دانلود کتاب Small Animal Internal Medicine Elsevier Ebook on Vitalsource Access Code

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Front Cover Small Animal Internal Medicine Copyright Page Section Editors Dedication Preface Organization Key Features of the Sixth Edition Acknowledgments Table Of Contents Video Contents One Cardiovascular System Disorders 1 Clinical Manifestations of Cardiac Disease Signs of Heart Disease Signs of Heart Failure Weakness and Exercise Intolerance Syncope Cardiovascular Causes of Syncope Cough and Other Respiratory Signs Cardiovascular Examination Respiratory Patterns Mucous Membranes Jugular Veins Arterial Pulses Precordium Evaluation for Fluid Accumulation Auscultation Transient Heart Sounds Gallop Sounds Other Transient Sounds Cardiac Murmurs Systolic murmurs Diastolic murmurs Suggested Readings 2 Diagnostic Tests for the Cardiovascular System Cardiac Biochemical Markers Cardiac Radiography Cardiomegaly Cardiac Chamber Enlargement Patterns Left Atrium Left Ventricle Right Atrium Right Ventricle Intrathoracic Blood Vessels Great Vessels Lobar Pulmonary Vessels Patterns of Pulmonary Edema Other Imaging Techniques Cardiac Computed Tomography and Magnetic Resonance Imaging Nuclear Cardiology Echocardiography Basic Principles Two-Dimensional Echocardiography Common Two-Dimensional Echocardiographic Views M-Mode Echocardiography M-Mode Views Common Measurements and Normal Values Contrast Echocardiography Doppler Echocardiography Pulsed Wave Doppler Continuous Wave Doppler Pressure Gradient Estimation Color Flow Mapping Other Echocardiographic Modalities Doppler Tissue Imaging and 2-D Speckle Tracking Transesophageal Echocardiography Three-Dimensional Echocardiography Lung Ultrasound Electrocardiography Normal ECG Waveforms Lead Systems Approach to ECG Interpretation Sinus Rhythms Ectopic Rhythms Supraventricular Premature Complexes Supraventricular Tachycardias Atrial Flutter Atrial Fibrillation Ventricular Premature Complexes Ventricular Tachycardia Accelerated Idioventricular Rhythm Ventricular Fibrillation Escape Complexes Conduction Disturbances Conduction Disturbances Within the Atrioventricular Node Intraventricular Conduction Disturbances Ventricular Preexcitation Mean Electrical Axis Chamber Enlargement and Bundle Branch Block Patterns Other QRS Abnormalities ST-T Abnormalities QT Interval Electrocardiographic Manifestations of Drug Toxicity and Electrolyte Imbalance Heart Rate Variability Common Artifacts Ambulatory Electrocardiography Holter Monitoring Intermittent Event Recording Other Techniques Central Venous Pressure Measurement Angiocardiography Cardiac Catheterization Endomyocardial Biopsy Suggested Readings Cardiac Biochemical Markers Radiography Echocardiography Electrocardiography 3 Management of Heart Failure Overview of Heart Failure Cardiac Responses Systemic Responses Neurohormonal Mechanisms Renal Effects Other Effects of Heart Failure General Causes of Heart Failure Approach to Treating Heart Failure Classification of Severity Preclinical Cardiac Disease Management of Mild or Early CHF Signs Treatment for Acute Congestive Heart Failure General Considerations Supplemental Oxygen Drug Therapy Diuresis Vasodilation Inotropic Support Other Acute Therapy Heart Failure Caused by Diastolic Dysfunction Monitoring and Follow-Up Management of Chronic Heart Failure General Considerations Diuretics Furosemide Other Loop Diuretics Spironolactone Thiazide Diuretics Angiotensin-Converting Enzyme Inhibitors Enalapril Benazepril Other Angiotensin-Converting Enzyme Inhibitors Angiotensin Receptor Blockers Positive Inotropic Agents Pimobendan Digoxin Digoxin Toxicity Other Vasodilators Hydralazine Amlodipine Prazosin Nitrates Dietary Considerations Taurine l-Carnitine Other Supplements β-Blockers in Patients With Heart Failure Chronic Diastolic Dysfunction Reevaluation and Monitoring Strategies for Recurrent or Refractory Congestive Heart Failure Suggested Readings Pathophysiology of Heart Failure Therapy of Heart Failure 4 Cardiac Arrhythmias and Antiarrhythmic Therapy General Considerations Development of Arrhythmias Approach to Arrhythmia Management Diagnosis and Management of Common Arrhythmias Clinical Presentation Tachyarrhythmias Rapid Irregular Rhythms Rapid Regular Rhythms Supraventricular Tachyarrhythmias Oral therapy for frequent supraventricular premature beats or paroxysmal tachycardia Vagal maneuver Ventricular Tachyarrhythmias Acute therapy for ventricular tachycardia Chronic oral therapy for ventricular tachyarrhythmias Atrial Fibrillation Therapy for atrial fibrillation Lone Atrial Fibrillation Bradyarrhythmias Sinus Bradycardia Sick Sinus Syndrome Atrial Standstill Atrioventricular Conduction Block Antiarrhythmic Agents Class I Antiarrhythmic Drugs Lidocaine Procainamide Quinidine Mexiletine Phenytoin Other Class I Agents Class II Antiarrhythmic Drugs: β-Adrenergic Blockers Atenolol Propranolol Esmolol Other β-Blockers Class III Antiarrhythmic Drugs Sotalol Amiodarone Other Class III Agents Class IV Antiarrhythmic Drugs: Calcium Entry Blockers Diltiazem Verapamil Other Calcium Channel Blockers So-Called Class V Drugs Digoxin Ivabradine Anticholinergic Drugs Atropine and Glycopyrrolate Oral Anticholinergic Drugs Sympathomimetic Drugs Other Drugs Suggested Readings Arrhythmias and Antiarrhythmic Drugs Cardiac Pacing 5 Congenital Cardiac Disease General Considerations Extracardiac Arteriovenous Shunt Patent Ductus Arteriosus Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Ventricular Outflow Obstruction Subaortic Stenosis Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Pulmonic Stenosis Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Intracardiac Shunt Ventricular Septal Defect Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Atrial Septal Defect Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Atrioventricular Valve Malformation Mitral Dysplasia Tricuspid Dysplasia Cardiac Anomalies Causing Cyanosis Tetralogy of Fallot Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Pulmonary Hypertension With Shunt Reversal Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Other Cardiovascular Anomalies Vascular Ring Anomalies Cor Triatriatum Endocardial Fibroelastosis Other Vascular Anomalies Suggested Readings General References Ventricular Outflow Obstruction Cardiac Shunts Other Anomalies 6 Acquired Valvular and Endocardial Disease Degenerative Atrioventricular Valve Disease Etiology and Pathophysiology Complicating Factors Clinical Features Diagnosis Clinicopathologic Findings Radiography Electrocardiography Echocardiography Treatment and Prognosis Preclinical (Stage B) CVMD Stage B1 Stage B2 CHF Onset in CMVD (Stage C) Mild to Moderate Signs of CHF Moderate to Severe Signs of CHF Transition to Home Care Monitoring Heart Failure Therapy Common Complications End-Stage/Refractory (Stage D) Heart Failure Pulmonary Hypertension Arrhythmias Ruptured Chordae Tendineae LA Rupture Chronic Airway Disease Abnormal Blood Pressure Renal Dysfunction Prognosis Infective Endocarditis Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Prognosis Antibiotic Prophylaxis Suggested Readings Degenerative AV Valve Disease Infective Endocarditis 7 Myocardial Diseases of the Dog Dilated Cardiomyopathy Etiology and Pathophysiology Clinical Findings Radiography Diagnosis Electrocardiography Echocardiography Clinicopathologic Findings Stage B (Occult) Dilated Cardiomyopathy Treatment Stage C (Clinically Evident) Dilated Cardiomyopathy Acute therapy Long-term therapy Monitoring Prognosis Arrhythmogenic Right Ventricular Cardiomyopathy Clinical Findings Diagnosis Treatment Prognosis Arrhythmogenic Right Ventricular Cardiomyopathy in Dogs of Other Breeds Secondary Myocardial Disease Myocardial Toxins Doxorubicin Other toxins Metabolic and Nutritional Deficiency l-carnitine Taurine Other factors Ischemic Myocardial Disease Tachycardia-Induced Cardiomyopathy Hypertrophic Cardiomyopathy Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Myocarditis Infective Myocarditis Etiology and Pathophysiology Viral myocarditis Other causes Noninfective Myocarditis Clinical Findings and Diagnosis Treatment Sepsis-Induced Myocardial Dysfunction Traumatic Myocarditis Suggested Readings Primary Myocardial Disease Myocarditis and Secondary Cardiomyopathies 8 Myocardial Diseases of the Cat Hypertrophic Cardiomyopathy Etiology Pathophysiology Clinical Features Radiography Diagnosis Electrocardiography Echocardiography Clinicopathologic Findings Subclinical Hypertrophic Cardiomyopathy (Stage B Disease) Treatment Congestive Heart Failure (Stage C Disease) Chronic Refractory Congestive Heart Failure Prognosis Secondary Myocardial Hypertrophy Restrictive Cardiomyopathy Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Dilated Cardiomyopathy Etiology Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Other Myocardial Diseases Arrhythmogenic Right Ventricular Cardiomyopathy Unclassified Cardiomyopathy Corticosteroid-Associated Heart Failure Myocarditis Suggested Readings 9 Pericardial Disease and Cardiac Tumors Congenital Pericardial Disorders Peritoneopericardial Diaphragmatic Hernia Clinical Features Diagnosis Treatment Other Pericardial Anomalies Pericardial Effusion Etiology and Types of Fluid Hemorrhage Transudates Exudates Pathophysiology Cardiac Tamponade Clinical Features Diagnosis Clinicopathologic findings Radiography Echocardiography Electrocardiography Central venous