Veterinary Internal Medicine and Therapy

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.

In 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

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.


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).

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