ANIMAL HEALTH APPLIED

SKILLS
APPROACH TO A CLINICAL CASE
INTRODUCTION
Focal point of any investigation of animal disease is the
making of a diagnosis.
Critical part in making that decision is clinical examination of
the individual animal or group of animals.
What is disease?
Can be defined as 'inability of an animal to perform
physiological functions at normal levels even though nutrition
and other environmental requirements are provided at
adequate levels'.
Introduction cont’
Not only a clinically ill animals come into area of examination
Also those animals or herds not clinically ill but that do not perform as
expected.
Veterinarians are required to recognize animals with recognizable:
• pathological lesion
• biochemical or metabolic deficit
• nutritional deficiency
That result in recognizable clinical signs
Introduction cont’
Also disease that owner recognizes simply as failure to perform or
reach predetermined objectives.
This is however not necessarily subclinical disease
In other situations, the owner may not recognize any abnormality
unless productivity is measured, e.g. milk production or growth rate
per day.
CLINICAL EXAMINATION OF THE INDIVIDUAL
ANIMAL
Clinical examination has three parts:
• The history
• The environment
• The animal

A. HISTORY
This is often the most important and it should suggest the diagnostic
possibilities and probabilities.
HISTORY TAKING

• Success involves veterinarian-client interactions learned by

experience.
• Vet should introduce him or herself with usual greetings to establish a
veterinarian-client relationship.
• Diplomacy and tact employed.
• Nontechnical terms used
• Statements esp. time, should be tested for accuracy.
• If detailed cross-examination of owner likely to arouse some
antagonism, vet to forego further questioning and be content with
own estimate of the dependability of the history.
HISTORY CONT.

The clinician must try to separate owners' observations from their

interpretations.
The components of history taking include:
• Patient and owner data
• Disease history
• Management history
1. PATIENT AND OWNER DATA
N/B: ACCURATE IDENTIFICATION OF THE PATIENT IS PARAMOUNT.
Relevant data includes:
Owner's:
• Name
• physical and postal address
• telephone number
Patient data cont’
The patients’:
• Species
• Breed (or estimate of parentage in a crossbred)
• Sex
• Age
• Name or number
• Body weight
• Use
• Color markings and other identifying marks.
2. DISEASE HISTORY

All disease states considered herd problems until proven otherwise.

I.e. to find animals in early stages of disease.
Taking of disease history includes:
• Present disease
• Morbidity
• case fatality
• population mortality rates
Disease history cont’
• Prior treatment
• Prophylactic and control measures
• Previous exposure
• Transit
• Culling rate
• Previous disease
2. MANAGEMENT HISTORY

This includes:
• Nutrition,
• Breeding policy and practice,
• Housing,
• Transport
• General handling.
• Etc
B. EXAMINATION OF THE ENVIRONMENT
Necessary part of any clinical investigation because of possible
relationship btn envtal’ factors and incidence of disease.
Vet to understand envtal’ needs of a particular spp or class of animals.
OUTDOOR ENVIRONMENT
This should include:
• Topography and soil type
• Feed and water supplies
• Waste disposal
Examination of the environment cont’
INDOOR ENVIRONMENT
This includes:
• Stocking rate (population density)
• Hygiene
• Ventilation
• Flooring
• Floor plan
• Lighting
C. EXAMINATION OF THE PATIENT

This is includes:
a) General examination
b) Physical examination
c) Laboratory examination
I. General Examination
The general examination of a patient consists of:
1. Distant examination
2. Particular distant examination of body regions
3. Close physical examination of all body regions and systems.
Distant Examination
N/B: there are some clinical signs that are best be assessed before the animal is
disturbed.
Includes:
• Behavior and general appearance
• Voice
• Eating
• Defecation
• Urination
• Posture
• Gait
• Body condition
• Skin
Distant Examination Cont.
a) Behavior and general appearance
• Separation from group is often indication of illness.
• behavior is also a reflection of the animal's health.
• If animal responds normally to external stimuli e.g. sound and
movement, it is classified as bright.
Examples of descriptions of behavior and general appearance include:
• Dull or apathetic- Reactions are sluggish and animal exhibits relative
indifference to normal stimuli.
Behavior and general appearance cont’

