Notes on Canine Internal Medicine

Notes on Canine Internal Medicine
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Canine Internal Medicine A thorough yet concise guide to diagnosing and managing canine medical conditions The newly revised Fourth Edition of Notes on Canine Internal Medicine delivers a comprehensive guide to the diagnosis of common and uncommon medical conditions in dogs. Written to act as a practical and fast-access subject reference for veterinary practitioners and students, Notes on Canine Internal Medicine encourages physicians to take a logical and evidence-based approach to canine medicine. Divided into five sections, the first four are dedicated to clinical presentations, physical and laboratory abnormalities, and – new to this edition – imaging patterns. It concludes with a section on the organ systems of canines, providing a robust summary of how to diagnose and manage common specific conditions of each system. This new edition includes: A thorough introduction to the clinical presentations of a variety of presenting complaints, with both common and uncommon causes of each complaint and a logical diagnostic approach In-depth examinations of common and uncommon physical problems, with a complete diagnostic approach including lab results and key imaging findings that aid in diagnosis Comprehensive explorations of laboratory abnormalities in haematology, serum biochemistry, and urinalysis Practical discussions of diagnostic imaging patterns, including plain radiographic, ultrasonographic, contrast radiographic, and cross-sectional imaging Notes on Canine Internal Medicine Fourth Edition is designed to be a useful resource for all veterinary clinicians; as a handy point of reference for veterinary students, recently graduated veterinary surgeons and those returning to work after career breaks, but also for experienced veterinary surgeons dealing with particularly difficult or challenging cases.

Оглавление

Kathryn F. Murphy. Notes on Canine Internal Medicine

Table of Contents

List of Illustrations

Guide

Pages

NOTES ON CANINE INTERNAL MEDICINE

PREFACE

Note

ACKNOWLEDGEMENTS

USING THIS BOOK. SECTION 1

SECTION 2

SECTION 3

SECTION 4

SECTION 5

COMMONLY USED ABBREVIATIONS

SECTION 1 PRESENTING COMPLAINTS

1.1 ABORTION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Infectious

Non‐infectious

UNCOMMON CAUSES. Infectious

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

Tests of dam

1.2 ALOPECIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Primary follicular disease

Secondary follicular disease

Self‐trauma when pruritic

UNCOMMON CAUSES. Primary follicular disease

Secondary follicular disease

Self‐mutilation

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Dermatological investigations

Imaging

Special tests

1.3 ALTERED BEHAVIOUR. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Pain

Intracranial disorders

Metabolic disorders

Intestinal disorders

Urinary tract disorders

UNCOMMON CAUSES. Metabolic disorders

Intracranial disorders

Dermatological disorders

Ocular disorders causing pain or impairing vision

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.4 ALTERED CONSCIOUSNESS. DEFINITION

RELATED CLINICAL SIGNS. Grades of dysfunction. Depressed or obtunded

COMMON CAUSES. Congenital

Inflammatory

Infectious

Iatrogenic

Metabolic

Neoplastic

Vascular

UNCOMMON CAUSES. Congenital

Infectious

Iatrogenic

Vascular

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging

Plain radiographs

Ultrasound

Special tests

1.5 ANOREXIA/HYPOREXIA/INAPPETENCE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Anorexia/inappetence

Pseudoanorexia

UNCOMMON CAUSES. True anorexia

Pseudo‐anorexia

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Haematology

Biochemistry

Special tests

1.6 ANOSMIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging

Special tests

1.7 ANURIA/OLIGURIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Infectious causes

Toxins

Drugs

Vascular

Miscellaneous

UNCOMMON CAUSES. Infectious

Vascular

Miscellaneous

Drugs

Neoplasia

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.8 ATAXIA. DEFINITION

RELATED CLINICAL SIGNS. Cerebellar ataxia

Vestibular ataxia

Proprioceptive (sensory) ataxia

COMMON CAUSES. Cerebellar ataxia

Vestibular ataxia

Central vestibular (brainstem or cerebellar)

Proprioceptive (sensory) ataxia

UNCOMMON CAUSES. Cerebellar ataxia

Vestibular ataxia

Proprioceptive (sensory) ataxia

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

1.9 BLEEDING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Disorders of affected organ

Systemic disease

UNCOMMON CAUSES. Disorders of affected organ

Systemic disease

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs and ultrasound

Special tests

1.10 BLINDNESS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Pre‐retinal

Retinal

Optic nerve

Central nervous system

UNCOMMON CAUSES. Pre‐retinal

Retinal

Optic nerve

Central nervous system

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.11 CONSTIPATION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Anorectal pain

Dietary

Drug‐induced

Environmental

Extraluminal obstruction

Intraluminal obstruction

Neuromuscular disease

Orthopaedic disease (pain and failure to posture)

Water‐electrolyte abnormalities

UNCOMMON CAUSES. Anorectal disease

Drug‐induced

Extraluminal obstruction

Intraluminal obstruction

Metabolic

Neuromuscular disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Plain radiographs

Contrast radiographs (barium enema)

Ultrasound

Special tests

1.12 CORNEAL OPACITY. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. White

Brown/black pigment

Red

UNCOMMON CAUSES. White

Brown/black pigment

Blue

Red

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Special tests

1.13 COUGHING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Allergic/immune‐mediated

Cardiovascular

Environmental irritants

Infectious/inflammatory

Parasitic

Pleural effusion

Physical/traumatic

UNCOMMON CAUSES. Allergic

Cardiovascular

Environmental irritants

Infectious/inflammatory

Neoplastic

Parasitic

Physical/traumatic

DIAGNOSTIC APPROACH

CLINICAL CLUES

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Thoracic radiographs

Special tests

1.14 DEAFNESS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Conductive

Sensorineural

UNCOMMON CAUSES. Conductive

Sensorineural

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Otoscopic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Special tests

1.15 DIARRHOEA. DEFINITION

RELATED CLINICAL SIGNS

1.15.1 ACUTE DIARRHOEA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Primary GI disease. Dietary

Drug/toxin

Infection – Bacterial

Infection – Parasitic

Infection – Viral

Obstructive (surgical)

Secondary, non‐GI disease

UNCOMMON CAUSES. Primary GI disease. Dietary

Drug/toxin

Infection – Bacterial

Infection – Parasitic

Infection – Rickettsial

Infection – Viral (often mild)

Obstructive (surgical)

Secondary, non‐GI disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Faecal examination

Imaging. Radiographs

Ultrasound

Special tests

1.15.2 CHRONIC DIARRHOEA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Primary GI disease

Secondary non‐GI disease

UNCOMMON CAUSES. Primary GI disease

Secondary non‐GI disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Faecal examination

Imaging. Radiographs

Ultrasound

Special tests

1.16 DROOLING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Pseudoptyalism

Ptyalism

UNCOMMON CAUSES. Pseudoptyalism

Ptyalism

DIAGNOSTIC APPROACH

Clinical clues

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Radiographs

Special tests

1.17 DYSPHAGIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Structural or functional diseases of the mouth and/or temporo‐mandibular joint and/or pharynx:

Oesophageal disorders

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

CLINICAL CLUES. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Oral and pharyngeal sampling

Imaging. Radiographs

Special tests

1.18 DYSPNOEA/TACHYPNOEA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Haematological disorders

Lower airway disorders

Mediastinal disorders

Peritoneal cavity disorders

Pleural/body wall disorders

Pulmonary parenchymal disorders

Upper airway disorders. Brachycephalic obstructive airway syndrome (BOAS)

Laryngeal disease

Tracheal disease

UNCOMMON CAUSES. Haematological disorders

Lower airway disorders. Extraluminal intrathoracic tracheal and/or bronchial compression

Tracheal diseases affecting thoracic trachea

Mediastinal disorders

Nasal cavity obstruction

Peritoneal cavity disorders

Pleural/body wall disorders

Pulmonary parenchymal disorders

Upper airway disorders. Cervical tracheal disease

Laryngeal disease

Miscellaneous

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

LABORATORY FINDINGS

IMAGING

SPECIAL TESTS

1.19 DYSURIA. DEFINITION

RELATED CLINICAL SIGNS. Major signs

Other potential signs

COMMON CAUSES. Lower urinary tract disorders

Neurological causes

UNCOMMON CAUSES. Lower urinary tract disorders

Neurological causes

Structural

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Radiographs

Ultrasound

Special tests

1.20 DYSTOCIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON AND UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound/Doppler

Special tests

1.21 EPISTAXIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Nasal disease

Systemic disease

UNCOMMON CAUSES. Nasal disease

Systemic disease

DIAGNOSTIC APPROACH. Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Special tests

