Syllabus

TU0029 Clinical veterinary medicine incl population medicine and veterinary public health with applied epidemiology and epizootiology, 70.0 Credits

Subjects

Education cycle

Modules

Advanced study in the main field

Grading scale

Language

Prior knowledge

Objectives

The course provides knowledge and skills to be able to perform primary veterinary care in the clinic and in ambulatory practice, independently and with a professional and scientific approach.

Upon completion of the course, the student shall be able to:

Generally for the course as a whole

• analyse, evaluate and correctly apply hygiene procedures, infection control, animal welfare and occupational safety in veterinary practice
• apply a professional approach towards animal owners and patients, co-workers and colleagues
• communicate in a professional manner orally and in writing with animal owners, co-workers, colleagues, authorities and companies
• keep various types of medical records and write referrals, referral responses, certificates and reports in accordance with applicable regulations
• analyse and evaluate financial consequences and ethical problems related to diagnostics and different treatment options, and identify their impact on animal welfare and food safety
• explain the impact of medicines on the development of resistance and their ecotoxicological consequences from a sustainability perspective.
• identify and take a stand on ethical issues and assess animal welfare and animal protection objectively in real situations

Ambulatory practice

• communicate with animal owners in a professional manner and independently take a clinical history, select and perform clinical examinations, demonstrate the ability to evaluate clinical findings, identify problems, suggest differential diagnoses and, if possible, diagnose the most common and significant diseases in field practice
• establish a rational diagnostic plan by supplementing clinical examination with appropriate tests and explain additional diagnostic possibilities and testing that may be considered
• propose, perform and evaluate relevant treatment options and prophylactic measures, at individual and herd level, taking into account the needs of the animal, the attitude of the owner, economic circumstances, ethical assessment, infection control and animal welfare
• perform medical and simple surgical treatments under field conditions
• assess prognosis at individual and herd level and assess when referral may be appropriate. 

Anaesthesiology

• choose method and perform appropriate sedation, local anaesthesia, dissociative anaesthesia, general anaesthesia, treatment and assessment of painful conditions and euthanasia based on the animal's general condition and planned treatment
• choose and perform action for anaesthesia-related complications
  choose appropriate method and perform euthanasia based on clinical situation and animal species.

Diagnostic imaging

• describe and evaluate the differences between different diagnostic imaging methods
• describe and practically apply radiation-safe working methods
• describe the principles, applications and uses of ultrasound in the examination of horses, dogs and cats
• identify the most common changes caused by diseases of the thoracic cavity, abdominal cavity and skeleton in radiographs of dogs and cats, and the most common changes caused by diseases of the extremities in radiographs of horses.

Diagnostic pathology

• perform autopsies of the most common domestic animals in Sweden, including examination of body and organs and sampling
• identify, describe and assess the most common morphological changes in body and organs using correct medical terminology
• assess morphological findings at autopsy and relate them to clinical data to formulate a probable diagnosis and explain the course of disease through clinical reasoning.

Porcine medicine

• explain the clinical changes and causes of the most common and significant diseases in swine
• identify abnormalities in a clinical examination and perform blood sampling
• explain the principles of performing normal castration of male pigs
• propose, perform and evaluate appropriate treatment at individual and herd level
• analyse and evaluate production reports and slaughter injury statistics, as well as results from various health and environmental tests and examinations in order to diagnose the most common and significant diseases in swine
• propose treatments and preventative measures for health problems in herds, which requires knowledge of management, feeding, and environmental factors affecting state of health. Suggested treatments and preventative measures should also consider resistance development, infection control, animal welfare, food safety, the environment and the economy.
• conduct routine visits in pig herds with conditional use of medicines.

