Contributors xiii
Preface xv
Chapter 1 Physical Examination 1
Charting 1
Goals of the consultation appointment 2
Conclusion 9
Chapter 2 Endocrinology 11
Section 1 Pituitary Gland 11
Growth hormone disorders 11
Diabetes insipidus 13
Section 2 Thyroid Glands 14
Canine hypothyroidism 14
Feline hyperthyroidism 16
Canine thyroid tumors 20
Section 3 Parathyroid Glands 22
Hypoparathyroidism 22
Hyperparathyroidism 23
Section 4 Adrenal Glands 25
Hypoadrenocorticism: Addison’s disease 25
Hyperadrenocorticism: Cushing’s disease 26
Pheochromocytoma 29
Section 5 Pancreas 31
Feline diabetes mellitus 31
Canine diabetes mellitus 37
Canine diabetic ketoacidosis 40
Insulinomas 41
Glucagonoma 45
Section 6 Miscellaneous Hormones, Glands, and Disease 47
Calcitriol 47
Erythropoietin 48
Gastrin 50
Gastrinoma 51
The kinins 52
Melatonin 53
Natriuretic peptides 55
Renin 57
Somatostatin 59
Other rare neuroendocrine tumors 60
Bibliography 62
Chapter 3 Musculoskeletal 69
Section 1 Anatomy and Physiology 69
The skeletal system 69
The muscular system 71
Section 2 Selected Diagnostics in Musculoskeletal Disease 72
Arthrocentesis 72
Muscle biopsy 73
Section 3 Diseases of the Musculoskeletal System 73
Inflammatory joint disease 73
Noninflammatory joint disease 76
Neuromuscular diseases 77
Inflammatory myopathies 78
Hepatozoonosis 79
Neoplasia 80
Section 4 General Musculoskeletal Examination 81
Section 5 Musculoskeletal Therapy 82
Veterinary rehabilitation therapy 82
Palliative radiation therapy 88
Section 6 Musculoskeletal Nutrition 89
Nutrients 90
Antioxidants 91
Energy and growth 91
Osteoarthritis 92
Body condition scoring 92
Body condition score uses 92
Muscle condition scoring 93
Bibliography 96
Chapter 4 The Neurological Examination 99
Clinical signs and the relevant anatomy 99
Seizures 102
Encephalopathies 103
Cerebral neoplasia 105
Inflammatory/infectious etiologies: encephalitis 105
Meningitis 107
Cranial nerve syndromes 107
Spinal diseases 109
Neuromuscular diseases 113
Diagnostic testing 114
Pharmacology 119
Nursing considerations 121
Neurological glossary 122
Suggested readings 124
Chapter 5 Thrombotic Disorders in Small Animal Medicine 127
Physiology 127
Thrombotic disorders 129
Diagnosis 130
Therapy 132
Client education 134
Suggested readings 134
Chapter 6 Respiratory 137
Section 1 Upper Airway Disease 137
Anatomy and physiology 137
Diseases of the upper airway 137
Nutritional considerations 140
Anesthetic and analgesic considerations 140
Section 2 Mediastinal Disease 141
Anatomy and physiology 141
Mediastinitis 141
Pneumomediastinum 141
Mediastinal masses 141
Section 3 Lower Airway Disease 142
Anatomy and physiology 142
Clinical signs 142
Diagnostic testing 142
Specific airway diseases and treatment 143
Anesthetic and analgesic considerations 146
Section 4 Pulmonary Parenchymal Disease 146
Anatomy and physiology 146
Clinical signs 146
Diagnostic testing 147
Treatment 148
Diseases 148
Nutritional considerations 151
Anesthetic and analgesic considerations 151
Section 5 Pleural Disease 152
Anatomy and physiology 152
Clinical signs 152
Diagnostic testing 152
Treatment 154
Nutritional considerations 156
Anesthetic and analgesic considerations 156
Section 6 Anesthesic and Analgesic Considerations in Respiratory Disease 156
Premedication 156
Induction 157
Maintenance anesthesia 157
Monitoring 157
Recovery 157
Section 7 Feeding Considerations for Respiratory Disease 157
Bibliography 158
Chapter 7 Hematology 161
Section 1 Anatomy and Physiology 161
The circulatory system 161
The lymphatic system 162
The spleen 162
The coagulation system 163
Section 2 Red Blood Cell Disorders 163
