Review on Practical Guidance of Veterinary Clinical Diagnostic Approach

Abstract

Animal disease problems have been investigated by veterinarians through undertaking a careful and clinical examination with the objective of recognizing the nature of the affection. So, that effective treatment and control measure is adopted. Clinical examination is one of the fundamental for diagnosing animals which are presented to clinic. Veterinary clinical examination relies on knowledge of Anatomy, Physiology, Pathology and Animal behavior, skills in the methods and techniques of clinical examination, clinical sign and pathogenesis of the diseases which are the basic requirements for clinician in his/ her good diagnostic approach. The diseased animals which are presented to veterinary clinic can be analyzed by veterinarian or clinician, the clinician approach through asking the owners complaint, which request for professional assistance by giving animal history. The accurate and complete history of patient may get from focusing on collection of patient data, present, past and environmental history in appropriate to patient animals. The veterinarian can approach to animals by the method of restraining in order to handle in safe condition. Physical examination is the examinations that apply to animals by general inspection, palpation, percussion and auscultation methods used to detect clinical signs of abnormalities. Clinical examination can be undergone by taking vital sign, general clinical examination and systemic examination of animals. Animals which have been diagnosed by veterinarian may have medication, through the injection or oral route with an appropriate dose of drug related to body weight, age and condition of animals. In conclusion, the veterinary clinical diagnostic approach is the core and the most important to generate accurate clinical examination, investigation of animal's disease problem and guide how to handle the animals and the methods of restraining of animals. The objective of this review paper is helps to understand and know how the procedure of veterinary clinical diagnostic undergoes and treatment of animals takes place, to guide and give knowledge on systemic and general examination of domestic animals.

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
Life Sciences Group
Abstract
Animal disease problems have been investigated by veterinarians through undertaking a careful
and clinical examination with the objective of recognizing the nature of the affection. So, that effective
treatment and control measure is adopted. Clinical examination is one of the fundamental for diagnosing
animals which are presented to clinic. Veterinary clinical examination relies on knowledge of Anatomy,
Physiology, Pathology and Animal behavior, skills in the methods and techniques of clinical examination,
clinical sign and pathogenesis of the diseases which are the basic requirements for clinician in his/
her good diagnostic approach. The diseased animals which are presented to veterinary clinic can
be analyzed by veterinarian or clinician, the clinician approach through asking the owners complaint,
which request for professional assistance by giving animal history. The accurate and complete history
of patient may get from focusing on collection of patient data, present, past and environmental history
in appropriate to patient animals. The veterinarian can approach to animals by the method of restraining
in order to handle in safe condition. Physical examination is the examinations that apply to animals
by general inspection, palpation, percussion and auscultation methods used to detect clinical signs of
abnormalities. Clinical examination can be undergone by taking vital sign, general clinical examination
and systemic examination of animals. Animals which have been diagnosed by veterinarian may have
medication, through the injection or oral route with an appropriate dose of drug related to body weight,
age and condition of animals. In conclusion, the veterinary clinical diagnostic approach is the core and the
most important to generate accurate clinical examination, investigation of animal’s disease problem and
guide how to handle the animals and the methods of restraining of animals. The objective of this review
paper is helps to understand and know how the procedure of veterinary clinical diagnostic undergoes and
treatment of animals takes place, to guide and give knowledge on systemic and general examination of
domestic animals.
Review Article
Review on Practical Guidance of
Veterinary Clinical Diagnostic Approach
Tagesu Abdisa*
Jimma University, College of Agriculture and
Veterinary Medicine, School of Veterinary Medicine
P.O Box 307, Jimma, Oromia Ethiopia
Dates: Received: 08 May, 2017; Accepted: 10 June,
2017; Published: 12 June, 2017
*Corresponding author: Tagesu Abdisa, Jimma Uni-
versity, College of Agriculture and Veterinary Medi-
cine, School of Veterinary Medicine P.O Box 307,
Jimma, Oromia Ethiopia, Tel: +251933681407, E-mail:
Keywords: Clinical examination; History taking;
Medication; Physical examination; Clinical diagnosis
https://www.peertechz.com
Introduction
Clinical examination is a fundamental part of the process
of veterinary diagnosis. It provides the veterinarian with the
information required to determine the disease or diseases
producing the clinical abnormalities. In addition, the
information derived from the clinical examination should
assist the veterinarian in determining the severity of the
pathophysiological processes present. Without a profi cient
clinical examination and an accurate diagnosis, it is unlikely
that the treatment, control, prognosis and welfare of animals
will be optimized [1-5].
The organs or systems involved, the location, type of lesion
present, the pathophysiological processes occurring and the
severity of the disease can be deduced from the information
gained during the clinical examination. The success of clinical
examination relies heavily on the knowledge of the clinician
and usually assumes a single condition is responsible for the
abnormalities. Many clinicians begin their examination by
performing a general examination which includes a broad
search for abnormalities [6,7]. The system or region involved
is identifi ed and is then examined in greater detail using
either a complete or a problem oriented examination. For
this sound knowledge of Anatomy, Physiology, Pathology
and Animal behavior, skills in the methods and techniques of
clinical examination, knowledge of etiology, clinical sign and
pathogenesis of the diseases are the basic requirements for
clinician to make diagnosis. The objectivity of this review on
practical veterinary diagnostic approach are as the following:
➢ Guide to how to handle the animals and the methods of
restraining of animals
➢ It helps to understand and know the procedure of
clinical diagnostic, how to take history
➢ To understand the general and systemic examination of
domestic animals

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
➢ Having knowledge of how to examine, treat and
identifi ed the complex disease of animas
➢ It guides to give knowledge on how to prepare and
administration of veterinary drugs
Literature Review
The practical guidance of veterinary diagnostic approach
Veterinary clinical examination relies on knowledge of
Anatomy, Physiology, Pathology and Animal behavior, skills in
the methods and techniques of clinical examination, clinical
sign and pathogenesis of the diseases which are the basic
requirements for clinician in his/her good diagnostic approach
[8]. The diseased animals which are presented to veterinary
clinic can be analyzed by veterinarian or clinician, the clinician
approach through asking the owners complaint, which request
for professional assistance by giving animal history. The clinical
examination ideally proceeds through a number of steps. The
owner’s complaint, the history of the patient, the history of the
farm and the signalment of the patient are usually established
at the same time by interview with the owner or keeper of the
animal [9]. The following points are going to be taken before
diagnosing presented animals:
Taking of patient history
History taking or anamnesis is the process of obtaining
information on the animal patient about its illness, onset of
illness and feeding practice through careful questioning of the
owner. In Veterinary practice, the disease is presented indirectly
in the form of a complaint by the owner or the attendant. Thus,
it is very necessary to have all the information from the owner.
Most of the time, the owner or attendant fails to provide
pertinent and adequate history and inaccurate history may
lead to misdiagnosis. The clinician must substantiate these
with rational question utilizing professional knowledge [1,5].
The disease problem of patient animals is diffi cult to diagnose
without knowing the history of animals, the history should be
taken from the owners of the patient and recording the owner’s
complaint. Disease information should include the group(s)
affected, the numbers of animal affected (morbidity) and the
identities of the animals affected; the number of animals that
have died (mortality) should be established. In order to get the
accurate and complete history of patience the following things
should be focused; patient data, present history, past history
and environmental history.
Patient data is essential to identify the patient and it
includes: Owner’s name, Owner’s address: postal address,
telephone, kebele, peasant association, Species, breed, sex,
age, name, ID No., body weight, Description including color,
marking, polledness, and other identifi cation marks of patient
[8,9].
Presented history of patient
It comprises of recording the sequential events from the
start of the patient chronic. Questions about physiological
functions such as appetite, urination, defecation, rumination,
respiration, sweating, milk production, gait, posture and also
of the fi rst symptoms shown by the animal should be asked. All
these information deal with the current problem of the animal
and the events associated with it. The point which going to be
asked is that as follows [1,5,8]:
Locations of the problems: Following up and attention at
the complaint that a farmer has to say and from there you can
tentatively say the likely system involved in that condition, for
instance:
 Digestive system involvement will be shown as absence
of rumination, appetite, bloat or diarrhea.
 Respiratory system involvement will be indicated
presence of nasal discharge, coughing, dyspnea.
 Urinary system involvement will be manifested as
frequent urination, passing red coloured or cloudy
urine.
 Musculo-skeletal and nervous system involvement
will be manifested as lameness, inco-ordination, and
paralysis.
Nature of illness: The clinician should be able to assess
and fi nd out the time of onset of disease, any change
management practices and signs noticed by the farmers.
 To assess to know the duration of disease whether it is
peracute, acute, subacute or chronic
 To know number of animal diseased and morbidity rate
and mortality rate of animals
 Determine whether any drug has been given for animals,
before patience come to clinic for assurance
 And the following question should be pointed:
 When did the farmer notice the disorder? (time)
➢ Did it occur suddenly/slowly? (acute /sub-acute /
chronic nature)
➢ What were the signs noticed? (anorexia/drop in milk
yield/ others)
➢ Are the animal fed / grazed in pasture / forest grazed?
(getting information on management practices e.g.
ketosis seen in stall fed animals, while babesiosis seen
in forest grazed animals)
➢ Is there any other animal affected with similar condition
in the same herd / in other farmer’s herd in the village
(to fi nd out if the disease is rapidly spreading)?
➢ Ask if there has been any introduction of new animal
to the herd / village (sick animal may have been bought
from affected area and disease has started)
➢ Is the affected animal vaccinated against food-and-
mouth disease (FMD), anthrax, hemorrhagic septicemia

