Jugular vein, cephalic, lateral saphenous or medial saphenous. From the marginal vein of the ear.

1. Jugular vein – preferred site in most animals. Expose the area (between chest entrance and angle

jaw), hold one hand under the chin (or grip the cheekbones with an uncalm cat), tip of the nose

must point to the ceiling, the other operator applies compression to block the blood flow so that the

vein and make the collection easier (regardless of the vein chosen, compression is done in the direction that

brings blood to the heart, for the jugular compress below, for the saphenous compress above). The same operator who

compresses, performs the sampling. If there is a suspicion of head trauma it is better to avoid the jugular. Alternative technique

animal in lateral recumbency with head extended, the vein is exposed.

2. Cephalic vein – passes over the arm, convenient position for taking blood, butterfly needles can be used, containment

classic one that moves the face away and keeps the arm outstretched. The operator who does the containment will do the

compression. It is usually an area that is very annoying and can cause pain but if I have to put a venous catheter

or peripheral is the one that is used. Suitable ONLY for large animals.

3. Lateral saphenous vein – it is seen very well in dogs but a little less in cats, dog in lateral recumbency but also from in

feet, the compression is done at the knee level since the vein passes behind the calf. The compression always

done by the person doing the retainer, it is clearly visible but it is an extremely mobile vein, you place yourself laterally to the vein

and pulls back slightly. It is mainly used for PCC-PT and blood glucose.

4. Medial saphenous vein – mainly used with cats, pressure is applied at the groin to perform the

compression.

5. Marginal vein of the ear: it is not a real blood sample, it is used to obtain a drop of blood, generally used

for blood sugar testing.

PART 2) OBSERVATION AND EVALUATION OF THE PATIENT – clinical examination

The clinical examination basically consists of 3 parts: signalment (the patient’s identity card), anamnesis, state

present.

Signalment: species; breed; sex (physiological state, therefore whether they are entire or neutered/sterilized); age; height at the withers,

Coat and identification are mainly valid for horses and cattle.

Anamnesis: “chat” with the owner, data collection to know the patient’s clinical history. All the information for

building a good diagnostic path is of fundamental importance! While the medicine of dogs, cats or horses is individual,

those of breeding are of group so make a different anamnesis. Collect immediately the “concern” of the

owner, general information about the animal, interaction with other humans or animals, environment, diseases

previous, allergies etc. EOG

Current status: perform EOG (physical examination proper, “general objective examination”). It consists of •TPR

in: TPR = temperature, pulse and respiration; skeletal development and constitution; nutritional status and •Skeletal development

•Nutritional status

muscle tone; sensory state; particular attitudes and signs; skin and connective tissue •Sensory state

subcutaneous; apparent mucous membranes (capillary filling); explorable lymph nodes. •Particular attitudes/signs

 •Skin and subcutaneous tissue

TEMPERATURE is normally taken from the rectum and recognises physiological variations (post •Apparent mucous membranes

physical activity, after performing various rectal explorations, circadian physiological fluctuation, •Explorable lymph nodes

environmental temperature and humidity, young age or pregnancy) or pathological

(HYPERTHERMIA: not feverish but linked to other reasons such as high environmental temperature which leads to heat stroke,

drug-related malignant hyperthermia, intoxication, dehydration, damage to the hypothalamic thermoregulatory center,

convulsions etc. HYPOTHERMIA: always due to environmental changes, hair clipping, reduced food intake

caloric/inanition, general anesthesia because it causes vasodilation, laparotomy which causes heat dispersion,

anemia, dehydration etc. be especially careful with very young or old animals. FEVER: increased frequency

cardiac and respiratory, sensory depression, anorexia, decreased milk production for cattle,

chronic weight loss, muscle tremors, etc.; True fever must recognize a mechanism by

endogenous/exogenous pyrogens or cytokines, which interact with the hypothalamic thermoregulatory center and alter the

body temperature; could be caused by infectious agents; autoimmune forms; neoplastic and processes

localized or systemic inflammatory).

 PULSE = arterial pulse (does not always reflect the heart rate but provides information on the cardiovascular system), it is

it takes place at the peripheral level (if the heart beats 80 times and the pulse is 60 it is probably an extrasystole), it is taken

the arterial one because it is linked to pressure (it is better felt in the arteries) also to feel the pulse

we have to compress the artery but with the vein it is complicated because it gets crushed and does not allow the passage of the flow,

if I feel the venous pulse it is a problem. Count the pulse for 15 seconds and multiply by 4, or count

directly per minute (recommended for unknown animals or those with cardiovascular problems). The pulses are

palpate from the femoral (dog and cat); facial (horse and bovine); ventral coccygeal (bovine – it is located on the face

ventral part of the tail, just below the vulvar rim, is used almost exclusively to assess heart rate) and other but

these three are the main ones. http://www.arcangelogentile.it/Semiologia/Polso.aspx. Palpation is almost always

bimanually, at least at the beginning, the inner thigh is palpated and it is a very large artery (it is a detachment of the arteries

iliac arteries, in turn detachment of the aorta). Characteristics of the pulse: not only frequency but also rhythm, amplitude,

speed, hardness/tension and synchrony (symmetry between the two wrists).

o FREQUENCY: is the number of beats (blood pressure waves) per minute.

