The Author RYANE E. ENGLAR, DVM, DABVP (Canine and Feline Practice), is Clinical Assistant Professor and Clinical Education Coordinator at Kansas State University College of Veterinary Medicine in Manhattan, Kansas, USA.

Author Bio xv

Preface xvii

Acknowledgments xix

Part One Introducing the Problem¿Oriented Approach 1

1 The Problem¿Oriented Approach to Clinical Medicine 3

2 The Role of the Comprehensive Patient History in the Problem¿Oriented Approach 11

Part Two The Integumentary System 19

3 Claw and Claw Bed Pathology 21

4 Wounds 41

5 Hypotrichosis and Alopecia 61

6 Infestation 95

7 Skin Fragility 125

8 Changes in Coat Color 135

9 Changes in Pigmentation 149

10 Nasal and Footpad Hyperkeratosis 169

11 Erythematous Wheals and Angioedema 181

12 Papules and Pustules 197

13 Scale and Crusts 209

14 Skin Nodules and Tumors 221

Part Three Eyes and Ears 239

15 Acute Blindness 241

16 Hyphema 257

17 Hypopyon 265

18 Anisocoria 271

19 Abnormalities Associated with the Upper and Lower Palpebrae 283

20 Abnormal Presentations Involving the Nictitans 293

21 Changes in Globe Position within the Orbit 299

22 Changes in Globe Size 311

23 Abnormal Alignment of One or Both Eyes 321

24 Nystagmus 331

25 Reflex Blepharospasm 337

26 Abnormal Tear Production and Other Ocular Discharge 345

27 Abnormal Appearances of the Conjunctiva 355

28 Abnormal Appearances of the Sclera 367

29 Abnormal Appearances of the Cornea 383

30 Abnormal Appearances of the Iris 393

31 Abnormal Appearances of the Lens 401

32 Abnormal Appearances of the External Ear 411

Part Four The Respiratory System 429

33 Nasal Discharge 431

34 Stertor and Stridor 449

35 Sneezing and Coughing 463

36 Changes in Respiratory Rates and Patterns 481

37 Abnormal Lung Sounds 505

Part Five The Cardiovascular System 517

38 Abnormal Mucous Membranes and Capillary Refill Time (CRT) 519

39 Palpably Cool or Cyanotic Extremities 535

40 Collapse 543

41 Jugular Vein Distension and Jugular Pulses 555

42 Muffled Heart Sounds 561

43 Abnormal Heart Sounds: Murmurs 569

44 Gallop Rhythms 583

45 Bradycardia 589

46 Tachycardia 595

Part Six The Digestive System 603

47 Abnormal Gut Sounds 605

48 Abnormal Ingestive Behaviors 611

49 Abnormal Numbers of Teeth and Enamel Defects 617

50 Acute Abdomen 627

51 Changes in Fecal Appearance 647

52 Dysphagia and Regurgitation 671

53 Halitosis 683

54 Emesis 695

Part Seven The Urogenital System 717

55 Abnormalities Associated with Testicular Palpation 719

56 Bilateral Pre¿Scrotal Swellings in the Canine Patient 729

57 Spines Along the Feline Penis 733

58 Abnormal Presentations Involving the Prepuce and the Penis 737

59 Preputial Discharge 747

60 Ambiguous External Genitalia 753

61 Vulvovaginal Discharge 757

62 Abnormal Presentations of the Mammary Glands 769

63 Abnormal Palpation of One or Both Kidneys 783

64 Polyuria and Polydipsia 799

65 Acute Presentations of Diminished Urine Output: Urinary Tract Obstruction (UTO) 811

66 Grossly Abnormal Urine 821

Part Eight The Musculoskeletal and Nervous Systems 831

67 Cervical Ventroflexion 833

68 Forelimb Lameness 843

69 Pelvic Limb Lameness 861

70 Shifting Leg Lameness 883

71 Abnormal Mentation 891

72 Head Tilt, Circling, and Other Manifestations of Vestibular Disease 907

73 Abnormal Somatic or Spinal Reflexes 921

74 Upper and Lower Motor Neuron Signs and Anatomic Localization of Disease 927

75 Diffuse Flaccidity in the Dog: Unusual Presentations Involving Diffuse Lower Motor Neuron Dysfunction 941

76 Unusual Presentations of Spastic Rigidity in the Dog 947

77 Involuntary Movements or Dyskinesias 955

78 Seizures 963

Index 983