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Differential Diagnosis in Small Animal Medicine

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Описание

Contents

Introduction xiii

Part 1: Historical Signs 1

1.1 General, systemic and metabolic historical signs 1

1.1.1 Polyuria/polydipsia 1

1.1.2 Weight loss 3

1.1.3 Weight gain 4

1.1.4 Polyphagia 5

1.1.5 Anorexia/inappetence 6

1.1.6 Failure to grow 8

1.1.7 Syncope/collapse 9

1.1.8 Weakness 13

1.2 Gastrointestinal/abdominal historical signs 16

1.2.1 Ptyalism/salivation/hypersalivation 16

1.2.2 Gagging/retching 18

1.2.3 Dysphagia 19

1.2.4 Regurgitation 20

1.2.5 Vomiting 21

1.2.6 Diarrhoea 26

1.2.7 Melaena 31

1.2.8 Haematemesis 33

1.2.9 Haematochezia 34

1.2.10 Constipation/obstipation 36

1.2.11 Faecal tenesmus/dyschezia 38

1.2.12 Faecal incontinence 39

1.2.13 Flatulence/borborygmus 40

1.3 Cardiorespiratory historical signs 40

1.3.1 Coughing 40

1.3.2 Dyspnoea/tachypnoea 42

1.3.3 Sneezing and nasal discharge 43

1.3.4 Epistaxis 44

1.3.5 Haemoptysis 46

1.3.6 Exercise intolerance 47

1.4 Dermatological historical signs 48

1.4.1 Pruritus 48

1.5 Neurological historical signs 51

1.5.1 Seizures 51

1.5.2 Trembling/shivering 55

1.5.3 Ataxia/conscious proprioceptive deficits 57

1.5.4 Paresis/paralysis 65

1.5.5 Coma/stupor 70

1.5.6 Altered behaviour - general changes 72

1.5.7 Altered behaviour - specific behavioural problems 74

1.5.8 Deafness 75

1.5.9 Multifocal neurological disease 77

1.6 Ocular historical signs 80

1.6.1 Blindness/visual impairment 80

1.6.2 Epiphora/tear overflow 82

1.7 Musculoskeletal historical signs 83

1.7.1 Forelimb lameness 83

1.7.2 Hind limb lameness 87

1.7.3 Multiple joint/limb lameness 90

1.8 Reproductive historical signs 91

1.8.1 Failure to observe oestrus 91

1.8.2 Irregular seasons 92

1.8.3 Infertility in the female with normal oestrus 94

1.8.4 Male infertility 95

1.8.5 Vaginal/vulval discharge 97

1.8.6 Abortion 98

1.8.7 Dystocia 98

1.8.8 Neonatal mortality 100

1.9 Urological historical signs 101

1.9.1 Pollakiuria/dysuria/stranguria 101

1.9.2 Polyuria/polydipsia 101

1.9.3 Anuria/oliguria 102

1.9.4 Haematuria 102

1.9.5 Urinary incontinence/inappropriate urination 104

Part 2: Physical Signs 106

2.1 General/miscellaneous physical signs 106

2.1.1 Abnormalities of body temperature - hyperthermia 106

2.1.2 Abnormalities of body temperature - hypothermia 110

2.1.3 Enlarged lymph nodes 111

2.1.4 Diffuse pain 113

2.1.5 Peripheral oedema 114

2.1.6 Hypertension 115

2.1.7 Hypotension 116

2.2 Gastrointestinal/abdominal physical signs 118

2.2.1 Oral lesions 118

2.2.2 Abdominal distension 120

2.2.3 Abdominal pain 120

2.2.4 Perianal swelling 123

2.2.5 Jaundice 124

2.2.6 Abnormal liver palpation 126

Cardiorespiratory physical signs 128

2.3.1 Dyspnoea/tachypnoea 128

2.3.2 Pallor 133

2.3.3 Shock 133

2.3.4 Cyanosis 135

2.3.5 Ascites 136