Equine surgery and medicine

• handle the horse in an examination and treatment situation, with and without restraint
• perform sedation of the horse, apply principles of analgesia and perform common nerve blocks and other common local anaesthetic procedures.
• identify and describe common and significant diseases and injuries in horses, and explain the aetiology, pathogenesis and pathophysiology
• explain the principles and suggest measures for the care of acutely ill animals
• independently take a history and identify the cause of the visit, perform relevant clinical examinations within a given time frame, independently evaluate and interpret clinical findings, propose differential diagnoses and subsequently develop an adequate investigation pathway, and if possible make a diagnosis and include ethical and financial perspectives
• independently perform commonly used sampling methods, tests and medicine administrations
• propose and justify relevant extended clinical diagnostics, evaluate analyses and analysis results based on the clinical situation and explain reasons for deviations in the results
• propose, justify and evaluate adequate treatment, including prognosis, and advise on appropriate prophylaxis and follow-up care
• evaluate limitations and possibilities to perform surgical and medical treatments under field conditions
• describe common surgical procedures, including postoperative care and be able to perform some simple surgical procedures while observing good/correct aseptic and surgical techniques
• explain the pathophysiology of common postoperative complications and propose a plan for postoperative care
• assess the need for referral, apply the appropriate referral procedure, and also assess when euthanasia is the most appropriate action
• reflect on working methods, procedures and collaborative roles in clinical work
• discuss, analyse and propose different management practices, prophylactic treatment and feeding, both at individual horse and herd level
  -independently perform all elements of an equine pre-purchase examination/horse vetting.

Ruminant medicine

• independently take a history, select and perform relevant clinical examinations, select and collect relevant samples and perform simple diagnostic tests based on differential diagnosis, and synthesise, interpret and evaluate findings from these, at individual and herd level
• explain diseases and injuries, including pathogenesis, pathophysiology and predisposing factors, and diagnose the most common and significant diseases in Sweden, including epizootic diseases of cattle, sheep and to some extent goats
• propose, discuss, perform and evaluate appropriate treatment and preventive measures, and assess prognosis for common and significant injuries, disorders and diseases, at individual and herd level
• describe common surgical procedures including their aftercare, and be able to perform some simple surgical procedures on cattle, sheep and to some extent goats
• describe the most common post-operative complications and suggest a plan for postoperative care
• discuss and evaluate different management routines, prophylactic measures and nutrition, in preventive ruminant medicine at individual and herd level
• plan and conduct herd health investigations and to some extent interpret and assess herd health statistics
• interpret and discuss results of herd data, and make an assessment of the state of health in cattle herds based on results of examinations and herd data
• explain how health problems in cattle can sometimes be related to different husbandry and production practices
• communicate with animal owners in a professional manner about history, examinations, treatments and preventive measures.

Meat inspection and food control

• independently carry out ante- and post-mortem inspection, assess and decide on the handling of live animals and the use of meat and animal products in accordance with current legislation
• perform inspection and smaller-scale audits at slaughterhouses in accordance with current legislation.

Population medicine

• describe the most common forms of animal husbandry for farm animals and horses,
• explain how background knowledge about the population impacts the clinical decision-making process,
• use ethological and epidemiological methodology to investigate how different animal related and environmental factors impact the health, behaviour, welfare and production of animals
• compile, critically assess and discuss scientific results and relate the significance of the results to animal husbandry, disease and clinical work,
• Perform objective assessment of animal welfare.

Professional approach

• demonstrate the ability to analyse and identify the importance of self-awareness and empathy for a professional approach and a sustainable professional situation
• handle people's different points of view and values
• identify their need for further knowledge and continuous development of skills
• demonstrate active, reflective listening skills as a basis for clarifying the expectations of the animal owner in the clinical situation
• communicate with a professional attitude using language appropriate to the individual animal owner and provide support in their decision on action for the individual animal or herd

