Large Animal Practice

Reproductive efficiency: clinical and instrumental examination for the evaluation of reproductive efficiency in the female, criteria for assessing female fertility, breeding fertility. Normal pregnancy, pregnancy diagnosis, obstetric terminology and obstetric examination: embryonic and fetal development, maternal recognition of pregnancy, placenta and criteria of classification. Disposition of the fetus during pregnancy and during birth, obstetric examination, techniques for induction of estrus (2 hours).
Stillbirth pathology: obstetric examination in dystocia, obstetric aids, obstetric manual skills dystocia from maternal causes, dystocia from fetal causes, operative procedures on the fetus, operative procedures on the mother, injuries resulting from parturition, diagnosis and therapy (1 hour).
Pathology of the puerperium: uterine atonia, uterine spasms, uterine prolapse, placenta retention, bacterial diseases, diagnosis and therapy (1 hour).
Techniques for inducing abortion: the most common treatments used in farm animals, when to use such procedures, advantages and disadvantages in the use of the different techniques (1 hour).
Ovarian pathologies, uterine pathologies, vaginal and vulvar pathologies, breast pathologies: clinical, surgical and therapeutic aspects of the main congenital and acquired pathologies (2 hours).
Cesarean section in the different species: containment, anesthesia, method of execution, therapy, follow-up (2 hours).
Assistance to the newborn: principles of neonatology, the normal and the pathological newborn (1 hour).
Andrologic clinical examination: examination in the male breeder and in the male patient, semen collection and evaluation, certification (1 hour).
Testicular Maldescent: etiopathogenesis, clinical presentation and medical or surgical management (1 hour).
Orchitis and testicular tumors: etiopathogenesis, clinical presentation and medical or surgical management (1 hour).
Male sexual glands diseases: etiopathogenesis, clinical presentation and medical or surgical management (1 hour).
Penile and preputial diseases: etiopathogenesis, clinical presentation and medical or surgical management (1 hour).
Male contraception: indications, surgical or pharmacologic management (1 hour).