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
(HS), Black quarter (BQ) (to fi nd out if the animal is
protected against common diseases)
Past history
Inquiring into the past history may help in arriving at a
diagnosis. History of drenching a day or two earlier may cause
aspiration pneumonia. History of past disease may be co-
related to the present illness. Past history will also give idea if
such condition prevailed previously in the area.
 Ask if such condition was reported previously too
(reveal endemic nature of disease, or occurrence of a
new disease)
 Does this occur at certain period of time? (fi nd out the
seasonal occurrence of the disease)
 Was the disease reported form other places in the
locality? (area of spread / occurrence can be found out)
 Has any animal recovered from such a sickness? (to aid
in prognosis)
 Is the disease restricted to certain age group / sex? (BQ
is seen in animals between 1 – 3 years of age in both
sexes [2,4].
Management and environmental history
The environment in which the animals were kept at the
time of the onset or just before the onset of the illness should be
carefully examined. The animals may be housed or outside. Risk
factors outdoors may include the presence of toxic material,
grazing management, biosecurity and regional mineral
defi ciencies. Risk factors indoors may include ventilation,
humidity, dust, stocking density, temperature, lighting,
bedding, water availability, feeding facilities and fi tments.
Environment or surrounding of the animals may help in the
diagnosis of disease. E.g.-Animal grazing on pasture irrigated
with sewerage water may suffer from nitrate poisoning.
Parasitic diseases are more in animals, which are kept in
marshy lands. Recent spraying of weedicide or insecticides may
poison the animals. Environmental history can be divided into
outdoor environment and indoor environment [9].
Outdoor environment history: It regard to the topography
of land where animals are reared, vegetation, type of
agriculture practiced in the locality, use of chemicals in
agriculture (pesticide, weedicide) and system garbage disposal
in the area. Animals that are grazed are likely to be infested by
parasites and prone to vector borne diseases like babesiosis,
trypanosomiasis, or animals that are grazed in the marshy area
including paddy fi led are likely to be infested by liver fl uke etc.
Indoor environment history: It regards with the types of
animal house. The following should be look assessed how is the
house of animals is designed:
√ If there is proper ventilation,
√ In the rural area, traditionally animals are housed in
the ground fl oor of the house where there hardly any
ventilation and this will predispose the animals to
respiratory diseases,
√ If the animals are stall fed check
√ If the animals are provided with enough drinking water,
√ If the fl oor is dry and clean, damp and dirty fl oor may
lead to mastitis in milking animals,
√ If the bedding materials are used
√ If the materials are changed daily of topped daily to
keep the animals dry and clean.
√ If the animals are housed separately see
√ If the height of the roof is at a required level,
√ If it is too low, in hot places animals may be subjected to
heat stress in summer months,
√ If it is too high animals will be exposed to rain.
The methods how to approach to animals
Restraint is the term used to imply control of an animal
and may be necessary for medical reasons and nonmedical
procedures. Animals are often resist to the clinical examination
procedures. The animal must be restrained so that it can be
examined carefully, safely and with confi dence. The methods
of restraint should be done, in order to able to carry out the
examination safetly and without danger to the clinician and
assistants, the methods available may be classifi ed as the
following [6,9].
 Physical restraint.
 Chemical restraint
 Verbal/Moral restraining
Physical restraint
It is important to perform all the physical manipulations in
a quiet and gentle manner in order to carry out the examination
safely without causing danger to the clinician or his assistants
and to avoid disturbing the patient. Restraining methods for
equine, cattle, Pet animal, sheep and goats
Restraints of the equine: Equipment used for restraint and
handling should be effective without causing stress to the horse
and should be designed for maximum safety of the handler and
horse. A horse should be approached from the front and slightly
to the left (near) side because they are accustomed to being
handled on that side. They become nervous when handled from
the right side [10]. Any restraint method used to assist normal
management or treatment of the horse should be the most mild
and effective method available, and should be applied for the
minimum amount of time necessary to carry out the task. A
halter and lead rope is the most common form of restraint.
Generally, the safest knots are those that can be quickly untied
even if the horse has pulled on it. When used by knowledgeable

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
handlers, other acceptable forms of restraint include hobbles,
twitches, lead chains, stocks and chutes [11]. Tethering is a
form of restraint that brings a high risk of injury to horses
unless used correctly. For the purpose of this Code, tethering
means attaching a long rope or chain to the halter or leg hobble
so the horse can graze. Tethering does not refer to tie stalls or
briefl y tying a horse to a fi xed object [11]. The following lists
are the method how to restraint horse [8,10] (Figure 1).
➢ Applying a halter.
➢ Rope twitch
➢ The hand twitch
➢ Neck skin grip: To restrain the horse, grasp the loose skin
of the neck.
➢ Twitch is applied to the upper or lower lip or to the ear
➢ Nose twitch
➢ Lifting the fore-leg and hind-leg by unaided hands or
with Leg twitch
➢ A loop of strong cord or soft rope is applied to the
appropriate part
➢ Two ropes one-person horse casting
➢ Two ropes four people’s horse casting
Restraint of the cattle: Restraint of cattle depends on breed,
age, sex and knowledge of animal behaviour. For example,
bulls are unpredictable and should be handled with care.
Aggressive bulls for instance, will paw the ground with front
feet, lower and shake the head. They may also make mowing
sounds. Nervous cows will keep head and tail up and may have
an anxious expression in their eyes [8,13]. The followings are
the methods for restraint of cattle:
 The nasal septum is gripped between the thumb and
one fi nger or with ‘bull-holder
 Leg twitches are also employed
 One rope locking two horns on a post or tree
 One rope two-person cattle casting
 Two ropes three-person cattle casting
 Chest twitch: Chest twitch is used for exceptionally
restless cattle.
 Procedure chest twitch: A rope is tied around the chest
and held under tension by a strong pole twisted in a
rope loop. However, chest twitch should be used only
when there is no other method of restraint.
 Nose lead: It restrains cattle by applying pressure to the
nasal septum.
 Procedure of nose lead: It is shaped like a pair of tongs
with a large ball at the end of each arm, which fi ts
against the nasal septum. Usually, it has a chain or rope
at the end. Hold the lead out for the animal to sniff.
As the animal raises its head to sniff, slip the nose lid
into the nostrils and close quickly. Then tie the rope to
the post for continuous restraint but remember it loses
effect when the nasal septum becomes numb. Manually
holding the nasal septum with index fi nger and thumb
nose grip and slip in the nose lead. It is advisable to avoid
using nose lead too frequently on the animal as it may
become “head shy”.
 Restraint using a crush: A crush can be used to restrain
many animals at a go. It can be constructed of posts
or planks or steel tubing. However, the internal surface
should be free of sharp edges or projections that can
injure the animal. So, it should comprise of an assembly
area with a funnel ending in a closed pen with the
fi nal run being just wide enough for one animal and
suffi ciently high enough to prevent it from jumping.
Backward movement is prevented by a transverse bar
inserted just behind the animal [13] (Figure 2).
Restraint of sheep and goat: Sheep have an intense instinct
to remain with the fl ock and as such, it is best to handle them
as a fl ock initially before isolating the animal you want to per-
form certain procedures on. When disturbed, they will stamp
their front feet and will use the head to attack. Hence, always
work gently, calmly and with assurance around them. Sheep
have very fragile bones that can easily be broken and heavily
woolled sheep may become hyperthermined if chased around
[13]. The following are the methods how to restraint and hold-
ing sheep [13]:
A. B.
C. D.
Figure 1: Pictures of how to restraint horse [12];
A: Halter If a horse or donkey’s head is restrained, it can be led or held for
procedures such as injections. A halter can be made from a piece of sisal or cotton
rope. Avoid using nylon rope against the skin.
B: The Lip twitch  the twitch is useful to restrain a horse before a painful
procedure, to examine it or give it treatment. It is known that a twitch placed
correctly on the nose causes the release of natural pain-killing substances in the
horse’s body.
C: Two Rope Casting used to prevent kicking and it can be done safely without
danger of being kicked. It is done to avoid being kicked when helping a mare that
is having a diffi cult birth and make it lie on its side.
D: Mild restraint without a twitch.