pressure Pericardial fluid evaluation Treatment and Prognosis Idiopathic Pericardial Effusion Neoplastic Pericardial Effusion Infectious Pericarditis Intrapericardial Hemorrhage Pericardiocentesis Verifying Catheter Location Complications of Pericardiocentesis Constrictive Pericardial Disease Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Cardiac Tumors Etiology and Pathophysiology Clinical Features Diagnosis Treatment and Prognosis Suggested Readings 10 Pulmonary Hypertension and Heartworm Disease Pulmonary Hypertension Etiology and Pathophysiology Clinical Findings Diagnosis Radiography Electrocardiography Echocardiography Advanced Imaging Clinicopathologic Findings Diagnosis of Underlying Disease Treatment and Prognosis Heartworm Disease Heartworm Life Cycle Heartworm Disease in Dogs Pathophysiology Heartworm Disease Testing Serologic (Antigen) Tests Clinical Features Diagnosis Radiography Electrocardiography Echocardiography Clinicopathologic Findings Treatment of Dogs With Heartworm Disease Preadulticide Evaluation and Treatment Adulticide Therapy in Dogs Postadulticide Pulmonary Thromboembolic Complications Treatment of Dogs With Complicated Heartworm Disease Pulmonary Complications Right-Sided Congestive Heart Failure Caval Syndrome Heartworm Prevention Heartworm Disease in Cats Pathophysiology Clinical Features Diagnosis Tests for Heartworm Disease in Cats Serologic tests Radiography Echocardiography Electrocardiography Other Tests Treatment of Cats With Heartworm Disease Medical Therapy and Complications Surgical Therapy Microfilaricide Therapy Heartworm Prevention Angiostrongylosis Suggested Readings Pulmonary Hypertension Heartworm Disease in the Dog Heartworm Disease in the Cat Canine Angiostrongylosis 11 Systemic Arterial Hypertension General Considerations Etiology Pathophysiology Clinical Features Diagnosis Blood Pressure Measurement Direct Blood Pressure Measurement Indirect Blood Pressure Measurement Cuff size and placement. Oscillometric method. Treatment and Prognosis Antihypertensive Drugs Hypertensive Emergency Suggested Readings 12 Thromboembolic Disease General Considerations Normal Hemostatic Mechanisms Pathophysiology Pulmonary Thromboembolism Systemic Arterial Thromboembolism in Cats Clinical Features Diagnosis Treatment and Prognosis Prophylaxis Against Arterial Thromboembolism in Cats Systemic Arterial Thrombosis in Dogs Clinical Features Diagnosis Treatment and Prognosis Prophylaxis Against Aortic Thrombosis Venous Thrombosis Suggested Readings Two Respiratory System Disorders 13 Clinical Manifestations of Nasal Disease General Considerations Nasal Discharge Classification and Etiology Diagnostic Approach Sneezing Etiology and Diagnostic Approach Reverse Sneezing Stertor Facial Deformity Suggested Readings 14 Diagnostic Tests for the Nasal Cavity and Paranasal Sinuses Nasal Imaging Radiography Computed Tomography and Magnetic Resonance Imaging Rhinoscopy Frontal Sinus Exploration Nasal Biopsy: Indications and Techniques Nasal Swab Nasal Flush Pinch Biopsy Turbinectomy Complications Nasal Cultures: Sample Collection and Interpretation Suggested Readings 15 Disorders of the Nasal Cavity Feline Upper Respiratory Infection Etiology Clinical Features Diagnosis Treatment Prevention in the Individual Pet Cat Prognosis Bacterial Rhinitis Diagnosis Treatment Prognosis Nasal Mycoses Cryptococcosis Aspergillosis Clinical Features Diagnosis Treatment Prognosis Nasal Parasites Nasal Mites Clinical Features and Diagnosis Treatment Prognosis Nasal Capillariasis Feline Nasopharyngeal Polyps Clinical Features Diagnosis Treatment Prognosis Canine Nasal Polyps Nasal Tumors Clinical Features Diagnosis Treatment Prognosis Allergic Rhinitis Etiology Clinical Features Diagnosis Treatment Prognosis Idiopathic Rhinitis Feline Chronic Rhinosinusitis Etiology Clinical Features and Diagnosis Treatment Idiopathic Canine Chronic (Lymphoplasmacytic) Rhinitis Etiology Clinical Features and Diagnosis Treatment Prognosis Suggested Readings 16 Clinical Manifestations of Laryngeal and Pharyngeal Disease Clinical Signs Larynx Pharynx Differential Diagnoses for Laryngeal Signs in Dogs and Cats Differential Diagnoses for Pharyngeal Signs in Dogs and Cats Suggested Readings 17 Diagnostic Tests for the Larynx and Pharynx Radiography Ultrasonography Fluoroscopy Computed Tomography and Magnetic Resonance Imaging Laryngoscopy and Pharyngoscopy Suggested Readings 18 Disorders of the Larynx and Pharynx Laryngeal Paralysis Etiology Clinical Features Diagnosis Treatment Prognosis Brachycephalic Airway Syndrome Clinical Features Diagnosis Treatment Prognosis Obstructive Laryngitis Laryngeal Neoplasia Clinical Features Diagnosis Treatment Prognosis Suggested Readings 19 Clinical Manifestations of Lower Respiratory Tract Disorders Clinical Signs Cough Exercise Intolerance and Respiratory Distress Resting Respiratory Rate Mucous Membrane Color Breathing Pattern Diagnostic Approach to Dogs and Cats With Lower Respiratory Tract Disease Initial Diagnostic Evaluation Physical Examination Thoracic auscultation Radiography Complete Blood Count Pulmonary Specimens and Specific Disease Testing Suggested Readings 20 Diagnostic Tests for the Lower Respiratory Tract Thoracic Radiography General Principles Trachea Lungs Vascular Pattern Bronchial Pattern Alveolar Pattern Interstitial Pattern Lung Lobe Consolidation Atelectasis Cavitary Lesions Lung Lobe Torsion Ultrasonography Computed Tomography and Magnetic Resonance Imaging Nuclear Imaging Parasitology Serology Urine Antigen Tests Polymerase Chain Reaction Tests Tracheal Wash Indications and Complications Techniques Transtracheal Technique Endotracheal Technique Specimen Handling Interpretation of Results Nonbronchoscopic Bronchoalveolar Lavage Indications and Complications Technique for NB-BAL in Cats Technique for NB-BAL in Dogs Recovery of Patients After BAL Specimen Handling Interpretation of Results Diagnostic Yield Transthoracic Lung Aspiration and Biopsy Indications and Complications Techniques Bronchoscopy Indications Technique Thoracotomy or Thoracoscopy With Lung Biopsy Blood Gas Analysis Indications Techniques Interpretation of Results Pao2 and Paco2 A-a Gradient Oxygen Content, Delivery, and Utilization Acid-Base Status Pulse Oximetry Indications Method Interpretation Suggested Readings 21 Disorders of the Trachea and Bronchi General Considerations Canine Infectious Respiratory Disease Complex, Including Canine Influenza Etiology and Client Communication Challenges Clinical Features Diagnosis Treatment Prognosis Prevention Canine Chronic Bronchitis Etiology Clinical Features Diagnosis Treatment General Management Drug Therapies Management of Complications Prognosis Feline Bronchitis (Idiopathic) Etiology Clinical Features Diagnosis Treatment Emergency Stabilization Environment Glucocorticoids Bronchodilators Other Potential Treatments Failure to Respond Prognosis Tracheobronchomalacia (Collapsing Trachea) Etiology Clinical Features Diagnosis Treatment Prognosis Allergic Bronchitis Oslerus Osleri Etiology Clinical Features Diagnosis Treatment Prognosis Suggested Readings 22 Disorders of the Pulmonary Parenchyma and Vasculature Viral Pneumonias Bacterial Pneumonia Etiology Clinical Features Diagnosis Treatment Antibiotics Airway Hydration Physiotherapy Prognosis Toxoplasmosis Fungal Pneumonia Pulmonary Parasites Capillaria (Eucoleus) Aerophila Paragonimus Kellicotti Aelurostrongylus Abstrusus Crenosoma Vulpis Aspiration Pneumonia Etiology Clinical Features Diagnosis Treatment Prognosis Eosinophilic Lung Disease (Eosinophilic Bronchopneumopathy) Clinical Features Diagnosis Treatment Prognosis Idiopathic Interstitial Pneumonias Idiopathic Pulmonary Fibrosis Clinical Features Diagnosis Treatment Prognosis Pulmonary Neoplasia Clinical Features Diagnosis Treatment Prognosis Pulmonary Hypertension Etiology Clinical Features and Diagnosis Treatment Prognosis Pulmonary Thromboembolism (PTE) Clinical Features Diagnosis Treatment Prevention Prognosis Pulmonary Edema Etiology Clinical Features Diagnosis Treatment Prognosis Suggested Readings 23 Clinical Manifestations and Diagnostic Tests of Pleural Cavity and Mediastinal Disease Clinical Signs General Diagnostic Approach Diagnostic Approach for Pleural Effusions Based on Fluid Cytology Transudates and Modified Transudates Septic and Nonseptic Exudates Chylous Effusions Hemorrhagic Effusions Effusion Caused by Neoplasia Diagnostic Tests for the Pleural Cavity and Mediastinum Radiography Pleural Cavity Pleural Thickening Pleural Effusion Pneumothorax Mediastinum Ultrasonography Computed Tomography Thoracocentesis Thoracoscopy and Thoracotomy Chest Tubes: Indications and Placement Suggested Readings 24 Disorders of the Pleural Cavity and Mediastinum Pyothorax Etiology Clinical Features Diagnosis Treatment Prognosis Chylothorax Etiology Clinical Features Diagnosis Treatment Prognosis Neoplastic Effusion Pneumothorax Traumatic Pneumothorax Spontaneous Pneumothorax Mediastinal Masses Pneumomediastinum Suggested Readings 25 Emergency Management of Respiratory Distress General Considerations Emergency Management Based on Localization Large Airway Disease Extrathoracic (Upper) Airway Obstruction Intrathoracic Large Airway Obstruction Pulmonary Parenchymal Disease Pleural Space Disease Oxygen Supplementation and Ventilation Oxygen Supplementation Oxygen Masks Oxygen Hoods Nasal Catheters Transtracheal Catheters Endotracheal Tubes Tracheal