2.3.6 Peripheral oedema 136

2.3.7 Abnormal respiratory sounds 137

2.3.8 Abnormal heart sounds 138

2.3.9 Abnormalities in heart rate 143

2.3.10 Jugular distension/positive hepatojugular reflux 145

2.3.11 Jugular pulse components 145

2.3.12 Alterations in arterial pulse 146

Dermatological signs 147

2.4.1 Scaling 147

2.4.2 Pustules and papules (including miliary dermatitis) 149

2.4.3 Nodules 151

2.4.4 Pigmentation disorders (coat or skin) 153

2.4.5 Alopecia 155

2.4.6 Erosive/ulcerative skin disease 157

2.4.7 Otitis externa 158

2.4.8 Pododermatitis 160

2.4.9 Disorders of the claws 162

2.4.10 Anal sac/perianal disease 163

Neurological signs 164

2.5.1 Abnormal cranial nerve (CN) responses 164

2.5.2 Vestibular disease (head tilt, nystagmus, circling, leaning,

falling, rolling) 167

2.5.3 Horner’s syndrome 171

2.5.4 Hemineglect syndrome 172

2.5.5 Spinal disorders 172

Ocular signs 174

2.6.1 Red eye 174

2.6.2 Corneal opacification 178

2.6.3 Corneal ulceration/erosion 179

2.6.4 Lens lesions 180

2.6.5 Retinal lesions 182

2.6.6 Intraocular haemorrhage/hyphaema 183

2.6.7 Abnormal appearance of anterior chamber 184

Musculoskeletal signs 185

2.7.1 Muscular atrophy or hypertrophy 185

2.7.2 Trismus (‘lockjaw’) 186

2.7.3 Weakness 187

Urogenital physical signs 187

2.8.1 Kidneys abnormal on palpation 187

2.8.2 Bladder abnormalities 189

2.8.3 Prostate abnormal on palpation 190

2.8.4 Uterus abnormal on palpation 191

2.8.5 Testicular abnormalities 191

2.8.6 Penis abnormalities 192

: Radiographic and Ultrasonographic Signs 193

Thoracic radiography 193

3.1.1 Artefactual causes of increased lung opacity 193

3.1.2 Increased bronchial pattern 193

3.1.3 Increased alveolar pattern 195

3.1.4 Increased interstitial pattern 199

3.1.5 Increased vascular pattern 201

3.1.6 Decreased vascular pattern 202

3.1.7 Cardiac diseases that may be associated with a normal

cardiac silhouette 203

3.1.8 Increased size of cardiac silhouette 203

3.1.9 Decreased size of cardiac silhouette 205

3.1.10 Abnormalities of the ribs 205

3.1.11 Abnormalities of the oesophagus 206

3.1.12 Abnormalities of the trachea 209

3.1.13 Pleural effusion 211

3.1.14 Pneumothorax 212

3.1.15 Abnormalities of the diaphragm 213

3.1.16 Mediastinal abnormalities 214

Abdominal radiography 217

3.2.1 Liver 217

3.2.2 Spleen 219

3.2.3 Stomach 221

3.2.4 Intestines 224

3.2.5 Ureters 230

3.2.6 Bladder 230

3.2.7 Urethra 233

3.2.8 Kidneys 234

3.2.9 Loss of intra-abdominal contrast 236

3.2.10 Prostate 238

3.2.11 Uterus 239

3.2.12 Abdominal masses 239

3.2.13 Abdominal calcification/mineral density 240

Skeletal radiography 241

3.3.1 Fractures 241

3.3.2 Altered shape of long bones 242

3.3.3 Dwarfism 243

3.3.4 Delayed ossification/growth plate closure 243

3.3.5 Increased radiopacity 243

3.3.6 Periosteal reactions 244

3.3.7 Bony masses 245

3.3.8 Osteopenia 246

3.3.9 Osteolysis 247