Handbook of Small Animal Dermatology (Pergamon Veterinary Handbook Series, Vol 11) pdf epub mobi txt 电子书 下载 2026

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出版者:Butterworth-Heinemann Medical

作者:Karen A. Moriello

出品人:

页数:0

译者:

出版时间:1995-07

价格:USD 60.00

装帧:Paperback

isbn号码:9780080422800

丛书系列:

图书标签:

• 小动物皮肤病学
• 兽医手册
• 动物医学
• 皮肤病
• 诊断
• 治疗
• 临床
• 宠物
• Pergamon
• 手册系列

Companion Animal Ophthalmology: A Comprehensive Guide Preface to the Second Edition The field of veterinary ophthalmology has experienced remarkable growth and refinement over the past decade. Advancements in diagnostic imaging, surgical techniques, and pharmacological understanding have fundamentally reshaped how we approach ocular diseases in companion animals. This revised edition of Companion Animal Ophthalmology: A Comprehensive Guide endeavors to integrate these pivotal developments, presenting the current gold standard in veterinary eye care for the practicing clinician, resident, and student. We recognize the enduring value of the foundational knowledge established in the first edition. However, the sheer volume of new research necessitates a significant expansion and reorganization of content. This volume is structured not merely as a repository of facts, but as a practical, clinically oriented manual designed to guide decision-making from the initial ophthalmic examination through complex therapeutic management. A core philosophy underpinning this text remains the integration of ophthalmology within the context of systemic health. Ocular signs are frequently the earliest indicators of underlying systemic pathology—endocrine, infectious, or immunologic. Therefore, the initial chapters have been rigorously updated to reflect the latest understanding of pathophysiology and associated systemic diagnostics. The contributions of numerous colleagues, researchers, and veterinary nurses have been instrumental in shaping this edition. Their dedication to advancing veterinary medicine ensures that the information presented is current, evidence-based, and directly applicable to the daily challenges faced in clinical practice. We sincerely thank all contributors for their expertise and commitment to clarity. Section I: Fundamentals of Ocular Science and Examination Chapter 1: Ocular Anatomy and Embryology Revisited This chapter provides an in-depth review of the anatomical structures of the canine and feline eye, emphasizing the microscopic architecture relevant to disease manifestation. Detailed attention is given to the organization of the lacrimal system, the intricate layers of the cornea and sclera, and the ultrastructure of the retina, particularly the differential distribution and function of the rod and cone populations across species. Embryological development is examined not merely as a historical footnote, but as the basis for understanding congenital anomalies, such as microphthalmia, persistent pupillary membranes, and coloboma formation. Modern imaging techniques, including high-frequency ultrasound biometry and anterior segment optical coherence tomography (AS-OCT), are introduced here to correlate in-vivo structural measurements with gross anatomy. Chapter 2: The Comprehensive Ophthalmic Examination: Technique and Instrumentation A meticulous examination remains the cornerstone of accurate diagnosis. This chapter systematically details the performance of the complete ocular assessment, starting with observation of menace response, dazzle, and PLR in the conscious patient, progressing through specialized diagnostics. Emphasis is placed on proper technique for tear film assessment (Schirmer Tear Test II modifications, Phenol Red Thread testing), intraocular pressure (IOP) measurement using both applanation (Goldmann) and rebound tonometry (Tonovet, iCare), and slit-lamp biomicroscopy. Coverage extends to specialized techniques: gonioscopy for angle evaluation, electroretinography (ERG) for functional assessment, and advanced ophthalmic photography, including fundus autofluorescence (FAF) imaging. Detailed protocols for performing these examinations under sedation are provided, ensuring patient comfort while maintaining diagnostic integrity. Chapter 3: Ocular Pharmacology and Therapeutics This section consolidates current knowledge regarding the pharmacokinetics and pharmacodynamics of ophthalmic agents. It moves beyond standard lists to discuss drug penetration across the corneal barrier, the role of the blood-ocular barrier, and strategies for enhancing topical drug delivery (e.g., liposomal formulations, subconjunctival injections). Specific attention is devoted to new generations of anti-inflammatory drugs (e.g., topical calcineurin inhibitors), advancements in glaucoma management (prostaglandin analogs, novel carbonic anhydrase inhibitors), and the management of microbial resistance in external ocular infections. Detailed dosing regimens, contraindications, and potential systemic side effects are summarized in tabular format for rapid clinical reference. Section II: Diseases of the Anterior Segment Chapter 4: Disorders of the Cornea and Conjunctiva Corneal pathology represents a significant portion of small animal caseloads. This chapter meticulously categorizes corneal disease based on the affected layer: epithelial defects (ulcers, erosions), stromal disorders (neovascularization, edema, scarring), and endothelial compromise (bullous keratopathy). Advanced management strategies for complicated and non-healing ulcers, including matrix metalloproteinase inhibitors (MMPs), conjunctival grafts (e.g., pedicle