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
Capturing a sheep: The sheep can be captured by driving
the fl ock into a small pen or enclosure and then approach an
individual animal slowly. Swing your arm around the neck and
front quarters and quickly wrap your other hand around the
hindquarters or grasp the tail if present.
Shepherds crook: Hook a rear leg at the hock, quickly
immobilizes sheep as above.
Halters: Can be used but remember sheep have a short nose
and should be careful not to block the nostrils.
Restraint of goat: Goats do not tolerate rough treatment and
will struggle violently if not properly handled. Therefore, re-
straint time should be as short as it is necessarily possible [14-
18].
Walls and fences: Push the goat against the fence or wall wit
h your legs and hip and leave your hands free for other proce-
dures. You can also push the hindquarters against a wall and
then put your hand around the neck to keep it still for tem-
perature taking or injection.
Restraint on lateral recumbency: The goat is placed parallel to
your legs; the jaws are grasped with one hand while the inside
rear leg is grasped with the other hand. Bring the leg forwards.
The goat will be thrown off balance and fall on the ground.
Restraint of the Head: This is best when the goat is pushed in
a corner and the body held against a wall. Procedure: Grasp the
beard (if bearded) with one hand and encircle the neck with the
other arm to stabilize the head.
Use of horns: This should only be for a short time as goats
react violently when horns are held. Moreover, horns should
not be used in very old goats as they break easily.
Cheek hold: Place one hand on either side of the cheeks and
wrap fi ngers around the mandibles to hold fi rmly. You can
examine the eyes or take blood from the jugular.
Collars: Leather collar or neck chain can be used in dairy
goats to lead or restrain them. They may be temporary or
permanent (collars). Neck chains should be made of small, fl at
links, which don’t catch easily as the goat rubs against a fence
(Figure 3).
Restraint of Pet animals: Cats have always relied on speed,
agility, caution, needle sharp teeth and dagger-like claws for
survival. Therefore, they should be approached in a feeble
manner. Restraint techniques of cat are as following [10,13]:
√ Leg restraint: Always place an index fi nger or middle
fi nger between two legs. This provides a better grip to
prevent escape.
√ Head – Mandible hold: The palm of the hand is placed
under the cat’s chin and the fi ngers are used to grasp
mandible.
√ Scruff of the neck: Hold as much of the loose skin on the
back of the cat’s neck as possible. This prevents the cat
from turning its head to bite.
√ Restraint with towel: Cover the head with a towel or cover
the entire cat; then lift it up, isolate the needed part and
uncover it. This is good for injection or examination.
√ Restraint bag: Feline restraint bag (cat bag) is normally
used to restrict the movement of the cat and also to
protect the handler from scratches.
√ Restraint with the adhesive tape: Apply adhesive tape
around the legs starting with the hind legs then followed
by the fore legs.
√ Gauze muzzle: They can be commercially available
(leather muzzles) or home made using gauze.
Procedure of gauze muzzle: Make an over hand knot in the
middle of the gauze to form a loop. Next, lower the loop
over the cat’s muzzle and tighten it on both ends of the
gauze. Bring the gauze under the jaws, which are tied
together under the mandible using an overhand knot
with both ends brought behind the ears.
A. B.
C. D.
Figure 2: The methods of restraint of the cattle. A & B: the methods of casting or
throwing of cattle. C&D: Nose holding and haltering respectively.
A. Goat
B. sheep
Figure 3: Picture of restraint methods in sheep and goat.

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
In restraint of dog the following devices prevent injury when
used correctly and judiciously [10]: (Figure 4)
√ Muzzles: Commercial muzzles are made of leather, wire
or fabric. There are also gauze or nylon rope muzzles.
√ Gauze or Rope Muzzles: For dogs with long noses, you do
not need to pass the passive end between the eyes to
secure the loop over the nose before tying the bow gauze
after passing behind the ears.
√ Blanket and towels: These are used to remove unfriendly
dogs from cages.
Restraint of poultry and birds: Free movement of the
sternum is essential for respiration in birds. They possess
no diaphragm and their lungs do not expand and contract.
They breathe through expansion and contraction of their air
sacs facilitated by their intercostal muscles. Thus, any undue
pressure on their sternum would restrict breathing. We have
all heard of instances where a bird has died in someone’s hand.
More than likely they had closed their hand around the chest
inhibiting respiration. When handling a bird, fi ngers should
never be closed around the chest, rather cupped in the hand to
allow for sternal movement. During handling carefully monitor
the bird for any signs of discomfort, stress or breathing
diffi culty. Due to struggling, the bird could contort and twist in
such a way to constrict the air passages. Also during restraint,
efforts to escape can lead to hyperthermia, especially if in a
towel, so be alert if the bird begins to pant heavily [10]. There
are fi ve basic means of holding a bird’s head.
 Extend the head between the index and middle fi nger,
 Grasp the head with the thumb and index fi nger on
either side of the head at the temporo-mandibular joint,
 Using three fi ngers, place the thumb and middle fi nger
just below the eyes and the index fi nger over the head,
called the ‘helmet grip,’
 Crook the index fi nger behind the back of the head and
gently place the thumb behind the lower mandible,
 Gently circling the neck with the thumb and index
fi nger as a tubular restraint collar would. (Figure 5)
Chemical restraint
Chemical restraint may be defi ned as the use of drugs
to bring about sedation or neurolepsis, neuroleptanalgesia,
neuroleptanaesthesia or short duration general anaesthesia.
This is a reversible process whose purpose is to produce
convenient, safe, effective and inexpensive means of restraint
so that clinical procedures may be carried out with minimum
of stress, pain, discomfort, and toxic effects to the patient,
the anaesthetist or the clinician [13]. Drugs that is useful
for this purpose includes: Acepromazine, Acetylpromazine,
Chlorpromazine, Promazine and Trimeprazine; members of
this group can be used in most species of animals, Butorphanol,
hloral hydrat [8,13].
A. Dog
C. Cat
Figure 4: Picture of restraint method in dog and cat.
A. Wild bird
B. Domestic bird(hen)
Figure 5: Restraint or holding methods for birds.
A) The method of holding wild bird.
B) The method of holding domestic bird.

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
Verbal/moral restraining
It is more practiced by owner e.g., feed provision,
massaging, calling name of animal etc. When the horse is alert,
the ears are fl icked forwards and the horse is usually curious
of one’s approach. A nervous horse will continuously fl ick the
ears back and forth especially when there is activity behind it
while an angry or fearful horse will pull its ears backwards.
This should however not be confused with laid-back ears where
a horse is concentrating on a diffi cult task such as calf roping
or barrel racing. The tail always indicates the horse’s attitude.
A wringing or circling Restraint of Domestic, Laboratory and
Wild Animals tail is an indication of nervousness. A tail held
straight down indicates pain or sleeping, while a tail clamped
tight indicates fear. Nevertheless, each horse is an individual
and should be treated accordingly. Horses can be calmed by
an even tone of voice and are most cooperative when handled
quietly and decisively. They can also, be easily “bribed” with
a handful of delicious foods like oats, carrots etc. Scratching
behind ears, eye ridges and the neck will convince the horse
you are friendly [5,10].
Physical examination
The main aims of physical examination is to apply general
inspection, palpation, percussion and auscultation methods
used to detect clinical signs of abnormalities.
General inspection: It is done some distance away from the
animal; sometimes go round the animal or herd/fl ock, in order
to get the general impression about the case [2]. Attention
should be paid to the following items: (Behavior, Appetite,
Defecation, Urination, Pasture, Gait, Body condition, Body
conformation), Lesions on outer surface of the body can be
observed: (Skin and coat, Nose, Mouth, Eyes, Legs and hoofs,
Anus).
Palpation: Palpation is used to detect the presence of pain
in a tissue by noting increased sensitivity and use fi ngers,
palm, back of the hand, and fi st, in order to get the information
about the variation in size, shape, consistency and temperature
of body parts and lesions, e.g., the superfi cial lymph nodes. The
terms, which can be used to describe the consistency of parts
during palpation, are [1,14]:
 Resilient, when a structure quickly resumes its normal
shape after the application of pressure has ceased (e.g.,
Normal rumen)
 Doughy, when pressure causes pit ting as in edema
 Firm, when the resistance to pressure is similar to that
of the normal liver (e.g., neoplasia/tumor)
 Hard, when the structure possesses bone-like
consistency (e.g., Actinomycotic lesion)
 Fluctuating, when a wave-like movement is produced
in a structure by the application of alternate pressure
(e.g., hernia, hemorrhage/hematoma)
 Emphysematous, when the structure is swollen and
yields on pressure with the production of a crepitating
or crackling sound (Table 1).
Percussion: Method of examination in which part of body
to be examined is struck with sharp blow using fi ngertips to
produce audible sound. Sound thus emitted will indicate the
nature of the tissue / organ involved for example rumen when
bloated will emit drum like sound. Some of the organs that
can be examined by percussion are: gastro-intestinal tract,
abdomen and thorax, frontal and nasal sinuses. The objectives
of percussion are to obtain information about the condition of
the surrounding tissues and, more particularly, the deeper lying
parts. Percussion can examine the area of the subcutaneous
emphysema, lungs, rumen and rump. Sounds produced from
various structures can be described as following list [1,3,5]:
 Dull / fl at – sound without resonance or echo, this type
of sound can be heard on percussion of thick muscles or
bone.
 Full sound – sound heard is with resonance but not
booming like drum. This type of sound is heard from
tissues like lungs that contain air inside.
 Tympanic sound – drum like sound can be heard,
and this type of sound is heard from bloated rumen,
abomasums and intestine.
Immediate percussion: Using fi ngers or hammer directly
strike the parts being examined.
Mediate percussion: Finger-fi nger percussion; Pleximeter-
hammer percussion. The quality of the sounds produced by
percussion is classifi ed as [3]:
➢ Resonant: This is characteristic of the sound emitted by
air containing organs, such as the lungs.
➢ Tympanic: The sound produced by striking a hollow
organ containing gas under pressure, e.g., tympanitic
rumen or caecum.
➢ Dull: Sound emitted by a solid organ like the liver or
heart.
Modifi ed percussion
Ballottement percussion: Tactile percussion or
ballottement: is method in which palpation and percussion
Table 1: The structures that can be palpated and what they are palpated for are:
No organs Palpated for
1 Superfi cial arteries Pulse
2 uterus Pregnancy
3 muscles Pain/swelling
4 bone Fracture/growth
5 Stomach, intestine Pain
6 esophagus Obstruction
7 rumen Bloat, impaction

