21425 - Clinical Medicine and Medical Therapy of Pets

Learning outcomes

At the end of the module the student is provided with the tools and skills necessary to perform all the appropriate procedures, in a context of pure interdisciplinarity, to obtain a diagnosis, to set the most appropriate therapeutic protocols and formulate the most correct prognostic judgments. The procedures start from the collection and interpretation of the medical history and the signalment of the patient. Than with the identification of the clinical signs (recalls of clinical and semeiotic methodology) and to complete all the available diagnostic investigations (clinical pathology, diagnostic imaging) serological tests, cytological and histopathological examinations, etc.) and interpreting the results in order to complete the diagnostic path. The lectures will have as their subject cases enrolled in the Veterinary Teaching Hospital. The student will be asked to integrate and expand, with appropriate teaching material, their knowledge in order to pursue a continuous personal update on the subject. The student will have acquired the skills necessary to diagnose a medical disease on a pet (dog and cat), formulate the prognosis and set the most appropriate treatment.

Course contents

The course is part of the Integrated Course "Veterinary Clinical and Medical Therapy".

The Companion Animal Clinical and Medical Therapy course is structured to fully align with the definition of CLINIC as "medical activity directed at the individual patient."

This is primarily a practical and applied course, which is completed through the Veterinary Clinical Medicine internship. Students will be guided in applying the knowledge, skills, and content acquired across all disciplines of the Veterinary Medicine degree, particularly from courses in Clinical Methodology, Semiotics, and Special Medical Pathology, to arrive at a diagnosis, prognosis, and the most appropriate therapeutic protocol for each patient. In other words, the course adopts an idiographic approach, focusing on the "problem" of the individual patient, aiming to identify both the common elements that categorize it within a specific disease and the unique aspects that distinguish it from the general pattern of that disease.

Through the analysis of practical cases related to common syndromes, the course aims to convey the fundamental principles of clinical practice, which include:

• A thorough and methodical collection of anamnesis and direct clinical findings.

• The ability to plan and rationalize collateral investigations, considering the available resources.

• A rational and justified interpretation of all observed phenomena.

• The ability to reconsider and question hypotheses based on new evidence.

• The ability to approach and solve cases with partial data.

• Continuous updating of one's knowledge.

• Evaluation of both successes and failures, including through anatomical-clinical feedback.

The course is divided into 4 modules:

• Prof. Fracassi - Endocrinology, pancreatic disorders,  dermatology

• Prof. Pietra - Gastroenterology, pulmonology, nephrology, general therapy

• Prof. Marconato - Oncology, hematology

• Prof. Gandini - Neurology, cardiology

The Integrated Program "Veterinary Clinical and Medical Therapy" contributes to the development of the Day One Competences, which can be accessed through the link below (dedicated page).

The course syllabus and the list of Day One Competences indicated by EAEVE that the course helps students to achieve are available on the dedicated page.

Topics covered:

• Pancreatitis (1 hour)

• Antibiotic therapy (1 hour)

• NSAID therapy (1 hour)

• Corticosteroid therapy (1 hour)

• Pulmonary therapies (1 hour)

• Therapy for chronic enteropathies (1 hour)

• Gait disorders (2 hours)

• Diagnostic and therapeutic approach to epilepsy (1 hour)

• Cushing’s syndrome therapy (1 hour)

• Diabetes mellitus therapy (1.5 hours)

• Hyperthyroidism therapy in cats (1 hour)

• Hypothyroidism therapy in cats (0.5 hours)

• Addison’s disease therapy (1 hour)

• Approach to hepatopathies (2 hours)

• Approach to the oncological patient (1 hour)

• Principles of oncological therapy (1 hour)

• Lymphoma in dogs (1 hour)

• Lymphoma in cats (1 hour)

• Approach to the anemic patient (1 hour)

• Vaccinations (1 hour)

• Chronic kidney disease (2 hours)

• Hypertrophic cardiomyopathy (1 hour)

• Dilated cardiomyopathy (1 hour)

• Mitral disease (1 hour)

• Problem-oriented approach to dermatological diseases (1 hour)

Readings/Bibliography

The teaching materials for this course are available on the Virtuale Learning Environment (https://virtuale.unibo.it/?lang=en ).

Books:

"Diagnostic and Therapeutic Algorithms in internal medicine for dogs and cats" F. Fracassi. Edra, Milano, 2022.

“Small Animal Internal  Medicine”Nelson RW, Couto G. Elsevier 5th Ed EV 2014

Ettinger’s Textbook of Veterinary Internal Medicine, 9th Edition  Stephen J. Ettinger & Edward C. Feldman & Etienne Cote. Elsevier 2024.

