Figure List xix
Preface xxv
Acknowledgments xxvii
Contributors xxix
About the Companion Website xxxi
Section One: Anatomy 3
Chapter 1: Anatomy 5
Anatomy 6
Overall 6
Musculature 8
Skeletal 8
Internal Organs 9
Circulatory System 11
Nervous System 13
Urogenital System 14
Eye 16
Ear 16
Section Two: Preventative Care 17
Chapter 2: Preventative Care and Vaccinations 19
Physical Examinations 21
Initial Examination 21
Physical Examination 23
Pediatric Physical Examination 26
Normal Parturition 29
Geriatric Physical Examination 30
Cardiac Examination 31
Pulmonary Examination 33
Abdominal Examination 34
Otoscopic Examination 34
Regional Lymph Node Examination 35
Neurological Examination 35
Orthopedic Examination 39
Vaccinations 40
Guidelines to Follow When Vaccinating an Animal 40
Canine Vaccination Protocol 41
Feline Vaccination Protocol 42
Canine Transmissible Diseases 43
Corona Virus, Distemper 43
Hepatitis, Infectious Tracheobronchitis 45
Leptospirosis, Lyme Disease 47
Parvovirus, Rabies 48
Feline Transmissible Diseases 50
Feline Calicivirus 50
Feline Infectious Peritonitis 51
Feline Panleukopenia Virus, Feline Immunodeficiency Virus 53
Feline Leukemia Virus, Feline Rhinotracheitis Virus 54
Bordetella bronchiseptica and Chlamydophila felis 56
Animal Care 57
Client Education: Home Dental Care 58
Grooming 59
Bathing 59
Nail Trimming 60
Anal Sac Expression 61
Ear Cleaning and Flushing 62
Chapter 3: Nutrition 63
General Nutrition 65
Patient Evaluation 65
Diet History 65
Body Condition Scoring System 67
Daily Caloric Requirement Worksheet for a Healthy Animal 68
General Life Stage Feeding Guidelines 70
Key Nutritional Factors (Calculated on a Dry Matter Basis) for Puppies and Kittens 72
Feeding Methods 72
Feeding Methods 72
Feeding the Reluctant Eater 72
Feeding the Overexcited Eater 73
Pet Food Evaluation 74
Pet Food Label Evaluation 74
Comparing Nutrient Levels on a Dry Matter Basis Worksheet 75
Estimating and Comparing Calorie Content Worksheet 76
Home-Prepared Diets 77
Nutraceuticals 77
Common Nutraceuticals 78
Disease Nutritional Requirements 79
Obesity Management 84
Weight Loss Plan Worksheet 85
Nutritional Support 86
Enteral Nutrition 86
Coax Feeding and Orogastric Tube 86
Nasoesophageal and Nasogastric Tube 87
Esophagostomy Tube 89
Gastrotomy Tube: Without Gastropexy 90
Gastrotomy Tube: With Gastropexy 91
Jejunostomy Tube 93
Feeding Tube Options 94
Enteral Nutrition Administration 94
Enteral Nutrition Administration 95
Parenteral Nutrition (PN) 96
Parenteral Nutrition 97
Parenteral Nutrition Administration 98
Worksheet: Calculation of Total Parenteral Nutrition (TPN) 99
Worksheet: Calculation of Peripheral or Partial Parenteral Nutrition (PPN) 100
Section Three: Diagnostic Skills 101
Chapter 4: Laboratory 103
Blood Chemistries 107
Blood Collection, Handling, Storage, and Transport Tips 107
Collection 107
Complications 107
Handling 107
Storage 108
Transport 108
Blood Collection Tubes 108
Blood Chemistries 109
Bone Marrow Evaluation 119
Bone Marrow Collection, Handling, Storage, and Transport Tips 119
Collection 119
Handling 119
Smear Techniques 119
Storage 120
Transport 120
Evaluation 120
Bone Marrow Evaluation 120
Cell Type Identifi cation 124
Interpretation 126
Cytology 126
Cytology Collection, Handling, Storage, and Transport Tips 126
Collection 126
Collection Techniques 126
