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STUDENT DIGITAL NEWSLETTER ALAGAPPA INSTITUTIONS |
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Maria Teresa Seville, M.D.
A more reliable and longer lasting (but unlicensed and expensive) combination of sedative drugs is as follows: · detomidine 50 to 100 mg/kg by i arrhythmia natural remedies discount furosemide 40mg online. Clinical examination Restraint for examination To be effective and stress-free arrhythmias purchase 100mg furosemide mastercard, the clinical examination must be carried out with minimum restraint of the patient hypertension essential furosemide 100mg for sale. Some degree of confinement and prevention of escape will be necessary in many cases blood pressure medication sore joints furosemide 100mg with mastercard. Large groups of pigs can be moved to smaller areas for detailed clinical examina262 Clinical Examination of the Pig Figure 16. The snare is placed around the upper jaw as far back as possible and is tied to a fixed object such as a post. The needle is inserted at a point halfway between the shoulder joint and the manubrium of the sternum. Azaperone at a dose of 2 mg/kg may be substituted for detomidine in the above combination. Ketamine may be included in the same syringe as butorphanol and detomidine or azaperone. Adult pigs Temperature, pulse and respiration Respiration Unless the pig is lying quietly or is ex- tremely dyspnoeic, counting the respiratory rate can be difficult. In the less severely ill pig the respiratory rate changes frequently whenever the pig is disturbed or finds something interesting to smell or investigate. Rapid breathing with cyanosis of the skin (white pigs) or mucous membranes (all pigs) indicates either severe cardiac disease. A temperature below 39°C is not a good sign, suggesting that the pig is unwell either through advanced disease, toxaemia or a metabolic disorder. Further examination and tests may be necessary to elucidate Expiratory line Figure 16. Note open mouth breathing, dogsitting position and the expiratory line caused by intense muscular contraction as the pig tries to force air out of its lungs. It is important to check that the thermometer is in contact with the rectal wall if a low temperature is recorded. Sudden movements of the pig backwards or sideways and other members of the group pushing between the clinician and the patient, can result in damage to the thermometer. Carcase lymph nodes these cannot normally be palpated in pigs unless they are grossly enlarged, because they are both deeply buried and surrounded by fat. Occasionally, in all ages of pig from 1 week to several years, multicentric lymphosarcoma is seen, with some or all of the lymph nodes being grossly enlarged, readily visible and palpable. Pulse Occasionally in a quiet, thin pig it is possible to palpate the femoral artery pulse, but in most cases reliance is placed upon measuring the heart rate by auscultating the heart. The tendency of the pig to move when the stethoscope is placed on the chest means that in many cases the pulse can only be counted for brief periods of 10 seconds or so, and the pulse rate per minute is calculated from this brief observation. Skin An overall assessment of the skin is made visually and then manually noting the following: Mucous membranes these can be inspected in a quiet pig by examining the ocular conjunctivae. Tickling the pig behind the eye with the finger and very quietly advancing the finger to depress the lower eyelid will allow brief but effective inspection and evaluation of the mucosa. In sows and gilts the vulval lining provides an alternative and easier access to the mucous membranes. Pallor of the mucosae is seen in anaemia, Skin colour this is important in white pigs. Dark purple blotches may be seen in cases of severe toxaemia and septicaemia resulting from toxic mastitis, for example. Such areas are mostly seen on the lower surface of the neck, behind the