Laurea Magistrale a Ciclo Unico in Medicina Veterinaria

The Course represents the student's first approach to the (localized) surgical diseases of domestic animals, of which he will learn the classification and the terminology. It will also learn the principles of execution and interpretation of the main diagnostic investigations, from biopsies to diagnostic imaging, in small and large animals, as well as some functional tests for the evaluation of lameness in the horse. In addition to theoretical learning, the course aims to stimulate in the student a reasoned and progressive clinical approach to the surgical disease, integrating with the previously acquired knowledge of anatomy and physiology. The course is preparatory to the subsequent study of anaesthesiology, surgical technique and of the specific surgical diseases of the various apparatuses.

At the end of the course the student will be able to:

Define the main (localized) surgical diseases of pets.

Know the healing modalities of hard and soft tissues and possible complications and interpret the related clinical pictures.

Know the main bioptic techniques and propose an adequate diagnostic plan.

Know the principles of acquisition and interpretation of the methods of Diagnostic Imaging (radiology, computed tomography, magnetic resonance imaging).

Recognize the normal radiographic anatomy, perform a correct positioning of the patient for radiographic investigations of the different districts; recognize and interpret pathological patterns in small and large animals.

Differentiate a CT image from an MRI image, recognizing the different TC "windows" and RM sequences and understanding their meaning.

Address a clinical question presented through images and discuss the formulation of a diagnostic plan.

Express himself on the case submitted with proper language.

The course consists of 42 hours of interactive lectures allowing for exchanges between the lecturer and the students and 32 hours of laboratories, scheduled as student groups in the different modules (Surgical pathology and diagnostic surgical methods, Radiology and  advanced diagnostic imaging techniques)

Surgical pathology. Lectures (7 hours): Keynote presentations, case presentations.

Laboratories (4 hours): in the form of seminars or student groups: interactive based on clinical case presentations.  Keynote presentations and movies with multiple choice questions, open questions, closed questions.

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.

Laboratories (4 hours small animal, 2 hours large animal) in groups 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 (small animal). 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 (large animal).

Laboratory on horse lameness (3 hours, video).

Radiology and  advanced diagnostic imaging techniques. Lectures (21 hours): power point presentations illustrating normal and abnormal imaging of different apparatus in small and large animals. 

Laboratories in groups in the lecture hall (8 hours): presentantion and discussion of normal radiographic anatomy of small and large animals. 

Laboratories in groups at the Teaching Hospital (9 hours): exercises in the radiology and advanced diagnostic imaging rooms and discussion of 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 and advanced diagnostic imaging 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. 

The evaluation consists of two tests, both mandatory and sequential: a written test with multiple choice questions and a practical test concerning the discussion of a clinical case proposed to the student. Both tests must be passed in the same round. The overall grade represents the arithmetic mean of the results acquired in each test.

Successful completion of the course  is being assessed 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. During the examination student will also be tested on the subjects covered in labs.

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, 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. Ultrasonographic evaluation of the musculo-skeletal structures in large animals. 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: fine 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.

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. (*)

Coulson, Lewis: An atlas of interpretative radiographic anatomy of the dog and cat. Wiley-Blackwell, 2008. (*)

Kidd, Lu, Frazer: Atlas of equine ultrasonography. Wiley-Blackwell, 2014. (*)

Thrall: Textbook of veterinary diagnostic radiology. Elsevier, 2013. (*)

Garcìa Real MI: Radiografia del cane e del gatto. Interpretazione e diagnosi. Edra-EV, 2018.

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. 

Mair T, Love S, Schumacher J et al. Equine surgery, medicine and reproduction. Elsevier, 2013, 2nd edition.

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.

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

Text for more insights:

Thrall, Robertson: Atlas of normal radiographic anatomy and anatomic variants in the dog and cat. Elsevier-Saunders, 2015. (*)

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

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

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

Mai W: Diagnostic MRI in dogs and cats. CRC Press, 2018.

Wisner E, Zwingerberger A.: Atlas of small animal CT and MRI. Wiley-Blackwell, 2015.

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