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are combined together to feel structures that cannot be felt by
either of these methods applied singly. This is normally used
for pregnancy diagnosis in cows when the foetus cannot be
palpated through per rectum. Here a fi rm-pushing stroke is
applied on to the uterus and the hand after pushing is kept in
contact with uterus so that the foetus will bound and strike
on it. While fi rm pushing is done, this sets fl uid in uterus
into motion and foetus is made to bounce [1]. This modifi ed
percussion is used to detect late pregnancy in small ruminants,
dogs and cats. And also, used for detection rebound of fl oated
material shows pregnancy.
Procedure: Apply a fi rm and interrupted push on the uterine
region of the abdomen of small ruminants.
Fluid percussion: Used to detect fl uid in the abdomen
Procedure: Apply a push on one side of the abdomen,
percussion on the other side. The presence of wave-like fl uid
movement shows accumulation of fl uid in the abdomen, e.g.,
ascites [9,15].
Auscultation
Word auscultation comes from ‘auscutona’ meaning ‘to
listen’. This is a technique of listening to the sounds produced
from organs in the abdominal and thoracic cavities. In olden
days listening to these sounds were done with naked ears.
This had certain limitations like the skin on animal being dirty
and infested by parasites it was not healthy for the clinicians
and was diffi cult to keep ears in contact on animal body due
to constant movement. Therefore, an instrument was later
developed for this purpose and this is called stethoscope [3,9]
(Figure 6).
The main objective of auscultation is that to listen the
sounds produced by the functional activity of an organ located
within a part of the body. This method used to examine the
lung, trachea, heart and certain parts of the alimentary tract.
Types of auscultation:
Direct auscultation
Procedure: Spread a piece of cloth on the part to be examined
using two hands to fi x the cloth and keep your ears close to the
body, then listen directly.
Indirect auscultation: Use stethoscope.
Procedure: Fix the probe of the stethoscope fi rmly on
the part of the body to be examined and listen to the sounds
produced by the functional activities of the body carefully.
Steps in auscultation
Place the ear piece into the ears, hold the chest piece and
give a gentle tap on diaphragm, if no sound is heard adjust it
by holding rubber tube with one hand and turning the chest
piece with the other until there is ‘click’ sound. Tap again there
should be amplifi ed sound heard. Place the chest piece over the
desired area and listen to the sound hear or lungs accordingly.
Areas for listening to heart and lungs sounds are shown below,
for rumen left fl ank region can be used [9] (Figure 7).
Succusion (shaking)
It is the method used to determine the presence of fl uid in
the body cavities like thoracic and abdominal cavity. Here the
animal is shaken from side to side to set fl uid into motion so
that audible fl uid sound is produced. This is diffi cult in large
animals and can be applied only in small animals like dogs and
cats [9].
Clinical Examination of the Patient
General physical examination
Physical examination can be carried out by taking vital sign
such as; Temperature taking, Pulse taking, Respiration taking,
Capillary Refi ll Time (CRT), Physical body condition, Normal
demeanor, Abnormal demeanor [8,9].
Temperature taking: Temperature is the measure of how
hot or cold the animal body is. On the basis of the ability to
regulate body temperature animals are divided into two groups
via homeotherms and poikilotherms. Homeotherms are those
animals including man that can regulate their temperature in
relation to the environmental temperature. Poikilotherms are
those animals that are unable to regulate their body temperature
in relation to the environmental temperature (eg. Amphibians,
Reptiles and fi shes). Heat is generated in the body via the
intracellular oxidation of food and the muscular activities.
It is lost via the physical process of conduction, convection,
and radiation and through the evaporation, respiration and
excretion [1].
Figure 6: Part of Stethoscope.
Figure 7: Area for lungs auscultation Area for heart auscultation.

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The body temperature is taken using a mercury or digital
electronic thermometer placed carefully into the rectum.
The thermometer should be lubricated before insertion and
checked (in the case of a mercury thermometer) to ensure
that the mercury column has been shaken down before use. It
should be held whilst it is in the rectum. Sudden antiperistalsis
movements in the rectum may pull the thermometer out of
reach towards the colon. The thermometer is left in position
for at least 30 seconds; the clinician should ensure the
instrument is in contact with the rectal mucosa, especially if
a lower than expected reading is obtained. The thermometer
must be cleaned after removal from the patient. It must not be
wiped clean on the patient’s coat. If the animal’s temperature
is higher or lower than anticipated it should be checked again
[1,9] (Figure 8).
Procedure: how to take temperature and how to recording
temperature [12,16].
The places, which can be used to take temperature, are
rectum or vagina (approximately 0.5 degree centigrade higher
in vagina).
➢ The thermometer should be sterilized by disinfectant
(antiseptics) before use. Wet the thermometer with cold
water or put some petroleum jelly (Vaseline) on the end
to make it more slippery.
➢ It should be well shaken before recording of temperature
to bring the mercury column below the lowest point
likely to be observed in different species of animals. If
the reading is not below 36°C, shake the mercury down
to the bulb. Use fl icking motions, taking care not to hit
the thermometer on anything.
➢ The bulb end of the thermometer should be lubricated
with liquid paraffi n or glycerin or soap especially in case
of small pup and kitten.
➢ Insert the thermometer in a rotational way and gentle
manner. Care should be taken so that the bulb of the
thermometer remains in contact with the rectal mucous
membrane.
➢ The thermometer should be kept in site for at least 3-5
minutes.
➢ Pull out the thermometer, clean it and read the number.
➢ Put a halter or head collar on the horse or donkey and
have an assistant hold the head.
➢ Read the value to defi ne and explain a state of fever,
hypothermia, and febrile or non-febrile animals.
Method of recording temperature
1. Keep the bulb of the thermometer immersed in the
antiseptic solution for sterilization.
2. Bring down the column of the mercury before recording
the temperature by shaking.
3. Lubricate the bulb with liquid paraffi n or Glycerine or
soap and water, when the thermometer is to be used in
pup or kitten.
4. Insert the bulb of the thermometer into the rectum
and tilt to one side so that the bulb of the thermometer
touches the mucous membrane of the rectum.
5. Keep the thermometer in this position for one minute.
6. Take it out, wipe the faeces with cotton and read the
temperature directly (Figure 9).
Interpretation of thermometer: Thermometer reading will
reveal if the temperature of animal being examined is normal,
above normal (fever) of below normal (subnormal). Based on
this fi nding action taken will vary. Fever: denotes the elevation
of body temperature of animal above normal. It is a general
reaction of animal and human body to the action of infectious
agents like bacteria, virus, parasites and exogenous substances
like bacterial toxins. Sign of fevers are Animal will refuse to
eat either completely or partially (anorexia), hair on the body
Figure 8: Picture of digital and mercury thermometer.
A.
B.
C.
Figure 9: Picture procedure how to take and read temperature of animals [12].
A: procedure how to insert thermometer to animal’s anus;
B: If the reading is not below 36°C, shake the mercury down to the bulb. Use fl icking
motions, taking care not to hit the thermometer on anything.
C: Take the thermometer out of its case and hold it between the thumb and
forefi nger. Roll it until you can see a broad silver band of mercury.

