Textbook of Veterinary Internal Medicine Expert Consult

Stephen Ettinger, Pet DRx Corporation, California Animal Hospital Veterinary Specialty Group, Los Angeles, CA

Edward Feldman, Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA

Etienne Côté, Associate Professor, Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada

Section 1: The Real Basics of Veterinary Medicine 1. The Medical History 2. The Physical Examination of the Dog and Cat 3. Basic Genetics 4. Clinical Genomics 5. Evidence-Based Medicine 6. Biomedical Statistics: Selected Topics 7. Euthanasia

Section 2: Differential Diagnosis for Chief Complaints General 8. ADR 9. Distinguishing Behavioral Disorders from Medical Disorders 10. Dermatologic Manifestations of Systemic Disease 11. Ophthalmic Manifestations of Systemic Disease 12. Neurologic Manifestations of Systemic Disease 13. Intoxication Versus Acute, Nontoxicologic Illness: Differentiating the Two 14. Orthopedic Manifestations of Systemic Disease 15. Swollen Joints and Joint Pain 16. Weight Gain 17. Abdominal Enlargement 18. Peripheral Edema 19. Weight Loss as a Chief Complaint 20. Failure to Grow 21. Weakness 22. Restlessness 23. Anorexia 24. Polyphagia 25. Body Odors Cardiorespiratory 26. Coughing 27. Sneezing and Nasal Discharge 28. Tachypnea, Dyspnea, and Respiratory Distress 29. Epistaxis and Hemoptysis 30. Syncope Neurologic 31. Movement Disorders 32. Tremors 33. Ataxia, Paresis, Paralysis 34. Stupor and Coma 35. Seizures Gastrointestinal 36. Halitosis and Ptyalism 37. Gagging 38. Dysphagia 39. Vomiting and Regurgitation 40. Diarrhea 41. Melena and Hematochezia 42. Constipation, Tenesmus, Dyschezia, and Fecal Incontinence 43. Flatulence Urogenital 44. Vulvar and Preputial Discharge 45. Polyuria and Polydipsia 46. Pollakiuria, Stranguria, and Urinary Incontinence 47. Hematuria and Other Conditions Causing Discolored Urine

Section 3: Differential Diagnosis for Physical Examination Abnormalities 48. Fever 49. Hypothermia 50. Pallor 51. Hyperemia 52. Cyanosis 53. Jaundice 54. Petechiae and Ecchymoses 55. Abnormal Heart Sounds and Heart Murmurs 56. Pulse Alterations

Section 4: Differential Diagnosis for Clinicopathologic Abnormalities 57. Anemia, Erythrocytosis 58. Leukopenia, Leukocytosis 59. Thrombocytopenia, Thrombocytosis 60. Hypo-/Hyperproteinemia 61. Hypo-/Hyperglycemia 62. Blood Urea Nitrogen and Creatinine 63. Cholesterol, Triglycerides 64. Amylase, Lipase 65. Liver Enzymes 66. Creatine Kinase 67. Sodium, Chloride 68. Potassium, Magnesium 69. Calcium, Phosphorus 70. Lactate 71. Ammonia 72. Urinalysis 73. Urinary Electrolyte Concentrations 74. Fluid Analysis: Thoracic, Abdominal, Joint

Section 5: Techniques General 75. Venous and Arterial Puncture 76. Jugular Catheterization and Central Venous Pressure Measurement 77. Intraosseous Catheters 78. Constant Rate Infusions 79. Ear Vein Blood Glucose Monitoring 80. Buccal Mucosal Bleeding Time 81. Fecal Examination 82. Nasoesophageal, Esophagostomy, Gastrostomy, and Jejunal Tube Placement Techniques 83. Care of Endoscopic Equipment 84. Hyperbaric Medicine Skin 85. Otoscopy, Ear Flushing, and Myringotomy 86. Scrapings, Fine-Needle Aspirations, and Biopsies of Skin and Subcutaneous Tissues 87. Cytology of the Skin and Subcutaneous Tissues Abdomen 88. Abdominal Ultrasonography 89. Abdominal Ultrasound: Aspirations and Biopsies 90. Abdominocentesis and Diagnostic Peritoneal Lavage 91. Laparoscopy General Centesis and Biopsy 92. Bone Marrow Aspiration and Biopsy 93. Cytology of Internal Organs 94. Arthrocentesis and Arthroscopy 95. Lymph Node Aspiration and Biopsy 96. Rhinoscopy, Nasal Flush, and Biopsy Respiratory/Cardiovascular 97. Respiratory and Inhalant Therapy 98. Pulse Oximetry 99. Blood Pressure Measurement 100. Chest Tube Placement 101. Transtracheal Wash and Bronchoscopy 102. Thoracocentesis/Pericardiocentesis 103. Electrocardiography 104. Echocardiography Renal/Urinary/Prostatic 105. Urine Collection 106. Management of Urinary Catheters 107. Unblocking of the Urethra 108. Cystoscopy and Urethroscopy 109. Peritoneal Dialysis 110. Continuous Renal Replacement Therapy/Hemodialysis 111. Prostatic Diagnostic Techniques Gastrointestinal 112. Gastric Intubation and Lavage 113. Gastrointestinal Endoscopy 114. Enemas and Deobstipation Neurologic 115. Cerebrospinal Fluid Collection, Analysis, and Myelography 116. Muscle and Nerve Biopsy 117. Electromyography, Nerve Conduction Velocity Reproductive 118. Artificial Insemination in the Dog 119. Vaginoscopy and Vaginal Cytology

