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E-raamat: Differential Diagnosis in Small Animal Medicine

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Kathryn F. Murphy (Highcroft Veterinary Referrals, Bristol, UK), Alex Gough (Partner at Bath Veterinary Referrals, in Bath, UK)

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Ilmumisaeg: 12-Jan-2015
Kirjastus: Wiley-Blackwell
Keel: eng
ISBN-13: 9781118409756

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Veterinary medicine: small animals (pets)

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Formaat: PDF+DRM
Ilmumisaeg: 12-Jan-2015
Kirjastus: Wiley-Blackwell
Keel: eng
ISBN-13: 9781118409756

Teised raamatud teemal:

Veterinary medicine: small animals (pets)

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A vital pocket-sized reference tool for busy practitioners and students, saving hours of searching through multiple sources. Differential Diagnosis in Small Animal Medicine, Second Edition brings together comprehensive differential diagnosis lists covering a wide range of presenting signs. This new edition has been fully updated with alphabetised lists for improved navigation. The lists cover the majority of presentations that are encountered in practice, including both common and uncommon conditions.

Details differential diagnoses from diverse findings such as history, physical examination, diagnostic imaging, laboratory test results and electrodiagnostic testing Provides guidance on how common conditions are, and how commonly they are the cause of the presenting sign Useful throughout the working day for vets in small animal practice, the information will save hours searching alternative multiple references New co-author Kate Murphy brings her expertise as an ECVIM diplomate For ultimate ease of use this book is also available as an app for iOS and Android devices. To purchase the app visit www.skyscape.com/wiley/DDxSAMed2

Arvustused

"Differential Diagnosis in Small Animal Medicine is not a book, it is a tool and very useful one." (European Journal of Companion Animal Practice, 1 October 2015)

"It will be handy for your clinical rota but I'm certain you will keep it when in practice." (Vet Nurses Today, 1 October 2015)

"The second edition of Differential Diagnosis in Small Animal Medicineis an excellent resource for third- and fourth-year veterinary students on clinical rotations and new graduates who are in need of a compact, pocket-friendly reference with a problem-oriented approach to clinical cases." (Journal of the American Veterinary Medical Association, 15 June 2015)

"I would say this book allows for peace of mind that every possible avenue has been explored. When dealing with a returning patient, which requires more in-depth examination, the book may well come into its own. The list-like structure makes referencing simple and clear, and explains the varying diagnosis resulting from a huge range of clinical signs and biological data." (Veterinary Record, 2016)

Introduction

(4)

Part 1: Historical Signs

(116)

1.1 General, systemic and metabolic historical signs

(17)

1.1.1 Polyuria/polydipsia

(2)

1.1.2 Weight loss

(2)

1.1.3 Weight gain

(1)

1.1.4 Polyphagia

(1)

1.1.5 Anorexia/inappetence

(2)

1.1.6 Failure to grow

(1)

1.1.7 Syncope/collapse

(4)

1.1.8 Weakness

(4)

1.2 Gastrointestinal/abdominal historical signs

(29)

1.2.1 Ptyalism/salivation/hypersalivation

(2)

1.2.2 Gagging/retching

(2)

1.2.3 Dysphagia

(1)

1.2.4 Regurgitation

(1)

1.2.5 Vomiting

(6)

1.2.6 Diarrhoea

(6)

1.2.7 Melaena

(2)

1.2.8 Haematemesis

(2)

1.2.9 Haematochezia

(2)

1.2.10 Constipation/obstipation

(2)

1.2.11 Faecal tenesmus/dyschezia

(1)

1.2.12 Faecal incontinence

(1)

1.2.13 Flatulence/borborygmus

(1)

1.3 Cardiorespiratory historical signs

(8)

1.3.1 Coughing

(1)

1.3.2 Dyspnoea/tachypnoea

(1)

1.3.3 Sneezing and nasal discharge

(2)

1.3.4 Epistaxis

(1)

1.3.5 Haemoptysis

(2)

1.3.6 Exercise intolerance

(1)

1.4 Dermatological historical signs

(2)

1.4.1 Pruritus

(2)

1.5 Neurological historical signs

(29)

1.5.1 Seizures

(4)

1.5.2 Trembling/shivering

(2)

1.5.3 Ataxia

(9)

1.5.4 Paresis/paralysis

(4)

