Ryane Englar

The University of Arizona | UA · College of Veterinary Medicine

Performing 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 patient...

Common Clinical Presentations in Dogs and Cats is a reliable resource and quick reference to essential information for diagnosing canine and feline patients, based on presenting complaints. The text takes a problem-oriented approach to recognizing common clinical conditions, and introduces diagnostic and treatment plans for companion animal practic...

Good communication skills provide better clinical outcomes and help prevent minor as well as major mistakes. Approximately 60-80% of negligence claims against veterinarians are related to poor communication, with new graduates especially vulnerable. Communication skills are a growing part of the curriculum in veterinary schools, recognising how fun...

This workbook is intended to be a bridge between classroom learning and clinical training; to improve patient care and clinician confidence in practice. Common presentations in small animal practice are presented as real-world case studies while the reader is guided through work-up, critical thinking and problem solving to run the consultation effi...

In Low-Cost Veterinary Clinical Diagnostics, the authors provide a hands-on resource designed to facilitate healthcare delivery across the spectrum of care. Historically, clinicians have been taught to apply the gold standard approach to the practice of medicine. However, recent advances in veterinary medical care and associated technologies have m...

As a supplement to this text, my colleague Teresa Graham Brett and I have developed a line of cards that is uniquely designed to support those who are grieving: www.intheirpaws.com. Many veterinary practices send sympathy cards to those who have experienced loss, but sympathy is about “feeling for.” Our clients actually need empathy, that is, “feel...

Accredited colleges of veterinary medicine are required by the American Veterinary Medical Association (AVMA) Council on Education (COE) to provide learners with hands-on diagnostic method training, including urinalysis. Although teaching hospitals and affiliated clinical partners offer opportunities to test and interpret urine, caseload is unpredi...

The ninth standard of accreditation as outlined by the American Veterinary Medical Association (AVMA) Council on Education (COE) mandates that all accredited colleges of veterinary medicine must provide instruction in medicine and surgery, including principles of practice, hands-on experiences with diagnostic methods, and interpretation of clinical...

This retrospective study evaluated factors responsible for mortality of dogs hospitalized for Canine Leishmaniosis. Medical records of 31 dogs with leishmaniosis from a Portuguese Veterinary Teaching Hospital were examined between August 2018 and January 2022. Females (n = 18) and pure breed dogs (n = 27) were overrepresented, with higher frequency...

Pheochromocytoma in cats is a rare clinical condition characterised by the development of a secre-tory endocrine tumour that arises from the adrenal medulla. An 8-year-old castrated male, domestic shorthair cat was referred for further investigation of a 4-month history of progressive weight loss with normal appetite, polyuria/polydipsia, generalis...

Loss is an unexpected yet expected part of life. We are not prepared for death, yet we experience loss, to varying degrees, every day. As time passes, we lose the present day to the past. Friends may come and go. We may trade our childhood home for a home of our own. We may lose one job and gain another. All these life events are losses, though som...

The American Veterinary Medical Association Council on Education mandates in standard 11 that all accredited colleges of veterinary medicine must develop and deliver formal processes by which students are observed and assessed in nine competencies. The eighth competency combines clinical communication and sensitivity toward soliciting and understan...

Chapters 12 and 13 examined the physical properties of urine: volume, color, turbidity, odor, and urine specific gravity (USG). The diagnostic capacity of urine extends beyond these features. A complete analysis of urine must include the chemical parameters of pH, protein, glucose, ketones, occult blood (heme) and bilirubin. The presence or absence...

The preceding chapter (Chapter 12) examined the physical properties of urine that could be appreciated by applying the special senses of sight and smell to diagnostic medicine: urine color, turbidity, and odor. This chapter will expand our understanding of urine's physical properties by considering its density. Specifically, readers will learn how...

The physical properties of feces should be inspected when performing a fecal analysis on every sample. These characteristics are easily observed by both client and clinician alike and as such add no expense to case management, yet fecal color and consistency are often overlooked in favor of microscopic analysis. The veterinary team would do well to...