Section 6: Minimally-Invasive Interventional Therapies 120. Overview of Interventional Medicine 121. Respiratory Interventional Therapies 122. Cardiovascular Interventional Therapies 123. Gastrointestinal Interventional Therapies 124. Urologic Interventional Therapies 125. Neoplastic Interventional Therapies

Section 7: Critical Care 126. Pain Physiology, Identification and Management in the Acute Care Setting 127. Shock 128. Acid-Base, Oximetry, and Blood Gas Analysis 129. Crystalloid and Colloid Fluid Therapy 130. Blood Transfusions, Component Therapy, and Oxygen-Carrying Solutions 131. Oxygen Therapy 132. Sepsis and the Systemic Inflammatory Response Syndrome 133. The Endocrine Response to Critical Illness 134. Heatstroke 135. Hemorrhage 136. 136. Status Epilepticus 137. 137. Systemic Anaphylaxis 138. 138. Sedation and Anesthesia in Critical Care 139. 139. Initial Evaluation of Respiratory Emergencies 140. Cardiopulmonary Arrest and CPR 141. Cardiac Emergencies 142. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome 143. Acute Abdomen 144. Gastrointestinal Emergencies 145. Hepatic and Splenic Emergencies 146. Reproductive Emergencies 147. Global Approach to the Trauma Patient 148. Head Trauma 149. Thoracic Trauma 150. Urinary Tract Trauma

Section 8: Toxicology 151. Toxin Exposure Therapy/Decontamination 152. Chemical Toxicoses 153. Prescription and Over-the-Counter Drug Toxicoses 154. Recreational Drug Toxicoses 155. Plant Toxicoses 156. Venomous Bites and Stings (Zootoxicoses)

Section 9: Blood Pressure 157. Pathophysiology and Clinical Features of Systemic Hypertension 158. Treatment of Systemic Hypertension 159. Systemic Hypotension

Section 10: Therapeutic Considerations in Medicine and Disease 160. Principles of Drug Disposition and Pharmacokinetics 161. Antibacterial Drug Therapy 162. Antifungal and Antiviral Therapy 163. Antiparasitic Therapy 164. Anti-inflammatory Therapy 165. Immunosuppressive Therapy 166. Analgesic Therapy 167. Antioxidants, Nutraceuticals, Probiotics, and Nutritional Supplements 168. Compounding Drugs 169. Adverse Drug Reactions

Section 11: Dietary Considerations of Systemic Problems 170. Nutritional Assessment 171. Neonatal and Pediatric Nutrition 172. Nutrition for Healthy Adult Dogs 173. Nutritional Management of the Canine Performance Athlete 174. Nutrition for Healthy Adult Cats 175. Nutrition in Healthy Geriatric Cats and Dogs 176. Obesity 177. Cachexia and Sarcopenia 178. Nutritional Management of GI Disease 179. Nutritional Management of Exocrine Pancreatic Disease 180. Nutritional Management of Hepatobiliary Disease 181. Nutritional Management of Endocrine and Metabolic Diseases 182. Dietary and Medical Considerations in Hyperlipidemia 183. Nutritional Management of Heart Disease 184. Nutritional Management of Renal Disease 185. Nutritional Management of Lower Urinary Tract Disease 186. Nutritional Management of Dermatologic Disease 187. Nutritional-Related Skeletal Disorders 188. Nutritional Management of Cancer 189. Critical Care Nutrition 190. Nutritional Uses of Fiber 191. Adverse Reactions to Food: Allergies versus Intolerance 192. Unconventional Diets (homemade, vegetarian, and raw) 193. Pet Food Safety and Regulatory Aspects of Pet Foods 194. Immunology and Nutrition

