Veterinary Internal Medicine and Therapy

A.Y. 2019/2020
12
Max ECTS
120
Overall hours
SSD
VET/08
Language
Italian
Learning objectives
Learning objectives (nuovo testo da inserire in W4):The aim of the course is to provide the student with the notions concerning internal medicine and the therapy of domestic animals dog and cat, horse, ruminants and pig, in order to acquire a correct systematic approach to the veterinary visit which includes the correct approach to: medical history, symptom and clinical examination, formulation of differential diagnoses, choice of collateral tests and formulation of diagnosis, prognosis and therapy
Expected learning outcomes
The student must:
-be able to transfer the knowledge acquired during lessons and exercises with a clear and appropriate terminology
-be able to put into practice the method of clinical procedure acquired during the theoretical and practical lessons in the studied domestic animal species.
-know the main manual skills that are performed during the clinical visit.
-to acquire a correct approach to the problem-oriented history and anamnesis, and the knowledge of the main, organ, apparatus, infectious and metabolic diseases of the animal species treated in order to formulate a correct differential diagnosis list based on the presented symptoms.
- to know how to choose the tests that allow the achievement of the diagnosis.
- knowing how to correctly formulate the diagnosis, the prognosis and prescribe the therapy also by filling in a clinical report
Course syllabus and organization

Unique edition

Responsible
Lesson period
First semester
Prerequisites for admission
The student must have acquired knowledge relating to medical semeiotics and veterinary medical pathology without which it is impossible to correctly approach the clinical visit.
Organization of the Course
The course includes 4 modules:
1) Small animals internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
2) Equine internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
3)Large animal internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
4) Veterinary therapeutics (3 CFU, lectures only)
Assessement methods and criteria
The examination takes place in 4 trials, 1 for each module. Each trial, consists of a written test and/or a practical examination in order to evaluate the student's knowledge and understanding.
1) Small animal module:
written exam consisting in 13 multiple choice questions (5 answers) - with the possibility of choosing only one correct answer - and an open question. The student must must pass the open question and at least five of the multiple choice questions.A maximum of 30/30 is given to the full correct exam.
2) Equine module:
written exam consists of 5 multiple choice questions (4 answers) - with the possibility of choosing only one correct answer. In order to access to the practical test the student must pass at least 3 out of 5 multiple choice questions.
Practical test: the student must autonomously evaluate a diseased patient and/or results of different ancillary diagnostic tests (ultrasonography, endoscopy, clinical pathology, etc) and achieve a correct diagnosis, prognosis and treatment.
3) Ruminants and swine module: 6 open questions. A maximum of 5 points is scored for each answerand the final scoring consists in the sum of the scores for each answer.
4) Therapeutics: 1 open question. A maximum of 30/30 is given to the correct answers.
The final scoring expressed in thirtieths corresponds to the matematical average of the scoring achieved in the four different tests described above.
Exams are in number of 8 in the academic year (in agreement with the decision of the Didactic Council) and take place in the months of January, February, March or April, June, July, September, October and November or December. The whole examination (including all 4 trials) must be concluded within 5 subsequent examination calls.
There are no additional calls for out-of-course.
To take the exam, it is essential to register through the online SIFA service of the university and must have passed the compulsory preparatory examinations as indicated by the Didactic Council. Besides the student must have attended at lest 75% of the hours included in the CFUs of the different modules.
Clinica medica veterinaria dei piccoli animali
Course syllabus
Problem-oriented approach. History and clinical visit
Approach to the patient, symptom, differential diagnosis, diagnostic protocol, laboratory diagnostics, therapy and prevention of dog and cat pathologies
Polyuria polydipsia syndrome in dogs and cats
Hyperadrenocorticism in dogs and cats
Chronic renal failure in dogs and cats
Diabetes mellitus in dogs and cats
Hypothyroidism in dogs
Hyperthyroidism in cats
Feline infectious peritonitis
FIV and FeLV infection in cats
Upper respiratory tract diseases in dogs and cats (URTD),
Canine distemper and vaccination program
Canine leishmaniasis
Canine ehrlichiosis
Babesia infection in dogs
Mycoplasms infection in cats
Cholangiohepatitis in cats
Lipidosis in cats
Transfusion medicine in dogs and cats: blood groups and transfusion compatibility, use of whole blood and blood components
Clinical diagnostic approach to otitis
Clinical approach to itching in dogs and cats
Approach to pyoderma in dogs
Teaching methods
Small animals internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
The course consists in lectures and practical training on clinical cases referred to the Small Animal Unit of the Veterinary Teaching Hospital. The students will be involved in the diagnostic process, including evaluation of history, clinical signs, physical examination, differential diagnosis and selection of ancillary diagnostic procedures (laboratory evaluation, ultrasonography, radiology, etc.). After the correct diagnosis is achieved, the students will be involved in the prognosis evaluation and institution of the correct therapeutic protocol.
Bibliography
Ettinger- Feldman Veterinary Internal
Muller Kirk Small Animal Dermatology
Dermatologia del cane A. Spaterna Point vet Italie
Manuale di Medicina Trasfusionale del cane e del gatto Point Vet Italie

