VET..CLINCAL EXAMINATION AND DIAGNOSIS

INTRODUCTION

SIGNS OF DISEASE(SYMTOMS)

Any evidence that indicate the presence of disease.

Types:

1-subjective signs: they are the sings which can not be observed by the

clinician but can be expressed by the patient

e.g;colic&back pain

2-objective signs: they are the signs which observed by any person.

e.g:diarrhea& nasal discharge

3-clinical signs: they are the signs which are discovered by the clinician

through various methods of examination

e.g:abnormal respiratory sounds&abnormal heart sounds

CLINICAL EXAMINATION OF INDIVIDUAL ANIMAL

The clinical examination of the animal1-case history2- Examination of the animal 3-examination of the patient

1-Case historyIt is the information that can be obtained&collected from the owner

(1)history takingA-Manner of history taking*The owner must be handled with diplomacy or intelligence.*Avoid using of technical terms during dealing with the owner *Avoid asking the unrequired question to obtain accurate information.*Do not depend on the owner observation completely.B-patient identification

1-owner date: include the name,address, and telphone numberThis data help in follow up the case.

2-animal data: (a)species (species specific disease) eg: *F.M.D "specific for footed cloven animals" *vesicular stomatitis "specific for equine&cattle"while sheep and goat are resistant *traumatic pericarditis "specific for ruminant only (b)breed has hereditary predisposing factor for certain disease such as *abomasal displacement commonly occurs in highly producing dairy cattle. (c)Age (age specific disease) *young animals are more susceptible to be infected with Infectious agent than adult animals due to ill-developed immune system. e.g:*neonatal diarrhea "in 1st week is E.coli" "in 2nd&3rd week is salmonella" (d)Sex (sex related disease)the sex is very important to avoid drug that affect on pregnancy or That causing abortion e.g: dexamethasone, Mg. sulphat………. etc. (E)pregnancy and lactation state(F)body weight *this help in determination the dose of the drug(G)special identifying marks (for complete identification of the animal) This include :color pattern & special features as ear tags and neck band

(2)Disease history1- past history

1-previous disease 2-previous vaccination & its time (this to know the post vaccinal reaction)3-previous treatment4-newelly purchased animals

2-present history1-the owner complaint2-questions about the case ,this includes:a-the onset &duration of the diseaseb-the progress of the problem

C-Presence of other cases in the farm or notD-Morbidity rate: (%) Numbers of the diseased animals/total numbers of the animalsE-Mortality rate: (%) Numbers of the dead animals/ total numbers of the animalsF-Case fatality: (%) Numbers of the dead animals/ numbers of the diseased animals.

2-examination of the environment:1-food&water supply(A)food supply*quantity of the diet: *quality of the diet: the diet is examined for its constituents, presence of any fungal growth which leads to G.I.T disturbance.*Type of food : (roughage or concentrate )

Green fodder :important source of vit. A. Young grass :decrease Mg level :so hypomagnesaemia occur.

b) Water supply : Quality of drinking water :the water must be free from any source of

contamination with organic or inorganic substance and also must be free from infectious agent .

Source of the drinking water :fresh water or artesian water "fluorine deficiency" or stagnantwater "algea & fasciola" or ponds "source of neurotoxic & hepatotoxic substances".

Amount of the drinking water.2-topography&soil type

Sandy soil:copper & cobalt deficiency●Muddy(damp):associated with outbreak of coli-form mastitis in dairy cattle & foot rot in sheep.3- climate: many diseases are influenced by climate as:

Foot rot :wet weather & muddy condition under foot Disease spread by insects: encouraged when the climatic condition favor

the propagation of the vector such asa) Ticks & lice: transmit the blood parasite.b) Mosquito: transmit R.V.F.

4-housing design & ventilation system

A)the quality of the floor Slippery floor is associated with high incidence of truma & fructure B)sanitation &hygiene Excessive accumulation of the feaces & urine favor the spread& Survival of the pathogenic bacteria C)bedding: type,quantity & quality Constant wetting of the bedding material under the animal lead to highly Incidence of mastitis & foot rot. D)the availability of the light is necessary because the light is important for Synthesis of Vit D, reproductive performance & its germicidal power. F) Ventilation :

*Bad ventilation leads to stagnant foul air so, increase CO2 ,NH3 ,dust concentration :leads to lowering resistance of Resp. Tract :High incidence of Resp. Tract diseases.*Over ventilation leads to chilling diseases.

h) Population density (stoking rate ) Number of animals should related to the space area The over crowd ness leads to the following:1- Fighting .2- Accumulation of excretions as manure and urine.3- Increased R.H. inside the building :is predisposing factor for

respiratory diseases ,also increase of CO2.4- In accurate identification of animals.

3-examination of the patient

A-General examination 1-general inspection 2-clinical examination(physical examination)B-Special examination of the body systems A-general examination1- General inspectionIt means examination of the animal from a distance using the sense of vision, thethis examination should include:(1)AppearanceHealthy cattle should have bright eyes, alert, glossy skin& the muzzle look moist.Any deviation from this appearance indicate disease problemE g: the animals appear dull &depressed The muzzle become wet& dry(2) The physical condition A- normal: if all the bony prominence of the body is covered with well developed muscles B-obese (fatty): if there is excessive deposition of the fat in certain areas of the body + complete absence of the bony prominence C-thin (lean): if the bony prominence is visible *physiologically: in case of some breed of dairy cattle *pathologically: in case of malnutrition D-emaciated (cachexic): there is very clear bony prominence + atrophy of

