medicine

Practical No. 2

Examination of the Visible Mucous MembraneMeticulous examination of visible mucous membrane may provide useful clinical

information about the sate of health of animal. Inspection should be made in day light. Artificial light may stand in the way of getting actual coloration in very many cases. A faint yellow discoloration may mislead the clinician when the mucous membrane is viewed through any oil lamp. Mucous membrane may be viewed in the following parts.

Conjunctival mucous membrane in all species of animals. Buccal mucous membrane in all species of animals. Vulvar mucous membrane in all female species of animals. Anal mucous membrane in all species of animals. Prepusal mucous membrane in all species of animals. Mucous membrane of third eyelid (membrane nictitan) of horse and dog. Ventral surface of tongue of cattle, buffalo, horse, sheep, goat, pig, dog and cat. Hard palate in cattle and buffalo Nasal mucous membrane in horse

Examination of conjunctival mucous membrane

The conjunctiva can be divided into two parts viz. bulbar conjunctiva and palpebral conjunctiva. The bulbar conjunctiva denotes the part that covers the anterior aspect of the eye globe extending upon corneal limbus. The Palperal conjunctiva denotes the part which lines the inner surface of eyelids and both surfaces of the third eyelids.Palpebral conjunctiva can be inspected by the following sequences:

i. Close the upper eyelid with the mid digital pressure of left thumb initially.ii. Then push back the eyeball into the orbit with the same left thumb.

iii. Finally, Evert the lower eyelid by pulling it down the pressure of the right thumb and index finger.

The third eyelid of the horse can be seen by tapping under the jaw with the help if the fingers or else it can be inspected by laying the forefinger and thumb along the upper eyelid and then driving them wide apart to expose the membrane nictitians. Conjunctival mucous membrane of both the eyes should be examined to delineate the eye problem as a local or general one. Animals Normal colour of conjunctival mucous membraneHorse Pale roseateCattle, Buffalo, Sheep and goat Pale PinkPig Reddish tingedDog RoseateCat Pale

It is advisable to note the changes of the mucous membrane rather than the changes in the skin. The common changes can be described as their appearance as:

Pale or Anemic or Paleness or Palidity or pallor

The conjunctiva appears lighter in colour. These changes indicate that there is acute or chronic blood loss. Extreme paleness of mucous membrane may look like white blotting paper or a piece of white porcelain. A pale blenched mucous membrane may ensue due to hemorrhagic shock.

Congested or Injected

When the mucous membrane is red, it is called congested but when it is intensely red, it is called injected. “Blood shot” is the extreme stage. This is due to hyperemic condition of the blood vessels which cause increased blood content in a particular area.

P r e p a r e d b y : S u r a j S u b e d i

Congested conjunctiva is generally seen in: Local inflammatory condition of the conjunctiva. Systemic diseases like encephalitis, meningitis, enteritis, rhinitis, impactive colic etc. Allergic sensitization Prolonged exposure to sunlight Effect of unusual stimuli like poison, toxins, hyperthermia etc. Venous congestion

Petechiated or petechiation or petechial hemorrhage

In this case, there are minute pinpoint hemorrhagic spots over the conjunctival mucous membrane. Minute hemorrhage is petechiae and if bigger called ecchymoses whereas hematomas are localized invasion of blood.

Cyanosis or cyanosed or bluish discolouration

The mucous membrane takes bluish grey or bluish violet discolouration. This is observed due to the defective or reduced oxygenation. The causes of cyanosis are: CHF, Circulatory disorder due to vulvular insufficiency, severe respiratory disorders, Tympani, diaphragm rupture, HCN and Nitrate poisoning etc.

Yellowness or icteric condition or jaundice

Mucous membrane appears pale yellow or lemon yellow. This discolouration is mainly due to the deposition of bile pigments in the mucous membrane and other tissues and integuments. Jaundice may be accompanied by accumulation of bile salts and other bile components in the blood. This type of conjunctiva is better appreciated in bright day light. Causes may be:

Pre-hepatic or hemolytic causes Hepatic or toxic causes Post-hepatic or obstructive causes

It may accompany liver cirrhosis, liver fluke infestation, hemoprotozoal infection,etc.It hepatocellular jaundice, the mucous membrane shoes orange yellow discolouration while hemolytic jaundice shows the pale yellow or grayish yellow discoloration.