FNB Needle and Syringe Selection 127
Handling 128
Smear Techniques 128
Storage 130
Transport 130
Cytology Evaluation 130
Cytologic Criteria of Malignancy 132
Specific Tumor Cells 136
Interpretation 141
Buffy Coat Evaluation 143
Effusion Cytology 145
Fecal Cytology 146
Fecal Cytology 147
Vaginal Cytology 149
Classifying Vaginal Cells 149
Staging the Estrus Cycle 151
Function Tests 153
Function Tests 153
Hematology 160
Complete Blood Count 160
Hemacytometer Use 164
Calculating a Differential 164
Blood Smear Evaluation 164
RBC Morphology and Alterations 165
RBC Alterations and Morphology 165
WBC Morphology and Alterations 172
WBC Morphology 173
WBC Alterations 174
WBC Left Shift 179
Platelet Morphology and Alterations 179
Platelet Alterations 179
Coagulation Tests 179
Coagulation Screening 180
Coagulation Tests 181
Blood Transfusions 184
Crossmatching 184
Blood Typing 185
Immunology and Serology Tests 186
Immunology and Serology Tests 186
Microbiology 188
Microbiology Collection, Handling, Storage, and Transport Tips 188
Collection 188
Collection Techniques 188
Handling 189
Storage 189
Specimen Storage 189
Transport 190
Most Commonly Used Culture Media 191
Culture Media Inoculation and Incubation 192
Culture Growth Evaluation 194
Staining Solutions and Procedures 195
Staining Problems 198
Bacteria Identifi cation 198
Fungi Identification 201
Parasitology 203
Fecal Collection, Handling, Storage, and Transport Tips 203
Collection 203
Handling 203
Storage 203
Transport 203
Fecal Evaluation 204
Endoparasite Examination Methods 204
Fecal Flotation Solutions 207
Endoparasites 208
Blood Parasite Examination Methods 218
Ectoparasite Examination Methods 219
Ectoparasites 220
Urinalysis 224
Urine Collection, Handling, Storage, and Transport Tips 224
Collection 224
Handling 224
Storage 224
Transport 225
Urine Examination/Urinalysis 225
Gross Examination 225
Chemistry Strip Examination 227
Sediment Examination 229
Sediment Examination 229
Urine Artifacts 242
Urine Artifacts 242
Chapter 5: Imaging 243
Radiology 245
Radiographic Equipment 246
Radiographic Exposure and Image Factors 247
Radiographic Technique Chart 248
Veterinary X-Ray Technique Chart 249
Evaluating Radiograph Technique 250
Exposure Evaluation 250
Density Evaluation 251
Scale of Contrast Evaluation 251
Radiographic Alterations 253
Radiographic Artifacts 255
Radiographic Positioning 255
Directional Terms 256
Positional Terms 256
Abdomen 257
Head Positioning 258
Nasal Cavities and Sinuses 258
Nasal Cavities and Sinuses (Continued) 259
Pharynx 259
Skull 260
Temporomandibular Joint 261
Tympanic Bullae 261
Zygomatic Arch 262
Spine Positioning 262
Cervical 264
Thoracic–Lumbar 266
Sacrum—Caudal 268
Shoulder and Forelimb Positioning 269
Scapula–Shoulder 269
Humerus 270
Elbow 271
Radius, Ulna, and Carpus 273
Metacarpus and Phalanges 274
Pelvis and Hind Limb Positioning 275
Pelvis 275
Femur, Stifles, Tibia, and Fibula 277
Tarsus and Metatarsals 279
Thorax 280
Radiographic Contrast Studies 281
Types of Contrast Media 282
Radiographic Contrast Studies 283
Fistulography 283
Abdominal Contrast Studies 283
Peritoneography 283
Gastrointestinal Tract Contrast Studies 284
Esophagography and Gastrography 284
Upper and Lower Gastrointestinal Study 286
Head Contrast Studies 288
Dacryocystorhinography and Sialography 288
Spinal and Joint Contrast Studies 289