1.22 EXERCISE INTOLERANCE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Cardiovascular disease

Endocrine disease

Generalised weakness

Metabolic disease

Muscular disease

Neurological/spinal disease

Neuromuscular disease

Respiratory disease

Skeletal disease

UNCOMMON CAUSES. Endocrine disease

Metabolic disease

Miscellaneous

Muscular disease

Neurological/spinal disease

Skeletal disease

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Special tests

1.23 FAECAL INCONTINENCE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Anal disease

Neurogenic sphincter mechanism incontinence

UNCOMMON CAUSES. Neurogenic sphincter incontinence

Neoplasia

Myopathy

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Plain radiographs

Contrast radiographs

Special tests

1.24 FLATULENCE/BORBORYGMI. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Aerophagia

Diseases causing malabsorption and alterations in microbiome

Ingestion of non‐absorbable substances

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Plain radiographs

Ultrasound

Special tests

1.25 HAEMATEMESIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Endocrine

Gastric ulceration

Generalised bleeding problem q.v. section 1.9. GI disease

Swallowed blood

UNCOMMON CAUSES

Duodenal ulceration

Gastric ulceration

Shock

Swallowed blood

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Special tests

1.26 HAEMATOCHEZIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Anal disease

Generalised bleeding disorder

Generalised GI disease

Large intestinal disease

UNCOMMON CAUSES. Large intestinal disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Faecal examination

Imaging

Special tests

1.27 HAEMATURIA AND DISCOLOURED URINE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES – HAEMATURIA. Urinary tract disease

Systemic disease

UNCOMMON CAUSES – HAEMATURIA. Urinary tract disease

Systemic disease

COMMON CAUSES – DISCOLOURED URINE. Red or brown urine – see haematuria

Dark yellow urine

UNCOMMON CAUSES – DISCOLOURED URINE. Red or brown urine – also see haematuria

Dark yellow urine

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

1.28 HAEMOPTYSIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Respiratory tract disease

Systemic disease

UNCOMMON CAUSES. Respiratory tract disease

Systemic disease

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.29 HALITOSIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

Abnormal ingestive behavior or pica

Oral diseases

UNCOMMON CAUSES

Abnormal ingestive behaviour or pica

Oral diseases

Oral contact with contaminated site

Remote causes producing malodorous exhalation

DIAGNOSTIC APPROACH

1.30 HEAD TILT. DEFINITION

RELATED CLINICAL SIGNS

Cerebellar disorder

Vestibular disorder

COMMON CAUSES. Cerebellar disorder

Vestibular disorder

UNCOMMON CAUSES. Cerebellar disorder

Vestibular disorder

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.31 MELAENA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Endocrine

Generalised bleeding problem q.v. section 1.9. Gastric neoplasia

Gastric ulceration

Intestinal disease

Intestinal neoplasia

Swallowed blood

UNCOMMON CAUSES. Gastric ulceration

Intestinal disease

Pancreatic disease

Swallowed blood

Severe oesophageal disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Palpation

Digital rectal examination

Laboratory findings

Imaging

Special tests

1.32 NASAL DISCHARGE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs

Special tests

1.33 NYSTAGMUS. DEFINITION

RELATED CLINICAL SIGNS. Cerebellar disorders

Vestibular disorders

COMMON CAUSES. Cerebellar disorders

Vestibular disorders

UNCOMMON CAUSES. Cerebellar disorders

Vestibular disorders

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.34 PARESIS/PARALYSIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs

Ultrasound examination

Special tests

1.35 PERINATAL DEATH. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Infectious

Non‐infectious

UNCOMMON CAUSES. Infectious

Non‐infectious

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination

Laboratory findings. Haematology

Special tests

1.36 POLYPHAGIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Behavioural

Drugs

Endocrine disease

GI disease

Physiological

UNCOMMON CAUSES. Metabolic/endocrine disease

Drugs

Neurological

Renal

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Special tests

1.37 POLYURIA/POLYDIPSIA (PU/PD) DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Primary polydipsia

Primary polyuria. Osmotic diuresis

Renal insensitivity to antidiuretic hormone (ADH) = Nephrogenic diabetes insipidus (NDI)

UNCOMMON CAUSES. Primary polydipsia

Primary polyuria

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Palpation

Auscultation

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Abdominal radiographs

Thoracic radiographs

Special tests

1.38 PREPUTIAL DISCHARGE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Haemorrhagic

Purulent

UNCOMMON CAUSES. Haemorrhagic

Purulent

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Contrast radiographs

Ultrasound examination

Special tests

1.39 PRURITUS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Special tests

1.40 RED EYE (AND PINK EYE) DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Ophthalmic examination

Laboratory findings

Imaging

Special tests

1.41 REGURGITATION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Intra‐luminal obstruction

Megaoesophagus

Oesophagitis

UNCOMMON CAUSES. Extra‐luminal obstruction

Intra‐luminal obstruction

Ingestive causes

Megaoesophagus

Mural disease

Myopathies

Neuropathies/junctionopathies

Toxins

Miscellaneous

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Biochemistry

Imaging. Plain radiographs of conscious dog

Contrast radiographs: barium swallow after plain films

Endoscopy

Special tests

1.42 SEIZURES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Extracranial causes

Intracranial causes

UNCOMMON CAUSES. Extracranial causes

Intracranial causes

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

1.43 SNEEZING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs

Special tests

1.44 STIFFNESS, JOINT SWELLING AND GENERALISED LAMENESS. DEFINITIONS

RELATED CLINICAL SIGNS

COMMON CAUSES. Spinal pain

Musculoskeletal pain

UNCOMMON CAUSES. Spinal pain

Musculoskeletal pain

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Orthopaedic and neurological examinations

Laboratory findings. Haematology and serum biochemistry

Imaging

Special tests

1.45 STUNTING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Radiographs

Ultrasound

Special tests

1.46 TENESMUS AND DYSCHEZIA. DEFINITION

RELATED CLINICAL SIGNS. Primary signs

Associated signs

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Rectal examination

Laboratory findings

Imaging. Plain radiographs

Ultrasound

Special tests

1.47 TREMORS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Cerebellar disease

Idiopathic

Metabolic disease

UNCOMMON CAUSES. Cerebellar disease

Miscellaneous

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging

Special tests

1.48 URINARY INCONTINENCE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Storage disorders

Overflow incontinence

UNCOMMON CAUSES. Storage disorders

Overflow incontinence

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

1.49 VOMITING. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Acute vomiting. Primary GI disease

Secondary, non‐GI disease

Chronic vomiting. Primary GI disease

Secondary, non‐GI disease

UNCOMMON CAUSES. Acute vomiting. Primary GI disease

Secondary, non‐GI disease

Chronic vomiting. Primary GI disease

Secondary, non‐GI disease

DIAGNOSTIC APPROACH

CLINICAL CLUES. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Radiographs

Ultrasound

Special tests

1.50 VULVAL DISCHARGE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

1.51 WEAKNESS, COLLAPSE AND SYNCOPE. DEFINITIONS

RELATED CLINICAL SIGNS. Weakness

Collapse

Signs related to underlying disease

COMMON CAUSES

Cardiovascular disease. Acquired disease

Arrhythmia

Congenital disease

Pericardial disease

Vascular

Endocrine/metabolic

Haematological

Neurological

Orthopaedic disease

Respiratory tract disease

UNCOMMON CAUSES. Cardiovascular disease. Acquired disease

Congenital disease

Pericardial disease

Vascular

Endocrine/metabolic

Iatrogenic

Neurological

Other

Respiratory tract disease

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Auscultation

Palpation

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

1.52 WEIGHT GAIN/OBESITY. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging

Special tests

1.53 WEIGHT LOSS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Normal to increased appetite, q.v. section 1.36. Physiological

Pathological

Decreased appetite. Any condition causing anorexia,q.v.section 1.5

UNCOMMON CAUSES. Normal to increased appetite

Decreased appetite

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Faecal examination for parasites. Imaging

Special tests

SECTION 2 PHYSICAL ABNORMALITIES

2.1 ABDOMINAL ENLARGEMENT. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Abdominal wall musculature weakness

Faeces

Fat

Fluid

Haemoperitoneum

Intraluminal

Uroperitoneum

Gas

Mass(es)

UNCOMMON CAUSES. Abdominal wall musculature weakness

Fat

Fluid. Bile peritonitis

Chylous effusion

Haemoperitoneum

Septic peritonitis

Uroperitoneum

Gas. Pneumoperitoneum

Intestinal enlargement

Mass(es)

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

2.2 ABDOMINAL MASSES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Gastrointestinal (GI)

Liver

Spleen

Uterus

UNCOMMON CAUSES. GI

Gonads

Liver

Kidney

Pancreas

Spleen

Uterus

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special tests

2.3 ABNORMAL LUNG SOUNDS. DEFINITION. Areas of dullness

Crackles

Wheezes

RELATED CLINICAL SIGNS

COMMON CAUSES. Areas of dullness. Focal

Dorsal to a line

Ventral to a line: pleural effusion

Crackles

Wheezes

UNCOMMON CAUSES. Areas of dullness. Focal

Dorsal to a line

Ventral to a line: pleural effusion,q.v.section 2.21

Crackles

Wheezes

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

2.4 ARRHYTHMIAS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Bradyarrhythmias

Tachyarrhythmias

UNCOMMON CAUSES. Bradyarrhythmias

Tachyarrhythmias

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound examination

Special tests

2.5 ASCITES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Blood

Low‐protein transudate (hypoalbuminaemia) Hepatic disease

Protein‐losing enteropathy

Protein‐losing nephropathy

High‐protein, modified transudate (portal hypertension) Cardiac tamponade (pericardial effusion)