Tubes Oxygen Cages Ventilatory Support Suggested Readings Three Digestive System Disorders 26 Clinical Manifestations of Gastrointestinal Disorders Dysphagia, Halitosis, and Drooling Distinguishing Regurgitation From Vomiting From Expectoration Regurgitation Vomiting Hematemesis Diarrhea Hematochezia Melena Tenesmus Constipation Fecal Incontinence Weight Loss Anorexia/Hyporexia Abdominal Effusion Acute Abdomen Abdominal Pain Abdominal Distention or Enlargement Suggested Readings 27 Diagnostic Tests for the Alimentary Tract Physical Examination Routine Laboratory Evaluation Complete Blood Count Coagulation Serum Biochemistry Profile Serum Cortisol Urinalysis Fecal Parasitic Evaluation Fecal Digestion Tests Bacterial Fecal Culture ELISA, IFA, and PCR Fecal Analyses Cytologic Evaluation of Feces Electron Microscopy Radiography of the Alimentary Tract Ultrasonography of the Alimentary Tract Techniques Findings Imaging of the Oral Cavity, Pharynx, and Esophagus Indications Techniques Findings Indications for Imaging of the Esophagus Techniques Findings Imaging of the Stomach and Small Intestine Indications for Radiographic Imaging of the Abdomen Without Contrast Media Techniques Findings Indications for Ultrasonography of the Stomach and Small Intestines Technique Findings Indications for Contrast- Enhanced Gastrograms Technique Findings Indications for Contrast- Enhanced Studies of the Small Intestine Technique Findings Indications for Barium Contrast Enemas Peritoneal Fluid Analysis Digestion and Absorption Tests Serum Concentrations of Vitamins Other Special Tests for Alimentary Tract Disease Endoscopy Capsule Endoscopy Biopsy Techniques and Submission Fine-Needle Aspiration Biopsy Endoscopic Biopsy Full-Thickness Biopsy Suggested Readings 28 General Therapeutic Principles Fluid Therapy Dietary Management Special Nutritional Supplementation Diets for Special Enteral Support Parenteral Nutrition Antiemetics Antacid Drugs Gastric and Cytoprotective Drugs Intestinal “Protectants” Digestive Enzyme Supplementation Motility Modifiers Antiinflammatory and Antisecretory Drugs Antibacterial Drugs Probiotics/Prebiotics Fecal Transplantation Anthelmintic Drugs Enemas, Laxatives, and Cathartics Suggested Readings References 29 Disorders of the Oral Cavity, Pharynx, and Esophagus Masses, Proliferations, and Inflammation of the Oropharynx Sialocele Etiology Clinical Features Diagnosis Treatment Prognosis Sialoadenitis/Sialoadenosis/Salivary Gland Necrosis Etiology Clinical Features Diagnosis Treatment Prognosis Neoplasms of the Oral Cavity in Dogs Etiology Clinical Features Diagnosis Treatment and Prognosis Neoplasms of the Oral Cavity in Cats Etiology Clinical Features Diagnosis Treatment Prognosis Feline Eosinophilic Granuloma Etiology Clinical Features Diagnosis Treatment Prognosis Gingivitis/Periodontitis Etiology Clinical Features Diagnosis Treatment Prognosis Stomatitis Etiology Clinical Features Diagnosis Treatment Prognosis Feline Lymphocytic-Plasmacytic Gingivitis and Pharyngitis/Caudal Stomatitis Etiology Clinical Features Diagnosis Treatment Prognosis Dysphagias Masticatory Muscle Myositis/Atrophic Myositis Etiology Clinical Features Diagnosis Treatment Prognosis Cricopharyngeal Achalasia/Dysfunction Etiology Clinical Features Diagnosis Treatment Prognosis Pharyngeal Dysphagia Etiology Clinical Features Diagnosis Treatment Prognosis Esophageal Weakness/Megaesophagus Congenital Esophageal Weakness Etiology Clinical Features Diagnosis Treatment Prognosis Acquired Esophageal Weakness Etiology Clinical Features Diagnosis Treatment Prognosis Esophagitis Etiology Clinical Features Diagnosis Treatment Prognosis Hiatal Hernia Etiology Clinical Features Diagnosis Treatment Prognosis Dysautonomia Etiology Clinical Features Diagnosis Treatment Prognosis Esophageal Obstruction Vascular Ring Anomalies Etiology Clinical Features Diagnosis Treatment Prognosis Esophageal Foreign Objects Etiology Clinical Features Diagnosis Treatment Prognosis Esophageal Cicatrix (Benign Stricture) Etiology Clinical Features Diagnosis Treatment Prognosis Esophageal Neoplasms Etiology Clinical Features Diagnosis Treatment Prognosis Suggested Readings References 30 Disorders of the Stomach Gastritis Acute Gastritis Etiology Clinical Features Diagnosis Treatment Prognosis Hemorrhagic Gastroenteritis (Acute Hemorrhagic Diarrheal Syndrome—See Under “Disorders of the Intestinal Tract”) Etiology Clinical Features Diagnosis Treatment Prognosis Chronic Gastritis Etiology Clinical Features Diagnosis Treatment Prognosis Helicobacter-Associated Disease Etiology Clinical Features Diagnosis Treatment Prognosis Physaloptera Rara Etiology Clinical Features Diagnosis Treatment Prognosis Ollulanus Tricuspis Etiology Clinical Features Diagnosis Treatment and Prognosis Gastric Outflow Obstruction/Gastric Stasis Benign Muscular Pyloric Hypertrophy (Pyloric Stenosis) Etiology Clinical Features Diagnosis Treatment Prognosis Gastric Antral Mucosal Hypertrophy Etiology Clinical Features Diagnosis Treatment Prognosis Gastric Foreign Objects Etiology Clinical Features Diagnosis Treatment Prognosis Iatrogenic Gastric Outflow Obstruction Gastric Dilation/Volvulus Etiology Clinical Features Diagnosis Treatment Prognosis Partial or Intermittent Chronic Gastric Volvulus Etiology Clinical Features Diagnosis Treatment Prognosis Idiopathic Gastric Hypomotility Etiology Clinical Features Diagnosis Treatment Prognosis Bilious Vomiting Syndrome Etiology Clinical Features Diagnosis Treatment Prognosis Gastrointestinal Ulceration/Erosion Etiology Clinical Features Diagnosis Treatment Prognosis Infiltrative Gastric Diseases Neoplasms Etiology Clinical Features Diagnosis Treatment Prognosis Pythiosis Etiology Clinical Features Diagnosis Treatment Prognosis Suggested Readings 31 Disorders of the Intestinal Tract Acute Diarrhea Acute Enteritis Etiology Clinical Features Diagnosis Treatment Prognosis Enterotoxemia Etiology Clinical Features Diagnosis Treatment Prognosis Dietary-Induced Acute Diarrhea Etiology Clinical Features Diagnosis Treatment Prognosis Infectious Diarrhea Canine Parvoviral Enteritis Etiology Clinical Features Diagnosis Treatment Prognosis Feline Parvoviral Enteritis Etiology Clinical Features Diagnosis Treatment/Prevention Prognosis Canine Coronaviral Enteritis Etiology Clinical Features Diagnosis Treatment Prognosis Other Canine Enteric Viruses Feline Coronaviral Enteritis Feline Leukemia Virus–Panleukopenia-Like Syndrome Etiology Clinical Features Diagnosis Treatment Prognosis Feline Immunodeficiency Virus–Associated Diarrhea Etiology Clinical Features Diagnosis Treatment Prognosis Salmon Poisoning/Elokomin Fluke Fever Etiology Clinical Features Diagnosis Treatment Prognosis Bacterial Diseases: Common Themes Campylobacteriosis Etiology Clinical Features Diagnosis Treatment Public Health Concerns Prognosis Salmonellosis Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Clostridial Diseases, Including Acute Hemorrhagic Diarrheal Syndrome Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Acute Hemorrhagic Diarrheal Syndrome Etiology Clinical Features Diagnosis Treatment/Prognosis Miscellaneous Bacteria Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Histoplasmosis Etiology Clinical Features Diagnosis Treatment Prognosis Pythiosis Etiology Clinical Features Diagnosis Treatment Prognosis Protothecosis Etiology Clinical Features Diagnosis Treatment Prognosis Alimentary Tract Parasites Whipworms Etiology Clinical Features Diagnosis Treatment Prognosis Roundworms Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Hookworms Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Tapeworms Etiology Clinical Features Diagnosis Treatment Public Health Concerns Strongyloidiasis Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Coccidiosis Etiology Clinical Features Diagnosis Treatment Prognosis Cryptosporidia Etiology Clinical Features Diagnosis Treatment and Prognosis Giardiasis Etiology Clinical Features Diagnosis Treatment Prognosis Public Health Concerns Trichomoniasis Etiology Clinical Features Diagnosis Treatment and Prognosis Heterobilharzia Etiology Clinical Features Diagnosis Treatment and Prognosis Maldigestive Disease Exocrine Pancreatic Insufficiency Etiology Clinical Features Non–Protein-Losing Malabsorptive Diseases Dietary-Responsive Small Intestinal Diarrhea Etiology Clinical Features Diagnosis Treatment Prognosis Antibiotic-Responsive Small Intestinal Enteropathy Etiology Clinical Features Diagnosis Treatment Prognosis Relation of Small Intestinal Dietary-Responsive Diarrhea and Antibiotic-Responsive Enteropathy Small Intestinal “Inflammatory Bowel Disease” (Chronic Enteropathy) Clinical Features Diagnosis Treatment Prognosis Dietary-Responsive Large Intestinal Diarrhea Fiber-Responsive Large Bowel Diarrhea Clinical Features Diagnosis/Treatment Prognosis Clostridial Colitis Clinical Features Diagnosis/Treatment/Prognosis Large Intestinal Inflammatory Bowel Disease Clinical Features Diagnosis Treatment Prognosis Granulomatous/Histiocytic Ulcerative Colitis Etiology Clinical Features Diagnosis Treatment Prognosis Protein-Losing Enteropathy Causes of Protein-Losing Enteropathy Intestinal Lymphangiectasia Etiology Clinical Features Diagnosis Treatment Prognosis Protein-Losing Enteropathy in Soft-Coated Wheaten Terriers Etiology Clinical Features Diagnosis Treatment and Prognosis Immunoproliferative Enteropathy of Basenjis Etiology Clinical Features