute onset of bloody diarrhea and vomiting.
• Diagnosis: compatible clinical signs, and exclusion of other causes.
• Treatment: needs to be aggressive and is primarily symptomatic/supportive (fluids, antiemetics).
• Prognosis: usually good if animals receive prompt treatment.

• A common unilateral neurological disorder of eye - can sometimes be bilateral.
• Cause: most common cause is idiopathic Horner syndrome - potentially lesion anywhere along the sympathetic pathway to the eye (brainstem, cervical spinal cord, T1-T3 spinal cord, brachial plexus, intrathoracic, vagosympathetic trunk, middle ear, retrobular).
• Signs: ptosis upper eyelid, miosis, enophthalmos, protrusion of third eyelid (due to enophthalmos and nictitans muscle relaxation in cats), conjunctival hyperemia in some animals.
• Diagnosis: sometimes can identify location of injury pharmacologically, more usually by other associated clinical signs.
• Treatment: specific treatment for underlying disease if it can be ascertained; clinical signs can often be improved with topical phenylephrine.
• Prognosis: can recover over protracted period, depending on site and nature of lesion.

Idiopathic cutaneous and renal glomerular vasculopathy in dogs

• Cause: unknown.
• Signs: often presents as a cutaneous 'lesion(s)' in an otherwise asymptomatic patient. Patient may or may not subsequently develop clinical signs of acute kidney injury (AKI). AKI may be identified concurrently with skin lesions at initial presentation.
• Diagnosis: histopathology reveals a dermal +/- renal vasculopathy. Suspicion is otherwise based upon clinical signs and exclusion of other possible causes of acute kidney injury.
• Treatment: aggressive management of acute kidney injury if present. Management of cutaneous lesion(s) as appropriate dependent upon presentation. The etiology of idiopathic cutaneous and renal glomerular vasculopathy is unknown and therefore there is currently no specific therapy.
• Prognosis: variable depending upon whether patient presents with cutaneous lesion(s) alone or cutaneous lesions and acute kidney injury. The prognosis in patients that develop acute kidney injury seems to be poor.

Ostertagiosis: Types 1 and 2 in Cattle

Vagal indigestion in cattle

• Cause:
  Vagal indigestion is characterized by dysfunction of reticulorumen, which hinders the passage of ingesta from the reticulorumen, abomasum or both, resulting in the distension of the abdomen.
  Vagal indigestion is a syndrome which is seen in cattle and also less commonly sheep.
  
• Signs: generally non-specific and depend on the location of the obstruction/problem; decreased milk yield and appetite, abnormal feces including quantity, abdominal distension with potentially recurrent bloating.
• Diagnosis:
  Diagnosis is often based on clinical presentation and examination in the field; however this could potentially lead to an incorrect diagnosis.
  The best diagnostic method(s) to implement will depend on the potential primary cause and findings of the clinical examination and are discussed in much further detail below.
  The most reliable method of obtaining a definitive diagnosis is usually an exploratory laparotomy.
  
• Treatment: depends upon primary cause.
• Prognosis: usually poor.

Cannabis poisoning in Dogs

• From plant Cannabis sativa - usually found in the form of cannabis/marijuana (dried leaves and flowers of plant) or hashish (dried resin from flower tips).
• Cause: accidental ingestion (or inhalation) of cannabis containing tetrahydrocannabinol (THC), which is the principal active ingredient.
• Signs: acute onset is usually within 1-3 hours: ataxia, drowsiness, stupor, behavioral changes, bradycardia, hypotension, hypothermia, increased appetite, conjunctival injection.
• Treatment: emesis (within 1 h of ingestion, only if asymptomatic), absorbents (activated charcoal), supportive therapy (intravenous fluids, warming).
• Prognosis: good, recovery usually within 24-96 h.