Hepatic disease

Right‐sided heart failure

Exudate – inflammatory. Non‐septic

Septic

Urine

UNCOMMON CAUSES. Blood

Low‐protein transudate. Hepatic disease

Protein‐losing enteropathy (PLE)

Protein‐losing nephropathy (PLN)

High‐protein, modified transudate (portal hypertension) Cardiac tamponade

Caudal vena cava (CVC) compression/obstruction

Liver disease

Non‐septic

Post‐hepatic obstruction

Exudate – inflammatory. Bile

Chyle (lymphatic obstruction or leakage)

Non‐septic

Septic

Urine

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Radiographs

Ultrasound

Special tests

2.6 CYANOSIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Central. Pulmonary disease

Neurological – depressed respiration

Peripheral. Physiological

UNCOMMON CAUSES. Central. Pulmonary disease

Cardiovascular disease

Neurological – depressed respiration

Peripheral. Arterial obstruction

Methaemoglobinaemia

Venous obstruction

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasonography

Special tests

2.7 EYE LESIONS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Cornea

Anterior chamber (aqueous humor)

Iris

Lens opacities

Vitreous

Retina

UNCOMMON CAUSES. Cornea

Anterior chamber (aqueous humor)

Iris

Lens opacities

Vitreous

Retina

DIAGNOSTIC APPROACH

Clinical clues

Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging

Special tests

2.8 HEPATOMEGALY. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Generalised. Congestion

Infiltrative disease

Drugs

Endocrinopathy

UNCOMMON CAUSES

Generalised. Congestion

Infiltrative disease

Inflammation

Focal

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound examination

Special tests

2.9 HORNER’S SYNDROME. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. First‐order (central)

Second‐order (preganglionic)

Third‐order (postganglionic)

UNCOMMON CAUSES. First‐order (central)

Second‐order (preganglionic)

Third‐order (postganglionic)

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Neurological examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs

Special tests

2.10 HYPERTENSION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Ophthalmic examination

Laboratory findings. Haematology, serum biochemistry

Urinalysis

Imaging. Plain radiographs and ultrasound

Special tests

2.11 HYPOTENSION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology, serum biochemistry and urinalysis

Imaging. Plain radiographs and ultrasound

Special tests

2.12 HYPOTHERMIA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs and ultrasound

Special tests

2.13 ICTERUS/JAUNDICE. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Prehepatic jaundice

Hepatic jaundice

Post‐hepatic jaundice

UNCOMMON CAUSES. Prehepatic jaundice

Hepatic jaundice

Post‐hepatic jaundice

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Auscultation

Palpation

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Radiography

Ultrasound

Special tests

2.14 LYMPHADENOPATHY. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs and abdominal ultrasound

Special tests

2.15 MURMUR. DEFINITION

2.16 ORAL MASSES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Benign hyperplasia

Benign tumours

Malignant neoplasia

UNCOMMON CAUSES

Benign tumours. Non‐odontogenic

Odontogenic

Malignant neoplasia

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Plain radiographs

Special tests

2.17 PAIN. DEFINITION

2.17.1 ABDOMINAL PAIN. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

Endocrine

Gastrointestinal

Pancreatic

Splenic

Urogenital

UNCOMMON CAUSES. Gastrointestinal

Hepatobiliary

Pancreatic

Peritoneal

Splenic

Toxins and drugs

Urogenital

DIAGNOSTIC APPROACH

Clinical clues

Predispositions

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

2.17.2 GENERALISED PAIN. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs and abdominal ultrasound

Special tests

2.18 PALLOR. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH. Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging

Special tests

2.19 PERINEAL LESIONS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Imaging. Radiographs

Ultrasound

Special tests

2.20 PERIPHERAL OEDEMA. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Generalised oedema. Decreased capillary oncotic pressure (hypoalbuminaemia)

Increased capillary hydrostatic pressure

Increased vascular permeability

Localised. Increased capillary hydrostatic pressure

Increased vascular permeability

UNCOMMON CAUSES. Generalised

Decreased capillary oncotic pressure (hypoalbuminaemia)

Increased capillary hydrostatic pressure

Increased vascular permeability

Localised. Increased capillary hydrostatic pressure

Increased vascular permeability

Lymphatic obstruction (variable localization)

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Biochemistry

Urinalysis

Imaging

Special tests

2.21 PLEURAL EFFUSION. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Chylothorax

Exudate. Neoplasia

Pulmonary masses

Pyothorax

Haemothorax

Modified transudate

UNCOMMON CAUSES. Chylothorax

Exudate. Neoplasia

Pyothorax

Sterile inflammation

Haemothorax

Modified transudate

Small volume

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs,q.v.section 4.3

Ultrasound examination

Special tests

2.22 PNEUMOTHORAX. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC APPROACH

2.23 PROSTATOMEGALY. DEFINITION

COMMON CAUSES

UNCOMMON CAUSES

RELATED CLINICAL SIGNS

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Rectal palpation

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound examination

Special tests

2.24 PULSE ABNORMALITIES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Hyperdynamic

Weak/absent

UNCOMMON CAUSES. Hyperdynamic

Weak/absent

DIAGNOSTIC APPROACH. Hyperdynamic pulses

Weak/absent pulses

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special tests

2.25 PYREXIA AND HYPERTHERMIA. DEFINITIONS. Hyperthermia

Pyrexia

RELATED CLINICAL SIGNS. Hyperthermia

Pyrexia

COMMON CAUSES. Hyperthermia

Pyrexia

UNCOMMON CAUSES. Hyperthermia

Pyrexia

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs and ultrasound

Special tests

2.26 SKIN LESIONS. DEFINITION

Primary lesions. Macules and patches

Nodules

Papules and plaques

Pustules

Scaling

Vesicles and bullae

Wheals

Secondary lesions. Crusting

Erosions and excoriations

Furunculosis

Hyperkeratosis

Lichenification

Ulcer

RELATED CLINICAL SIGNS

COMMON CAUSES. Macules (and patches)

Nodules. Inflammation

Epithelial neoplasia

Round cell neoplasia

Mesenchymal neoplasia

Non‐inflammatory, non‐neoplastic

Papules and plaques. Immune‐mediated

Infection

Pustules

Scaling. Primary and inherited disorders of keratinisation

Secondary scaling

Vesicles and bullae

Wheals (urticaria)

UNCOMMON CAUSES. Macules (and patches)

Nodules. Inflammation

Epithelial neoplasia

Melanocyte neoplasia

Round cell neoplasia

Mesenchymal neoplasia

Metastatic

Non‐inflammatory, non‐neoplastic

Papules and plaques. Immune‐mediated

Infection

Metabolic

Neoplasia

Pustules

Scaling. Exfoliative dermatoses

Primary and inherited disorders of keratinisation

Secondary scaling

Vesicles and bullae

Wheals (urticaria)

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Distribution of lesions

Claw

Ear margins

Facial

Interdigital pododermatitis

Nasal depigmentation

Nasodigital hyperkeratosis

Oral lesions

Scrotal lesions

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging

Special tests

2.27 SKIN PIGMENTATION CHANGES. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Blue

Black. Hyperpigmentation/melanosis

Brown

Red/purple (blood, haemoglobin)

Yellow

UNCOMMON CAUSES. Black

Red/purple (blood, haemoglobin)

Yellow

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging

Special tests

2.28 SPLENOMEGALY. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Diffuse enlargement

Focal mass(es)

UNCOMMON CAUSES. Diffuse enlargement

Focal mass(es)

DIAGNOSTIC APPROACH

CLINICAL CLUES. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound examination

Special tests

2.29 STOMATITIS. DEFINITION

RELATED CLINICAL SIGNS

COMMON CAUSES. Local disease

Systemic disease

UNCOMMON CAUSES. Local disease

Contact stomatitis

Systemic disease

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Special tests

2.30 STRIDOR AND STERTOR. DEFINITIONS. Stridor

Stertor

RELATED CLINICAL SIGNS. Stridor

Stertor

COMMON CAUSES. Stridor

Stertor

UNCOMMON CAUSES. Stridor

Stertor

DIAGNOSTIC APPROACH

Clinical clues. Predisposition

History

Clinical examination. Visual inspection

Physical examination

Laboratory findings. Haematology and serum biochemistry

Imaging. Plain radiographs and abdominal ultrasound

Special tests. Stertor

Stridor

SECTION 3 LABORATORY ABNORMALITIES

3A BIOCHEMICAL TESTS

3.1 ACID–BASE

COMMON CAUSES. Acidosis

Alkalosis

UNCOMMON CAUSES. Acidosis

Alkalosis

DIAGNOSTIC SIGNIFICANCE

Adjunctive tests

3.2 AMMONIA

COMMON CAUSES. Decreased

Increased

UNCOMMON CAUSES. Decreased

Increased

ARTEFACT. Increased

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.3 AMYLASE AND LIPASE

COMMON CAUSES. Marked increase

Mild increase

UNCOMMON CAUSES. Marked increase

Mild increase

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.4 AZOTAEMIA

COMMON CAUSES. Pre‐renal

Renal

Post‐renal

UNCOMMON CAUSES. Pre‐renal

Renal

Post‐renal

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.5 BILE ACIDS

CAUSES. Decreased

Marked increases

Mild increases

Secondary hepatic disease

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.6 BILIRUBIN

3.7 CALCIUM

3.7.1 HYPERCALCAEMIA

COMMON CAUSES. Marked

Mild

UNCOMMON CAUSES. Marked

Mild/moderate

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.7.2 HYPOCALCAEMIA

COMMON CAUSES

UNCOMMON CAUSES

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.8 CARDIAC BIOMARKERS

3.8.1 N‐TERMINAL PRO B‐TYPE NATRIURETIC PEPTIDE (NT‐PROBNP)

COMMON CAUSES. Marked increase

Mild increase

UNCOMMON CAUSES. Marked increase

Mild increase

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.8.2 TROPONIN I

COMMON CAUSES. Marked increase

Mild increase

UNCOMMON CAUSES. Marked increase

Mild increase

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.9 CHLORIDE

3.9.1 HYPERCHLORAEMIA. COMMON CAUSES. Increased plasma osmolality (normal corrected chloride)

Acid–base disturbance (increased corrected chloride)

