Page 879 - Clinical Small Animal Internal Medicine
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                    Preface



                    Internal medicine is hard. Progress in science and tech-  While we all like to make lists of the 20 differential diag-
                    nology makes it almost impossible to keep abreast of   noses for a given patient’s abnormalities, it’s important to
                    recent advances and on top of that, all of us want to bal-  recognize that in clinical practice, common things occur
                    ance our life both at work and home. Is there enough   commonly and those differentials should be at the top of
                    time in the day for everything?                    your rule‐out list.
                      There are a variety of ways in which we learn and the   There are numerous excellent textbooks on the market
                    path is not the same for everyone. For those of us with an   and I use many of them on a daily/weekly basis. Some
                    interest  in  internal  medicine,  and  I’m  assuming  that   serve as definitive reference works for the topic under dis-
                    includes the reader of this book, we rely on a number of   cussion. Some are brief, bullet point, clinically oriented
                    resources.  Our  colleagues,  continuing  education  semi-  texts that one can use to find something quickly. What I
                    nars, the literature, professional educational networks,   thought was currently lacking was a text that would be
                    and reference textbooks. A concern of mine over the past   continually updated, provide enough background physi-
                    few years has been the increasing reliance on technology   ology to help the reader understand normal versus abnor-
                    to arrive at a clinical diagnosis rather than emphasizing   mal, and provide useful and, more importantly, clinically
                    the  need  to  understand  physiology  and  the  value  of  a   relevant material to help you with your patients.
                    complete history and a thorough physical examination.   The goal of this text was to first identify section editors
                    We feel increasing pressure to arrive at a specific and   who were recognized experts in their field both academi-
                    definitive diagnosis and, more importantly, to arrive at   cally and clinically. The section editors then identified
                    that diagnosis almost immediately.                 topics they felt were of greatest clinical importance and
                      Your goal in internal medicine is not to arrive at a diag-  selected authors who could translate this information
                    nosis. I would much prefer to see a pet respond to my   into a text that would be used every day. I hope we have
                    treatment and recover without a definitive diagnosis   achieved that goal. We will be updating the text online
                    than to arrive at a definitive diagnosis at necropsy. If you   with new information and updated references on a quar-
                    are successful in achieving a diagnosis, that can be very   terly basis, adding additional sections and chapters with
                    rewarding. However, your goal should be to accurately   future editions, and  uploading podcasts consisting of
                    identify problems and address those problems in a logi-  interviews with the authors to highlight and emphasize
                    cal, timely, and cost‐effective manner, always weighing   the material in the text and any recent advances in the
                    the risk/benefit of running myriad diagnostics versus   field.
                    improving the quality of life of your patient and the pet   We hope that you will find the text helpful and all
                    owner. While not every pet owner will be able to afford   credit for that success goes to the authors. Any omissions
                    or desire to follow each and every one of our recommen-  or errors lie with me so please let me know both the good
                    dations, it is our job to make sure that whatever decision   and the bad so we can improve things going forward.
                    the owner makes is based on being fully informed.   As  my  favorite  philosopher  once  said  “It’s  a  magical
                      Illness is really physiology gone awry. If you have an   world, Hobbes, ol’ buddy, let’s go exploring.”
                    understanding of what is normal, it makes your job of   All the best and enjoy exploring the mysteries of
                    identifying the abnormal much easier. The body has a   medicine.
                    limited repertoire of responses to an insult so often many
                    diseases will have very similar clinical presentations.                                      Dave
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