elbows, on the caudal surface of the thighs and on the perineum. Skin pallor is seen in cases of anaemia in a litter in which the iron injection has been missed. Dark purple blotches may be seen on the ear-tips, jowl, belly, behind the forelegs and on the caudal aspects of the thighs. Sow showing gross lesions and common sites of sarcoptic mange, louse infestation, ringworm and pityriasis. Generalised thickening of the skin may be seen in the rare conditions of zinc deficiency (parakeratosis) and vitamin B deficiency. Ectoparasites the large dorsoventrally flattened pig louse, Haematopinus suis, is occasionally seen and may cause pruritus. Pruritic pink lesions are seen in early cases; thickened pruritic lesions on the head, back, flanks and hindquarters are seen later. Mites are difficult to find in chronic cases where allergy-related skin changes are the dominant feature. Skin texture the skin of the dorsal part of the body is normally thick and immobile. On the ventral sur266 Skin turgor this can only be effectively assessed on the eyelids or on the ventral surface of the body. Skin lesions the raised, diamond-shaped lesions of acute and subacute swine erysipelas may be visible and palpable, especially on the dorsal surface of the neck and over the thoracic walls. Initially the lesions are pink, but they become red and then black as the lesions age. Occasionally in neglected cases much of the thick skin of the dorsal surface of the body sloughs off leaving exposed subcutaneous tissues. In black pigs the lesions are palpable but Clinical Examination of the Pig Figure 16. Subcutaneous abscesses are also common, being seen as raised, warm, fluctuant lesions of varying size: to confirm diagnosis a needle is inserted, releasing pus. Ringworm is common, especially in some outdoor herds; most cases are caused by Trichophyton mentagrophytes and large light brown irregular lesions are seen. Much more common than true ringworm is the condition of unknown aetiology, pityriasis rosea, seen in individual growing pigs. Slightly elevated and irregular lesions are seen, especially on the ventral surface of the body. Head this is examined methodically noting the following: Shape of the head In ill-thriven pigs, the nose may be very long and the head looks larger than the body. Ears these should be checked for bite wounds, haematomata and damage sustained through loss of ear tags. The outside of the pinna should be examined for signs of sarcoptic mange such as crusty pruritic lesions, which are often also on the poll; the proximal ear canal should be examined for evidence of the dark wax also present with this infestation. In very good light it may be possible to see pin-headsized mites moving in this wax. The eyes may quickly sustain corneal damage if the pig has struggled in lateral recumbency for some time. Protrusion of the eyes giving an exophthalmic appearance is seen in the uncommon condition of mediastinal lymphosarcoma. Ocular discharge may be seen in some respiratory infections with tear staining on the cheeks of affected animals. Heart Auscultation of the heart can be difficult other than in quiet or very ill animals. When these animals are exercised a marked increase in heart rate is noted and the heart rate is slow to return to normal. A cardiac apex beat may be palpable in young, thin animals or anaemic animals where cardiac enlargement has occurred. Fluid sounds are occasionally heard in cases of pericarditis and mulberry heart disease. Mouth the mouth is difficult to examine in an unsedated subject, but is rarely involved in abnormalities. In the unsedated animal the mouth can be examined by restraining the pig on a snare and prizing the mouth open with a smooth piece of wood. Nose and nostrils Asymmetry or deviation of the nose may be seen in cases of atrophic rhinitis. Lungs Auscultation of the lungs is unrewarding in many cases due to movement of the pig, noise from the patient, its fellows and the environment.