Today's veterinary client is an active participant in health‐care decisions about their pet (1). This mirrors the trend in human health care in which the patient expects to provide input on the diagnostic and/or treatment plans. Delivery of health care is thus a partnership between the provider and client. Although veterinarians provide counsel, th...

The preceding chapter (Chapter 17) introduced direct smears or wet mounts as a convenient and expedient in‐house diagnostic tool that evaluates feces for motile organisms, including trophozoites. This chapter will explore an additional means by which we can microscopically examine feces. We will learn how to perform both passive (gravitational) and...

The preceding chapter (Chapter 16) examined the physical properties of feces that can be appreciated by applying sight and smell to diagnostic medicine: fecal color, consistency, and odor. This chapter will expand our understanding of fecal diagnostics by transitioning from macroscopic to microscopic assessment. We will concentrate on how to perfor...

The physical properties of urine should be inspected when performing urinalysis on every sample. These characteristics are easily observed by both client and clinician alike and as such add no expense to case management, yet urine volume, color, clarity, and odor are often overlooked in favor of microscopic analysis. The veterinary team would do we...

This retrospective study aimed to assess the prevalence of ultrasonographic detected adrenomegaly in clinically ill cats, evaluating the final established diagnosis, describe adrenal ultrasound findings and if the adrenomegaly was suspected or incidental. Abdominal ultrasonography reports of cats presenting to a veterinary teaching hospital between...

The push for competency-based veterinary medical education by accrediting bodies has led to the inclusion of non-technical skills within curricula. Communication, self-awareness, and cultural humility are considered essential for post-graduate success. To facilitate skills development, veterinary educators have incorporated a variety of modalities...

Xanthinuria is a significant adverse effect in dogs on long-term allopurinol for treatment of leishmaniosis. The study aims to investigate how the Iberian veterinary community (IVC) identifies, manages, and proactively prevents xanthinuria secondary to allopurinol treatment. A cross-sectional study was conducted using an online survey, translated i...

This study aims to gather knowledge about the use of deoxycorticosterone pivalate (DOCP) by Western European Veterinarians (WEV) in dogs with typical hypoadrenocorticism. An observational cross-sectional study was conducted using an online survey, translated into four languages and disseminated to veterinary affiliates and mailing lists in six coun...

Adenosine (AD) has been implicated in human healthcare as an endogenous signaling nucleotide in both physiologic and pathologic states. The effects of AD on cardiorespiratory parameters in ruminants has not yet been studied. The objective of this study was to evaluate the cardiac and respiratory changes that resulted from an intravenous AD infusion...

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend ha...

Research over the past 2 decades has demonstrated that veterinary clientele prefer responsive clinicians who encourage shared decision-making. Relationship-centered care facilitates dialogue about patient health status, client expectations, and anticipated clinical outcomes. The veterinary profession caters to an extraordinarily diverse clientele....

Objective: To characterize communication challenges between veterinarians and dog or cat breeders and elicit their perspectives on how professional relationships between the two might be improved. Sample: 793 dog breeders, 540 cat breeders, and 514 veterinarians. Procedures: Veterinarians, cat breeders, and dog breeders were recruited through...

Objective: To evaluate signalment, clinical presentation, location and type of nasal foreign bodies identified by rhinoscopy in dogs. Materials and Methods: We retrospectively reviewed medical records from dogs that presented for consultation between April 2012 and June 2019 and were diagnosed with nasal foreign body via rhinoscopy. results: Forty-...

Objective: To evaluate signalment, clinical presentation, location and type of nasal foreign bodies identified by rhinoscopy in dogs. Materials and methods: We retrospectively reviewed medical records from dogs that presented for consultation between April 2012 and June 2019 and were diagnosed with nasal foreign body via rhinoscopy. Results: F...

