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MANIFESTATIONS OF DISEASE Abdominal distention, 98 Gestation, prolonged, 189 Pruritus, 166 Abdominal pain, 24, 94 Growth, decreased, 131 Ptosis, drooped eyelid, 126 Abortion, 184 Grunting, 24 Pulse, abnormal peripheral, 86 Agalactia (fescue toxicosis), 187, 195 Hair coat, length and density, abnormal, Pustules, papules, and vesicles, skin, Anestrus, 181 171 169 Anuria, 159 Head pressing, 111, 121 Pyuria, 157 Ascites, 76 Head tilt, 114, 124, 126 Reflexes, abnormal, 119, 126, 129 Ataxia, 112, 127 Heart sounds, muffled, 82 Regurgitation and vomiting (feed Behavior, abnormal, 24, 110, 121 Hematuria, 155 returning to mouth or nares), 100 Blindness, hemianopsia, 118, 122, Hemianopsia, blindness, 118, 122 Repeat breeder, 182 126 Hemoptysis, 53 Respiratory distress (dyspnea), 56 Body condition, poor, 131 Hypermetria, 125, 128 Respiratory noise, abnormal, 66, 126 Bruxism, 24 Hyperreflexia, 116, 128, 130 Respiratory rate, elevated, 56 Cardiac arrhythmia, 78 Hyporeflexia, 116, 128, 130 Retained fetal membranes, 192 Circling, 113, 120, 124 Hyperthermia, 31 Roaring, snoring, dysphonia, 126 Colic (abdominal pain), 24, 94 Hypothermia, 39 Scaling, crusting skin, 170 Collapse or sudden death, 214 Icterus (jaundice), 105 Seizures (convulsions), 112, 121 Coma, semicoma, 112, 121 Incontinence, urinary, 128, 130, 153 Sensorium, abnormal, 121 Conscious proprioceptive deficit, 113 Jaw weakness, 119, 126 Sexual functions, male, alterations in, Constipation, 98 Lactation, alterations in, 194 176 Cough, 40 Lameness, stiffness, 24, 197 Spasticity, 115, 125, 130 Crusting, skin, 170 Lymph nodes, enlarged, 86 Strabismus, 118, 120, 126 Crystalluria, 158 Mammary gland, enlarged, 194 Straining to urinate, 153 Cyanosis, 63 Melena, 97 Stranguria, 153 Cyclic irregularity, 179 Menace, loss of, 115, 117, 126, 128 Stridor, 66 Deafness, 126 Murmurs, cardiac, 80 Sudden death, collapse, 215 Dental abnormalities, 104 Muscle atrophy, 115, 117, 129 Sweating, absence of (anhidrosis), 32 Depressed mentation, 110, 121 Muscle spasms and myoclonus, 211 Swelling in limb, 85, 207 Diarrhea, 88 Muscular rigidity or flaccidity, 129 Swellings, enlargements, Dysentery, 98 Myoclonus and muscle spasms, 211 musculoskeletal, 207 Dysphagia, 101 Narcolepsy, 112, 123 Swellings, painful peripheral, 85 Dyspnea, 56 Nasal discharge, 48 Syncope, weakness, exercise Dysrhythmia, cardiac, 78 Nodules, tumors, and swellings, 167 intolerance, 83, 121 Dystocia, 190 Nystagmus, 119, 124, 126 Tachypnea, 56 Dysuria, 153 Obesity, 147 Teeth grinding (bruxism), 24 Early embryonic death, 184 Oliguria, 159 Temperature, elevated, 31 Edema, peripheral, 76 Opisthotonos, 113, 125 Temperature, subnormal, 39 Epistaxis, 53 Pain, diagnosis, 23, 24 Treading, 24 Erosions, oral, 103 Papules, pustules, and vesicles, skin, Tremors, intention, 125 Estrus, irregular, 179 169 Udder edema, 76, 195 Exercise intolerance, poor performance, Paralysis, 127, 129 Ulcerations and erosions, skin, 168 70 Paresis and ataxia, 119, 127, 209 Ulcers or growths, oral, 103 Exercise intolerance, weakness, Performance reduced, 70, 83 Uremia, 160 syncope, 70, 83 Pica, 152 Urinary incontinence, 130 Facial anesthesia, analgesia, 119, 126 