• 'Dummy' syndrome- A pronounced state of indifference in which

animal remains standing and is able to move but does not respond at
all to external stimuli. This occurs in subacute lead poisoning,
listeriosis and some cases of acetonemia in cattle.
• Coma- The terminal stage of apathy or depression in which the
animal is unconscious and cannot be roused.
• Anxiety or apprehension- Animal is alert and looks about constantly
but is normal in its movements. Usually expressive of moderate
constant pain or other abnormal sensation, as in early parturient
paresis or in recent blindness.
Behavior and general appearance cont’
• Restlessness- in which the animal moves about a good deal, lies
down and gets up and may go through other abnormal movements
such as looking at its flanks, kicking at its belly and rolling and
bellowing. Again, this demeanor is usually indicative of pain
• Mania- the animal performs abnormal movements with vigor
• Frenzy-the actions are so wild and uncontrolled that the animals are a
danger to anyone approaching them
Distant Examination Cont.
b) Voice
• Abnormality of the voice should be noted. It may be:
• hoarse in rabies
• weak in gut edema
• There may be continuous lowing in nervous acetonemia
• Persistent bellowing indicative of acute pain.
• Soundless bellowing and yawning are commonly seen in rabid cattle
• yawning is common in animals affected with hepatic insufficiency
Distant Examination Cont.
c) Eating
• The appetite of the animal can be assessed by observing its reaction
to the offering of feed or by the amount of feed available that has not
been eaten.
• It is important to determine the total amount of feed that the animal
is eating per day.
• In a patient that has retained its appetite, there may be abnormality
of prehension, mastication or swallowing and, in ruminants, of
belching and regurgitation.
Distant Examination Cont.
d) Defecation
• In constipation and rectal paralysis or stenosis, defecation may be
difficult and be accompanied by straining or tenesmus.
• Abdominal pain or laceration of the mucocutaneous junction at the
anus, defecation may cause pain.
• Involuntary defecation occurs in severe diarrhea and when there is
paralysis of the anal sphincter.
• Consideration of frequency, volume and character of feces is given
later under the section on special examination of the digestive tract.
Distant Examination Cont.
e)Urination
• May be difficult when there is partial obstruction of the urinary tract
• May be painful when there is inflammation of the bladder or urethra.
• In cystitis and urethritis, there is increased frequency with the
passage of small amounts and the animal remains in the urination
posture for some time after the flow ceases.
• Incontinence, with constant dribbling of urine, is usually due to partial
obstruction of the urethra or paralysis of its sphincter.
• If the animal urinates during the visual inspection, a sample of urine
should be obtained, examined grossly and submitted for urinalysis.
Distant Examination Cont.
f) Posture
• Resting of a limb in painful conditions e.g. laminitis
• Arching of the back with the limbs tucked under the body usually
indicates mild abdominal pain
• Downward arching of the back and 'saw horse' straddling of the legs
is characteristic of severe abdominal pain
• Abduction of the elbows is usually synonymous with chest pain or
difficulty in breathing.
• Elevation and rigidity of the tail, and rigidity of the ears and limbs, are
good indications of tetanus in animals.
Posture cont’
• The carriage of the tail in pigs is a useful barometer of their state of
health.
• Sheep that are blind, as in early pregnancy toxemia, are immobile but
stand with the head up and have an expression of extreme alertness.
When the animal is recumbent, there also may be abnormalities of
posture.
• In cattle affected by dislocation of the hip or by sciatic nerve paralysis,
the affected limb is not held flexed next to the abdomen but sticks
straight out in an awkward position