Objective – To identify communication challenges between veterinarians and breeders of dogs and cats, and to elicit perspective concerning how to improve professional relationships. Sample – 793 dog breeders, 540 cat breeders, and 513 veterinarians. Procedures – Veterinarians, cat breeders, and dog breeders were recruited through social media and...

The manuscript for the sequel to Writing Skills for Veterinarians is almost complete. The text, A Guide to Oral Communication in Veterinary Medicine, is anticipated to be available for purchase in print in early 2020.

The veterinary profession is a customer service industry. Cat-breeders represent a unique pool of clients in terms of their reported experience and knowledge base. Their familiarity with certain breeds may provide them with a greater than average understanding of cat breeds as well as breed-specific health care challenges. In some cases, they may e...

The veterinary profession is a customer service industry. Dog-breeders represent a unique pool of clients in terms of their reported experience and knowledge base. Their familiarity with certain breeds may provide them with a greater than average understanding of dog breeds as well as breed-specific health care challenges. In some cases, they may e...

The veterinary profession is a customer service industry. Dog and cat breeders represent a unique pool of clients in terms of their perceived experience and knowledge base. Their familiarity with certain breeds and their preconceived views about breed-specific healthcare may challenge you and your team in your daily interactions with them. Behind t...

Skin pigmentation is highly variable among companion animal patients and is determined by the production and distribution of melanin. Various skin conditions can increase or decrease the amount of pigment, causing hyperpigmentation or depigmentation respectively. When hyperpigmentation of the skin occurs, it may be hereditary, as in orange cats wit...

The tomcat penis is directed caudally from the perineum, as compared to the dog, in which the penis is carried between the upper thighs. When non‐erect, the feline penis is sheathed by the prepuce. During erection, the conical‐shaped penis comes into view. The feline penis is unique in that it develops testosterone‐dependent keratinized papillae al...

Eating and drinking are normal physiological processes that are required by the body to maintain caloric intake and hydration. Abnormal ingestive behaviors may develop in both dogs and cats for medical or behavioral reasons. Patients that develop pica ingest non‐food items. Patient are said to be coprophagic when they consume fecal matter, regardle...

Gut sounds are present in health as well as in disease. Gut sounds, otherwise known as borborygmi, result from waves of peristaltic contractions that propel digesta through the gastrointestinal tract. Auscultation of the abdomen allows for characterization of these sounds as hypoactive, normoactive, and hyperactive. Sound quality and frequency are...

In health, the external jugular veins are neither palpable nor visible without manual compression by the restrainer at the level of the thoracic inlet. When the external jugular veins become either palpable or visible without assistance, the patient has underlying pathology. Sometimes, the patient will also develop a jugular pulse. If the jugular p...

The lens contributes two‐thirds of the refractive power of the eye. As such, it plays an important role in vision. Although less so in companion animals than in humans, the lens also contributes to accommodation, so that both near and far objects come into focus. For the lens to function as a refractive surface, it must maintain transparency. Trans...

Teeth are an important part of the digestive tract in that they facilitate prehension and ingestion of food. Teeth develop in embryonic life; however, they take weeks to months to erupt in the pediatric patient. Developmental anomalies are not very common in companion animal patients; however, it is important to recognize that they do exist and may...

The respiratory system is complex. Although it consists of upper and lower respiratory tracts, the former is the focus of this chapter. The primary function of the upper respiratory tract is to conduct air from the external environment into the lower airway. This process begins at the external nose. Air moves through the nares and into paired nasal...

Neuromuscular disease may involve the lower motor neurons (LMNs) and result in focal dysfunction. For example, lesions between C6 and T2 cause LMN signs to the thoracic limbs, and lesions between L4 and L6 cause LMN signs to the pelvic limbs (DeLahunta, A., Glass, E., and Kent, M. (2015). Veterinary Neuroanatomy and Clinical Neurology, 4. St. Louis...

