Addis Ababa University

College of Veterinary Medicine & Agriculture

Doctor of Veterinary Medicine (DVM)
Program

Veterinary Clinical Diagnosis (Vetm3131)

By
Abebe Wirtu

January, 2023
Systemic Clinical Examination
1. Clinical Examination of Musculoskeletal system

• Main function is to support the body in order to

ensure normal locomotion and posture

Disease of Musculoskeletal system

i. Primary Disease

• Disease give rise to abnormal locomotion and

changes in posture that are involving muscle, bone
and joints
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Systemic Clinical Examination

ii) Secondary Disease

• Those diseases that cause alteration in posture and

locomotion that are arise from abnormalities
involving structure other than musculoskeletal
system

• Ex. Nervous system disease, systemic disease

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 Systemic Clinical Examination
The abnormalities occur in this system can be
categorized as:
a) Degenerative
 Arthropathy: degeneration of joints
 Myopathy: degeneration of muscle
 Osteopathy: degeneration of bone
b) Inflammatory: Arthritis, myositis, Osteomyelitis
c) Proliferative: Tumor
d) Developmental: Arthrogryposis (Fixed joints in a
distorted position)
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 Systemic Clinical Examination
Examination of Muscle
 Done by Inspection and Palpation
Abnormalities in muscle
 Increased tone:-
 Continuous spasm- Tetanus
 Intermittent spasm-Strychnine
poisoning
 Muscle tremor: repetitive twitching of
voluntary muscle

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 Systemic Clinical Examination

• Myopathy – Degeneration of muscle; it cause

recumbency and change in posture

 White Muscle Disease (WMD) which is caused

by Vitamin E and Selenium deficiency

• Myositis – Black leg, Trichnellosis

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Systemic Clinical Examination
Examination of the Bone
Can be done by:- essay bone examination

 Inspection

 Palpation

 Radiology

 By inspection and palpation we can recognize

change in contour (form), shape, pain and
consistency
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 Systemic Clinical Examination
Abnormalities Observed in Bone
• Achondroplastic dwarfism (Developmental)-
the body are not proportional
• Osteodystrophy- Degenerative defects
 Decrease in vit. D (Decrease ca+2 absorption)
 Ca: P imbalance (Rickets in young and
Osteomalacia in old)
• Problem in kidney cause Osteomalacia
• Osteomyelitis – Infection and injury
- Actionomycosis, Brucellosis (Hygroma)
• Proliferative (Tumor)- Osteosarcoma 8
 Systemic Clinical Examination
Examination of Joints
 Can be done by:-
 Inspection
 Palpation
 Radiology
Abnormalities Observed in joints
 Congenital: Arthrogryopsis
 Arthritis: Bacterial invasion
 Arthropathy: Rheumatoid arthritis (man,
poultry)
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 Systemic Clinical Examination

• Joints have very high affinity for

multiplication of micro-organism

• Examination and management of joints need

sterile environment

• Therefore, if you get swelling in joint don’t

puncture it directly

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 Systemic Clinical Examination
Examination of Feet
• Done by inspection and palpation

Abnormalities observed in feet

• Keratoma: accumulation of keratin (Bulging of hoof)

• Hoof overgrowth: common in stable animal it will

predispose to trauma

• Laminitis: inflammation of sensitive Lamine (Allergy)

• Foot rot: Fusobacterium necrophorum

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 Systemic Clinical Examination
2. Examination of the Nervous system
• Nervous system is responsible for maintenance of
normal posture and gait and controls the activity
of smooth muscles and endocrine glands

• Brain and spinal cord are covered by bony

structures called skull and vertebral column
respectively

• Therefore they are not readily available for clinical

examination
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 Systemic Clinical Examination
• The clinical examination of nervous system is
based on behaviors of the animal to various
stimuli
• The diseases of nervous system are generally
suspected when animal exhibits an abnormal
behavior characterized by:
 Alteration in locomotion
 Convulsion (continuous spasm)
 Increased activity
 Loss of function
 Reduced sensitivity
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Systemic Clinical Examination
Classification of nervous system disorders

1.Central disorders (Brain and spinal cord)