Section 12: Hematologic and Immunologic Diseases 195. Immunologic and Hematologic Diseases: Intro and Drug Therapy 196. Coagulation Testing 197. Hyper- and Hypocoagulable States 198. Immune-Mediated Hemolytic Anemia and Other Regenerative Anemias 199. Nonregenerative Anemia 200. Primary Polycythemia and Erythrocytosis 201. Immune-Mediated Thrombocytopenia, von Willebrand Disease, and Other Platelet Disorders 202. Immune-Mediated and Other Nonneoplastic White Blood Cell Disorders 203. Immune-Mediated Polyarthritis and Other Nonneoplastic Joint Disorders 204. Immune-Mediated Dermatologic Disorders 205. Systemic Lupus Erythematosus 206. Nonneoplastic Diseases of the Spleen

Section 13: Infectious Diseases General 207. Laboratory Dx of Infectious Dz 208. Companion Animal Vaccinations 209. Antimicrobial Resistance, Surveillance, and Nosocomial Infections 210. Zoonoses Bacterial Diseases 211. Lyme Disease 212. Mycobacterial Infections, Actinomycosis, and Nocardiosis 213. Brucellosis 214. Tetanus and Botulism 215. Bartonella - canine 216. Bartonella - feline 217. Leptospirosis 218. Ehrlichiosis, Anaplasmosis, Rocky Mountain Spotted Fever, and Neorickettsia 219. Erythrocytic Parasites 220. Enteric Bacterial Diseases Protozoal Dzs 221. Protozoal Diseases Viral Dzs 222. Feline Immunodeficiency Virus Infection 223. Feline Leukemia Virus Infection 224. Coronavirus Infections, including Feline Infectious Peritonitis 225. Canine and Feline Parvovirus 226. Rabies 227. Canine Infectious Airway Disease 228. Canine Distemper and Other Canine Viral Infections 229. Feline Upper Respiratory Infections 230. Other Feline Viral Infections Fungal Dzs 231. Cryptococcosis 232. Coccidioidomycosis 233. Blastomycosis and Histoplasmosis 234. Aspergillosis - Canine 235. Aspergillosis - Feline 236. Miscellaneous Fungal Infections (Sporotrichosis, Pythiosis, Candidiasis, Lagenidiosis, Opportunistic Fungal Infections)

Section 14: Diseases of the Ears, Nose, and Throat 237. Diseases of the Ear 238. Diseases of the Nose, Sinuses, and Nasopharynx 239. Diseases of the Larynx

Section 15: Respiratory Disease 240. Clinical Evaluation of the Respiratory Tract 241. Diseases of the Trachea and Small Airways 242. Diseases of the Pulmonary Parenchyma 243. Pulmonary Hypertension and Pulmonary Thromboembolism 244. Diseases of the Pleural Space 245. Diseases of the Mediastinum, Chest Wall, and Diaphragm

Section 16: Cardiovascular Disease 246. Pathophysiology of Heart Failure 247. Congestive Heart Failure: Clinical Management 248. Cardiac Arrhythmias 249. Cardiac Pacing 250. Congenital Heart Disease 251. Adult-Onset Valvular Heart Disease 252. Myocardial Disease: Canine 253. Myocardial Disease: Feline 254. Pericardial Disease 255. Feline and Canine Heartworm Disease 256. Arterial Thromboembolic Disease 257. Venous and Lymphatic Diseases

Section 17: Neurologic Disease 258. Neurophysiology 259. Neurologic Exam and Neuroanatomic Diagnosis 260. Brain Diseases: Congenital, Vascular, Neoplastic, and Idiopathic Epilepsy 261. Brain Diseases: Inflammatory, Infectious, and Other Multifocal 262. Sleep Disorders 263. Cognitive Dysfunction in Aged Dogs 264. Cranial Neuropathies 265. Vestibular Disease 266. Spinal Cord Diseases: Congenital (Developmental), Inflammatory, and Degenerative Disorders 267. Spinal Cord Diseases: Traumatic, Vascular, and Neoplastic Disorders 268. Peripheral Neuropathies 269. Neuromuscular Junction Disorders 270. Unique Feline Neurologic Disorders

