The author
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice), is Assistant Professor of Small Animal Primary Care at Midwestern University College of Veterinary Medicine in Glendale, Arizona, USA.

About the Author xiii

Preface xiv

Acknowledgments xv

Part One Performing the Feline Physical Examination 1

1 Setting the Stage: Feline-Friendly Practice 3

1.1 Challenges Faced in Feline Practice 3

1.2 The Emergence of Feline-Friendly Practice 4

1.3 Key Principles of Feline-Friendly Practice 4

1.4 The Role of Sound 8

1.5 The Role of Tactile Stimulation 8

1.6 The Role of Scent 8

1.7 The Role of Advance Preparation 9

1.8 Examination Room Etiquette: Accessing the Cat 10

1.9 Recognizing Body Language 12

1.10 Feline-Friendly Handling 16

1.11 Other Feline Handling Tools 20

2 Assessing the Big Picture: the Body, the Coat, and the Skin of the Cat 24

2.1 Forms of Identification 24

2.2 Body Condition Scoring 25

2.3 Assessing Hydration 29

2.4 Inspecting the Coat: First Impressions 30

2.5 Identifying Coat Colors and Coat Patterns 32

2.6 Assessing Coat Quality 34

2.7 Inspecting the Skin 40

3 Examining the Head of the Cat 52

3.1 Skull Shape and Facial Symmetry 52

3.2 The Eyes and Accessory Visual Structures 52

3.2.1 A Systematic Approach to the Eye Examination 52

3.2.2 Evaluating the Adnexa of the Eye 53

3.2.3 Evaluating the Globe 58

3.2.4 Evaluating the Sclera 60

3.2.5 Evaluating the Cornea 61

3.2.6 Evaluating the Iris 61

3.2.7 Evaluating the Pupils 62

3.2.8 Assessing Ocular Reflexes 62

3.2.9 Assessing the Anterior Chamber 64

3.2.10 Assessing the Lens 65

3.2.11 Introduction to Fundoscopy 66

3.2.12 Fundoscopy and Direct Ophthalmoscopy 67

3.2.13 Fundoscopy and Indirect Ophthalmoscopy 67

3.3 The Ears 68

3.4 The Nose 72

3.5 The Extra-Oral Examination 73

3.6 The Intra-Oral Examination 75

3.6.1 Assessing Mucous Membrane Color 75

3.6.2 Assessing Capillary Refill Time 76

3.6.3 Examining the Mucosa 76

3.6.4 Examining the Gingiva 78

3.6.5 Assessing the Dentition 78

3.6.6 Assessing the Occlusion 79

3.6.7 Assessing for Calculus 81

3.6.8 Opening the Mouth 81

3.6.9 Examining the Tongue 82

3.6.10 Assessing for Periodontal Disease 82

3.6.11 Feline-Specific Dentistry 84

4 Examining the Endocrine and Lymphatic Systems of the Cat 90

4.1 Evaluating the Thyroid Gland 90

4.1.1 The Pathophysiology of Hyperthyroidism 90

4.1.2 The Etiology of Hyperthyroidism 91

4.1.3 The Art of Palpating an Enlarged Thyroid Gland 91

4.2 Assessing the Lymphatic System 93

4.2.1 Examining the Submandibular Lymph Nodes 93

4.2.2 Examining the Superficial Cervical or Pre-Scapular Lymph Nodes 93

4.2.3 Examining the Popliteal Lymph Nodes 94

4.2.4 Feeling for Lymph Nodes That Should Not Be Present 94

5 Examining the Cardiovascular and Respiratory Systems of the Cat 98

5.1 The Cardiac Patient 98

5.2 Assessing the Cardiovascular System Prior to Auscultation 99

5.2.1 Attitude 99

5.2.2 Respiratory Rate 99

5.2.3 Respiratory Effort 99

5.2.4 Respiratory Route 99

5.2.5 Mucous Membrane Color 99

5.2.6 Capillary Refill Time (CRT) 99

5.2.7 Jugular Pulse 99

5.2.8 Palpating the Ventral Neck 100

5.2.9 Palpating the Limbs for Warmth and Assessing the Extremities for Color 100

5.2.10 Assessing Femoral Pulses 100

5.3 Cardiothoracic Auscultation 101

5.3.1 Recalling the Cardiac Cycle 101

5.3.2 Normal Heart Sounds 101

5.3.3 Abnormal Heart Sounds: Murmurs 101

5.3.4 Other Heart Sounds 102

5.3.5 Ausculting the Heart 102

5.3.6 Understanding How the Stethoscope Is Built to Facilitate Auscultation 105

5.4 The Respiratory Patient 105

5.4.1 The Upper Airway Patient 105

5.4.2 The Lower Airway Patient 105

5.4.3 The Patient with Thoracic Cavity Disease 107

5.5 Assessing the Respiratory System Prior to Auscultation 110

5.5.1 The Nose 112

5.5.2 The Larynx and the Trachea 113

5.5.3 Thoracic Compliance 113

5.5.4 Thoracic Percussion 113

5.6 Understanding Normal Airway Sounds 114

5.7 Ausculting the Airway 114

5.8 Understanding Adventitious Airway Sounds 115

5.9 Using Airway Sounds to Corroborate Percussive Findings 116

5.10 Purring as an Obstruction to Auscultation 116

6 Examining the Abdominal Cavity of the Cat 120

6.1 Overview of the Digestive Tract as It Pertains to Presenting Complaints 120

6.2 The Esophagus 122

6.3 Visual Inspection of the Abdomen 122

6.4 Superficial Palpation of the Abdomen 122

6.5 Deep Palpation of the Abdomen 124