flaps), and keratoprosthesis techniques, are described in detail. Conjunctival diseases, including immune-mediated conditions like follicular conjunctivitis and systemic associations like Pemphigus complex, receive thorough coverage. Chapter 5: Uveitis: Diagnosis and Management Uveitis remains one of the most challenging syndromes to manage due to its diverse etiology. This chapter systematically breaks down the causes of anterior uveitis (AU) into infectious (e.g., toxoplasmosis, fungal), inflammatory (e.g., heterochromic iridocyclitis, idiopathic), and neoplastic categories. Critical emphasis is placed on the diagnostic algorithm: comprehensive systemic workup (PCR panels, serology, abdominal ultrasound) coupled with aqueous humor analysis (e.g., protein electrophoresis, cell counts). Therapeutic protocols emphasize aggressive early control of inflammation while balancing the risks of topical corticosteroid use, including detailed protocols for managing associated complications such as synechiae formation and secondary glaucoma. Chapter 6: Intraocular Pressure and Glaucoma Glaucoma is addressed as an emergent condition requiring rapid, decisive action. The pathophysiology of aqueous humor dynamics is reviewed, followed by a detailed comparison of primary (inherent angle closure, open angle) and secondary forms (uveitis-induced, lens luxation-induced). Diagnostic standards for IOP measurement and gonioscopic evaluation are reinforced. The management strategy is tripartite: immediate pressure reduction (osmotic agents, topical medications), surgical intervention (cyclophotocoagulation, aqueous shunts), and long-term monitoring protocols for the fellow eye prophylaxis. Differential diagnoses for hypotony are also addressed. Section III: Diseases of the Posterior Segment Chapter 7: Lens and Vitreous Disorders Disorders of the lens, primarily cataract formation, are examined in depth. Cataracts are classified according to etiology (diabetic, traumatic, inherited) and morphology (nuclear sclerosis differentiation is crucial). Surgical management, focusing on phacoemulsification techniques, instrumentation updates, and management of postoperative complications (e.g., lens capsule rupture, retinal detachment), forms a major component of this chapter. Vitreous changes, including asteroid hyalosis, synchysis, and vitreous hemorrhage, are evaluated concerning their impact on retinal visibility and prognosis. Chapter 8: Retinal Pathophysiology and Degenerative Diseases This chapter delves into the complex structure and function of the canine and feline retina. Focus areas include inherited retinopathies (e.g., Progressive Retinal Atrophy, generalized vs. central forms), vascular diseases (e.g., sudden acquired retinal degeneration syndrome—SARDS, retinal detachment secondary to systemic hypertension), and infectious causes (e.g., fungal chorioretinitis). Electroretinography (ERG) interpretation is provided as a critical diagnostic tool for differentiating functional deficits from anatomical lesions. Advanced imaging modalities, particularly spectral-domain OCT, are utilized to illustrate subtle changes in photoreceptor layer thickness associated with early disease progression. Chapter 9: Diseases of the Optic Nerve and Visual Pathways Optic nerve health is directly linked to the integrity of the visual pathway. This section details the etiology, diagnosis, and prognosis of optic neuritis (inflammatory vs. compressive) and optic nerve hypoplasia. Diagnostic methods rely heavily on advanced cross-sectional imaging (MRI) to assess retrobulbar structures and rule out intracranial masses compressing the nerve or chiasm. Treatment protocols emphasize the judicious use of systemic anti-inflammatory and immunosuppressive therapy. Section IV: Ocular Surgery and Specialized Topics Chapter 10: Principles of Ophthalmic Surgery This chapter provides a surgeon-centric overview of key operative procedures. It covers microsurgical principles, including magnification use, irrigation/aspiration management, and suture material selection tailored for the delicate ocular tissues. Detailed step-by-step guides are provided for common procedures such as third eyelid gland excision (with emphasis on recurrence prevention), deep corneal stromal wedge resection, and placement of subconjunctival implants. Chapter 11: Ocular Tumors and Neoplasia A systematic approach to ocular oncology is presented, covering common tumors of the eyelid (e.g., squamous cell carcinoma, meibomian gland adenoma), globe (e.g., melanoma), and orbit. Diagnosis relies on fine-needle aspirate cytology, biopsy, and advanced staging using CT/MRI. Treatment modalities discussed include surgical excision (with margins assessment), radiation therapy protocols, and chemotherapeutic applications for uveal and orbital malignancies. Prognostication strategies are clearly outlined based on tumor type and stage. Chapter 12: Oculocutaneous Syndromes and Systemic Associations The final chapter emphasizes the interconnectedness of ocular health and the rest of the body. It comprehensively reviews dermatologic manifestations involving the eye, such as Sebaceous Adenitis, VKH-like syndrome (Uveodermatologic Syndrome), and systemic infectious diseases (e.g., Blastomycosis, Ehrlichiosis) presenting with ocular signs. Management protocols integrate systemic therapy recommendations from relevant specialists. Furthermore, the chapter addresses pharmacologically induced ocular toxicity, particularly concerning long-term use of systemic anti-neoplastic or immunosuppressive agents.