Section 18: Gastrointestinal Disease 271. Laboratory Evaluation of the Gastrointestinal Tract 272. Oral and Salivary Gland Disorders 273. Diseases of the Pharynx and Esophagus 274. Host-Microbial Interactions in Gastrointestinal Health 275. Diseases of the Stomach 276. Diseases of the Small Intestine 277. Diseases of the Large Intestine 278. Rectoanal Diseases 279. Peritonitis

Section 19: Hepatobiliary Disease 280. History, Clinical Signs, and Physical Findings in Hepatobiliary Disease 281. General Principles in the Treatment of Liver Disease 282. Canine Inflammatory/Infectious Hepatic Disease 283. Feline Inflammatory/Infectious Hepatic Disease 284. Hepatic Vascular Anomalies 285. Metabolic Liver Diseases 286. Toxic Liver Diseases 287. Neoplasms of the Liver 288. Diseases of the Gallbladder and Extrahepatic Biliary System

Section 20: Pancreatic Disease 289. Pancreatitis: Etiology and Pathophysiology 290. Canine Pancreatitis: Dx and Tx 291. Feline Pancreatitis: Dx and Tx 292. Exocrine Pancreatic Insufficiency 293. Exocrine Pancreatic Neoplasia

Section 21: Endocrine Disease 294. Feline Growth Hormone Disorders 295. Canine Growth Hormone Disorders 296. Diabetes Insipidus 297. Primary Hyperparathyroidism 298. Primary Hypoparathyroidism 299. Canine Hypothyroidism 300. Feline Hypothyrodism 301. Feline Hyperthyroidism 302. Canine Hyperthyroidism 303. Insulin-Secreting Tumors 304. Canine Diabetes Mellitus 305. Feline Diabetes Mellitus 306. Canine Hyperadrenocorticism 307. Feline Hyperadrenocorticism 308. Non-Cortisol-Secreting Adrenocortical Tumors and Incidentalomas 309. Hypoadrenocorticism 310. Gastrointestinal Endocrinology 311. Pheochromocytoma

Section 22: Reproductive Diseases 312. Reproductive Endocrinology and Breeding Husbandry of the Bitch 313. Effect of Age at the Time of Spay or Castration on Long-Term Health of Dogs and Cats 314. Clinical Feline Reproduction 315. Pregnancy, Parturition, and Periparturient Problems in Dogs and Cats 316. Pyometra and Cystic Endometrial Hyperplasia 317. Other Infectious Causes of Infertility and Subfertility in Dogs and Cats 318. Breeding Soundness Examination and Disorders of Reproduction in Male Dogs 319. Reproductive Disorders in the Neutered Male or Female Dog 320. Pediatric Care During the Post-Partum Period

Section 23: Renal Diseases 321. Clinical Approach and Laboratory Evaluation of Renal Disease 322. Acute Kidney Injury/Acute Uremia 323. Renal Transplantation 324. Chronic Kidney Disease 325. Glomerular Diseases 326. Renal Tubular Disorders 327. Pyelonephritis 328. Familial and Congenital Renal Diseases of Cats and Dogs

Section 24: Diseases of the Lower Urinary Tract 329. Ureteral Disorders 330. Lower Urinary Tract Infections 331. Lower Urinary Tract Urolithiasis - Dogs 332. Lower Urinary Tract Urolithiasis - Cats 333. Diseases of Abnormal Micturition 334. Feline Idiopathic Cystitis 335. Urethral Disorders 336. Congenital Lower Urinary Tract Diseases 337. Prostatic Diseases

Section 25: Cancer 338. The Hallmarks/Origin of Cancer 339. Principles and Practice of Chemotherapy 340. Principles and Practice of Radiation Oncology 341. Cancer Immunotherapy/Vaccinology 342. Molecular Targeted Therapy 343. Adverse Effects of Cancer Therapy 344. Hematopoietic Tumors 345. Tumors of the Skin 346. Soft-Tissue Sarcomas 347. Hemangiosarcoma 348. Bone and Joint Tumors 349. Mast Cell Disease 350. Canine and Feline Histiocytic Diseases 351. Urogenital and Mammary Gland Tumors 352. Paraneoplastic Syndromes

Section 26: Musculoskeletal Diseases 353. Skeletal Disorders 354. Muscular Disorders 355. Rehabilitation Therapy 356. Chronic Pain Management

Section 27: Comorbidities 357. Heart Disease and Kidney Disease 358. Diabetes Mellitus and Corticosteroid-Responsive Disease 359. Obesity and Exercise-Limiting Disorders 360. Concurrent Infection and Immune Suppression