Stress to the patient the need for good nutrition arteria coronaria dextra 100 mg furosemide sale, oral hygiene and plenty of rest blood pressure medications list buy cheap furosemide 40mg online. Have patient swish with 1 cap full of chlorhexidine (Peridex) for 30 sec and expectorate hypertension 5 mg buy furosemide 40mg low cost, b blood pressure medication long term effects furosemide 40 mg on-line. Acetaminophen with codeine (Tylenol # 3), 1 - 2 tablets q 4-6 hours for severe pain. It results if the clot that forms after tooth extraction is lost too early (usually 2-3 days after surgery). The extraction site (socket) will have a grayish appearance and there is usually a bad odor. Treatment: Use sterile water or saline to gently irrigate the socket and remove necrotic debris. Apply a palliative medication: Nu-gauze slightly moistened with Eugenol placed in the socket for 24 hours this should relieve the intense ache within 30 - 40 minutes. Continue to change the dressing every 24 hours for 3 days, gently irrigating the extraction site with sterile saline before replacing dressing. Notify dental clinic of any persistent symptoms and arrange for patient to be seen as soon as possible. Treatment: Administer topical anesthetic, lidocaine viscous (oral preparation), 1 tablespoon four times a day (before meals and at bedtime) to provide short-term relief and to facilitate eating if patient has multiple ulcers. Apply a protective dental paste (Orabase) to individual ulcers 4 times a day (after meals and at bedtime) to prevent irritation by the teeth and oral fluids. Treatment: Immediate Action: Examine socket area and gums for any obvious bone fragment or deformity (remove any loose deformity). Place a small amount of wax on the avulsed tooth and adjacent teeth to help stabilize tooth. If Save A Tooth solution is not available, other storage solution options include the following (in order of preference): milk, saline, saliva, or sterile water. If unable to move tooth into original position, place gauze between posterior teeth as a jaw rest. Contact dentist to determine evacuation priority and modality Administer analgesic P. Initial caries appears as a white spot on the tooth or a halo-like dark shadow in the enamel. Caries that produce pain are usually in the advanced stages, appearing as very large dark areas or even as a wide-open hole in the tooth. If symptoms are not relieved with analgesics, notify dental clinic and arrange for patient to be seen as soon as possible. The fracture can involve just the enamel or can be so severe as to involve the pulp, where the nerves and blood vessels are located. Notify dental clinic and arrange for patient to make a routine scheduled appointment. As the abscess forms, pressure form the swelling and pus formation causes the tooth to be pushed up in its socket. If the built up pus has no where to drain, the jaw may swell and the patient will have much pain. Treatment: Immediate Action: If obvious superficial fluctuant swelling is present, induce drainage with #11 Bard Parker. Acetaminophen with Codeine (Tylenol# 3), 1 - 2 tablets q 4-6 hours for severe pain. Stress to the patient the need for good oral hygiene to improve the condition of the gum in spite of the pain or bleeding. Dispense an irrigation syringe to patient and show them how to irrigate area four times a day with saline solution. Treatment: Immediate Action: If possible, remove obvious plaque buildup by irrigation of the area using large amounts of saline and an irrigation syringe. Clinical Note: If symptoms do not improve in 24 hours, notify dental clinic and arrange for patient to make a routine scheduled appointment. Stainless steel plastic filling instrument for application of cements, dressings, etc. Topical anesthetic 20% Benzocaine gel 30gm bottles (2) - used for topical mucosal anesthetic 10. Glass ionomer restorative material such as Vitrebond standard package (1) used for covering fractured teeth. Multi-dose bottle (1) used as a topical antibacterial agent in the mouth or buccal mucosa. Save A Tooth solution (Hanks Balanced Salt Solution) kit (1) Prompt treatment of dental emergencies can prevent potential life threatening complications. Recognition of disease states, accurate diagnoses, and appropriate treatment will contribute to successful outcomes. Wellness is a disciplined overall pattern of good lifestyle choices leading to optimal health and quality of life; a way of life aimed at heightened vigor, fitness, and outlook. You can do a lot for yourself that will prevent illness from striking and prepare you to better deal with problems should they occur: Take charge of your health. Make changes in achievable steps that reinforce your successes and keep you motivated to continue. Each positive change you make, regardless of how small, improves your overall health. Tobacco contains dangerous substances; among others, tar, nicotine and carbon monoxide. Tar is a mixture of several chemicals that condense into a sticky 6-1 substance in the lungs. Nicotine is an addictive drug that is absorbed from the lungs and acts mainly on the nervous and circulatory systems. Carbon monoxide lessens the ability of red blood cells to carry oxygen throughout the body. Smoke particulates are complex chemical mixtures that settle in the mouth, throat and lungs and can cause chronic lung disease