2.Motor disturbance

3.Sensory disturbance

4.Autonomic nervous system disturbance

5.Reflexes

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Systemic Clinical Examination
1. Central disorders (Brain and spinal cord)
Cerebral affections:
 Linked with increased motor nerve activity
 Manifested by paralysis, spasms, disturbance of
vision/hearing and unconsciousness
Cerebellum disorder:
 Characterized by loss of equilibrium,
incoordination of limbs, falling
Spinal cord disorder:
 Manifested by regional spasticity and paralysis of
the dependent organ or part of the body
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 Systemic Clinical Examination
2. Motor disturbance
Paralysis:
 Is loss of motor nerve control over any of the body
function
Muscular atrophy:
 Prolonged deprivation of motor innervations
 Leads to wastage (degeneration)
Spasm: blank space

 Is exaggerated contractions of muscle that is

associated with increased tone
 can be tonic (continuous spasm ex. Tetanus) or16
clonic (alternate spasm Ex. Strychnine Poisoning)
Types of paralysis
• Central paralysis:- occurs due to involvement of
brain and spinal cord
• Peripheral paralysis: occurs only in the area
supplied by one or few nerves of that area
Terms used for paralysis pralised on the bull
 Hemiplegia: is paralysis of one side of the body
including fore and hind legs of the same side
 Diplegia: complete paralysis of fore and hind legs
 Monoplegia: paralysis of single limb
 Paraplegia: - paralysis of all organs behind a
certain level of body/loss of muscle function in the lower17half
of the body
 Systemic Clinical Examination
3. Sensory Disturbances
• Sensory disturbances are observed as any
alteration in touch, sight, smell, taste and
hearing
• They are difficult to diagnose since animal can
not speak
• While diagnosing this disturbance one should
be careful to rule out the damage in eye, ear,
nasal mucosa, skin and tongue before drawing
any conclusion
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 Systemic Clinical Examination
Sensory abnormalities can be:

• Analgesia – complete insensitivity to palpation or

pain stimulus

 Done by pricking the skin of sensitive

areas like lips, withers and perineum

• Amaurosis: blindness (Optic nerve dysfunction)

(Poisoning)

• Deafness- hereditary, poisoning 19

 Systemic Clinical Examination
Sensory abnormalities

• Ansomia: loss of smell sensation Ex. Dogs with

severe rhinitis

• Hypersensitivity (Hyperesthesia): the animal

becomes so sensitive for some stimuli

 Hypersensitivity to light: photophobia

 Hypersensitivity to sound
 Tetanus affected animals are hypersensitive to
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light and sound
 Systemic Clinical Examination

4. Autonomic nervous system disturbance

• We can see disturbance in their area of works

such as respiration, cardiac activity, sweat
gland activity, digestion, urination and soon

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 Systemic Clinical Examination
5. Reflexes
• Reflex is an involuntary activity induced in a
muscle or gland in response to stimulus

• It helps to assess the functional status of the

nervous system

• It can be absent, diminished or exaggerated

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Systemic Clinical Examination
i. Corneal Reflex

• Occur by touching the peripheral part of

cornea with wet finger tip which cause the
animal to blink

• Used in testing the status of anesthesia

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 Systemic Clinical Examination
ii) Pupillary reflex

• It is observed by keeping the animal in dark room for

sometime and directing a beam of light through a
pencil beam in one eye

• Normally in dark pupil is dilated whereas it constricted

on light

 Mydriasis: pupillary dilation

 Miasis: pupillary constriction

• In both mydriasis and miasis the reflex is absent 24

 Systemic Clinical Examination
iii. Cutaneous reflex
 It is induced by touching/pricking the skin
Pedal reflex:
 Pinch interdigital fold and withdrawal of leg observed
 Used to check status of the fetus (alive or not)
Anal reflex:
 Touching the anus and Jerking contraction
observed
 Used to check the status of the fetus
Digital reflex:
 pinch the digit
 Used to check the status of the fetus 25
The Skin, Coat and Associated Structures
Home take messages (Objectives)
• Which disease cause skin abnormality?

• How we characterized skin lesions?

• Which clinical examination techniques we need to

apply in examination of skin?

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The Skin, Coat and Associated Structures
• The skin is a heterogeneous organ which serves as the
principal medium of communication between the animal and
its environment.