• unilateral pain in the chest may cause an animal to lie habitually on
the other side
Posture cont’
• a weak hindleg may be, kept under the animal.
• The head may be carried around towards the flank in parturient
paresis in cows and in colic in horses.
• Sheep affected with hypocalcemia, and cattle with bilateral hip
dislocation, often lie in sternal recumbency with the hindlegs
extended behind in a frog-like attitude.
• Inability or lack of desire to rise are usually indicative of muscle
weakness or of pain in the
Distant Examination Cont’
g) Gait
• Movements of the limbs can be expressed in terms of rate, range,
force and direction of movement e.g.
• High stepping gait
• Shuffling
• stumbling walk
• Walking in circles
• Compulsive walking or walking directly ahead regardless of
obstructions
Distant Examination Cont’
h) Body condition
• The animal may be in normal bodily condition, or obese, thin or
emaciated.
• Difference btn thinness and emaciation is one of degree: the latter is
more severe.
• In an emaciated (cachectic) animal the coat is poor, the skin is dry and
leathery and work performance is reduced. Thin animals, on the
other hand, are physiologically normal.
• The difference between fatness and obesity is of the same order.
• body condition on a scale of 1-5 or preferably 1-10.
Distant Examination Cont’
i) Body conformation
• Assessment of conformation or shape is based on the symmetry and
the shape and size of the different body regions relative to other
regions.
• An abdomen that is very large relative to the chest and hindquarters
can be classified as an abnormality of conformation.
• More on conformation in the description of body regions.
Distant Examination Cont’
j) Skin
• Skin abnormalities can usually be seen at a distance. They include
changes in the hair or wool, abnormal sweating, the presence of
discrete or diffuse lesions, evidence of soiling by discharges and of
itching.
• The normal luster of the coat may be absent: it may be dry as in most
chronic debilitating diseases or excessively greasy as in seborrheic
dermatitis.
• Alopecia may be evident: in hyperkeratosis it is diffuse; in ringworm it
may be diffuse but more commonly occurs in discrete areas.
• Hypertrophy and folding of the skin may be evident, hyperkeratosis
being the typical example.
Skin cont’
• 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.
Particular Distant Examination
• This is the inspection of Body Regions
a) Head
• Facial expression may be abnormal. Rigidity of tetanus, cunning leer
or maniacal expression of rabies and acute lead poisoning are cases
in point.
• Symmetry and configuration of the bony structure should be
examined.
• Doming of the forehead occurs in some cases of congenital
hydrocephalus
• Swelling of the maxillae and mandibles occurs in osteodystrophia
fibrosa; in cattle enlargement of the maxilla or mandible is common
in actinomycosis.
Particular Distant Examination (Head) cont’
• Asymmetry of the soft structures may be evident and is most
obvious in the carriage of the ears, degree of closure of the eyelids
and situation of the muzzle and lower lip.
• Slackness of one side and drawing to the other are constant features
in facial paralysis.
• Tetanus is accompanied by rigidity of the ears, prolapse of the third
eyelid and dilatation of the nostrils.
• The carriage of the head is most important:
• rotation is usually associated with defects vestibular apparatus on
one side, deviation with unilateral involvement of the medulla and
cervical cord;
Particular Distant Examination (Head) cont’
• opisthotonos is an excitation phenomenon associated with tetanus,
strychnine poisoning, acute lead poisoning, hypomagnesemic tetany,
polioencephalomalacia and encephalitis.
• The eyes: Visible discharge should be noted
• protrusion of the eyeball, as occurs in orbital lymphomatosis
• retraction of the bulb, as occurs commonly in dehydration
• 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.
Particular Distant Examination (Head) cont’