Diagnosis Treatment Prognosis Enteropathy in Chinese Shar-Peis Etiology Clinical Features Diagnosis Treatment Prognosis Enteropathy in Shiba Dogs Etiology Clinical Features Diagnosis Treatment Prognosis Idiopathic Granulomatous Enteritis and/or Colitis Intestinal Obstruction Simple Intestinal Obstruction Etiology Clinical Features Diagnosis Treatment Prognosis Incarcerated Intestinal Obstruction Etiology Clinical Features Diagnosis Treatment Prognosis Mesenteric Torsion/Volvulus Etiology Clinical Features Diagnosis Treatment Prognosis Linear Foreign Objects Etiology Clinical Features Diagnosis Treatment Prognosis Intussusception Etiology Clinical Features Diagnosis Treatment Prognosis Cecocolic Intussusception Etiology Clinical Features Diagnosis Treatment Miscellaneous Intestinal Diseases Short Bowel Syndrome Etiology Clinical Features Diagnosis Treatment Prognosis Neoplasms of the Small Intestine Alimentary Lymphoma Etiology Clinical Features Diagnosis Treatment Prognosis Intestinal Adenocarcinoma Intestinal Leiomyoma/Leiomyosarcoma/Stromal Tumor Neoplasms of the Large Intestine Adenocarcinoma Etiology Clinical Features Diagnosis Treatment Prognosis Rectal Polyps Etiology Clinical Features Diagnosis Treatment Prognosis Diseases of the Perineal Area and Anus Acute Proctitis Etiology Clinical Features Diagnosis Treatment Prognosis Rectal Prolapse Etiology Clinical Features Diagnosis Treatment Prognosis Perineal Hernia Etiology Clinical Features Diagnosis Treatment Prognosis Perianal Fistulae Etiology Clinical Features Diagnosis Treatment Prognosis Anal Sacculitis Etiology Clinical Features Diagnosis Treatment Prognosis Perianal Neoplasms Anal Sac (Apocrine Gland) Adenocarcinoma Etiology Clinical Features Diagnosis Treatment Prognosis Perianal Gland Tumors Etiology Clinical Features Diagnosis Treatment Prognosis Constipation Pelvic Canal Obstruction Caused by Malaligned Healing of Old Pelvic Fractures Etiology Diagnosis Treatment Prognosis Benign Rectal Stricture Etiology Clinical Features Diagnosis Treatment Prognosis Dietary Indiscretion Leading to Constipation Etiology Diagnosis Treatment Prognosis Idiopathic Megacolon Etiology Clinical Features Diagnosis Treatment Prognosis Suggested Readings 32 Disorders of the Peritoneum Inflammatory Diseases Septic Peritonitis Etiology Clinical Features Diagnosis Treatment Prognosis Hemoabdomen Abdominal Hemangiosarcoma Etiology Clinical Features Diagnosis Treatment Prognosis Miscellaneous Peritoneal Disorders Abdominal Carcinomatosis Etiology Clinical Features Diagnosis Treatment Prognosis Mesothelioma Etiology Clinical Features Diagnosis Treatment Prognosis Feline Infectious Peritonitis Suggested Readings References Four Hepatobiliary and Exocrine Pancreatic Disorders 33 Clinical Manifestations of Hepatobiliary and Pancreatic Disease General Considerations Gastrointestinal Signs Abdominal Pain Polyuria and Polydipsia Abdominal Effusion Pathogenesis of Transudates Pathogenesis of Exudates Hepatic Encephalopathy Pathogenesis Clinical Signs Change in Liver Size Jaundice, Bilirubinuria, and Change in Fecal Color Coagulopathies Protein-Calorie Malnutrition Pathogenesis Clinical Signs and Diagnosis Suggested Readings 34 Diagnostic Tests for the Hepatobiliary and Pancreatic System Diagnostic Approach Diagnostic Approach to Liver Disease Diagnostic Approach to Pancreatic Disease Diagnostic Tests Predominantly to Assess the Status of the Hepatobiliary System Serum Liver Enzyme Activities Diagnostic Tests to Assess Hepatobiliary System Function Serum Bilirubin Concentration Serum Bile Acid Concentration Urinary Bile Acid Concentration Plasma Ammonia Concentration Plasma Protein C Activity Nonspecific Tests of Liver Function Serum Albumin Concentration Serum Urea Nitrogen Concentration Serum Cholesterol Concentration Serum Glucose Concentration Diagnostic Tests to Assess Pancreatic Inflammation and Function Specific Tests of Pancreatic Inflammation Tests of Pancreatic Exocrine Function Tests of Pancreatic Endocrine Function Nonspecific Tests Important for Prognosis and Supportive Care in Both Liver and Pancreas Disease Serum Biochemistry Complete Blood Count Coagulation Tests Abdominocentesis—Fluid Analysis—in Liver and Pancreas Disease Urinalysis Fecal Evaluation Diagnostic Imaging Survey Radiography Ultrasonography Computed Tomography Magnetic Resonance Imaging Scintigraphy Biopsy and Cytology Liver Cytology Liver Biopsy: Indications Liver Biopsy: Techniques Techniques Pancreatic Biopsies Suggested Readings 35 Hepatobiliary Diseases in the Cat General Considerations Hepatic Lipidosis Etiology and Pathogenesis Primary Hepatic Lipidosis Secondary Hepatic Lipidosis Clinical Features Treatment and Prognosis Biliary Tract Disease Cholangitis Neutrophilic Cholangitis Pathogenesis and Etiology Treatment and Prognosis Lymphocytic Cholangitis Pathogenesis and Etiology Treatment and Prognosis Sclerosing Cholangitis Liver Fluke Infestation Etiology and Pathogenesis Treatment Cholecystitis Extrahepatic Bile Duct Obstruction Pathogenesis and Etiology Clinical Features Diagnosis Treatment Ductal Plate Abnormalities Biliary Cysts Hepatic Amyloidosis Etiology Clinical Signs Diagnosis Treatment and Prognosis Feline Copper Storage Disease Neoplasia Etiology Clinical Features Diagnosis Treatment Prognosis Congenital Portosystemic Shunts Etiology and Pathogenesis Clinical Features Diagnosis Treatment Prognosis Hepatobiliary Infections Toxic Hepatopathy Pathogenesis and Etiology Diagnosis Treatment Hepatobiliary Manifestations of Systemic Disease Suggested Readings 36 Hepatobiliary Diseases in the Dog General Considerations Chronic Hepatitis Idiopathic Chronic Hepatitis Potential Etiology Lobular Dissecting Hepatitis Shared Pathogenesis of All Forms of Chronic Hepatitis Clinical Features of All Forms of Chronic Hepatitis Diagnosis Treatment Treatment of Underlying Cause Copper Storage Disease Pathogenesis and Etiology Clinical Features Diagnosis Treatment Acute Hepatitis Etiology and Pathogenesis Clinical Features Diagnosis Treatment and Prognosis Biliary Tract Disorders Cholangitis and Cholecystitis Gallbladder Mucocele Extrahepatic Bile Duct Obstruction Clinical Features Diagnosis Treatment and Prognosis Bile Peritonitis Congenital Vascular Disorders Disorders Associated With Low Portal Pressure: Congenital Portosystemic Shunt Etiology and Pathogenesis Clinical Features Diagnosis Overview of Treatment Options and Prognosis Management of Hepatic Encephalopathy Management of Acute Hepatic Encephalopathy Disorders Associated With High Portal Pressure Primary Hypoplasia of the Portal Vein, Microvascular Dysplasia, and Noncirrhotic Portal Hypertension Etiology and Pathogenesis Congenital Ductal Plate Abnormalities Etiology Arterioportal Fistula Focal Hepatic Lesions Abscesses Etiology Clinical Features Diagnosis Treatment and Prognosis Nodular Hyperplasia Neoplasia Etiology Clinical Features Treatment and Prognosis Hepatocutaneous Syndrome and Superficial Necrolytic Dermatitis Etiology and Pathogenesis Clinical Findings Diagnosis Treatment and Prognosis Secondary Hepatopathies Hepatocyte Vacuolation Hepatic Congestion and Edema Nonspecific Reactive Hepatitis Diagnosis Suggested Readings 37 The Exocrine Pancreas General Considerations Pancreatitis Acute Pancreatitis Etiology and Pathogenesis Clinical Features Diagnosis Routine clinical pathology Prognostic indicators Fluid analysis Treatment and Prognosis Intravenous fluids and electrolytes Nutrition Antiemetics Gastroprotectants Chronic Pancreatitis Etiology and Pathogenesis Idiopathic chronic pancreatitis Clinical Features Diagnosis Noninvasive diagnosis Biopsy Treatment and Prognosis Exocrine Pancreatic Insufficiency Pathogenesis Clinical Features Diagnosis Routine Clinical Pathology Pancreatic Enzymes Other Diagnostic Tests Treatment Drugs Diet Prognosis Exocrine Pancreatic Neoplasia Pancreatic Abscesses, Cysts, and Pseudocysts Suggested Readings Five Urinary Tract Disorders 38 Clinical Manifestations of Urinary Disorders Clinical Approach History Physical Examination Presenting Problems Hematuria Idiopathic Renal Hematuria Dysuria Polyuria and Polydipsia Psychogenic Polydipsia Renomegaly Perinephric Pseudocysts Suggested Readings 39 Diagnostic Tests for the Urinary System Glomerular Function Blood Urea Nitrogen Serum Creatinine Symmetric Dimethylarginine Cystatin C Fibroblast Growth Factor-23 N-Acetyl-β-D-Glucosaminidase and γ-Glutamyl Transferase Kidney Injury Molecule-1 Neutrophil Gelatinase-Associated Lipocalin Creatinine Clearance Single-Injection Methods for Estimation of Glomerular Filtration Rate Iohexol Clearance Radioisotopes Urine Protein-to-Creatinine Ratio Microalbuminuria Bladder Tumor Antigen Test Tubular Function Urine Specific Gravity and Osmolality Water Deprivation Test Gradual Water Deprivation Fractional Clearance of Electrolytes Urinalysis Physical Properties of Urine Appearance Specific Gravity Chemical Properties of Urine pH Protein Glucose Ketones Occult Blood Bilirubin Leukocyte Esterase Reaction Urinary Sediment Examination Red Blood Cells White Blood Cells Epithelial Cells Casts Organisms Crystals Miscellaneous Microbiology Diagnostic Imaging Radiography Ultrasonography Urodynamic Testing Urethral Pressure Profile Procedure Cystometrography Procedure Urethrocystoscopy Renal Biopsy Suggested Readings 40 Glomerular Disease Normal Structure Pathogenesis Mechanisms of Immune Injury Progression Histopathologic Lesions