Anemia 163
Polycythemia 167
Transfusion medicine 167
Immune-mediated hemolytic anemia 171
Section 3 Leukocyte Disorders 174
Methods for determining the leukogram 174
Disorders of neutrophils 175
Disorders of eosinophils 180
Disorders of basophils 180
Disorders of monocytes 180
Disorders of lymphocytes 181
Section 4 Platelet, Coagulation, and Inherited Disorders 182
Diseases of coagulation 182
Disorders of platelets 184
Breed-related disorders 188
Bibliography 189
Chapter 8 Gastrointestinal 193
Section 1 Clinical Signs and Examination of the GI Patient 193
Patient history 193
Physical examination 194
Clinical signs of gastrointestinal disorders 194
Conclusion 197
Section 2 Selected Diagnostics in Gastrointestinal Disease 197
Laboratory evaluation 198
Microscopic fecal evaluation 198
Bacteriologic examination 199
Virologic examination 199
Occult blood 199
Alpha1-protease inhibitor 200
Imaging 200
Special tests 201
Conclusion 201
Section 3 Gastrointestinal Disease 201
Oral disease 201
Esophageal disorders 204
Gastric disease 207
Alimentary tract parasites 213
Diseases of the small intestine 216
Diseases of the large intestine 235
Section 4 Pharmacology 238
Antacids 238
Antiemetics 239
Anti-inflammatory and immunosuppressive drugs 240
Antibiotics 241
Gastromucosal protectants 241
Digestive enzymes 241
Laxatives 241
Section 5 Feeding Tubes 242
Feeding tubes 242
Esophagostomy tube placement 243
Gastrostomy tube placement 244
Jejunostomy tube placement 247
Conclusion 247
Feeding tube management and complications 247
Section 6 Food Intolerance and Food Allergy 251
Clinical signs 251
Causes 251
Diagnostics 251
Treatment 251
Elimination diets 252
Proteins 252
Carbohydrates 252
Prebiotics and probiotics 253
Section 7 Anesthesia and Analgesia Considerations in Gastrointestinal Disease 255
Premedication 255
Induction 255
Maintenance anesthesia 256
Monitoring 256
Recovery 256
Bibliography 256
Chapter 9 Liver 263
Section 1 Hepatic Disease 263
Acute hepatitis 263
Chronic hepatitis 265
Copper-associated chronic hepatitis 266
Hepatic lipidosis 268
Toxic hepatopathy 270
Hepatocutaneous syndrome 272
Congenital vascular anomaly 274
Liver neoplasia 275
Section 2 Posthepatic Disease 276
Feline cholangitis complex 276
Biliary cysts 278
Extrahepatic biliary obstruction 279
Gallbladder mucocoeles 280
Section 3 Nutrition in Liver Disease 282
Protein 283
Fats 283
Carbohydrates 283
Fiber 283
Vitamins and minerals 284
Feeding plan 284
Section 4 Anesthesia and Analgesia Considerations in Hepatic Disease 284
Premedication 284
Induction 284
Maintenance anesthesia 285
Monitoring 285
Recovery 286
Bibliography 286
Chapter 10 Urinary and Renal Diseases 289
Section 1 Urinary Anatomy and Physiology 289
Section 2 Clinical Signs 291
Section 3 Urinary Diseases 292
Chronic kidney disease 292
Acute renal failure 293
Urinary tract infections 294
Pyelonephritis 295
Urolithiasis 295
Prostatic diseases 298
Lower urinary tract disease in cats 299
Ectopic ureters 299
Urethral sphincter mechanism incompetence 300
Protein-losing nephropathy 301
Urinary neoplasia 301
Section 4 Urinary Diagnostics and Therapeutic Implications 302
Urinalysis 302
Complete blood count and serum biochemistry profile 306
Proteinuria 309
Blood pressure 311
Urine culture 313
Section 5 Urinary Tract Biopsy Techniques 315
Aspiration biopsy 315
Biopsy 316
Sample handling 319
Postbiopsy nursing care 319
Section 6 Urinary Imaging 319
Radiology 319
Ultrasound 321
Cystoscopy and vaginoscopy 323
Computed tomography 323
Section 7 Renal and Urinary Disease Pharmacology 324
