Veterinary Medical Clinic II

1. Recognize cardio-respiratory and digestive diseases. Students will have to complete a thorough physical examination and obtain detailed data from clinical history.
2. To know the etiopathogenic aspects of the disease taking into consideration the problems identified based on physical examination and recognizing the symptoms the animal is suffering.
3. List the differential diagnoses following a protocol and be able to select the most suitable diagnostic test to make a diagnosis as well as to determine the aetiology of the process.
4. To know the different therapeutic modalities.
5. To know the prophylactic measures that must be established, not only individually but also collectively.
6. Be able to give a prognosis, bearing in mind the profitability, functionality and quality of life of the animal.
7. Develop the clinical activity in a scientific and ethical way.
8. To know and to apply knowledge from related subjects.
9. To know and to use the bibliographic resources.

LECTURES (36 hours)

SECTION I: MEDICAL DISEASES OF THE DIGESTIVE SYSTEM (Small animals) (10 hours)
•Diseases of the oropharyngeal. Approach to the patient with dysphagia and disorders of swallowing.
•Diseases of the esophagus. Approach to the patient with regurgitation. Megaesophagus. Esophagitis. Esophageal strictures and foreign bodies.
•Diseases of the stomach. Approach to the patient with vomiting. Acute and chronic gastritis. Gastric ulceration. Gastric dilatation-volvulus. Gastric motility disorders.
•Diseases of the intestine. Acute and chronic diarrhea. Approach to the patient with diarrhea/ constipation. Diseases of the small intestine. Diseases of the large intestine.
•Diseases of the liver and hepatobiliary system. Approach to the patient with liver disease. Canine liver diseases. Feline liver diseases.
•Diseases of the pancreas. Pancreatitis. Exocrine pancreatic insufficiency.

SECTION II: MEDICAL DISEASES OF THE DIGESTIVE SYSTEM (Large animals) (10 hours)
•Diseases of the reticuloruminal motor function. Frothy and free gas bloat. Traumatic reticuloperitonitis. Vagal indigestion.
•Diseases of the reticulorruminal fermentative function. Simple indigestion. Acute and chronic ruminal acidosis. Ruminal alkalosis.
•Diseases of the abomasum. Abomasal displacement and volvulus. Abomasal ulcers. Abomasal impactium. Cecal dilatation and volvulus.
•Digestive diseases of calves. Ruminal drinking. Abomasitis. Neonatal diarrhea.
•Clinic approach to colic syndrome in horses.


SECTION III: MEDICAL DISEASES OF THE RESPIRATORY SYSTEM (8 hours)
•Diseases of the upper respiratory tract (nasal cavity and larynx). Clinical approach to the patient with nasal discharge and clinical approach to stridor/ stertor.
•Diseases of the lower respiratory tract (trachea and bronchus). Clinical approach to the patient with cough.
•Diseases of the lung parenchyma. Clinical approach to the patient with respiratory distress.
•Diseases of the pleural cavity. Clinical approach to the patient with pleural effusion.



SECTION IV: INTERNAL MEDICINE OF THE CARDIOVASCULAR SYSTEM (8 hours)
•Clinical approach to the heart failure.
•Endocardial diseases. Degenerative valve diseases. Infective endocarditis.
•Myocardial diseases. Dilated Cardiomyopathy. Hypertrophic Cardiomyopathy. Restrictive Cardiomyopathy. Myocarditis.
•Pericardial diseases. Pericardial effusion. Pericarditis in ruminants.
•Congenital heart diseases. Valve malformations. Lesions causing vascular shunting.
•Clinical approach to the cardiac arrhythmias. bradyarrhythmias, taquiarritmias supraventricular tachyarrhythmias and ventricular arrhythmias.