• The skin is a stratified tissue consisting of two major layers:

the outer epithelial layer called epidermis and the inner corium
or dermis.
• Other structures or parts associated with skin as its
appendages are hoofs, hairs, horns, quills, claws, nails,
sebaceous glands and sweat glands, all develop from the
epidermis. 27
 Elasticity of the skin
• Elasticity of skin is tested by lifting up and then releasing
a fold of skin in the region of neck, back or ribs

• In healthy animal, the fold of skin is easily grasped and

on release immediately flattens out again

• When elasticity is reduced, the skin is less easily picked

up and the fold tend to return slowly
Ex. If the animal is dehydrated, the skin will
slowly return to its original state

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 Elasticity of the skin

 When the elasticity is completely lacking it is

difficult to pick up even a small fold, this condition
called hidebound

 In general loss of elasticity arises when there is

reduction in semi fluid ground substance of dermis
and SC tissue as well as elastic fibers

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 Elasticity of the skin

 Loss of elasticity of skin may occur due to:-

 Disease accompanied by severe fluid loss ( diarrhea,
dysentery, hemorrhage) Ex. Enteric Colibacillosis,
Salmonellosis, Gastroenteritis

 Diseases of skin which are extensive and longstanding

Ex. Ectoparasitosis

 Systemic disorders associated with marked loss

condition ex. Malnutrition, TB, Jhone’s Disease
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 The skin, coat and associated structure
What are the functions of skin?
• Medium of communication b/n internal and external
environment
• Peripheral thermoregulation
• Water and electrolyte balance
• Mechanical protection( external barrier which protect
the internal organs against injury)
• Secretion of sweat and sebum
• Synthesis of vitamin D from sunlight (Skin contain 7 –
dehydrocholestrol which is a precursor of vitamin D)
• Sensory perceptivity
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 Clinical Examination of Skin

• Skin is important index of general state of health

• Skin is superficial organ exposed to various

environmental conditions (Physical & chemical injury)

Abnormalities of skin include:

 Changes in hair or wool

 The presence of discrete or diffuse lesions

 Evidence of discharges and itching

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 Classification of skin disease
Primary skin disease
• Disease initially affect the skin

• Lesions restrict to skin and its appendages or other

parts get affects later on

• Ectoparasite (mange mites, ticks, lice)

Secondary skin disease

• Extensions of disease from any other parts of the body

• Lumpy Skin Disease (LSD), POX

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 How To differentiate 1O and 2O skin diseases
 History of the animal

 Nature and character of change observed

 Associated clinical examination

 Take skin scrapies to examine any recognized

causative agent

 Take temperature, if there is febrile reaction it is

secondary skin disease

Why important to differentiate as 1O and 2O skin

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diseases?
According to the etiological agent the skin disease are
grouped as:-
• Bacterial (Dermatophylosis)

• Viral (LSD, Sheep or Goat pox)

• Fungal (Dermatophytosis ( Ring worm))

• Parasitic (Demodecosis)

• Allergic (FAD (Flea Allergy Dermatitis))

 Examination of the skin can be done by

inspection, palpation and by using available
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lab tests
 Consideration during examination of skin
• Some skin disease are contagious, so that careful

recognition is essential in order to prevent further

dissemination Ex. Ring worm

• Certain skin disease have public health

implication Ex. Sarcoptic mange and certain

ringworm

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Condition of the hair coat
• In well nourished animal it is smooth and shiny
whereas in deficiency it becomes dry, lusterless and
staring

• However consideration should be given to species,

breed, season and management

Example:-

In bush pasture will have rough coat

Animal under pasture for long period during

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winter develop rough and long hair coat
 Conditions associated with hair coat

1. Bristling coat ( Raised or Erected)

• Produced by contraction of Errector pilurm
muscles due to nervous reaction
• Occur in emotional states associated with the
release of Adrenaline( Excitement, Fear,
Anger)
• Can occur during shivering stage of fever
• Erection of hairs occurs locally in areas of
serous infiltration ex. Urticaria (skin allergic
reaction)
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Conditions associated…….cont’d
2. Hair loss ( Hypotrichosis)

