MANUAL OF CLINICAL BEHAVIORAL MEDICINE FOR DOGS AND CATS - Dog and Cat Behavior. Covering proven techniques of behavior modification, Manual of Clinical Behavioral Medicine for Dogs and Cats provides a practical approach to the treatment and prevention of common canine and feline behavior problems. More than simple obedience training, this book describes both normal and undesirable behaviors and offers solutions for common small animal difficulties including digging, barking, biting, anxiety, and marking. It also discusses the role of pharmacology in behavior modification. Written by well- known veterinary behavior specialist Dr. Karen Overall, this reliable reference includes a DVD video that shows humane behavioral care and explains how dogs communicate with and learn from humans.
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Expanded Description: Covering proven techniques of behavior modification, Manual of Clinical Behavioral Medicine for Dogs and Cats provides a practical approach to.
Key Features⢠World- renowned author Dr. Karen Overall is a leading veterinary behavior specialist and a founding member of the board of clinical specialists, a Diplomate of the American College of Veterinary Behavior, certified by the Animal Behavior Society as an Applied Animal Behaviorist, and one of The Bark magazineâs 1. Companion DVD includes a 3. Supplemental material includes 4. Hundreds of images illustrate important techniques and key concepts.
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Tables and boxes summarize key assessment information, behavioral cues, and pharmacologic management. Content. Part One: Understanding Behavior: Modern Paradigms. Embracing Behavior as a Core Discipline: Creating the Behavior- Centered Practice.
The Science and Theory Underlying Behavioral Medicine: Terminology, Diagnosis, Mechanism and the Importance of Understanding Reactivity. Changing Behavior: Roles for Learning, Negotiated Settlements, and Individualized Treatment Plans. Part Two: Canine Behavior. Normal Canine Behavior and Ontogeny: Neurological and Social Development, Signaling and Normal Canine Behaviors. Problematic Canine Behaviors: Roles for Undesirable, Odd and Management- related Concerns. Abnormal Canine Behaviors and Behavioral Pathologies Involving Aggression. Abnormal Canine Behaviors and Behavioral Pathologies Not Primarily Involving Pathological Aggression.
Part Three: Feline Behavior. Normal Feline Behavior and Ontogeny: Neurological and Social Development, Signaling and Normal Feline Behaviors. Undesirable, Problematic, and Abnormal Feline Behavior and Behavioral Pathologies.
Part Four: Behavioral Supplements and Medications. Pharmacological Approaches to Changing Behavior and Neurochemistry: Roles for Diet, Supplements, Nutraceuticals and Medication. Part Five: Supplemental Materials. Protocols and Questionnaires.
DVD contents. Humane Behavioral Care for Dogs: Problem Prevention and Treatment. Questionnaires and protocols.
A Practical Guide to Clinical Medicine. Web Site Design by Jan Thompson, Program Representative, UCSD School of Medicine. Content and Photographs by Charlie Goldberg, M.
D., UCSD School of Medicine and VA Medical Center, San Diego, California 9. Send Comments to: Charlie Goldberg, M. D. Vital Signs. Vital signs include the measurement of: temperature, respiratory rate, pulse, blood pressure and, where appropriate, blood oxygen saturation. These numbers provide critical information (hence the name "vital") about a patient's state of health. In particular, they.
Can identify the existence of an acute medical problem. Are a means of rapidly quantifying the magnitude of an illness and how well the body is.
The more deranged the vitals, the sicker the. Are a marker of chronic disease states (e. Most patients will have had their vital signs measured by an RN or health care assistant before you have a chance to see them. However, these values are of such great importance that you should get in the habit of repeating them yourself, particularly if you are going to use these values as the basis for management decisions. This not only allows you to practice obtaining vital signs but provides an opportunity to verify their accuracy.
As noted below, there is significant potential for measurement error, so repeat determinations can provide critical information. Getting Started: The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a. Johnny") and leave the room (or draw a separating curtain) while they change.
Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways.
While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out- of- the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient.
Temperature: This is generally obtained using an oral thermometer that. As most exam rooms do not have thermometers, it is not necessary to repeat this. Depending on the bias of a particular institution, temperature. Celcius or Farenheit, with a fever defined as greater. C or 1. 01- 1. 01. F. Rectal temperatures, which most closely reflect.
F higher than those obtained. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 3.
Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 1. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio- pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.
You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.
Vascular Anatomy. Technique for Measuring the Radial Pulse. The pictures below demonstrate the location of the radial artery (surface anatomy on the left. Frequently, you can see transmitted pulsations on careful visual inspection of this region, which may. Upper extremity peripheral vascular disease is relatively uncommon, so the radial. Push lightly at first, adding pressure if there is a lot of subcutaneous fat or you are unable to detect a pulse.