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might be seen standing up, dullness, and dry muzzle. Fever
management: There are preparations to reduce temperature.
Preparations like paracetamol, Phenylbutazone is normally
given to control fever (refer drug index for these preparations)
in addition keeping animals in cool place [3].
Subnormal temperature / hypothermia: The temperature of
animal drops below normal and this occurs when animals get
exposed to extreme cold for example when a calf is exposed to
heavy rain, when animal is in shock and a clinical condition
like milk fever. Here the animal body is unable to regulate body
temperature or the heat regulatory mechanism fails to generate
heat to compensate the heat loss from the body.
Signs of hypothermia: Shivering, chattering of teeth,
cold extremities and skin on touch, and reduced pulse and
respiratory rates are observed.
Hypothermia management: Place the affected animal
in warm place or provide shelter to protect from rain, rub
extremities and apply liniments if available, provide warm
porridge if animal has appetite, inject warm DNS / NS, inject
calcium preparations in the case of milk fever the temperature
will automatically rise (Table 2).
Pulse taking: Pulse is defi ned as the regular expansion and
contraction of the arterial wall caused by the fl ow of blood
through it at every heartbeat. Pulse gives information with
regard to the cardio-vascular abnormalities.
It is infl uenced by exercise, excitement, annoyance, rela-
tive humidity, environmental temperature. Pulse can be
adapted from the number of heart beats per minute by using
stethoscope in less manageable animals. The rhythm of pulse
should also be noticed while taking pulse. The pulse rate can
rise rapidly in nervous animals or those which have undergone
strenuous exercise. In such cases the pulse should be checked
again after a period of rest lasting 5 to 10 minutes [3,9].
Procedure how to examine and take pulse
• Place the digits on the artery to be examined
• Applying gentle pressure until the pulse wave can be
detected
Note the pressure or pulsation of the arteries felt on the
fi nger digits. It is useful to be able to fi nd out how fast the
heart is beating. For example, it can help you decide whether
colic is serious. An adult horse’s heart beats more slowly than
ours, especially when the horse is fi t. It takes practice to fi nd
the pulse. There are several places where it can be felt. Using a
watch with a second hand, count how many beats can be felt in
a minute. Feel for it under the bone (mandible) at the side of the
face [12]. Or feel for it behind the fetlock joint. Feel for it just
above the hoof on the inside of the leg. It is useful to practice
fi nding the pulse here because, if the horse has laminitis, this
pulse will feel stronger. If you know what the pulse normally
feels like here, it will help you recognize when it is different
[12]. Count the number of beats per minute (counting should
be done at least for 30 seconds and multiplied by 2); notice the
quality and rhythm of pulse (Table 3).
Method to record pulse
1. Hold the tail / limb.
2. Locate the artery for recording pulse accordingly.
3. Place the tip of the index / middle fi nger on the artery.
4. Count the pulse for one minute and record it. (Figure 10)
Factors infl uencing pulse
1. Species: different species of animal have different pulse
rate, which is number of rise and fall of arterial wall per
minute.
2- Size: higher in small than in large animals.
3- Age: higher in young than adult animals.
4- Sex: male slightly lower than female animal.
5- Parturition &Late stage of pregnancy: relatively more
pulse rate
6- Exercise: increase pulse rate.
7- Ingestion of food: cause momentary increase in
frequency of pulse.
8- Posture: pulse rate reduced about 10% when animal is
recumbent than when standing [17,18] (Table 4).
Table 2: Normal temperature of domestic animals.
No Animal species Temperature/°C
1 Cattle/ adult 37.8 –39.2
2 Calve 38.5 –39.8
3 Horse/adult 37.2 - 38
4 Foal 37.5 -38.5
5 Sheep 38.9 - 40
6 Goat 38.6 –40.2
7 Pig/adult 37.8- 38.9
8 Piglet 38.9 - 40
9 Small dog 38.6 -39.2
10 Large dog 37.5 –38.6
11 Cat 37.8 –39.2
12 chicken 4 1.7
Table 3: Site of pulse taking in domestic animals.
No Animals Site of pulse taking
1 Equine
External maxillary artery
Transverse facial artery Median artery
Great metatarsal artery
2 Cattle and pig
Middle coccygeal artery
Facial artery
Median artery
3 Sheep, Goat, Calf. Femoral artery.
4 Piglet, Dog and Cat. Femoral artery.

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Respiration taking: Respiratory movements can be observed
at the right fl ank. Any change in the rate indicates respiratory
involvement. Thoracic respiration is seen in animals suffering
from acute peritonitis and abdominal respiration in pleurisy.
Double expiratory movements are seen in emphysema in
horses [3,14].
Types of respiration:
1. Costal respiration: In this type of respiration thoracic
muscles are mainly involved and the movement of the
rib cage is more prominent. It is seen in dogs and cats.
2. Abdominal respiration: This type of respiration is seen
in ruminants viz cattle, goat, sheep and yak. Here the
abdominal muscles are involved and movement of the
abdominal wall is noticed.
3. Costo- abdominal respiration: In this type of respiration
muscles of both thorax and abdomen are involved so
the movement of the ribs and the abdominal wall are
noticed
4. The respiration rate is measured through counting
of either contraction or expansion of the thorax
and abdomen which can be observed during clinical
examination. A method for respiration rate taking
includes [4,9]:
• Inspection: Stand behind and to one side of the
animal, and observe the movement of the thoracic and
abdominal areas of the body.
• Palpation: Put one hand in front of the nostril, feel the
exchange of the gas; or put one hand on the lung area or
the thorax and feel the respiratory movements.
• Auscultation: Use stethoscope, listen to the respiration
sound in the trachea or lung area.
Inspiratory or expiratory movements of the chest wall or
fl ank can be counted. In cold weather, exhaled breaths can be
counted. If the animal is restless the clinician should count
the rate of breathing for a shorter period and use simple
multiplication to calculate the respiratory rate in breaths/
minute. Mouth breathing is abnormal in cattle and is usually
an indication of very poor lung function or a failing circulation
(Table 5).
Visible mucous membrane: The mucous membrane in the
eyes, mouth and vagina in the case of females can be examined
to determine the health status of an animal. Examination
of the mucous membrane should be done in natural light
(sunlight) not in the lamplight. The abnormalities of color of
mucous membrane are cause by different factor like Pallor of
the mucous membranes may indicate anaemia caused by direct
blood loss or by haemolysis, A blue tinge may indicate cyanosis
caused by insuffi cient oxygen in the blood, A yellow colour is
a sign of jaundice, the mucosae may be bright red (sometimes
described as being ‘injected mucous membranes’) in febrile
animals with septicaemia or viraemia, Bright red colouration
of the conjunctiva is often seen, for example, in cases of bovine
respiratory syncitial virus infection. A cherry-red colouration
may be a feature of carbon monoxide poisoning. A greyish
tinge in the mucosae may be seen in some cases of toxaemia –
such membranes are sometimes said to be ‘dirty’. High levels
of methaemoglobin, seen in cases of nitrate and/or nitrite
poisoning, may cause the mucosae to be brown coloured [3,9].
The normal colour of different species of animal is listed below
table (Table 6).
The color of mucous membrane may change occurs in
various diseases as follow by the following [19]:
A. B.
C
Figure 10: Site of pulse taking in animals;
A: cattle. B: horse. C: small animals.
Table 4: Normal Range of pulse rate in animals.
No Animals Pulse rate/minute
1 Cattle 60 – 90
2 Young calves 100-120
3 Horse 28 – 42
4 Foal up to 1 year 70-80
5 Sheep 68 - 90
6 Goat 68 - 90
7 Pig 60 - 90
8 Dog 90 - 130
9 Cat 110 - 130
10 Chicken 200 - 400
Table 5: The respiratory rate of domestic animal per minute.
No Species of animals Respiration rate/minute
1 Cattle 25 - 30
2 Horse 8 – 16
3 Sheep 10 – 20
4 Goat 10 – 20
5 Pig 10 – 20
6 Dog 16 – 30
7 Cat 20 – 30
8 Chicken 15 – 30

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Anaemic mucous membranes.
➢ Blood loss anaemia.
➢ Parasitic infestations leading to haemolysis.
➢ Tumours or leucosis.
➢ Iron defi ciency anemia.
➢ Long-standing infectious diseases.
➢ Exposure to X-rays and some medications.
Congested mucous membranes.
➢ High environmental temperatures and exercise.
➢ Any disease resulting in fever.
➢ Diseases of the heart, brain and its membranes.
Yellowish or icteric mucous membranes.
➢ Icterus of jaundice occurs due to increase of
blood bilirubin concentration (blood parasites,
leptospirosis, hepatitis, cholangitis, cholecystitis and
cholangiohepatitis).
➢ Infectious anaemia and contagious pleuropheumonia of
horses.
➢ Chronic gastric dilatation.
Cyanosed mucous membranes.
➢ Bluish discoloration of visible mucous membranes
resulting from presence of reduced haemoglobin in
blood capillaries.
➢ Myocarditis, pericarditis.
➢ Plant and mineral intoxications.
Swelling of mucous membranes: Infl ammation of mucous
membranes results in its swelling; in which case the mucous
membranes may also be hot and tender (i.e. showing cardinal
signs of infl ammation). Marked swelling of conjunctival mucous
membranes is characteristic of equine infl uenza. A slight
degree of swelling is noticed in contagious pleuropneumonia
of horse and cattle plague, anthrax and fowl diphtheria [19].
Capillary Refi ll Time (CRT): Capillary refi ll time (CRT) is
defi ned as “time required for return of color after application
of blanching pressure to a distal capillary bed [20-25]. This
is taken by compressing the mucosa of the mouth or vulva to
expel capillary blood, leaving a pale area, and recording how
long it takes for the normal pink colour to return. In healthy
animals, the CRT should be less than 2 seconds. ACRT of more
than 5 seconds is abnormal, and between 2 and 5 seconds it
may indicate a developing problem. An increase in CRT may
indicate a poor or failing circulation causing reduced peripheral
perfusion of the tissues by the blood [8,9].
Methods how to examine mucous membrane by capillary refi ll
time as follow:
 This is taken by compressing the mucosa of the mouth
or vulva to expel capillary blood, leaving a pale area
 Recording how long it takes for the normal pink color to
return.
 In healthy animals, the CRT should be less than 2
seconds.
 A CRT of more than 5 seconds is abnormal, and between
2 and 5 seconds may indicate a developing problem
Physical body condition: Body condition scoring is an
important management practice used by producers as a tool
to help optimize production, evaluate health, and assess
nutritional status. Different scores can be given for individual
animal and can further classifi ed as normal, fatty, lean/thin,
emaciation [9].
Condition Score 1: Very thin: This animal’s skeletal structure is
very prominent. Notice the deep depressions next to the spine,
between the pelvis and rib cage, between the hooks and pins,
and around the tail head.
Condition Score 2: Thin: The animal’s skeleton is still very
apparent. The individual spinous processes are clearly visible,
but there is a small amount of fat tissue over the spine, hooks,
and pins.
Condition Score 3: Medium (Normal body condition): The
animal appears smooth over the spine, ribs, and pelvis and the
skeletal structure can be easily palpated. The hooks and pins
are still discernible, with a moderate, rather deep depression
between the pelvis and rib cage, hooks and pins, and around
the tail-head.
Condition Score 4: Fat: There are no spinous processes
detectable, and no depression in the loin area, which gives the
top-line of the animal a fl at, tabletop appearance. The ribs
can no longer be felt, and the pelvis can only be felt with fi rm
pressure. The hooks and pins have a rounded appearance due
to areas of fat covering.
Condition Score 5: Very Fat: The animal appears rounded
and smooth with a square-shaped appearance, because of the
amount of fat fi lling in the loin. The skeletal structure is no
longer visible, and can only be palpated with excessive pressure
(Figure 11).
Normal demeanor: When, on being approached, an animal
makes a normal response to external stimuli, such as
Table 6: The normal colour of mucous membrane of different animals.
Animal Colour of mucous membrane
Cattle, sheet and goat Pale pink
Horse Pale roseate
Pig Reddish
Dog Pale roseate
Cat Pale pink