• Dilatation of the nostrils and nasal discharge suggest closer

examination of the nasal cavities.
• 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 inflammatory, as in actinobacillosis
and strangles, or edematous, as in acute anemia, protein starvation or
congestive heart failure. Unilateral or bilateral swelling of the cheeks
in calves usually indicates necrotic stomatitis.
Particular Distant Examination cont’
b) Neck
• Enlargement of throat region should closely examined to determine
whether cause is inflammatory and whether L/Ns, salivary glands or
other soft tissues are involved.
• Goitre leads to local enlargement located further down the neck.
• A jugular pulse, jugular vein engorgement and edema should be
looked for
• local enlargement due to esophageal distension should be noted.
Particular Distant Examination cont’
c) Thorax
• Respiration should be examined preferably with animal standing.
recumbency is likely to modify it considerably.
• Allowance be made for effects of exercise, excitement, high env’tal
temps and fatness.
• Obese cattle may have respiratory rates X2 to X3 of normal.
• The rate, rhythm, depth and type of respiration should be noted.
• Increased resp rate is designated as polypnea, decreased rate as
oligopnea and complete cessation as apnea.
Particular Distant Examination (Thorax) cont’
• Rate may be counted by observation of rib or nostril movements, by
feeling the nasal air movements or by auscultation of the thorax or
trachea.
• Significant rise in envi’tal temp or humidity may double the normal
respiratory rate.
• Animals that are acclimatized to cold outdoor temperatures are
susceptible to heat stress when exposed suddenly to warmer
temperatures. When brought indoors the respiratory rate may
increase to six or eight times the normal, and panting open-mouth
breathing may be evident within 2 hours.
Particular Distant Examination (Thorax) cont’
• Respiratory rhythm The normal respiratory cycle consists of three
phases of equal length: inspiration, expiration and pause; variation in
the length of one or all phases constitutes an abnormality of rhythm.
• Respiratory depth The amplitude or depth of respiratory movements
may be reduced in painful conditions of the chest or diaphragm and
increased in any form of anoxia. Moderate increase in depth is
referred to as hyperpnea and labored breathing as dyspnea.
• In dyspnea, accessory respiratory movements become more
prominent: there is extension of head and neck, dilatation of nostrils,
abduction of the elbows and breathing through the mouth plus
increased movement of the thoracic and abdominal walls. Loud
respiratory sounds, especially grunting, may also be heard.
Particular Distant Examination (Thorax) cont’
• Type of respiration. In normal respiration there is movement of the
thorax and abdomen. In painful conditions of the thorax, e.g. acute
pleurisy, and in paralysis of the intercostal muscles, there is relative
fixation of the thoracic wall and a marked increase in the movements
of the abdominal wall
• The reverse situation is thoracictype respiration, in which the
movements are largely confined to the thoracic wall, as in peritonitis,
particularly when there is diaphragmatic involvement.
• Thorax symmetry. Collapse or consolidation of one lung may lead to
restriction of movements of the thoracic wall on the affected side.
Particular Distant Examination (Thorax) cont’
• Respiratory noises or stridors These include:
• Coughing - due to irritation of the pharynx, trachea and bronchi
• Sneezing - due to nasal irritation
• Wheezing - due to stenosis of the nasal passages
• Snoring -when there is pharyngeal obstruction, as in tuberculous
adenitis of the pharyngeal lymph nodes
• Roaring - in paralysis of the vocal cords
• Grunting - a forced expiration against a closed glottis, which happens
in many types of painful and labored breathing
Particular Distant Examination cont’