1.5.5 Coma/stupor

(2)

1.5.6 Altered behaviour: General changes

(2)

1.5.7 Altered behaviour: Specific behavioural problems

(1)

1.5.8 Deafness

(2)

1.5.9 Multifocal neurological disease

(3)

1.6 Ocular historical signs

(5)

1.6.1 Blindness/visual impairment

(3)

1.6.2 Epiphora/tear overflow

(2)

1.7 Musculoskeletal historical signs

(9)

1.7.1 Forelimb lameness

(4)

1.7.2 Hindlimb lameness

(4)

1.7.3 Multiple joint/limb lameness

103

(1)

1.8 Reproductive historical signs

104

(11)

1.8.1 Failure to observe oestrus

104

(2)

1.8.2 Irregular seasons

106

(1)

1.8.3 Infertility in the female with normal oestrus

107

(1)

1.8.4 Male infertility

108

(3)

1.8.5 Vaginal/vulval discharge

111

(1)

1.8.6 Abortion

111

(1)

1.8.7 Dystocia

112

(2)

1.8.8 Neonatal mortality

114

(1)

1.9 Urological historical signs

115

(6)

1.9.1 Pollakiuria/dysuria/stranguria

115

(1)

1.9.2 Polyuria/polydipsia

115

(1)

1.9.3 Anuria/oliguria

116

(1)

1.9.4 Haematuria

117

(2)

1.9.5 Urinary incontinence/inappropriate urination

119

(2)

Part 2: Physical Signs

121

(92)

2.1 General/miscellaneous physical signs

121

(14)

2.1.1 Abnormalities of body temperature - hyperthermia

121

(6)

2.1.2 Abnormalities of body temperature - hypothermia

127

(1)

2.1.3 Enlarged lymph nodes

127

(3)

2.1.4 Diffuse pain

130

(1)

2.1.5 Peripheral oedema

130

(2)

2.1.6 Hypertension

132

(1)

2.1.7 Hypotension

133

(2)

2.2 Gastrointestinal/abdominal physical signs

135

(11)

2.2.1 Oral lesions

135

(2)

2.2.2 Abdominal distension

137

(1)

2.2.3 Abdominal pain

138

(3)

2.2.4 Perianal swelling

141

(1)

2.2.5 Jaundice

142

(2)

2.2.6 Abnormal liver palpation

144

(2)

2.3 Cardiorespiratory physical signs

146

(18)

2.3.1 Dyspnoea/tachypnoea

146

(5)

2.3.2 Pallor

151

(1)

2.3.3 Shock

151

(2)

2.3.4 Cyanosis

153

(2)

2.3.5 Ascites

155

(1)

2.3.6 Abnormal respiratory sounds

155

(1)

2.3.7 Abnormal heart sounds

156

(4)

2.3.8 Abnormalities in heart rate

160

(3)

2.3.9 Jugular distension/hepatojugular reflux

163

(1)

2.3.10 Alterations in arterial pulse

163

(1)

2.4 Dermatological signs

164

(19)

2.4.1 Scaling

164

(2)

2.4.2 Pustules and papules (including miliary dermatitis)

166

(2)

2.4.3 Nodules

168

(2)

2.4.4 Pigmentation disorders (coat or skin)

170

(2)

2.4.5 Alopecia

172

(2)

2.4.6 Erosive/ulcerative skin disease

174

(2)

2.4.7 Otitis externa

176

(2)

2.4.8 Pododermatitis

178

(2)

2.4.9 Disorders of the claws

180

(2)

2.4.10 Anal sac/perianal disease

182

(1)

2.5 Neurological signs

183

(9)

2.5.1 Abnormal cranial nerve (CN) responses

183

(3)

2.5.2 Vestibular disease

186

(3)

2.5.3 Homer's syndrome

189

(1)

2.5.4 Hemineglect syndrome (Forebrain dysfunction q.v.)

190

(1)

2.5.5 Spinal disorders

190

(2)

2.6 Ocular signs

192

(12)

2.6.1 Red eye

192

(5)

2.6.2 Corneal opacification

197

(1)

2.6.3 Corneal ulceration/erosion

198

(2)

2.6.4 Lens lesions

200

(1)

2.6.5 Retinal lesions

201

(2)

2.6.6 Intraocular haemorrhage/hyphaema

203

(1)

