medicina interna de grandes animales.pdf

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MEDICINA INTERNA

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mientras que estudiar libros sin pacientes es como no navegar en absoluto.

SIR WILLIAM OSLER

prelims.indd ii

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BRADFORD P. SMITH

DVM, DACVIM, Professor Emeritus

School of Veterinary Medicine

University of California

Davis, California

MEDICINA INTERNA

DE GRANDES ANIMALES

C U A R T A

E D I C I

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Copyright

_©

MMIX by Mosby, Inc., an affi liate of Elsevier Inc. Revisi ó n cient í fi ca

Dra. Consuelo Serres Dalmau

Departamento de Medicina y Cirug í a Animal Facultad de Veterinaria

Universidad Complutense de Madrid

©

2010 Elsevier Espa ñ a, S.L.

Travessera de Gr à cia, 17-21 – 08021 Barcelona, Espa ñ a Fotocopiar es un delito (Art. 270 C.P.)

Para que existan libros es necesario el trabajo de un importante colectivo (autores, traductores, dibujantes, correctores, impresores, edi-tores … ). El principal benefi ciario de ese esfuerzo es el lector que aprovecha su contenido.

Quien fotocopia un libro, en las circunstancias previstas por la ley, delinque y contribuye a la « no » existencia de nuevas ediciones. Adem á s, a corto plazo, encarece el precio de las ya existentes.

Este libro est á legalmente protegido por los derechos de propiedad intelectual. Cualquier uso fuera de los l í mites establecidos por la legislaci ó n vigente, sin el consentimiento del editor, es ilegal. Esto se aplica en particular a la reproducci ó n, fotocopia, traducci ó n, graba-ci ó n o cualquier otro sistema de recuperagraba-ci ó n y almacenaje de informagraba-ci ó n.

ISBN edici ó n original: 978-0-323-04297-0 ISBN edici ó n espa ñ ola: 978-84-8086-492-3 Dep ó sito Legal: B. 17.503 - 2010

Traducci ó n y producci ó n editorial: Impreso en Espa ñ a por Grafos, S.A.

Advertencia

La veterinaria es un á rea en constante evoluci ó n. Aunque deben seguirse unas precauciones de seguridad est á ndar, a medida que aumenten nuestros conocimientos gracias a la investigaci ó n b á sica y cl í nica habr á que introducir cambios en los tratamientos y en los f á rmacos. En consecuencia, se recomienda a los lectores que analicen los ú ltimos datos aportados por los fabricantes sobre cada f á rmaco para comprobar las dosis recomendadas, la v í a y duraci ó n de la administraci ó n y las contraindicaciones. Es responsabilidad ineludible del m é dico determinar las dosis y el tratamiento m á s indicados para cada paciente, en funci ó n de su experiencia y del conocimiento de cada caso concreto. Ni los editores ni los directores asumen responsabilidad alguna por los da ñ os que pudieran generarse a personas o propiedades como consecuencia del contenido de esta obra.

El editor

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Editores

Monica Aleman, MVZ, PhD, DACVIM

Danika Bannasch, DVM, PhD

George M. Barrington, DVM, PhD, DACVIM ,

Andrea Bohn, BA, DVM, PhD, DACVP, (Anatom í a patol ó gica)

Gordon W. Brumbaugh, DVM, PhD, DACVIM, DACVCP ,

T. Douglas Byars, DVM, DACVIM, DACVECC

Gary P. Carlson, DVM, PhD, DACVIM, DACVP

Stan W. Casteel, DVM, PhD, DABVT

Bruce W. Christensen, DVM, MS, DACT

Victor S. Cortese, DVM, PhD, DABVP (Vacas lecheras)

Robin M. Dabareiner, DVM, MS, PhD, DACVS ,

Sherrill A. Fleming, DVM, DABVP (Alimentos animales),

DACVIM

Francis D. Galey, DVM, PhD, DABVT

Lisle W. George, DVM, PhD, DACVIM

Kathleen Casey Gonda, DVM, MS, DACVIM

Arlyn Jud Heinrichs, BS, MS, PhD

John K. House, BVMS, PhD, DACVIM

Angela M. Hughes, DVM

Pam Hullinger, DVM, MPVM

Jill R. Johnson, DVM, MS, DACVIM, DABVP

Janet K. Johnston, DVM, DACVIM

Coleen Jones, MS

Samuel L. Jones, DVM, PHD, DACVIM

Christian M. Leutenegger, DrMetVet, PhD, FVH

Jeanne Lofstedt, BVSC, MS, DACVIM

John Maas, DVM, MS, DACVN, DACVIM

K. Gary Magdesian, DVM, DACVIM, DACVECC, DACVCP

David J. Maggs, BVSC (Hons), DACVO

Dianne McFarlane, DVM, PhD, DACVIM, DABVP

Sheila M. McGuirk, MS, PhD, DVM, DACVIM

James N. Moore, DVM, PhD, DACVS

Dawn E. Morin, DVMN, MS, DACVIM

Paul S. Morley, DVM, PhD, DACVIM

Debra Deem Morris, DVM, MS, DACVIM

Erwin G. Pearson, DVM, MS, DACVIM

Nicola Pusterla, Dr.Med.Vet., Dr.Med.Vet.Habil., DACVIM

Virginia B. Reef, DVM, DACVIM

Joan Rowe, DVM, MPVM, PhD

Bradford P. Smith, DVM, DACVIM

Mary O. Smith, BMVS, PhD, DACVIM (Neurolog í a)

Meri Stratton-Phelps, DVM, PhD, DACVIM

Raymond W. Sweeney, VMD, DACVIM

Ronald L. Terra, DVM, MS, MBA

Mats H.T. Troedsson, DVM, PhD, DACT, DECAR

James R. Turk, DVM, PhD, DACVP

Stephanie J. Valberg, DVM, PhD, DACVIM

David C. Van Metre, DVM, DACVIMZ

Scott Weese, DVM, DVSC, DACVIM

Stephen D. White, DVM, DACVD

Susan L. White, DVM, MS, DACVIM

Pamela A. Wilkins, DVM, PhD, DACVIM, DACVECC

W. David Wilson, BVMS, MS, MRCVS

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vii

Colaboradores

Dorothy Ainsworth , DVM, PhD, DACVIM

Professor of Medicine

Department of Clinical Sciences College of Veterinary Medicine Cornell University

Ithaca, New York

Monica Aleman , MVZ, PhD, DACVIM

Senior Veterinarian

Veterinary Medicine and Epidemiology University of California

Davis, California

Trevor R. Ames , DVM, MS, DACVIM

Professor and Department Chair

Veterinary Population Medicine College of Veterinary Medicine University of Minnesota St. Paul, Minnesota

John A. Angelos , DVM, PhD, DACVIM

Assistant Professor

Veterinary Medicine and Epidemiology University of California

Davis, California

Jane E. Axon , BVSc (Hons), MACVSc, DACVIM

Director

Clovelly Intensive Care Unit Scone Veterinary Hospital Scone, New South Wales Australia

John C. Baker , DVM, PhD, DACVIM

Associate Director and Professor

Michigan Agricultural Experiment Station Michigan State University

East Lansing, Michigan

Lora Rickard Ballweber , MS, DVM, DEVPC

Associate Professor and Clinical Parasitologist

Department of Microbiology, Immunology, and Pathobiology Colorado State University

Fort Collins, Colorado

Danika Bannasch , DVM, PhD

Associate Professor

Department of Population Health and Reproduction School of Veterinary Medicine

University of California Davis, California

George M. Barrington , DVM, PhD, DACVIM

Associate Professor, Large Animal Internal Medicine Department of Veterinary Clinical Sciences Washington State University