of Glomerulonephritis Amyloidosis Clinical Findings History and Physical Examination Findings Laboratory Findings Management of Patients With Glomerular Disease Complications Hypoalbuminemia Sodium Retention Thromboembolism Hyperlipidemia Hypertension Prognosis Suggested Readings 41 Acute Kidney Injury and Chronic Kidney Disease Acute Kidney Injury Pathophysiology Clinical Findings Clinicopathologic Findings Treatment Prognosis Chronic Kidney Disease Staging Pathophysiology Uremia as Intoxication Hyperfiltration Functional and Morphologic Changes in Remnant Renal Tissue External Solute Balance Development of Polyuria and Polydipsia Calcium and Phosphorus Balance Acid-Base Balance Anemia Hemostatic Defects Gastrointestinal Disturbances Cardiovascular Complications Metabolic Complications Clinical Findings Clinicopathologic Findings and Imaging Conservative Treatment General Principles Supportive Care Course and Prognosis Suggested Readings 42 Bacterial Cystitis, Pyelonephritis, and Prostatitis in the Dog and Cat Introduction Classification of Bacterial Cystitis Physical Examination Findings Diagnosis Treatment Treatment of Uncomplicated Urinary Tract Infections Recurrent and Complicated Bacterial Cystitis Subclinical Urinary Tract Infections Bacterial Prostatitis Suggested Readings 43 Canine and Feline Urolithiasis Introduction Principles of Stone Analysis Stone Removal Calcium Oxalate Calculi Etiology Ureterolithiasis in Dogs and Cats Clinical Signs of Ureterolithiasis Diagnostic Imaging Medical Treatment Surgical Intervention for Treatment of Ureteral Calculi Ureteral stents and subcutaneous ureteral bypass Prevention of Calcium Oxalate Urolithiasis Dietary modifications Drug therapy Struvite Stone Management For dogs For cats Urate Urolithiasis in Dogs Etiology Urate Urolithiasis Management Urate Urolithiasis in Cats Etiology Urate Urolithiasis Management Calcium Phosphate Calculi in Cats and Dogs Cystine and Silica Urolithiasis in Cats and Dogs Etiology and Management Dried Solidified Blood Calculi in Cats Xanthine Uroliths Conclusions Suggested Readings 44 Obstructive and Nonobstructive Feline Idiopathic Cystitis Introduction Pathophysiology Histopathology Bladder Abnormalities Infectious Agents Systemic Abnormalities Pathophysiology of the Blocked Cat Diagnostic Tests for Cats With Lower Urinary Tract Signs Treatment Options Acute Episodes Obstructive Feline Idiopathic Cystitis Nonobstructive Feline Idiopathic Cystitis Chronic Management Environmental Alterations Pheromones Drug Therapy Conclusions Suggested Readings 45 Disorders of Micturition Anatomy and Physiology Definitions and Types of Urinary Incontinence Ectopic Ureters Urethral Sphincter Mechanism Incompetence Urinary Incontinence Increased Urethral Closure Pressure Overactive Bladder Suggested Readings Six Endocrine Disorders 46 Disorders of the Hypothalamus and Pituitary Gland Polyuria and Polydipsia Diabetes Insipidus Etiology Central Diabetes Insipidus Nephrogenic Diabetes Insipidus Clinical Features Signalment Clinical Signs Physical Examination Diagnosis Response to Trial Therapy With Desmopressin Acetate Modified Water Deprivation Test Random Plasma Osmolality Additional Diagnostic Tests Treatment Prognosis Primary (Psychogenic) Polydipsia Endocrine Alopecia Feline Acromegaly Etiology Clinical Features Clinical Pathology Diagnosis Acromegaly Versus Hyperadrenocorticism Treatment Managing Insulin-Resistant Diabetes Prognosis Pituitary Dwarfism Etiology Clinical Features Signalment Clinical Signs Clinical Pathology Diagnosis Treatment Prognosis Suggested Readings Diabetes Insipidus Endocrine Alopecia Feline Acromegaly Pituitary Dwarfism 47 Disorders of the Parathyroid Gland Classification of Hyperparathyroidism Primary Hyperparathyroidism Etiology Signalment Clinical Signs Physical Examination Diagnosis Treatment Prognosis Primary Hypoparathyroidism Etiology Clinical Features Signalment Clinical Signs Physical Examination Diagnosis Treatment Prognosis Suggested Readings Primary Hyperparathyroidism Primary Hypoparathyroidism 48 Disorders of the Thyroid Gland Hypothyroidism in Dogs Etiology Clinical Features Dermatologic Signs Neuromuscular Signs Reproductive Signs Miscellaneous Clinical Signs Myxedema Coma Cretinism Autoimmune Polyendocrine Syndromes Clinical Pathology Dermatohistopathologic Findings Ultrasonographic Findings Tests of Thyroid Gland Function Overview Baseline Serum T4 Concentration Baseline Serum fT4 Concentration Baseline Serum TSH Concentration TSH and TRH Stimulation Tests Antibody Tests for Lymphocytic Thyroiditis Factors Affecting Thyroid Gland Function Tests Nonthyroidal Illness Syndrome (Euthyroid Sick Syndrome) Drugs Breed Variations Diagnosis Diagnosis in a Previously Treated Dog Diagnosis in Puppies Treatment Therapy With Sodium Levothyroxine (Synthetic T4) Response to Sodium Levothyroxine Therapy Therapeutic Monitoring Thyrotoxicosis Prognosis Hypothyroidism in Cats Etiology Clinical Signs Diagnosis Treatment Prognosis Hyperthyroidism in Cats Etiology Clinical Features Signalment Clinical Signs Physical Examination Clinical Pathology Common Concurrent Problems Thyrotoxic Cardiomyopathy Urinary Tract Infection Diagnosis Baseline Serum T4 Concentration Serum Free T4 Concentration Serum TSH Concentration T3 Suppression Test Thyroid Scintigraphy Cervical Ultrasound Treatment Initial Treatment Recommendation Oral Antithyroid Drugs Iodine-Restricted Diet Surgery Radioactive Iodine Prognosis Canine Thyroid Neoplasia Etiology Clinical Features Diagnosis Treatment Surgery External Beam Radiation Therapy Radioactive Iodine (131I) Chemotherapy Oral Antithyroid Drugs Prognosis Suggested Readings Canine and Feline Hypothyroidism Feline Hyperthyroidism Canine Thyroid Neoplasia 49 Disorders of the Endocrine Pancreas Hyperglycemia Etiology Clinical Features Hypoglycemia Etiology Clinical Features Diagnostic Approach Treatment Diabetes Mellitus in Dogs Etiology and Classification Clinical Features Signalment History Physical Examination Diagnosis Treatment Overview of Insulin Preparations Storage and Dilution of Insulin Initial Insulin Recommendations for Diabetic Dogs Diet Exercise Identification and Control of Concurrent Problems Protocol for Identifying Initial Insulin Requirements Techniques for Monitoring Diabetic Control History and Physical Examination Single Blood Glucose Determination Serum Fructosamine Concentration Urine Glucose Monitoring Serial Blood Glucose Curves Home Blood Glucose Monitoring Interpreting the Serial Blood Glucose Curve Insulin Therapy During Surgery Complications of Insulin Therapy Hypoglycemia Chronic Complications of Diabetes Mellitus Cataracts Lens-Induced Uveitis Systemic Hypertension Prognosis Diabetes Mellitus in Cats Etiology, Classification, and Diabetic Remission Clinical Features Signalment and Risk Factors History Physical Examination Diagnosis Treatment Initial Insulin Recommendations for Diabetic Cats Diet Identification and Control of Concurrent Problems Oral Hypoglycemic Drugs Adjusting Insulin Treatment and Blood Glucose Monitoring Home Blood Glucose Monitoring and Diabetic Remission Role of Serum Fructosamine in Stressed Diabetic Cats Insulin Therapy During Surgery Complications of Insulin Therapy Stress Hyperglycemia Hypoglycemia and Diabetic Remission Chronic Complications of Diabetes Mellitus Diabetic Neuropathy Prognosis Diabetic Ketoacidosis Etiology Clinical Features Diagnosis Treatment of “Healthy” Dogs or Cats With Diabetic Ketosis or Diabetic Ketoacidosis Treatment of Sick Dogs or Cats With Diabetic Ketoacidosis Fluid Therapy Potassium Supplementation Magnesium Supplementation Insulin Therapy Hourly Intramuscular Insulin Technique Constant Low-Dose Intravenous Insulin Infusion Technique Concurrent Illness Prognosis Diabetic Hyperosmolar Hyperglycemic State Insulin-Secreting β-Cell Neoplasia Etiology Clinical Features Signalment Clinical Signs Physical Examination Peripheral Neuropathy Clinical Pathology Diagnosis Treatment Overview of Treatment Perioperative Management of Dogs Undergoing Surgery Postoperative Complications Medical Treatment for Chronic Hypoglycemia Frequent Feedings Prognosis Gastrin-Secreting Neoplasia Clinical Features Diagnosis Treatment Prognosis Suggested Readings Canine Diabetes Mellitus Feline Diabetes Mellitus Diabetic Ketoacidosis Insulin-Secreting Islet Cell Neoplasia Gastrinoma 50 Disorders of the Adrenal Gland Hyperadrenocorticism in Dogs Etiology Pituitary-Dependent Hyperadrenocorticism Adrenocortical Tumors Iatrogenic Hyperadrenocorticism Clinical Features Signalment Clinical Signs Pituitary Macrotumor Syndrome Medical Complications: Thromboembolism Initial Diagnostic Evaluation Clinical Pathology Diagnostic Imaging Tests of the Pituitary- Adrenocortical Axis Urine Corticoid/Creatinine Ratio Oral Dexamethasone Suppression Test High-Dose Dexamethasone Suppression Test Medical Treatment Trilostane Mitotane Induction Therapy Adverse Reactions to Mitotane Treatment Ketoconazole Adrenalectomy Pituitary Irradiation Hypophysectomy Prognosis Occult (Atypical) Hyperadrenocorticism in Dogs Hyperadrenocorticism in Cats Etiology Clinical Features Clinical Signs and Physical Examination Findings Clinical Pathology Diagnostic Imaging Tests of the Pituitary- Adrenocortical Axis Urine Cortisol/Creatinine Ratio Adrenocorticotropic Hormone Stimulation Test Diagnosis Treatment Prognosis Hypoadrenocorticism Etiology Clinical Features Signalment Clinical