Materiale didattico in Ariel
Clinica medica veterinaria del cavallo
Course syllabus
n the equine patient, particular attention will be devoted to the following abnormalities:
Poor performance syndrome: diagnostic protocol at rest and during high speed treadmill exercise
Upper airways: obstructive disorders (both static and dynamic) of the pharynx and larynx, guttural pouch disorders, disorders of nasal cavities and paranasal sinuses
Lower airways: pneuomonia and pleuropneumonia, EIPH, Equine asthma (RAO, IAD)
Circulatory system: arrythmias and valvular incompetences, anemia, thrombocytopenia, myeloid and lymphoid leukemia
Digestive system: esophageal disorders, equine gastric ulcer syndrome, malabsorption syndromes, enterocolitis
Skin: urticaria, insect hypersensitivity, equine sarcoid and other nodular skin disorders
Nervous system: encephalytis and encephalomyelitis, equine motor neuron disease, peripheral neuropathies, etc.
Locomotor system: myopathies (RER, EPSM, ecc.), tenitis, desmitis, arthrosynovitis, etc.
Urinary system: urethritis, cystitis, lythiasis, nephropathies
Endocrine disorders: PPID, metabolic syndrome, laminitis, tyroid disorders, hyperlipemia
Teaching methods
2) Equine internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
The course consists in lectures and practical training on clinical cases referred to the Equine Clinic of the Veterinary Teaching Hospital. The students will be involved in the diagnostic process, including evaluation of history, clinical signs, physical examination, differential diagnosis and selection of ancillary diagnostic procedures (laboratory evaluation, ultrasonography, endoscopy, electrodiagnosis, high speed treadmill evaluation, radiology, magnetic resonance, tomography, etc.). After the correct diagnosis is achieved, the students will be involved in the prognosis evaluation and institution of the correct therapeutic protocol
Bibliography
Testo consigliato
Equine Internal Medicine, 4 ed. S.M. Reed, W.M. Bayly, D. C. Sellon. Saunders Philadelphia 2016

Sito Ariel: http://fferruccicmc.ariel.ctu.unimi.it/v3/home/Default.aspx

Altri testi di consultazione
Equine Respiratory Medicine and Surgery. B.C. McGorum, P.M. Dixon, N.E. Robinson, J. Scumacher. 4 Ed Saunders, Philadelphia, 2018
Current therapy in equine medicine, N.E. Robinson, Elsevier health sciences, varie edizioni (7 edizione, 2015)
Cardiology of the horse. C.M. Marr & M. Bowen. 2nd ed.Saunders, Philadelphia, 2010
Equine Sports Medicine and Surgery. K.W. Hinchcliff, A.J. Kaneps, R.J. Geor. Saunders, 2 Ed, Philadelphia, 2014
Large Animal Neurology. J. Mayhew. Wiley & Blackwell, 2008.
Equine infectious diseases. D.C. Sellon, M.T. Long, Elsevier health sciences, 2007, 2nd ed.
Equine dermatology. D.W. Scott, W.H. Miller. Saunders, Philadelphia, 2nd ed, 2010
Equine diagnostic ultrasound. Ed. Virginia B. Reef. W.B. Saunders Company, 1998
Equine endoscopy (second edition). Eds Traub-Dargatz and Brown. Mosby 1997.

