Small Animal Medical Differential Diagnosis: A Book of Lists, 2e

364 Pages·2013·3.53 MB·English

by  Mark Thompson DVM DABVP(Canine and Feline)

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.
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Notices
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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)