Pullman, Washington

Daniela Bedenice , DVM, DACVIM, DACVECC

Assistant Professor

Department of Clinical Sciences Large Animal Medicine

Cummings School of Veterinary Medicine Tufts University

North Grafton, Massachusetts

Steven L. Berry , DVM, MPVM

Extension Dairy Specialist, Dairy Management and Health Animal Science

Christine F. Berthelin-Baker , DVM, DACVIM

(Neurolog í a), DECVN

Neurologist/Neurosurgeon

All Animals Neurology and Neurosurgery Animal Emergency Center

Atlanta, Georgia

Andrea A. Bohn , DVM, PhD, DACVP (Anatom í a

patol ó gica)

Assistant Professor

Department of Microbiology, Immunology, and Pathology Colorado State University

Carole A. Bolin , DVM, PhD

Professor

Department of Pathobiology and Diagnostic Investigation College of Veterinary Medicine

Michigan State University East Lansing, Michigan

Terry L. Blanchard , DVM, MS, DACT

Hill N Dale Farm

Lexington, Kentucky

Anthony T. Blikslager , DVM, PhD, DACVS

Interim Department Head and Associate Professor, Equine Surgery Department of Clinical Sciences

College of Veterinary Medicine North Carolina State University Raleigh, North Carolina

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James P. Brendemuehl , DVM, PhD, DACT

Assistant Professor

Veterinary Teaching Hospital College of Veterinary Medicine Oregon State University Corvallis, Oregon

Babetta A. Breuhaus , DVM, PhD

Associate Professor

Department of Clinical Sciences College of Veterinary Medicine North Carolina State University Raleigh, North Carolina

Steven P. Brinsko , DVM, MS, PhD, DACT

Associate Professor

Large Animal Medicine and Surgery Texas A & M University

College Station, Texas

Gordon W. Brumbaugh , DVM, PhD, DACVIM, DACVCP

Associate Professor

Veterinary Physiology and Pharmacology College of Veterinary Medicine

Texas A & M University College Station, Texas

T. Douglas Byars , DVM, DACVIM, DACVECC

Byars Equine Advisory, LLC

Georgetown, Kentucky

Robert J. Callan , DVM, MS, PhD, DACVIM

Associate Professor

Department of Clinical Sciences Colorado State University Fort Collins, Colorado

Gary P. Carlson , DVM, PhD, DACVIM, DACVP

Professor Emeritus

Department of Veterinary Medicine University of California

Davis, California

Elizabeth A. Carr , DVM, PhD, DACVIM, DACVECC

Assistant Professor

Department of Large Animal Clinical Sciences College of Veterinary Medicine

Stan W. Casteel , DVM, PhD, DABVT

Professor of Toxicology

Veterinary Medicine Diagnostic Laboratory College of Veterinary Medicine

University of Missouri Columbia, Missouri

Christopher Cebra , VMD, MA, MA, DACVIM

Associate Professor, Large Animal Medicine

College of Veterinary Medicine Oregon State University Corvallis, Oregon

M. Keith Chaffi n , DVM, MS, DACVIM

Professor

Erin S. Champagne , DVM, DACVO

Ophthalmologist

Veterinary Specialists of Western New York Buffalo, New York

A. Berkley Chesen , DVM

Large Animal Surgery

College of Veterinary Medicine Texas A & M University College Station, Texas

Bruce W. Christensen , DVM, MS, DACT

Senior Veterinarian

Goulburn Valley Equine Clinic Congupna, Victoria

Australia

Anthony W. Confer , DVM, PhD, DACVP

Department Head, Regents Professor and Sitlington Endowed Chair for Food Animal Research

Department of Veterinary Pathobiology Oklahoma State University

Center for Veterinary Health Sciences Stillwater, Oklahoma

Vanessa L. Cook , Vet mb, MS, DACVS, DACVECC

Research Associate

Department of Clinical Sciences North Carolina State University Raleigh, North Carolina

Kevin T.T. Corley , BVMs, PhD, DACVIM, DACVECC,

MRCVS

Anglesey Lodge Equine Hospital The Curragh

County Kildare, Ireland

Victor S. Cortese , DVM, PhD, DABVP (Vacas lecheras)

Director Veterinary Specialty Operations

Cattle Immunology Pfi zer Animal Health Simpsonville, Kentucky

Beate M. Crossley , DVM, PhD, MPVM

Virologist

California Animal Health and Food Safety Laboratory System University of California

Davis, California

Robin M. Dabareiner , DVM, MS, PhD, DACVS

Assistant Professor of Lameness

College of Veterinary Medicine Texas A & M University College Station, Texas

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Andrew J. Dart , BVSc, DVCS, MACVSc,

DACVS, ECVS

Senior Registrar University of Sydney New South Wales Australia

Elizabeth J. Davidson , DVM, DACVS

Assistant Professor, Sports Medicine Department of Clinical Studies New Bolton Center

University of Pennsylvania Kennett Square, Pennsylvania

Eric W. Davis , DVM, MS, DACVIM, DACVS

Department of Large Animal Clinical Sciences University of Tennessee

Knoxville, Tennessee

Jennifer L. Davis , DVM, PhD, DACVIM, DACVCP

Clinical Assistant Professor of Equine Medicine and Pharmacology Department of Clinical Sciences

College of Veterinary Medicine North Carolina State University Raleigh, North Carolina

Fabio Del Piero , DVM, Dial. ACVP, PhD

Associate Professor of Pathology

School of Veterinary Medicine University of Pennsylvania Kennett Square, Pennsylvania

Andr é Desrochers , DVM, MS, DACVS, DECBHM

Professor

University of Montreal Faculty of Veterinary Medicine St-Hyacinthe, Quebec

Thomas J. Divers , DVM, DACVIM, DACVECC

Chief, Section of Large Animal Medicine Clinical Sciences

College of Veterinary Medicine Cornell University

Ithaca, New York

Maarten Drost , DVM, DACT

Professor, Emeritus

University of Florida Gainesville, Florida

Gerald E. Duhamel , DVM, PhD, DACVP

Professor

Department of Veterinary Biomedical Sciences University of Nebraska-Lincoln

Lincoln, Nebraska

Bettina Dunkel , DVM, DACVIM, DACVECC

Veterinary Basic Sciences

Royal Veterinary College University of London North Mymms, Hertfordshire United Kingdom

Noel O. Dybdal , DVM, PhD, DACVIM

Genentech, Inc.

South San Francisco, California

Joan Dziezyc , DVM, DACVO

Associate Professor

Department of Small Animal Medicine and Surgery Texas A & M University

Jack Easley , DVM, MS, DABVP (Caballos)

Owner

Equine Veterinary Practice Shelbyville, Kentucky

Nancy East , DVM, MPVM, MS

Associate Professor (retired)

Department of Medicine and Epidemiology School of Veterinary Medicine

Randall B. Eggleston , DVM, DACVS

Assistant Clinical Professor

Large Animal Medicine College of Veterinary Medicine University of Georgia Athens, Georgia

John A. Ellis , DVM, PhD, DACVP, DACVM

Professor

Veterinary Microbiology

Western College of Veterinary Medicine University of Saskatchewan Saskatoon, Saskatchewan Canada

Roger W. Ellis , DVM, MS

Assistant Professor Extension Veterinarian Department of Clinical Sciences Colorado State University Fort Collins, Colorado

Robert English , DVM, PhD, DACVO

Animal Eye Care Associates

Cary, North Carolina

Anne G. Evans , DVM, MBA, DACVD

Rancho Mirage, California

James F. Evermann , MS, PhD

Professor, Infectious Diseases, Diagnostic Medicine

Veterinary Clinical Sciences and Washington Animal Diseases Diagnostic Laboratory