Conclusion: Thus we were acquainted with the knowledge about the method of examination of visible mucous membrane in animals and the colour of mucous membrane in different pathologic condition.


Practical No. 3

Anamnesis (History Taking)History taking is one of the most significant facets to diagnose a disease. In human

practice lots of information can be obtained from the patient but in veterinary practice there is obvious limitations as the animal are incapable to place their symptoms and signs. Disease processes are thus presented to the clinician through the medium of complaint from the owner of the animal or his animal attendant. The deposition of statement may be spontaneous or may require to be obtained through a careful interrogation or cross questioning. This procedure is considered as “taking the history”. Clinician should make an effort to gather correct history. For this, one has to acquire confidence of the owner by polite, simple and humorous language. Care should be taken to avoid leading and technical question in professional language. It is not wise to put direct questions e.g. “Why have you brought the cattle?” “What is wrong with your dog?” But sometimes it is rather impossible to avoid the leading questions; e.g. “Did the calf scour?” “Whether there is any vomiting in your dog?” Clinicians should not expect that the owner will tell the history in the language of the clinician but the owner should be encouraged to tell the history in his own language.

If cooperative owner, the true history is deposited to the doctor which will help in disease diagnosis.

Clinician should make notes on the paper to review the entire episode which you consider abnormal.

In majority of cases, the history procures is accurate to a great extent. But still history may be colored by the personal conception of a client. It is logical to verify validity of history and to evaluate or supplement it through detailed clinical examination of the patient. Incorrect history is not s\consistent with clinical observation.

The history enumerates not only the key of accurate diagnosis but also foretell about the probabilities of a disease.

History provides background information on the nature of disease and the nature of the environment.

To obtain detail, one may ask questions to the owner, attendant, milker or allow that person to relate his own account depending on circumstances and the value of information provided.

Very valuable information may be obtained from hospital record of a patient who is under treatment in the same hospital. Such records unfold much information which is likely to be useful adjunct for diagnosis.

History of a case is divided into main parts:

a. Immediate history or Present historyb. Past history or Previous history

Immediate history (present history)

The immediate history deals with the present problem and sequence of events associated with it. Following points are relevant and to be included while collecting immediate history.

A. Location of illness

a. Absence of ruminal or tympani or colic of diarrhea indicate that the location of the disease is in the digestive system

b. Nasal discharge, coughing or dyspnoea indicate that he disease location is in the respiratory system

c. Posture or frequent micturition, passage of red urine or cloudy urine indicate that probable location of he disease is in the urinary system


d. Lameness, in coordination of gait or paralysis may reveal that the disease lies in the nervous or locomotory system.

B. Nature and manifestation of illnessa. When was the present disorder noticed?b. Under what circumstances the disease prevailed?c. What type of the symptoms the animal exhibited?d. Did the illness appear in the stall or grazed cattle at pasture?e. Did the disease owe its origin to exercise, insemination, lactation, or transport?f. Whether any other animals of the owner or in the same or adjoining localities are

showing illness?g. Did the disease occur after introduction of new sick animal to the farm?h. What steps have been adopted to treat the animal?i. Whether the animals were immunized against notified disease?

Past history (Previous history)

In collecting the past history following considerations are to be given due attachment.a. Whether the animal(s) exhibited such illness previously? If so, the nature and course of

illness, identical in manifestation or not?b. Whether any other animal of the same herd or herd nearby were affected with similar

problems?c. Whether the offspring of the dame animal suffered from identical illness or deformities?d. Whether the onset if such illness prevailed in a particular season or month of the year?e. Whether the disease was observed after the introduction of a new stock in the herd?f. Whether the disease was observed following managemental changes concerning housing,

nutrition, etc.? If so these are to be attended carefully?g. Whether the animals were previously treated or not?h. How many animals of the herd sustained illness and how many of them died showing

similar manifestation?i. Whether the animals were protected against scheduled infectious disease or not? If so, date

of last vaccination, follow up of vaccination scheduled should be noted carefully.

