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วิดิโอประกอบการสอน

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วิดิโอประกอบการสอน

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เอกสารประกอบการสอน

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เอกสารประกอบการสอน

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เอกสารประกอบการสอน 2

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เอกสารประกอบการสอน 2

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Veterinary Internal Medicne - 2019 - Keene - ACVIM consensus guidelines for the diagnosis and treatment of myxomatous

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Veterinary Internal Medicne - 2020 - Luis Fuentes - ACVIM consensus statement guidelines for the classification  diagnosis 

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A nine year old male, neutered DSH cat was presented to the hospital for the investigation of acute respiratory distress. The owners reported that the cat had been lethargic, inappetent, subsequently developing breathing difficulties. He was fully vaccinated and wormed, and had never travelled abroad. On presentation, the patient was quiet, alert and responsive. Respiratory rate was 80 breaths/minute with severe respiratory effort. Prolonged expiratory phase and orthopnoea were noted. Mucous membranes were pink and capillary refill time was two seconds. Lung auscultation revealed increased respiratory sounds throughout the entire lung field. Cardiac auscultation revealed marked gallop sounds, a heart rate of 200 beats/minute and regular rhythm. A heart murmur was not detected. Femoral pulses were of fair quality and symmetric. The physical examination was otherwise unremarkable. Rectal temperature was
not measured initially to minimise stress.

What are the problem lists and differential diagnosis?

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guideline ที่สรุปการวินิจฉัยโรค DCM มีเกณฑ์ในการวินิจฉัยโรคด้วย Echocardiographic parameters แนะนำให้จำ major criteria ในการวินิจฉัยให้ได้ทั้งสามข้อ

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A 3-month-old female Alaskan malamute was presented with a grade IV/VI systolic heart murmur, exercise intolerance, and anorexia. On examination, the dog was found to have cyanosis and inadequate growth.

What are the problem lists?

What are your differential diagnosis?

What is the next diagnostic tool?

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A 6-month-old intact, 6.2 kg, female Shiba Inu dog was brought to the Veterinary Medical Teaching

At the referring hospital, the dog exhibited a cough and exercise intolerance. Left-sided heart failure was suspected because of pulmonary edema on thoracic radiography and cardiac dilatation on echocardiography. Physical examination revealed a heart rate (HR) of 127 bpm and a Levine 2/6 systolic murmur at the left parasternal region. The systolic, diastolic, and mean blood pressure (BP) measured via the oscillometric method were 136 mmHg [reference range (RR): 121 to 139 mmHg], 57 mmHg (RR: 67 to 71 mmHg), and 81 mmHg (RR: 88 to 92 mmHg), respectively.

According to history and physical examinations, what are the problem lists?

What are the futher diagnostic tools?

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A 4-month-old Persian intact male cat weighing 3.1 kg was presented for evaluation of a heart murmur noted during examination by the referring veterinarian. The cat had been diagnosed with anterior uveitis, which responded to topical prednisolone dropsa administered q6h for 5 weeks. Tests for underlying feline leukemia virus, feline immunodeficiency virus, toxoplasmosis, and feline infectious peritonitis were negative. No additional clinical signs were reported by the owner, although the kitten had never been very active.

On physical examination, a harsh grade 5 holosystolic murmur was audible over the right and left thorax but was loudest on the left. Pulse amplitude was normal. Mucous membranes were pink.

What are the problem list?

What are your differential diagnosis?

What is the next diagnostic tool to diagnose?

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ตัวอย่างกรณีศึกษา

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ตัวอย่างกรณีศึกษา

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กิจกรรม Active Learning

รายวิชา 145-452 อายุรศาสตร์ในสุนัขและแมว I

Case study 1

An 11-year-old intact male Chihuahua dog was referred to the University Veterinary Hospital  with history of coughing and laboured breathing. The dog had severe increased coughing and labour breathing for 3 months prior to presentation at hospital.

Upon physical examination, the dog was quiet, alert and responsive. Temperature and heart rate were within normal limits with a body condition score of 2.5 out of 5.0. Vaccination and deworming status were up-to-date. Upon observation, the dog was panting heavily. Dog has severe halitosis due to gingivitis and severe accumulation of tartar built up on the surface of the bilateral molars and pre-molars. Heart auscultation revealed that patient had systolic heart murmur grade V/VI with maximum point of intensity at the left heart base. Further auscultation revealed crackled lung sounds and a productive cough was triggered post tracheal pinch.

Question1: What are the initial problem lists according to history and physical examinations?

What is your differential diagnosis?

Question2:What is the next diagnostic tool?

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A two years old spayed female Golden Retriever weighting 31 kg was present to Hospital, with history of heart murmurs and abnormal echocardiography assessed by local Veterinarians without obvious cardiovascular signs. No exercise intolerance or syncope was found while she was exercised regularly. Physical examination revealed high heart rate, normal lung sound, and continuous heart murmur grade IV/VI with point of maximal intensity (PMI) at base of the heart on the left side.

According to history and physical examinations, what are the problem lists?

What are the next diagnostic tools?