College of Veterinary Medicine Washington State University Pullman, Washington

Darien J. Feary , BVSc, MS, DACVIM, DACVECC

Lecturer in Equine Medicine

University Veterinary Hospital, Camden University of Sydney

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Gilles Fecteau , DVM, DACVIM

Professor

Department of Clinical Sciences Universit é de Montr é al Saint-Hyacinthe, Qu é bec Canada

C. Langdon Fielding , DVM

Loomis Basin Equine Medical Center Loomis, California

Sherrill A. Fleming , DVM, DABVP (Alimentos animales),

DACVIM

Associate Professor

Department of Pathobiology and Production Medicine College of Veterinary Medicine

Mississippi State University Mississippi State, Mississippi

David Francoz , DMV, MSc, DACVIM

Associate Professor

D é partement des Sciences Cliniques Facult é de M é decine V é t é rinaire Universit é de Montr é al Saint-Hyacinthe, Qu é bec Canada

Nicholas Frank , DVM, PhD, DACVIM

Assistant Professor

Department of Large Animal Clinical Sciences University of Tennessee

Knoxville, Tennessee

Francis D. Galey , DVM, PhD, DABVT

Dean

College of Agriculture University of Wyoming Laramie, Wyoming

Franklyn Garry , DVM, MS, DACVIM

Professor

Lisle W. George , DVM, PhD, DACVIM

Professor

Terry C. Gerros , DVM, DACVIM

Owner and Practitioner

Santiam Equine Salem, Oregon

E. Paul Gibbs , BVSc, PhD, FRCVS

Professor of Virology

Department of Infectious Diseases and Pathology College of Veterinary Medicine

Steeve Gigu è re , DVM, PhD, DACVIM

Associate Professor, Director Hofmann Equine Neonatal Intensive Care Unit

Department of Large Animal Clinical Sciences University of Florida

Gainesville, Florida

Mary Belle Glaze , DVM, MS, DACVO

Gulf Coast Animal Eye Clinic

Houston, Texas

Jesse P. Goff , DVM, PhD

Research Leader

Periparturient Diseases of Cattle Research Unit National Animal Disease Center, USDA-ARS Ames, Iowa

Kathleen Casey Gonda , DVM, MS, DACVIM

Specialty Equine Medicine

Keswick, Virginia

Daniel H. Gould , DVM, PhD, DACVP

Professor Emeritus

College of Veterinary Medicine and Biomedical Sciences Colorado State University

Daniel L. Grooms , DMV, PhD, DACVIM

Associate Director

Michigan Agricultural Experiment Station Assistant Professor

Charles L. Guard , PhD, DVM

Associate Professor

Cornell University Ithaca, New York

Alison A. Gunn , BVSc, MVS, MACVSc

Lecturer in Ruminant Health and Production Livestock Veterinary Teaching and Research Unit Faculty of Veterinary Science

University of Sydney New South Wales, Australia

Spring K. Halland , DVM, DACVIM

Assistant Clinical Professor

Joanne Hardy , DVM, PhD, DACVS, DACVECC

Clinical Associate Professor

Large Animal Clinical Sciences Texas A & M University College Station, Texas

Arlyn Jud Heinrichs , MS, PhD

Professor of Dairy Science

Department of Dairy and Animal Science The Pennsylvania State University University Park, Pennsylvania

Sharon K. Hietala , PhD

Professor of Clinical Diagnostic Immunology Veterinary Medicine and Epidemiology University of California

Davis, California

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K.W. Hinchcliff , BVSc, MS, PhD, DACVIM

Professor and Dean

Faculty of Veterinary Sciences University of Melbourne Melbourne, Victoria, Australia

Melissa T. Hines , DVM, PhD, DACVIM

Associate Professor

Department of Veterinary Clinical Sciences Washington State University

Pullman, Washington

Charles A. Hjerpe , DVM

Professor Emeritus

School of Veterinary Medicine University of California Davis, California

David R. Hodgson , BVSc, PhD, DACVIM, FACSM,

MACVSc

Professor of Large Animal Medicine and Director University Veterinary Centre, Camden

Faculty of Veterinary Science, University of Sydney Camden, New South Wales, Australia

Patricia M. Hogan , VMD, DACVS

Hogan Equine Clinic at Fair Winds Farm Cream Ridge, New Jersey

Clifford M. Honnas , DVM, DACVS

Associate Professor

Equine Orthopedic Surgery and Lameness Large Animal Clinic

John K. House , BVMS, PhD, DACVIM

Associate Professor

Faculty of Veterinary Medicine Sydney University

Camden, New South Wales, Australia

Angela M. Hughes , DVM

Veterinary Genetics

Veterinary Medical Teaching Hospital University of California

Davis, California

Pam Hullinger , DVM, MPVM

Research Scientist

Medical Physics and Biophysics Division Physics and Advanced Technology Directorate Lawrence Livermore National Laboratory Livermore, California

Jared J. Janke , DVM

Veterinary Resident Instructor Large Animal Clinical Sciences Texas A & M University College Station, Texas

Jill R. Johnson , DVM, MS, DACVIM, DABVP

Professor of Equine Medicine

Department of Veterinary Clinical Sciences Veterinary Teaching Hospital and Clinics School of Veterinary Medicine

Louisiana State University Baton Rouge, Louisiana

Janet K. Johnston , DVM, DACVIM

Department of Clinical Studies

New Bolton Center University of Pennsylvania Kennett Square, Pennsylvania

Coleen M. Jones , MS

Research Associate

Department of Dairy and Animal Science The Pennsylvania State University University Park, Pennsylvania

Samuel L. Jones , DVM, PhD, DACVIM

Assistant Professor of Equine Medicine College of Veterinary Medicine North Carolina State University Raleigh, North Carolina

Will C. Jordan , DVM

Large Animal Clinical Sciences Texas A & M University College Station, Texas

Carter E. Judy , DVM, DACVS

Staff Surgeon

Alamo Pintado Equine Medical Center Los Olivos, California

Steven G. Kamerling , RPh, PhD

Senior Scientist, Discovery Research Pharmacia Animal Health Kalamazoo, Michigan

Gabriele A. Landolt , DVM, MS, PhD, DACVIM

Assistant Professor

V. Michael Lane , DVM, MPVM, DABVP, DACT

Associate Professor of Clinical Reproduction and Herd Health Veterinary Medicine: Population Health and Reproduction University of California

Davis, California

Richard A. LeCouteur , BVSc, PhD, DACVIM

(Neurolog í a), DECVN

Professor

Surgical and Radiological Sciences School of Veterinary Medicine University of California Davis, California

Guy D. Lester , BSc (Hons), BVMS, PhD, DACVIM

Associate Professor of Equine Medicine

School of Veterinary and Biomedical Sciences Murdoch University

Murdoch, Western Australia

Christian M. Leutenegger , Dr Vet Med, PhD, FVH

Lead Scientist

Molecular Diagnostic Laboratory IDEXX

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Robert L. Linford , DVM, PhD, DACVS

Professor and Chief, Equine Medicine and Surgery Department of Clinical Sciences

College of Veterinary Medicine Mississippi State University Starkville, Mississippi

K.C. Kent Lloyd , DVM, PhD

Associate Professor

Veterinary Anatomy, Physiology, and Cell Biology Center for Comparative Medicine

Jeanne Lofstedt , BVSc, MS, DACVIM

Professor of Health Management

Atlantic Veterinary College University of Prince Edward Island Atlantic Veterinary College