The muscle + depression of the supra orbital fosse This appears in case of old age, heavy intestinal parasitism, chronic depilating disease such as T.B& neoplasm.(3) Mental status: the ability of the animal to respond to external stimuli, * alert animal (bright): it is the animal which normally responsed to the external stimuli* this response may be increase or decrease (a) Increase of response (exited) Anxiety: increase response to external stimuli Hyper excitability: excessive response to normal stimuli and restlessness

Frenzy: its violent movement of animal regardless the surrounding atmosphere Mania: its violent movement of animal regardless the surrounding atmosphere but associated with sensory movement as biting for itself or owner, licking ofwall and itself, blowing, abnormal voice and apparent blindness e.g. mania: rabies, encephalitis and acute lead poisoning Frenzy: hypomagnesaemia and acute colic of horse (b) Decrease of response (depression) Dull: when the reaction to normal stimuli is sluggish and depressed (febrile and Toxemic condition).Semi coma: partial or mild degree of coma Coma: complete unconsciousness without any response to external stimuli 4-General behavior*in case of herd or flock: separation of the animal from the rest of the herd May be an indication of the disease* careful observation of the animal for detection of any abnormal behavior,(Any bad vices) as biting of another animal, licking of the wall& the ground, eating of the bone and feces.5- Animal posture: it means the standing position of the animal. *Abnormal posture;

Abduction of elbow & extension of head and neck in cattle: indicates traumatic pericarditis or pleurisy.

Sternal recumbence : indicates hypocalcaemia ( milk fever).. Arching of back , kicking at belly & periodical rolling in horse :

indicates abdominal pain ( colic ) N.B/ kyphosis: it means dorsal bending of the vertebral column. Lordosis : it means ventral bending of the vertebral column . Scoliosis: it means lateral bending of the vertebral column. 6-Gait: it means the manner of walking of the animal.* normal gait: straight direction.

* abnormal gait: Walking in circle: listeriosis, obits, and ostrus ovis in sheep.

Circumduction of the limb(weaving): shoulder rheumatism Knuckling of the fetlock: nerve paralysis. Ataxia(in coordination of the movement): cerebello-vestibular

disease 7- Skin coat * normal skin: shiny, smooth, elastic& has no corregation. * abnormal:

Alopecia: zinc def., mange, ring worm,……..etc. Wrinkling & loss of elasticity: indicates dehydration. Dry, rough, lusterless, indicates nutritional deficiency. Greasy hair: indicates seborrhea. Steely wool in sheep: indicates Cu deficiency.

8- Respiration * (type, count & depth)9- Any discharge from natural orifices of body 10-Prehension of the food

* any deviation from this normal state indicate lesion in the organ of prehension. e.g: cattle: when eat by lips" there is disease in the tongue as inflammation or vesicles" equine: when eat by the tongue" there is disease in the lips as vesicles"

11-Act of defecation & urination(a) The defecation:

Frequency of defecation: increase or decrease Character of the feces: soft as in case of diarrhea or firm as in

case of constipation. Act of defecation :

- normally in cattle: raising of the tail& abduction of the hind leg

- it may be (a) easy as in case of diarrhea or (b) difficult + Straining as in case of constipation.

(b) The urination: You must determine the normal act of urination " according to

the species "then determine if there is any deviation from the normal pattern or not.

E g: painful urination associated with frequent urination, arching of the back & grunting sound "in case of cystitis & uretheritis.

- difficult urination " in case of complete obstruction of the urinary passage with calculi"

2-physical examination (1)inspection

(2)palpation* method of application:1-direct palpation(direct contact) by means of tips of finger or fest of hand2-indirect palpation by means of probe this to avoid transport of skin lesion* items of palpation1) Consistency of the organa-resilient (return of organ quickly to its normal consistencyafter removal of pressure).e.g: normal constancy of rumenb-doughy (by pressure there is an impression of finger on the organeg : ruminal impaction s/c edema c- firm (resist the pressureeg: liver initial stage of abscessd-hard (have bone- like consistency)eg: bone – liver cirrhosis (abnormal)e-fluctuating (wave like movement produced by application of pressure)eg: haematoma & abscess (ripping)f- emphysematous (crepitating or crackling sound)this due to accumulation of gases under the skineg: s/c emphysema2)Temperature of tissue.acute inflammation (local rise of temperature).chronic inflammation (normal).cold temperature of limb indicates gangrene .3) sensitivity ( tenderness ) :

application of pressure leads to induction of pain as in case of pleurisy 4) Examination of pulse .

(3)Percussion : Methods of percussion : 1-Direct method ( finger – finger method )

used in small animals by using both hands .. 2-Indirect method which used in large animals by using plexor & pleximeter *Precautions : 1)The animal must be fixed and well secured . 2)The pleximeter is firmly fixed against boy surface so that no air space present between the pleximeter & the skin of animal . 3)The pleximeter or middle finger is placed on the intercostal space . 4)The hand using the hummer must be at higher level than the hand holding the pleximeter . 5)The movement of percussion hummer should come from the wrist ,not from the elbow or shoulder . 6)The plexor should be made perpendicular to the pleximeter . 7)Percussion should be performed in a systemic manner ( vertical & horizontal )

Sounds produced by percussion : a) Resonant sound : the sound which emitted when percussion on organ containing air ;e.g lungs b) Tympanic sound ( drum sound ) this sound emitted from an organ containing gas under pressure e.g ;sinus ,tympanic rumen , tympanic cecum . c) Dull sound : this sound emitted from solidified organ contains no gas. e.g ; liver ,heart ,bone ,impacted rumen . (4)Auscultation :

It means listening to the sound produced by the functional activity of the organ such as lungs ,heart ,trachea ,rumen & intestine .