Performing the Small Animal Physical Examination offers an easy-to-follow guide to successfully executing a thorough physical exam in cats and dogs, with nearly 1,000 clinical photographs depicting step-by-step details.

About the Author xiii Preface xiv Acknowledgments xv Part One Performing the Feline Physical Examination 1 1 Setting the Stage: Feline-Friendly Practice 3 1.1 Challenges Faced in Feline Practice 3 1.2 The Emergence of Feline-Friendly Practice 4 1.3 Key Principles of Feline-Friendly Practice 4 1.4 The Role of Sound 8 1.5 The Role of Tactile Stimulation 8 1.6 The Role of Scent 8 1.7 The Role of Advance Preparation 9 1.8 Examination Room Etiquette: Accessing the Cat 10 1.9 Recognizing Body Language 12 1.10 Feline-Friendly Handling 16 1.11 Other Feline Handling Tools 20 2 Assessing the Big Picture: the Body, the Coat, and the Skin of the Cat 24 2.1 Forms of Identification 24 2.2 Body Condition Scoring 25 2.3 Assessing Hydration 29 2.4 Inspecting the Coat: First Impressions 30 2.5 Identifying Coat Colors and Coat Patterns 32 2.6 Assessing Coat Quality 34 2.7 Inspecting the Skin 40 3 Examining the Head of the Cat 52 3.1 Skull Shape and Facial Symmetry 52 3.2 The Eyes and Accessory Visual Structures 52 3.2.1 A Systematic Approach to the Eye Examination 52 3.2.2 Evaluating the Adnexa of the Eye 53 3.2.3 Evaluating the Globe 58 3.2.4 Evaluating the Sclera 60 3.2.5 Evaluating the Cornea 61 3.2.6 Evaluating the Iris 61 3.2.7 Evaluating the Pupils 62 3.2.8 Assessing Ocular Reflexes 62 3.2.9 Assessing the Anterior Chamber 64 3.2.10 Assessing the Lens 65 3.2.11 Introduction to Fundoscopy 66 3.2.12 Fundoscopy and Direct Ophthalmoscopy 67 3.2.13 Fundoscopy and Indirect Ophthalmoscopy 67 3.3 The Ears 68 3.4 The Nose 72 3.5 The Extra-Oral Examination 73 3.6 The Intra-Oral Examination 75 3.6.1 Assessing Mucous Membrane Color 75 3.6.2 Assessing Capillary Refill Time 76 3.6.3 Examining the Mucosa 76 3.6.4 Examining the Gingiva 78 3.6.5 Assessing the Dentition 78 3.6.6 Assessing the Occlusion 79 3.6.7 Assessing for Calculus 81 3.6.8 Opening the Mouth 81 3.6.9 Examining the Tongue 82 3.6.10 Assessing for Periodontal Disease 82 3.6.11 Feline-Specific Dentistry 84 4 Examining the Endocrine and Lymphatic Systems of the Cat 90 4.1 Evaluating the Thyroid Gland 90 4.1.1 The Pathophysiology of Hyperthyroidism 90 4.1.2 The Etiology of Hyperthyroidism 91 4.1.3 The Art of Palpating an Enlarged Thyroid Gland 91 4.2 Assessing the Lymphatic System 93 4.2.1 Examining the Submandibular Lymph Nodes 93 4.2.2 Examining the Superficial Cervical or Pre-Scapular Lymph Nodes 93 4.2.3 Examining the Popliteal Lymph Nodes 94 4.2.4 Feeling for Lymph Nodes That Should Not Be Present 94 5 Examining the Cardiovascular and Respiratory Systems of the Cat 98 5.1 The Cardiac Patient 98 5.2 Assessing the Cardiovascular System Prior to Auscultation 99 5.2.1 Attitude 99 5.2.2 Respiratory Rate 99 5.2.3 Respiratory Effort 99 5.2.4 Respiratory Route 99 5.2.5 Mucous Membrane Color 99 5.2.6 Capillary Refill Time (CRT) 99 5.2.7 Jugular Pulse 99 5.2.8 Palpating the Ventral Neck 100 5.2.9 Palpating the Limbs for Warmth and Assessing the Extremities for Color 100 5.2.10 Assessing Femoral Pulses 100 5.3 Cardiothoracic Auscultation 101 5.3.1 Recalling the Cardiac Cycle 101 5.3.2 Normal Heart Sounds 101 5.3.3 Abnormal Heart Sounds: Murmurs 101 5.3.4 Other Heart Sounds 102 5.3.5 Ausculting the Heart 102 5.3.6 Understanding How the Stethoscope Is Built to Facilitate Auscultation 105 5.4 The Respiratory Patient 105 5.4.1 The Upper Airway Patient 105 5.4.2 The Lower Airway Patient 105 5.4.3 The Patient with Thoracic Cavity Disease 107 5.5 Assessing the Respiratory System Prior to Auscultation 110 5.5.1 The Nose 112 5.5.2 The Larynx and the Trachea 113 