and cancer. Some brands of tobacco contain less tar and nicotine than others, but there is no such thing as a safe brand. Switching to mild cigarettes does little to help: heavy smokers adapt their smoking habits by taking longer puffs and inhaling more deeply. Children whose parents smoke have more diseases of the respiratory tract, including life-threatening asthma, than do children of nonsmokers. Most people who quit smoking will enjoy major health benefits the rest of their lives. Also, you will notice that your environment will be friendlier when you are not a smoker. A lot of the daily hassles and high costs that impair the quality of your life as a smoker go away when you stop this habit. Here are some tips for quitting: Tip 1: Decide firmly that you really want to stop. Make a log (small enough to carry with you) of every cigarette you usually smoke in a 24-hour period, along with the times when you automatically light up, such as: with every cup of coffee, after every meal, or as you begin work. This increasing concern with the act of smoking is a good way to prepare for the task of giving up the habit. This is often the most successful and in the long run the least painful way to break the smoking habit. It may help to choose a time when your usual routine is being changed for another reason. Tip 2: Feel free to choose devices you can use safely as a cigarette substitute during the early days. You can expect that the physical addiction to nicotine may produce withdrawal symptoms. After several days, the physical addiction can be expected to drop noticeably, while the psychological craving can sometimes last a long time.
Some wheat is fed to farm animals blood pressure ranges american heart association effective 100mg furosemide, particularly in years of surplus production in the large producing countries class 1 arrhythmia drugs furosemide 100 mg cheap. Low quality wheat rejected as human food also goes into livestock feed in most countries arteria umbilical furosemide 100mg on-line. Ochratoxin and citrinin are produced by the same fungal species blood pressure medication used to treat adhd generic 100 mg furosemide otc, Pйnicillium viridicatum, and frequently occur together in contaminated grain. The few analyses that have been reported give no indication of greater incidence of aflatoxin contamination in any geographic region. This might be expected in view of the low incidence and levels of aflatoxin that have been found in wheat. The very low incidence of the aflatoxin-producing fungus, Aspergillus flavus, in wheat as collected from the field in the United States reduces the probability of pre-harvest contamination. Low incidence has been found even in samples collected from fields that, because of heavy rains, remained unharvested for several weeks after the grain had ripened. In contrast, the relatively high inocula of Aspergillus flavus to which wheat and other grains are exposed after harvest in handling and storage facilities provide a favourable condition for fungal growth and toxin production if the grain has a moisture content above 18%. Until contrary evidence is presented, it may be assumed that the major precaution to be taken in preventing aflatoxin contamination in wheat is to ans ure that it be handled and stored at a safe moisture level. For long-term storage this is 13% or less, depending mainly on the temperature, but also on the amount of broken kernels, rubbish and other foreign material present, and the extent of fungal contamination. Department of A g r i c u l t u r e, samples representing all market grades and all classes of w h e a t from the different growing regions were collected from principle markets and analysed for a f l a t o x i n. In a survey of the 1964 c r o p, 531 samples of mainly hard red winter w h e a t w e r e collected from three m i d western m a r k e t s. Aflatoxin w a s detected in two samples b y thin-layer chromatographic analysis at levels of 9 J^g/kg total a f l a t o x i n s. Administration of extraots of these samples to ducklings gave an inconclusive, but probably negative test for a f l a t o x i n. Aflatoxin w a s not detected in any sample including those in Sample Grade which were collected in disproportionate numbers relative to their occurrence in the m a r k e t. The grain w a s from the 1968 crop that w a s harvested under unfavourable weather c o n d i t i o n s. A n estimated 7 0 % or more of the crop was stored at h i g h moisture levels, resulting in heating and s p o i l a g. Pour of the samples had been stored in covered stores but the other six had remained u n c o v e r e d. The aflatoxin level in all the covered samples w a s 5,WgAgbut ranged, in the uncovered samples, from 5 to 240yigfcg w i t h an average contamination level of 100>ig/kg. In Yugoslavia, 8 of 15 samples, or 60%, of wheat analysed w e r e found to contain aflatoxin at an average concentration of 6. In the Canadian investigation of mycotoxins in heated wheat described io section 14*4*3*3» analyses for zearalenone were made but all samples were negative. It is known, however, that Fusarium roseum, a fungus that produces zearalenone, is one of the Fusarium spp. Scab occurs in wheat when subjected to extended periods of cool, rainy weather prior to harvest. Serious epidemics of the disease occurred in wheat in the United States in 1919» 1928 