FOURTH Notes on EDITION Canine Internal Medicine Victoria L. Black · Kathryn F. Murphy Jessie Rose Payne · Edward J. Hall NOTES ON CANINE INTERNAL MEDICINE NOTES ON CANINE INTERNAL MEDICINE Fourth Edition Victoria L. Black, MA, VetMB, FHEA, DipECVIM-C A, MRCVS Senior Clinician in Small Animal Medicine EBVS® European Specialist in Small Animal Internal Medicine RCVS Specialist in Small Animal Medicine Langford Vets, Bristol Veterinary School Bristol, UK Kathryn F. Murphy, BVSc, DSAM, PGCertHE, DipECVIM- CA, FRCVS EBVS® European Specialist in Small Animal Internal Medicine, RCVS Specialist in Small Animal Medicine Rowe Referrals, Bristol VetCT UK Jessie Rose Payne, BVetMed, MVetMed, PhD, DipACVIM (Cardiology), MRCVS Senior Clinician in Cardiology ACVIM Specialist in Veterinary Cardiology RCVS Specialist in Veterinary Cardiology Langford Vets, Bristol Veterinary School Bristol, UK Edward J. Hall, MA, VetMB, PhD, DipECVIM-C A, FRCVS Emeritus Professor of Small Animal Internal Medicine EBVS® European Specialist in Small Animal Internal Medicine RCVS Specialist in Small Animal Medicine (Gastroenterology) University of Bristol Bristol, UK This edition first published 2022 specifically disclaim all warranties, including © 2022 John Wiley & Sons Ltd without limitation any implied warranties of merchantability or fitness for a particular purpose. Edition History No warranty may be created or extended by sales Wright Imprint by IOP Publishing Limited representatives, written sales materials or (1e, 1983; 2e, 1986) promotional statements for this work. The fact that Blackwell Science Ltd (3e, 2003) an organization, website, or product is referred to in this work as a citation and/or potential source of All rights reserved. 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Black publisher and authors have used their best efforts in preparing this work, they make no representations Set in 9/11.5pt Sabon by Straive, Pondicherry, India or warranties with respect to the accuracy or completeness of the contents of this work and 10 9 8 7 6 5 4 3 2 1 We all recognise the patience and support of our respective families during the production of this book. However, individually we wish to dedicate it specifically to: All the vets and vet students I have met with a curious approach to our patients – your enthusiasm continues to inspire and motivate. Victoria L. Black Those who inspired me to know more as a student and resident (particularly Ed!) and my col- leagues, clients and patients who continue to encourage me to learn more. Kathryn F. Murphy My patients, who make each day different from the last and continue to inspire me to learn every day. Jessie Rose Payne All the Medicine Residents and colleagues (particularly Kate and Vicki!) I have worked with, who have pushed me to learn more. Edward J. Hall CONTENTS Preface xvii Acknowledgements xix Using this book xxi Commonly used abbreviations xxiii Section 1 Presenting Complaints 1 1.1 Abortion 3 1.2 Alopecia 4 1.3 Altered behaviour 7 1.4 Altered consciousness 10 1.5 Anorexia/hyporexia/inappetence 12 1.6 Anosmia 14 1.7 Anuria/oliguria 15 1.8 Ataxia 17 1.9 Bleeding 19 1.10 Blindness 21 1.11 Constipation 23 1.12 Corneal opacity 25 1.13 Coughing 26 1.14 Deafness 29 1.15 Diarrhoea 30 1.15.1 Acute diarrhoea 31 1.15.2 Chronic diarrhoea 34 1.16 Drooling 38 1.17 Dysphagia 39 1.18 Dyspnoea/tachypnoea 41 1.19 Dysuria 44 1.20 Dystocia 46 1.21 Epistaxis 48 1.22 Exercise intolerance 49 1.23 Faecal incontinence 51 1.24 Flatulence/borborygmi 52 1.25 Haematemesis 54 1.26 Haematochezia 55 1.27 Haematuria and discoloured urine 57 1.28 Haemoptysis 60 1.29 Halitosis 61 1.30 Head tilt 62 1.31 Melaena 64 1.32 Nasal discharge 66 1.33 Nystagmus 67 1.34 Paresis/paralysis 69 1.35 Perinatal death 70 viii Contents 1.36 Polyphagia 72 1.37 Polyuria/polydipsia (PU/PD) 73 1.38 Preputial discharge 77 1.39 Pruritus 78 1.40 Red eye (and pink eye) 80 1.41 Regurgitation 81 1.42 Seizures 84 1.43 Sneezing 86 1.44 Stiffness, joint swelling and generalised lameness 87 1.45 Stunting 89 1.46 Tenesmus and dyschezia 91 1.47 Tremors 92 1.48 Urinary incontinence 94 1.49 Vomiting 96 1.50 Vulval discharge 98 1.51 Weakness, collapse and syncope 100 1.52 Weight gain/obesity 104 1.53 Weight loss 105 Section 2 Physical Abnormalities 109 2.1 Abdominal enlargement 111 2.2 Abdominal masses 113 2.3 Abnormal lung sounds 115 2.4 Arrhythmias 118 2.5 Ascites 121 2.6 Cyanosis 124 2.7 Eye lesions 126 2.8 Hepatomegaly 129 2.9 Horner’s syndrome 131 2.10 Hypertension 133 2.11 Hypotension 134 2.12 Hypothermia 135 2.13 Icterus/jaundice 136 2.14 Lymphadenopathy 139 2.15 Murmur 140 2.16 Oral masses 141 2.17 Pain 142 2.17.1 Abdominal pain 142 2.17.2 Generalised pain 146 2.18 Pallor 147 2.19 Perineal lesions 148 2.20 Peripheral oedema 149 2.21 Pleural effusion 151 2.22 Pneumothorax 154 2.23 Prostatomegaly 154 2.24 Pulse abnormalities 156 2.25 Pyrexia and hyperthermia 158 2.26 Skin lesions 160