History of Environment

Environment surrounding the animal have got direct or indirect bearing on the health of animals. Meticulous examination of the environment may give a fair guideline to diagnose the forthcoming illness of a single animal or a fair percentage of animals in a herd.

Outdoor Environment

Topography of the region, grass, land and soils are to be examined and assessed in relation to disease. Marshy land encourages the spread of fly and mosquito borne diseases; damp soil permits the soil borne diseases lie leptospirosis etc. Sometimes the various agricultural pesticides become the source of victimization to the animals when thrown indiscriminately in the field.

Indoor Environment

Inadequate ventilation, inadequate water supply, damp of the house floor may predispose the animals to suffer from illness. Attention regarding house spacing, sanitation and hygienic measures is a must. Stall fed animals are more prone to metabolic diseases and dietary abnormalities; e.g. Ketosis is mainly found in stall fed high yielding cattle. So investigation of the indoor environment along with the feeds and feeding leads to proper disease diagnosis.


Effect of Climates and Environment on the health of Animals

Climatic stress depresses the appetite of the animals. High ambient temperature reduces the feed intake, milk yield and metabolic rate. Intense chilling modifies the mucous secretions and causes sub-mucous edema of

animals (bottle jaw). Cold moist situation during the spring may augment hypomagnesaemic tetany in

cattle. Industrial fumes and smoke produce respiratory affections in animals while they graze

in the vicinity. Liver fluke infestation in the cattle is co-related with high temperature and high

rainfall.

Conclusion: Thus we were able to know about the method of history taking and its types.


Practical No: 4

TemperatureThe temperature of the body of different animals varies widely. The temperature of the

body surface is usually less than the temperature of the deeper structures of the body. During the process of the examination of the mucous membrane, skin and mouth, the clinicians may appreciate the rise or fall of body temperature. But, the exact temperature has to be recorded with the help of a clinical thermometer. Recording of temperature helps in establishing a diagnosis of febrile disease from an afebrile one. Temperature chart, if maintained properly, may help in determining the progress and fate of a disease.

Sites of recording of temperature

The temperature of domestic animals is recorded in the rectum. A fair amount of idea may be gained by digital feeling over the skin and base of ear. In female animal, the vaginal temperature may also be considered but it should be borne in mind that vaginal temperature may remain high during estrus. Vaginal temperature is 10F higher than the rectal temperature of healthy animal.

Techniques in Recording of temperature

The temperature is recorded with the help of clinical thermometer. Short blunt clinical thermometer is preferred.

i. The thermometer should be sterilized with the help of disinfectant like dettol prior to use.ii. It should be well shaken before recording of temperature to bring the mercury column

down below the lowest point likely to be observed in different species of animals.iii. The bulb end of thermometer to be lubricated with liquid paraffin or glycerin or soap

especially in case of small pup and kitten.iv. Care should be taken so that the bulb of the thermometer remains in contact with the rectal

mucous membrane. For this in large animals the thermometer is slanted so that it will remain in contact with the rectal mucous membrane.

v. The Thermometer should be kept in site for at least 1 to 2 minutes.

Precautions while Recording the Temperature

The animal should be placed in an isolated place away from human annoyance. Care should be taken that it is less frightened and less excited. The animal should be restrained properly with less mutilation. The reliability of thermometer should be judged as a defective thermometer may result

erroneous result. The animal should be kept away from hot exposure prior to recording of temperature. The animal should be given rest for at least 20-30minutes if it has traversed a long

distance especially in hot summer. The temperature should not be recorded immediately after prolonged walking, ploughing,

working or race. The animal should not be offered any hot or cold drink at least 15-20 minutes prior to

recording of temperature. The thermometer should be kept strictly in touch with the rectal mucosa to obtain the

desired result. The thermometer should be washed with antiseptic solution before use against each

animal.

