1. Objectives: State what features of an animal/bird can be observed and recorded from a distance and explain the importance of the distant inspection. Describe the “Tip-of-Nose” to “Tip-of-Tail” method of animal examination. List the steps involved in the physical examination. And discuss t he relevance of the observations you make during this examination. Know the normal TPR for a cat, dog and horse. Discuss the reasons for the order of these steps Know the position and name of the arteries used (and where they are located) to measure the pulse rate, rhythm and strength in a cat, dog, horse. Know the CRTand its clinical relevance. Know what is normal. Know the causes of prolonged and increased CRT. Discuss the signs of dehydration, and methods of assessing this during clinical examination of an animal.

2.  Protocol for clinical exam  Distance exam  TPR and weight  The head and neck including the oral cavity. ALL superficial lymph nodes are examined at this time.  Heart, lungs, and thoracic wall.  Abdominal organs including genitalia and mammary glands.  Muscles, joints, bones, ligaments and tendons of all limbs ( Often it is best to evaluate the area of chief complaint, even if only briefly at first. This reassures the owner that you are paying attention to what he or she perceives as the major problem.)  Temperature, Pulse and Respiration Values  Dog cat and horse must be memorised  What are poikilotherm/ectotherms?  What is a PBT? Species Temperature C Heart/Pulse Rate/Minute Respiratory Rate/Minute Dog38.3 – 39.270 –14010 – 30 Cat38.2 – 38.6100 – 20020- 30 Horse37.2 - 38.9 30 – 40 70 – 80 young 12 –20

3.  Take in the order RPT ie least invasive to most invasive and most sensitive to least so stress of manipulation alters the sensitive parameters least. Thus a valid baseline can be assessed before the stress of invasive hands on exam that follows  Excitement, stress, hot day, and exercise alter TPR values  Inflammation, pain and infection alter TPR values

4.  Respiration  At rest not panting  count only breathing in or out, not both  Define hyperpnoea, oligpnoea, apnoea  Pulse  Felt in arteries  Dog and cat: femoral, lingual, digital  Horse and cattle: facial and coccygeal  Sinus arhythmia: normal  Pulse deficit indicates Dysrhythmia: abnormal

5.  Define pyrexia, hyperthermia  Mercury thermometers are still in use in many practices. Ensure you know the protocol for cleaning and disposal of a broken thermometer  Digital thermometers or thermister probes are used for rectal temperature

6. Examination of the head and neck - Look for symetry or abnormalities - Eyes - Prolapse third eyelid - Mucus membranes - Pupil size/cornea - Entropion /ectropion - Muzzle and nares, patency and discharge - Oral cavity - Lips - Gingiva - CRT 1-2 sec - Teeth - Palates - tonsils

7. Examination of the head and neck cont. Ears – look for discharge, palpate for pain Palpate superficial lymph nodes memorise dog and cat What does it mean if the popliteal lymph node on the left hind leg is larger and more tender than the contralateral node? Larynx and trachea Does gentle palpation elicit a cough Thyroids and oesophagus not usually palpable Jugular vein- distension and a jugular pulse indicate problems in small animals

8. Examination of the thorax Inspiratory distress = upper airway obstruction eg laryngeal hemi plegia Expiratory distress = lower airway obstruction eg allergic bronchospasm Restrictive lung disease eg pneumothorax Auscultate lung sounds in a quiet environment

9.   Areas for auscultation in the dog.  Left side: 1. Mitral area. 2. Aortic area. 3. Pulmonic area.  Right side: 4.Tricuspid area

10.  Examine for alopaecia ectoparasites, lesions and discharge  Skin tent as part of evaluation of hydration status RECOGNITION OF DEHYDRATION Grade% Fluid Deficit B WtClinical Signs Slight<5%not detectable Mild5-8%Tacky mucus membranes slightly less skin pliability slightly prolonged CRT slightly sunken eyes normal to slight increase in HR Mild/ moderate 8-10%dry mucous membranes delay in skin fold return (tenting) prolonged CRT sunken eyes tachycardia oliguria Moderate10-12%tenting of skin stays in place sunken eyes prolonged CRT >2sec tachycardia cold extremities early signs of shock, pulse rapid and weak anuria Severe12-15%clinical signs of shock, i.e. unconscious tachycardia, weak pulse pale mucous membranes cold extremities anuria

11. Match the following pictures to the degree of dehydration Slight 5% Mild 6-8% Mild toModerate 8-10% Severe 12-15%

13.  Trunk, Limbs, Feet/Hooves  Mammary Glands  Vulva  Male Reproductive Organs  Abdominal Examination  What are the 6 Fs to check if the abdomen is increased in size  Palpate organs gently

14.  Objectives  Recognise and describe normal and abnormal behaviour in animals in the hospital environment.  Understand the meaning and importance of these behaviours and what actions (if any) need to be taken when they are observed  Task (after reading the lecture material answer the following)  Define polyuria, stecoraceous vomit, dysphagia, ptyalism, tenesmus  When is a dark green discharge from the vulva seen in the bitch  What are the signs of a grade 2 lameness  Write 3 more questions from this lecture content for a buddy to answer and answer the 3 questions they write for you