UNCOMMON CAUSES. Increased plasma osmolality (normal corrected chloride)

Acid–base disturbance (increased corrected chloride)

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.9.2 HYPOCHLORAEMIA. COMMON CAUSES. Decreased plasma osmolality (normal corrected chloride)

Acid–base disturbance (decreased corrected chloride)

UNCOMMON CAUSES. Decreased plasma osmolality (normal corrected chloride)

Acid–base disturbance (decreased corrected chloride)

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.10 COBALAMIN

COMMON CAUSES. Decreased

Increased

UNCOMMON CAUSES. Decreased

ARTEFACT. Decreased

DIAGNOSTIC SIGNIFICANCE. Decreased

Increased

ADJUNCTIVE TESTS

3.11 CORTISOL (BASAL)

COMMON CAUSES. Decreased

Increased

UNCOMMON CAUSES. Decreased

Increased

ARTEFACT. Decreased

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.12 CREATINE KINASE

COMMON CAUSES. Moderate to marked increase

Mild increase

UNCOMMON CAUSES. Moderate to marked increase

Mild increase

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.13 CREATININE

CAUSES. Decreased

Increased

DIAGNOSTIC SIGNIFICANCE

3.14 C‐REACTIVE PROTEIN (CRP)

CAUSES. Marked increase

Mild increase

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.15 FOLATE

COMMON CAUSES. Decreased

Increased

UNCOMMON CAUSES. Decreased

Increased

ARTEFACT. Decreased

Increased

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.16 FRUCTOSAMINE

COMMON CAUSES. Decreased

Increased

UNCOMMON CAUSES. Decreased

Increased

ARTEFACT. Decreased

Increased

Diagnostic significance

ADJUNCTIVE TESTS. Increased fructosamine

Decreased fructosamine: to investigate possible insulinoma

3.17 GLUCOSE

3.17.1 HYPERGLYCAEMIA

COMMON CAUSES. Marked

Mild

UNCOMMON CAUSES. Marked

Mild

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.17.2 HYPOGLYCAEMIA

COMMON CAUSES

UNCOMMON CAUSES

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.18 IRON PROFILE

COMMON CAUSES. Decreased iron, TIBC saturation and ferritin

Decreased iron, but normal or increased TIBC saturation and ferritin

Increased iron and ferritin

UNCOMMON CAUSES. Decreased iron, TIBC saturation and ferritin

Increased iron and ferritin

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.19 LIPIDS. 3.19.1 HYPERLIPIDAEMIA AND HYPERCHOLESTEROLAEMIA

COMMON CAUSES

UNCOMMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.19.2 HYPOCHOLESTEROLAEMIA. COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.20 LIVER ENZYMES

CAUSES

ADJUNCTIVE TESTS

3.20.1 HEPATOCELLULAR MARKER ENZYMES. DIAGNOSTIC SIGNIFICANCE

3.20.1A ALANINE AMINOTRANSFERASE (ALT)

CAUSES

ARTEFACT

3.20.1B ASPARTATE AMINOTRANSFERASE (AST)

CAUSES

ARTEFACT

3.20.1C OTHER HEPATOCELLULAR ENZYMES

3.20.2 CHOLESTATIC MARKER ENZYMES

3.20.2A ALKALINE PHOSPHATASE (ALP OR ALKP)

CAUSES

ARTEFACT

3.20.2B GAMMA‐GLUTAMYL TRANSFERASE (GGT) CAUSES

ARTEFACT

3.21 PANCREATIC LIPASE (cPL)

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.22 PHOSPHATE

3.22.1 HYPERPHOSPHATAEMIA. COMMON CAUSES

UNCOMMON CAUSES

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.22.2 HYPOPHOSPHATAEMIA. COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.23 POTASSIUM

3.23.1 HYPERKALAEMIA

COMMON CAUSES. Marked

Mild

UNCOMMON CAUSES

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.23.2 HYPOKALAEMIA

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.24 SODIUM

3.24.1 HYPERNATRAEMIA

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.24.2 HYPONATRAEMIA

COMMON CAUSES. Increased plasma osmolality

Reduced plasma osmolality. Hypovolaemic

Normovolaemic

Hypervolaemic

UNCOMMON CAUSES. Increased plasma osmolality

Reduced plasma osmolality. Hypovolaemic

Normovolaemic

Hypervolaemic

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.25 SYMMETRIC DIMETHYLARGININE (SDMA)

COMMON CAUSES. Kidney disease

Non‐kidney causes

UNCOMMON CAUSES. Kidney disease

Non‐renal causes

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.26 THYROID HORMONE

COMMON CAUSES. Decreased TT4

Increased TT4

UNCOMMON CAUSES. Decreased TT4

Increased TT4

ARTEFACT. Decreased

Increased

DIAGNOSTIC SIGNIFICANCE. Decreased

Increased

ADJUNCTIVE TESTS

3.27 TOTAL PROTEIN (ALBUMIN AND GLOBULIN)

3.27.1 HYPERPROTEINAEMIA

3.27.1A HYPERALBUMINAEMIA. CAUSES

ARTEFACT

3.27.1B HYPERGLOBULINAEMIA. COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.27.2 HYPOPROTEINAEMIA

3.27.2A HYPOALBUMINAEMIA

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.27.2B HYPOGLOBULINAEMIA. COMMON CAUSES

UNCOMMON CAUSES

ADJUNCTIVE TESTS

3.28 TRYPSIN‐LIKE IMMUNOREACTIVITY (TLI)

CAUSES. cTLI < 2.5 μg/l

cTLI < 5.0 but > 2.5 μg/l

cTLI > 50.0 μg/l

ARTEFACT

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.29 UREA

COMMON CAUSES. Decreased

Increased

UNCOMMON. Decreased

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS. Decreased

Increased

3B HAEMATOLOGY

3.30 RED BLOOD CELLS (RBCs)

3.30.1 ANAEMIA

COMMON CAUSES

Blood loss/haemorrhage. Bleeding disorders

Gastrointestinal blood loss

Neoplasia

Trauma

Haemolysis. Immune‐mediated disease

Mechanical fragmentation

Immune‐mediated disease

Iron deficiency

Secondary to extra‐marrow factors

UNCOMMON CAUSES

Blood loss/haemorrhage. Bleeding disorders

Blood‐sucking ectoparasites

Gastrointestinal blood loss

Neoplasia

Urinary tract bleeding

Haemolysis

Chemical or toxic injury

Immune‐mediated disease

Intracorpuscular problem

Mechanical fragmentation

Iron deficiency

Nutritional deficiencies

Anaemia with other cytopenias or pancytopenia

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.30.2 ERYTHROCYTOSIS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.31 PLATELETS

3.31.1 THROMBOCYTOPENIA

COMMON CAUSES. Decreased platelet production

Increased platelet consumption/use

Increased platelet destruction

UNCOMMON CAUSES. Decreased platelet production

Increased platelet consumption/use

Increased platelet destruction

ARTEFACTS

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.31.2 THROMBOCYTOSIS

COMMON CAUSES

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.32 WHITE BLOOD CELLS (WBCs)