2.6.7 Abnormal appearance of anterior chamber

204

(1)

2.7 Musculoskeletal signs

204

(3)

2.7.1 Muscular atrophy or hypertrophy

204

(2)

2.7.2 Trismus ('lockjaw')

206

(1)

2.7.3 Weakness

207

(1)

2.8 Urogenital physical signs

207

(6)

2.8.1 Kidneys abnormal on palpation

207

(1)

2.8.2 Bladder abnormalities

208

(2)

2.8.3 Prostate abnormal on palpation

210

(1)

2.8.4 Uterus abnormal on palpation

210

(1)

2.8.5 Testicular abnormalities

211

(1)

2.8.6 Penis abnormalities

211

(2)

Part 3: Radiographic and Ultrasonographic Signs

213

(100)

3.1 Thoracic radiography

213

(24)

3.1.1 Artefactual causes of increased lung opacity

213

(1)

3.1.2 Increased bronchial pattern

213

(1)

3.1.3 Increased alveolar pattern

214

(3)

3.1.4 Increased interstitial pattern

217

(3)

3.1.5 Increased vascular pattern

220

(1)

3.1.6 Decreased vascular pattern

221

(1)

3.1.7 Cardiac diseases that may be associated with a normal cardiac silhouette

222

(1)

3.1.8 Increased size of cardiac silhouette

222

(1)

3.1.9 Decreased size of cardiac silhouette

223

(1)

3.1.10 Abnormalities of the ribs

224

(1)

3.1.11 Abnormalities of the oesophagus

225

(3)

3.1.12 Abnormalities of the trachea

228

(2)

3.1.13 Pleural effusion

230

(2)

3.1.14 Pneumothorax

232

(1)

3.1.15 Abnormalities of the diaphragm

233

(1)

3.1.16 Mediastinal abnormalities

234

(3)

3.2 Abdominal radiography

237

(27)

3.2.1 Liver

237

(2)

3.2.2 Spleen

239

(2)

3.2.3 Stomach

241

(3)

3.2.4 Intestines

244

(7)

3.2.5 Ureters

251

(1)

3.2.6 Bladder

251

(3)

3.2.7 Urethra

254

(1)

3.2.8 Kidneys

255

(3)

3.2.9 Loss of intra-abdominal contrast

258

(2)

3.2.10 Prostate

260

(1)

3.2.11 Uterus

261

(1)

3.2.12 Abdominal masses

261

(1)

3.2.13 Abdominal calcification/mineral density

262

(2)

3.3 Skeletal radiography

264

(11)

3.3.1 Fractures

264

(1)

3.3.2 Altered shape of the long bones

264

(1)

3.3.3 Dwarfism

265

(1)

3.3.4 Delayed ossification/growth plate closure

266

(1)

3.3.5 Increased radiopacity

266

(1)

3.3.6 Periosteal reactions

267

(1)

3.3.7 Bony masses

267

(1)

3.3.8 Osteopenia

268

(2)

3.3.9 Osteolysis

270

(1)

3.3.10 Mixed osteolytic/osteogenic lesions

271

(1)

3.3.11 Joint changes

271

(4)

3.4 Radiography of the head and neck

275

(7)

3.4.1 Increased radiopacity/bony proliferation a of the maxilla

275

(1)

3.4.2 Decreased radiopacity of the maxilla

275

(1)

3.4.3 Increased radiopacity/bony proliferation of the mandible

276

(1)

3.4.4 Decreased radiopacity of the mandible

276

(1)

3.4.5 Increased radiopacity of the tympanic bulla

276

(1)

3.4.6 Decreased radiopacity of the nasal cavity

277

(1)

3.4.7 Increased radiopacity of the nasal cavity

277

(2)

3.4.8 Increased radiopacity of the frontal sinuses

279

(1)

3.4.9 Increased radiopacity of the pharynx

279

(1)

3.4.10 Thickening of the soft tissues of the head and neck

280

(1)

3.4.11 Decreased radiopacity of the soft tissues of the head and neck

281

(1)

3.4.12 Increased radiopacity of the soft tissues of the head and neck

281

(1)

3.5 Radiography of the spine

282

(7)

3.5.1 Normal and congenital variation in vertebral shape and size

282

(1)

3.5.2 Acquired variation in vertebral shape and size

283

(2)

3.5.3 Changes in vertebral radiopacity

285

(1)