The ability of the eyes to fixate on a single object in space is a highly coordinated action that relies upon functional extraocular muscles, cranial nerves, and input from the higher centers. Eye alignment also contributes to visual acuity and binocular vision. Abnormal eye alignment, meaning that one or both eyes deviate from the expected visual...

Swallowing is a complex process that requires coordination between the musculoskeletal, neurological, and gastrointestinal systems. Each step must be completed in sequence in order to successfully propel a bolus of food from the mouth into the stomach, using the esophagus as a tunnel to get there. Dysphagia is a clinical sign that results when a pa...

The majority of the female reproductive tract is internal in both the dog and the cat. When vulvovaginal discharge is clinically present, it may originate from anywhere within this tract. Vulvovaginal discharge may be physiologic, corresponding to various phases of the estrous cycle. For example, it is common for the female dog to develop serosangu...

Reflexes are the body's way of reacting to external or internal stimuli, without requiring conscious input from the patient. Autonomic reflexes are concerned with effecting change at the level of the viscera, whereas somatic or spinal reflexes exert control over skeletal muscle. The emphasis of this chapter is on the latter. Spinal reflexes may be...

Seizures occur when bursts of uncontrolled electrical activity translate into motor activity. Seizure activity takes on a variety of presentations, depending upon the patient and the degree to which one or both cerebral hemispheres are involved. Generalized seizures are characterized by whole‐body involvement, collapse, and loss of consciousness. P...

The vestibulocochlear organ is a multi‐part structure that consists of the external, middle, and inner ear. Given that it can be readily observed on physical examination, the external ear is the focus of this chapter. The purpose of the external ear is to funnel sound toward the tympanic membrane, or eardrum. This facilitates the special sense of h...

The flow of air from the upper to lower respiratory tracts is relatively quiet in the normal patient at rest. However, abnormal sounds may result from obstructive upper airway disease. These sounds are audible without a stethoscope. Their presence and, in particular, their persistence, suggests that a diagnostic work‐up for the patient is indicated...

The cornea contributes to the outer layer of the globe. Its primary functions are to maintain eye shape and refract incoming light. Refraction is made possible by maintaining corneal transparency. Corneal transparency is the result of the tissue itself being avascular, with its fibers arranged in lamellar form. The presence of one or more corneal o...

Several pathological conditions can occur that directly impact the male external genitalia. These conditions may be congenital or acquired, and have implications for the patient's ability to breed. Hypospadias, a condition in which the urethra develops abnormally during fetal life, is one of the most common canine congenital anomalies. Although hyp...

The mammary glands are an extension of the integumentary system that extend in two rows along the ventral body wall. These accumulations of glandular and connective tissue are responsive to hormonal changes that allow milk production to feed litters immediately following delivery. Both females and males have mammary glands. These are rudimentary in...

Forelimb lameness is a common clinical sign in companion animal practice. It may result from primary musculoskeletal or neurological disease. It may also be secondary to systemic pathology, as from metastatic cancer. Lists of differential diagnoses for this clinical sign are extensive, and no one summary of forelimb lameness can be exhaustive. The...

The iris is a vital component of the uveal, or middle, layer of the globe. Its primary function is to adjust pupil size like the aperture of a camera. When the iris dilator muscle contracts, the pupil widens to allow more light into the eye. When the smooth sphincter muscle of the iris contracts, the pupil constricts to reduce the amount of light t...

Traumatic wounds were the focus of Chapter 4, given that they are common presentations in clinical practice. However, atraumatic wounds deserve additional mention. Although they present with less frequency, they highlight a constellation of concerning disorders that may require recurrent care and/or diagnostic investigation to detect underlying dis...

Lameness is a common clinical presentation among companion animal patients. Although forelimb and hind limb lameness may be distinct, patients may also develop so‐called shifting leg lameness. This implies that lameness “jumps” from limb to limb. This clinical sign is not pathognomonic for one particular disease. However, when a patient presents fo...