and 1935* Scab is well known as a disease in wheat and other small grains in Japan where it is described as "Akakabibyo" or red mould disease. However, hyperestrogenism, the characteristic sign of zearalenone intoxication, has not been reported in Jap^i in animals fed scabby grains and it appears that other Fusarium toxins were present. I»» 06) 14*5*3 No association of zearalenone-contaminated wheat with mycotoxicosis in farm animals or humans has been established. Citrinin is frequently found to accompany ochratoxin since both are produced by Pйnicillium viridicatum, one of the Penicillia found in stored grains contaminated with ochratoxin. However, analyses for citrinin were oonducted only in Canadian studies of samples of grain that had heated in storage. Ochratoxin A was found in 14 of 19 samples of wheats ranging in concentration from 0. The wheat was stored damp as a result of unfavourable weather at harvest and mould growth and heating resulted. Levels of ochratoxin A found in some samples of heated wheat in a Canadian study appear to be high enough to cause adverse effects if fed as a major feed component to swine or chicken. Department of Agriculture survey of 848 samples of wheat oollected in the 1970-1973 crop years at principal markets, 11 samples were found to contain ochratoxin A at levels ranging from a trace to 35 Jig/kg» generally much lower than found in the heated grain in Canada. It is noteworthy that ochratoxin A was not detected in any of the 271 soft red winter wheat samples included in the survey although rainfall is generally higher in the region growing this class of wheat than in the regions growing the hard red winter and hard red spring wheats, the other two classes of wheat analysed. The survey was conducted in a village in Croatia where Balkan endemic nephropathy is prevalent. However, it is evident from the Canadian studies that high levels of ochratoxin A and citrinin can develop in wheat if it is stored above safe moisture levels even in a cool climate. Ochratoxin A has been found in wheat and bread in an affected area of Yugoslavia and possibly may Jbe involved in this disease. Notable exceptions, however, are Japan and the Koreas in Asia, Italy in Europe, and California in the United States, each of which produces more than 1 million tons annually. This area extends across southeastern Asia from India to Japan, and includes practically all of the adjacent tropical and subtropical islands. The other 10% of world production was reported in forty countries in Africa, 14 in North and Central America, 13 in South America, 10 in Europe and Australia. Only low quality grain rejected as food because of mould or other damage is used as feed for livestock. Per capita consumption in south and southeast Asia ranges from 170 to over 440 g daily, supplying up to 70? Other mycotoxins have been found in rice inoculated with spores of Pйnicillium species associated with yellow rice disease. Rice imported into Japan at the end of the second world war was affected with this disease and oaused illness and death in humans. Incidence of yellow rice disease since that time appears not to have been significant. Despite its culture in tropical and subtropical regions of high rainfall and humidity, the reported incidence of aflatoxin contamination in raw rice is relatively l o w. However, because of the high consumption in many areas, even a low level of contamination may have adverse affects on human health. There are, however, several stages where moisture conditions could provide opportunity for growth of the aflatoxin producing fungus, Aspergillus flavus, and toxin production. There is no evidence for this but scientists at the University of Agricultural Sciences, Bangalore, India have initiated a study to find whether A. Rice harvested with combines usually contains 18-25$ moisture and is dried gradually down to 12 or 13$ moisture in artificial d r i e r s. Drying must start within 24 hours after combining to avoid mould growth and heating of the grain. In most Asiatic countries, the rice is harvested b y cutting straw bearing the panicles; the straw may be left on the ground to dry or tied in bundles and suspended from p o l e s. After drying to a moisture level suitable for threshing, the grain is beaten out, cleaned, and dried for 3-4 days on straw mats until the moisture level in the grain is reduced to 13 or 14$. If the drying 1 operation is prolonged by rainy weather, opportunity for mould growth is presented. Among frequent causes are moisture migration and condensation arising from inadequate ventilation of the stored grain that frequently provide conditions for mould g r o w t h. Generation of high moisture levels b y insect activity is another condition that favours mould development. Unless mixing is thorough and equilibrium is reached quickly, the high moisture component provides high risk of moulding. Aflatoxins: incidence in rice in Central America Analyses of rice for aflatoxin have been conducted in two Central American (26, 27) 15. In an exploratory survey of food and feed grains conducted in the vicinity of Medullin b y the National University of Colombia, 8 3 $ of the rice samples collected contained over 20 yg/kg aflatoxin. Possible causes of contamination mentioned were prolonged drying periods after harvesting and deficiencies in storage conditions.
