Small Animal Medical Differential Diagnosis: A Book of Lists, 2e PDF
Preview Small Animal Medical Differential Diagnosis: A Book of Lists, 2e
SECOND EDITION Small Animal S T Medical S Differential I L Diagnosis F O K O O B A Mark S. Thompson Diplomate, American Board of Veterinary Practitioners Certifi ed in Canine/Feline Practice Brevard Animal Hospital Brevard, North Carolina 3251 Riverport Lane St. Louis, Missouri 63043 SMALL ANIMAL MEDICAL DIFFERENTIAL DIAGNOSIS: A BOOK OF LISTS, SECOND EDITION ISBN: 978-1-4557-4454-1 Copyright © 2014, 2007 by Saunders, an imprint of Elsevier Inc. 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 p ractitioners, 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, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Thompson, Mark S., author. Small animal medical differential diagnosis : a book of lists / Mark S. Thompson. – Second edition. p. ; cm. Includes index. ISBN 978-1-4557-4454-1 (pbk.) I. Title. [DNLM: 1. Dog Diseases–diagnosis–Handbooks. 2. Cat Diseases–diagnosis–Handbooks. 3. Diagnosis, Differential–Handbooks. SF 991] 636.089'6075–dc23 2013008764 Content Strategy Director: Penny S Rudolph Associate Content Developer: Katie Starke Publishing Services Manager: Catherine Albright Jackson Senior Project Manager: Mary Pohlman Project Manager: Anitha Sivaraj Book Designer: Jessica Williams Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my wife Sandi for 30 years of marriage. PREFACE When I was asked by Elsevier to create a second edition of Small Animal Differential Diagnosis: A Book of Lists, I envisioned an easy process of updating the lists of the first edition and adding some new material. I couldn’t have been more wrong. The goal was to duplicate the format of the first edition: a quick, concise, and practical reference to differential diagnosis, etiology, laboratory values, and classification of clinical signs and medical disorders in dogs and cats. As I reviewed each list I was surprised to see how many needed to be revised. In fact, nearly all of the lists required additions, subtractions, or sometimes complete reor- ganization. A project like this one is a great illustration of how much the veterinary medical literature expands in a 6-year pe- riod. Once again, this text will be a pocket-sized, rapid reference or an electronic application. Its greatest value will be to aid the clinician in making reliable on-the-scene decisions and to al- low veterinary students and interns to more fully participate in clinical rounds with their instructors. It will also be used by the more seasoned practitioner to come up with those more esoteric differentials that we sometimes forget to include in our list of potential diagnoses. The lists in this book have been compiled from comprehen- sive veterinary references published by Elsevier, especially: • Ettinger and Feldman: Textbook of Veterinary Internal Medicine, seventh edition and • Nelson and Couto: Small Animal Internal Medicine, fourth edition. Also consulted for information were: • Henry and Higginbotham: Cancer Management in Small Animal Practice • Beaver: Canine Behavior: Insights and Answers, second edition • Landsberg: Handbook of Behavior Problems of the Dog and Cat, second edition • Bonagura: Kirk’s Current Veterinary Therapy XIV • Maggs et al: Slatter’s Fundamentals of Veterinary Ophthalmology, fifth edition • Willard and Tvedten: Small Animal Clinical Diagnosis by Laboratory Methods, fifth edition • Fossum: Small Animal Surgery, fourth edition The reader is encouraged to consult these and other texts for more detailed information. vii viii PREFACE About the Book As with the first edition, the lists are divided into three parts and serve as a concise guide to the differential diagnosis, etiology, laboratory abnormalities, and classification of clinical signs and medical disorders in dogs and cats. Part One contains lists based on clinical signs that may be identified by the clinician. Part Two approaches differential diagnosis from a systems perspec- tive. Fifteen body systems are represented. Part Three once again is a quick reference of laboratory tests and gives typical normal ranges and differential diagnoses based on test results. Overall the book comprises 400 lists, 60 of which are new to this edition. In all lists an attempt has been made to prioritize them from least common to most common. Acknowledgments I wish to thank my fellow veterinarians at Brevard