Pigmentation, abnormal, 173 Venous distention and pulsations, 84 Facial paralysis, 119, 126 Pigmenturia, 155 Vesicles, pustules, and papules, skin, Feces; blood, fibrin, mucus in, 98 Pleural effusion, 76 169 Fever, 33 Polydipsia, 159 Vocalization, abnormal, 24, 121, Flaccid tail and anus, 130 Polyuria, 158 126 Gait, abnormal, 24 Postural deformities, 203 Vomiting, 100 Galactorrhea (inappropriate lactation), Pregnancy loss, 184 Weight gain, decreased, 131 196 Prolonged gestation, 187, 189 Weight loss, 137 DISORDERS AND MANAGEMENT OF THE NEONATE FOAL DISORDERS Inguinal hernia, 232 Assessment of dam during late gestation, 279 Abdominal exam and ultrasound, 233, 236 Lameness and reluctance to walk, 253, 257 Assessment of fetal viability, 282, 284 Anemia, 261 Lethal white foal syndrome, 239, 273 Assessment of the neonatal calf, 285 Apgar score, 229 Management of high-risk late-gestation mare, Blood gas abnormalities, 283, 310 Asphyxia, perinatal, 227 226 Cerebrospinal fluid assessment, 306 Assessment of fetal viability, 224 Meconium aspiration, 268 Colostrum management and assessment and Assessment of newborn foal, 229 Meconium impaction, 232, 275 FPT, 286 Bacterial infection, treatment, 249 Mucous membranes, abnormal, 230 Cyanosis, 337 Behavior, abnormal, 229 Necrotizing enterocolitis, 277 Dental abnormalities, 295 Blood gas abnormalities, 235 Nutritional support, 245 Diarrhea, 314 Blood gas values, 235 Ocular abnormalities, 230 Distended or painful abdomen, 312 Cardiac arrhythmias, 233 Oliguria and stranguria, 228 Failure to thrive, 338 Care of abnormal foals, 243 Patent urachus, omphalitis, and other Fever, 337 Cerebrospinal fluid assessment, 238 umbilical abnormalities, 278 Heart murmur, 296, 338 Cleft palate, 231 Perinatal asphyxia, 224, 227 Icterus, 338 Colic, 273 Physical exam, 229, 248 Induction of parturition, 282 Colostrum management and assessment and Placentitis, 225 Lameness and reluctance to walk, 335 FPT, 223, 240 Prematurity, 262 Mucous membranes, abnormal, 295 Contracted/lax tendons, 239 Respiratory distress, 266 Ocular abnormalities, 296 Dental abnormalities, 231 Resuscitation, 227, 243 Patent urachus, omphalitis, and other Diarrhea, 270 Ruptured urinary bladder, 236 umbilical abnormalities, 336 Distended or painful abdomen, 273 Seizures, 258 Perinatal adaptation, 283 Dysmaturity, 262 Sepsis, 247 Physical exam of neonatal ruminant, 294 Effects of placental insufficiency, 224 Sepsis score, 250 Prevention of infections, 289 Fluid and drug therapy, 243 Septic arthritis/osteomyelitis, 253 Respiratory distress, 308, 310, 312 Gait/limb abnormalities, 257 Supportive care, 243 Resuscitation, 285 Goiter, 231 Umbilical enlargement, 236, 278 Seizures, 305 Heart murmur, 234 Umbilicus abnormal on ultrasound, 236 Sepsis, 302 Hematology and biochemistry values, 241 Uroperitoneum, 275 Septic arthritis/osteomyelitis, 335 Hemoperitoneum, 277 Vertebral abnormalities, 232 Stillbirth, 281 High-risk neonatal foal, 223 Weakness and/or somnolence, 246 Umbilical care, 297 Hypoglycemia, 241 Umbilical enlargement, 336 Hypothermia, 245 RUMINANT DISORDERS Umbilicus abnormal on ultrasound, 297 Icterus, 231 Vertebral anomalies, 296 Abdominal exam and ultrasound, 297 Ileus, 276 Weakness