Introduction to the Course (1 hour). Textbooks, basic knowledge, course structure, organization of exercises, exam modalities. Course evaluation sheets. Anamnesis and clinical examination, symptom assessment, principles of differential diagnosis, selection of diagnostic tests, prognosis, formulation of suitable therapy for bovine patients, prevention. Reference range for the most important hematological and biochemical parameters in cattle.
Examples of Differential Diagnosis (1 hour). Analysis of an illustrative clinical case applying clinical reasoning to livestock animals and performing differential diagnosis. Differential diagnosis of diseases causing edema: clinical appearance and causes of dyscrasic, stasis, inflammatory, and allergic edema. Differential diagnosis of subcutaneous emphysema and icterus in cattle. Differential diagnosis of diseases causing edema associated with ruminal meteorism. Diagnosis of paratuberculosis. Diagnosis and treatment of actinogranulomatosis.
Clinical Approach to Metabolic Pathologies (1 hour). Ketosis, insulin-resistant diabetes mellitus, electrolyte disorders, and their differential diagnosis. Interpretation of a blood gas analysis. Metabolic acidosis and alkalosis, respiratory acidosis, mixed acidosis. Meaning of anion gap value and Base Excess. Strong Ion Theory. Strong ion difference (SID) and non-volatile buffers (Atot). Strong Ion Acidosis and alkalosis, Atot acidosis and alkalosis. Therapy for acidosis, alkalosis, and dehydration in cattle.
Clinical Approach to Digestive System Pathologies (7 hours). Neonatal calf diarrhea: epidemiology, clinical evaluation, therapy, prophylaxis. Procedures for reaching the etiological diagnosis and setting up a farm prevention plan. Precision approaches to neonatal calf diarrhea: importance of colostrum administration in preventing calf neonatal diseases; inadequate transfer of passive immunity (ITPI) syndrome. Differential diagnosis of ping sounds. Diagnosis of left and right abomasal displacement, diagnosis of cecal paratopia. Diagnosis of other causes of ileus in young and adult cattle. Left abomasal displacement: etiopathogenesis, diagnosis, therapeutic options. Omentopexy following right flank laparotomy (Dirksen method, 1967); rolling and abdominal massage (Braun, 1968); ventral omentopexy following left flank laparotomy (Utrecht method) (Lagerweij & Numans, 1968); "Blind Stitch": fixation of the abomasum to the ventral abdominal wall without laparotomy (Hull, 1972); "Toggle suture" (Sterner & Grymer, 1982); abomasopexy under endoscopic control (Janowitz, 1998). Right abomasal displacement: etiopathogenesis, diagnosis, therapeutic options. Clinical and diagnostic approach to anterior and posterior functional stenoses (syndromes of Hoflund). Traumatic reticuloperitonitis in cattle: etiopathogenesis, epidemiology, clinical signs, laboratory investigations, imaging diagnostics, and setting up the most appropriate therapy. Differential diagnosis of meteorism in young and adult cattle. Rumen cannulation, rumenocentesis, examination of rumen fluid and its diagnostic significance, rumenotomy. Meteorism associated with pneumonia in calves; application of Buff's three-quarters. Rumen acidosis in calves and adult cattle. Etiopathogenesis of acute, sub-acute, and chronic ruminal acidosis. Clinical approach to acute ruminal acidosis in adult cattle and acute ruminal acidosis (rumen drinking) in calves. Diagnostic, therapeutic, and prophylactic approach to S.A.R.A. (sub-acute ruminal acidosis). Ultrasound diagnosis and therapy of digestive, liver, and urinary system pathologies in calves and adult cattle.
Clinical Approach to Bovine Skin Pathologies (1 hour). Clinical appearance and diagnosis of the most frequent skin pathologies in cattle: solar dermatitis from ingestion of photosensitizing essences, from liver insufficiency and in the course of congenital porphyria. Clinical appearance and differential diagnosis of the most frequent pathologies with cutaneous and mucosal repercussions in cattle: Foot and Mouth Disease, Malignant catarrhal fever, Mucosal disease, Papular stomatitis, Calf ringworm, IBR/IPV, Besnoitiosis, Mange, Lice infestation, Dermatomycosis, Cutaneous leukosis, Bovine papillomatosis.
Clinical Approach to Respiratory System Pathologies (2 hours). Clinical approach to bovine respiratory system pathologies, differential diagnosis. Clinical approach to Bovine Respiratory Disease (BRD): etiopathogenesis, clinical symptoms, auscultatory findings, evaluation using the Wisconsin calf respiratory scoring chart (WCRSC), evaluation using the California calf respiratory scoring chart in calves before and after weaning, thoracic ultrasonography (TUS), nasal swab, non-endoscopic bronchial lavage or tracheobronchial aspirate execution and interpretation of microbiological findings, choice of therapy and vaccine prophylaxis.
Clinical Approach to Nervous System and Musculoskeletal System Pathologies (2 hours). Permanent recumbency syndrome in cows and calves: definition, causes, pathogenesis, diagnosis, pharmacological therapy, and bovine physiotherapy. Clinical implications of Emergency Special Slaughter (MSU). Examination of cerebrospinal fluid in cattle. Clinical examination of the musculoskeletal and nervous system of cattle. Detection and interpretation of neurological symptoms, differential diagnosis, and treatment of bovine nervous system pathologies. Calf arthrogryposis, etiopathogenesis, clinical forms, diagnosis, therapy.
Clinical Approach to Umbilical Pathologies in Calves (1 hour). Anatomy of the umbilicus and umbilical structures both before and after birth. Umbilical pathologies of calves. Umbilical hernia, excisional hernia, and laparocele. Omphalitis, omphalo-phlebitis, omphalo-arteritis, urachal inflammation, extra- and intra-abdominal umbilical abscess, persistence of the omphalomesenteric duct: etiopathogenesis, clinical appearance, clinical approach, differential diagnosis, ultrasound aspects, and conservative and/or surgical therapy.
Practical training (16 hours). Clinical practice at the clinic for ruminants and swine of the veterinary teaching hospital of the university of Milan: clinical management of patients, taking care of the collection of anamnestic data, performing the clinical examination, eventually accompanied by laboratory investigations. Then students will discuss the findings and the possible need for additional investigations with tutors, to be able to make the diagnosis and set the most correct therapy. Compilation of the clinical records for the visited animals. Acquisition of principles of biosecurity applied to the clinic of farm animals.

Review of current legislation on prescription and drug management in food animals (1 hour).
Traceability of the drugs in food animals (1 hour).
Prudent use of antimicrobials in veterinary medicine (1 hour).
Report suspected adverse reactions or inefficacy through the appropriate channel (1 hour).
Electronic veterinary prescription (4 hours): operating flow, prescription, supply of medicines, loading and unloading drugs on a log, recording of treatments, use of the App for mobile devices, management of the list of favorite medicines, drug use in derogation and improper use of drugs, issue of the prescription for food animals, modification of the recipe, veterinary prescription for medicated feed, prescription for own stock, management of drug stock in food animal herds.