Gough Alex Murphy Kate - Differential Diagnosis in Small Animal Medicine

Second Edition

By

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

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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.

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

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!