Charlottetown, Prince Edward Island Canada

Guy H. Loneragan , BVSc (Hons), MS

Associate Professor and Epidemiologist Department of Agricultural Sciences West Texas A & M University Canyon, Texas

Maureen Long , DVM, MS, PhD, DACVIM

Associate Professor

Department of Infectious Diseases and Pathology College of Veterinary Medicine

D. Paul Lunn , BVSC, MS, PhD MRCVS, DACVIM

Professor and Department Head

Department of Clinical Sciences

James L. Voss Veterinary Teaching Hospital

John Maas , DVM, MS, DACVN, DACVIM

Extension Veterinarian

School of Veterinary medicine University of California Davis, California

Melinda H. MacDonald , DVM, PhD, DACVS

Assistant Professor Equine Surgery

Department of Surgical and Radiological Sciences School of Veterinary Medicine

Robert J. MacKay , BVSc, PhD, DACVIM

Professor and Chief, Large Animal Medicine Department of Large Animal Clinical Sciences University of Florida

Gainesville, Florida

Jennifer M. MacLeay , DVM, PhD, DACVIM

Associate Professor

John E. Madigan , DVM, MS, DACVIM

Professor

Department of Veterinary Medicine and Epidemiology University of California

Davis, California

K. Gary Magdesian , DVM, DACVIM, DACVECC,

DACVCP

Lecturer

Equine Medicine and Emergency/Critical Care Veterinary Medical Teaching Hospital School of Veterinary Medicine University of California Davis, California

David J. Maggs , BVSc(Hons), DACVO

Associate Professor

Surgical and Radiological Sciences University of California

Davis, California

John B. Malone , BS, DVM, PhD

Professor of Veterinary Parasitology Pathobiological Sciences

School of Veterinary Medicine Louisiana State University Baton Rouge, Louisiana

Peggy S. Marsh , DVM, DACVIM

Clinical Assistant Professor

Department of Veterinary Large Animal Clinical Sciences Texas A & M University

Melissa Mazan , DVM, DACVIM

Associate Professor and Director of Equine Sports Medicine Program Department of Clinical Sciences

Tufts Cummings School of Veterinary Medicine North Grafton, MA

Craig McConnel , DVM, MVCS

Patrick M. McCue , DVM, PhD, DACT

Associate Professor

Dianne McFarlane , DVM, PhD, DACVIM, DABVP

Assistant Professor

Department of Physiological Sciences Oklahoma State University

Stillwater, Oklahoma

Sheila M. McGuirk , DVM, MS, PhD, DACVIM

University of Wisconsin

School of Veterinary Medicine Madison, Wisconsin

Nat T. Messer , IV , DVM, DABVP

Associate Professor

Department of Veterinary Medicine and Surgery University of Missouri

Columbia, Missouri

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Jason C. Mez , DVM

Veterinary Resident Instructor Large Animal Medicine and Surgery Texas A & M University

Paul G.E. Michelsen , MS, DVM

Partner

Mendocino Equine Clinic Redwood Valley, California

Nicholas J. Millichamp , BVetMed, PhD, DVOphthal,

DECVO, MRCVS, DACVO

Department of Small Animal Medicine and Surgery College of Veterinary Medicine

James N. Moore , DVM, PhD, DACVS

Research Professor

Department of Large Animal Medicine College of Veterinary Medicine University of Georgia Athens, Georgia

Cecil P. Moore , DVM, MS, DACVO

Professor and Chairman

Veterinary Medicine and Surgery University of Missouri

Director

Veterinary Medicine Teaching Hospital Columbia, Missouri

Dawn E. Morin , DVMN, MS, DACVIM

Associate Professor

Veterinary Clinical Medicine College of Veterinary Medicine

University of Illinois at Urbana-Champaign Urbana, Illinois

Paul S. Morley , DVM, PhD, DACVIM

Associate Professor

Epidemiology and Biosecurity Director of Biosecurity James L. Voss Teaching Hospital

Director, Animal Population Health Institute Department of Clinical Sciences

Colorado State University Fort Collins, Colorado

Debra Deem Morris , DVM, MS, DACVIM

Chief of Staff

Banfi eld the Pet Hospital Chula Vista, California

Derek A. Mosier , DVM, PhD

Professor

Diagnostic Medicine and Pathobiology Kansas State University

Manhattan, Kansas

Michael Murphy , DVM, PhD, DABVT

University of Minnesota

College of Veterinary Medicine St. Paul, Minnesota

Michael J. Murray , DVM, MS, DACVIM

Director, Companion Animal Biologicals and Equine Brands Global Strategic Marketing

Merial Limited Duluth, Georgia

T.G. Nagaraja , MVSc, PhD

Professor

Diagnostic Medicine and Pathobiology Kansas State University

Manhattan, Kansas

Mark Nasisse , DVM, DACVO

Staff Ophthalmologist

Carolina Veterinary Specialists Greensboro, North Carolina

Jonathan A. Naylor , BSc, BVSc, PhD, DACVIM, DACVN

School of Veterinary Medicine Ross University

Basseterre, St. Kitts

Guy H. Palmer , DVM, PhD

Professor of Microbiology and Pathology Washington State University

College of Veterinary Medicine Pullman, Washington

John R. Pascoe , BVSc, PhD, DACVS

Professor of Surgery

Department of Surgical and Radiological Sciences University of California

Davis, California

Steven M. Parish , DVM, DACVIM

Professor, Large Animal Internal Medicine Veterinary Teaching Hospital

Washington State University Pullman, Washington Michael Payne

Outreach Program Coordinator

Western Institute for Food Safety and Security University of California

Davis, California

Anthony P. Pease , DVM, MS, DACVR

Assistant Professor in Diagnostic Imaging Molecular Biomedical Sciences

North Carolina State University Raleigh, North Carolina

Erwin G. Pearson , DVM, MS, DACVIM

Professor Emeritus

Department of Clinical Sciences Oregon State University Corvallis, Oregon

Konnie H. Plumlee , DVM, MS, DACVIM, DABVT

Laboratory Director

Veterinary Diagnostic Laboratory

Arkansas Livestock and Poultry Commission Little Rock, Arkansas

Nicola Pusterla , Dr. Med. Vet., Dr. Med. Vet. Habil.,

DACVIM

Assistant Professor

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Virginia B. Reef , DVM, DACVIM

Professor

Director of Large Animal Cardiology and Ultrasound Department of Clinical Studies

School of Veterinary Medicine University of Pennsylvania Philadelphia, Pennsylvania

David G. Renter , DVM, PhD

Assistant Professor

Diagnostic Medicine and Pathobiology College of Veterinary Medicine Kansas State University Manhattan, Kansas

Sarah M. Reuss , VMD

Resident in Large Animal Internal Medicine Department of Large Animal Clinical Sciences Texas A & M University

Steven M. Roberts , DVM, MS, DACVO

Chief of Staff

Animal Eye Center, PC Loveland, Colorado

Julie Ross , MA, VetMB, MRCVS, DACVIM

Veterinary Surgeon

Centre for Preventive Medicine Animal Health Trust

Newmarket, Suffolk United Kingdom

Joan Dean Rowe , DVM, MPVM, PhD

Associate Professor

Department of Population Health and Reproduction School of Veterinary Medicine

Bonnie R. Rush , DNM, MS, DACVIM

Department Head and Professor, Department of Clinical Sciences College of Veterinary Medicine

Kansas State University Manhattan, Kansas

Nicolas Sattler , DVM, DES, DACVIM

Charg é de cours contractuel

Pathologie du B é tail et des Animaux de Basse-Cour É cole Nationale V é t é rinaire de Maisons-Alfort Maisons-Alfort, France