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我必须得提到这本书在“专业术语的解释与本土化”方面所做的努力，这对于非英语母语的读者来说，简直是太友好了。虽然这是一本原汁原味的专业著作，但它的叙事风格非常平易近人，它有一种将复杂概念“翻译”成易于理解的临床语言的能力。很多专业的皮肤病学术语，初次接触时会让人望而生畏，但作者总能巧妙地将这些术语融入到具体的临床场景中进行解释，让你在不知不觉中就掌握了它们的确切含义和应用语境。这种教学方法避免了枯燥的词典式查阅，而是采用了“情景教学法”。同时，书中对一些新出现的治疗药物和概念的介绍，也保持了极高的前沿性。它不会让你感觉手中的是一本过时的旧书，而是能感受到作者对领域最新研究的持续关注和整合。阅读这本书的过程，更像是一次与领域内顶尖专家的深度对话，他们不仅传授了知识，更传递了对待科学严谨求实的态度，这种潜移默化的影响，远比单纯记住几个治疗方案要宝贵得多。

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对于需要处理复杂、慢性皮肤病病例的兽医来说，这本书的价值在于它对“难治性”疾病的处理策略进行了系统化的梳理和挑战。很多教科书在谈到慢性复发性皮炎时，往往会陷入一个“用药-好转-停药-复发”的循环描述中，但这本书却致力于打破这个怪圈。它深入探讨了皮肤屏障功能障碍在慢性炎症中的核心作用，并花了大量篇幅讲解了现代皮肤营养学和辅助治疗手段的结合应用。我特别欣赏它对“环境因素”和“生活质量”的重视。在谈到特应性皮炎的管理时，它不仅仅关注抗组胺药或皮质类固醇的使用，而是强调了如何通过优化环境控制、皮肤护理频率、甚至心理因素来协同降低炎症负荷。这种多维度的、以患者为中心的治疗哲学，在当前推崇循证医学和全人护理的时代背景下，显得尤为可贵。我感觉，这本书教会我的不仅仅是如何“治好”一次发作，更是如何“管理一生”的皮肤健康，这是一种更高级别的专业素养的体现。

