And off we go. Well, folks, it's a pleasure to be here today. My name is Dr. Steve McLaughlin. I'm the president and founder of Zuku Review and Our Topic Today is top 20 Classic NAVLE® topics for board success. We're going to cover horses, pigs and poultry here. And we're going to review a little bit about some useful study approaches to help you get a better handle on the information. OK. So this is the breakdown for the farm animal questions on the NAVLE®. And as you can see, the majority of questions are in ruminants and horses. OK, pigs and chickens together don't count for very much. But the nice thing about these small categories, particularly chickens and some of the exotics and things like that, you don't have to know very many diseases to do well. So that's that's nice. That's on your side. A third of your NAVLE® is on horses. Ruminants and horses. OK. If we include small ruminants with cattle plus horses, that's a third of your NAVLE® right there. OK, so that's worth investing some time in.

Earlier, we had a question from Ivan asking about the structure of the NAVLE®. There are 300 questions that count on the day you take your test and of the 300, they break them down this way. But a big take home message about farm animals is that right there, nearly 30 percent of the questions that count horses and cattle. And if you pick up the other farm animals, you're well over a third of the questions just in farm animals. OK? So that makes them worth a little bit of your time, right? If you look at the NAVLE® another way, you basically need 70 percent to pass your NAVLE®. If you get 70 percent of the 300 that count right, you're very likely to pass, OK? And this is a way to triage and just say, "Wow, I guess I really want to focus on dog, cat, horse and cow." That's where you want to invest your best time. Right? If you get enough of those questions right, you're going to pass.

So this is just a brief look at what we at Zuku among ourselves as the editors have come up with what we think are some of the most important horse topics. If you got, you know, 10 equine clinicians together and ask them what they thought this list, how it looked to them, you know, they might quibble and disagree about one or two diseases. But I think most vets are going to agree that equine abortion is a worthy topic. Laminitis, for sure. You're going to see some questions on that on your NAVLE®. Strangles. We covered that a couple of weeks ago with Dr. Grenanger OK, so if you don't know where to start, this is a reasonable place to start. OK? But often people will ask us. They'll say, "Well are those diseases guaranteed to be on my test?" Guaranteed, no. Likely, yes. Pretty likely. OK. If you don't know where to start. Start with the big stuff. So where do all these NAVLE® Diagnosis options come from? Last week we looked at this for bovine. But all the disease categories and specific conditions come from the ICVA self-assessments veterinary assessments NAVLE® species and diagnosis list. And they put this out about every seven or eight years and make a new one, and it's about 30 pages of different diagnoses. This is one page of equine diagnoses. Overall, it's over a thousand conditions, right? Nobody has time to try to learn everything they need to know about a thousand conditions, right? So pick 20. Make headway there, and that's probably going to be plenty, OK? For your interest, this this is our take on the top 10 porcine. We've already covered some of these so far. If you saw some of my pig talks, we covered neonatal diahhrea, you covered the mycoplasma pneumonia. TGE was part of the diahhreas. We certainly talked about classical swine fever, also known as hog cholera, in the reportables talk. So today I picked one more pig disease to cover. Leave it to you to guess what it is when we hit it, OK? But that's enough for pigs, right? There's more to study here, and that's for you to go ahead and dig on your own. But you don't need to know everything. Same thing with chickens. This is our take on what we think are 10 of the most important diseases. But if all you did was study these three, that's a pretty good start. OK.

So how the heck are you going to study all this stuff? Triage and do the big stuff first. Just like we do in the clinic. How how do you start that? We talked about this last week and now we're going to do it again with a couple of different topics. Literally take a sheet of paper, a half sheet of paper and write the disease name on the top and then go online to your good friend, Dr. Google, and find a good picture of that image. You are allowed, copyright rules allow you to find images online and use them for your own personal use and educational purposes in your notes. What you're not allowed to do is take images. You've got somewhere, put them in your notes, put them out there in public online, as if you took those pictures or you try to sell it. That's a no no. But for your personal use, you can do whatever you want with those images. So go get a good one, get two good ones, slap it in your notes, and then there's three things. What is a classic case look like? What is the key test or tests that I want to know for that disease, and how do I treat this? That's a good approach to know three big things for a disease and then just review those notes and quiz yourself. It's the quizzing that helps the information stick.