d) Abdomen
• Variations in abdominal size are usually appreciated during the
general inspection of the animal.
• Increase in size may be due to the presence of excessive feed, fluid,
feces, flatus or fat, the presence of a fetus or a neoplasm.
• Further differentiation is usually possible only on close examination.
• In advanced pregnancy, fetal movements may be visible over the right
flank of cattle.
• In severe distension of the intestines with gas, the loops of intestine
may be visible in the flank, especially in calves.
Particular Distant Examination (Abdomen) cont’
• Intestinal tympany usually results in uniform distension of the
abdomen whereas fluid tends to result in increased distension
ventrally.
• The term' gaunt' is used to describe obvious decrease in size of the
abdomen. It occurs most commonly in starvation, in severe diarrhea
and in chronic dses where appetite is reduced.
• An umbilical hernia, omphalophlebitis, or dribbling of urine from a
previous urachus may be apparent on visual inspection of the ventral
abdominal wall.
Particular Distant Examination (Abdomen) cont’
• Ventral edema is commonly associated with approaching parturition,
gangrenous mastitis, congestive heart failure, infectious equine
anemia, and rupture of the urethra due to obstructive urolithiasis.
• A grossly enlarged asymmetrical swelling of the flank may suggest
herniation of the abdominal wall.
• Ruminal movements can be seen in the left paralumbar fossa and
flank of cattle but a complete examination of the rumen requires
auscultation, palpation and percussion, which are described later.
Particular Distant Examination cont’
e) External genitalia
• Gross enlargements of preputial sheath or scrotum are usually
inflammatory in origin. Varicocele or tumors can also be responsible.
• Degenerative changes in the testicles may result in a small scrotum.
• Discharges of pus and blood from the vagina indicate infection of the
genitourinary tract.
f) Mammary glands
• Disproportionate size of udder suggests acute inflammation, atrophy
or hypertrophy of the gland. These conditions can be differentiated
by further palpation and examination of the milk or secretions.
Particular Distant Examination cont’
g) Limbs
• General abnormalities of posture and gait have been described.
Symmetry is important and comparison of the various aspects of pairs
of limbs should be used when there is doubt about the significance of
an apparent abnormality.
• Enlargement or distortion of bones, joints, tendons, sheaths and
bursae should be noted and so should any enlargement of peripheral
lymph nodes and lymphatic vessels.
Close Physical Examination
• Some of the techniques used in making a close physical examination
are set out below.
1. Palpation
Direct palpation with fingers or indirect palpation with a probe is aimed
at determining the size, consistency, temperature and sensitivity of a
lesion or organ.
• Terms used to describe palpation findings include:
• Doughy - when the structure pits on pressure, as in edema
• Firm - when the structure has the consistency of normal liver
• Hard - when the consistency is bonelike
Palpation cont’
• Fluctuating - when the structure is soft, elastic and undulates on
pressure but does not retain the imprint of the fingers
• Tense -when the structure feels like a viscus distended with gas or
fluid under some considerable pressure
• Emphysematous - when the structure is puffy and swollen, and
moves and crackles under pressure because of the presence of gas in
the tissue.
Close Physical Examination cont’
2. Percussion
• The body surface is struck so as to set deep parts in vibration and
cause them to emit audible sounds. The sounds vary with the density
of the parts set in vibration and may be classified as follows:
• Resonant - sound emitted by organs containing air, e.g. normal lung
• Tympanitic - drum-like note emitted by an organ containing gas under