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movement and sound, the demeanor is said normal (bright).
Normal reaction under these circumstances may consist of
elevating the head and ears, turning towards and directing the
attention at the source of stimuli, walking away and evincing
signs of attack or fl ight [8].
Abnormal demeanor: Behavioral change/ response to external
stimuli. The Abnormal demeanors in domestic animals are as
follow list [8,9]
 Decreased response (depression): dull (apathetic);
dummy state; comma.
 Excitation or increased response: apprehension (mildly
anxious); restlessness; mania; frenzy.
 Posture: It denotes the anatomical confi guration when
they remain in stationary situation. How does it stand?
How does it sit? How does it lie?
 Gait: It indicates about the locomotory process of an
animal.
 Body conformation: shape and size of the different body
regions relative to other regions
Regional or systematic clinical examination
Clinical Examinations of the head and neck region:
Before handling the head a further visual inspection and
observation of the head and neck is advisable as wether the
following question are present [9]:
 Movements of head and neck – normal or abnormal
 Carriage of head – normal or tilted,
 Can the animal see?
 Can the animal hear?
 Ocular or nasal discharge,
 Salivation – normal or excessive,
 Ability to prehend, masticate and swallow food
 Mobility of the neck.
The perspective of this examination is to identify pale
and discolored mucus membranes; assess problems of oral
cavity and deranged appetite. The following points are to be
considered:
 Visible mucous membrane
 Eyelids, conjunctivae and eyes
 Nasal regions and nasal mucous membrane
 Prehension, mastication and deglutition
 Salivation
 Teeth eruption
Procedure:
• Visible mucous membrane examined by visual
inspection to note the presence of lesions, discharge,
glaucoma, nystagmus.
• Examine the nose and nasal sinuses; lesions, discharges
should be noted by percussion, palpation
• Examine the mouth and appetite; oral lesions, salivation,
feed intake should be noted. The rigidity of tetanus, the
cunning leer or maniacal expression of rabies and acute
lead poisoning are cases in point.
The symmetry and confi guration of the bony structure
should be examined. Doming of the forehead occurs in some
cases of congenital hydrocephalus and in chondrodysplastic
dwarfs, and in the latter there may be bilateral enlargement of
the maxillae. Swelling of the maxillae and mandibles occurs in
osteodystrophia fi brosa; in horses swelling of the facial bones
is usually due to frontal sinusitis; in cattle enlargement of the
maxilla or mandible is common in actinomycosis. opisthotonos
is an excitation phenomenon associated with tetanus, strychnin
poisoning, acute lead poisoning, hypomagnesemic tetany,
polioencephalomalacia and encephalitis [3]. Visible discharge
should be noted; protrusion of the eyeball, as occurs in orbital
lymphomatosis, and retraction of the bulb, as occurs commonly
in dehydration, are important fi ndings; spasm of the eyelids
and excessive blinking usually indicate pain or peripheral
nerve involvement; prolapse of the nictitating membrane
usually characterizes central nervous system derangement,
generally tetanus [3]. Excessive salivation or frothing at the
mouth denotes painful conditions of the mouth or pharynx or
is associated with tremor of the jaw muscles due to nervous
involvement. Swellings below the jaw may be infl ammatory,
as in actinobacillosis and strangles, or edematous, as in acute
anemia, protein starvation or congestive heart failure.
Examination of skin and appendages: The skin provides
protection against minor physical injuries supports hair
growth and offers some defence against microbial invasion.
The condition of the skin is a refl ection of the general health
Figure 11: Body condition score of animal.

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Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
of the animal, deteriorating in cases of ill health, ill thrift and
debility. In some conditions, such as jaundice, the skin may
provide through discolouration direct diagnostic evidence of a
specifi c disease process. In other conditions, such as parasitism
or severe mineral defi ciency, a nonspecifi c general deterioration
of skin health may occur causing a greater number of hairs
than normal to enter the telogen or resting phase and a delay in
their replacement, leaving the coat in poor condition with little
hair. Sebaceous secretions may be reduced, allowing the skin to
become abnormally dry and infl exible and less able to perform
its normal defence role in an already debilitated animal. In
other cases, sebaceous secretion increases causing the skin
to have either a greasy or a dry seborrhoeic, fl aky Appearance
[9]. Structures or parts associated with skin as its appendages
are hoofs, hairs, horns, quills, claws, nails, sebaceous glands
and sweat glands. Discrete skin lesions range in type from
urticarial plaques to the circumscribed scabs of ringworm, pox
and impetigo. Diffuse lesions include the obvious enlargements
due to subcutaneous edema, hemorrhage and emphysema.
Enlargements of lymph nodes and lymphatics are also evident
when examining an animal from a distance [3,4].
The perspective point toassessing the condition of skin and
coat to identify clinical signs of skin lesions such as:
 Condition of the coat
 Elasticity of the coat
 Pruritus
 Primary and secondary skin lesions
 Dermatitis
 Hyperkeratosis or parakeratosis
 Presence of ectoparasites.
Discoloration of the skin may arise due to anaemia, cyanosis,
jaundice, hyperaemia.In febrile conditions hair may be erect
and in all chronic diseases with disturbances in nutrition,
hair become rough, lusterless dry and coarse. Alopecia (Loss
of hair) may occur due to diseases like ring worm, scabies,
eczema, Iodine and Vit A defi ciencies, Procedure: Examine
the skin and coat: grasp the skin of the upper part of the body
and notice the elasticity, visual inspection of the condition
of the coat and presence of skin lesions should be noted.the
abnormalities which occurred from skin due to diasease and
others are summarized in table 7.
Examinations of the thoracic cavity
Examination of the thoracic cavity guide to show the
regional anatomy of the lungs and the heart, and perform
physical examination of the lung and the heart area. Regional
anatomy of the lungs -locate the lung area. The lung is located
on the external surface of the thoracic region by forming an
imaginary triangle by using the points at the angle of the
scapula, olicranun process and the second intercostals space
from the last [8,9].
Physical examination of the thorax (lung area).
• Inspection -note respiratory movements
• Palpation -check the presence of pain by applying pressure
• Percussion -notice resonant sound
• Auscultation -note bronchial sounds (trachea and anterior
part of the lungs) and alveolar sounds
Palpation
Chest palpation can be useful to identify thoracic pain
which may be caused by rib fractures and pleuritis. Gentle
pressure should be applied to the thorax using the palm of
the hand and the animal observed for a pain response. The
entire thorax should be explored in a systematic manner to
identify focal areas of pain. In addition to pain, subcutaneous
emphysema may be detected as a spongy sensation which
may be accompanied by crackling noises. This clinical sign
is sometimes seen in outbreaks of respiratory syncytial virus
(RSV) and is caused by rupture of emphysematous bullae in the
lungs [9].
Auscultation
During auscultation, the stethoscope should be moved
systematically to cover the whole of thoracic lung fi elds with
the aim of identifying any abnormal sounds present, their
location and their occurrence in relation to the respiratory
cycle. The location of an abnormal sound is deduced from the
position of maximal intensity. Particular attention should be
given to the apical lobe if bacterial pneumonia is suspected or
the diaphragmatic lobe if lungworm is suspected [3,9].
Regional anatomy of the heart -locate the heart area:
The heart is suspended by great vessels and located on the
Table 7: Examples of primary and secondary skin lesions.
Primary skin
lesions Description Examples Secondary
skin lesions Notes
Spot
Circumscribed red area
of skin which is not
elevated or swollen
Flea bites Erosion
Destructive
separation of
the epidermis
(contagious
pustular
dermatitis of
sheep and goat).
Papule
Firm elevation of skin
surface caused by
cellular infi ltration
Pox Ulcer
Circumscribed
shallow
destructive
area of tissue
with or without
elevated edges
(equine ulcerative
lymphangitis)
Vesicle
Elevation of superfi cial
layer of skin with
accumulation of serous
fl uid beneath it.
FMD,
vascular
stomatitis,
pox
Crust
A fi rm mthass
consisting of dry
infl ammatory
exudate or blood.
Blister A large vesicle Dandruff Secondary to
ectoparasites
Pustule A pus-fi lled vesicle