Variations in Normal Temperature

Temperature of healthy animal varies during morning and evening. Diurnal variation in body temperature of healthy animals is seen, lowest being in the morning and highest in the


evening. This variation is about 1.50F. Contrary wise, in certain diseases e.g. pulmonary tuberculosis, the temperature of animal may be higher in the morning than in the evening.

Normal Temperature of Different Animals

Animal Temperature (Range)0F 0C

Cattle (adult) 100 – 102.5 37.8 – 39.2Calf 101.5 – 103.5 38.6 – 39.8Buffalo 99 – 102 37.2 – 38.9Sheep 101.5 – 105.5 38.9 – 39.8Goat 101.5 – 103.5 38.6 – 39.8Pig (adult) 100.0 – 102.0 37.8 - 38.9Piglets 102.0 – 104.0 38.9 – 40.0Horse (adult) 99 – 100.5 37.2 – 38Foal 99.5 – 101.5 37.5 – 38.6Dog (large) 99.5 101.5 37.5 – 38.6Dog (small) 101.5 – 102.5 38.6 – 39.2

Factors affecting the body temperature

Age Sex Breeds Body weight Feeding Pregnancy Excitement

Pain Estrus Exercise Rectal affection Infection Environment

Conclusion: Thus we were able to know the temperature taking methods and the normal temperature of common farm animals.


Practical No: 5

PulsePulse is defined as the expansion and elongation of the arterial wall imparted by the

column of arterial blood due to the contraction of the left ventricle. Pulse foretells us the useful information regarding the health state concerning the cardiovascular abnormalities. Pulse rate may be adversely affected by the influence of exercise, excitement, annoyance, irritation, high environmental temperature, relative humidity etc. While examining the pulse, it is always necessary to keep the animals at rest with no external disturbance as far as possible.

Sites of recording Pulse in some animals

Animal Sites

Horse, Donkey, Mule External Maxillary artery

Great metatarsal artery

Cattle, Buffalo Middle coccygeal artery (about 10 cm below the level of anus)

Facial artery

Goat, Sheep Femoral artery high up in the inguinal region

Small Pig Femoral artery

Small calf Femoral artery

Large Pig Middle coccygeal artery (if difficult, heart beat as an alternative)

Dog, Cat Femoral artery

Procedure of pulse recording

Pulse is recorded by means of tactile senses. So sensitive part of finger is used for counting. Generally index finger is avoided for measuring pulse.

Animal shouldn’t be disturbed prior to recording of pulse.

Pulse recorded for at least 30 seconds to 1 minute.

It is important to palpate the artery of both the sides (left and right femoral) to assess the quality of the pulse wave.

Rate, Rhythm, volume and character of the pulse is recorded along with the size and strength. A full pressure may help in obliteration of the pulse wave.

Note: Heart rate commensurate with the pulse rate except in some pathological conditions like extrasystolic arrhythmia, atrial fibrillation or premature beat.

Pulse rate:

It indicates no of beats per second. Increased pulse rate is trachycardia and decrease pulse rate is bradycardia.

Pulse rate is more during last trimester of pregnancy, at parturition.

Pulse rate increases immediately after exercise

Athletic animals have less pulse rate than other non-athletic animals.

S u r a j s u b e d i

Normal pulse rate in animals

Animal Pulse rate / minute

Horse, donkey, asses 33 – 41

Cattle, buffalo 42 – 60

Goat, sheep 60 – 70

Dog (large) 70 – 90

Dog (small) 90 – 120

Pig (adult) 60 – 90

Rhythm

It denotes regularity of successive pulse waves within a defined time period. In some occasion interval between pulses may vary.

a. Irregular Pulse: Interval between pulses varies. Also called arrhythmia. It may develop under conditions: Sinus arrhythmia, Atrial Fibrillation, Toxemia, Myocarditis, Febrile diseases

b. Intermittent pulse: Pulse beat is absent as a regular sequence or at irregular intervals known as regularly intermittent of irregularly intermittent pulse respectively.

It can be observed under following conditions like etopic beat, partial heart block, sino atrial block, sinus arrest, focal myocarditis, atrial flutter etc.