pressure such as a tympanitic rumen or cecum
• Dull - the sound emitted by solid organs such as heart and liver.
• Percussion can be performed with the fingers using one hand as a
plexor and one as a pleximeter. In large animals a pleximeter
hammer on a pleximeter disk is recommended for consistency.
Percussion cont’
• The quality of the sound elicited is governed by a number of factors.
The strength of the percussion blow must be kept constant as the
sound volume increases with stronger percussion.
• Allowances be made for thickness and consistency of overlying
tissues. E.g., the thinner the thoracic wall, the more resonant the
lung.
• Percussion on a rib must not be compared with percussion on an
intercostal space.
• Size and body condition score of the animal are important
considerations.
• Percussion may be relatively ineffective in a fat animal. In pigs and
sheep, the fatness of the pig and the wool coat of the sheep plus the
uncooperative nature of both species make percussion impracticable.
Percussion cont’
• In mature cattle and horses, abdominal organs are too large and
overlying tissues too thick for satisfactory outlining of organs or
abnormal areas, unless the observer is highly skilled.
• Lungs of cattle and horses can be satisfactorily examined by
percussion but requires practice and experience to become skillful
and accurate.
• Percussion is a valuable aid in the diagnosis of diseases of the lungs
and abdominal viscera of all large animals.
• Increased dullness over thorax indicates consolidation of the lung, a
pleural effusion, or space-occupying lesion such as tumor or abscess.
• Increased resonance over thorax suggests emphysema or
pneumothorax.
Close Physical Examination cont’
3. Ballottement
• Is a technique used to detect floating viscera or masses in the
abdominal cavity.
• Using extended fingers clenched fist, the abdominal wall is palpated
vigorously with a firm push to move the organ or mass away and then
allow it to rebound on to the fingertips.
• Ballottement of a fetus is a typical example; the fetal prominences
can be easily felt by pushing the gravid uterus through the abdominal
wall over the right flank in pregnant cattle.
• Impaction of the abomasum, large tumors and abscesses of the
abdominal cavity may also be detected by ballottement.
 Ballottement cont’
• Ballottement and auscultation of flanks of cattle is useful to detect fluid
-splashing sounds. Their presence on the left side suggests
carbohydrate engorgement and excessive quantities of fluid in the
rumen, or left-side displacement of the abomasum.
• Right flank, fluid -splashing sounds may indicate intestinal obstruction,
abomasal volvulus, cecal dilatation and torsion, and paralytic ileus.
• Tactile percussion is when a cavity containing fluid is percussed sharply
on one side and the fluid wave thus set up is palpated on the other. The
sensation created by the fluid wave is called a fluid thrill. It is felt most
acutely by the palm of the hand at the base of the fingers. Diseases that
cause ascites and accumulation of fluid in the peritoneal cavity are
examples where this technique is useful.
Close Physical Examination cont’
4. Auscultation
• Direct listening to the sounds produced by organ movement is
performed by placing the ear to the body surface over the organ.
• Indirect auscultation by a stethoscope is the preferred technique.
• Percussion and simultaneous auscultation of the abdomen is a useful
technique for examination in large animals. The stethoscope is placed
and the areas around the stethoscope and radiating out from it are
percussed.
• This is valuable for detection and localization of a gas-filled viscus in
the abdomen of cattle with LDA, right-side dilatation and volvulus of
the abomasum, cecal dilatation and torsion, intestinal tympany
associated with acute obstruction or paralytic ileus, or
pneumoperitoneum.
Close Physical Examination cont