Teaching methods

The course is structured with lectures and practical sessions.

Many of the practical session involve the interactive discussion of clinical cases.

At the end of the internship, the student must present a clinical case managed during the internship period to the instructor.

Each student must write a report on a case treated and admitted to the "G. Gentile" University Veterinary Hospital, which will be assessed by the instructor. Outgoing Erasmus students must refer to cases treated at the host institution. The report must also be submitted by those who are taking the exam only for the internship (including Erasmus students).

The written report must be sent via email to federico.fracassi@unibo.it and must be received at least one month before the date of the first available exam session. For example, if the first exam session is on March 15, the report must be sent by 24:00 on February 14; if the session is on June 18, the report must arrive by 24:00 on May 17, and so on.

Assessment methods

At the end of the Internal Medicine internship (Tirocinio), the student must present (power-point presentation) a clinical case managed during the internship period to the instructor. After completing the internship, the student must submit a written thesis on a clinical case. There is also a written exam and an oral exam, which consists of two parts.

The written exam takes place immediately before the oral exam (on the same day) and involves describing and commenting (open-ended questions only) on the laboratory findings of a clinical case (dog or cat). The written report (exam) will be corrected and discussed at the beginning of the oral exam. The evaluation of the written exam is not given as a grade but as either pass or fail for proceeding with the oral exam. During the oral exam, after the written discussion, if the instructor considers the student eligible, the first question will focus on the diagnostic approach to a clinical case. This question will assess the student’s ability to integrate clinical information, formulate a differential diagnosis, and select the best diagnostic procedures. The second question will concern medical therapy. If the written exam is not considered pass, the student will be informed by the instructor that they cannot continue with the oral exam.

The purpose of the oral exam is to assess the student's ability to apply their knowledge and perform the necessary logical-deductive connections. The oral exam usually lasts 15-20 minutes.

The final grade is based on:

1. Activities performed during the Internal Medicine internship (rated from 1 to 4). The average of all activities during the internal medicine internship month is evaluated.

2. Discussion of the internal medicine case at the end of the internship (rated from 1 to 4).

3. Discussion of the emergency medicine case at the end of the internship (rated from 1 to 4).

4. Evaluation of the thesis (rated from 1 to 4).

Finally, the grade is based on the final oral exam (graded from 18 to 30).

For the evaluation of the above points (1, 2, 3, and 4), an average will be calculated. This average will modify the oral exam grade and, therefore, the final grade as follows:

• Average 4: +1 point to the oral exam grade

• Average 3.5-4: +0.5 points to the oral exam grade

• Average 3 to 3.5: No change to the oral exam grade

• Average 2 to 3: -1 point from the oral exam grade

• Average 1 to 2: -2 points from the oral exam grade

The final grade is expressed in thirtieths for exams. The exam is passed with a grade of at least 18/30. In case of the maximum grade (30/30), cum laude may be awarded at the instructor's discretion.

Oral exam grading scale:

• Comprehensive preparation on course topics, ability to make independent critical analysis and connections, full mastery of specific terminology, ability to argue and self-reflect (30-30L).

• Preparation on a broad range of course topics, ability to make independent critical analysis, mastery of specific terminology (25-29).

• Preparation on a limited number of course topics and ability for autonomous analysis only on purely procedural issues; correct use of language (20-24).

• Preparation on a very limited number of course topics and ability to analyze only with the help of the instructor; generally correct use of language (18-19).

A detailed program of the topics covered by each instructor in the various course modules, along with the corresponding chapters or articles for exam preparation, will be provided to the student.

The student has the right to refuse the positive grade proposed at least once (according to the University teaching regulations, ART.16, paragraph 5).

Since this is an Integrated Course, the grading instructor is Prof. Federico Fracassi.

The final grade for the Integrated Course is the arithmetic average between the courses "Clinical and Medical Therapy of Livestock Animals" and "Clinical and Medical Therapy of Companion Animals". Cum laude is awarded only if the grade is 30 in both courses, and cum laude was awarded in at least one of them.

Students with DISABILITIES or SEN can contact the instructor to request adjustments to teaching during the course or in the final evaluation. The student must email the instructor, including the reference staff who is supporting them in CC.

Teaching tools

The lectures will be conducted using PowerPoint presentations, clinical case videos, and interactive tools (such as Kahoot or WooClap). Students will be encouraged to use specialized search engines (e.g., PubMed) and to consult the Veterinary Educational Portal for further study of the topics covered.

Office hours

See the website of Federico Fracassi

See the website of Laura Marconato

See the website of Marco Pietra

See the website of Gualtiero Gandini