Riviste e periodici
Equine Veterinary Education
Equine Veterinary Journal
Journal of equine veterinary sciences
Veterinary Clinics of North America, Equine
Equine exercise physiology, EVJ supplements
Clinica medica veterinaria degli animali da reddito
Course syllabus
1. Theoretical class (lecture-hall, Lodi):

Introduction (1 hour): History and clinical examination, symptoms collection, differential diagnostics, selection of collateral exams, prognosis, therapy prescription in food animals and related implications for public health, drug legislation and regulation, prophylaxis.

Examples of differential diagnostics (1 hour): Consideration about edema, icterus and emphysema in cattle.

Clinical approach to metabolic disorders in cattle (2 hours): ketosis, insulin-resistant diabetes, electrolytes disorders. Blood gas analysis interpretation. Respiratory and metabolic acidosis and alkalosis and related treatment. Anion gap relevance.

Clinical approach to digestive disorders (6 hours): Clinical approach to Neonatal Calf Diarrhea. Differential diagnosis of left and right flank ping/pung sounds. Left and right abomasal displacement, cecal displacement and torsion. Ileus in young and adult cattle. Traumatic reticulo-peritonitis: etiopathogenesis, epidemiology, clinical aspect, laboratory tests, image diagnostic and treatment. Clinical approach to functional stenosis. Ruminal bloat in young and adult cattle. Oro-esophagel tubing, ruminocentesis, ruminotomy. Pneumonia-associated ruminal bloat, use of a Buff Trocar. Ruminal acidosis and alkalosis. Clinica approach to Sub-Acute Ruminal Acidosis (SARA).

Extra-genital ultrasonography in calves and adult cattle (1 hour): Ultrasonographic diagnosis of digestive disorders, liver and urinary diseases.

Clinical approach to skin diseases (1 hour): clinical aspect and diagnosis of the most frequent cutaneous disorders of cattle.

Clinical approach to respiratory diseases of cattle (1 hour): Bovine Respiratory Disease, clinical aspect, Wisconsin scoring system, differential diagnosis, serological tests, etiological diagnosis by means of nasal swabs or trans-tracheal airway wash, treatment and prophylaxis.

Clinical approach to nervous system disorders (1hour): Collection and interpretation of symptoms, differential diagnosis, treatment.

Clinical approach to locomotory disorders (1 hour): Downer cow syndrome: definition, etiopathogenesis, diagnosis, treatment. Artrogriphosis in calves: clinical aspects and treatment.

Clinical approach to umbilical disorders of calves (1 hour): omphalitis, omphalophlebitis, omphaloarteritis, infection of the urachus, intra- and extra- abdominal umbilical abscess, umbilical hernia: differential diagnosis, ultrasonographic aspect and treatment.


2. Practical training:

Lodi, lecture hall: Clinical cases discussion with all student groups, also with the patient in the hall, in order to better understand how to conduct a physical examination. Discussion on differential diagnosis and ancillary tests, treatment regimens and preventive strategies (1 hour for 8 different clinical cases, tot. 8 hours).