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left median mediastinum of ventral thorax. The left side of
the heart apex reaches the chest wall. After locating the heart
the following should be noted through physical examination
(palpation, percussion, auscultation) the following would be
examined [9, 16 and 19].
 Heart rate
 Abnormal variation in heart rate
 Heart sounds
 Normal heart sounds (dub-lab)
 Adventitious heart sounds (murmurs)
 Pericardial frictional sounds
 Venous pulsation (jugular pulsation) (Table 8)
Anatomical locations of valves
➢ Mitral valves:
Examined on the left side in the 5th intercostals space, 4
inches above the sternal extremity of 5th rib.
➢ Tricuspid valves:
Present on the right side in the 3rd intercostals space and 3
inches above the sternal extremity of the 4th rib.
➢ Aortic semi-lunar valve:
Present on the left side in the 4th intercostals space level
with the shoulder point [16].
Clinical examinations of the abdominal and associated
digestiveorgans
Objective: to undertake clinical examination of the abdomen
and identify disturbances of the digestive system. The
examination of abdominal of ruminant as following [9]:
The examination of rumen: The examination of rumen
is performed by inspection, palpation, percussion and
auscultation; stomach tube can be used as well. In bloat
case, the left side would be bulged, and the motility would be
decreased.
The examination of reticulum: TRP by back grasp, below
pole lifting, up and down hill leading, hand palpation
The examination of omasum: done by exploratory
puncture. The examination of the displacement of abomasums
is done by inspection, palpation, and auscultation. The disorder
of stomach can be detected by taking stomach contents
sample: Insert the stomach tube or nasal tube after cleaning,
disinfecting and lubrication or trocarisation.
Rectal examination of the internal abdominal structures:
cut and smooth the nail; wear shoulder long glove; lubricate;
cone shape of the fi ngers; insert in rotating way; notice: the
hand cannot open, or even grasp organs inside. It’s necessary
or possible to use tranquilizer to reduce the sensitivity of the
rectum in horse. In bloat case, the pressure in the abdomen
would be very high, so it would be diffi cult to insert the hand
inside.
Conditions occurring in ruminant [9].
 Reticulum – actinobacillosis/actinomycosis infection of
the oesophageal groove, neoplasia of the oesophageal
groove, reticular abscess, reticuloperitonitis.
 Rumen – secondary free gas bloat, frothy bloat, ruminal
acidosis, cold water ruminal atony, neoplasia of rumen,
rumen collapse syndrome, rumen foreign body, rumen
impaction, vagal indigestion.
 Omasum – omasal impaction.
 Abomasum – right abomasal dilatation (RDA) and
torsion, abomasal rupture, left abomasal displacement
(LDA), abomasal impaction (dietary), abomasal
ulceration, abomasal neoplasia.
 Small intestine – Johne’s disease, salmonellosis,
winter dysentery, bovine virus diarrhoea, gut tie
(intestinal strangulation), foreign body intestinal
obstruction, intussusception, neoplasia of small
intestine, prolapse of the intestines through the
mesentery, torsion of the root of the mesentery,
small intestine rupture post calving, spasmodic
colic
 Large intestine – caecal dilatation and torsion.
 Rectum – rectal perforation, rectal prolapse
 Abdomen/peritoneum – ascites, uroperitonium,
fat necrosis, focal or diffuse peritonitis, acute
pnemoperitonium.
 Liver – abscessation, hepatitis, cholangitis.
Ausculation of the rumen help in recognizing the rate,
quality and rhythm of the normal ruminal movements.
The ruminal movements arise from the churning
action of the organ. The rate of ruminal movement
in health animals is 2-5 in cattle, 3-6 in sheep, 2-4
movements every two minutes in goats. It decreases in
cases of rumen atony; diseases of reticulum, omasum
and abomasum; impaction and late stage of tympany;
also in severe feverish conditions and in traumatic
Table 8: Anatomical location heart in equines and ruminants [16].
Area Equines Ruminants
Base From 2nd to 6th intercostal space From 3rd to 6th rib
Apex Half an inch from the last sternal segment One inch from the
diaphragm
Posterior
border Opposite to the 6th rib Opposite to the 5th rib
Left surface Composed of left ventricle and extends
from 3rd to 6th rib
Extends from 3rd to
4th rib
Right surface Extends from 3rd to 4th rib Not examined

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reticuloperitonitis. Increased rate is seen in early stage
of digestive disorders such as tympany and the form of
vagus indigestion with hypermotility [19].
Absence of movements occurs in the following [9,16]:
 Severe dilation of the rumen with gases (tympany) or
with food (impaction).
 Toxic conditions.
 The quality could be described as strong in healthy
animals, weak in cases of ruminal atony and very strong
as in early stages of digestive disorders such as tympany
and vagus indigestion with hypermotility.
Clinical Examinations of the Feces: Objective: To see
Character of the feces and abnormal constituents in feces
Procedure:
• Observe the surface of the faeces, where mucus and
blood always exists
• The colour of the faeces surface, the odour of the feces
• Fishy smell generally indicates bleeding, and abnormal
constituents in feces [9].
Examination of the urogenital system
In the horse and cow only the left kidney is accessible
for palpation from the rectum. The right kidney lies further
forward and cannot be reached by the hand. In the horse, the
left kidney extends back to about four inches behind the last rib
and its inner border is separated from the median line by about
the same distance. In ruminants, it is loosely suspended below
the lateral processes of the fi rst lumbar vertebrae. Sometimes
it may be shifted over to the right side. In dogs the kidneys lie
in the lumbar region. The manifestations of the urinary tract
diseases include abnormal constituents and appearance of
urine, changes in the volume of daily urine fl ow and frequency,
pain and dysuria and uremia [19].
Objective: To identify the regional anatomy, undertake
clinical and physical examination of urinary system and assess
urinary abnormalities, perform clinical examination of female
and male reproductive organs as well as the mammary glands
and teats. Identify the anatomic structure of the kidney on
live animal: the left kidney is located ventral of the transverse
process of the 3rd to 5th lumbar vertebrae. The kidney can be
examined by inspection, external palpation, rectal palpation,
and urianalysis. The examination of the urinary bladder is
performed by stimulating the sense of urination from the
lower part between the two hind legs on small animals or
rectal palpation on large animals. Attention should be paid to
the paralysis of the bladder and retention of urine and rupture.
Clinical examination of male genital organs- visual inspection
and palpation are employed to examine the testes, prepuce and
the penis after withdrawing from the prepuce.Here orchitis,
cryptorchidism, scrotum hernia, obstruction of urethra by
calculi, phimosis, paraphimosis, infl ammation of the prepuce,
testes and penis are noted [3,5,9].
Clinical examination of female genital organs- visual
inspection and palpation of the vaginal region, use of vaginal
speculum to examine the inside of vagina and intra-rectal
examination of the cervix, uterus and ovaries would be
performed [3,8,9]:
 Take the sample of urine examine through physical
methods
 Fresh urine is collected with test tube after stimulating
urination by palpating the perennial region or by
inserting catheter
 Clinical examination of the mammary glands and
teat- inspection and palpation to detect the presence
of swelling and lesions on the teats/decrease in size
and shape, any discharge, temperature of the udder,
consistency, and pain reactions are performed
 Clinical examination of milk samples: after collecting
the milk samples in clean test tubes one can apply
different physical and laboratory examinations
 For the gross examination of the milk, the change of the
color, odor, viscosity and fl akes in the milk should be
identifi ed.
Palpation
External palpation of the kidneys in the horse is not
performed due to the considerable thickness and rigidity
of the abdominal wall. Kidneys can be palpated through the
abdominal wall in the majority of small and medium sized
dogs. In sheep, goat and pigs, external palpation of the kidneys
is of little value. In the cat, kidneys are large and pendulous
therefore easily palpable. Identifi cation is aided by recognition
of the hilus on the attached border. In cattle, rectal palpation
may help in examination of the kidneys [19].
Examinations of the nervous and musculoskeletal
system: Objective: For examination and detection of clinical
signs of various problems associated with the nervous and
musculoskeletal systems.
Procedure:
The examination of the nervous system:
1. Observe the behavior of the animal
2. Note responses of the animal while applying different
stimuli
• Examine the brain by corneal refl ex, the pupil refl ex
• Examine the spinal cord of the neck and thorax by
withers refl ex
• Examine the spinal cord of the back part by applying
hoof stimuli and anus stimuli
• Move the animal to and from or uncomfortable position
to examine the locomotors

