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Gough Alex Murphy Kate - Differential Diagnosis in Small Animal Medicine

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CONTENTS Guide Pages Differential Diagnosis in Small Animal Medicine Second - photo 1
CONTENTS
Guide
Pages
Differential Diagnosis in Small Animal Medicine

Second Edition

By

Alex Gough

MA VetMB CertSAM CertVC PGCert MRCVS

Kate Murphy

BVSc (Hons) DSAM DipECVIM-CA MRCVS PGCert (HE)

This edition first published 2015 2015 by John Wiley Sons Ltd Registered - photo 2

This edition first published 2015 2015 by John Wiley & Sons, Ltd

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The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

Gough, Alex, author.
Differential diagnosis in small animal medicine / by Alex Gough, Kate Murphy. Second edition.
pages ;cm
Includes bibliographical references and index.

ISBN 978-1-118-40968-8 (pbk.)
1.DogsDiseasesDiagnosisHandbooks, manuals, etc.2.CatsDiseasesDiagnosisHandbooks, manuals, etc.
3.Diagnosis, DifferentialHandbooks, manuals, etc.I.Murphy, K. F. (Kate F.), author.II.Title.
[DNLM:1.Animal DiseasesdiagnosisHandbooks.2.Diagnosis, DifferentialHandbooks.
3.Veterinary MedicinemethodsHandbooks. SF 748]
SF991.G672 2015
636.0896075dc23

2014034803

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: dog and cat iStockphoto tetsuomorita; all other images reproduced with permission of the University of Bristol Photographic Unit

Introduction

The first edition of this book was written by Alex Gough to fill a gap in the market. The aim was to provide a ready list of differential diagnoses to assist in the investigation of challenging medical cases, and the sales of the book would suggest this was a success.

This second edition has been co-authored by Alex Gough and Kate Murphy. Content has been reviewed and expanded where needed and some sections have been removed.

This book provides a ready reference for differential diagnoses for the majority of medical presentations that are encountered in general practice, including both common and uncommon conditions. This text should be of use to veterinary students, general practitioners, veterinary interns, residents and anyone who cannot fully carry these lists around in their heads. We hope clinicians find it useful.

The differential diagnosis list is one of the most important aspects of the problem-oriented approach to clinical diagnosis. For those who are not familiar with the problem-oriented approach, a brief outline follows.

As the name implies, problem-oriented medical management (POMM) concentrates on the individual problems of a patient. A differential diagnosis list should be made for each and every problem that is found in a patient, whether in the history, the physical examination, imaging or clinicopathological tests. Although superficially this may not sound very holistic', in fact, if all the patient's problems are considered individually, the whole patient will have been evaluated, without falling into the trap of presuming that all of the findings are caused by a single condition. Some problems are of course less specific and less emphasis is given to the problem solving on those signs, e.g. lethargy and inappetence in a vomiting, jaundiced pet.

The problem-oriented approach starts with a thorough history, and it is important to discover what the owners perceive to be the main problems after all, they usually know their animal better than the clinician does. However, there may be relevant historical signs that the owners had not considered significant, so failing to systematically ask all the questions which could be of importance in a case can lead to overlooking important information.

In every case, a complete physical examination should be carried out, including body systems that are not apparently of immediate concern.

Once the history has been taken and the physical examination has been completed, the clinician should list every problem (ideally rank the problems) that has been discovered. Problems may include such findings as exercise intolerance, pruritus, pyrexia or a heart murmur. A differential diagnosis list should then be created for every problem. The list should be appropriate to that animal. There is no point listing feline leukaemia virus as a likely diagnosis in a dog!

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