Reproduction

• communicate with owners in a professional manner and independently take a clinical history, select and perform clinical examinations and tests relevant to the animal species within the field of reproduction, based on differential diagnostic assessments, and also summarise, interpret and evaluate findings from these, both at individual and herd level.
• explain the normal sexual functions of male and female ruminants, pigs, horses, dogs and cats
• describe and evaluate disorders of the genital organs of ruminants, pigs, horses, dogs and cats, as well as during pregnancy, parturition and post-partum, with regard to aetiology, prophylactic measures and pathogenesis, clinical signs of disease, diagnosis and therapy
• evaluate, propose and carry out methods for regulating reproduction that are appropriate to the animal species in question
• diagnose pregnancy and carry out antenatal examinations
• diagnose, treat and evaluate obstetric cases
• apply knowledge for the evaluation, diagnosis and treatment of mammary gland disorders
• explain the most common measures of fertility and analyse data concerning reproduction and udders at individual and herd level
• identify and evaluate animal welfare and ethical aspects of domestic animal reproduction
• describe the use of reproductive biotechnology in domestic animal breeding and the principles of reproductive biotechnology techniques, including artificial insemination
• describe how artificial insemination is used in breeding and to prevent the spread of disease, including how to reduce the use of antibiotics
• carry out routine herd visits and preventive work in reproduction and udder diseases on farms with production animals
• interpret and discuss the results of herd data, and make an assessment based on the results of examinations and herd data.

Small animal surgery and medicine

• communicate with animal owners in a professional manner, and independently take a clinical history and identify the cause of the visit, perform relevant clinical examinations within the given time frame, evaluate and interpret clinical findings, and then develop an appropriate course of investigation, suggest differential diagnoses and, where possible, make a diagnosis
• propose and evaluate relevant clinical pathology tests and test results and other diagnostic investigations based on the clinical situation, and explain the reasons for deviations in the results
• explain diseases and injuries, including aetiology, pathogenesis and pathophysiology, for the most common and significant diseases and suggest, perform and evaluate appropriate treatment, including prevention and prognosis
•  perform common diagnostic examinations and treatments, and independently interpret the results of diagnostics
  describe the principles of emergency care of acutely ill animals
  perform basic examinations, tests and medicine administration
  perform simple surgical procedures under supervision
• describe the most common postoperative complications and propose a plan for postoperative care
• perform dressing of wounds, including surgical wounds
• propose follow-up and rehabilitation after surgical procedures
• explain various care routines, including applied nutrition, in preventive healthcare and perform vaccinations and inspections.

Veterinary public health science with applied epidemiology and epizootiology

• highlight the role of the veterinary profession and veterinary medicine in public health,
• apply veterinary knowledge to public health-related issues,
• identify and explain animal-related public health risks,
• -explain the basics of Swedish contingency plans for epizootic diseases
• describe in detail the most important diseases covered by the legislation on epizootic diseases and zoonoses, and identify aspects that are important for their detection, control and eradication
• apply the legislation on epizootic diseases and in various veterinary capacities act upon suspicion of a serious contagious animal disease
• explain strategies for prevention, control and eradication of the diseases covered by the legislation on epizootic diseases and zoonoses
• apply epidemiological methods to issues and problems concerning animal and public health.

Content

The course provides training in diagnosing, treating and preventing diseases and injuries affecting Swedish domestic animals, particularly cattle, horses, pigs, dogs, cats, sheep, goats and poultry; under Swedish conditions and according to Swedish standards.

In this course, the preclinical, more theoretical, knowledge of animal welfare, animal protection and ethics is applied by the students in practical, real-world situations. These three subjects are therefore integrated into all course components and are studied in greater depth in this subsection.

Practical skills training is included in all modules of the course, and is given, at the University Animal Hospital, the Ambulatory clinic, the Ruminant medicine clinic, Lövsta pig and cattle herds, other herds with farm animals, slaughterhouses or at SLU Pathology, depending on the course elements. The majority of instruction takes place during normal working hours on weekdays, but a small number of weekend and evening sessions are included.

In addition, the course consists of lectures, seminars, rounds, case reviews, practical exercises, farm and herd visits, and visits to food establishments.
The course covers various aspects of ecological, socioeconomic and occupational sustainability perspectives. The course includes teaching on live animals, animal cadavers, organs, tissue materials and models.