Signs and Physical Examination Findings Clinical Pathology Electrocardiography Diagnostic Imaging Diagnosis Treatment Therapy for Acute Addisonian Crisis Maintenance Therapy for Primary Adrenal Insufficiency Prognosis Atypical Hypoadrenocorticism Pheochromocytoma Etiology Clinical Features Diagnosis Treatment Prognosis Incidental Adrenal Mass Suggested Readings Hyperadrenocorticism in Dogs Atypical Cushing’s Syndrome in Dogs Hyperadrenocorticism in Cats Hypoadrenocorticism Pheochromocytoma Incidental Adrenal Mass Seven Metabolic and Electrolyte Disorders 51 Weight Loss and Obesity Polyphagia With Weight Loss Obesity Etiology Diagnosis Treatment Prevention Suggested Readings 52 Hyperlipidemia Hyperlipidemia Pathophysiology Classification Clinical Features Diagnosis Treatment Suggested Readings 53 Electrolyte Imbalances Hypernatremia Etiology Clinical Features Diagnosis Treatment Hyponatremia Etiology Clinical Features Diagnosis Treatment Hyperkalemia Etiology Clinical Features Diagnosis Treatment Hypokalemia Etiology Clinical Features Diagnosis Treatment Hypercalcemia Identification Etiology Clinical Features Diagnosis Treatment Hypocalcemia Etiology Clinical Features Diagnosis Treatment Hyperphosphatemia Etiology Clinical Features Treatment Hypophosphatemia Etiology Clinical Features Treatment Hypomagnesemia Etiology Clinical Features Diagnosis Treatment Hypermagnesemia Etiology Clinical Features Diagnosis Treatment Suggested Readings Eight Reproductive System Disorders 54 The Practice of Theriogenology The Prebreeding Consultation Estrous Cycle of the Bitch Canine Ovulation Timing: Evaluation of the Estrous Cycle to Identify the Optimal Time to Breed Serum Hormone Interpretation Estrogen Luteinizing Hormone Progesterone Clinical Protocol: Veterinary Breeding Management The Dog and Tom Semen Collection Semen Analysis Fresh, Fresh Chilled, and Frozen Artificial Inseminations (AI) Vaginal AI Intrauterine AI Estrous Cycle of the Queen Obstetrics Pregnancy Diagnosis Gestational Length and Fetal Age Determination Suggested Readings 55 Clinical Conditions of the Bitch and Queen Normal Variations of the Estrous Cycle Later Than Typical Puberty Silent Heat Cycles Split Heat Cycles Abnormalities of the Canine Estrous Cycle Prolonged Proestrus/Estrus Prolonged Interestrous Intervals Prolonged Anestrus Prolonged Diestrus Shortened Interestrous Intervals Exaggerated Pseudocyesis (Pseudopregnancy) Vaginal Hyperplasia Manipulation of the Estrous Cycle Prevention of Estrous Cycles Estrus Induction Pregnancy Termination Estrogens Antiestrogens Prostaglandins Dexamethasone Dopaminergic Compounds Antiprogestational Agents Prepartum Disorders Drug Therapy During Pregnancy Vaccination During Pregnancy Semen Peritonitis Pregnancy Loss Idiopathic Preterm Labor Pregnancy Loss Associated With Infectious Disease Canine Brucellosis Abortion Associated With Other Bacteria Protozoal Disease Toxoplasmosis/Neosporosis/Cryptosporidiosis Canine Viral-Associated Pregnancy Loss Herpes Virus Minute Virus Feline Viral-Associated Pregnancy Loss Leukemia Virus (FeLV), Panleukopenia Virus (FPV), Herpes Virus (FHV), Infectious Peritonitis (FIP), and Feline Immunodeficiency Virus (FIV) Vector Borne Disease Metabolic Disorders Hyperemesis Gravidarum Gestational Diabetes Pregnancy Toxemia Vasculitides Pregnancy Thrombosis Pregnancy Edema Parturition and Parturient Disorders Eutocia Dystocia Tocodynamometry Medical Therapy Cesarean Section Postpartum Disorders Inappropriate Maternal Behavior Metabolic Disorders Eclampsia Uterine Disorders Uterine Trauma Subinvolution of Placental Sites Postpartum Endometritis Mammary Disorders Agalactia Galactostasis Mastitis Feline Mammary Fibroadenomatous Hyperplasia Disorders of the Reproductive Tract in Ovariohysterectomized Bitches and Queens Chronic Vestibulovaginitis in the Ovariohysterectomized or Ovariectomized Bitch Ovarian Remnant Syndrome/Hyperestrogenism Infertility/Subfertility in the Bitch and Queen Microbiology and Female Fertility Cystic Endometrial Hyperplasia/Pyometra Complex Suggested Readings 56 Clinical Conditions of the Dog and Tom Cryptorchidism Testicular Torsion Persistent Penile Frenulum Urethral Prolapse Scrotal Dermatitis Balanoposthitis Priapism, Paraphimosis, and Phimosis Testicular Neoplasia in Stud Dogs Microbiology and Male Fertility Infectious Orchitis and Epididymitis Brucellosis Other Infectious Agents Prostatic Disorders in the Valuable Stud Dog Benign Prostatic Hyperplasia and Cystic Benign Prostatic Hyperplasia Infectious Prostatitis Prostatic Neoplasia Acquired Infertility Immune-Mediated Orchitis Obstructive Disorders of Ejaculation Retrograde Ejaculation Defects of Spermatogenesis Congenital Infertility Heritable Teratospermia Disorders of Sexual Differentiation Suggested Readings 57 Neonatology and Pediatrics Neonatal Resuscitation Anomalies Apparent at the Neonatal Exam Fading Neonates Orphans’ Special Needs Pediatric Systemic Abnormalities Cardiovascular Disorders Respiratory Disorders Musculoskeletal Disorders Urogenital Disorders Gastrointestinal Disorders Neurologic Disorders Ophthalmologic Disorders Dermatologic Disorders Endocrinologic Pediatric Vaccination Suggested Readings Nine Nervous System and Neuromuscular Disorders 58 Lesion Localization and the Neurologic Examination Functional Anatomy of the Nervous System and Lesion Localization Brain Forebrain Pons and Medulla Cerebellum Spinal Cord Lower Motor Neuron Signs Upper Motor Neuron Signs Spinal Cord Sensory Pathways Localizing Spinal Cord Lesions Neuromuscular System Peripheral Nerves Neuromuscular Junction Muscle Neurologic Control of Micturition Screening Neurologic Examination Mental State Posture Schiff-Sherrington Posture Decerebrate Rigidity Decerebellate Rigidity Gait Paresis/Paralysis Ataxia Lameness Circling Postural Reactions Muscle Size/Tone Spinal Reflexes Patellar Reflex Pelvic Limb Withdrawal (Flexor) Reflex Sciatic Reflex Thoracic Limb Withdrawal (Flexor) Reflex Crossed Extensor Reflex Perineal Reflex and Bulbourethral Reflex Cutaneous Trunci Reflex (Panniculus) Sensory Evaluation Pain/Hyperpathia Urinary Tract Function Cranial Nerves Evaluation of Menace Response, Vision, and Pupils Examine for Strabismus, Nystagmus, and Head Tilt Evaluation of Trigeminal (CN5) Nerves Evaluation of the Facial (CN7) Nerves Evaluation of the Glossopharyngeal (CN9), Vagus (CN10), and Hypoglossal (CN12) Nerves Lesion Localization Diagnostic Approach Animal History Disease Onset and Progression Suggested Readings 59 Diagnostic Tests for Nervous System and Neuromuscular Disorders Neurologic Examination Search for Systemic Abnormalities Routine Laboratory Evaluation Immunology, Serology, and Microbiology Routine Systemic Diagnostic Imaging Radiographs Ultrasound Diagnostic Imaging of the Nervous System Spinal Radiographs Myelography Computed Tomography Magnetic Resonance Imaging Cerebrospinal Fluid Collection and Analysis Indications Contraindications Technique Cisternal Puncture Lumbar Puncture Analysis Electrodiagnostic Testing Electromyography Nerve Conduction Velocities Electroretinography Brainstem Auditory Evoked Response Electroencephalography Biopsy of Muscle and Nerve Muscle Biopsy Nerve Biopsy Suggested Readings 60 Intracranial Disorders General Considerations Abnormal Mentation Intoxications Metabolic Encephalopathies Hypermetria Diagnostic Approach to Animals With Intracranial Disease Intracranial Disorders Head Trauma Vascular Accidents Hypertensive Encephalopathy Feline Ischemic Encephalopathy Feline Hippocampal Necrosis Thiamine Deficiency Hydrocephalus Lissencephaly Cerebellar Hypoplasia Inflammatory Disease (Encephalitis) Inherited Degenerative Disorders Affecting the Brain Neuroaxonal Dystrophy Cerebellar Cortical Degeneration (Abiotrophy) Neoplasia Suggested Readings 61 Loss of Vision and Pupillary Abnormalities General Considerations Neuroophthalmologic Evaluation Vision Menace Response Pupillary Light Reflex Dazzle Reflex Pupil Size and Symmetry Disorders of Eyeball Position and Movement Lacrimal Gland Function Loss of Vision Lesions of the Retina, Optic Disk, and Optic Nerve Sudden Acquired Retinal Degeneration Optic Neuritis Papilledema Lesions of the Optic Chiasm Lesions Caudal to the Optic Chiasm Horner Syndrome Protrusion of the Third Eyelid Suggested Readings 62 Seizures and Other Paroxysmal Events Seizures Nonepileptic Paroxysmal Events Seizure Descriptions Seizure Classification and Localization Differential Diagnosis Idiopathic Epilepsy Intracranial Disease Scar Tissue–Related Acquired Epilepsy Extracranial Disease Diagnostic Evaluation Antiepileptic Drug Therapy Antiepileptic Drugs Phenobarbital Potassium Bromide Zonisamide Levetiracetam Gabapentin Felbamate Pregabalin Diazepam Alternative Therapies Emergency Therapy for Dogs and Cats in Status Epilepticus Paroxysmal Events That Are Not Seizures Paroxysmal Dyskinesias Exercise-Induced Collapse Disorders Sleep Disorders Suggested Readings 63 Head Tilt General Considerations Nystagmus Localization of Lesions Peripheral Vestibular Disease Central Vestibular Disease Paradoxical (Central) Vestibular Syndrome Disorders Causing Peripheral Vestibular Disease Otitis Media-Interna Geriatric Canine Vestibular Disease Feline Idiopathic Vestibular Syndrome Neoplasia Nasopharyngeal Polyps Trauma Congenital Vestibular Syndromes Aminoglycoside Ototoxicity Chemical Ototoxicity Hypothyroidism Disorders Causing Central Vestibular Disease Inflammatory