and/or somnolence, 302, 306 Anemia, 337 Induction of parturition, 226 COLLECTION OF SAMPLES AND INTERPRETATION OF LABORATORY TESTS MAJOR BIOCHEMICAL ABNORMALITIES OR PROBLEMS ENCOUNTERED Acute phase response, 388 Hyperfibrinogenemia, 397 Molecular tests for DNA or RNA, 412 Agglutination of RBCs, 377 Hyperglobulinemia, 388 Monocytosis, 384 Anemia, 377 Hyperglycemia, 369 Neutropenia, 383 Anion gap, 363, 364 Hyperkalemia, 358 Neutrophilia, 382 Base excess or deficit, 364 Hypermagnesemia, 361 Normal values (clinical chemistries, serum Basophilia and basopenia, 384 Hypernatremia, 357 proteins), 354 Bicarbonate, 364 Hyperphosphatemia, 361 Osmolality and osmolal gap, 359 Bilirubin, 368 Hyperproteinemia, 387 Other tests of hemostatic function, 398 Blood loss, 379 Hypoalbuminemia, 390 Packed cell volume (PCV), 376 Blood urea nitrogen, 370 Hypocalcemia, 360 Panhyperproteinemia, 387 Body fluid analysis, 375 Hypochloremia, 359 Panhypoproteinemia, 391 Bone marrow collection, 400 Hypofibrinogenemia, 398 Plasma fibrinogen, 398 Bone marrow evaluation, 407 Hypoglycemia, 369 Platelet function defects, 395 Causes of elevations of serum enzymes and Hypokalemia, 358 Polymerase chain reaction (PCR), 415 bilirubin, 365, 366 Hypomagnesemia, 361 Prolonged activated partial thromboplastin Coomb test (direct antiglobulin test), 377 Hyponatremia, 356 time, 396 Creatinine, 369 Hypophosphatemia, 361 Prolonged prothrombin time, 395 Decreased erythrocyte production, 379 Hypoproteinemia, 390 Red blood cell count, 376 Decreased plasma antithrombin III, 397 Increased fibrin/fibrinogen degradation Respiratory acidosis, 363 Eosinophilia, 384 products, 397 Respiratory alkalosis, 363 Erythrocyte morphology, 376 Lymph node aspirate, 375 Strong ion difference, 365 Erythrocytosis (polycythemia), 379 Lymphocytosis, 384 Strong ion gap, 365 Fluid and electrolyte balance, 356 Lymphopenia, 384 Synovial fluid analysis, 375 Fractional urinary clearance of electrolytes, Mean cell volume, 376 Thrombocytopenia, 393 372 Mean cell hemoglobin concentration and Thrombocytosis, 394 Hematocrit, 376 mean cell hemoglobin, 376 Thromboplastin time, 396 Hemoglobin, 376 Metabolic acidosis, 362 Total carbon dioxide, 364 Hemolysis, 379 Metabolic alkalosis, 362 Urinalysis, 371 Hypercalcemia, 360 Metabolic profiling, 352 Hyperchloremia, 359 Mixed acid-base imbalances, 363 Expand research on specific topics of interest Visit www.largeanimalinternalmedicine.com Further your understanding of large animal internal medicine by accessing this book’s companion website—featuring an extensive list of useful references, each linked to the original abstract on PubMed. Large Animal Internal Medicine To study the phenomena of disease without books is to sail an uncharted sea, While to study books without patients is not to go to sea at all. SIR WILLIAM OSLER Editor-in-Chief Bradford P. Smith, DVM, DACVIM Professor Emeritus Department of Medicine and Epidemiology School of Veterinary Medicine University of California, Davis Davis, California Large Animal Internal Medicine FIFTH EDITION 3251 Riverport Lane St. Louis, Missouri 63043 LARGE ANIMAL INTERNAL MEDICINE, FIFTH EDITION ISBN: 978-0-323-08839-8 Copyright © 2015 by Mosby, an imprint of Elsevier Inc. Copyright © 2009, 2002, 1996, 1990 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instruc- tions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Large animal internal medicine / editor in chief, Bradford P. Smith.