3.32.1 LEUKOCYTOSIS

COMMON CAUSES. Eosinophilia. Hypersensitivity/immune‐mediated reactions

Parasitism, e.g

Lymphocytosis

Monocytosis

Neutrophilia

UNCOMMON CAUSES. Eosinophilia

Lymphocytosis

Monocytosis

Neutrophilia

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.32.2 LEUKOPENIA

COMMON CAUSES. Eosinopenia

Lymphopenia

Neutropenia

UNCOMMON CAUSES. Eosinopenia

Lymphopenia

Neutropenia

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3.33 PANCYTOPENIA

UNCOMMON CAUSES

DIAGNOSTIC SIGNIFICANCE

ADJUNCTIVE TESTS

3C URINALYSIS

3.34 BIOCHEMICAL ANALYSIS

3.34.1 PROTEIN

3.34.2 BILIRUBIN

CAUSES

3.34.3 GLUCOSE

CAUSES

3.34.4 HAEM

CAUSES

ARTEFACT

3.34.5 KETONES

CAUSES

3.35 SEDIMENT. 3.35.1 RED BLOOD CELLS

3.35.2 WHITE BLOOD CELLS

CAUSES

3.35.3 EPITHELIAL CELLS

3.35.4 CRYSTALS

3.35.5 TUBULAR CASTS

3.35.6 WAXY CAST

3.36 URINE PROTEIN: CREATININE (UPC) RATIO

CAUSES. Pre‐renal proteinuria

Renal proteinuria

Post‐renal proteinuria

3.37 URINE SPECIFIC GRAVITY (USG)

USG > 1.030 – HYPERSTHENURIA

USG < 1.030

USG 1.008–1.012 – ISOSTHENURIA

USG < 1.008 – HYPOSTHENURIA

SECTION 4 IMAGING PATTERNS

4.1 ABDOMEN. 4.1.1 RADIOGRAPHY

4.1.1A ABDOMINAL ENLARGEMENT AND MASS(ES)

COMMON CAUSES. Cranial abdomen

Mid‐abdomen

Caudal abdomen

UNCOMMON CAUSES. Cranial abdomen

Mid‐abdomen. SI

Spleen

Caudal abdomen

4.1.1B CALCIFICATION (BONE/MINERAL DENSITY)

COMMON CAUSES

UNCOMMON CAUSES

4.1.1C EXTRA‐INTESTINAL GAS. COMMON CAUSES

UNCOMMON CAUSES

4.1.1D GAS DILATION OF GI TRACT

COMMON CAUSES. Gastric

Small intestinal. Lumenal diameter < 1.5 × the height of the L5 body

Lumenal diameter > 1.5 × the height of the L5 body

Bunching with comma‐shaped gas bubbles

Large intestine

UNCOMMON CAUSES. Gastric

Small intestine. Lumenal diameter < 1.5 × the height of the L5 body

Lumenal diameter > 1.5 × the height of the L5 body

4.1.1E LOSS OF CONTRAST/PERITONEAL DETAIL/SEROSAL DETAIL. COMMON CAUSES

UNCOMMON CAUSES

4.1.1F METAL DENSITIES. COMMON CAUSES

UNCOMMON CAUSES

4.1.1G ORGAN DISPLACEMENT

COMMON CAUSES

UNCOMMON CAUSES

4.1.1H ORGANOMEGALY OR CHANGE IN SHAPE

4.1.2 ULTRASOUND

4.1.2A FREE ABDOMINAL FLUID. COMMON CAUSES

UNCOMMON CAUSES

4.1.2B LYMPHADENOPATHY – MESENTERIC/INGUINAL/SUBLUMBAR

4.2 BONE

4.2.1 BONE DEFORMITIES

COMMON CAUSES

UNCOMMON CAUSES

4.2.2 BONE DENSITY CHANGES

4.2.2A DECREASED BONE DENSITY (OSTEOPENIA)

CAUSES. Hypovitaminosis D (rickets)

Mucopolysaccharidosis

Renal hyperparathyroidism

4.2.2B INCREASED BONE DENSITY

CAUSES. Calvarial hyperostosis

Craniomandibular osteopathy, Figure 4.2.1

Osteopetrosis

Panosteitis

4.2.3 BONE LUCENCIES AND PROLIFERATIVE LESIONS

CAUSES. Avascular necrosis of the femoral head (Legg‐Calve‐Perthes‐disease)

Bone cysts

Bone tumours (primary or metastatic)

Hypertrophic osteopathy (HO) (Figure 4.1.1c)

Metaphyseal osteopathy

Multiple myeloma

Osteomyelitis

4.3 THORAX

4.3.1 ALVEOLAR PATTERN

COMMON CAUSES

UNCOMMON CAUSES

4.3.2 BRONCHIAL PATTERN

COMMON CAUSES

UNCOMMON CAUSES

4.3.3 CHANGES IN CARDIAC OUTLINE AND PULMONARY VASCULATURE

COMMON CAUSES. Cardiomegaly

Microcardia

Pulmonary venous enlargement

UNCOMMON CAUSES. Aortic enlargement

Cardiomegaly

Microcardia

Pulmonary vessels

4.3.4 INTERSTITIAL PATTERN

COMMON CAUSES

UNCOMMON CAUSES

4.3.5 LOSS OF DETAIL

COMMON CAUSES

UNCOMMON CAUSES

SECTION 5 ORGAN SYSTEMS

5.1 ALIMENTARY SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Malabsorption

Protein‐losing enteropathy (PLE)

Diagnostic Methods. History

Clinical examination

Laboratory findings

Imaging

Plain radiographs

Contrast radiographs

Ultrasound examination

Empirical treatment

Special investigative techniques

5.1.1 OROPHARYNX

Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History

Clinical examination

Laboratory findings

Imaging. Plain radiographs

Special investigative techniques

5.1.1A CRANIOMANDIBULAR OSTEOPATHY. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition, Historical clues

Clinical examination, Laboratory findings

Imaging

Special investigations

Treatment

Prognosis

5.1.1B CRICOPHARYNEAL ACHALASIA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition and historical clues

Clinical examination/laboratory findings

Imaging

Special investigations

Treatment

Prognosis

5.1.1C MASTICATORY MYOSITIS. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition, Historical clues

Clinical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Skull radiographs

Special investigations

Treatment

Monitoring

Prognosis

5.1.1D ORAL NEOPLASIA

Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition, Historical clues, Clinical examination

Laboratory findings

Imaging, Special investigations

Treatment

Monitoring

Prognosis

Odontogenic fibroma (epulides)

Papilloma

Fibrosarcoma

Squamous cell carcinoma

Osteosarcoma, malignant melanoma

5.1.1E STOMATITIS. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition, Historical clues, Clinical examination, Laboratory findings

Imaging

Special investigations

Treatment

Monitoring

Prognosis

5.1.2 SALIVARY GLANDS

Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic approach

History, Clinical examination, Laboratory findings, Imaging

Special investigative techniques

5.1.2A HYPERSIALOSIS/SALIVARY GLAND INFARCTION/SIALOADENITIS. Aetiology

Hypersialosis

Salivary gland infarction

Sialoadenitis

Major signs

Minor signs

Potential sequelae

Predisposition

Clinical examination

Laboratory findings

Imaging

Special investigations

Treatment

Monitoring

Prognosis

5.1.3 OESOPHAGUS. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic approach

Diagnostic methods. History

Clinical examination

Laboratory findings

Imaging. Plain radiographs

Contrast radiographs

Special investigative techniques

5.1.3A FOREIGN BODY. Aetiology. Accidental ingestion

Deliberate ingestion

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Clinical examination

Laboratory findings

Imaging. Radiographs. Plain

Contrast

Special investigations

Treatment. Removal of FB

Monitoring

Prognosis

5.1.3B MEGAOESOPHAGUS (MO) Aetiology. Primary

Secondary

Myopathies

Neuropathies/junctionopathies

Toxins

Miscellaneous

Localised

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Clinical examination. Visual inspection

Auscultation

Palpation

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Barium swallow

Special investigations. Manometry

Oesophagoscopy

Focal myasthenia gravis (MG)

Generalised MG

Hypothyroidism

Polymyositis and polyneuropathy

Systemic lupus erythematosus

Treatment. Idiopathic megaoesophagus. No specific therapy

Myasthenia gravis

Monitoring

Prognosis

5.1.3C OESOPHAGITIS. Aetiology

Ingestion

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Clinical examination

Laboratory findings

Imaging

Special investigations

Treatment. Prevent perpetuation of damage by further gastric reflux

Rest oesophagus

Treat oesophageal inflammation

Monitoring

Prognosis

5.1.3D SLIDING HIATAL HERNIA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Clinical examination/laboratory findings

Imaging. Thoracic radiographs. Plain

Contrast

Special investigations. Oesophagoscopy

Treatment. Reduce precipitating factors

Medical management

Surgical management

Prognosis

5.1.3E STRICTURE

5.1.4 STOMACH. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic approach

Diagnostic methods. History

Clinical examination

Laboratory findings

Imaging. Plain radiographs

Contrast radiographs

Ultrasound examination

Special investigative techniques

5.1.4A ACUTE GASTRITIS

5.1.4B CHRONIC GASTRITIS

5.1.4C GASTRIC CARCINOMA

5.1.4D GASTRIC DILATATION‐VOLVULUS (GDV)

5.1.4E DELAYED GASTRIC EMPTYING

5.1.4F GASTRIC ULCER

5.1.5 SMALL INTESTINE. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

5.1.5.1 ACUTE SMALL INTESTINAL DISEASES. Diagnostic Approach

Diagnostic Methods. History

Clinical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Faecal examination

Imaging

Special investigative techniques

5.1.5.1A ACUTE ENTERITIS

Haematology

Serum biochemistry

Urinalysis

Faecal examination

Radiographs. Plain

Contrast

Ultrasound examination

Antibiotics

Anti‐emetics

Anti‐diarrhoeals

5.1.5.1B ACUTE HAEMORRHAGIC DIARRHOEA SYNDROME (AHDS)/HAEMORRHAGIC GASTROENTERITIS (HGE)