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3. Examine the joints long bones and different muscles:
arthritis, dislocation of the joints, rickets or osteocalcin,
muscular atrophy, central or peripheral origin paralysis
[3,9].
Examination of skeletal muscle of an animal
The musculoskeletal system is composed of the bones of the
skeleton, joints, ligaments, muscles and tendons. In addition to
the nervous system, the musculoskeletal system is important
for the maintenance of posture and for locomotion. The aim of
the clinical examination is to identify the site and the cause of the
lameness. Identifi cation of the affected limb, the site of the
lesion within the limb and assessment of the severity of the
lesion, are primary aims of the initial part of the examination.
Localization to a foot or an upper limb problem may be possible
by observation. Abnormalities of posture and gait, weight
bearing and gross swellings, wounds and deformities should
be noted [9]. Posture means the anatomical confi guration
of animals when they remain standing. And sitting in other
words, it means how the animal stands and sits. Postural
abnormalities can be of great help in making a diagnosis (Table
9).
Gait: Gait is denotes the locomotor processes of the
animals. A locomotor disturbance of the animal is judged by
the movements (Walking, running, trotting, circling etc.)
There are certain diseases, which interfere with the process of
locomotion. The gaits of the dog are commonly used patterns
of locomotion that can be divided into two main groups:
symmetric and asymmetric. With symmetric gaits such as
the walk, trot, and pace, the movement of the limbs on one
side of the dog’s body repeats the motion of the limbs on the
opposite side with the intervals between foot falls being nearly
evenly spaced. With asymmetric gaits such as the gallop, the
limb movements of one side do not repeat those of the other
and the intervals between foot falls are unevenly spaced. When
considering gaits, one full cycle is referred to as a stride [21]
(Table 10).
Examination of superfi cial lymphnodes of animals:
Objectives: to compared each paired node for size and consistency
with the contralateral node.
Method: Grossly enlarged lymph nodes may have been
seen during observation of the patient before it is handled.
Observation andpalpation is possible when the animal is
restrained.
Anatomical Location of lymphnodes (LN): Lymph nodes
are round or bean-shaped structures that are widely distributed
throughout the body. Imbedded in connective tissue or fat,
they are concentrated in the cervical, axillary, and inguinal
regions – the neck, armpits, and groin, respectively. They are
typically less than ½ inch in length, depending on the size of
the animal. The lymph nodes fi lter the lymph before returning
it to the veins [2,9].
Submandibular lymph nodes: situated and are palpable on the
medial aspect of the ‘angle of the jaw’ where the horizontal and
vertical rami of the mandible meet. (Normal size is 1.5 to 2 cm)
Prescapular lymph nodes: It lies subcutaneously and underneath
the cutaneous muscle just anterior to the shoulder joint (Normal
size 1 cm × 3.5 cm) Axillary lymph nodes: Found on each side of
the chest in the armpit area. Normally only palpable in young
calves without heavy muscling (Normal size 1.5 cm) Popliteal
lymph nodes: These nodes are found surrounded by dense muscle
tissue immediately behind the stifl e. It found on each rear leg on
the opposite side of the knee. They are relatively superfi cial and
easy to feel (normal size 1-1.5 cm) Inguinal lymph nodes: These
are usually palpable as a small group of fairly mobile and fi rm
structures adjacent to the inguinal canal. (Normal size 0.5 cm)
Supramammary lymph nodes: These are normally readily
palpated on the caudal aspect of the udder just above the upper
limit of the mammary glandular tissue, normal size 2.5 cm
[8,23] (Figure 12).
Preparation and Administration of Medica-
ments
Drug dosage form
The body condition of a livestock is generally assessed
by visual observation. The references to an animal being
too thin, in good fl esh, or obese all relate to the animal’s
weight. Therefore, the weight of an animal can be used as a
measurement tool to determine its well-being, or the presence
of problems which may threaten the health of the horse.
Several methods can be used to determine the body weight of
livestock in an approximate scale. The domestic animals body
weight estimation equation as following [24].
*Equation of equine body weight estimation:
  
girth measurement in cm 2 x length measurement in cm
Weight kg 11,900

*Equation of Bovine body weight estimation:
Length x Girth square
Live weight in lbs.’ 300

Because of the variety of dosage forms in veterinary
Table 9: Abnormal posture in animals.
Posture Disease/disorders
Cow sit on sternum with head fl exed to one side and
resting on the fl ank Milk Fever
Abducted elbow with extension of head and neck
accompanied by mouth breathing in farm animals Pneumonia
Arched back with tense abdomen Peritonitis
Extension and rigidity of limbs, neck, ear and jaw Tetanus
A male dog urinating like a bitch Cystitis
Table10: Abnormality of gait in domestic animals.
Gait Disease
Lameness and disinclination to move Laminitis, foot rot
Stiff gait Arthritis
Walking in circles / head pressing Gid (Coenuruses)/otitis/ listeriosis
Dragging of the hind leg subluxation of medial patellar ligament

023
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medicine and the diversity of animal and bird species treated,
drug or dosage delivery sometimes requires the development
ofspecifi c devices to ensure fast, safe, effective and low cost
effi cient treatment. Formulation of Drug Dosage Forms of
Animals are listed as following [25].
Oral dosage forms: Refers to administration of drug through
the mouth. The most commonly used preparations are solid
oral dosage forms such as tablets, capsules, granules, powder,
paste and boluses.
Parentral dosage forms: the most common parenteral dosage
forms are stable aqueous solutions and subcutaneous implants.
External dosage forms:
• Ointment- semisolid preparation for external
application.
• Cream- a viscous semisolid, consisting of oil in water
emulsion or water in oil emulsion.
• Dusting powder e.g., popular antibacterial agent applied
on animal wounds.
• Lotion- an aqueous solution or suspension for local
application.
Spray-a drug applied in liquid form by pressure.
Inhalation dosage forms: gaseous and volatile liquid
anaesthetic agent (drugs), given by inhalation, e.g., Halothane
Routes of drug administration
Medications are administered to cattle by injection for
a variety of reasons. For example, vaccines (biological) are
injected to prevent disease, and antibiotics or anthelmintic
may be injected to treat bacterial or parasitic infections,
respectively. Other medications may be given by injection
for supportive medical care, to relieve pain or to enhance
production. Injection may be the best, or the only, route of
administration for a particular medication [23].
The routes of drug administration in domestic animals are
summarized as following form [8,12,22,23,25].
Oral administration: There are large numbers of pharmaceutical
preparations available for oral administration. Solid dosage
forms (powders, tablet, capsules, pills, etc.) and liquid dosage
forms (syrups, emulsion, mixture, drench, electrolytes, etc.)
Parenteral administration (IV, IM, SC, Id, epidural,
subconjunctival): It refers to a drug administration by injection
directly in to the tissue fl uid or blood without having to cross
the intestinal mucosa.
Intravenous route (IV): Gives swift, effective and highly
predictable blood concentration and allows rapid modifi cation
of dose and is used for emergency treatment. In most animals
(horse, cattle, sheep and goat) usually given through jugular
vein, in pig-ear veins, in the dog and cat-cephalic vein and
recurrent tarsal vein.
Intramuscular (IM) route: Absorption occurs either
haematogenous or via lymphatic and is usually fairly rapid
except for long acting preparation.
Subcutaneous (SC) route: Preferred when slow and continuous
absorption of drug is required. The injected drug disperses
through the loose connective tissues. They dissolve in tissue
fl uid before it can enter either capillaries or lymphatic.
Intradermal route (ID): Used for testing hypersensitivity test and
for vaccination.
A.
B.
C. D.
Figure 12: anatomical location of animal lymph node. A: Horse; B: Cattle; C: cat; D: Dog.

024
Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
Acknowledgement
First and Above all, I would like to praise Almighty God for
providing me this opportunity and granting me the capability
to proceed successfully.
Secondly, I would like to thanks the ICT center of Jimma
University College of Agriculture and Veterinary Medicine for
they guide and support me by internet and computer access.
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Table 11: Site of parenteral injection in domestic animals.
No Animal
species Intramuscular injection site Intravenous injection
site
1Horse,
Buffalo Rump, thigh, neck Jugular vein
2 Cattle, yak Rump, thigh (semimebranosus and
semitendinosus ) Jugular vein
3 Sheep, Goat Thigh Jugular vein
4 Dog, cat Thigh Cephalic, saphenous
veins
5 Chicken Chest, pectoral muscle Wing vein
6 Pig Thigh Ear vein
A. Site of injection in pig B. Site of injection in sheep
C. How to take drug from bottled D. Intramuscular injection site in horse
Figure 13: Site of parenteral injection in domestic animals.
Epidural route: Refers to deposition of drug up on or outside
the dura matter. E.g., Introduction of local anesthetics between
the fi rst and second coccygeal vertebra to eliminate straining.
Subconjunctival: Disposition of a pharmaceutical preparation
beneath the conjunctiva.
Topical or local application: It refers to external application of
drug to the body surface for localized action at accessible site,
such as skin, eyes, body orifi ces, body cavity.
Drug dose calculation
If drugs are used incorrectly, disease organisms can build
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from under dosing or overdosing drugs. It is best to calculate
the correct dosage based upon the weight of each animal
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be administered at one time and expressed in mg/kg or IU/kg.
(Table 11) (Figure 13).
Method and procedure how to load a syringe during taking drug
[12].
 Be sure the needle is fi rmly attached.
 Draw some air into the syringe by pulling back the
plunger.
 Turn the bottle of medicine upside-down, insert the
needle through the centre of the rubber stopper and
slowly inject air into the bottle.
 Now draw the medicine into the syringe.
 Keep the bottle above the syringe so any air bubbles in
the syringe go to the top.
 Push the plunger carefully so the air comes out.
 Now see if the right amount is in the syringe (the top of
the plunger should be on the line for the proper dose).
 Withdraw more medicine or squirt some back into the
bottle until the right amount is in the syringe.
Body weight x Dose Rate
:Dose Concentration

025
Citation: Abdisa T (2017) Review on Practical Guidance of Veterinary Clinical Diagnostic Approach. Int J Vet Sci Res 3(2): 006-025.
Copyright: © 2017 Abdisa T. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.
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