It lies on the left side of the body with its visceral surface in contact with the dorsolateral walls of the rumen and reticulum blood pressure normal level cheap 40 mg furosemide with mastercard. The upper extremity is level with the dorsal parts of the 12th and 13th ribs blood pressure medication used for withdrawal cheap furosemide 40 mg with visa, and the lower extremity is level with the costochondral junction of the 7th rib blood pressure medication yeast infections furosemide 100 mg with amex. It is normally not palpable pulse pressure deficit purchase furosemide 40 mg, but if grossly enlarged it may be palpated just caudal to left rib cage. The spleen can be palpated at laparotomy either directly or through the wall of the opened rumen. It is seldom involved in disease, although its lymphoid tissue may be involved as part of the bovine leucosis complex. Popliteal lymph nodes these nodes are found surrounded by dense muscle tissue immediately behind the stifle. Inguinal lymph nodes these are usually palpable as a small group of fairly mobile and firm structures adjacent to the inguinal canal. In the male they are found just anterior to the scrotum, and in the female just anterior and lateral to the udder. It defends the body it covers and is involved in the maintenance of homeostasis including water conservation. The skin is involved in body temperature conservation through insulation and in heat loss through perspiration. The skin provides protection against minor physical injuries, supports hair growth and offers some defence against microbial invasion. The condition of the skin is a reflection of the general health of the animal, deteriorating in cases of ill health, ill thrift and debility. In some conditions, such as jaundice, the skin may provide through discolouration direct diagnostic evidence of a specific disease process. In other conditions, such as parasitism or severe mineral deficiency, a nonspecific general deterioration of skin health may occur causing a greater number of hairs than normal to enter the telogen or resting phase and a delay in their replacement, leaving the coat in poor condition with little hair. Sebaceous secretions may be reduced, allowing the skin to become abnormally dry and inflexible and less able to perform its normal defence role in an already debilitated animal. In other cases sebaceous secretion increases causing the skin to have either a greasy or a dry seborrhoeic, flaky appearance. The mutual dependency of the skin and the body it covers must be borne in mind during every clinical examination. Abnormalities of the skin may be caused by specific skin disease or by the poor general health status of the patient. The epithelial cells of this layer are produced by the stratum germinativum and as further cells are produced reach the outer surface of the skin in about 3 weeks. The dermis is a connective tissue layer containing blood vessels, nerves, hair follicles, sebaceous and sweat glands. The subcutis contains fibrous and fatty tissues which provide insulation for the body and support for the outer skin layers. The skin has considerable elasticity in the normal animal, allowing body movements to occur. This elasticity may be reduced by ill health, especially in dehydrated animals, and also as a result of inflammation and injury to the skin. Hair follicles cover much of the bovine body but are not present at the mucocutaneous junctions or the surfaces of the muzzle and teats. History of the case the general history of the case will have been considered at an earlier stage in the process of diagnosis. There are specific points of history, however, that may have direct bearing on the consideration of skin disease. The history of the herd and a knowledge of the geographical area may provide useful information for the clinician. Previous skin disease problems on the farm with details of Clinical Examination of the Skin Large subcutaneous abscess Hair loss through rubbing in feed passage Skin damage sustained in parlour or cubicle house Figure 4. The history of the patient, including recent contacts with other cattle at shows or markets, may also be important. Failure to ensure an adequate supply of minerals and vitamins can contribute to poor skin health. Details of previous