—Fifth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-0-323-08839-8 (hardcover : alk. paper) I. Smith, Bradford P., editor of compilation [DNLM: 1. Veterinary Medicine. 2. Animal Diseases. 3. Diagnosis, Differential. SF 745] SF745 636.089—dc23 2013049831 Vice President and Publisher: Linda Duncan Content Strategy Director: Penny Rudolph Content Development Specialist: Brandi Graham Publishing Services Manager: Catherine Jackson Project Manager: Rhoda Bontrager Design Direction: Brian Salisbury Printed in the United States Last digit is the print number: 9 8 7 6 5 4 3 2 1 CONSULTING EDITORS Danika L. Bannasch, DVM, PhD Christian M. Leutenegger, DrMedVet, PhD, FVH George M. Barrington, DVM, PhD, DACVIM Robert J. MacKay, BVSc (Dist), PhD, DACVIM Ellen Belknap, DVM, MS, DACVO K. Gary Magdesian, DVM, DACVIM, DACVECC, DACVCP Catherine J. Benson, DVM, DACVP Dianne McFarlane, DVM, PhD, DACVIM Andrea A. Bohn, DMV, PhD, DACVP Anne J. Gemensky Metzler, DVM, MS, DACVO T. Douglas Byars, DVM, DACVIM, DACVECC Suzanne T. Millman, BSc (Agr), PhD Barbara A. Byrne, DVM, PhD, DACVIM, DACVM Paul S. Morley, DVM, PhD, DACVIM Stan W. Casteel, DVM, PhD, DABVT Jed A. Overmann, DVM, DACVP Bruce W. Christensen, DVM, MS, DACT Paul J. Plummer, DVM, PhD, DACVIM Johann (Hans) F. Coetzee, BVSc, Cert CHP, PhD, DACVCP Nicola Pusterla, DrMedVet, DrMedVetHabil, DACVIM Victor S. Cortese, BS, DVM, PhD, DABVP Virginia B. Reef, DVM, DACVIM, DACVSMR, Lais R. Costa, MV, MS, PhD, DACVIM (LA), DABVP Associate Member ECVDI (Equine) Pamela L. Ruegg, DVM, MPVM Robin M. Dabareiner, DVM, PhD, DACVS Leslie C. Sharkey, DVM, PhD, DACVP Jennifer L. Davis, DVM, PhD, DACVIM (LA), DACVCP Geof W. Smith, DVM, PhD, DACVIM Kari J. Ekenstedt, DVM, PhD Dominic R. Dawson Soto, DVM, DACVIM, CCRT Ronald J. Erskine, DVM, PhD Henry Stämpfli, DVM, DrMedVet, DACVIM Marie-Eve Fecteau, DVM, DACVIM Meri Stratton-Phelps, DVM, MPVM, DACVIM, DACVN Sherrill A. Fleming, DVM, DACVIM, DABVP (Food Animal) Ronald L. Terra, DVM, MS, MBA Sandra Godden, DVM, DVSc Mats H.T. Troedsson, DVM, PhD, DACT, DECAR Kathleen Casey Gonda, DVM, MS, DACVIM-LA Stephanie J. Valberg, DVM, PhD, DACVIM, DACVSMR John K. House, BSc, BVMS (Hons), PhD Sarel Van Amstel, BVSc, MMedVet (Med), DipMedVet, Lynn Rolland Hovda, RPH, DVM, MS, DACVIM DACVIM Angela M. Hughes, DVM, PhD David C. Van Metre, DVM, DACVIM Pamela Joanne Hullinger, DVM, MPVM, DACVPM Johanna L. Watson, DVM, PhD, DACVIM Robert E. James, BS, MS, PhD J. Scott Weese, DVM, DVSc, DACVIM Jennifer L. Johns, DVM, PhD, DACVP Stephen D. White, DVM, DACVD Samuel L. Jones, DVM, PhD, DACVIM Pamela A. Wilkins, AS, BS, DVM, MS, PhD, DACVIM, Carter E. Judy, DVM, DACVS DACVECC Jeffrey Lakritz, DVM, PhD, DACVIM W. David Wilson, BVMS, MS, Hon DACVIM Kara M. Lascola, DVM, MS, DACVIM Amelia R. Woolums, DVM, MVSc, PhD, DACVIM, DACVM Guy D. Lester, BVMS, PhD, DACVIM (LAIM) v CONTRIBUTORS Dorothy M. Ainsworth, DVM, PhD, DACVIM Daniela Bedenice, DrMedVet, DACVIM, DACVECC Professor of Medicine Associate