So let's just try one. Last week you remember we did listeriosis in cattle and in ruminants, small ruminants. Today let's try Parelaphostrongylus tenuis. P tenuis. This is one you think about with llamas and small ruminants, mostly. And it's a parasite. It's a parasite of white tailed deer. And it doesn't really make the deer sick. But if it gets into the wrong host, like a llama, they have neurological signs. Or if it gets into a sheep or a goat. So a classic case might be a llama or sheep or goats that's got some sort of ataxia, pelvic limb lameness, they could be stiff, they could be circling, they might be lame. They could have a scoliosis where the, they're concave opposite on the side of the lesion. You may see paralysis and you might see sort of a waxing, waning temporary remissions. That's pretty typical. And basically, what we've got here is this parasite migrating around looking for familiar white tailed deer tissue and not finding it. So I told you, we have some visits, so here's our first visit. This is Mr. Boo, the diabetic cat in remission. He is about sixteen years old. He's been in remission for diabetes for about three years now. And let me tell you what, he brings new meaning to the words PUPD. That litter box fills up fast. So let's get back to P. tenuis. Test of choice, the short answer is there's no - and there's our dogs Saint coming to say hi to the cat, the cat is his favorite chew toy - there's no ante mortem test that's conclusive for P. Tenuis. There's no blood test you can take and it'll tell you, yes or no that you've got it. The best way with this diagnosis. One is clinical signs and a cereberospinal fluid tap. You can do an analysis of the CSF. You'll be looking there for Pleocytosis, elevated protein, you might see some increased eocinophils in there. You might see xanthochromia, so like the CSF fluid is yellow. You can also do histopath on necropsy of the neural tissue like the spinal cord, and you can see it there. OK. Treatment, there's no definitive treatment for this, but most clinicians use fenbendazole or ivermectin. There are problems with this condition for antihelmintic resistance, which complicates things. And even though drugs like ivermectin are not supposed to cross the blood brain, blood brain barrier, it appears that with the inflammation you get with P. Tenuis, it does appear to cross into the central nervous system and help out. This may be a disease that's easier to prevent than it is to treat, although easy is a relative term. So, you know, if you have a bunch of valuable llamas, you want to have some deer proof fencing to keep the deer out.  Certainly for small ruminants like sheep and goats using antihelmintic's every 30 to 45 days from spring to fall is a good idea anyway, because of the problems that we worry about with things like haemonchus, ostertagia, and some of those other gastrointestinal parasites. Little bonus fact. It's a guarded prognosis, and recumbency is a bad prognostic sign, so if they've got this and they're down, it's not good.

So if you were to learn just these three key points for, say, 80 to 100 big diseases for the NAVLE®. That's a really solid foundation. Is it everything? No, but it gives you a toehold, right? It gives you something to start with. It gives you a picture in your head to which you can hang some information. If you get this stuff really solid and you know these top three things for 80 or 100 diseases, you can expand your notes. There's no problem with that. Or if you have some particular diseases that you know are big and warrant a little more. Yeah, sure. But at least get a foundation. OK. OK, fine. I made some notes. Now what doc? Well, repetition. Review. Review Review. Don't just write the notes and throw them away for six months. Review them frequently and then quiz yourself. Quizzing ourself is what's it's the way you learn. It's been shown in studies of adult learning that people that practice test, outperform people that just study books and never quiz themselves. OK. This is how we learn. It's called working memory. Working memory just means by quizzing yourself, you're trying to access the information in your head over and over and over. If you don't quite have it there, you read the notes again. You firm it up and you keep doing that over time and eventually you own it and it becomes yours. And you know, information can fade over time, which is why we review OK. But when we review stuff that we made a nice little half page of notes on with a good picture or two, it'll come back fast.

So here's a couple of quick questions about P. Tenuis. Just tell me and chat, folks your answers What species are the aberrant hosts for Parelaphostrongylus tenuis? Yeah. Good. So llamas, of course, and who else? Yeah, small ruminants. Goats and sheep. Good. Good job. What are five clinical signs of P. Tenuis In an affected Lama? So just give me some of the signs you might see in an animal that's affected. Scoliosis away from the lesion. Good. Yep. Yep, CNS signs, kind of multifocal. Remember, it's random. Like these little parasites are wandering around the spinal column and causing trouble, right? So circling, maybe. Paralysis, weakness, things like that. Good job. Yeah. Good job, you know, and recumbency, bad prognosis. What's our treatment of choice? And it suddenly goes quiet. Yeah, there's no, there's no, you know, firmly established treatment of choice, but we often these days youuse fenbendazole or ivermectin. Right? And prevention is the thing you want to remember. Good job. Good job, everybody. Remember this kind of quizzing yourself. It may seem simplistic, but it's the quizzing, that's where the money is. That's how you get information to stick. And if you do this over and over, you'll get better. And this is the, if on one hand you're doing practice tests and Zuku like two thirds of your time through the week, on the other hand, about a third of your time, you're making notes, reviewing books and quizzing yourself. And that together, that's the recipe for success. Two thirds of your time practice testing on Zuku or VetPrep, whatever you are using, and one third studying, making notes, quizzing yourself.

OK, finally, really important when we look at people who just didn't quite make it to pass their test, the BCSE or the PAVE or the NAVLE®. Over the years, a common thing, we see that all those people share is they didn't spend time at the end to re-review. But if you can manage to spend the final five to seven weeks for NAVLE®, maybe four to five weeks for BCSE or PAVE, just doing practice tests with the timed clock ticking time test they call it, and spending about a third of your time reviewing your notes and quizzing yourself that re-review people that do that they always do better. As you re-review, as you do practice tests, remember you will miss questions and that is normal. OK? It's called practice testing because you're getting better at it for practicing. If you go to yoga, we call it yoga practice because you don't go to yoga to get one 100 today, you go to yoga to try to improve a little bit. So the missed ones help you. The missed ones usually sting a little bit, and then you remember them better next time, and the system will recycle the missed ones back at you. OK. You do not need 100 to pass any of these tests. You basically need a C. That means you can miss plenty of questions and you'll be OK.