Myelography and Epidurography 289
Discography and Arthrography 290
Urethra Contrast Studies 291
Urethrography 291
Vaginal Contrast Studies 293
Vaginography 293
Urinary Tract Contrast Studies 294
IVP 294
Cystography 295
Additional Imaging Techniques 297
Computed Tomography and
Echocardiography 297
Fluoroscopy 298
Magnetic Resonance Imaging (MRI) and Nuclear Medicine 298
Ultrasonography 299
Ultrasonography 299
Basic Scanning Technique 300
Sites for Ultrasound Scanning 300
Interventional Radiology 302
Chapter 6: General Medicine 303
Cardiopulmonary 307
Asthma and Brachycephalic Airway Syndrome 307
Bronchitis and Cardiomyopathy, Hypertrophic 309
Cardiomyopathy, Dilated 312
Cardiomyopathy, Restrictive and Congenital Heart Diseases 314
Endocardiosis and Heartworm Disease 316
Congestive Heart Failure 319
Hypertension 321
Myocarditis and Pleural Effusion 323
Pneumonia 325
Rhinitis and Sinusitis and Tracheal Collapse 326
Dermatology 328
Acne 328
Acral Lick Dermatitis, Atopy, and Flea Allergy Dermatitis (FAD) 330
Food Hypersensitivity and Otitis Externa 332
Pyoderma 334
Endocrinology and Reproduction 336
Abortion and Diabetes Insipidus 336
Diabetes Mellitus 338
Dystocia and Eclampsia 340
Hyperadrenocorticism and Hyperparathyroidism 341
Hyperthyroidism and Hypoadrenocorticism 344
Hypoparathyroidism and Hypothyroidism 346
Mastitis 348
Pregnancy and Pyometra 349
Gastroenterology 351
Anal Sac Disease and Cholangitis and Cholangiohepatitis 351
Constipation and Megacolon 353
Diarrhea 355
Exocrine Pancreatic Insufficiency (EPI) and Gastric Dilatation Volvulus (GDV) 357
Hepatic Disease and Failure 359
Hepatic Lipidosis and Infl ammatory Bowel Disease (IBD) 361
Megaesophagus 363
Pancreatitis and Peritonitis 365
Protein-Losing Enteropathy and Vomiting 367
Hematology 369
Anemia and Disseminated Intravascular Coagulation (DIC) 369
Thrombocytopenia and von Willebrand’s Disease 371
Infectious Diseases 373
Brucellosis and Erlichiosis 373
Rocky Mountain Spotted Fever and Salmon Poisoning 375
Tetanus and Toxoplasmosis 377
Musculoskeletal 379
Arthritis 379
Cruciate Disease and Hip Dysplasia 381
Osteochondrosis and Osteomyelitis 383
Panosteitis and Patella Luxation 385
Neurology 386
Encephalitis and Epilepsy 386
Intervertebral Disk Disease and Meningitis 389
Myasthenia Gravis and Myelopathy 391
Vestibular Disease and Wobbler Syndrome 393
Oncology 395
Neoplasia 395
Histiocytoma, Mammary Gland Neoplasia, and Mast Cell Tumor 397
Various Neoplasias 399
Ophthalmology 407
Anterior Uveitis and Cataracts 407
Conjunctivitis and Entropion 409
Cilia Disorders and Glaucoma 411
Keratitis and Keratoconjunctivitis Sicca (KCS) 413
Lens Luxation and Prolapsed Gland of the Third Eyelid 415
Urology 417
Cystic Calculi, Feline Lower Urinary Tract Disease (FLUTD), and Pyelonephritis 417
Renal Failure 420
Urinary Tract Obstruction and Urinary Tract Infection 423
Chapter 7: Emergency Medicine 425
Emergency Medicine 427
Medical Preparedness 427
Emergency Supplies 427
Telephone Assessment and Emergency Transportation Recommendations 430
Inducing Vomiting at Home 432
Triage 432
Primary Survey 433
Modifi ed Heimlich Maneuver 434
Hemostasis 435
Cardiopulmonary Resuscitation (CPR) 436
Secondary Survey 443
Shock 444
Types of Shock 445
Cardiovascular Emergencies 447
Environmental Emergencies 448
Gastrointestinal Emergencies 449