SEMINARS (5 hours)

PRACTICAL CLINICAL WORK (28 hours):

Aims:
•Obtain detailed data from a complete history and complete a thorough physical examination.
•Introduce detailed clinical history in the software.
•List the problems identified based on the history and physical examination (select and localize the problem, physiopathology mechanism and disease). Select the problems most likely to provide a diagnosis.
•Identify the problems that require a rapid therapeutic management and the diagnosis would be delayed.
•Choose the initial diagnostic test based on prioriziting, ruling in or out the most likely diseases, Choose test initially that are least invasive, and to some extent easiest and/or cheapest to perform.
•Sampling.
•Interpreting the results of the test.
•Formulate a therapeutic plan based on the diagnoses identified.
•Establish a proper assessment of costs and benefits in the case of livestock.
•Update the problem list, diagnoses and treatment with SOAP method (subjective, objective, assessment, and plan).
•Management of the hospitalized patient.
•Clinical sessions: review and discussion of clinical cases seen during clinical practices with the active participation of students following the principles of evidence-based medicine and clinical reasoning.
• Differential diagnosis and treatment session: to develop and present a diagnostic process and a therapeutic approach on an assigned clinical case.

BASIC BIBLIOGRAPHY
• Bonagura JD, Twedt DC. (2014). Kirk's Current Veterinary Therapy XV. Philadelphia, Saunders Elsevier. VMD-398
• Bruyete D, (2020). Clinical small animal internal medicine. New Jersey, Willey-Blackwell. https://onlinelibrary-wiley-com.ezbusc.usc.gal/doi/book/10.1002/9781119…
• Cockcroft, Peter D. (2015). Bovine Medicine. 3 ed. Willey. VZ2-350. https://onlinelibrary-wiley-com.ezbusc.usc.gal/doi/book/10.1002/9781118….
• Constable PD, Hinchcliff KW, Done HD, Gruenberg W. (2017). Veterinary Medicine. A textbook of the diseases of cattle, horses, sheep, pigs and goats - two-volume set. 11th Edition. Elsevier. Access by BUGalicia - Uni Santiago Compostela (https://www.sciencedirect.com/book/9780702052460/veterinary-medicine )
• Divers, T.J.; Peek, S.F. (2018). Rebhun’s Diseases of Dairy Cattle. 3rd Edition. Elsevier..Access by BUGalicia - Uni Santiago Compostela (https://www.sciencedirect.com/book/9780323390552/rebhuns-diseases-of-da…) (https://onlinelibrary.wiley.com/doi/book/10.1002/9781118948538) (Access by BUGalicia - Uni Santiago Compostela).
• Ettinger, S.J., Feldman, E.C., Cote, E. (2017). Textbook of veterinary internal medicine Expert Consult. 8th ed. Elsevier. VZ5-783
• Ettinger, S.J., Feldman, E.C., Cote, E. (2021). Tratado de Medicina Interna Veterinaria. 2 vol. 8 ed. Axon España. (castellano)
• Fidalgo, L.E., Rejas, J., Ruiz de Gopegui, R., Ramos, J.J. (2003). Patología Médica Veterinaria. Universidades de León, Santiago de Compostela y Zaragoza, España. VMD 276, 279 y 343
• Maddison JE, Volk HA, Church DB. (2022). Clinical Reasoning in Veterinary Practice: Problem Solved. 2nd edition. Ed Wiley-Blackwell. VMD-278
• Nelson R.W., Couto C.G. (2010). Medicina interna de pequeños animales. Ed. Elsevier. Mosby. Barcelona. (castellano) https://web-s-ebscohost-com.ezbusc.usc.gal/ehost/detail/detail?vid=0&si…
• Nelson R.W., Couto C.G. (2019). Small Animal Internal Medicine. 6th ed. Ed Mosby- Elsevier.
• Nelson RW, Couto CG. (2020). Medicina interna de pequeños animales. 6ª ed. Elsevier. Mosby. VZ5-764, 765.
• Pastor, J. (2019). Razonamiento clínico y diagnósticos diferenciales. Ed SERVET
• Radostits, O.M., Gay, C.C., Blood, D.C., Hinchcliff, K.W. (2002). Medicina Veterinaria. Tratado de las enfermedades del ganado bovino, ovino, porcino, caprino y equino. Mc Graw-Hill Interamericana, 9ª ed., Madrid. (castellano)
• Rand Jacquie (2006). Problem-based Feline Medicine. Elsevier. VZ5-362
• Smith BP, Van Metre D, Pusterla N (2019). Large animal internal medicine. 6th ed. Mosby, Elsevier.
• Smith, B.P. (2010). Medicina interna grandes animales. Elsevier. Madrid (castellano)
• Tilley LP, Smith FWK (2010). Blackwell's Five-Minute Veterinary Consult: Canine and Feline PDA. 4th ed. Wiley-Blackwell. VZ5 685

