Laurea Magistrale a Ciclo Unico in Medicina Veterinaria

Learning  a rational and / or advanced clinical approach  to (localized) surgical diseases in domestic animals employing previously acquired knowledge of  anatomy and organ-specific or systemic physiology.

Understanding the modalites involved in healing  of bones and soft tissues and diseases related to pathological bone consolidation and wound healing.

Learning the most common surgical diagnostic techniques used in dogs, cats and large animals. Learning the principle functioning and operation of radiographic equipment, acquiring skills to independently perform radiographic examinations utilizing different projections, acquiring understanding of the radiographic anatomy of the various body parts and recognition of pathological changes in those anatomical sites.

The student must be able to distinguish a computed tomography (CT) image from a magnetic resonance (MR) image and interpret it appropriately based on the information presented in class on the principle differences between the two imaging technologies; students must recognize different CT windows and MR sequences and interpret them accordingly and they must become self-proficient in interpreting density and signal changes in order to eventually come up with an appropriate differential diagnosis.

Knowledge of radiographic anatomy and proper skills to interpret radiological findings  by exposure to radiographic images of domestic animals.

Interpretation of clinical signs of surgical diseases of small and large animals.

Identification of etiopathogenetic aspects and interpretation of surgical diseases through surgical diagnostic techniques.

Learning of diagnostic imaging methodologies: Radiology, computed tomography (CT), magnetic resonance imaging (MRI) and interpretation of normal and pathological images.

Knowledge which should allow students to perform literature searches to propose diagnostic hypotheses and establish a proper diagnostic work-up.

Ability to select and perform appropriate diagnostic techniques.

Ability to identify the status of healing of soft and bone tissues.

Acquisition of skills to develop a diagnostic plan  following recognition  of pathological signs, the interpretation of diagnostic results by comparing them with each other and, where appropriate, with data presented in scientific textbooks

Ability to describe findings of an  examined case with proper language.

Ability to properly convey the diagnostic results in veterinary expert language.

Ability to develop scientific methodologies that facilitate the acquisition of new knowledge.

The course consists of 42 hours of interactive lectures allowing for exchanges between the lecturer and the students and 24 hours of laboratories. scheduled as small-size student groups in the different modules (Surgical pathology and diagnostic surgical methods, Radiology and  advanced diagnostic imaging techniques)

Surgical pathology. Lectures: Keynote presentations, case presentations

Seminars: interactive based on clinical case presentations.  Keynote presentations and movies with multiple choice questions, open questions, closed questions offered during the seminar.

Practical Training: based on clinical and surgical cases referred to the University Veterinary Hospital.

Diagnostic surgical methods. Lectures (14 hours): Power point presentations supported by demonstration material and video clips illustrating how to implement in clinical practice procedures for biopsies, centesis, and insertion of chest drains, locoregional blocks of the limbs and the head of the horse, sinocentesis, placement of nasogastric tube, abdominocentesis, thoracentesis, tracheobronchial aspirate and bronchoalveolar lavage.

Labs are scheduled in small-size groups. The students are divided into 4 groups and each student is expected to perform four hours of practical exercises. They are performed in the gross pathology room and gross anatomy room on cadaveric material. In the wet labs each student is expected, to practice the following procedures:

Fine needle aspiration, tru-cut, and punch biopsy; bone marrow aspiration and insertion of chest drains (PA).

Loco-regional anesthesia of the head and limbs (peripheral nerves distal to carpus/ tarsus), intra-articular anesthesia of the distal joints in front and hind limbs, placement of a nasogastric tube, insertion of an endoscope in the upper airways, cannulation of the nasolacrimal duct and trephination of the sinuses with positioning of a cannula for suction and washing of  sinuses (GA).

Radiology and  advanced diagnostic imaging techniques. Teaching includes 14 hours of lectures, 8 hours of repeat exercises in the lecture hall for 4 groups,  4 and 3 hours of exercises in the radiology repeated for 8 groups. In the classroom teaching hours  students are being exposed to and discuss pathological images of the various organ systems. The classroom exercises are intended to help students to visualize, discuss and familiarize themselves with radiographic anatomical images of the dog and the horse. Exercises in the radiology rooms offer students the opportunity to learn how to use the radiographic equipment, patient positioning for performing a requested radiographic projection and reading of acquired radiographic images. For the advanced imaging modalities (CT, MRI) power-point presentations are being presented that cover the various program topics and the theoretical basis behind those imaging technologies . Practical exercises are divided in two hours of classroom teaching (discussing clinical cases  and supplemented with a guided question / answer tour  offered in power point format available online) and three teaching hours in small groups in the hospital where students assist with acquisition of diagnostic images.