5.5.3 Thoracic Compliance 113 5.5.4 Thoracic Percussion 113 5.6 Understanding Normal Airway Sounds 114 5.7 Ausculting the Airway 114 5.8 Understanding Adventitious Airway Sounds 115 5.9 Using Airway Sounds to Corroborate Percussive Findings 116 5.10 Purring as an Obstruction to Auscultation 116 6 Examining the Abdominal Cavity of the Cat 120 6.1 Overview of the Digestive Tract as It Pertains to Presenting Complaints 120 6.2 The Esophagus 122 6.3 Visual Inspection of the Abdomen 122 6.4 Superficial Palpation of the Abdomen 122 6.5 Deep Palpation of the Abdomen 124 6.5.1 The Liver 126 6.5.2 The Stomach 127 6.5.3 The Spleen 127 6.5.4 The Pancreas 127 6.5.5 The Small Intestine 128 6.5.6 Mesenteric Lymph Nodes 129 6.5.7 The Large Intestine 129 6.5.8 The Rectal Examination 130 6.6 The Upper Urinary Tract 132 6.7 The Lower Urinary Tract 134 6.8 The Male Reproductive Tract 135 6.9 The Female Reproductive Tract 137 6.10 Being Presented with a Female of Unknown Sexual Status 138 6.11 Neonates 138 7 Examining the Musculoskeletal System of the Cat 145 7.1 Muscle Condition Score (MCS) 145 7.2 The Skeleton as a Whole 146 7.2.1 Key Components of the Axial Skeleton to Appreciate on Physical Examination 148 7.2.2 Key Components of the Appendicular Skeleton to Appreciate on Physical Examination 150 7.2.3 Additional Components of the Skeleton to Appreciate on Physical Examination 153 7.3 The Appendicular Skeleton: The Forelimb 153 7.4 The Appendicular Skeleton: The Hind Limb 160 8 Evaluating the Nervous System of the Cat 174 8.1 Assessing Behavior and Mental Status 174 8.2 Assessing Posture 176 8.3 Assessing Coordination and Gait 177 8.4 Assessing Postural Reactions 178 8.5 Assessing for Other Abnormal Movements 180 8.6 Evaluating the Spinal Reflexes 181 8.7 Assessing the Cranial Nerves 183 8.7.1 Reviewing the Ocular Reflexes Associated with the Cranial Nerves 183 8.7.2 Reviewing the Cranial Nerves Associated with Ocular Movement 185 8.7.3 Reviewing the Cranial Nerves Associated with Tactile Sensation 185 8.7.4 Reviewing the Cranial Nerves Associated with Muscle Movement Other Than Ocular 186 8.7.5 Reviewing the Cranial Nerves Associated with Digestion 186 8.7.6 Reviewing the Cranial Nerves Associated with Maintaining Posture 186 8.8 Assessing Nociception 186 Part Two Performing the Canine Physical Examination 191 9 Setting the Stage: Canine-Friendly Practice and Low-Stress Handling 193 9.1 Challenges Faced in Canine Practice 193 9.2 The Concept of Low-Stress Handling 194 9.3 White Coat Syndrome 196 9.4 The Role of Scent 198 9.5 The Role of Advance Preparation 199 9.6 Examination Room Etiquette: Setting the Tone for Initial Veterinary Interactions with the Dog 199 9.7 Recognizing Body Language 199 9.8 Creative Approaches to Challenging Interactions with Canine Patients 205 9.9 Other Canine Handling Tools 206 10 Assessing the Big Picture: the Body, the Coat, and the Skin of the Dog 213 10.1 Forms of Identification 213 10.2 Body Condition Scoring 214 10.3 Assessing Hydration 221 10.4 Breed Designation 222 10.5 Inspecting the Coat: First Impressions 223 10.6 Identifying Coat Colors and Coat Patterns 225 10.7 Assessing Coat Quality 233 10.8 Inspecting the Skin 237 10.9 Primary Skin Lesions 240 10.10 Secondary Skin Lesions 245 10.11 Miscellaneous Skin Lesions 246 10.12 Hyperkeratosis 249 10.13 Skin Folds 250 10.14 Nails and Paw Pads 251 10.15 Skin Incisions 252 10.16 Mammary Glands 255 11 Examining the Head of the Dog 261 11.1 Skull Shape: Function Versus Cosmesis 261 11.2 Facial symmetry 265 11.3 The Eyes and Accessory Visual Structures 265 11.3.1 A Systematic Approach to the Eye Examination 265 11.3.2 Evaluating the Adnexa of the Eye 265 11.3.3 Evaluating the Globe 274 11.3.4 Evaluating the Sclera 275 11.3.5 Evaluating