5. Succussion
• This technique, which involves moving the body from side to side to
detect the presence of fluid, is an adaptation of the above method.
• By careful auscultation while the body is moved, free fluid in the
intestines or stomach will result in fluids plashing or tinkling sounds.
Sequence used in the close physical examination
• The close physical examination should be performed as quietly and
gently as possible to avoid disturbing the patient and thus increasing
the resting heart and respiratory rates.
• At a later stage it may be necessary to examine certain body systems
after exercise, but resting measurements should be carried out first.
• If possible the animal should be standing, as recumbency is likely to
cause variation in heart and pulse rates, respiration, etc.
• The sequence used in close physical examination will vary with the
species being examined, results of the distant examinations, history
obtained, and diagnostic hypotheses that the clinician has generated.
Sequence cont’
• The various parts of the close physical examination can be modified
according to individual circumstances but it is important to do a
thorough clinical examination based on the circumstances.
• Following the distant examination, and the particular distant
examination, it is recommended that the vital signs be determined
before the animal is handled for examination of body regions such as
the oral cavity.
• In general, an appropriate sequence for the close physical
examination would be as follows:
1. Vital signs: temperature, pulse and heart beats, respirations, state of
hydration
 Sequence cont’
2. Thorax: heart sounds (rate, rhythm, intensity); lung sounds
3. Abdomen
4. Head and neck: including eyes, oral cavity, facial structures, and jugular
5. Rectal examination
6. Urinary tract
7. Reproductive tract
8. Mammary gland
9. Musculoskeletal system
10. Nervous system
11. Skin: including ears, hooves and horns.
Sequence cont’
• The important principle is to determine the vital signs before handling
and examining other body systems, which may distort the vital signs.
• The sequence that follows taking the vital signs can vary, based on
individual circumstances, the urgency of the case, if any, and the ease
of doing the particular examinations.
• For example, when presented with a lactating dairy cow with
peracute mastitis, the sequence will be recording the temperature,
heart rate and sounds, respirations and status of the lungs, status of
the rumen, followed by careful examination of the mammary gland.
Vital signs
1. Temperature:
• Normally the temperature is taken per rectum. When not possible it
is taken per vaginum.
• Ensure that the mercury column is shaken down, moisten the bulb to
facilitate entry and, if rectum is flaccid or full of hard feces, insert a
finger also to ensure the thermometer bulb is held against the
mucosa.
• When the temp is read immediately after defecation, or if
thermometer is stuck into a ball of feces or is left in the rectum for
insufficient time, a false, low reading will result.
• As a general rule the thermometer should be left in place for 2
minutes.
Temperature cont’
• If there is doubt as to the accuracy of the reading, the temperature
should be taken again.
• Normal physiological variations occur in body temperature and are
not an indication of disease: a diurnal variation of up to 1°C may
occur, with the low point in the morning and the peak in the late
afternoon.
• There may be a mild rise of about 0.6°C in late pregnancy, but a
precipitate although insignificant decline just before calving is not
uncommon in cows and ewes and lower temperatures than normal
occur just before estrus and at ovulation - the degree of change
(about 0.3°C) is unlikely to attract clinical attention.
Temperature cont’
• In sows the body temperature is subnormal before farrowing and
there is a significant rise in body temperature coinciding with
parturition. This rise is commonly high enough to exceed the critical
temperature of 40°C and may be considered erroneously as evidence
of disease.
• The elevation of temperature that occurs in sows at the time of
parturition, of the order of 1°C, is maintained through lactation and
disappears at weaning.
• High environmental humidity and temperature and exercise will cause
elevation of the temperature; the deviation may be as much as 1.6°C
in the case of high environmental temperatures and as much as 2.5-
3°C after severe exercise; in horses, after racing, 2 hours may be
required before the temperature returns to normal.
 Temperature cont’
• Animals acclimatized to cold outside temps if brought indoors to a
warmer temp, their body temps may exceed the critical temp within 2-4
hours.
• Marked temperature variations are an indication of a pathological
process:
• Hyperthermia is simple elevation of the temp past the critical point, as
in heat stroke
• Fever or pyrexia is the state where hyperthermia is combined with
toxemia, as in most infectious diseases
• Hypothermia is a subnormal body temperature, occurs in shock,
Circulatory collapse (as in parturient paresis and acute rumen impaction
of cattle), hypothyroidism and just before death in most diseases.
Vital signs
2. Pulse
• The pulse should be taken at the middle coccygeal or facial arteries in
cattle, the facial artery in the horse and the femoral artery in sheep
and goats.
• With careful palpation a number of characters may be determined,
including rate, rhythm, amplitude, tone, maximum and minimum
pulse pressures and the form of the arterial pulse.
a) Rate is dependent on the heart alone and is not directly affected by
changes in the peripheral vascular system. It may or may not represent
the heart rate; in cases with a pulse deficit, where some heartbeats do
not produce a pulse wave, the rates will differ.
Pulse cont’
• Although there are significant differences in rate between breeds of