Large Animal Practice Clinique V é t é rinaire St-Vallier

St-Vallier-de-Bellechasse, Qu é bec, Canada

John W. Schlipf , Jr. , DVM, MS, DACVIM

Assistant Professor

Large Animal Internal Medicine Veterinary Teaching Hospital College of Veterinary Medicine Oregon State University Corvallis, Oregon

Harold C. Schott II , DVM, PhD, DACVIM

Associate Professor, Equine Medicine

Debra C. Sellon , DVM, PhD, DACVIM

Professor, Equine Medicine

Department of Veterinary Clinical Sciences Washington State University

Pullman, Washington

Bradford P. Smith , DVM, DACVIM

Professor Emeritus

John A. Smith , DVM, MS, MAM, DACVIM, DACPV

Director of Health and Hatchery Services

Fieldale Farms Corp. Baldwin, Georgia

Mary O. Smith , BVMs, PhD, DACVIM (Neurolog í a)

Staff Neurologist

Affi liated Veterinary Specialists Maitland, Florida

Joseph H. Snyder , DVM

Owner and Veterinarian Myrtle Veterinary Hospital Myrtle Point, Oregon

Stanley P. Snyder , DVM, PhD, DACVP

Professor Emeritus of Pathology

Veterinary Diagnostic Laboratory College of Veterinary Medicine Oregon State University Corvallis, Oregon

J. Glenn Songer , PhD

Professor

Department of Science and Microbiology The University of Arizona

Tucson, Arizona

Sharon J. Spier , DVM, PhD, DACVIM

Professor

Brett Sponseller , DVM, PhD, DACVIM

Assistant Professor

Department of Veterinary Clinical Sciences Iowa State University

Ames, Iowa

Guy St. Jean , DVM, MS, DACVS

Professor of Surgery

Assistant Dean of Student Affairs Department of Clinical Sciences School of Veterinary Medicine Ross University

Basseterre, St. Kitts

Allison J. Stewart , BVSc(Hons), MS, DACVIM

Assistant Professor

Department of Clinical Sciences Auburn University

Auburn, Alabama

ctr.indd xiv

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Susan M. Stover , DVM, PhD, DACVS

Professor

Department of Anatomy, Physiology, and Cell Biology School of Veterinary Medicine

George M. Strain , PhD

Professor of Neuroscience

Department of Comparative Biomedical Sciences School of Veterinary Medicine

Louisiana State University Baton Rouge, Louisiana

Meri Stratton-Phelps , DVM, MPVM, DACVIM, DACVN

Owner

All Creatures Veterinary Nutrition Counseling West Sacramento, California

Raymond W. Sweeney , VMD, DACVIM

Department of Clinical Studies New Bolton Center

Corinne R. Sweeney , DVM, DACVIM

Associate Dean for New Bolton Center Professor of Medicine

Department of Clinical Studies New Bolton Center

Cyprianna E. Swiderski , DVM, PhD, DACVIM

Assistant Professor, Equine Medicine

Department of Clinical Sciences College of Veterinary Medicine Mississippi State University Mississippi State, Mississippi

Tamara M. Swor , DVM, DACVS

Clinical Assistant Professor

Ronald L. Terra , DVM, MS, MBA

Professor

Food Animal Production Medicine Western University of Health Sciences College of Veterinary Medicine Pomona, California

Alain Th é on , Dr Med Vet, MS, PhD, DACVR-RO

Professor

Department of Surgical and Radiological Sciences College of Veterinary Medicine

Mark C. Thurmond , DVM, MPVM, PhD

Professor

Ramiro E. Toribio , DVM, MS, PhD, DACVIM

Assistant Professor

Department of Veterinary Clinical Sciences College of Veterinary Medicine

The Ohio State University Columbus, Ohio

Mats H.T. Troedsson , DVM, PhD, DACT,

DECAR

Professor

Department of Large Animal Clinical Sciences University of Florida

College of Veterinary Medicine Gainesville, Florida

James R. Turk , DVM, PhD, DACVP

Associate Professor

Department of Veterinary Pathobiology College of Veterinary Medicine University of Missouri Columbia, Missouri

Christine Uhlinger , DVM

Brandywine Equine Clinic Apex, North Carolina

Wendy E. Vaala , DVM, DACVIM

Senior Equine Technical Service Veterinarian Intervet Inc – a part of Schering-Plough Corp Millsboro, Delaware

Stephanie J. Valberg , DVM, PhD, DACVIM

Professor

Michael S. Vanderklok , DVM

Bovine Tuberculosis Eradication Coordination Animal Industry Division

Michigan Department of Agriculture Lansing, Michigan

Steven D. Van Camp , DVM, DACT

Associate Professor, Retired

Farm Animal and Resource Management College of Veterinary Medicine

North Carolina State University Raleigh, North Carolina Owner

Relative Veterinary Services Lincoln, California

David C. Van Metre , DVM, DACVIM

Associate Professor

Dickson D. Varner , DVM, DACT

Professor Theriogenology and Pin Oak Chair of Stallion Reproductive Studies

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Betsy Vaughan , DVM

Assistant Clinical Professor of Large Animal Ultrasound Department of Surgical and Radiological Services School of Veterinary Medicine

Aurora Villarroel , DVM, MPVM, DACVPM

Assistant Professor

Clinical and Extension Veterinarian Department of Clinical Sciences College of Veterinary Medicine Oregon State University Corvallis, Oregon

Kristina R. Vygantas , DVM, DACVO

Veterinary Ophthalmologist

Veterinary Surgical and Diagnostic Specialists Millstone, New Jersey

Richard L. Walker , DVM, MPVM, PhD

Professor

Clinical Diagnostic Bacteriology

California Animal Health and Food Safety Laboratory School of Veterinary Medicine

Kevin E. Washburn , DVM, DACVIM, DABVP

Assistant Professor

Jeffrey P. Watkins , DVM, MS, DACVS

Professor and Chief of Surgery

Large Animal Medicine and Surgery College of Veterinary Medicine Texas A & M University College Station, Texas

Scott Weese , DVM, DVSc, DACVIM

Associate Professor

Department of Clinical Studies University of Guelph

Guelph, Ontario Canada

Stephen D. White , DVM, DACVD

Susan L. White , DVM, MS, DACVIM

Josiah Meigs Distinguished Teaching Professor Large Animal Medicine

Acting Associate Dean for Public Service and Outreach College of Veterinary Medicine

University of Georgia Athens, Georgia

Nathaniel A. White , II , DVM, MS, DACVS

Theodora Ayer Randolph Professor of Surgery Marion DuPont Scott Equine Medical Center

Virginia Maryland Regional College of Veterinary Medicine Polytechnic Institute and State University

Blacksburg, Virginia

Elizabeth M. Whitley , DVM, MS, PhD, DACVP

Assistant Professor and Assistant Dean for Academic Affairs and

Curriculum

Department of Pathobiology College of Veterinary Medicine Auburn University

Auburn, Alabama

R. David Whitley , DVM, MS, DACVO

Professor and Department Head

Department of Clinical Sciences College of Veterinary Medicine Auburn University

Auburn, Alabama

Robert H. Whitlock , DVM, PhD, DACVIM

Associate Professor of Medicine

Clinical Studies New Bolton Center University of Pennsylvania Kennett Square, Pennsylvania

Steven E. Wikse , DVM, DACVP

Professor and Extension Veterinarian Large Animal Clinical Services

College of Veterinary Medicine and Biomedical Sciences Texas A & M University

Pamela A. Wilkins , DVM, PhD, DACVIM, DACVECC

Associate Professor of Medicine

Chief, Emergency, Critical Care and Anesthesia Clinical Studies

New Bolton Center University of Pennsylvania School of Veterinary Medicine Kennett Square, Pennsylvania