3.5.4 Abnormalities in the intervertebral space

286

(1)

3.5.5 Contrast radiography of the spine (myelography)

287

(2)

3.6 Thoracic ultrasonography

289

(5)

3.6.1 Pleural effusion

289

(1)

3.6.2 Mediastinal masses

290

(1)

3.6.3 Pericardial effusion

290

(1)

3.6.4 Altered chamber dimensions

291

(3)

3.6.5 Changes in ejection phase indices of left ventricular performance (fractional shortening, FS%; ejection fraction, EF)

294

(1)

3.7 Abdominal ultrasonography

294

(14)

3.7.1 Renal disease

294

(3)

3.7.2 Hepatobiliary disease

297

(3)

3.7.3 Splenic disease

300

(1)

3.7.4 Pancreatic disease

301

(1)

3.7.5 Adrenal disease

302

(1)

3.7.6 Urinary bladder disease

302

(2)

3.7.7 Gastrointestinal disease

304

(1)

3.7.8 Ovarian and uterine disease

305

(1)

3.7.9 Prostatic disease

306

(1)

3.7.10 Ascites

306

(2)

3.8 Ultrasonography of other regions

308

(5)

3.8.1 Testes

308

(1)

3.8.2 Eyes

309

(2)

3.8.3 Neck

311

(2)

Part 4: Laboratory Findings

313

(97)

4.1 Biochemical findings

313

(29)

4.1.1 Albumin

313

(2)

4.1.2 Alanine transferase

315

(1)

4.1.3 Alkaline phosphatase

316

(2)

4.1.4 Ammonia

318

(1)

4.1.5 Amylase

319

(1)

4.1.6 Aspartate aminotransferase

320

(1)

4.1.7 Bilirubin

321

(1)

4.1.8 Bile acids/dynamic bile acid test

322

(1)

4.1.9 C-reactive protein (D)

322

(1)

4.1.10 Cholesterol

323

(1)

4.1.11 Creatinine

324

(1)

4.1.12 Creatine kinase

324

(1)

4.1.13 Ferritin

325

(1)

4.1.14 Fibrinogen

326

(1)

4.1.15 Folate

326

(1)

4.1.16 Fructosamine

327

(1)

4.1.17 Gamma-glutamyl transferase

327

(1)

4.1.18 Gastrin

328

(1)

4.1.19 Globulins

329

(1)

4.1.20 Glucose

330

(3)

4.1.21 Iron

333

(1)

4.1.22 Lactate dehydrogenase

333

(2)

4.1.23 Lipase

335

(1)

4.1.24 Triglycerides

336

(1)

4.1.25 Troponin

337

(1)

4.1.26 Trypsin-like immunoreactivity

338

(1)

4.1.27 Urea

338

(3)

4.1.28 Vitamin B12 (cobalamin)

341

(1)

4.1.29 Zinc

341

(1)

4.2 Haematological findings

342

(23)

4.2.1 Regenerative anaemia

342

(3)

4.2.2 Poorly/non-regenerative anaemia

345

(3)

4.2.3 Polycythaemia

348

(2)

4.2.4 Thrombocytopenia

350

(3)

4.2.5 Thrombocytosis

353

(1)

4.2.6 Neutrophilia

354

(1)

4.2.7 Neutropenia

355

(2)

4.2.8 Lymphocytosis

357

(1)

4.2.9 Lymphopenia

358

(1)

4.2.10 Monocytosis

359

(1)

4.2.11 Eosinophilia

360

(1)

4.2.12 Eosinopenia

361

(1)

4.2.13 Mastocytemia

361

(1)

4.2.14 Basophilia

362

(1)

4.2.15 Increased buccal mucosal bleeding time (disorders of primary haemostasis)

362

(1)

4.2.16 Increased prothrombin time (disorders of extrinsic and common pathways)

363

(1)

4.2.17 Increased partial thromboplastin time or activated clotting time (disorders of intrinsic and common pathways)

363

(1)

4.2.18 Increased fibrin degradation products

364

(1)

4.2.19 Decreased fibrinogen levels

364

(1)

4.2.20 Decreased antithrombin III levels

364

(1)

4.3 Electrolyte and blood gas findings

365

(16)

4.3.1 Total calcium

365

(2)

4.3.2 Chloride

367

(2)