Hematologic Emergencies 450
Metabolic and Endocrine Emergencies 451
Neonate and Pediatric Emergencies 452
Neurological Emergencies 453
Ophthalmic Emergencies 454
Renal and Urinary Emergencies 455
Reproductive and Genital Emergencies 456
Respiratory Emergencies 457
Toxicologic Emergencies 458
Toxins 459
Trauma Emergencies 462
Section Four: Patient Care Skills 463
Chapter 8: Patient Care Skills 465
Patient Care 468
Monitoring Levels 468
Hospitalized Patient Care 469
Neonatal and Pediatric Care 471
Heat Administration 474
Cold Administration 475
Recumbent Patient Care 476
Medical Nursing 477
Patient Monitoring 477
Blood Pressure 477
Blood Pressure Procedure 478
Blood Pressure Evaluation 479
Central Venous Pressure 479
Passive Test 479
Active Test 479
Central Venous Pressure 480
Blood Gas Analysis 481
Blood Gas Analysis 481
Arterial Blood Gas Interpretation 482
Acid–Base Disturbances 483
Electrocardiogram 483
ECG Procedure 483
ECG Leads 485
ECG Interpretation 486
Normal Canine ECG 488
Heart Rate Calculation 489
Common Rhythm Abnormalities 490
Atrial Premature Contraction/Complex 492
S-T Elevation 492
Ventricular Premature Contraction/Complex 493
ECG Problems and Artifacts 494
Venipuncture 494
Venipuncture Vein Choice 495
Blood Sampling 495
Venous Blood Collection Techniques 496
Drug Administration 497
Injections 497
Intravenous Catheter Placement 498
Peripheral and Jugular 498
Arterial and Intraosseous 500
Monitoring and Maintenance 501
Chemotherapy 502
Chemotherapy Administration 502
Extravasation Injury 505
Chemotherapy Toxicity 506
Client Education: Monitoring Treatment Response 509
Insulin Therapy 510
Insulin Types 510
Insulin Handling 510
Insulin Dilution 510
Insulin Syringes 511
Blood Glucose Curve 511
Insulin Constant Rate Infusions (CRI) 511
Client Education: Insulin Administration 512
Client Education: Monitoring Insulin Response 513
Client Education: Monitoring for Hypoglycemia 514
Fluid Therapy 514
Hydration Assessment 515
Calculating Fluid Requirements 517
Routes of Fluid Administration 518
Commonly Used Fluids 519
Fluid Additives 521
Calculating Drip Rates 522
Monitoring Fluid Therapy 522
Blood Transfusions 524
Blood Types 524
Feline Blood Types 524
Blood Collection 525
Blood Products 527
Blood Administration 529
Blood Transfusion Reactions 530
Oxygen Therapy 531
Oxygen Administration 531
Routes of Oxygen Administration 532
Oxygen Hood and Nasal Catheter 532
Transtracheal and Tracheostomy 533
Chapter 9: Pain Management 535
Pain Management 537
Pain Management Myths 537
Types of Pain 537
Acute and Chronic Pain 537
Chronic Pain Evaluation 538
Pain Assessment 539
Expected Pain Associated with Illness, Injury, and Surgical and Hospital Procedures 539
Pain Scales 540
Instructions for Using the CSU Acute Pain Scale 542
Behaviors Suggesting Pain and Anxiety 545
Patient Follow-Up 548
Pain Management Drugs 548
Pain Management Drugs 549
Pain Management Techniques 555
Local Anesthesia 555
Constant Rate Infusions 555
Constant Rate Infusions Drugs 556
Constant Rate Infusion Calculations 558
Constant Rate Infusion Tips 559
Setting up an MLK Constant Rate Infusion 559
Nondrug Approach to Pain Management 560
Nondrug Approach 560
Patient Care to Decrease Pain and Anxiety 561
Chapter 10: Wound Care and Bandaging 563
Wound Treatment and Bandaging 565
Wound Healing Process 565
Classifi cation of Wounds 566