Kurt J. Williams , DVM, PhD, DACVP

Department of Pathobiology and Diagnostic Investigation College of Veterinary Medicine

W. David Wilson , BVMS, MS, MRCVS

Associate Professor

Department of Veterinary Medicine and Epidemiology School of Veterinary Medicine

Amelia R. Woolums , DVM, MVSc, PhD, DACVIM, DACVM

Associate Professor

Large Animal Medicine College of Veterinary Medicine University of Georgia Athens, Georgia

Anne M. Zajac , DVM, PhD

Associate Professor

Department of Biomedical Sciences and Pathobiology Virginia/Maryland Regional College of Veterinary Medicine Virginia Polytechnic Institute and State University Blacksburg, Virginia

Jerry L. Zaugg , DVM, PhD

Professor

Caine Veterinary Teaching Center University of Idaho

Caldwell, Idaho

ctr.indd xvi

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Yibi, Alex, Chris, Bonnie, Kate y Everett por su cari ñ o y apoyo

Y A

los autores y editores, que se han esforzado para que la medicina

interna de grandes animales alcance nuevos niveles

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xix

Prefacio

CONTENIDO

Medicina interna de grandes animales es un volumen enciclop é dico para los veterinarios de grandes animales que trabajan con caba-llos, vacas, ovejas o cabras, proporcionando la informaci ó n m á s actual disponible gracias a 190 expertos colaboradores. Esta edi-ci ó n contiene edi-cinco nuevos cap í tulos y m á s de 450 ilustraedi-ciones. Muchas de las secciones se han reforzado con la participaci ó n de nuevos autores destacados y los cap í tulos se han revisado y mejorado con nuevas referencias.

ABORDAJE ORIENTADO AL PROBLEMA

PARA EL DIAGN Ó STICO

DE LAS ENFERMEDADES

La mayor í a de los libros de texto presentan un problema: el cl í nico debe conocer el diagn ó stico para localizar y leer una enfermedad espec í fi ca, lo que crea un c í rculo vicioso. Medicina interna de gran-des animales es un texto que permite al cl í nico emplear el abordaje orientado al problema en el diagn ó stico de enfermedades en caba-llos, vacas, ovejas y cabras. Se discuten m á s de 130 signos cl í nicos y manifestaciones, enumerados alfab é ticamente en las p á ginas 21 y 22. Esta lista puede emplearse para localizar una manifestaci ó n con-creta de la enfermedad. Estas mismas manifestaciones se encuentran enumeradas por sistema org á nico al comienzo de los cap í tulos 3 al 14 (parte dos del libro). Una de las caracter í sticas favoritas de las ediciones previas son los cuadros de diagn ó sticos diferenciales. En esta edici ó n hemos mantenido estas herramientas de diagn ó stico de valor incalculable. A lo largo de la parte dos, se ofrecen listas com-pletas de enfermedades frecuentes, menos frecuentes e infrecuentes asociadas a las manifestaciones o signos de la enfermedad en estos cuadros f á ciles de localizar (v. ejemplos en p á gs. xx a xxi). Al cl í nico se le ofrece un abordaje de cada manifestaci ó n de las enfermedades y una metodolog í a de trabajo hacia el diagn ó stico. La fi siopatolo-g í a de una determinada manifestaci ó n de la enfermedad se ofrece de forma resumida. Incluso si no se alcanza un diagn ó stico fi nal, puede tratarse la sintomatolog í a del animal con diarrea, tos u otros problemas, una pr á ctica muy empleada hoy en d í a.

De manera similar, en la parte cuatro se discuten las anoma-l í as en anoma-los resuanoma-ltados de anoma-laboratorio y, en cuadros de f á cianoma-l anoma-lectura, se encuentran listas completas de enfermedades asociadas a una anomal í a concreta (v. ejemplo en p á g. xxi). Se facilita la interpre-taci ó n de anomal í as en pruebas cl í nicas de qu í mica, hematolog í a, prote í nas sangu í neas y coagulaci ó n. Por ejemplo, si el problema es que el calcio s é rico est á elevado, se discuten concisamente las causas de hipercalcemia y se ofrecen listas de enfermedades. El cl í nico puede proceder entonces a un abordaje racional de ano-mal í as de laboratorio concretas. Muchos lectores han considerado extremadamente ú til la tabla de conversi ó n de unidades « america-nas » al SI.

ORGANIZACI Ó N

La organizaci ó n b á sica no ha cambiado con relaci ó n a la tercera edici ó n. El libro se divide en siete partes:

PARTE UNO: Anamnesis, exploraci ó n f í sica y registros m é -dicos

PARTE DOS: Manifestaciones de enfermedad PARTE TRES: Trastornos y tratamiento del neonato

PARTE CUATRO: Toma de muestras e interpretaci ó n de prue-bas de laboratorio

PARTE CINCO: Trastornos de los sistemas org á nicos PARTE SEIS: Estrategias preventivas y terap é uticas

PARTE SIETE: Trastornos cong é nitos, hereditarios, inmunol ó -gicos y t ó xicos

En las partes cinco, seis y siete de Medicina interna de grandes animales se incluye una discusi ó n detallada de cada enfermedad. Una vez que el lector tiene la lista de patologías que correspon-den a un determinado problema, las dolencias espec í fi cas se encuentran en dichas secciones fi nales del libro. La organizaci ó n es la de un texto tradicional orientado a la enfermedad:

Defi nici ó n y etiolog í a

Signos cl í nicos y diagn ó stico diferencial Patolog í a cl í nica

Fisiopatolog í a Epidemiolog í a

Resultados de la necropsia Tratamiento y pron ó stico Prevenci ó n y control

La parte cinco est á organizada siguiendo el sistema corporal e incluye abordajes de medicina interna. Para cada sistema, están defi nidas las pruebas diagn ó sticas que pueden emplearse, como ecograf í a, endoscopia, radiograf í a, termograf í a, tomograf í a com-putarizada, resonancia magn é tica, t é cnicas de recogida de mues-tras, electrocardiograf í a, recogida de l í quido cefalorraqu í deo y biopsia de ó rganos. Hay numerosas ilustraciones, entre las que se incluyen fotograf í as, ecograf í as, radiograf í as, registros de elec-trocardiogramas y endoscopias. Estos cap í tulos han sido escritos por expertos en el campo de la medicina interna de grandes ani-males y proporcionan detalles de los tratamientos m á s actuales disponibles. Medicina interna de grandes animales complementa los textos existentes sobre tratamientos actuales.

Una secci ó n sobre enfermedades neonatales (parte tres), orga-nizada partiendo del problema existente, discute todos los temas desde las diarreas hasta la septicemia de potros, terneros, cor-deros y cabritos. Para ayudar al cl í nico a alcanzar el diagn ó stico correcto, se proporcionan listas de enfermedades para cada manifestaci ó n de enfermedad neonatal. Dichas listas se presen-tan en los cap í tulos 19 y 20. En los cap í tulos 51 y 52 se detallan los trastornos gen é ticos y las pruebas gen é ticas, la mayor í a de las cuales son de desarrollo reciente. En todo el texto se hacen refe-rencias cruzadas a las diferefe-rencias en el abordaje del diagn ó stico y el tratamiento en neonatos y adultos.

En la parte seis, « Estrategias preventivas y terap é uticas » , se incluyen cap í tulos con informaci ó n pr á ctica sobre asistencia intensiva y fl uidoterapia, tratamiento antimicrobiano, control de las infecciones, prevenci ó n y detecci ó n de animales for á neos, programas de vacunaci ó n y vacunas, y programas de control de par á sitos. El cap í tulo 50 trata de la nutrici ó n del animal enfermo y proporciona formulaciones para tratamientos enterales y parenterales.