BIBLIOGRAFÍA COMPLEMENTARIA
• King, L. (2006) Enfermedades respiratorias del perro y el gato. Multimédica. (castellano)
• Johnson, L.R. (2011). Medicina respiratoria clínica en el perro y el gato. (castellano).
• Smith F.W.K. (2017). Manual de Cardiología Canina y Felina. 5ª edición. Multimedia Ediciones Veterinarias, Barcelona. (castellano).
• Tams, T.R. (2005) Manual de gastroenterología en animales pequeños. 2ª ed. Intermédica.
• Chandler, M (2011). Saunders solutions in veterinary practice: small animal gastroenterology. Saunders USA.

RECURSOS DE INTE

General Competencies
•GVUSC05. Capability to put knowledge into practice.
•GVUSC09. Capability to communicate in different areas.
•GVUSC10. Ethical commitment and undertaking of responsibilities.

Disciplinary specific competencies (knowledge)
•CEDVUSC 08. Knowledge and diagnosis of the various animal diseases, both individual and collective, and its prevention measures with special emphasis on zoonoses and notifiable diseases.
•CEDVUSC 09. General basis of medical and surgical treatments.
•CEDVUSC 16. To know the basic analytical techniques and its interpretation.

Specific Professional Competencies (expertise, day-one skills)
•D1VUSC 01. Obtain an accurate and relevant medical history and perform a complete clinical examination of the animal.
•D1VUSC 02. Collect and send specimens with the corresponding reports.
•D1VUSC 03. Perform standard laboratory tests, and interpret clinical, biological and chemical results.
•D1VUSC 04. Diagnose common diseases using complementary protocols and diagnostic techniques.
•D1VUSC 07. Perform basic medical and surgical treatments in animals.
•D1VUSC 08. Prescribe, manage and administer properly veterinary medicines.
•D1VUSC 17. Perform technical reports specific to veterinary competencies.

Specific Academic Competencies (want to do)
•CEAVUSC 01. Analyze, synthesize and solve problems and make decisions within the scope of the Veterinary profession.
•CEAVUSC 02. Be aware of the ethical responsibilities of the veterinary profession in relation to the society.
•CEAVUSC 03. Disclose information obtained during the Veterinary professional practice in a easy oral and written way, with other colleagues, authorities and society in general.
•CEAVUSC 05. Know and apply the scientific method in professional practice, including evidence-based medicine.

Transversal competences
•CTVUSC 07. Ability to solve problems through the Integration and application of knowledge.

The Clinical Veterinary Medicine II in-classroom workload will be develop in 36 hours of lectures, 1 hour of tutoring in small groups, 5 hours of seminars and 28 hours of clinical work.

The LECTURES are considered an important part of student in-classroom workload, and comprise 36 hours. These hours will be distributed through the whole semester according to the centre’s official timetable.

The SEMINARS hold 5 hours distributed through the whole semester embedded in the time slot of the lectures according to the centre’s official timetable. In these SEMINARS, applicative concepts associated with the subject taught will be developed interactively.

Lectures with ICT support and the systematic use of the Virtual Campus as support teaching. Presential lectures will require the application of hygiene measures determined by the authorities (hydrogel, mandatory mask, minimum safety distance). Exceptionally, classroom teaching may be combined with virtual teaching up to 10% of the total hours of the subject.