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这本书的配图和图表质量，绝对是顶级的视觉盛宴，这对于依赖视觉学习的皮肤病学领域来说，简直是王道。很多皮肤病，尤其是在早期或非典型表现时，仅靠文字描述是极其抽象和容易混淆的。但是，这本手册中的病理组织学图片，色彩还原度和对比度都达到了专业出版的水准，让你一眼就能分辨出嗜酸性粒细胞的浸润和中性粒细胞的聚集有何不同。更不用说那些临床实景照片了，它们精准地捕捉了各种皮损的形态——从丘疹、脓疱到色素沉着和苔藓化，每张图片都配有精准的病理学注释，使得“看图识病”不再是空泛的口号，而是可以切实执行的技能。此外，书中穿插的大量流程图和决策树，设计得极其精妙，它们将复杂的诊断和治疗路径简化成清晰的逻辑步骤，极大地提高了查找和应用信息的效率。当我在急诊处理一个不明原因的皮疹时，能够迅速在脑海中构建起这些视觉化的导引路径，这无疑大大缩短了诊断时间，避免了不必要的试错。

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这本书简直是兽医学习者和临床实践者的福音，尤其是像我这种对皮肤病学充满好奇但又时常感到无从下手的“新手村”选手来说。它就像一本武功秘籍，但又不是那种晦涩难懂的古籍，而是经过精心编排、图文并茂的现代教材。我尤其欣赏它在基础知识构建上的扎实程度。从最基础的皮肤生理结构、病理生理机制，到各种常见的皮肤病原体识别，这本书都提供了极其详尽的阐述。我记得有一次在处理一个棘手的瘙痒病例时，我翻阅了关于过敏反应那一章节，作者对I型到IV型超敏反应在犬猫皮肤上的具体表现和分子机制的讲解，清晰得仿佛在进行一次现场的解剖教学。它不像有些教科书那样仅仅罗列事实，而是深入剖析了“为什么会发生”以及“我们该如何从根本上理解它”，这种深度对于建立稳固的临床思维至关重要。书中对诊断流程的梳理也极为人性化，它没有一味推崇昂贵的检测，而是强调了如何通过细致的病史采集和基础的皮肤刮片、细胞学检查来锁定方向，这对于资源有限的基层诊所来说，简直是雪中送炭的宝贵经验。读完这部分内容，我感觉自己像是学会了如何用最锋利的工具，而非蛮力去拆解复杂的皮肤问题。

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这本书的结构安排简直可以用“教科书级别的范本”来形容，它在广度与深度之间找到了一个近乎完美的平衡点。我特别喜欢它处理不同皮肤疾病时的系统性方法论。例如，在讨论到内分泌性皮肤病时，作者并没有简单地堆砌不同激素水平的参考值，而是构建了一个清晰的鉴别诊断树。从最常见的库欣综合征到甲状腺功能减退，每一种疾病的临床表现、实验室检测的金标准、以及针对性的治疗策略，都被拆解得井井有条。最让我感到惊艳的是，它没有止步于标准的治疗指南，而是加入了许多专家在实际操作中积累的“灰色地带”处理技巧。比如，在一些复杂的、对标准治疗反应不佳的病例中，书中会穿插一些关于免疫调节剂选择的细微差别，或者如何根据特定品种的遗传倾向来调整药物剂量的心得体会。这种从理论到实战的无缝对接，让这本书的价值瞬间提升了一个档次。阅读过程中，我常常会停下来，对照我近期遇到的实际案例，这本书提供的视角总能帮我找到那个被我遗漏的关键线索。它不仅仅是一本参考书，更像是一位经验丰富、言传身教的导师在耳边低语。

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