treatment given and the response to such treatment may also provide useful information. The environment of modern cattle, especially the dairy cow, contains many features that may damage the skin. The cubicles, the parlour and the floor may have abrasive surfaces or sharp corners that can cause injury to the skin, often repeatedly. Such problems in the environment are especially likely to be important if a number of cattle in the herd are seen with identical superficial injuries. Overcrowding and insufficient feeding facilities may also contribute to poor coat condition including superficial skin damage. Abnormalities such as a very poor coat, evidence of excessive self-grooming or large areas of alopecia may be seen from a distance, but the areas of the skin must be closely examined too. Opportunities to examine the skin arise as each part of the body is examined, but in order to get a general impression of the skin it can be assessed separately before the more detailed examination of each area begins. Visual appraisal of the skin the whole body surface is methodically inspected initially from a distance and then more closely, looking for areas of abnormal skin or hair which will later be subjected to closer scrutiny. Healthy animals have lick marks on their skin, especially over the flank and shoulders. The presence of any obvious abnormalities, including swellings or discharging abscesses, should be noted for further investigation later. Gangrenous changes in the skin and deeper tissue may have arisen through loss of circulation and may be seen or noted during manual appraisal of the skin. Pathological thickening of the skin occurs in a number of skin conditions, including sarcoptic mange. Thickening in the form of callus formation can occur in areas of skin, including those covering joints, which are repeatedly subjected to trauma. Lesions caused by photosensitisation are commonly seen in lightly pigmented areas on the dorsal parts of the body which are exposed to sunlight. Ringworm lesions in calves are particularly common on the head and neck, but also occur elsewhere. Manual appraisal of the skin this should involve as much of the body surface as possible, using caution when touching sensitive areas which might cause the animal to kick. Manual appraisal will enable the clinician to detect lesions which are not immediately visible, for example beneath matted hair. Any abnormalities detected are subjected to further scrutiny which may necessitate removal of hair and examination of the skin in good light with the aid of a hand lens. The thickness of the skin and the presence of any subcutaneous oedema or infection should also be noted. The average skin thickness in adult cattle is 6 mm, with decreasing thickness being evident from the dorsal to the ventral body surfaces. This area of skin may have a spongy texture when compressed and may give an impression of subcutaneous oedema although it does not pit on pressure. Genuine oedema which does pit on pressure may be seen in this area and between the mandibles in cases of right sided cardiac failure. Manual examination of the skin will also allow assessment of skin turgor its resilience and flexibility. In a well hydrated animal the pinched skin falls immediately back into place; in a dehydrated animal the return to normal is delayed. Description of the skin lesions the clinician should try to determine exactly what abnormalities are present in the skin, which tissues are involved and how deeply the disease process extends into and over the skin. Skin temperature, thickness, consistency and colour are observed and compared with adjacent areas. The presence of subcutaneous oedema or increased skin turgor is noted: these abnormalities may be caused by hypoproteinaemia or heart failure and dehydration, respectively, but they can also be the result of local pathology. When numbers of skin lesions are found it is important to determine if they share the same aetiology. There may be abnormalities in the sebaceous and sweat glands or gross proliferation of the superficial layers. Skin abnormalities may involve some or all of the component structures of the skin: the hair, follicles, epidermal, dermal and subcutaneous tissues.
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