The course consists of the following components:

• Ambulatory practice, 3 credits
• Anaesthesiology, 1.5 credits
• Diagnostic imaging, 3 credits
• Diagnostic pathology, 4.5 credits
• Porcine medicine, 3 credits
• Equine surgery and medicine, 10 credits
• Ruminant medicine, 9 credits
• Meat inspection and food control, 3 credits
• Population medicine, 6 credits
• Professional approach, 0,5 credits
• Reproduction, 6 credits
• Small animal surgery and medicine, 13,5 credits
• Veterinary public health with applied epidemiology and epizootiology, 7 credits

Ambulatory practice

Previously acquired theoretical and practical knowledge and skills are applied in ambulatory practice. The tuition is based on clinical cases from animal owners and is problem-based using cases commonly encountered in large animal ambulatory practice. In each individual case, a case history is taken, followed by a thorough clinical examination, possibly supplemented by sample collection. This is the basis for diagnosis, prognosis, and the proposal and carrying out of appropriate treatment. During the course, students practice selecting, calculating dosage and performing sedation in the field.
Herd analyses and preventive animal health work of varying scope are carried out in cattle, sheep and pig herds and in horse populations. Clinical teaching and participation in on-call activities is mandatory.

 Anaesthesiology

The module provides a practical clinical application of theoretical knowledge of sedation, dissociative and general anaesthesia and analgesia for animals. Training is given in assessment of preoperative status, induction, intubation, monitoring and maintenance of anaesthesia, and assessment and management of anaesthesia-related complications and pain. The module practises selection of appropriate treatment in the context of changing physiology. The student will be present during euthanasia of animals.

Diagnostic imaging

Instruction is provided in the form of seminars, rounds, theoretical and practical exercises, and web-based case exercises. Students work independently with case descriptions to practice writing radiological statements, which are discussed in seminars. Practical exercises in radiation safety work practices with follow-up, as well as participation in some rounds and seminars are compulsory.

Diagnostic pathology

The module is based on compulsory participation in autopsy activities with clinical cases, including rounds. This includes exercises in basic autopsy techniques with a review of hygiene and infection control in autopsy work. It also includes practice in identifying, assessing and orally presenting macroscopic changes and medical record writing. Clinical reasoning skills are practiced through synthesising findings and clinical data to into probable diagnosis, pathogenesis and possible differential diagnoses. Results are presented orally and in written reports throughout the module and the clinical reasoning skills are assessed during a specimen autopsy with associated medical record writing.

In addition, the students participate in a compulsory tutorial regarding tissue sampling and participates in an in- depth case review seminar. The case review seminar includes histopathological assessment, a detailed description of the pathogenesis and a discussion regarding possible differential diagnoses. Great emphasis is placed on training in the use of correct medical terminology.

Porcine medicine

Students are trained in the diagnosis and treatment of various diseases through theoretical seminars, case reviews, practical exercises and group farm visits. Emphasis is also placed on preventive healthcare. The farm visits involve visits to different types of pig herds. There will be a written report and oral presentation of findings and recommendations after the visits and seminar. Farm visits, practical exercises, investigation cases and seminars are compulsory, as is active participation in all practical elements that arise during farm visits. It is compulsory for everyone to take blood samples from pigs, and to examine, diagnose and treat common diseases in piglets and fattening pigs. The module covers the various euthanasia methods used on pigs in practice.

Equine surgery and medicine

This module provides theoretical knowledge with practical application on common and important diseases and injuries affecting horses. The student applies knowledge of scientific thinking and critical review in the investigation of cases, case presentations and rounds.
Instruction is in the form of lectures, seminars, demonstrations, and clinical practical skills training on teaching animals as well as on patients at the equine clinic. Training is given in taking a history, conducting clinical examination and other relevant investigations, making possible differential diagnoses, and formulating treatment strategies. Applied nutrition is an integral part of rounds and investigation of different types of cases. The module also includes performing sedation of the horse, applying principles of analgesia and performing common conduction anaesthesia. Students will practice dissociative anaesthesia at a level suitable for clinical use in the field. The principles of pharmacological euthanasia and mechanical stunning of horses are also included in the module. Daytime clinical instruction, on-call activities, and practical exercises and some seminars are compulsory.