Dog Cat Horse Foal Cattle Calf

Small = 80-180bpm 120-240bpm 25-50bpm < 1 week = 60-120bpm 60-72bpm 80-120bpm

Large = 60-140bpm 1 week – 6 months = 40-60bpm

Puppies = 110-120bpm

Tachi > 180bpm T > 260bpm T > 50bpm T > 80bpm

Brady < 60bpm B < 120bpm B < 20bpm B < 60bpm

Tachysphygmia increased heart rate, bradysphygmia decreased heart rate.

▪ Causes of tachysphygmia: fever; inflammation of the heart (myocarditis, endocarditis, pericarditis); anemia; pain; vices

uncompensated valvular heart disease; electrolyte imbalances (hypokalemia); shock (the body is unable to cope with a

rapid hemodynamic change, usually affecting the vessels, such as a deep cut that causes a lot of blood loss

all together); drugs; pericardial effusions (accumulation of fluid in the pericardium, the heart is unable to

expand, so it has to make more movements).

▪ Causes of bradysphygmia: vagal stimulation; chronic hydrocephalus; tumors and depressive states of encephalitis; disorders of

conduction; hyperkalemia.

or RHYTHM: is the interval between two pulsations (beat cadence). Evaluation of the regular succession of pulsations

arterial, if the interval is normal we speak of sinus rhythm, if it is variable we speak of arrhythmic pulse. In particular if it is

repetitive and regular over time is called rhythmic arrhythmia. Classic example in the dog in which it is physiological, called

sinus or respiratory arrhythmia, occurs during respiratory acts in which the heart rate drops with

exhalation and rises with inhalation; if it is totally irregular it is an arrhythmic arrhythmia. In the horse there is an arrhythmia

physiological condition known as second degree atrioventricular block.

o AMPLITUDE: Represents the difference between systolic and diastolic blood pressure. Depending on the height of the vessel,

the wider it is, the more oscillation in height there is. It gives us information on blood pressure but also on cardiac output, blood volume and

elasticity of the vessel. Increase (broad pulse) is caused by fever, bradycardia, anemia, congenital heart disease with shunt

left-right blood, extrasystole etc. The decrease (small or weak pulse) could be due to tachycardia, hypovolemia,

pericardial effusion, aortic and mitral stenosis, anemia, etc.

o CELERITY: the speed with which the arterial wall rises and falls, usually if the pulse is small and frequent it is

also fast. It would be the middle way between frequency and amplitude. The causes are in fact similar.

o HARDNESS/TENSION: indication of the pressure, it is the force that we must apply to completely close the

vessel, it is necessary that our pressure is sufficient to overcome the pressure of the vessel itself. Soft wrist for

arterial hypotension, cardiac failure, vasomotor paralysis and hypovolemia all leading to shock. Pulse

hard for systemic hypertension and pain (pain tends to “harden” the vessels).

o SYMMETRY: contemporaneity of the sphygmic wave in symmetrical pulses and latency of the pulse with respect to cardiac systole.

 BREATHING = in standard conditions it is assessed by standing to the side of the animal (to the right in cattle otherwise we see the rumen,

on the left in the horse otherwise we see the cecum, dog and cat it does not matter). You can see the thoracic expansion. The characters are

type, frequency, amplitude, speed and rhythm.

TYPE: evaluation of the participation of the thoraco-abdominal walls, physiologically in animals it is thoraco (or

~ cost) abdominal with 90% prevalence of the thoracic component, which could increase or decrease in

presence of some conditions. The abdominal component could increase for example due to pathologies affecting

of the pleural cavity (pleural effusion, pneumothorax, diaphragmatic hernias). Then I evaluate whether the

chest or abdomen.

What to look for immediately in an animal in emergency: ABC, or A = Airways (whether the airways are clear or not); B =

breathing (if he breathes); C = circulation (the pulse).

FREQUENCY: number of respiratory acts that the animal performs in a unit of time, usually one minute. See

~ slide: ABC is a respiratory act. Generally among animals of the same species they are similar regardless of size,

around 20-30. Tachypnea (increase in respiratory rate) has multiple causes, primarily stress, age,

digestion but these are physiological, the pathological causes are to be found in anemia, insufficiency

cardiovascular, lesions in the main or deep airways, gas t