The final exam is oral and  for students to be admitted they must have  successfully passed  each individual module test on the subjects covered in the course. During the examination students will also be tested on the subjects covered in labs. The overall course score of each student represents the arithmetic mean of the test results acquired in individual modules.

There will be a practical test on Radiographic Anatomy which must have been passed by the student in order to sit the oral exam.

Successful completion of the course  is being assessed by means by evaluating the student’s capacity to appropriately interpret clinical and diagnostic images of local and systemic diseases that may affect one or more organs. The student must demonstrate to be able to identify the etiological aspects and interpret the pathogenesis and clinical signs of the surgical disease, assess tissue healing and possible healing pathways and progress through clinical evaluation and with help of diagnostic imaging modalities.

Pre-exam review sessions are being offered in radiology with various pathological x-rays to review.

The theoretical and practical course includes the following modules:

1. Radiology and  advanced diagnostic imaging techniques: use of radiological equipment, radiographic techniques for the examination of different anatomical regions, the study of radiographic anatomy and interpretation of images acquired with all diagnostic imaging technologies that are currently available for small and large animals, including plain and contrast-medium- enhanced images. Familiarity with the operating principles of CT and MRI equipment. Recognition of anatomical structures of the chest, abdomen and skull in CT and MRI and related peculiarities. Recognition of different CT windows and MR sequences used in diagnostic imaging and image interpretation. Administration and effects of contrast media used for  CT and MRI imaging. practical procedures for carrying out CT and MRI examinations and precautions taken to minimize the risks associated with ionizing radiation and magnetic fields.

2. Surgical pathology and diagnostic surgical methods:

Surgical pathology: Introduction to surgical disease, principles of pathological processes occurring following tissue injury, inflammation, and soft tissue healing; wound healing, biomechanics of fractures, bone healing, pathological bone healing.

Diagnostic surgical methods: biopsy methods: thin needle biopsy, incisional biopsy by tru-cut, punch, excisional biopsy, organ biopsy, bone biopsy, centesis, bone marrow harvest, inserting a tube thoracostomy; locoregional blocks of the limbs and the head of the horse, sinocentesis, nasogastric tube placement, abdominocentesis, thoracentesis, tracheobronchial aspirate and bronchoalveolar lavage.

The program also includes:

• Seminars with groups of 25 students, where specific topics are covered and interactively discussed.

Exercises in small groups carried out mainly on clinical cases referred to the Veterinary University Hospital of the Struttura Didattica Speciale Veterinaria.

Recommended/adopted texts:

Schebitz H,  Wilkens H: Radiographic anatomy oh horse. Thieme 2008 (*)

Schebitz H,  Wilkens H: Radiographic anatomy oh dog and cat. Parey, 1977. (*)

(*) Hard copies and computerized copies (CD) of texts are available at the library

Muhlbauer M.C., Kneller S.K.: Radiography of the dog and cat: guide to making and interpreting radiographs.

D.A., Hendrickson, A.N. Baird: "Turner and McIlwraith's Techniques in Large Animal Surgery. 4th Edition Wiley Blackwell 2013

Fossum T.W.: Small animal surgery. Mosby Elsevier IV ed , 2013. 

Ross MW, Dyson SJ: Diagnosis and management of lameness in the horse. Elsevier, 2011.

Moyer W, Schumacher J, Schumacher J: A guide to equine joint injection and regional anesthesia. Vet Learning System, 2007.

 Rose RJ, Hodgson DR: Manuale di clinica del cavallo. Delfino, 2005.

Orsini JA, Divers TJ: Equine Emergencies: Treatment and Procedures,  Saunders, 2014.

Texts for more insights:

Schwarz T, Saunders J: Veterinary computed tomography. Wiley-Blackwell, 2011.

Gavin PR, Bagley RS: Practical small animal MRI. Wiley-Blackwell, 2009.

King LG: Textbook of respiratory disease in dogs and cats. Saunders, 2003.

The practical exam for the Radiographic Anatomy session, restricted to a maximum of 10 students, is scheduled weekly and results are being published online. If the student fails to pass the test, the student can retake the test, however,  no less than a month in between tests. A positive test outcome is valid for one year.