If you push too hard, you might occlude the vessel and mistake your own pulse for that of the patient. During palpation, note the following: Quantity: Measure the rate of the pulse (recorded in beats per minute). Count for 3. 0 seconds. If the rate is particularly slow or fast, it is probably best to measure for a full 6. Normal is between 6. Regularity: Is the time between beats constant?
In the normal setting, the heart rate should. Irregular rhythms, however, are quite common. If the pattern is entirely chaotic with no discernable pattern, it is referred to as irregularly irregular and likely represents atrial fibrillation.
Extra beats can also be added into the normal pattern, in which case the rhythm is described as regularly irregular. This may occur, for example, when impulses originating from the ventricle are interposed at regular junctures on the normal rhythm. If the pulse is irregular, it's a good idea to verify the rate by listening over the heart (see cardiac exam section). This is because certain rhythm disturbances do not allow adequate ventricular filling with each beat. The resultant systole may generate a rather small stroke volume whose impulse is not palpable in the periphery.
Volume: Does the pulse volume (i. This reflects changes in stroke volume. In the setting of hypovolemia. There. may even be beat to beat variation in the volume, occurring occasionally with. Rhythm Simulator. Blood Pressure: Blood pressure (BP) is measured using mercury based manometers, with readings reported in millimeters of mercury (mm Hg). The size of the BP cuff will affect the accuracy of these readings.
The inflatable bladder, which can be felt through the vinyl covering of the cuff, should reach roughly 8. If it is too small, the readings will be artificially elevated. The opposite occurs if the cuff is too large. Clinics should have at least 2 cuff sizes available, normal and large. Try to use the one that is most appropriate, recognizing that there will rarely be a perfect fit. Blood Pressure Cuffs. In order to measure the BP, proceed as follows.
Wrap the cuff around the patient's upper arm so that the line marked "artery". The placement. does not have to be exact nor do you actually need to identify this artery. Antecubital Fossa.
The pictures below demonstrate the antecubital fossa anatomy (surface anatomy on the left, gross anatomy on the right). Put on your stethescope so that the ear pieces are angled away from your. Twist the head piece so that the bell is engaged. This can be verified. With your left hand, place the bell over the area of the brachial artery.
While most practitioners use the diaphragm of the stethescope, the bell is actually be superior for picking up the low pitched sounds used for measuring BP. It's worth mentioning that a. Read the. instruction manual accompanying your stethoscope in order to determine how. Grasp the patient's right elbow with your right hand and raise their arm so that the brachial. The arm should remain somewhat bent and. You can provide additional support by gently trapping their hand and forearm. If the arm is held too high, the reading will be artifactually.
Turn the valve on the pumping bulb clockwise (may be counter clockwise in some cuffs) until. This is the position which allows air to enter and remain in the bladder. Hold the bell in place with your left hand. Use your right hand to pump. Hg on the manometer. This is a bit above the top end of.
SBP). Then listen. If you immediately hear sound, you have. SBP. Pump up an additional 2. Hg and repeat. Now slowly deflate the. Hg per second) by turning the valve in a counter- clockwise. The first sound. that you hear reflects the flow of blood through the no longer completely occluded brachial artery.
The value on the manometer at this moment is the SBP. Note that although the needle may. SBP. Continue listening while you slowly deflate the cuff. The diastolic blood. DBP) is measured when the sound completely disappears.
This is the. point when the pressure within the vessel is greater then that supplied by. These are known as the Sounds of Korotkoff. Technique for Measuring Blood Pressure. Repeat the measurement on the patient's other arm, reversing the position of your hands. The two readings should be within 1. Hg of each other. Differences greater than this imply that there is differential blood flow to each arm, which most frequently occurs in the setting of subclavian artery atherosclerosis.
Occasionally you will be unsure as to the point where systole or diastole occurred and wish to repeat the measurement. Ideally, you should allow the cuff to completely deflate, permit any venous congestion in the arm to resolve (which otherwise may lead to inaccurate measurements), and then repeat a minute or so later. Furthermore, while no one has ever lost a limb secondary to BP cuff induced ischemia, repeated measurement can be uncomfortable for the patient, another good reason for giving the arm a break. Avoid moving your hands or the head of the stethescope while you are taking readings as this. Sounds of Koratkoff. You can verify the SBP by palpation. To do this, position the patient's right arm as described above.
Place the index and middle fingers of your right hand over the radial artery. Inflate the cuff until you can no longer feel the pulse, or simply to a value 1. SBP as determined by auscultation. Slowly deflate the cuff until you can again detect a radial pulse and note the reading on the manometer. This is the SBP and should be the same as the value determined with the use of your stethescope. Ohio State University, Blood Pressure Simulator. Normal is between 1.
Hypertension is thus defined as either SBP greater then 1. DBP greater than 9.