28 hours of PRATICAL CLINICAL WORK in 5 sessions to be taught at the HVU Rof Codina (small and large animal internal medicine services) and Gayoso Castro Experimental Farm that will be distributed throughout the semester as follows:

CMV II C1: Session of differential diagnosis and treatment from 9 to 11 h (2 hours)
CMV II C2: Small Animal Clinical Practice 3 days from 10:00 to 14:20 h (16 hours)
CMV II C3: Clinical session 1 day from 9 to 11 (2 hours)
CMV II C4: Large Animal Clinical Practice 1 day from 10 to 14 h (4 hours)*
CMV II C5: Large Animal Clinical Practice 1 day from 10 to 14 h (4 hours)*
* large animal clinical practice may last slightly longer hours due to the displacement to the farms


One hour of TUTORIAL will be given -CMV II T1-. Tutorial will take place at the first day, in this session the subject organization will be explained (rules, clinical classes, test, etc.).

Moreover, through the course several activities will be posed based in the resolution of different clinical situations and searching of information (self-directed learning). Virtual USC will be an important support to carry out and the management of all the additional work the student performs.

By means of virtual USC students may get supporting material for attend the lectures and seminars, clinical work, as well as the complementary material which includes recommended readings, case studies, web links….

In this subject, the class attendance waiver does not apply.

The assessment of the subject will be performed on the basis of a system of final exam (80%) and continuous evaluation (20%).

FINAL EXAM (80% of the final score): consists of a test of theoretical contents (test test) and a test of clinical reasoning (exam of short questions to be developed). To pass the subject the student will have to pass both tests independently of each other.

• THEORETICAL CONTENTS test (60% of the final exam score). This test will consist of test questions. Test questions are single answers. Well-answered questions will add up to 1 point, poorly answered questions will subtract 0.50 points and unanswered questions will not count. The exam is divided into thematic blocks that must be passed independently. To pass the exam of theoretical contents it is necessary that a minimum score of 50% of the total score is reached, and that in each of the thematic blocks at least 50% of the questions have been answered correctly.
• CLINICAL REASONING test (40% of the final exam score). This test will consist of 10 short development questions related to the topics of the subject. Each question will have a maximum value of 1 point. To pass the clinical reasoning test it is necessary to reach a minimum assessment of 5/10.


CONTINUOUS EVALUATION (20% of the final score): throughout the regulated teaching activity, controls of the progress and effort of the student in the subject will be carried out through the Virtual Campus. These controls include the tests of the theoretical contents, the tests of the clinical sessions and the session of differential diagnosis and treatment. The sessions of differential diagnosis and treatment weigh 40% of the continuous evaluation and the remaining 60% are provided by the tests of the theoretical contents and the clinical sessions.
The score of the continuous evaluation of the students will have a validity of one academic year (the following academic year) provided that the grade is higher than a 7.5/10. After this period, the student must do it again. All those students who have a score of the continuous evaluation of the previous course higher than 7.5 can retake it to improve their grade. For the purposes of final qualification, the one with the best overall score will be considered.

CLINICAL PRACTICE ASSISTANCE.
Attendance at clinical practices is mandatory. Once completed, they will be considered valid until the student passes the subject.

GLOBAL RATING
To pass the subject it will be necessary to pass the Final Exam (both, theoretical Contents test and the Clinical Reasoning test). The score obtained in the Final Exam will represent 80% of the student's total score, the remaining 20% is obtained from the score of the continuous evaluation.

In this subject, the class attendance waiver does not apply.
In case of plagiarism, fraud or improper use of technologies for the realization of the telematic tests, the provisions of the “Normativa de avaliación do rendemento académico dos estudantes e de revisión de cualificacións” will apply.

The workload of the student (70 hours):
•Lectures: 36 hours
•Practical work: 28 hours
•Seminars: 5 hours
•Tutorials: 1 hour

Self-directed learning and individual study of the student (80 hours):
• Individual study: 53,5 hours
• Resolution of cases/problems and tasks, bibliographic review and reports: 22,5 hours
• Examinations: 4 hours

• Regular attendance at all timetable classes, practical work and seminars.
• Continuous work and simultaneous follow up of self-study with regular lectures and practical work.
• Check assignment deadlines and exam dates, and begin assignments early.
• Regular use of the personalized tutorials or through the communication tools of the virtual USC.
• Use of the materials provided by teachers as a study guide: outlines lessons and notes distributed in the virtual USC.
• Use of the self-elaborated material and notes taken by students during the lessons and practical work.
• Use of recommended learning resources as for example textbooks, image atlas, Web sites.