Veterinary

CLINICAL

DIAGNOSIS

Second Edition

W. R.KELLY

M.A., M.V.M. (N.U.I.), M.R.C.V.S.

Professor of Medicine, Pharmacology and Food Hygiene, Faculty of Veterinary Medicine, University College, Dublin

BAILLIERE TINDALL • LONDON

Contents

Preface vii

1. General Consideration of Clinical Problems and Methods 1

2. History (Anamnesis) 8

3. General Examination of the Patient 12

4. Temperature 21

5. Pulse 27

6. Respiration 32

7. The Skin, Coat and Associated Structures 39

8. The Head and Neck 81

9. The Thorax 113

10. The Abdomen and Associated Digestive Organs 147

11. The Urinary System 214

12. The Reproductive System 239

13. The Blood and Blood-forming Organs 261

14. The Nervous System 301

15. The Musculoskeletal System 330

16. Diagnostic Tests 350

Index363

Preface

When I wrote the first edition of this book my purpose was to provide a comprehensive and well illustrated statement of the principles of clinical diagnosis as applied to domestic and farm animals with emphasis on the importance of methodical investigation and the critical evaluation of the clinical information thus obtained. Though primarily written for the student starting on a course of clinical instruction, others, such as more advanced students and general practitioners, have found the book useful and acceptable to them. A further indication of its wide acceptance is the fact that it has been translated into French, German and Spanish. I am pleased to have been able to make this contribution to the harmonization of veterinary education within the E.E.C.

In preparing the new edition, not only was the text thoroughly revised and some new material included, but it was also found necessary to re-arrange some of the material in order to render the sequence more logical, and to take account of the changes that have taken place in the interval since the first edition was published, as witness, for example, the intensification of farm animal production, which necessitates a knowledge and understand­ing of the disease problems arising from such farming techniques. All the experience gained from this source substantiates the view that modern animal production enterprises require the services of highly specialized and skilful veterinarians.

With the passage of time, existing laboratory-based sophisticated technology is being increasingly modified for use under field conditions, to aid the investigation and diagnosis of animal disease. It has indeed been suggested that the clinician of the future may come to have as high regard for the computer as for his stethoscope. In addition an increasing num­ber of therapeutic agents, which in many instances possess a powerful but limited range of specificity, are now available to the veterinarian. Although rising costs are a constraint on both the over-application of laboratory procedures and excessive exuberance in prescribing therapeutic substances, both these aspects demand accuracy in diagnosis, which is best achieved by the application of clinical procedures in a careful and orderly manner. By these means all the circumstances of the individual animal or group will receive that measure of consideration necessary to the establishment of the diagnosis.

Newer concepts which must occupy the attention of the veterinarian arise in respect of the use of those chemotherapeutic agents or agricultural chemicals from which the problems of bacterial resistance and/or chemical residues in animal products arise.

Although the basic principles of veterinary clinical methodology and diagnosis do not change in any significant degree, the rapid expansion in knowledge of disease situations, and the increasing use of aids to diagnosis render it necessary to keep written texts in harmony with recent developments. This, in itself was an important motivating force in the prepara­tion of a new edition of the book. Many other influences, however, were also at work, and acted as a stimulus providing encouragement throughout the long period given to the re­vision of the manuscript.

My sincere thanks are due, therefore, to a great many persons, all of whom assisted in a variety of ways. In the preface to the first edition I acknowledged the assistance of many kind friends in North America and elsewhere with regard to the provision of illustrative material and the preparation of the text. I hereby further record my indebtedness to them all, more particularly to those who supplied helpful and constructive comment relating to the substance and format of the first edition. In this context, almost all the critiques which appeared in scientific journals were also found to be helpful. I thank those persons who prepared them.

Almost all the illustrations in the previous edition have been retained. To all those con­cerned in supplying them I record my continuing appreciation. For new illustrative material I am indebted to the American Optical Company for the photographs for Figs 166 and 199.

For the remainder of the new illustrations I am obliged to my colleagues Mr B. A. McErlean, Mr J. D. Collins, Mr T. Twomey, Mr T. D. Grimes, Mr T. O'Nuallain, Mr K. Dodd and Mr J. P. O'Connor. Mr J. K. Kealy supplied the radiographs from which Figs 113, 124, 177, 204, 234 and 235 were prepared, and Dr L. N. Gleeson provided the instru­ments illustrated in Fig. 116. All the photographic work involved was undertaken by Mr С J. King.

My wife has continued to give devoted assistance during the preparation and typing of the manuscript. Mr B. A. McErlean provided assistance of inestimable value by reading the finished proofs. To everyone concerned, including all the unnamed persons I consulted, who also contributed to the production of this book, I extend my sincere thanks.

In conclusion, it gives me great pleasure to record my appreciation of the forbearance shown, and kindly assistance provided by Mr R. F. West, and to express my thanks to all the other persons on the staff of Bailliere Tindall who were concerned with the preparation of the book.

Dublin, November 1973

W. R. Kelly