Fluid therapy and correction of electrolyte imbalances 327
Section 8 Anesthetic and Analgesic Considerations 335
Anesthesia 335
Pain management 336
Section 9 Nutritional Considerations 336
Chronic kidney disease 336
Urolithiasis 338
Feline idiopathic cystitis 341
Bibliography 341
Chapter 11 Infectious Diseases 349
Section 1 Infectious Bacterial Diseases 349
Bartonella 349
Lyme borreliosis 350
Canine brucellosis 352
Ehrlichiosis 353
Helicobacter-associated disease 355
Leptospirosis 357
Methicillin-resistant Staphylococcus aureus 360
Mycobacterial disease 361
Mycoplasmal diseases 363
Plague 365
Section 2 Fungal Diseases 366
Histoplasmosis 366
Aspergillosis 368
Coccidioidomycosis 368
Cryptococcosis 369
Blastomycosis 370
Section 3 Protozoal Diseases 374
Amebiasis 374
Babesiosis 374
Giardia 375
Trichomoniasis 375
Leishmaniasis 376
Toxoplasmosis 376
Neosporosis 377
Cytauxzoonosis 378
Hepatozoonosis 379
Section 4 Infectious Viral Diseases 381
Canine and feline herpesvirus 381
Influenza 383
Papillomas 384
Section 5 Infectious Disease Testing 385
Disease prevention and control in the small animal hospital 395
Bibliography 400
Chapter 12 Vaccine, Vaccination, and Immunology 403
Section 1 The Immune Response and Cancer Immunotherapy 403
Innate and adaptive immune response 403
Humoral and cell-mediated immunity 404
Immunomodulation 404
Cancer vaccines 404
Cytokine immunotherapy 405
Summary 405
Section 2 Laboratory Diagnostics in Immunology 405
Serology 405
Biopsy techniques 407
Section 3 Immunosuppressive Medications 409
Corticosteroids 409
Immunosuppresives 411
Less commonly used immunosuppressives 412
Novel immunosuppressive medications 412
Immunomodulating medications 413
Conclusion 413
Section 4 Vaccines and Vaccination 413
Vaccination strategies 413
Canine vaccines 416
Feline vaccines 422
Vaccinations and adverse reactions 427
Bibliography 429
Chapter 13 Pain and Its Management 433
Veterinary technician as pain management team leader 433
What is pain? 434
Pathophysiology of pain 434
Types of pain 435
Causes of pain 436
General approach to pain control 436
General rules of thumb in managing pain 436
Questions to consider 437
How to be an analgesic advocate for your patient 437
Clinical signs and means of detection 438
Pain scoring systems 439
Analgesics 439
Nursing care as analgesic 446
Clinical examples 447
Conclusion 448
Bibliography 448
Chapter 14 Nursing 449
Section 1 Occupational Health and Safety 449
Making the work place safe 449
Health and safety committees 449
Hazards in the workplace 450
Chemotherapy safety 452
Conclusion 453
Section 2 Pharmacological Implications in Internal Medicine 453
Drug calculations, compatibilities, dosing, and administration 453
Constant rate infusion 453
Drug compatibilities 454
Drug dosage adjustments in patients with heart, renal, and hepatic insufficiency or failure 454
Oxygen therapy 460
Drug calculations 461
Client education 462
Section 3 Nutritional Support 463
Nutritional support 463
Energy balance: weight loss versus weight gain 468
Refeeding syndrome 471
Section 4 Diagnostic Procedures 474
Cystocentesis 474
Abdominocentesis 475
Thoracocentesis 478
Urinary catheters 480
Bone marrow collection 484
Section 5 Endoscopy 487
Flexible endoscope 487
Videoendoscope 489
Instrumentation 489
Rigid endoscopes 490
Reprocessing 492
Patient and equipment preparation 495
Section 6 Selected Nursing Considerations of Internal Medicine Patients 495
Thermoregulation 495
Fever or hyperthermia? 495
Hypothermia 498
The sepsis syndrome 499
Bibliography 504
Appendix Accredited State Veterinary Diagnostic Laboratories 509
Abbreviations 515
Index 521