Animal Hospital: Dr. Christine Weaver, Dr. Clyde Brooks, Dr. Chad Lothamer, and Dr. Alana Terrell. They were a sounding board for ideas and helped me discover deficiencies in the first edition. In addition, our discussions about cases helped me determine new lists that needed to be generated. PART ONE Clinical Signs Approach to Differential Diagnosis 1 2 PART ONE Clinical Signs Approach to Differential Diagnosis Abdominal Distension Organomegaly Hepatomegaly (infiltrative, inflammatory, lipidosis, neoplasia) Splenomegaly (infiltrative, inflammatory, neoplasia, hematoma) Renomegaly (neoplasia, infiltrative) Miscellaneous neoplasia (GI tract, ovaries, uterus, pancreas, prostate, adrenal glands) Generalized neoplasia (carcinomatosis, lymphosarcoma) Granuloma (pythiosis, aspergillosis) Pregnancy Fluid Contained in Organs Congestion resulting from splenic torsion or volvulus, or hepatic congestion from right-sided heart failure Cysts (paraprostatic, perinephric, hepatic) Hydronephrosis Distended urinary bladder Obstruction of intestines or stomach Ileus Pyometra Free Fluid in Abdomen Transudate (portal hypertension, right-sided heart failure, hypoproteinemia secondary to protein-losing enteropathy, protein-losing nephropathy, or hepatic failure) Modified transudate (neoplasia, postsinusoidal portal hypertension, right-sided heart failure, heartworm caval syndrome, liver disease) Exudate (pancreatitis, feline infectious peritonitis, urine, bile, neoplasia, bowel perforation, foreign body) Chyle (trauma, neoplasia, infection, right-sided heart failure) Blood (coagulopathy, trauma, neoplasia) Gas Contained in Organs Gastric dilatation/volvulus Intestines secondary to obstruction Parenchymal organs infected with gas-producing bacteria Free in Abdomen Iatrogenic (after laparoscopy, laparotomy) Rupture of gastrointestinal tract or uterus PART ONE Clinical Signs Approach to Differential Diagnosis 3 Fat Obesity/lipoma Weakened Abdominal Musculature Hyperadrenocorticism Feces Obstipation/megacolon Abdominal Effusions and Ascites Transudate (<1000 Cells, <2.5 Total Solids, <1.017 Specific Gravity) Portal Hypertension Presinusoidal or sinusoidal liver disease Right-sided heart failure Hypoalbuminemia (see Albumin p. 286) Liver failure Protein-losing enteropathy Glomerulopathy Modified Transudate (>1000 but <10000 Cells, 2.5-5.0 Total Solids, <1.025 Specific Gravity) Postsinusoidal Portal Hypertension Right-Sided Heart Failure Heartworm caval syndrome Liver disease Neoplasia Increased Hydrostatic Pressure Vasculitis Exudate (>5000 Cells, >3.0 Total Solids, >1.025 Specific Gravity) Nonseptic Pancreatitis Feline infectious peritonitis (FIP) Urine Bile Neoplasia Septic Bowel perforation Foreign body 4 PART ONE Clinical Signs Approach to Differential Diagnosis Chyle Trauma Neoplasia Infection Right-sided heart failure Blood Coagulopathy Trauma Neoplasia (hemangiosarcoma) Iatrogenic (postsurgical) Abdominal Pain, Acute Gastrointestinal System Gastrointestinal ulceration Foreign body Gastric dilation-volvulus Gastroenteritis Obstipation Colitis Neoplasia Adhesions Intestinal ischemia Intestinal spasm Urogenital System Lower urinary tract infection Lower urinary tract obstruction Nonseptic cystitis (idiopathic cystitis—cats) Prostatitis/prostatic neoplasia Uroliths/renoliths/ureterolith Pyelonephritis Neoplasm Metritis Pyometra/uterine rupture Uterine torsion (rare) Testicular torsion Mastitis Dystocia Ovarian cyst Pancreatitis Spleen Rupture Neoplasm PART ONE Clinical Signs Approach to Differential Diagnosis 5 Infection Torsion Peritoneum Peritonitis • Septic • Nonseptic (e.g., uroabdomen) Adhesions Mesenteric neoplasia, volvulus, inflammation Hepatobiliary Hepatitis Hepatic abscess Hepatic trauma, rupture Hepatobiliary neoplasia Cholelithiasis or cholecystitis Cholangiohepatitis Musculoskeletal Fractures Intervertebral disk disease Diskospondylitis Abscess Strangulated hernia Miscellaneous Adrenalitis (associated with hypoadrenocorticism) Heavy metal intoxication Vasculopathy • Rocky Mountain spotted fever • Infarct Autonomic (abdominal) epilepsy Iatrogenic • Misoprostol • Bethanechol • Postoperative pain Aggressive Behavior Cats Pathophysiologic Causes of Feline Aggression Rabies Hyperthyroidism Seizures (epilepsy, central nervous system inflammation) Paradoxical effects of therapeutic drugs (e.g., benzodiazepines) Toxins (side effects)
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