Management of Disease - Small animal Flashcards
What does SOAP stand for
Subjective exam
Objective exam
Assessment of findings
Plan of action
Describe how you would go about the subjective part of the exam
do not touch the animal, assess body condition score and demeanor, also good to take the respiratory rate during this time too. Ask the owner about the animal’s age, breed, use (if any), sex
Ask the owner if the animal has been eating, drinking, urinating and defeacating and find out as much as you can about the presenting problem from the owner
When examining the head and neck what should you look for?
· Posture of head and neck
· Symmetry of musculature - lack of tone could signify nerve damage
· Discharge; nasal, ocular, ear
Assess function of cranial nerve
When examining the eyes what should you look for?
· Look for abnormalities
· Look at the size and shape of the eye
· Is there any ocular discharge
Is the eye position normal
When examining the nose what should you look for?
· Is there any discharge
· Check airflow from both nostrils
· Is there any pain
· Is there any swelling, depigmentation or asymmetry
· Listen for stertor - noisy/ laboured snorting sound while trying to breathe through nose
De-pigmentation, pain and unilateral blocked nose is common in aspergillus fungal infections
Unilateral obstructed airflow can also be due to a tumour or a foreign body
When examining the mouth what should you look for?
· Lip symmetry
· Mucous membrane colour - white signifies anaemia, purple can indicate endotoxaemia
· Capillary refill time - slow cpr signifies poor perfusion
· Check hydration status
· Look for masses or ulceration
· Check teeth for tartar, fracture or periodontal disease - gingivitis in cats can be indicative of FIV or calicivirus
· Check the tongue for ulceration and paralysis or deviation - latter two could be due to cranial nerve damage
· Assess the pharynx
Look for general trauma, neoplasia or inflammation
When examining the ears what should you look for?
· Check for haematomas - could be due to trauma, head shaking due to an ear infection or could indicate something more serious like a coagulopathy
· Look for neoplasia
· Look for hyperplastic change
· Check for any discharge, if present is it purulent, ceruminous or haemorrhagic
· Use an otoscope to assess the ear canal
Look for presence of parasites
When examining the neck what do you look for?
· Palpate the larynx and trachea – check for a cough response, signifies inflammation, common sign of kennel cough
Palpate the thyroid glands, the lymph nodes ( should always be sampled if enlarged) and the jugular veins - engorged jugulars could signify heart failure - right sided congestive
Name the three main palpable lymph nodes and where to find them?
Popliteal - on the hind limb just above the knee on the caudal surface of the limb
Pre-scapular - just before the cranial border of the scapula
Sub mandibular - along the lower jaw line
When examining the abdomen what do you look for?
· Palpate normal structures - in a cat useful to assess kidneys; if one is abnormally small good indicator of kidney disease, if abnormally large could be due to cysts or a tumour
· Is there ascites, check for a fluid thrill
· Palpate to assess body condition
· Is there abdominal distension – what is the cause; torsion, pyometra, pregnancy, organomegally, ascites (often due to right sided heart failure)
Note: German sheperds have abnormally large spleens
Describe the position of the palpable abdominal organs
- liver sits under the costal arch, hard to feel unless enlarged
- stomach and spleen - left cranial
- kidneys, left is more caudal and easier to feel than right which sits by rib cage
- small intestine - majority of the abdomen should feel gas and fluid filled
- colon usually contains faeces, the descending part sits on the caudal left hand side
bladder sits in the caudal part of the abdomen assess it’s size, shape and turgidity
when examining the skin what would you look for?
· Check for dermal and subdermal masses
· Look for external parasites
· Is there alopecia if so what is the likely cause?
· Look for areas of inflammation and erythema
· Assess any lesions; are they scaly and crusty with evidence of hyperkeratosis or are they pustules nodules or vesicles
what is the normal respiratory rate for a dog and cat?
dogs - 10-40
cats - 20-40
when examining the cardiorespiratory system what would you look for?
· Auscultate the chest for abnormal sounds e.g. crackles, wheezes, stertor or stridor
· Auscultate the trachea for upper airway noise and harshness
· High resp rate could be due to asthma, pneumonia, bronchitis or from pulmonary oedema due to congestive heart failure (hear lung crackles)
· Inspiratory dyspnoa - signifies a upper respiratory problem
· Expiratory dyspnoea - signifies a lower respiratory tract problem
· Auscultate the heart, listen for extra heart beats, arrhythmias, murmurs, muffled heart sounds, identify first and second heart sound and if there are abnormalities try to associate with one or the other
· Muffled heart sounds are likely due to a pericardial or pleural effusion
· Check the femoral and peripheral pulses to check they match heart rate, that there is symmetry of the pulse in both sides of the body and that the pulse is strong.
Uneven pulses often signifies a thromboembolism
Where should you place your stethoscope to hear the different valves
On the left side over rib spaces 3,4 and 5 you can here the pulmonic, the aortic and the mitral valve
on the right side you can hear the tricuspid valve over rib space 4
What is the normal heart rate for a dog and cat
Dog Heart Rate: 70-140
Cat Heart Rate: 145-200 - get incredibly stressed in the vets so can be very high but still normal
What is the normal rectal temperature of a cat and dog?
· Ensure it makes contact with the rectal wall
· Normal rectal temp for a cat: 38-39.5
Normal rectal temp for a dog: 37.5 – 39
when examining the urogenital tract what should you look for?
· Check for discharge
· Check symmetry and firmness of the testicles, ensure there are two!
· Check for evidence of trauma or any masses
· Check for masses of the mammary glands, is there any discharge or swelling?
· Check the colour of the urogenital organs
· Cryptorchid = undescended testicle
Anal sac tumours often cause excessive drinking due to the tumours often release calcium which increases thirst
What should your list for differential diagnoses be?
DAMNIT - V: Degenerative, developmental Autoimmune, anatomic anomalies Metabolic, mechanical Nutritional, neoplastic Inflammatory, infectious Toxic, traumatic Vascular