Haematology

Serum biochemistry

Urinalysis

Faecal parasitology

5.1.5.1C BACTERIAL ENTERITIS

Haematology

Serum biochemistry

Urinalysis

Faecal culture

Faecal parasitology

5.1.5.1D PARVOVIROSIS

Haematology

Serum biochemistry

Urinalysis

Faecal examination

Radiographs. Plain and contrast

Ultrasound

5.1.5.1E SMALL INTESTINAL OBSTRUCTION

Haematology

Serum biochemistry

Urinalysis

Radiographs. Plain

Contrast

Ultrasound examination

5.1.5.2 CHRONIC SMALL INTESTINAL DISEASES. Diagnostic Approach

Diagnostic Methods. History

Clinical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Faecal examination

Imaging

Special investigative techniques

5.1.5.2A ALIMENTARY LYMPHOMA (AL)

Haematology

Serum biochemistry

Radiographs

Ultrasound examination

5.1.5.2B ANTIBIOTIC‐RESPONSIVE DIARRHOEA (ARD)

Haematology

Serum biochemistry

Faecal examination

Radiographs

Ultrasound examination

Diet

Probiotics

Faecal microbiota transplantation

Vitamins

5.1.5.2C CHRONIC INFLAMMATORY ENTEROPATHY (CIE)

Haematology

Serum biochemistry

Urinalysis

Faecal examination

Radiographs. Plain

Contrast

Ultrasound

Antibiotics

Metronidazole

Oxytetracycline

Diet

Faecal microbiota transplantation

Immunosuppression. Prednisolone

Azathioprine

Chlorambucil

Ciclosporin (Cyclosporin)

Probiotics

Vitamin supplements

5.1.5.2D DIETARY SENSITIVITY

Haematology

Serum biochemistry

5.1.5.2E INTESTINAL PARASITISM

Cestodes (Tapeworms)

Nematodes (Helminths) Ascarids (Roundworms)

Hookworms

Spiruroidea

Threadworms

Whipworms

Trematodes (flukes/flatworms) Alaria alata

Heterobilharzia americanum

Haematology

Serum biochemistry

Faecal examination

Radiographs and ultrasound

5.1.5.2F INTESTINAL PROTOZOAL INFECTIONS

5.1.5.2G LYMPHANGIECTASIA

Haematology

Serum biochemistry

Radiographs

Ultrasound examination

5.1.6 LARGE INTESTINE. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History

Clinical examination

Rectal examination

Laboratory findings

Imaging. Radiographs

Ultrasound

Special investigative techniques

5.1.6A ACUTE COLITIS

5.1.6B CHRONIC COLITIS

5.1.6C CONSTIPATION

5.1.6D GRANULOMATOUS (HISTIOCYTIC ULCERATIVE) COLITIS

5.1.6E LARGE INTESTINAL NEOPLASIA

5.1.7 PANCREAS. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Methods. History

Clinical examination

Laboratory findings

Serum amylase, lipase and DGGR lipase

Serum trypsin‐like immunoreactivity (cTLI)

Serum pancreatic lipase (cPL)

Imaging. Radiographs

Ultrasound

Special investigative techniques

5.1.7A ACUTE PANCREATITIS

5.1.7B CHRONIC PANCREATITIS

5.1.7C EXOCRINE PANCREATIC INSUFFICIENCY (EPI)

5.2 CARDIOVASCULAR SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History

Clinical examination. Visual inspection

Physical examination

Cardiac examination. Auscultation

Laboratory findings

Haematology

Serum biochemistry

Imaging. Plain radiographs

Special investigative techniques

5.2.1 ACQUIRED CARDIAC DISEASES

5.2.1A ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC)

Plain radiographs

Echocardiography

Electrocardiography

ECG Holter monitor

5.2.1B DILATED CARDIOMYOPATHY (DCM)

Plain radiographs

Echocardiography

BP

Electrocardiography

ECG Holter monitor

5.2.1C HEARTWORM DISEASE/DIROFILARIASIS

Haematology

Serum biochemistry

Thoracic radiographs

Echocardiography

5.2.1D MYXOMATOUS MITRAL VALVE DISEASE

Plain radiographs

Echocardiography

5.2.2 CONGENITAL CARDIAC DISEASES

5.2.2A AORTIC STENOSIS

Plain radiographs

Echocardiography

Cardiac catheterisation

Electrocardiography

5.2.2B MITRAL VALVE DYSPLASIA

Plain radiographs

Echocardiography

Electrocardiography

5.2.2C PATENT DUCTUS ARTERIOSUS

Plain radiographs

Echocardiography

Cardiac catheterisation and angiography

Electrocardiography

5.2.2D PULMONIC STENOSIS

Plain radiographs

Echocardiography

Cardiac catheterisation

Electrocardiography

5.2.2E TETRALOGY OF FALLOT

Plain radiographs

Echocardiography

Bubble study

Electrocardiography

5.2.2 FTRICUSPID DYSPLASIA

Plain radiographs

Echocardiography

Electrocardiography

5.2.2G VENTRICULAR SEPTAL DEFECT

Plain radiographs

Electrocardiography

5.2.3 CONGESTIVE HEART FAILURE (CHF) Aetiology

Treatment. If possible, treat the underlying cause

Acute CHF treatment

Chronic CHF treatment

Monitoring. Acute CHF

Chronic CHF

5.2.3A LEFT‐SIDED CONGESTIVE HEART FAILURE

Plain radiographs

Echocardiography

BP

ECG

5.2.3B RIGHT‐SIDED CONGESTIVE HEART FAILURE

Plain radiographs

Echocardiography

5.2.4 ARRHYTHMIAS

SINUS RHYTHMS

SINUS ARRHYTHMIA

5.2.4.1 BRADYARRHYTHMIAS

5.2.4.1A ATRIAL STANDSTILL

5.2.4.1B ATRIOVENTRICULAR (AV) BLOCK

5.2.4.1C SINUS BRADYCARDIA

5.2.4.1D SINUS ARREST

5.2.4.1E SICK SINUS SYNDROME

5.2.4.2 TACHYARRHYTHMIAS

5.2.4.2A SINUS TACHYCARDIA

5.2.4.2B SUPRAVENTRICULAR TACHYARRHYTHMIAS

5.2.4.2C VENTRICULAR TACHYARRHYTHMIAS

Single ventricular premature complexes

Accelerated idioventricular rhythm

Couplets/triplets

Ventricular fibrillation

Ventricular tachycardia

5.2.5 PERICARDIAL DISEASES. 5.2.5A PERICARDIAL EFFUSION

Common causes

Uncommon causes

Idiopathic pericardial effusion

Left atrial rupture

Neoplasia

Plain radiographs

Echocardiography

Electrocardiography

5.2.5B PERITONEAL PERICARDIAL DIAPHRAGMATIC HERNIA (PPDH)

Plain radiographs

Echocardiography

Barium swallow

5.3 ENDOCRINE SYSTEM. Problems

Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History, Physical examination, Laboratory findings

Imaging. Plain radiographs

Ultrasound

Special investigative techniques

5.3.1 DIABETES INSIPIDUS (DI)

Central DI (CDI)

Causes

Nephrogenic DI (NDI)

Causes

Haematology and serum biochemistry

Urinalysis

Thoracic and abdominal radiographs

Water deprivation test

Absolute water deprivation test

Modified water deprivation test

Protocol for water deprivation test (absolute or end of modified)

Interpretation

ADH response test

Therapeutic trial with desmopressin

CDI or partial NDI

NDI

5.3.2 DIABETES MELLITUS (DM)

Causes of IDDM

Causes of NIDDM

Early

Late

Haematology

Serum biochemistry

Urinalysis

Plain radiographs

Ultrasound

Arterial blood gas analysis

Glycosylated serum proteins

Serum insulin concentrations

cPL

cTLI

Other investigations

Diabetic ketoacidosis (DKA)

Non‐ketotic diabetic. Stabilisation period

Fructosamine

Glycated haemoglobin

5.3.3 GROWTH HORMONE DISORDERS

5.3.3A ACROMEGALY (HYPERSOMATOTROPISM)

Common causes

Uncommon causes

Plain radiographs

Ultrasound

5.3.3B PITUITARY DWARFISM

5.3.4 ADRENAL GLAND DISORDERS

5.3.4A HYPERADRENOCORTICISM (HAC)

Haematology

Serum biochemistry

Urinalysis

Thoracic radiographs

Abdominal radiographs

Ultrasonography. Adrenals

Liver

Hypothalamo‐pituitary‐adrenal test protocols. Basal cortisol

ACTH stimulation test

Low dose dexamethasone suppression test (LDDS)

High‐dose dexamethasone suppression test (HDDS)

High‐high dose dexamethasone suppression test (HHDDS)

Plasma endogenous ACTH concentration

Urine cortisol:creatinine ratio (UCCR)

Imaging. CT/MRI

Medical. Trilostane

Mitotane (o,p′‐DDD)