4.3.3 Magnesium

369

(2)

4.3.4 Potassium

371

(2)

4.3.5 Phosphate

373

(2)

4.3.6 Sodium

375

(2)

4.3.7 pH

377

(2)

4.3.8 paO2

379

(2)

4.3.9 Total CO2

381

(1)

4.3.10 Bicarbonate

381

(1)

4.3.11 Base excess

381

(1)

4.4 Urinalysis findings

381

(11)

4.4.1 Alterations in specific gravity

381

(2)

4.4.2 Abnormalities in urine chemistry

383

(5)

4.4.3 Abnormalities in urine sediment

388

(2)

4.4.4 Infectious agents

390

(2)

4.5 Cytological findings

392

(9)

4.5.1 Tracheal/bronchoalveolar lavage

392

(2)

4.5.2 Nasal flush cytology

394

(1)

4.5.3 Liver cytology

395

(2)

4.5.4 Kidney cytology

397

(1)

4.5.5 Skin scrapes/hair plucks/tape impressions

398

(1)

4.5.6 Cerebrospinal fluid (CSF) analysis

398

(2)

4.5.7 Fine-needle aspiration of cutaneous/subcutaneous masses

400

(1)

4.6 Hormones/endocrine testing

401

(7)

4.6.1 Thyroxine

401

(2)

4.6.2 Parathyroid hormone

403

(1)

4.6.3 Cortisol (baseline or post-ACTH stimulation test)

404

(1)

4.6.4 Insulin

405

(1)

4.6.5 ACTH

405

(1)

4.6.6 Vitamin D (1,25-dihydroxycholecalciferol)

405

(1)

4.6.7 Testosterone

406

(1)

4.6.8 Progesterone

406

(1)

4.6.9 Oestradiol

407

(1)

4.6.10 Pro-BNP

407

(1)

4.7 Faecal analysis findings

408

(2)

4.7.1 Faecal blood

408

(1)

4.7.2 Faecal parasites

408

(1)

4.7.3 Faecal culture

409

(1)

4.7.4 Faecal fungal infections

409

(1)

4.7.5 Undigested food residues

409

(1)

Part 5: Electrodiagnostic Testing

410

(14)

5.1 Electrocardiographic findings

410

(12)

5.1.1 Alterations in P wave

410

(1)

5.1.2 Alterations in QRS complex

411

(2)

5.1.3 Alterations in P-R relationship

413

(1)

5.1.4 Alterations in S-T segment

414

(1)

5.1.5 Alterations in Q-T interval

415

(1)

5.1.6 Alterations in T wave

416

(1)

5.1.7 Alterations in baseline

416

(1)

5.1.8 Rhythm alterations

416

(4)

5.1.9 Alterations in rate

420

(2)

5.2 Electromyographic findings

422

(1)

5.2.1 Spontaneous activity

422

(1)

5.2.2 Evoked activity

423

(1)

5.3 Nerve conduction velocity findings

423

(1)

5.3.1 Decreased velocity

423

(1)

5.3.2 Increased velocity

423

(1)

Index

424

About the authors

Alex Gough, MA, VetMB, CertSAM, CertVC, PGCert (Neuroimaging), MRCVS Alex is the director of a referral and first opinion practice in Bath, UK, where he sees referrals in small animal medicine, cardiology and neurology. He is a holder of the Royal College of Veterinary Surgeons Certificate of Small Animal Medicine and Veterinary Cardiology and a Postgraduate Certificate in Neuroimaging for Research. He is the author of Breed Predispositions to Disease in Dogs and Cats (with Alison Thomas, Wiley-Blackwell, 2010) and is a frequent contributor to the Veterinary Times.

Kate Murphy, BVSc (Hons), DSAM, DipECVIM-CA, MRCVS, PGCert(HE) Kate is the clinical lead in a referral practice in Bristol, UK, where she sees a wide spectrum of medicine cases. Before working in referral practice, Kate was a small animal medicine clinician at the University of Bristol from 2002 to early 2011 where she ran the intensive care and emergency medicine service and also the medicine referral team. She is a diplomate of the European College of Veterinary Internal Medicine. Kate is co-author of Notes on Canine Internal Medicine (with Edward Hall and Peter Darke, Wiley-Blackwell, 2004), has contributed chapters to BSAVA manuals and also has a number of peer-reviewed publications.

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