the Cornea 277 11.3.6 Evaluating the Iris 278 11.3.7 Evaluating the Pupils 280 11.3.8 Assessing Ocular Reflexes 281 11.3.9 Assessing the Anterior Chamber 281 11.3.10 Assessing the Lens 282 11.3.11 Introduction to Fundoscopy 282 11.3.12 Fundoscopy and Direct Ophthalmoscopy 283 11.3.13 Fundoscopy and Indirect Ophthalmoscopy 283 11.4 The Ears 284 11.5 The Nose 289 11.6 The Extra-Oral Examination 291 11.7 The Intra-Oral Examination 295 11.7.1 Assessing Mucous Membrane Color 295 11.7.2 Assessing Capillary Refill Time 296 11.7.3 Examining the Mucosa 296 11.7.4 Examining the Gingiva 296 11.7.5 Assessing the Dentition 297 11.7.6 Assessing the Occlusion 301 11.7.7 Assessing for Calculus 302 11.7.8 Miscellaneous Acquired Tooth-Related Defects 303 11.7.9 Opening the Mouth 304 11.7.10 Examining the Tongue 305 11.7.11 Assessing for Periodontal Disease 306 12 Examining the Endocrine and Lymphatic Systems of the Dog 312 12.1 Thyroid Gland Neoplasia in the Dog 312 12.2 The Typical Presentation of Thyroid Gland Neoplasia in the Dog 313 12.3 The Pathophysiology of Hypothyroidism 313 12.4 The Typical Presentation of a Hypothyroid Dog 314 12.5 The Atypical Presentation of a Hypothyroid Dog 315 12.6 Assessing the Lymphatic System 315 12.7 Examining the Submandibular Lymph Nodes 316 12.8 Examining the Superficial Cervical or Pre-Scapular Lymph Nodes 316 12.9 Examining the Popliteal Lymph Nodes 316 12.10 Feeling for Lymph Nodes That Should Not Be Present 317 13 Examining the Cardiovascular and Respiratory Systems of the Dog 320 13.1 Congenital Heart Disease in the Dog 320 13.2 Acquired Heart Disease in the Dog 321 13.3 Assessing the Cardiovascular System Prior to Auscultation 322 13.3.1 Attitude 322 13.3.2 Respiratory Rate 323 13.3.3 Respiratory Effort 323 13.3.4 Respiratory Route 323 13.3.5 Mucous Membrane Color 323 13.3.6 Capillary Refill Time (CRT) 323 13.3.7 Jugular Pulse 324 13.3.8 Assessing Femoral Pulses 324 13.4 Cardiothoracic Auscultation 325 13.4.1 Normal Heart Sounds 325 13.4.2 Abnormal Heart Sounds 326 13.4.3 Other Heart Sounds 326 13.4.4 Ausculting the Heart 326 13.4.5 Understanding How the Stethoscope Is Built to Facilitate Auscultation 326 13.4.6 Understanding the Limitations of Cardiothoracic Auscultation 326 13.5 The Respiratory Patient 330 13.5.1 The Upper Airway Patient 330 13.5.2 The Patient with Laryngeal Disease 332 13.5.3 The Lower Airway Patient 332 13.5.4 The Patient with Thoracic Cavity Disease 333 13.6 Assessing the Respiratory System Prior to Auscultation 334 13.6.1 The Nose 334 13.6.2 The Larynx and the Trachea 334 13.6.3 Thoracic Compliance 335 13.6.4 Thoracic Percussion 335 13.7 Understanding Normal Airway Sounds 335 13.8 Ausculting the Airway 335 13.9 Understanding Adventitious Airway Sounds 336 13.10 Panting as an Obstruction to Auscultation 337 14 Examining the Abdominal Cavity of the Dog 342 14.1 Overview of the Digestive Tract 342 14.2 The Esophagus 342 14.3 Visual Inspection of the Abdomen 343 14.4 Auscultion and Superficial Palpation of the Abdomen 344 14.4.1 Auscultation of the Abdomen 344 14.4.2 Superficial Palpation of the Abdomen 344 14.5 Deep Palpation of the Abdomen 346 14.5.1 The Liver 348 14.5.2 The Stomach 348 14.5.3 The Spleen 350 14.5.4 The Pancreas 351 14.5.5 The Small Intestine 352 14.5.6 The Mesenteric Lymph Nodes 354 14.5.7 The Large Intestine 354 14.5.8 The Anal Sacs 354 14.5.9 The Rectal Examination 355 14.6 The Upper Urinary Tract 357 14.7 The Lower Urinary Tract 358 14.8 The Male Reproductive Tract 361 14.9 The Female Reproductive Tract 364 14.10 Being Presented with a Female of Unknown Sexual Status 367 14.11 Neonates 368 15 Examining the Musculoskeletal System of the Dog 380 15.1 Muscle Condition Score (MCS) 380 15.2 The Skeleton as a Whole 382 15.2.1 Key