Volume

It is the amplitude or degree of expansion of atrial wall that occurs during the transmission of pulse wave.

a. High volume Pulse: Observed in hyperkinetic circulating disease following specific diseases like aortic incompetence, fever, severe anaemia, liver cirrhosis etc.

b. Low volume pulse: Observed in loss of body fluid, loss of plasma, loss of blood, aortic stenosis, mitral stenosis, Peripheral circulatory failure etc.

Character or Quality of Pulse

1. Frequent pulse: No. of beats per minute exceeds the normal range.

2. Infrequent Pulse: No. of beats below the normal range. Generally seen in disease of CNS.

3. Slow Pulse (Sluggish Pulse): Each beat takes more time than the normal. Pulse duration is more.

4. Quick Pulse (Skipping Pulse): Each beat occupies less time than the normal. E.g. Inflammatory disease of CNS

5. Large Pulse (Full Pulse): In each pulse, there is extensive distension of the arterial wall. e.g. Pulmonary congestion

6. Small Pulse (Empty Pulse): Artery poorly distended and remains empty. E.g. Myocardial asthenia

7. Hard Pulse: Wall of artery very rigid and pulse cannot be obliterated with digital pressure. e.g. impairment of vascular tone

8. Soft Pulse: Pulse is poorly developed. Pulse wave can be compressed fairly easily. E.g. Toxemia, Septicaemia, thinning of pulse etc.


9. Strong bonding Pulse: Artery much distended. Amplitude of Pulse wave is very high and the pulse wave cannot be resisted with digital pressure. e.g. Hypertension, increased stroke volume of the heart, hypertrophy of the myocardium, laminitis is horse and chronic interstitial nephritis.

10. Soft Small Pulse: Pulse weak and infrequent. Pulse cannot be obliterate very easily. E.g. myocardial asthenia

11. Wiry Pulse: Pulse brief, small and hard in nature. E.g. Cerebral hemorrhage, endocarditis, pleurisy, acute peritonitis. Outcome of this is very bad indicates approaching death.

12. Thready Pulse: Pulse weak, small and prolonged. Wave can be prevented by digital pressure. This may lead to stage where the pulse is considered as running down pulse. This is a very grave condition leading to fatality. Temperature may drop down to a critically low level along with this pulse.

13. Water hammer or Corrigan’s or collapsing pulse: Rapid rise of pulse wave with high volume until artery is over filled up, followed by an equally sudden sharp collapse of the arterial wall. e.g. Aortic incompetence, complete heart block, aortic valve defect, severe annemiaetc.

14. Alternate pulse: High and low volume pulse follows each other equidistantly and alternately. e.g. Acute left ventricular failure

15. Pulsus myurus: Group of continuous weak waves of pulse. E.g. Cardiac damage

16. Dicrotic-pulse: Immediately after the main pulse wave a second wave follows. E.g. Acute Fever

17. Pulsus paradoxus: Volume of pulse decreases during deep inspiration and increases during deep expiration e.g. Pericardial effusion, traumatic pericarditis, obstruction

18. Pulsus bisferiens: A single pulse beat is split into 2 waves, e.g. Combine aortic stenosis, aortic incompetence

19. Pulsus bigeminus: Two pulse beat followed by a gap e.g. Ectopic beat of ventricle, A-V block

Jugular Pulse: Pulsation of the jugular vein is known as jugular pulse.

a. Positive jugular pulse: It indicates a true pulse wave running from the angle of mandible to the shoulder region. This results due to traumatic pericarditis, incompetence of tricuspid vulve. There is regurgitation of blood in the jugular vein. This positive pulse is often accompanied by brisket edema. N

b. Negative jugular pulse: It is seen in lean cattle when the blood is unable to enter the right atrium and there is eventual backflow in the jugular vein. This may be observed in tricuspid valve stenosis.

In some lean animals, pulse wave of underlying carotid artery may produce movement in the jugular vein resembling positive jugular pulse and is known as false jugular pulse. A true jugular pulse can be obliterated by pressure while a false jugular pulse cannot be obliterated.

Conclusion: Thus we were able to know the pulse taking method, site of pulse in different animals along with the different types of pulse seen in various abnormal condition.


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