Companion animals will frequently present for hypotrichosis or alopecia. The list of differential diagnoses that may be associated with these clinical signs is extensive. When presented with a case of hair loss in a dog or cat, consider grouping potential diagnoses into the following categories: non‐endocrine versus endocrine disease, and inflammat...

Pelvic limb lameness is a clinical presentation that may result from primary musculoskeletal or neurological disease. Lists of differential diagnoses for this clinical sign are extensive. The goal of this chapter is to summarize the most common presentations that are seen in companion animal practice. In addition, this chapter will review how to ap...

Skin nodules and tumors are common in canine and feline patients. They may be the reason that the patient is presenting to the veterinarian, for example, if the client initially discovered one or more masses. Alternatively, these cutaneous lesions may be incidental findings on canine and feline physical examinations. However masses are discovered,...

Diagnosis making in healthcare is both an art and a science. It requires the clinician to consider which diagnosis is most likely and to proceed with case management in the face of uncertainty. As veterinarians develop experience in clinical practice, they build a library of associations that they can then apply to new case presentations. Their rel...

The kidneys and ureters comprise the upper urinary tract. Of these structures, only the kidneys are palpable on physical examination. In cats, kidneys are highly mobile retroperitoneal structures, so much so that both can be felt on abdominal palpation. Renal shape, surface texture, symmetry, and size can be estimated and documented in the medical...

The process of taking one complete breath is the respiratory cycle. This cycle repeats, on average, 16–25 times each minute for cats and 18–25 times for dogs. This constitutes the normal resting respiratory rate for each species. Each breath requires coordinated effort between the musculoskeletal, nervous, and respiratory systems to bring sufficien...

The testes develop in embryonic life near the caudal pole of each kidney. Testicular descent through the inguinal canal to their final resting place, the scrotal sac, should be complete by the time the inguinal canal closes. The result is that mature, male, intact canine and feline patients should have two palpable scrotal testes. Testicular evalua...

In health, movement is a coordinated activity that requires effective communication between the central nervous system (CNS), the peripheral nervous system (PNS), and effector organs, such as muscle fibers. Some movement is self‐directed, meaning that patients make a deliberate decision to move from point A to B. Other movement is reflexive, meanin...

The normal heart sounds, S1 and S2, create the characteristic “lub‐dub” that is heard on cardiothoracic auscultation. Additional heart sounds, S3 and S4, are not appreciated in the normal patient. When S3 or S4 is present in addition to S1 and S2, the patient is said to have a gallop rhythm. If both S3 and S4 are present in addition to S1 and S2, t...

The central nervous system (CNS) is a control center that is responsible for receiving and responding to all incoming messages from the periphery. It relies upon an extensive network of neurons to transport messages throughout the body to effector organs, muscles, and glands. Upper motor neurons (UMNs) connect the brain to various spinal cord segme...

Both the size and shape of the pupil are important because they determine how much light the eye lets in at any given point in time. Pupil size is dynamic; however, normal pupils work in concert with one another‚ meaning that if one dilates, then so, too, should the other. Anisocoria is the state of having asymmetrical pupils. This is abnormal. Whe...

Claw and claw bed pathology are relatively rare as primary diseases in companion animal practice. When such pathology exists as a stand‐alone medical complaint, it is more often than not the result of trauma‚ as from biting or crushing injuries. Traumatic claw avulsions occur with frequency, paving the way for secondary bacterial infections and par...

Both intact and neutered male dogs may present to clinical practice for bilateral pre‐scrotal swellings. Sometimes these swellings are mistaken for testicles by the inexperienced dog owner. When these swellings appear post orchiectomy, clients may even question that their dog was in fact neutered. These swellings are typically the result of an engo...

The eyelids are protective of the globe. The blinking reflex is the natural response of the eyelids to keep foreign material from injuring the eye. However, pain within or surrounding one or both eyes may lead to reflex blepharospasm, a condition in which eyelid closure is sustained and forced. This creates the appearance that the patient is squint...

