Biomedical Engineering Reference
In-Depth Information
identified with dental problems should be scheduled for
appropriate treatment.
Working downwards, the chest should be thoroughly
ausculted for any signs of heart or lung disease. Heart
murmurs secondary to valvular disease are recognized in
older animals and should be monitored for signs of
progression. Pulmonary disease due to opportunistic
infection in the immunosuppressed, TB disease, or other
primary lung disease may be recognized. If abnormalities
are detected, thoracic radiography, echocardiography, or an
electrocardiogram should be performed. The axillary
lymph nodes are easily palpable in most larger species.
The abdomen should be thoroughly palpated. The
kidneys, spleen, caudal edges of the liver, and intestines,
are easily palpable, especially in sedated animals and
should be palpated for any abnormalities. A rectal palpation
may be performed in some species. In many species the
cervix and uterus are best palpated using the bimanual
method with one finger in the rectum and one hand on the
abdomen (
Mahoney, 1975
). In smaller species such as
Saimiri and the Callitrichids, one is limited to abdominal
palpation and the nonpregnant uterus may be difficult, if
not impossible, to detect. Palpation of the uterus is useful in
detecting abnormalities, determining pregnancy, and esti-
mating gestational age. The inguinal
“unless for the immediate medical needs of the animal
.
or scientific research approved by an Institutional Animal
Care and use Committee” (
USDA, 2007
). If teeth do need
to be removed or blunted for medical reasons, endodontic
procedures should be performed by a qualified person.
If there is obvious dental disease, excess tartar buildup,
gingivitis, or other indication, animals should be scheduled
for a dental cleaning. Depending on the size of individual
facilities, dental prophylaxis can also be considered as part
of routine preventive healthcare with annual or semiannual
dental cleanings. A decision to implement a regular dental
prophylaxis program should consider the risks of contact
with potentially hazardous zoonotic agents.
Dental prophylaxis should be performed by an indi-
vidual trained in dental procedures and aware of the
potential risks, generally a trained veterinary technician.
Dental prophylaxis should always be performed under
anesthesia. Basic dental cleaning procedures can be per-
formed using a hand scaler and other instruments, but can
be more efficiently performed using ultrasonic dental
scalers and electric polishers. Teeth should be scaled to
remove plaque and tartar and special attention should be
paid to regions below the gum line. If hand scalers are used,
care should be taken to avoid wounds to the hands from the
sharp instruments.
While cleaning the teeth, signs of dental disease should
be observed. Loose teeth or those with serious caries should
be considered for extraction. More advanced procedures
such as root canals may be performed, but generally require
consultation with a specialist.
The use of adequate personal protective equipment for
personnel performing or observing dental procedures is
necessary to prevent exposure to zoonotic agents, espe-
cially Macacine herpesvirus 1. Not only is there a risk of
injury from the instruments themselves, but some agents
can be aerosolized and inhaled by personnel. Minimum
personal protective equipment includes goggles, a face
mask, double gloves, scrubs, and tyvek arm sleeves.
However, institutions should strongly consider requiring
the use of N95 or similar respirators, powered air purifying
respirators, or similar devices to prevent aerosol exposure.
Kevlar gloves can be considered to prevent injuries to the
hands.
lymph nodes can
easily be palpated in most species.
The extremities should be examined. Legs and arms
should be evaluated for muscle mass, coat quality,
symmetry, and joint health. All joints should have full
range of motion. Any joint effusion or bony abnormalities
should be recorded in the medical record and considered as
possible signs of arthritis or other abnormality that may
require treatment. The hands and feet are frequent sites of
injury and should be examined for cuts, abscesses, or other
problems.
Dental Prophylaxis
Good dental health is an important aspect of an overall
preventive medicine program. Dental disease can cause
a variety of secondary problems including periodontal
abscesses and cardiac valve disease. Animals with serious
dental disease may be reluctant
to eat and may have
significant pain and discomfort.
Screening for dental disease should be performed at the
time of physical examination. Diseased teeth may cause
facial abscesses which are easily recognizable on physical
examination. Most often the maxillary canines, whose roots
are long and curved, are involved and lesions may occur as
high as the orbit and even involve the eye itself. While
blunting or pulling large canine teeth has previously been
employed as a method to protect both animals and staff, this
procedure is no longer in common use and is no longer
considered appropriate veterinary care by the USDA
Baseline Diagnostic Testing
Clinical laboratory tests are important adjuncts to the
physical examination and a main aspect of diagnostic
testing. For routine examinations of aged or sick animals,
and for preproject examinations, baseline diagnostic
screening is usually indicated. Possible tests include
complete blood count, chemistry profiles, serology, and
parasite examinations. Additional diagnostics may be
pursued based on the results of these preliminary tests.