Clinic for Ruminants and Swine: clinical examination of patients, differential diagnostics and treatment of patients admitted to the Clinic (8 hours/student: 4 hours a day for 2 days for 12 groups of students).
Teaching methods
3) Ruminants and swine internal medicine (3 CFU, divided into lectures - 2 CFU - and practical clinical training - 1 CFU)
Lectures, clinical examination of sick animals admitted to the hospital, discussion of clinical cases, treatment of sick animals
The course (3 CFU) includes:

Theoretical class (2 CFU - 16 hours): to teach the correct clinical reasoning process to gain diagnosis, prognosis, therapies or preventive measures of a clinical problem in a patient.

Practical training (1 CFU - 16 hours):
8 hour/student of practice exercise at the Clinic for Ruminants and Swine for 12 groups of students (tot. 96 hours).
8 hours of interactive discussion with all the groups of students concerning clinical cases.
Bibliography
Dirksen G, Gründer HD, Stöber M (2004). Medicina interna e chirurgia del bovino. Le point Vétérinaire Italie, Milano

ALTRO MATERIALE DIDATTICO
-Ariel: http://dpravettonicmvar.ariel.ctu.unimi.it/

PERIODICI
Veterinary Clinics of North America, Food Animal Practice
Large Animal Review
Veterinary journal
Preventive veterinary medicine
Terapia medica veterinaria
Course syllabus
The course includes:
Veterinary pharmacy
Antiinflammatory agents
Antibacterial agents
Therapy of the respiratory system
Therapy of the cardiovascular system
Therapy of the neurological system
Therapy of the dermatological system
Therapy of the gastrointestinal system
Teaching methods
4) Veterinary therapeutics (3 CFU, lectures only)
Bibliography
Ariel website + medical texts of the different animal species such as those recommended by the teachers of the other modules of the course
Clinica medica veterinaria degli animali da reddito
VET/08 - VETERINARY CLINICAL MEDICINE - University credits: 3
Practicals: 16 hours
Lessons: 16 hours
Professor: Pravettoni Davide
Shifts:
Professor: Pravettoni Davide
Turno 1 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 10 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 11 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 12 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 13 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 2 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 3 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 4 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 5 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 6 per tutti gli studenti
Professor: Pravettoni Davide
Turno 7 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 8 per un gruppo di studenti
Professor: Pravettoni Davide
Turno 9 per un gruppo di studenti
Professor: Pravettoni Davide
Clinica medica veterinaria dei piccoli animali
VET/08 - VETERINARY CLINICAL MEDICINE - University credits: 3
Practicals: 16 hours
Lessons: 16 hours
Shifts:
Professor: Proverbio Daniela
Turno 1 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 10 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 11 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 12 per un gruppo di studenti
Professor: Perego Roberta
Turno 13 per un gruppo di studenti
Professor: Spada Eva
Turno 14 per un gruppo di studenti
Professor: Spada Eva
Turno 15 per un gruppo di studenti
Professor: Spada Eva
Turno 16 per un gruppo di studenti
Professor: Spada Eva
Turno 17 per un gruppo di studenti
Professor: Spada Eva
Turno 18 per un gruppo di studenti
Professor: Spada Eva
Turno 2 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 3 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 4 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 5 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 6 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 7 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 8 per un gruppo di studenti
Professor: Proverbio Daniela
Turno 9 per un gruppo di studenti
Professor: Proverbio Daniela
Turno per tutti gli studenti
Professor: Proverbio Daniela
Clinica medica veterinaria del cavallo
VET/08 - VETERINARY CLINICAL MEDICINE - University credits: 3
Practicals: 16 hours
Lessons: 16 hours
Professor: Ferrucci Francesco
Shifts:
Professor: Ferrucci Francesco
Turno 1 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 10 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 11 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 12 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 13 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 2 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 3 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 4 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 5 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 6 per tutti gli studenti
Professor: Ferrucci Francesco
Turno 7 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 8 per un gruppo di studenti
Professor: Ferrucci Francesco
Turno 9 per un gruppo di studenti
Professor: Ferrucci Francesco
Terapia medica veterinaria
VET/08 - VETERINARY CLINICAL MEDICINE - University credits: 3
Lessons: 24 hours
Professor: Zucca Enrica