Factors Affecting the Healing Process 567
Wound Care 568
Client Education: Drain Care 570
Wound Cleaning Solutions 571
Topical Wound Medications 572
Wound Therapy 574
Wound Bandaging 575
General Bandaging Tips 577
Client Education: Bandage Care 578
Bandages 578
Head or Ear Bandage 578
Chest/Abdominal Bandage 579
Extremity Bandage 581
Robert Jones Bandage 587
Tail Bandage 589
Tie-Over Bandage 590
Splints and Casts 591
Distal Limb Splint 591
Casts 592
Slings 593
Ehmer Sling 593
90-90 Flexion 595
Velpeau Sling 596
Hobbles 597
Chapter 11: Medical Procedures 599
Bone Marrow Collection 601
Bone Marrow Collection 601
Gastrointestinal Procedures 603
Stomach Tube and Gastric Lavage 603
Gastrointestinal Tube Placement Verification 604
Abdominocentesis and Diagnostic Peritoneal Lavage 604
Enema, Warm Water, DSS 605
Ophthalmic Procedures 606
Schirmer’s Tear Test, Fluorescein Sodium Stain, and Tonometry 606
Respiratory Procedures 607
Thoracocentesis and Thoracostomy Tube Placement 607
Nebulization, Coupage, and Metered-Dose Inhalers 608
Urogenital Procedures 609
Urine Collection: Voided, Manual Expression, and Cystocentesis 609
Urine Collection 610
Urine Collection Devices 610
Urinary Catheterization 611
Urinary Catheter Maintenance 612
Section Five: Anesthesia and Anesthetic Procedures 613
Chapter 12: Anesthesia 615
Guidelines for Safe Anesthesia 617
Preanesthesia 619
Preanesthetic Evaluation 619
Preanesthetic Drugs 620
Steps to Choosing a Preanesthetic Combination 621
Anesthesia 621
Anesthetic Equipment 621
Anesthetic Machine 621
Anesthetic Machine Setup 623
Dead Space 624
Anesthetic Breathing Systems 625
Ventilation 626
Ventilator Machine Setup 628
Ventilation Administration 628
Intermittent Positive Pressure Ventilation 630
Anesthetic Administration 630
General Anesthesia Induction 630
Endotracheal Intubation 632
Anesthetic Induction Complications 634
Local and Regional Anesthesia 635
Commonly Used Local Anesthetics 635
Local Anesthetic Uses 636
Perioperative 642
Anesthetic Monitoring 642
Patient Care 642
Stages of Anesthesia 644
Anesthesia Monitoring 646
Capnograph Waveforms 654
Postanesthetic 655
Recovery 655
Stages of Anesthesia Recovery 656
Postanesthetic Monitoring 658
Case-Based Anesthesia 661
Anesthetic Drugs 669
Preanesthetic Drugs 669
Anticholinergics, General Information 669
Anticholinergic Drugs 669
Phenothiazines, General Information 670
Phenothiazine Drugs 670
Benzodiazepines, General Information 671
Benzodiazepines 671
Alpha-2 Agonists, General Information 672
Alpha-2 Agonist Drugs 673
Opioids, General Information 674
Opioid Drugs 675
Injectable Induction Anesthetics 677
Barbiturates, General Information 677
Barbiturate Drugs 678
Cyclohexamines, General Information 679
Cyclohexamine Drugs 680
Propofol, General Information 681
Propofol 681
Alfaxalone, General Information 682
Alfaxalone 682
Etomidate, General Information 683
Etomidate 683
Inhalant Anesthetics 684
Inhalant Anesthetics, General Information 684
Inhalant Anesthetic Agents: Isoflurane and Sevoflurane 685
Inhalant Anesthetics: Desflurane 686
Chapter 13: Dentistry 687
Dentistry 689
Anatomy 689
Dental Instruments and Equipment 692
Handheld Instruments 692
Instrument Maintenance 692
Sharpening Technique 693
Mechanical Instruments 693
Dental Prophylaxis 694
Dental Cleaning Procedure 694
Dental Charting 697