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CARACTER Í STICAS

ENCARTES EN COLOR. El cap í tulo 32, « Enfermedades del tracto gastrointestinal » , incluye l á minas en color con vistas endosc ó picas de trastornos del tracto gastrointestinal equino. El cap í tulo 39, « Enfermedades del ojo » , contiene l á minas en color de determinadas patolog í as oculares que se observan mejor a todo color.

LISTAS Y TABLAS. Las listas y tablas impresas al fi nal del libro proporcionan informaci ó n a la que se hace referencia con frecuencia:

Manifestaciones de enfermedad

Manifestaciones de enfermedad en el neonato Qu í mica cl í nica: rangos normales en grandes animales Valores normales del eritr ó n en rumiantes y caballos Valores normales del leucograma (animales adultos) Valores normales de hemostasia en rumiantes y caballos

NUEVO EN ESTA EDICI Ó N

NUEVOS TEMAS. La variedad de nuevos temas es extraor-dinaria. Cada cap í tulo ha sido actualizado por completo. Entre los nuevos temas se incluyen toma de muestras y evaluaci ó n de la m é dula ó sea, pruebas de detecci ó n de ant í genos y PCR, nue-vos aspectos de la asistencia intensiva, m é todos de control de las infecciones en la hospitalizaci ó n de grandes animales, preven-ci ó n, detecpreven-ci ó n y respuesta a enfermedades de animales ex ó ticos, nuevas pruebas gen é ticas, nuevas pruebas para Clostridium diffi -cile y nuevos hallazgos sobre la diarrea v í rica bovina. Se emplean habitualmente nuevas pruebas ecogr á fi cas, se han actualizado las tablas del National Research Council, se han revisado extensa-mente las secciones neonatales, se describen los nuevos hallazgos en la etiolog í a de la queratoconjuntivitis aguda, y se han aña-dido los requisitos legales para el empleo de f á rmacos en pien-sos para animales y los avances en vacunas, en el tratamiento de las sacudidas de cabeza en caballos y trastornos endocrinos y musculares.

Í NDICE ALFABÉTICO

Un libro es tan bueno como lo sea su í ndice. El de Medicina interna de grandes animales es extenso y riguroso, lo que hace que sea una referencia f á cil de utilizar para encontrar la respuesta a cualquier pregunta.

AGRADECIMIENTOS

Muchas personas han trabajado duro para hacer de Medicina interna de grandes animales el texto de calidad que es. M á s de 190 autores han contribuido en su á rea de especializaci ó n. Queremos dar las gracias especialmente a Teri Merchant, Shelly Stringer, Sarah Wunderly, Gretchen Van Houten y al resto de personas de Elsevier que han trabajado tanto en este proyecto. Diana Gomez ayud ó enormemente con el mecanografi ado y la preparaci ó n de los originales. Estoy en deuda con ella.

La motivaci ó n para llevar a cabo Medicina interna de grandes ani-males vino, en parte, de la infl uencia que tuvieron muchos profesores y colegas de alto nivel en mi carrera profesional. En particular, que-rr í a mostrar mi agradecimiento a Alex Ardans, Humphrey Knight, Martin Drost y Dick Mansmann. Mi gratitud y respeto hacia ellos son profundos. Durante mis treinta y cinco a ñ os como profesor, he tenido la fortuna de trabajar con muchos colegas de talento, curiosos y esforzados, incluyendo a Gary Carlson, Ian Mayhew, Lisle George, Sharon Spier, John Madigan y Bob BonDurant, as í como a muchos otros que me han ayudado. Quiz á quienes m á s infl uencia tienen en un profesor son los alumnos y residentes que a trav é s de su curio-sidad nos mantienen interesados. Gracias tambi é n a John House, Gilles Fecteau, Dave Van Metre, John Angelos, Mike McCloskey y al resto de los grandes veterinarios con los que he trabajado.

Finalmente, querr í a dejar constancia del cari ñ o, apoyo y á nimo de mi incre í ble familia: Yibi, Chris, Alex, Bonnie, Kate y Everett. La familia te mantiene con los pies en la tierra y ¡te dice cu á ndo debes callarte y sentarte!

Bradford P. Smith Davis, California

Causas de ictericia en caballos

H Í GADO Causas frecuentes

Toxicidad por el alcaloide pirrolicidina Hepatitis por suero

Hepatitis aguda Hepatitis cr ó nica activa Colangitis o colangiohepatitis

C á lculos biliares, otras obstrucciones biliares Hiperbilirrubinemia por ayuno

Causas menos frecuentes

Afl atoxicosis con insufi ciencia hep á tica Enfermedad de Tyzzer (potros) Lipoidosis hep á tica

Abscesos hep á ticos

Causas infrecuentes

Hepatitis necr ó tica infecciosa

Hemangioma, hemangiosarcoma, angiosarcoma Neoplasia card í aca

Arteritis v í rica

Ú lceras g á stricas o duodenales Infecci ó n grave por asc á ridos Linfosarcoma

ANEMIA HEMOL Í TICA Causas frecuentes

Anemia hemol í tica inmunomediada

Erliquiosis (Ehrlichia equi) Isoeritr ó lisis neonatal

Piroplasmosis (babesiosis) Mordedura de serpiente Transfusi ó n sangu í nea Eritrocitosis

Arteritis v í rica equina Leptospirosis

Picadura de abeja o avispa Intoxicaci ó n por azufre

Pienso extra í do con tricloroetileno Intoxicaci ó n por hierro

Intoxicaci ó n por f ó sforo Intoxicaci ó n por herbicidas Intoxicaci ó n por fenotiacinas

Intoxicaci ó n por ra í z de serpiente blanca (tremetol) Cebollas

Arce rojo (Acer rubrum)

Intoxicaci ó n por pentaclorofenol Intoxicaci ó n por roble

Micotoxicosis

Surra, Trypanosoma evansi (ex ó tica)

Mal de caderas, Trypanosoma equinum (ex ó tica) Murrina de caderas, Trypanosoma hippicum (ex ó tica)

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Causas de ictericia en rumiantes

H Í GADO Causas frecuentes

Intoxicaci ó n por el alcaloide pirrolicidina Afl atoxicosis

S í ndrome de la vaca gorda (h í gado graso)

Hepatitis aguda Fasciolosis hep á tica Hepatitis necr ó tica infecciosa Abscesos hep á ticos

Colangiohepatitis

Sarcocistosis Neoplasia hep á tica Rotura de la ves í cula biliar Colelitiasis

Obstrucci ó n biliar

Intoxicaci ó n por Nolina (yuca) Intoxicaci ó n por Lantana Intoxicaci ó n por Agave

Enfermedad de Wesselsbron (ex ó tica) (B, O)

ANEMIA HEMOL Í TICA Causas frecuentes

Leptospirosis Anaplasmosis

Hemoglobinuria bacilar (Clostridium haemolyticum) Piroplasmosis, babesiosis (ex ó tica)

Mordedura de serpiente

Anemia hemol í tica inmunomediada Reacci ó n a la transfusi ó n

Anemia hemol í tica posparto

Intoxicaci ó n por cobre (especialmente en ovejas) Isoeritr ó lisis neonatal

Enfermedad amarilla del cordero ( Clostridium perfringens tipo A) (O)

Anaplasma ovis Eperitrozoonosis Picadura de abeja o avispa

Intoxicaci ó n por especies de Brassica

Intoxicaci ó n por pienso extra í do con tricloroetileno Intoxicaci ó n por hierro

Intoxicaci ó n por cebollas Intoxicaci ó n por cinc Intoxicaci ó n por f ó sforo Intoxicaci ó n por mercurio

Intoxicaci ó n por rodadora (Kochia scoparia) Lupinosis mic ó tica

Intoxicaci ó n por Microsporum

Teileriosis (fi ebre de la Costa Este) (ex ó tica)

B, bovino; O, ovino.