Canine neural angiostrongylosis

• From plant Cannabis sativa - usually found in the form of cannabis/marijuana (dried leaves and flowers of plant) or hashish (dried resin from flower tips).
• Cause: accidental ingestion (or inhalation) of cannabis containing tetrahydrocannabinol (THC), which is the principal active ingredient.
• Signs: acute onset is usually within 1-3 hours: ataxia, drowsiness, stupor, behavioral changes, bradycardia, hypotension, hypothermia, increased appetite, conjunctival injection.
• Treatment: emesis (within 1 h of ingestion, only if asymptomatic), absorbents (activated charcoal), supportive therapy (intravenous fluids, warming).
• Prognosis: good, recovery usually within 24-96 h.

Vasculitis in Horses

• Cause: immune-mediated hypersensitivity; infection (EVA, EIA, anaplasma, EHV); toxin (including drug-induced); hepatopathy; photo-activated; neoplasia.
• Signs: edema, erythema, subcutaneous hemorrhage including mucosal petechiae and ecchymosis, crust, ulcers and serum oozing on distal limbs, face, abdomen and ears. Reluctance to move, pyrexia, inappetence, depression and weight loss. Secondary cellulitis, thrombophlebitis, laminitis and pneumonia have been described.
• Diagnosis: clinical history, histopathology, response to medication.
• Treatment: treatment of underlying disease; therapeutic antimicrobial therapy; systemic glucocorticoids in immune-mediated disease; NSAIDs. If edema is severe then intensive care may be required for fluid therapy, hydrotherapy and a tracheostomy if laryngeal obstruction occurs.
• Prognosis: fair with early and aggressive therapy; depends on underlying cause.

Penile squamous cell carcinoma in horses

• Squamous papillomas, squamous cell carcinomas, melanomas and sarcoids are the most common tumors of the penis seen in the horse.
• The penile tumor is mostly seen in geldings and is more common in the aged gelding.
• Benign and malignant forms occur. The former are more common in older geldings while the latter is more common in geldings under 12-13 years of age.
• Cause: precarcinomatous changes caused by smegma.
• Signs: clinically two forms can be recognized:
  Proliferative lesion.
  Ulcerative/destructive lesion.
  
• Mixed forms may also occur.
• The early precancerous stage can often be recognized, particularly in geldings with non-pigmented penile skin.
• Spread to involve or primary involvement of the preputial skin is a serious sign that is usually accompanied by high malignancy, both locally and systemically.
• Malignant forms may metastasize to local lymph nodes (inguinal/iliac) or to organs remote from these, however enlargement of lymph nodes because of may be also a result of secondary infections.
• Metastasis to lumbar vertebral bodies, lungs, liver and spleen have been reported.
• Diagnosis: examination of sheath/penis/prepuce, biopsy, rectal examination, bacteriology.
• Treatment: regular washing, surgical extirpation of affected skin/penile amputation, cryonecrosis of focal lesions, reefing of preputial reflection, resection of circumferential segment of internal preputial lamina or phallectomy.
• Prognosis: guarded.

Patellar fracture and dental anomaly syndrome (PADS) in cats

• Cause: unknown, hereditary cause suspected. Affected cats prone to pathological fractures.
• Signs: lameness, discharging sinuses around the mouth and chin, mandibular (and maxillary) osteomyelitis, persistent nail bed infections.
• Diagnosis: radiographic changes showing typical fractures, presence of persistent deciduous teeth or absence of adult teeth with presence of unerupted teeth on CT scans.
• Treatment:  unknown for the syndrome. Individual fractures can be treated appropriately. Patellar fractures usually do well with conservative management. Persistent and unerupted teeth should be removed.
• Prognosis: guarded, in over a third of cats they will develop fractures in other bones

Haw's syndrome in cats

• Cause: idiopathic but speculatively it may be associated with tapeworm infestation or virus infection.
• Signs: a syndrome of prolapse of the third eyelids (nictitating membranes) often with diarrhea as well.
• Occasionally cats can be ill but they will recover with supportive care.
• Diagnosis: usually just on signs.
• Treatment: none.
• Prognosis: good, generally completely benign and self-limiting.