Patients with acute blindness typically present with mydriasis and a history of disorientation that may involve bumping into familiar objects. Acute blindness may be transient or permanent. For simplicity, lesions typically occur in one of three zones along this complex pathway: the retina, the optic nerve, or the visual cortex. Retinal lesions inc...

Several pathological conditions in companion animal patients present as cases of acute abdomen. Acute abdomen describes a state of intense abdominal pain that causes patients to present with tense abdomens and hunched postures. Dogs often stand with an arched back and/or assume the “prayer posture.” Depression, inappetence, vomiting, and diarrhea a...

The production of tear film is a defensive mechanism by the body to protect the corneal surface from contamination with debris and microorganisms. In health, tear film is a three‐layered composite of lipid, water, and mucus that collectively creates a smooth, even optical surface. Physiologic and pathologic states may alter the composition by impac...

The conjunctiva is a protective, supportive, lymphoid tissue that cradles the globe. In health, it is barely visible, if at all, and requires manual manipulation by the clinician to evaluate on physical examination. Various disease states increase the prominence of the conjunctiva, which may develop hyperemia, chemosis, and/or injection. Conjunctiv...

Clinical presentations involving the upper and/or lower eyelids are common in companion animal medicine. Signs range from complete absence of the eyelid(s), as is seen in extreme cases of eyelid agenesis, to eyelid swelling and/or abnormal positioning of the eyelid(s). Entropion and ectropion, eyelid inversion and eversion respectively, occur with...

Allergic skin disease often results in wheals, so‐called urticaria. Wheals may occur with or without angioedema. Both signify that the patient is experiencing a hypersensitivity reaction that may culminate in anaphylaxis. There are many causes of anaphylaxis. IgE‐mediated anaphylaxis may stem from vaccinations, insect stings or reptile envenomation...

Urine is a natural by‐product of metabolism. It is a liquid vehicle by which waste is eliminated from the body. Normal urine is one of many shades of yellow, depending upon the degree to which it is concentrated. The yellow hue results from one of urine's constituents, partially oxidized urobilinogen. Various pathologies may cause urine to take on...

Feces are the by‐product of digestion. Fecal amount, shape, and consistency provide insight into gastrointestinal and systemic health. Fecal scoring is a tool that can facilitate veterinary team discussions about bowel habits. When gut transit time is lengthened, stool is retained. Retention of feces causes a net loss of fecal moisture, and the sto...

Halitosis refers to the state of having bad breath. When breath is offensive because of its odor, it can negatively affect interactions between client and patient. Halitosis takes away from the human–animal bond, and may reduce the desire for face‐to‐face encounters. Clients are likely to identify halitosis and raise the topic for discussion at the...

Sexual differentiation requires a complex series of steps that are initiated in embryonic life, beginning with the act of fertilization. Patients that undergo normal sexual differentiate exhibit complete alignment between their chromosomal, gonadal, and phenotypic sex. That is, an XX female will have two female gonads, the ovaries, and will display...

Blood in the anterior chamber of the eye is called hyphema. Hyphema may be secondary to trauma. Alternatively, hyphema may result in bleeding disorders that involve platelet and/or erythrocyte number and function. Many bacteria, viruses, fungi, protozoa, and parasites either adversely impact these important blood cells or cause anterior uveitis, wh...

Emesis is the act of evacuating upper gastrointestinal tract contents. It requires a series of coordinated actions to force food from the stomach and out of the body, through the mouth. This reflex is controlled by the vomiting center within the medulla oblongata. This center registers signals from four relay stations throughout the body: the cereb...

Mucous membranes are normal structures that line body cavities and organ surfaces. These tissues protect the structures that they line. In addition, they provide secretions to keep body structures moist. In the respiratory tract, these mucous secretions are invaluable in that they trap particulate matter before it gains entry to the deeper airways....