• Hair loss is normal in seasonal shedding or

moulting

Loss of hair can be due to:-

• Demonstrable disease of skin itself ( Dermatitis

, mange , ringworm)

• Generalized disease (Iodine deficiency,

hyperkeratosis(thickening of skin) 39
Conditions associated…….cont’d
 Hair loss without any structural change called Alopecia

• Alopecia which can occur due to :-

Follicular dysfunction

Congenital (Hereditary)

Mineral imbalance (Selenium and Mercury

toxicity or due to Copper deficiency)

Hormonal imbalance Ex. Hypothyroidism

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Conditions associated…….cont’d
3. Excessive hair growth (Hypertrichosis)
• Usually inherited or congenital

• Abundant growth of hair occur where skin has

been subjected to some form of irritation
(inflammation or pressure)

Ex. Harness marks: white patches in area subjected

to prolonged pressure from harness

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4. Hyperemia / Redness of skin
• Can be diffuse or circumscribed
• It can occur in :-
 Dermatitis ( inflammation) ex. FAD
 Dilation of cutaneous capillary
 Swine Erysipellosis (E. adiopathy) which is
characterized by Diamond shaped hyperemic
lesions (pathognomonic)

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 5. Cutaneous hemorrhage

• Occurs in rupture of cutaneous blood vessel

or increased permeability of dermal vessels

• Blood vessels of skin may rupture due to :-

 Trauma ex. Bruising
 Sweet clover and warfarin poising
 In horse by Parafilaria bovicola

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 Jaundice (Ictrus)
• Yellowish discoloration of skin and m/m
• Excessive bilirubin accumulation
• Bilirubin can accumulate due to : -
• Liver damage,
• Bile duct obstruction or
• Excessive hemolysis

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 Pruritus (Itching)
• Pruritus is a typical itching sensation

• Characterized by:-

 Scratching

 Biting and

 Rubbing the affected skin against any hard

object

• An indication of pain
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 Sweat gland Activity
1. Appocrine sweat gland
• Develop from the hair follicles

• Susceptible to Adrenaline in blood stream

• Active during excitement state

• Not involved in central thermoregulation but

regulate superficial temperature

• Common in domestic animal

• They present on whole body surface except foot pad

and muzzle 46
 Sweat gland Activity
2. Eccrine sweat glands
• Innervated by sympathetic cholinergic nerve
fibers present in sympathetic nerves
• Involved in central thermoregulation
• Important in sensation of hot and cold
• Common in human and other primates
• Unlike true sweating in human with secretion of
abundant amount of liquid, sweating is not
easily appreciated in domestic animal but in
case of equine we can easily observes sweating
especially during equine colic
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 i. Hyperhidrosis (Increased sweat secretion)
• Can be generalized which occur due to :-
 Painful disease (Equine colic)
 Muscular spasm (Tetanus)
 Febrile disease
 Acute renal insufficiency
• Can be localized which occur as a result of :-
 Peripheral nerve damage (paralysis) (It is
associated with Eccrine sweat gland )
 Obstruction of sweat gland
• Hyperhidrosis may lead to hyponatremia

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 ii. Anhidrosis (Reduced sweat secretion)
• Characterized by absence of sweat under mane in
horses
• Can be generalized which occur due to :-
 Systemic disease with excessive fluid losses ex. Enteritis
with diarrhea
 Diabetes – polyurea
 Vomition
 Diarrhea
 Hemorrhage
 Hypovolemic shock
• Can be localized due to reduced blood supply to the
area Example. Ergotism ( peripheral arterial spasm)

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 Sebaceous gland activity
• Produces sebum (oily secretion) which gives skin
shinny and lustrous appearance
• Sebum secretion reduced due to:-
 Nutritional disorders
 Febrile disease
 Chronic wasting diseases
 Parasitic disease
• Sebum secretion may increase due to :-
 Dermatitis or
 Eczema

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 Odour of the skin
• Occur due to secretions of appocrine and
sebaceous glands

• Introduction of medicine in animal may change the

odour specific to that medicine Example penicillin

• In dermatitis, Canine distemper and demodectic

mange, there is strong unpleasant smell

• In ketosis and advanced diabetes mellitus, the odour

of acetone is observed

• Urinous odour observed during uremia 51