Causas de elevaci ó n de las enzimas s é ricas

ELEVACI Ó N DE SDH Causas frecuentes

Insufi ciencia hep á tica aguda Abscesos hep á ticos

Secundario a lesiones intestinales Estrangulaci ó n intestinal Enteritis aguda t ó xica Insufi ciencia hep á tica cr ó nica

Anemia aguda y grave Anestesia general Anoxia

ELEVACI Ó N DE GGT Causas frecuentes

Insufi ciencia hep á tica aguda Insufi ciencia hep á tica cr ó nica Intoxicaci ó n por alcaloide pirrolicidina Afl atoxicosis

Colangiohepatitis Colelitiasis Fasciolosis hep á tica

Causas poco frecuentes

Rango normal elevado en animales j ó venes H í gado graso

ELEVACI Ó N DE FA Causas frecuentes

Insufi ciencia hep á tica aguda Insufi ciencia hep á tica cr ó nica

Intoxicaci ó n por el alcaloide pirrolicidina Colangiohepatitis

Colelitiasis Fasciolosis hep á tica

Rango normal elevado en animales j ó venes H í gado graso

ELEVACI Ó N DE CPK Causas frecuentes

Rabdomi ó lisis de esfuerzo (azouria, miositis, enfermedad de los lunes)

Miodegeneraci ó n nutricional (defi ciencia de selenio, vitamina E) Trastorno multisist é mico tras ejercicio de resistencia

S í ndrome de la vaca ca í da (s í ndrome de compresi ó n muscular) Hipertermia maligna

Edema maligno

Dec ú bito prolongado e incapacidad de levantarse

Elevaci ó n moderada normal tras el ejercicio o el transporte Cardiomiopat í a aguda

P ú rpura hemorr á gica Gripe equina Sarcosporidiosis

Irritaci ó n local por inyecciones intramusculares

ELEVACI Ó N DE LDH Causas frecuentes

Enfermedad muscular

Rabdomi ó lisis de esfuerzo (azouria, miositis, enfermedad de los lunes)

Miodegeneraci ó n nutricional (defi ciencia de selenio, vitamina E) Trastorno multisist é mico tras ejercicio de resistencia

S í ndrome de la vaca ca í da (s í ndrome de compresi ó n muscular) Hipertermia maligna

Edema maligno

Enfermedad hep á tica

Insufi ciencia hep á tica aguda Insufi ciencia hep á tica cr ó nica Colangiohepatitis

Colelitiasis

Hem ó lisis in vitro Causas infrecuentes

Anemia hemol í tica Cardiomiopat í a aguda P ú rpura hemorr á gica Gripe equina Sarcosporidiosis

Irritaci ó n local por inyecciones intramusculares H í gado graso

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xxiii

La redacci ó n de cada edici ó n de Medicina interna de grandes ani-males se ha visto facilitada por el sistema de diagn ó stico en l í nea Consultant . 1_{Consultant contiene informaci ó n sobre} enfermeda-des enfermeda-descritas en la bibliograf í a veterinaria: 1.183 enfermedaenfermeda-des del ganado, 1.165 de caballos, 808 de ovejas, 662 de cabras, 606 de cerdos, 1.491 de perros, 1.046 de gatos y 395 de aves en el momento de redactar este texto. Para cada enfermedad, se pro-porciona una breve descripci ó n, bibliograf í a, v í nculos al cada vez mayor n ú mero de art í culos de revistas en l í nea y los signos cl í nicos que pueden observarse. La informaci ó n de Consultant se actualiza diariamente mediante la revisi ó n peri ó dica de la bibliograf í a disponible en l í nea y en papel a trav é s de la Flower-Sprecher Veterinary Library de la Cornell University. Consultant est á en http://www.vet.cornwell.edu/consultant/consult.asp ; en el a ñ o 2006 recibi ó alrededor de 1,3 millones de visitas de 380.000 visitantes.

Dos de las caracter í sticas de Consultant son las claves para su uso en este libro. La edici ó n en l í nea es din á mica y la informa-ci ó n procedente de la bibliograf í a aparece r á pidamente en la base de datos. Esta veloz actualizaci ó n, combinada con el amplio n ú mero de fuentes de informaci ó n, permite que Consultant con-tenga una cantidad de material actualizado dif í cil de encontrar en otro lugar, incluyendo informaci ó n sobre intoxicaciones, enfermedades raras o ex ó ticas en Norteam é rica. El segundo fac-tor importante es la capacidad para que el usuario introduzca un signo cl í nico o varios (p. ej., tos, c ó lico, aborto) para una deter-minada especie y obtenga una lista de enfermedades para las que se han registrado esos signos.

¿C ó mo se emple ó Consultant para la elaboraci ó n de Medicina interna de grandes animales ? Gran parte de este libro est á organi-zada por signos cl í nicos. Consultant proporcion ó una vista amplia de las causas posibles para los problemas cl í nicos que se solicit ó a los autores que incorporaran a sus listas de diagn ó sticos dife-renciales. Se pidi ó a los colaboradores que redujeran, categori-zaran y aportaran datos a las listas generadas por Consultant

bas á ndose en su experiencia cl í nica. Este uso de la base de datos facilit ó la organizaci ó n en cap í tulos basados en signos.

Consultant y este libro de texto son simbi ó ticos. La base de datos puede verse como un generalista que « conoce » cierta informaci ó n actualizada sobre la mayor í a de las enfermedades veterinarias. A pesar de eso, se mantiene como una mera herra-mienta para el cl í nico que lo emplea. Por ejemplo, hay docenas de causas de epistaxis en caballos y de manera simple se consi-gue una lista de ellas y otro tipo de informaci ó n relacionada en Consultant . El cl í nico debe coger la lista y decidir qu é causas bus-car en un paciente concreto, en qu é orden, por qu é medios, con qu é coste y con qu é tratamiento o pron ó stico terminar. Cuando es necesario tomar decisiones dif í ciles, las opiniones de expertos halladas en este libro son de gran ayuda.

Estamos en los estadios iniciales de nuevos modos de acce-der a la informaci ó n veterinaria: art í culos de revistas en l í nea, libros de texto en l í nea, libros de texto con revisiones elaboradas por expertos « distribuidos » en servidores a lo largo del mundo. En el momento en que escribo esto, la p á gina Veterinary wiki no muestra contenidos y la cobertura de los temas veterinarios en la Wikipedia es puntual, pero el crecimiento del modo Wiki de tratar la informaci ó n parece inexorable. 2_{A pesar de estas} tendencias, la letra impresa contin ú a siendo un modo popu-lar y efi caz de obtener informaci ó n. La cooperaci ó n realizada entre Consultant y Medicina interna de grandes animales permite a los cl í nicos y estudiantes benefi ciarse de la uni ó n entre la memoria incansable y la facilidad de recuperaci ó n de datos del ordenador, y la comodidad del conocimiento experto en forma de libro.

BIBLIOGRAF Í A

1. White ME. Consultant , Ithaca, NY, Cornell University,

_©

2007. Disponible en: http://www.vet.cornell.edu/consultant/consult.asp .

2. Wikipedia . Disponible en: http://www.wikipedia.org .

Empleo de la base de datos

de diagn ó sticos Consultant

para el desarrollo de este libro

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