6.5.1 The Liver 126

6.5.2 The Stomach 127

6.5.3 The Spleen 127

6.5.4 The Pancreas 127

6.5.5 The Small Intestine 128

6.5.6 Mesenteric Lymph Nodes 129

6.5.7 The Large Intestine 129

6.5.8 The Rectal Examination 130

6.6 The Upper Urinary Tract 132

6.7 The Lower Urinary Tract 134

6.8 The Male Reproductive Tract 135

6.9 The Female Reproductive Tract 137

6.10 Being Presented with a Female of Unknown Sexual Status 138

6.11 Neonates 138

7 Examining the Musculoskeletal System of the Cat 145

7.1 Muscle Condition Score (MCS) 145

7.2 The Skeleton as a Whole 146

7.2.1 Key Components of the Axial Skeleton to Appreciate on Physical Examination 148

7.2.2 Key Components of the Appendicular Skeleton to Appreciate on Physical Examination 150

7.2.3 Additional Components of the Skeleton to Appreciate on Physical Examination 153

7.3 The Appendicular Skeleton: The Forelimb 153

7.4 The Appendicular Skeleton: The Hind Limb 160

8 Evaluating the Nervous System of the Cat 174

8.1 Assessing Behavior and Mental Status 174

8.2 Assessing Posture 176

8.3 Assessing Coordination and Gait 177

8.4 Assessing Postural Reactions 178

8.5 Assessing for Other Abnormal Movements 180

8.6 Evaluating the Spinal Reflexes 181

8.7 Assessing the Cranial Nerves 183

8.7.1 Reviewing the Ocular Reflexes Associated with the Cranial Nerves 183

8.7.2 Reviewing the Cranial Nerves Associated with Ocular Movement 185

8.7.3 Reviewing the Cranial Nerves Associated with Tactile Sensation 185

8.7.4 Reviewing the Cranial Nerves Associated with Muscle Movement Other Than Ocular 186

8.7.5 Reviewing the Cranial Nerves Associated with Digestion 186

8.7.6 Reviewing the Cranial Nerves Associated with Maintaining Posture 186

8.8 Assessing Nociception 186

Part Two Performing the Canine Physical Examination 191

9 Setting the Stage: Canine-Friendly Practice and Low-Stress Handling 193

9.1 Challenges Faced in Canine Practice 193

9.2 The Concept of Low-Stress Handling 194

9.3 White Coat Syndrome 196

9.4 The Role of Scent 198

9.5 The Role of Advance Preparation 199

9.6 Examination Room Etiquette: Setting the Tone for Initial Veterinary Interactions with the Dog 199

9.7 Recognizing Body Language 199

9.8 Creative Approaches to Challenging Interactions with Canine Patients 205

9.9 Other Canine Handling Tools 206

10 Assessing the Big Picture: the Body, the Coat, and the Skin of the Dog 213

10.1 Forms of Identification 213

10.2 Body Condition Scoring 214

10.3 Assessing Hydration 221

10.4 Breed Designation 222

10.5 Inspecting the Coat: First Impressions 223

10.6 Identifying Coat Colors and Coat Patterns 225

10.7 Assessing Coat Quality 233

10.8 Inspecting the Skin 237

10.9 Primary Skin Lesions 240

10.10 Secondary Skin Lesions 245

10.11 Miscellaneous Skin Lesions 246

10.12 Hyperkeratosis 249

10.13 Skin Folds 250

10.14 Nails and Paw Pads 251

10.15 Skin Incisions 252

10.16 Mammary Glands 255

11 Examining the Head of the Dog 261

11.1 Skull Shape: Function Versus Cosmesis 261

11.2 Facial symmetry 265

11.3 The Eyes and Accessory Visual Structures 265

11.3.1 A Systematic Approach to the Eye Examination 265

11.3.2 Evaluating the Adnexa of the Eye 265

11.3.3 Evaluating the Globe 274

11.3.4 Evaluating the Sclera 275

11.3.5 Evaluating the Cornea 277

11.3.6 Evaluating the Iris 278

11.3.7 Evaluating the Pupils 280

11.3.8 Assessing Ocular Reflexes 281

11.3.9 Assessing the Anterior Chamber 281

11.3.10 Assessing the Lens 282

11.3.11 Introduction to Fundoscopy 282

11.3.12 Fundoscopy and Direct Ophthalmoscopy 283

11.3.13 Fundoscopy and Indirect Ophthalmoscopy 283

11.4 The Ears 284

11.5 The Nose 289

11.6 The Extra-Oral Examination 291

11.7 The Intra-Oral Examination 295

11.7.1 Assessing Mucous Membrane Color 295

11.7.2 Assessing Capillary Refill Time 296

11.7.3 Examining the Mucosa 296

11.7.4 Examining the Gingiva 296

11.7.5 Assessing the Dentition 297

11.7.6 Assessing the Occlusion 301

11.7.7 Assessing for Calculus 302

11.7.8 Miscellaneous Acquired Tooth-Related Defects 303

11.7.9 Opening the Mouth 304

11.7.10 Examining the Tongue 305

11.7.11 Assessing for Periodontal Disease 306

12 Examining the Endocrine and Lymphatic Systems of the Dog 312

12.1 Thyroid Gland Neoplasia in the Dog 312

12.2 The Typical Presentation of Thyroid Gland Neoplasia in the Dog 313

12.3 The Pathophysiology of Hypothyroidism 313

12.4 The Typical Presentation of a Hypothyroid Dog 314