Diseases Thiamine Deficiency Intracranial Neoplasia Cerebrovascular Disease Acute Vestibular Attacks Neurodegenerative Disorders Metronidazole Toxicity Suggested Readings 64 Encephalitis, Myelitis, and Meningitis General Considerations Neck Pain Noninfectious Inflammatory Disorders Steroid-Responsive Meningitis-Arteritis Canine Meningoencephalitis of Unknown Etiology Granulomatous Meningoencephalitis Necrotizing Meningoencephalitis Necrotizing Leukoencephalitis Canine Steroid-Responsive Tremor Syndrome Canine Eosinophilic Meningitis/Meningoencephalitis Feline Polioencephalitis Infectious Inflammatory Disorders Feline Immunodeficiency Virus Encephalopathy Bacterial Meningoencephalomyelitis Canine Distemper Virus Rabies Feline Infectious Peritonitis Toxoplasmosis Neosporosis Lyme Disease Mycotic Infections Rickettsial Diseases Parasitic Meningitis, Myelitis, and Encephalitis Suggested Readings 65 Disorders of the Spinal Cord General Considerations Localizing Spinal Cord Lesions C1-C5 Lesions C6-T2 Lesions T3-L3 Lesions L4-S3 Lesions Diagnostic Approach Peracute or Acute Spinal Cord Dysfunction Trauma Clinical Features Diagnosis Treatment Prognosis Hemorrhage/Infarction Acute Intervertebral Disk Extrusion Clinical Features Diagnostic Approach Treatment Recommendations Medical Management Traumatic Disk Extrusions Fibrocartilaginous Embolism Clinical Features Diagnosis Treatment Prognosis Atlantoaxial Instability Neoplasia Progressive Spinal Cord Dysfunction Subacute Progressive Disorders Infectious Inflammatory Disease Noninfectious Inflammatory Disease Diskospondylitis Clinical Features Treatment Chronic Progressive Disorders Neoplasia Clinical Features Treatment Spinal Articular Cysts Spinal Arachnoid Diverticula (Cysts) Type II Intervertebral Disk Protrusion Clinical Features Degenerative Myelopathy Etiology Diagnosis Cauda Equina Syndrome Clinical Features Cervical Spondylomyelopathy (Wobbler Syndrome) Clinical Features Treatment Progressive Disorders in Young Animals Breed-Associated Neuronal Abiotrophies and Degenerations Metabolic Storage Diseases Atlantoaxial Instability and Luxation Clinical Features Syringomyelia/Hydromyelia Congenital Nonprogressive Disorders in Young Animals Spina Bifida Caudal Agenesis of Manx Cats Spinal Dysraphism Suggested Readings 66 Disorders of Peripheral Nerves and the Neuromuscular Junction General Considerations Focal Neuropathies Traumatic Neuropathies Peripheral Nerve Sheath Tumors Clinical Features Diagnosis Treatment Facial Nerve Paralysis Clinical Features Diagnosis Treatment Trigeminal Nerve Paralysis Hyperchylomicronemia Ischemic Neuromyopathy Polyneuropathies Congenital/Inherited Polyneuropathies Acquired Chronic Polyneuropathies Diabetic Polyneuropathy Hypothyroid Polyneuropathy Insulinoma Polyneuropathy Paraneoplastic Polyneuropathy Chronic Inflammatory Demyelinating Polyneuropathy Chronic Idiopathic Polyneuropathy Acute Lower Motor Neuron Tetraparesis Acute Polyradiculoneuritis Clinical Features Diagnosis Disorders of the Neuromuscular Junction Tick Paralysis Clinical Features Diagnosis Treatment Botulism Clinical Features Diagnosis Treatment Myasthenia Gravis Clinical Features Diagnosis Treatment Prognosis Dysautonomia Clinical Features Diagnosis Treatment Suggested Readings 67 Disorders of Muscle General Considerations Inflammatory Myopathies Masticatory Myositis Clinical Features Diagnosis Treatment Extraocular Myositis Canine Idiopathic Polymyositis Clinical Features Diagnosis Treatment Prognosis Feline Idiopathic Polymyositis Dermatomyositis Infectious Inflammatory Myositis Acquired Metabolic Myopathies Glucocorticoid Excess Hypothyroidism Feline Hypokalemic Polymyopathy Noninflammatory Inherited Myopathies Muscular Dystrophy Centronuclear Myopathy of Labrador Retrievers X-Linked Myotubular Myopathies Inherited Myopathy of Great Danes Myotonia Inherited Metabolic Myopathies Involuntary Alterations in Muscle Tone and Movement Opisthotonos Tetanus Myoclonus Tremors Dyskinesias Disorders Causing Exercise Intolerance or Collapse Suggested Readings Ten Joint Disorders 68 Clinical Manifestations of and Diagnostic Tests for Joint Disorders General Considerations Clinical Manifestations Diagnostic Approach Diagnostic Tests Minimum Database Synovial Fluid Collection and Analysis Collection Method Analysis of Gross Appearance Analysis of Microscopic Appearance Synovial Fluid Culture Synovial Membrane Biopsy Radiography Immunologic and Serologic Tests Lyme Disease Titers Rickettsial Titers Systemic Lupus Erythematosus Rheumatoid Factor Suggested Readings 69 Disorders of the Joints General Considerations Noninflammatory Joint Disease Canine Degenerative Joint Disease Etiology Clinical Features Diagnosis Treatment Feline Osteoarthritis Infectious Inflammatory Joint Diseases Septic (Bacterial) Arthritis Etiology Clinical Features Diagnosis Treatment Prognosis Mycoplasma Polyarthritis Rickettsial Polyarthritis Lyme Disease Etiology Clinical Features Diagnosis Treatment Prevention Leishmaniasis Fungal Arthritis Viral Arthritis Calicivirus Noninfectious Polyarthritis: Nonerosive Reactive Polyarthritis Idiopathic Immune-Mediated Nonerosive Polyarthritis Clinical Features Diagnosis Treatment Prognosis Systemic Lupus Erythematosus–Induced Polyarthritis Clinical Features Diagnosis Treatment Prognosis Breed-Specific Polyarthritis Syndromes Familial Chinese Shar-Pei Fever Lymphoplasmacytic Synovitis Noninfectious Polyarthritis: Erosive Canine Rheumatoid-Like Polyarthritis Etiology Clinical Features Diagnosis Treatment Erosive Polyarthritis of Greyhounds Feline Erosive Immune Mediated Polyarthritis Feline Periosteal Proliferative Polyarthritis Feline Rheumatoid-Like Arthritis Suggested Readings Eleven Immune-Mediated Disorders 70 Pathogenesis of Immune-Mediated Disorders General Considerations and Definition Immunopathologic Mechanisms Pathogenesis of Immune-Mediated Disorders Organ Systems Involved in Autoimmune Disorders Suggested Readings 71 Diagnostic Testing for Immune-Mediated Disease Clinical Diagnostic Approach Specific Diagnostic Tests Slide Agglutination Test Coombs Test (Direct Antiglobulin Test) Antiplatelet Antibodies Antinuclear Antibody Test Lupus Erythematosus Test Rheumatoid Factor C-Reactive Protein Immunofluorescence and Immunohistochemistry Autoimmune Panels Suggested Readings 72 Treatment of Primary Immune-Mediated Diseases Principles of Treatment of Immune-Mediated Diseases Overview of Immunosuppressive Therapy Glucocorticoids Azathioprine Chlorambucil Cyclosporine (Ciclosporin) Leflunomide Mycophenolate Mofetil Splenectomy Human Intravenous Immunoglobulin Pentoxifylline Vincristine Suggested Readings 73 Common Immune- Mediated Diseases Immune-Mediated Hemolytic Anemia Etiology Clinical Features Diagnosis Treatment Prevention of Hemolysis Blood Transfusion Prevention of Thromboembolism Supportive Care Prognosis Feline Immune-Mediated Hemolytic Anemia Pure Red Cell Aplasia Idiopathic Aplastic Anemia Immune-Mediated Thrombocytopenia Classification/Etiology Clinical Features Diagnosis Immunosuppression Treatment Supportive Care Prognosis Feline Immune-Mediated Thrombocytopenia Immune-Mediated Neutropenia Etiology Clinical Features Diagnosis and Treatment Polyarthritis Etiology Clinical Features Diagnosis Treatment Systemic Lupus Erythematosus Etiology Clinical Features Diagnosis Treatment Glomerulonephritis Etiology Clinical Features Diagnosis Treatment Acquired Myasthenia Gravis Perianal Fistula Etiology Clinical Features Treatment Immune-Mediated Myositis Masticatory Myositis Polymyositis Dermatomyositis Suggested Readings Twelve Oncology 74 Cytology General Considerations Fine-Needle Aspiration Impression Smears Staining of Cytologic Specimens Interpretation of Cytologic Specimens Normal Tissues Epithelial Tissues Mesenchymal Tissues Hematopoietic Tissues Hyperplastic Processes Inflammatory Processes Malignant Cells Carcinomas Sarcomas Round (Discrete) Cell Tumors Lymph Nodes Normal Lymph Node Reactive or Hyperplastic Lymphadenopathy Lymphadenitis Neoplasia Decision Making in Lymph Node Cytologic Evaluation Suggested Readings 75 Principles of Cancer Treatment General Considerations Patient-Related Factors Family-Related Factors Treatment-Related Factors Suggested Readings 76 Practical Chemotherapy Cell and Tumor Kinetics Basic Principles of Chemotherapy Indications and Contraindications of Chemotherapy Mechanism of Action of Anticancer Drugs Types of Anticancer Drugs Metronomic Chemotherapy Safe Handling of Anticancer Drugs Suggested Readings 77 Complications of Cancer Chemotherapy General Considerations Hematologic Toxicity Gastrointestinal Toxicity Hypersensitivity Reactions Dermatologic Toxicity Pancreatitis Cardiotoxicity Urotoxicity Hepatotoxicity Neurotoxicity Pulmonary Toxicity Acute Tumor Lysis Syndrome Suggested Readings 78 Approach to the Patient With a Mass Approach to the Cat or Dog With a Solitary Mass Approach to the Patient With Metastatic Lesions Approach to the Patient With a Mediastinal Mass Clinicopathologic Features and Diagnosis Treatment Suggested Readings 79 Lymphoma Etiology and Epidemiology Clinical Features Hematologic and serum biochemical features Imaging Diagnosis Treatment COP-Based Protocols Induction of remission Maintenance CHOP-Based Protocols Should You Use COP-Based or CHOP-Based Protocols? Intensification Reinduction of remission or rescue Management of dogs with indolent lymphomas Management of solitary and