In health, the globes, cranial nerves, functional visual pathways, and vestibular systems work as a cohesive unit to maintain proper alignments of the globes, conjugate eye movement, and vision. Movement of the globes should be smooth and coordinated. Dysfunction at any point in the pathway can result in involuntary, rhythmic oscillations. Patients...

Purulent material in the anterior chamber is called hypopyon. The most common cause of hypopyon is anterior uveitis. Most clinical presentations of uveitis in companion animals are idiopathic or noninfectious. Noninfectious uveitis may be caused by trauma, cataract resorption, and intraocular neoplasia. When uveitis is infectious, it may be the res...

The body's ability to maintain a near‐constant thermal set point is critical for survival. Thermoregulation requires coordinated efforts between the hypothalamus, as the body's central control, and the periphery. Peripheral body temperature may be sacrificed at the expense of core body temperature for the good of the whole. When this occurs, the pa...

Patient posture is the visually apparent by‐product of skeletal stability, muscle tone, and neuromuscular innervation. Abnormal presentations that involve posture may be suggestive of underlying pathology, particularly when certain regions of the body are involved. Cervical ventroflexion is a commonly described presentation in clinical practice. Th...

The forward flow of blood through pulmonary and systemic circulation is made possible by the heart acting as a mechanical pump, in combination with strategically placed heart valves. Closure of valves at coordinated intervals during the cardiac cycle maintains circulation, and creates normal heart sounds, S1 and S2. In health, these sounds are cris...

The previous chapter, Chapter 64, considered pathological and behavioral conditions that increase urine output. In contrast, this chapter emphasizes acute presentations in which urine output is decreased. Urine output may be reduced for physiologic reasons. For example, the patient that is dehydrated must conserve water. Dehydration calls upon the...

The upper urinary tract plays an integral role in maintaining homeostasis. The kidneys, in particular, are responsible for filtration of systemic circulation multiple times per day. This filtration achieves two goals: (a) excretion of waste products in the urine and (b) reabsorption of essentials, in the form of water and electrolytes. In health, w...

The sclera and the cornea collectively form the outer layer of the globe. As such, the sclera performs a protective function: it maintains the globe's shape to support internal structures. It also serves as an attachment site for extraocular muscles. In health, the sclera should be fibrous and tough. Its default color is white; however, melanin dep...

To maintain a steady state, homeostasis, the body tightly regulates physiological processes, including heart rate. Heart rate is the function of two opposing pathways, the sympathetic and parasympathetic nervous system, working in sync to coordinate the cardiac cycle. When heart rate drops below the reference range for what is considered normal, do...

The nictitans or nictitating membrane is the third eyelid of dogs and cats. It serves a protective purpose by shielding the globe with each blink, and contributes significantly to tear film production by means of a gland at its base. In health, the nictitans is not visible, but requires inspection by the veterinarian at each examination. Certain di...

The clinician must consider three pieces of clinical data to make an accurate diagnosis: the patient history, physical examination findings, and diagnostic test results. Of these three components of diagnosis‐making, the patient history carries the most weight in human healthcare. Although there are no comparable studies in veterinary medicine, it...

Wounds are common presenting complaints in primary care and emergency practice. They take a variety of shapes and forms, and many result from external injury. Bite injuries are particularly concerning because they create contaminated wounds that cannot heal until infected and devitalized tissue has been removed. A mixed population of bacteria from...

Overproduction of keratin results in epidermal thickening. This so‐called hyperkeratosis may occur in any region of the body; however, it often concentrates at the nasal planum and footpads of companion animal patients. This gross appearance is unmistakable, but not pathognomonic for any one particular disease. For example, nasal and footpad hyperk...

Lung sounds are part of the normal respiratory cycle. So‐called bronchial sounds result from turbulent airflow that is generated within the normal trachea and larger airways. These sounds are relatively harsh and can be ausculted by placing a stethoscope over the windpipe. As air enters into progressively smaller passageways, airflow becomes more l...