Components of the Axial Skeleton to Appreciate on Physical Examination 382 15.2.2 Key Components of the Appendicular Skeleton to Appreciate on Physical Examination 383 15.2.3 Additional Components of the Skeleton to Appreciate on Physical Examination 386 15.3 The Appendicular Skeleton: The Forelimb 386 15.4 The Appendicular Skeleton: The Hind Limb 392 16 Evaluating the Nervous System of the Dog 412 16.1 Assessing Behavior and Mental Status 412 16.2 Assessing Posture 413 16.3 Assessing Coordination and Gait 415 16.4 Assessing Postural Reactions 415 16.5 Assessing for Other Abnormal Movements 418 16.6 Evaluating the Spinal Reflexes 419 16.7 Assessing the Cranial Nerves 421 16.7.1 Reviewing the Ocular Reflexes Associated with the Cranial Nerves 421 16.7.2 Reviewing the Cranial Nerves Associated with Ocular Movement 422 16.7.3 Reviewing the Cranial Nerves Associated with Tactile Sensation 422 16.7.4 Reviewing the Cranial Nerves Associated with Muscle Movement Other than Ocular 423 16.7.5 Reviewing the Cranial Nerves Associated with Digestion 423 16.7.6 Reviewing the Cranial Nerves Associated with Maintaining Posture 423 16.8 Assessing Nociception 423 Index 432

Performing the Small Animal Physical Examinationwww.wiley.com/go/veterinaryPerforming the Small Animal Physical Examination offers an easy-to-follow guide to successfully executing a thorough physical exam in cats and dogs. With practical tips for ensuring that the exam goes smoothly and facilitates diagnostic and therapeutic recommendations, the book provides a comprehensive manual for examining canine and feline patients in sickness and in health. Nearly 1,000 color photographs demonstrate the individual components of the physical exam and provide picture matching for identification and diagnosis of abnormal findings. Divided into separate sections for the cat and dog, the book tracks the logical progression of an exam beginning with initial observations about the patient and how the patient interacts with the environment. Subsequent chapters cover the in-depth examination of each body system. Performing the Small Animal Physical Examination is an essential resource for veterinary and veterinary technology students, recent veterinary graduates, and veterinary technicians. Key features• Provides comprehensive, practical information on the physical examination in small animal patients• Presents nearly 1,000 color photographs with step-by-step details of the procedures and principles• Offers advice on preparing the examination room, useful tips, and concrete guidance for examining each body system• Outlines a systematic, in-depth approach to the initial examination in dogs and cats• Supports new and experienced veterinarians and veterinary technicians alike in performing a thorough basic exam The authorRyane E. Englar, DVM, DABVP (Canine and Feline Practice), is Assistant Professor of Small Animal Primary Care at Midwestern University College of Veterinary Medicine in Glendale, Arizona, USA.

�Performing the Small Animal Physical Examination provides a very detailed overview of how to complete a comprehensive physical examination in dogs and cats�.Although the text contains many medical terms, it is easy to read and follow. The best part of this book is the vast amount of color photographs it contains that complement and reinforce information provided in the text and provide comparisons of normal versus abnormal�.This book will be an excellent resource for veterinary and veterinary technician students and new graduates. It will also be appropriate for experienced large animal veterinarians who are transitioning into small animal medicine and desire information on current low-stress examination techniques for dogs and cats.� JAVMA, January 2018