dairy cow, and between high- and low-producing cows, the
differences would not be noticeable to a clinician performing a
routine examination.
• Pulse is not readily palpable in pigs
• Bradycardia (marked slowing of the heartbeat) is unusual unless
there is partial or complete heart block, but occurs in cases of space-
occupying lesions of the cranium, in cases of diaphragmatic adhesions
after traumatic reticulitis in cattle, or when the rumen is much
emptier than normal.
• Tachycardia (increased pulse rate) is common and occurs in most
cases of septicemia, toxemia, circulatory failure and in animals
affected by pain and excitement.
Pulse cont’
b) Rhythm may be regular or irregular. There are two components of
the rhythm, namely the time between peaks of pulse waves and the
amplitude of the waves. These are usually both irregular at the one
time, variations in diastolic filling of the heart causing variation in the
subsequent stroke volume.
c) Amplitude is determined by amount of digital pressure required to
obliterate the pulse wave. It is largely a measure of cardiac stroke
volume and may be considerably increased, as in the 'water hammer'
pulse of aortic semilunar valve incompetence, or decreased, as in most
cases of myocardial weakness.
Vital signs cont’
3. Heart beat
• Auscultafion of the heart is aimed at determining the character of
normal heart sounds and detecting the presence of abnormal sounds.
• Optimum auscultation sites are the fourth and fifth intercostal spaces.
• Extension of the forelimb may facilitate auscultation if the animal is
quiet.
• The first (systolic) sound is heard best over the cardiac apex, the
tricuspid closure being most audible over the right apex and mitral
closure over the left apex.
• The second (diastolic) sound is heard best over the base of the heart,
the aortic semilunar closure posteriorly and the pulmonary semilunar
anteriorly, both on the left side.
Heart beat cont’
• In auscultation of the heart, the points to be noted are the rate,
rhythm, intensity and quality of sounds and whether abnormal
sounds are present.
• Comparison of the heart and pulse rates will determine whether
there is a pulse deficit due to weak heart contractions failing to cause
palpable pulse waves; this is most likely to occur in irregular hearts.
• Normally the rhythm is in three time and can be described as LUBB -
DUPP - PAUSE, the first sound being dull, deep, long and loud and the
second sound sharper and shorter.
• As the heart rate increases the cycle becomes shortened, mainly at
the expense of diastole and the rhythm assumes a two-time quality.
Heart beat cont’
• More than two sounds per cycle is classified as a 'gallop' rhythm and
may be due to reduplication of either the first or second sounds.
• Reduplication of the first sound is common in normal cattle and its
significance in other species.
• With irregularity, there is usually variation in the time intervals
between cycles and in the intensity.
• The intensity of the heart sounds may vary in two ways, absolutely or
relatively: absolutely when the two sounds are louder than normal,
and relatively when one sound is increased compared to the other in
the cycle. For example, there is increased absolute intensity in anemia
and in cardiac hypertrophy.
Heart beat cont’
• The intensity of the first sound depends on the force of ventricular
contraction and is thus increased in ventricular hypertrophy and
decreased in myocardial asthenia.
• The intensity of the second sound depends upon the semilunar
closure, i.e. on the arterial blood pressure, and is therefore increased
when the blood pressure is high and decreased when the pressure is
low.
• Abnormal sounds may replace one or both of the normal sounds or
may accompany them.
• The heart sounds are muffled when the pericardial sac is distended
with fluid.
Vital signs cont’
4. Respirations
• Lung area Auscultation, percussion and palpation are the major
methods used for examination of the lungs.
• The lung area available for satisfactory auscultation is slightly larger
than that available for percussion.
• The normal breath sounds are heard over most of the lungs,
particularly in the middle third anteriorly over the base of the lung,
and consist of a soft, sipping VEE-EFF, the latter, softer sound
occurring at expiration.
• The sounds are heard with variable ease depending on the thickness
of the chest wall and the amplitude of the respiratory excursion.
Respirations cont’
• The amplitude or loudness of the breath sounds is increased in
dyspnea and in early pulmonary congestion and inflammation.
• The amplitude of the breath sounds is decreased or totally inaudible
when there is pleural effusion, and in space-occupying lesions in the
lung or pleural cavity.
• Abnormal lung sounds include crackles, wheezes and pleuritic friction
rubs. They are the result of interference with the free movement of
air in and out of the lungs, and of the presence of lesions that
interfere with the normal movement of the lung and thus create
additional respiratory sounds, which are an indication of disease.
Respirations cont’

• The intensity of abnormal lung sounds may be increased and their

clarity improved by measuring the rate and depth of respirations with
forced mild exercise such as walking for a few minutes followed by
immediate auscultation.
• If exercise is undesirable the occlusion of both nostrils for 30-45
seconds will be followed by some deep inspirations and accentuation
of abnormal lungs.
Vital signs cont’
5. State of hydration
• The state of hydration is assessed by inspection of the eyes for
evidence of dehydration and evaluating the elasticity of the skin.
• Dehydration is characterized by sunken eyes of varying degrees, and
the skin will 'tent' when lifted with the fingers and remain tented for
varying lengths of time.