Page 21 - 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