extranodal lymphomas Central nervous system lymphoma Ocular lymphoma Cutaneous lymphoma Alimentary lymphoma “Low-Budget” Lymphoma Protocols Suggested Readings 80 Leukemias Definitions and Classification Leukemias in Dogs Acute Leukemias Prevalence Clinical Features Hematologic Features Diagnosis Treatment Chronic Leukemias Prevalence Clinical Features Hematologic Features Diagnosis Treatment Leukemias in Cats Acute Leukemias Prevalence Clinical Features Hematologic Features Diagnosis and Treatment Chronic Leukemias Suggested Readings 81 Selected Neoplasms in Dogs and Cats Hemangiosarcoma in Dogs Clinical and Clinicopathologic Features Diagnosis Treatment and Prognosis Osteosarcoma Etiology and Epidemiology Clinical Features Diagnosis Treatment and Prognosis Mast Cell Tumors in Dogs and Cats Mast Cell Tumors in Dogs Etiology and Epidemiology Clinical and Pathologic Features Biologic Behavior Diagnosis Treatment and Prognosis Mast Cell Tumors in Cats Etiology and Epidemiology Clinical and Pathologic Features Diagnosis and Treatment Injection Site Sarcomas in Cats Suggested Readings Osteosarcoma Mast Cell Tumors Injection Site Sarcomas Thirteen Hematology 82 Anemia Definition Clinical and Clinicopathologic Evaluation Management of the Anemic Patient Regenerative Anemias Blood Loss Anemia Hemolytic Anemia Immune-mediated hemolytic anemia Nonregenerative Anemias Anemia of Chronic Disease Bone Marrow Disorders Bone marrow (or erythroid) aplasia-hypoplasia Myelophthisis, myelodysplastic syndromes, myelofibrosis, and osteosclerosis-osteopetrosis Anemia of Renal Disease Acute and Peracute Blood Loss or Hemolysis Iron Deficiency Anemia Transfusion Therapy Blood Groups Cross-Matching and Blood Typing Blood Administration Complications of Transfusion Therapy Suggested Readings 83 Clinical Pathology in Greyhounds and Other Sighthounds Hematology Erythrocytes Leukocytes Platelets Hemostasis Clinical Chemistry Creatinine/SDMA Liver Enzymes Serum Electrolytes and Acid-Base Balance Protein Thyroid Hormones Cardiac Troponins and Pro-B Natriuretic Peptide Renin, Angiotensin, Aldosterone Cobalamine, Folate, and Homocysteine Clinical Pathology in Greyhounds: the Author’s Experience Conclusions Suggested Readings 84 Erythrocytosis Definition and Classification Clinical and Clinicopathologic Findings Diagnosis and Treatment Suggested Readings 85 Leukopenia and Leukocytosis General Considerations Normal Leukocyte Morphology and Physiology Leukocyte Changes in Disease Neutropenia Neutrophilia Eosinopenia Eosinophilia Basophilia Monocytosis Lymphopenia Lymphocytosis Suggested Readings 86 Combined Cytopenias and Leukoerythroblastosis Definitions and Classification Clinicopathologic Features Bone Marrow Aplasia-Hypoplasia Myelophthisis Myelodysplastic Syndromes Myelofibrosis and Osteosclerosis Suggested Readings 87 Disorders of Hemostasis General Considerations Physiology of Hemostasis Clinical Manifestations of Spontaneous Bleeding Disorders Clinicopathologic Evaluation of the Bleeding Patient Management of the Bleeding Patient Primary Hemostatic Defects Thrombocytopenia Approach to the Patient With Thrombocytopenia Immune-Mediated Thrombocytopenia Platelet Dysfunction von Willebrand Disease Other Congenital Platelet Function Defects Secondary Hemostatic Defects Congenital Clotting Factor Deficiencies Vitamin K Deficiency Mixed (Combined) Hemostatic Defects Disseminated Intravascular Coagulation Pathogenesis Clinical Features Diagnosis Treatment Halting Intravascular Coagulation Maintaining Good Parenchymal Organ Perfusion Prognosis Thrombosis Suggested Readings 88 Lymphadenopathy and Splenomegaly Applied Anatomy and Histology Function Lymphadenopathy Etiology and Pathogenesis Clinical Features Splenomegaly Etiology and Pathogenesis Clinical Features Approach to Patients With Lymphadenopathy or Splenomegaly Clinicopathologic Features Imaging Additional Diagnostic Tests Management of Lymphadenopathy or Splenomegaly Suggested Readings 89 Hyperproteinemia Suggested Readings 90 Fever of Undetermined Origin Fever and Fever of Undetermined Origin Disorders Associated With Fever of Undetermined Origin Diagnostic Approach to the Patient With Fever of Undetermined Origin History and Physical Examination Clinicopathologic Evaluation Treatment Suggested Readings Fourteen Infectious Diseases 91 Laboratory Diagnosis of Infectious Diseases Demonstration of the Organism Fecal Examination Direct Smear Stained Smear Fecal Flotation Baermann Technique Preservation of Feces Cytology Bacterial Diseases Rickettsial Diseases Fungal Diseases Cutaneous Parasitic Diseases Systemic Protozoal Diseases Viral Diseases Tissue Techniques Culture Techniques Immunologic Techniques Molecular Diagnostics Animal Inoculation Electron Microscopy Antibody Detection Serum Body Fluids Antemortem Diagnosis of Infectious Diseases Suggested Readings 92 Practical Antimicrobial Chemotherapy Anaerobic Infections Bacteremia and Bacterial Endocarditis Central Nervous System Infections Gastrointestinal Tract and Hepatic Infections Musculoskeletal Infections Respiratory Tract Infections Skin and Soft Tissue Infections Urogenital Tract Infections Suggested Readings 93 Prevention of Infectious Diseases Biosecurity Procedures for Small Animal Hospitals General Biosecurity Guidelines Patient Evaluation Hospitalized Patients Basic Disinfection Protocols Biosecurity Procedures for Clients Vaccination Protocols Vaccine Types Vaccine Selection Vaccination Protocols for Cats Core Vaccines Feline panleukopenia virus, feline calicivirus, feline herpesvirus-1 Noncore Vaccines Bordetella bronchiseptica Feline immunodeficiency virus Vaccination Protocols for Dogs Core Vaccines Canine parvovirus, canine adenovirus, and canine distemper virus Rabies Noncore Vaccines Bordetella bronchiseptica Suggested Readings 94 Polysystemic Bacterial Diseases Canine Bartonellosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Feline Bartonellosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Feline Plague Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Leptospirosis Etiology and Epidemiology Clinical Findings Diagnosis Treatment Zoonotic Aspects and Prevention Mycoplasma and Ureaplasma Etiology and Epidemiology Clinical Findings Diagnosis Treatment Zoonotic Aspects and Prevention Suggested Readings Canine Bartonellosis Feline Bartonellosis Feline Plague Leptospirosis Mycoplasma and Ureaplasma 95 Polysystemic Rickettsial Diseases Canine Granulocytotropic Anaplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Feline Granulocytotropic Anaplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Canine Thrombocytotropic Anaplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Canine Monocytotropic Ehrlichiosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Feline Monocytotropic Ehrlichiosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Canine Granulocytotropic Ehrlichiosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Rocky Mountain Spotted Fever Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Other Rickettsial Infections Suggested Readings Canine Granulocytotropic Anaplasmosis Feline Granulocytotropic Anaplasmosis Canine Thrombocytotropic Anaplasmosis Canine Monocytotropic Ehrlichiosis Feline Monocytotropic Ehrlichiosis Canine Granulocytotropic Ehrlichiosis Rocky Mountain Spotted Fever 96 Polysystemic Viral Diseases Canine Distemper Virus Etiology and Epidemiology Clinical Features Diagnosis Treatment Prevention and Zoonotic Aspects Feline Coronavirus Etiology and Epidemiology Clinical Features Diagnosis Treatment Prevention and Zoonotic Aspects Feline Immunodeficiency Virus Etiology and Epidemiology Clinical Features Diagnosis Treatment Prevention and Zoonotic Aspects Feline Leukemia Virus Etiology and Epidemiology Clinical Features Diagnosis Treatment Prevention and Zoonotic Aspects Suggested Readings Canine Distemper Virus Feline Infectious Peritonitis Virus Feline Immunodeficiency Virus Feline Leukemia Virus 97 Polysystemic Mycotic Infections Blastomycosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Coccidioidomycosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Cryptococcosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Histoplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Suggested Readings Blastomycosis Coccidioidomycosis Cryptococcosis Histoplasmosis 98 Polysystemic Protozoal Infections Babesiosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Cytauxzoonosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Hepatozoonosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Leishmaniosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Neosporosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Feline Toxoplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Canine Toxoplasmosis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention American Trypanosomiasis Etiology and Epidemiology Clinical Features Diagnosis Treatment Zoonotic Aspects and Prevention Suggested Readings Babesiosis Cytauxzoonosis Hepatozoonosis Leishmaniasis Neosporosis Toxoplasmosis American Trypanosomiasis 99 Zoonoses Enteric Zoonoses Nematodes Cestodes Coccidians Flagellates, Amoeba, and Ciliates Bacteria Bite, Scratch, or Exudate Exposure Zoonoses Bacteria Fungi Viruses Respiratory Tract and Ocular Zoonoses Bacteria Viruses Genital and Urinary Tract Zoonoses Shared Vector Zoonoses Shared Environment Zoonoses Suggested Readings Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z