Professor; Department of Clinical Sciences Residency Training Director College of Veterinary Medicine Department of Clinical Sciences Cornell University Tufts Cummings School of Veterinary Medicine Ithaca, New York Tufts University North Grafton, Massachusetts Monica Aleman, MVZ, PhD, DACVIM (Internal Medicine, Neurology) Ellen Belknap, DVM, MS, DACVO Veterinarian Ophthalmologist The William Pritchard Veterinary Medical Teaching Hospital Metropolitan Referral Hospital Large Animal Clinic Akron, Ohio School of Veterinary Medicine University of California, Davis Davis, California Catherine J. Benson, DVM, DACVP Specialty VETPATH John A. Angelos, DVM, PhD, DACVIM Seattle, Washington Associate Professor Department of Medicine and Epidemiology Steven L. Berry, DVM, MPVM School of Veterinary Medicine Extension Specialist Emeritus: Dairy Management and Health University of California, Davis Department of Animal Science Davis, California University of California, Davis Davis, California Jane E. Axon, BVSc (Hons), MANZCVSc, DACVIM Director Clovelly Intensive Care Unit Christine F. Berthelin-Baker, DVM, DACVIM Scone Equine Hospital (Neurology), DECVN Scone, New South Wales, Australia Atlanta, Georgia Lora Rickard Ballweber, MS, DVM, DACVM (Parasitology) Terry L. Blanchard, DVM, MS, DACT Professor, Veterinary Parasitology Professor Department of Microbiology, Immunology, & Pathology College of Veterinary Medicine College of Veterinary Medicine and Biomedical Sciences Texas A&M University Colorado State University College Station, Texas Fort Collins, Colorado Anthony T. Blikslager, DVM, PhD Danika L. Bannasch, DVM, PhD Professor, Equine Surgery Population Health and Reproduction Department of Clinical Sciences University of California, Davis College of Veterinary Medicine Davis, California North Carolina State University Safia Z. Barakzai, BVSc, MSc, DESTS, DECVS, Assoc Raleigh, North Carolina ECVDI, MRCVS Equine Surgeon Andrea A. Bohn, DVM, PhD, DACVP Chine House Veterinary Hospital Associate Professor Sileby, Leicestershire, United Kingdom Department of Microbiology, Immunology, & Pathology College of Veterinary Medicine and Biomedical Sciences George M. Barrington, DVM, PhD, DACVIM Colorado State University Professor Fort Collins, Colorado Department of Veterinary Clinical Sciences College of Veterinary Medicine Carole A. Bolin, MS, DVM, PhD Washington State University Professor; Pullman, Washington Director of the Diagnostic Center for Population & Animal Michelle Henry Barton, DVM, PhD, DACVIM Health Fuller E. Callaway Endowed Chair; Department of Pathobiology and Diagnostic Investigation Professor of Large Animal Medicine (PDI) Department of Large Animal Medicine College of Veterinary Medicine The University of Georgia Michigan State University Athens, Georgia East Lansing, Michigan vi

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Large Animal Internal Medicine, 5th Edition features a problem-based approach to the diagnosis and management of disease in horses, cattle, sheep, and goats. It offers discussions of over 150 clinical signs and manifestations, as well as comprehensive coverage of laboratory and diagnostic testing. T
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