Pituitary irradiation

Surgical. Hypophysectomy

Bilateral adrenalectomy for PDH

Unilateral adrenalectomy for adrenal‐dependent HAC

5.3.4B HYPOADRENOCORTICISM (ADDISON’S DISEASE)

Primary

Secondary (rare)

Initial signs

Crisis

Haematology

Serum biochemistry

Urinalysis

Thoracic radiography

Abdominal radiography

Ultrasonography

Blood pressure

Arterial blood gas analysis

ECG

Hormone assays. ACTH stimulation test

Aldosterone assay

Endogenous ACTH

Acute crisis

Fluid therapy

Glucocorticoid therapy

Mineralocorticoid therapy

Management of hyperkalaemia

Maintenance therapy. Mineralocorticoids

Glucocorticoids

Salt (NaCl)

Secondary hypoadrenocorticism

5.3.5 HYPOTHYROIDISM

Dermatological

Cardiovascular

Neurological

Ocular

Haematology

Serum biochemistry

Hormone assays. Basal thyroid hormone concentrations

Endogenous canine thyroid‐stimulating hormone (cTSH)

TSH response/stimulation test

TRH response test

Other tests. Antibodies

Thyroid biopsy

L‐thyroxine

Response to treatment

5.3.6 INSULINOMA

Radiographs

Ultrasound

Acute crisis

Medical

Surgical excision

5.3.7 PARATHYROID DISEASES

5.3.7A PRIMARY HYPERPARATHYROIDISM (PHPT)

Haematology

Serum biochemistry

5.3.7B HYPOPARATHYROIDISM

Causes

Haematology

Serum biochemistry

PTH assay

During tetany

Maintenance

5.4 HAEMOPOIETIC SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

Special investigative techniques

5.4.1 ANAEMIA OF CHRONIC KIDNEY DISEASE (CKD)

Haematology

Serum biochemistry, q.v.section 5.12.1

Urinalysis

Radiography

Blood pressure assessment

ACTH stimulation test

PTH concentration

Serum erythropoietin (EPO) concentration

Iron profile

Gastrointestinal and other blood loss

Blood transfusion

Recombinant human erythropoietin

5.4.2 IMMUNE‐MEDIATED HAEMOLYTIC ANAEMIA (IMHA)

Haematology

Serum biochemistry

Urinalysis

Immunosuppressive therapy

Supportive therapy

Blood transfusion

Alternatives for refractory cases

5.4.3 IRON‐DEFICIENCY ANAEMIA

5.4.4 LYMPHOID LEUKAEMIA

Acute lymphoblastic leukaemia (ALL)

Chronic lymphocytic leukaemia (CLL)

Intermediate‐grade leukaemia

ALL

CLL

5.4.5 OTHER HAEMOPOIETIC NEOPLASMS

Acute myeloid leukaemia (AML)

Chronic myeloid/granulocytic leukaemia (CML/CGL)

Chronic eosinophilic leukaemia

Myelodysplastic syndrome (MDS)

5.4.6 LEUKOPENIA

5.4.7 THROMBOSIS

5.5 HAEMOSTATIC SYSTEM

Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

Special investigative techniques

Buccal mucosal bleeding time (BMBT)

Platelet number and morphology

Platelet function

Platelet aggregation tests

von Willebrand factor (vWF) antigen

Activated clotting time (ACT)

Coagulation profile

Activated partial thromboplastin time (aPTT)

One‐stage prothrombin time (OSPT/PT)

Whole blood clotting time

Antithrombin (AT) (formerly known as antithrombin III)

D‐dimer

Fibrin degradation products (FDPs)

Fibrinogen

Thrombin clot time (TCT)

Viscoelastic testing with thromboelastography (TEG) or rotational thromboelastometry (ROTEM)

5.5.1 ANTICOAGULANT RODENTICIDE POISONING

Anticoagulant rodenticides

Haematology

Serum biochemistry

Coagulation profile

Abdominal radiographs

Thoracic radiographs

Ultrasonography

Vitamin K

Transfusion therapy

Management of toxic incident

Symptomatic therapy

5.5.2 DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

Acute

Chronic

Haematology

Serum biochemistry

Coagulation screen

5.5.3 FACTOR VIII DEFICIENCY (HAEMOPHILIA A)

Severe disease

Moderate disease

Haematology

Coagulation profile

Thoracic and abdominal radiographs and ultrasound

Transfusion

5.5.4 HYPERFIBRINOLYSIS

5.5.5 IMMUNE‐MEDIATED THROMBOCYTOPENIA (IMTP)

Haematology

Serum biochemistry

Urinalysis

5.5.6 VON WILLEBRAND DISEASE

Excessive bleeding from mucosal surfaces

Excessive bleeding after surgery or trauma

Coagulation screen

5.5.7 VASCULITIS

Dermatological examination

Ophthalmic examination

Haematology

Biochemistry

Urinalysis

5.6 HEPATOBILIARY SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History. Clinical signs

Age

Specific clinical signs

Non‐specific clinical signs

Clinical examination. Visual inspection

Physical examination

Laboratory findings

Haematology

Serum biochemistry

Urinalysis

Imaging. Radiographs

Ultrasound

Special investigative techniques

Treatments

5.6.1 CHRONIC HEPATITIS (CH)/CIRRHOSIS

Ultrasound

Control HE

Immunosuppression

Manage ascites

Non‐specific

5.6.2 CHOLANGITIS/CHOLANGIOHEPATITIS

5.6.3 CHOLECYSTITIS

5.6.4 CONGENITAL PORTO‐SYSTEMIC SHUNT (PSS)

Haematology

Serum biochemistry

Radiography

Contrast radiography

Ultrasound

5.6.5 COPPER‐ASSOCIATED CHRONIC HEPATITIS

5.6.6 EXTRA‐HEPATIC BILE DUCT OBSTRUCTION (EHBDO)

Common causes

Uncommon causes

Radiograph

Ultrasound

5.6.7 GALL BLADDER MUCOCOELE

Haematology

Serum biochemistry

Radiographs

Ultrasound

5.6.8 HEPATIC NEOPLASIA

Haematology

Serum biochemistry

Radiography

Ultrasound

5.6.9 INFECTIOUS CANINE HEPATITIS

Differential diagnoses

Haematology

Serum biochemistry

5.6.10 NODULAR HYPERPLASIA

Radiographs

Ultrasound

5.6.11 PORTAL VEIN HYPOPLASIA (PVH)

5.6.11A MICROVASCULAR DYSPLASIA (MVD)

Radiographs

Portovenogram or CT angiography

Ultrasound

5.6.11B NON‐CIRRHOTIC PORTAL HYPERTENSION/JUVENILE HEPATIC FIBROSIS

5.6.12 STEROID HEPATOPATHY

Causes

5.6.13 VACUOLAR/REACTIVE HEPATOPATHY

5.7 IMMUNE SYSTEM

Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic approach

Diagnostic methods. History

Physical examination

Laboratory findings. Haematology

Biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special investigative techniques

5.7.1 (AUTO)IMMUNE‐MEDIATED DISORDERS

5.7.1.1 IMMUNE‐MEDIATED POLYARTHRITIS (IMPA) Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.7.1.2 IMMUNODEFICIENCY. Aetiology

5.7.1.2A CANINE LEUKOCYTE ADHESION DEFICIENCY (CLAD)

5.7.1.2B CYCLIC HAEMATOPOIESIS (CYCLIC NEUTROPENIA) Aetiology

Major signs

Minor signs

Predisposition

Historical clues

Physical examination

Laboratory findings

Imaging

Special investigations

Treatment

Prognosis

5.7.1.2C HEREDITARY SELECTIVE COBALAMIN MALABSORPTION (IMERSLUND‐GRÄSBECK SYNDROME)

Major signs

Minor signs

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Biochemistry

Imaging

Special investigations

Treatment

Monitoring

Prognosis

5.7.1.2D IMMUNOGLOBULIN DEFICIENCY

Major signs

Minor signs

Predisposition

Historical clues

Physical examination

Laboratory findings

Imaging

Special investigations

Treatment

Prognosis

5.7.1.2E TRAPPED NEUTROPHIL SYNDROME. Aetiology

Major signs

Minor signs

Predisposition

Historical clues

Laboratory findings

Imaging

Special investigations

Treatment

Prognosis

5.7.1.3 LYMPHADENITIS. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.7.1.4 SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) Aetiology

Major signs

Minor signs

5.7.2 NEOPLASIA OF IMMUNE CELLS. 5.7.2.1 LYMPHOMA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.7.2.2 MAST CELL TUMOUR (MCT) Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings

Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.7.2.3 MULTIPLE MYELOMA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.7.2.4 THYMOMA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology

Biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8 NEUROLOGICAL SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History

Physical examination

Modified Glasgow Coma Scale

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigative techniques

5.8.1 CEREBROVASCULAR DISEASE. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and serum biochemistry

Urinalysis

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8.2 CORTICOSTEROID‐RESPONSIVE TREMOR SYNDROME. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8.3 HYDROCEPHALUS. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings

Imaging. Radiographs and ultrasound

Special investigations

Treatment

5.8.4 IDIOPATHIC EPILEPSY. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8.5 IDIOPATHIC HEAD TREMOR. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Prognosis

5.8.6 IDIOPATHIC VESTIBULAR DISEASE. Aetiology

Major signs

Minor signs

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Prognosis

5.8.7 INFECTIOUS DISEASES AFFECTING THE NERVOUS SYSTEM. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations, treatment, monitoring and prognosis

5.8.8 MOVEMENT DISORDERS. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Prognosis

5.8.9 MENINGOENCEPHALITIS OF UNKNOWN ORIGIN (MUO) Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8.10 MYASTHENIA GRAVIS (MG) Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment, q.v. section 5.1.3B

Monitoring

Prognosis

5.8.11 NEOPLASIA OF THE NEUROLOGICAL SYSTEM. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Ophthalmic examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.8.12 POLYRADICULONEURITIS. Aetiology

Major signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Neurological examination

Laboratory findings

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Prognosis

5.8.13 STEROID‐RESPONSIVE MENINGITIS‐ARTERITIS (SRMA) Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology and biochemistry

Imaging. Plain radiographs and ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.9 REPRODUCTIVE SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History

Physical examination

Laboratory findings

Imaging

Special investigative techniques

5.9.1 MAMMARY GLAND DISEASE

5.9.1A MASTITIS. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings

Imaging. Radiography

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.9.1B MAMMARY NEOPLASIA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Physical examination

Laboratory findings

Imaging. Radiography

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.9.2 OVARIAN REMNANT SYNDROME. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Prognosis

5.9.3 PROSTATIC DISEASE. Aetiology

Conditions

Major signs

Minor signs

Predisposition

Potential sequelae

Historical clues

Physical examination

Laboratory findings

Haematology

Biochemistry

Urinalysis

Imaging. Plain radiographs

Contrast radiographs

Ultrasound

Special tests

Treatment. BPH

Squamous metaplasia

Prostatitis

Prostatic cyst

Neoplasia

Monitoring

Prognosis

5.9.4 PSEUDOCYESIS (FALSE PREGNANCY) Aetiology

Major signs

Minor signs

Predisposition

Historical clues

Laboratory findings

Imaging

Special tests

Treatment

Monitoring

Prognosis

5.9.5 PYOMETRA. Aetiology

Major signs

Minor signs

Predisposition

Potential sequelae

Historical clues

Physical examination

Laboratory findings. Haematology

Biochemistry

Urinalysis

Imaging. Plain radiography

Ultrasound

Special tests

Treatment

Monitoring

Prognosis

5.9.6 TESTICULAR NEOPLASIA. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings. Haematology:

Imaging. Plain radiographs

Ultrasound

Special investigations

Treatment

Monitoring

Prognosis

5.9.7 VAGINITIS. Aetiology

Major signs

Minor signs

Potential sequelae

Predisposition

Historical clues

Physical examination

Laboratory findings

Imaging

Special investigations

Treatment

Monitoring

Prognosis

5.10 RESPIRATORY SYSTEM. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods. History. Age

Breed‐associated disease

Environment

General details

Onset of signs

Clinical signs

Clinical examination. Visual inspection

Physical examination

Respiratory examination

Laboratory findings. Haematology

Serum biochemistry

Imaging. Plain radiographs

Ultrasound

Special investigative techniques

5.10.1 NASAL DISORDERS

5.10.1A CHRONIC IDIOPATHIC RHINITIS

Haematology and serum biochemistry

Plain radiographs

5.10.1B SINONASAL ASPERGILLOSIS (FUNGAL RHINITIS)

Haematology and serum biochemistry

5.10.2 UPPER‐AIRWAY DISORDERS

5.10.2A BRACHYCEPHALIC OBSTRUCTIVE AIRWAY SYNDROME (BOAS)

Haematology and serum biochemistry

Plain radiographs

5.10.2B INFECTIOUS TRACHEOBRONCHITIS

Haematology and serum biochemistry

Plain radiographs

5.10.2C LARYNGEAL PARALYSIS

Haematology and serum biochemistry

Plain radiographs

Ultrasound

5.10.2D TRACHEAL COLLAPSE

Haematology and serum biochemistry

Plain radiographs

5.10.2E TRACHEOBRONCHIAL FOREIGN BODY

Haematology and serum biochemistry

Plain radiographs

5.10.3 LOWER‐AIRWAY DISORDERS

5.10.3A CHRONIC BRONCHITIS

Haematology and serum biochemistry

Plain radiographs

5.10.3B EOSINOPHILIC BRONCHOPNEUMOPATHY

Haematology and serum biochemistry

Plain radiographs

5.10.3C LUNGWORM (ANGIOSTRONGLYLUS VASORUM)

Haematology

Serum biochemistry

Plain radiographs

5.10.4 PULMONARY PARENCHYMAL DISEASE

5.10.4A PNEUMONIA

Haematology

Serum biochemistry

Plain radiographs

Ultrasound

5.10.4B NON‐CARDIOGENIC PULMONARY OEDEMA

Haematology and serum biochemistry

Plain radiographs

Ultrasound

5.10.4C PULMONARY FIBROSIS

Haematology and serum biochemistry

Plain radiographs

Ultrasound

5.10.4D PULMONARY NEOPLASIA

Haematology

Serum biochemistry

5.10.5 PLEURAL SPACE DISEASE

5.10.5A IDIOPATHIC CHYLOTHORAX

Haematology

Serum biochemistry

Plain radiographs

Ultrasound

5.10.5B PNEUMOTHORAX

Haematology and serum biochemistry

Plain radiographs

Ultrasound

5.10.5C PYOTHORAX

Haematology

Serum biochemistry

Plain radiographs

Ultrasound

5.11 SYSTEMIC INFECTIONS

Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

History

Physical examination

Laboratory findings. Haematology

Serum biochemistry

Urinalysis

Imaging. Plain radiographs/CT

Ultrasound

Special investigative techniques

Specific Conditions

5.11.1 ANAPLASMOSIS

Haematology

Serum biochemistry

5.11.2 BABESIOSIS

Haematology

Serum biochemistry

Urinalysis

5.11.3 BORRELIOSIS (LYME DISEASE)

Haematology and biochemistry

Urinalysis

5.11.4 BRUCELLOSIS

Haematology and biochemistry

Urinalysis

NB potential zoonosis, contact laboratory before sending samples

5.11.5 DISTEMPER

Haematology

Serum biochemistry

5.11.6 EHRLICHIOSIS

Haematology

Biochemistry

Urinalysis

5.11.7 HEPATOZOONOSIS

5.11.8 LEISHMANIOSIS

Haematology

Biochemistry

Urinalysis

5.11.9 LEPTOSPIROSIS

Haematology

Serum biochemistry

Urinalysis

5.11.10 NEOSPOROSIS

Haematology

Serum biochemistry

5.11.11 RABIES

5.11.12 TOXOPLASMOSIS

Haematology

Biochemistry

5.12 URINARY SYSTEM

5.12.1 KIDNEY DISEASES

Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

5.12.1A ACUTE KIDNEY INJURY

Haematology

Serum biochemistry

Urinalysis

Plain radiographs

Ultrasound

5.12.1B CHRONIC KIDNEY DISEASE

Haematology

Serum biochemistry

Urinalysis

Plain radiographs

Ultrasound

5.12.1C GLOMERULAR DISORDERS

Haematology

Biochemistry

Urinalysis

Plain radiographs

Ultrasound

5.12.1D PYELONEPHRITIS

Haematology

Serum biochemistry

Urinalysis

Plain radiographs

Ultrasound

5.12.1E RENAL TUBULAR DISORDERS

Haematology

Biochemistry

Urinalysis

Plain radiographs and ultrasound

5.12.2 LOWER URINARY TRACT DISEASES. Problems. Presenting complaints

Physical abnormalities

Laboratory abnormalities

Diagnostic Approach

Diagnostic Methods

Haematology

Serum biochemistry

Urinalysis

Abdominal radiography

Thoracic radiography

Contrast radiography

Ultrasonography

5.12.2A FUNCTIONAL DISORDERS OF URINATION

Haematology

Biochemistry

Urinalysis

Plain radiographs and ultrasound

5.12.2B NEOPLASIA OF THE URINARY SYSTEM

Haematology and biochemistry

Urinalysis

Plain radiographs

Ultrasound

5.12.2C URETHRITIS

Haematology

Biochemistry

Urinalysis

Plain radiographs and ultrasound

5.12.2D URINARY TRACT INFECTION (UTI)

Haematology

Biochemistry

Urinalysis

Plain radiographs and ultrasound

5.12.2E UROLITHIASIS

Upper urinary tract uroliths

Lower urinary tract uroliths

Haematology

Biochemistry

Urinalysis

Plain radiographs

Ultrasound

ABBREVIATIONS

INDEX

WILEY END USER LICENSE AGREEMENT

Отрывок из книги

Fourth Edition

Victoria L. Black,

.....

Jessie Rose Payne,

BVetMed, MVetMed, PhD, DipACVIM (Cardiology), MRCVS

.....

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