Common Dental Disorders 702
Anatomical Disorders 702
Pathological Disorders 703
Radiology 704
Equipment 704
Technique Chart 705
Radiographic Film 705
Radiographic Techniques 706
Radiographic Positioning 706
Extractions 711
Extraction Procedures 711
Local Dental Nerve Blocks 712
Root Canal Treatment 715
Mixing ZOE and Notes on Gutta-percha 716
Vital Pulpotomy 716
Chapter 14: Surgery 717
Instrument Packs 720
Packing Instrument Packs 721
Folding Gowns for Sterilization 721
Folding Drapes for Sterilization 724
Wrapping Packs for Sterilization 725
Patient Preoperative Protocol 728
Surgical Preparation 730
Surgical Procedures 731
Abdominal Surgery 731
Abdominal Hernia, Diaphragmatic Hernia, Hepatectomy 733
Splenectomy 734
Aural Surgery 734
Aural Hematoma, Lateral Ear Canal Resection 735
Gastrointestinal Surgery 736
Anal Sacculectomy, Enterotomy 736
Gastric Dilation Volvulus and Gastrotomy 737
Intestinal Resection and Anastomosis 738
Integument Surgery 738
Abscess and Laceration 739
Mass Removal and Onychectomy 740
Neurological Surgery 741
Disk Fenestration, Dorsal Laminectomy, and Hemilaminectomy 742
Ophthalmic Surgery 743
Cataracts, Ectropion, and Entropion 744
Conjunctival Flap and Enucleation 745
Glaucoma and Nictitating Membrane Flap Replacement 745
Prolapse of the Gland of the Third Eyelid and Traumatic Proptosis 746
Orthopedic Surgery 746
Cranial Cruciate Ligament (CCL) Rupture, Femoral Head Ostectomy (FHO), and Fracture Repair 747
Patellar Luxation, Total Hip Replacement, and Triple Pelvic Osteotomy (TPO) 748
Reproductive Tract Surgery 749
Cesarean Section, Orchiectomy, and Ovariohysterectomy 749
Neonatal Resuscitation Postcesarean 751
Postoperative Care of Neonates and the Dam 752
Thoracic Surgery 753
Sternotomy, Thoracotomy, Intercostal 754
Upper Respiratory Surgery 755
Stenotic Nares, Elongated Soft Palate, Everted Laryngeal Saccules 755
Laryngeal Paralysis/Tracheal Collapse 756
Urogenital Tract Surgery 756
Cystotomy and Urethostomy 757
Urethostomy 758
Suture Techniques 758
Suture Patterns 759
Knot Tying 760
Postoperative Care Protocol 760
Standard Postoperative Care Instructions 760
Preventing Self-Trauma 761
Alternative Surgical Options 761
Endoscopy 761
Flexible Gastrointestinal (GI) and Rigid 761
Laser Surgery 763
Radiation Therapy 764
Teletherapy, Brachytherapy and Systemic Therapy 764
Temperature Therapy 765
Hyperthermia and Cryosurgery 765
Section Six: Complementary and Alternative Veterinary Medicine and Pharmacology 767
Chapter 15: Complementary and Alternative Veterinary Medicine 769
Complementary and Alternative Veterinary Medicine 770
Physical Rehabilitation 770
Benefi ts of Physical Rehabilitation 771
Physical Rehabilitation 773
Electric Stimulation Therapy 775
Laser Therapy 775
Magnetic Field Therapy 776
Temperature Therapy 777
Therapeutic Ultrasound Therapy 778
Traditional Chinese Medicine (TCM) 778
Ayurveda and Chiropractic 780
Flower Essences and Homeopathy 781
Homotoxicology and Hyperbaric Oxygen Therapy 782
Prolotherapy and Western Herbal Medicine 783
Chapter 16: Pharmacology 785
Basic Calculations 786
Appendix 825
Metric Units 825
Weights 826
Liquid Measure 826
Length 827
Kilograms to Body Surface Area 827
Disinfectants 828
Temperature Conversion 831
Abbreviations 833
Glossary 839
Bibliography 855
Index 869
Color plate section is found between pages 612 and 613.