Ruminant medicine

Through seminars, group discussions, demonstrations, exercises and clinical practical teaching, students are trained to diagnose, assess the prognosis of, prevent and treat various diseases of cattle, sheep and to some extent goats, at individual and herd level, and to recognise clinical signs of epizootic diseases in ruminants.
Teaching in applied nutrition is included. The teaching provides the student with the knowledge to select and perform appropriate sedation, local and dissociative anaesthesia, treatment of painful conditions and euthanasia, based on the general condition of the animal and the planned surgery.
The student shall apply knowledge of pathophysiology and scientific thinking and critical examination in the context of seminars, group discussions and investigation of clinical cases. The clinical practical skills training includes working with healthy and sick animals and animal groups, including herd visits. Oral and written reports are included. Seminars, presentations, demonstrations, exercises and clinical practical skills training are compulsory.

Meat inspection and food control

This module includes compulsory practical sessions, exercises and seminars in food control with the application of current legislation.
The module covers slaughter techniques, slaughter hygiene and various aspects of food control in slaughterhouses: food safety, animal welfare and epizootiology. The course provides practical training in ante- and post-mortem inspection, including food chain information (FCI), live animal inspection, meat inspection, cold storage and butchering of cattle, pigs and sheep. Students practice making decisions about animals and about meat with various inspection findings. The course includes exercises in inspection, auditing, sampling, HACCP (Hazard Analysis and Critical Control Points) and animal by-products. The module deals with the professional approach to communication with companies, authorities and colleagues.

Population medicine

The course covers how heredity and environment affect health, behaviour, welfare and production/performance in domestic animal populations, and how these can be measured and described. An introduction to the role of domestic animals and to animal health in a global and historical perspective is given. The course also provides an insight into practical animal husbandry. Lectures highlight, explain and discuss theoretical concepts and contexts. Exercises include statistical, epidemiological and genetic calculations. During study visits, different animal environments and the conditions of agriculture are demonstrated and discussed. The study visits and certain exercises are mandatory.

Professional approach

This module deals with the student's ability to show respect and consideration for others. This can be done by demonstrating the ability to actively listen and adapt their communication to suit the context. The module also covers the handling of difficult conversations, and how communication affects compliance. Upon completion of the course, students shall be able to identify, reflect on and demonstrate respect for their own and others' values and their implications in veterinary care. Students shall also be able to identify and reflect on their own and other professionals' competencies and interact with other professionals in veterinary healthcare.

Reproduction

Teaching is in the form of lectures and compulsory participation in seminars, demonstrations and practical clinical instruction. The module covers both the normal sexual functions in females and males and disorders of sexual functions in different animal species (cattle, small ruminants, pigs, horses, dogs and cats), i.e. it includes aetiology, pathogenesis, clinical signs of disease, diagnosis, prophylaxis and therapeutics.
The student practices basic gynaecological examination using methods appropriate for the respective animal species. In mares and cows, the student is trained to describe normal cyclical changes, changes during pregnancy, and changes in case of reproductive disorders using rectal examinations. Basic andrological examination, including semen evaluation, is demonstrated and discussed. Insemination techniques are also covered.
Visits to farms with production animals give the student insight into overall reproduction and udder health at herd level.
Relevant measures and treatment strategies for disorders and diseases of the reproductive organs and udder are discussed and applied to cases.
Emphasis is placed on the knowledge and application of hygiene and occupational safety (confinement measures, ergonomics, etc.) in the context of clinical work.

Small animal surgery and medicine

This module provides theoretical knowledge and practical clinical application in small animal surgery and medicine. Training is given in history taking, clinical examination, diagnosis and proposing treatment strategies. The module includes the supervised performance of surgical procedures and the care and treatment of acutely ill animals.
In the outpatient clinical setting, students will see scheduled primary cases during the day and acutely ill animals during both daytime and on-call. The activities also include discussing and reflecting on ethical and animal welfare problems in animal healthcare based on the cases, and training in oral and written communication. The student is trained to plan and carry out work tasks both individually and in groups within given time frames.
Instruction covers various elements which take place in the emergency department (including clinical instruction during out of hours), the medical outpatient clinic, the surgical outpatient clinic and in the surgical wards. During rounds and seminars, students' cases will be presented and discussed together with teachers.
Practical clinical skills training in anaesthesiology is included in the module. The student will practice selecting and performing sedation and local anaesthesia, selecting and administering pre-medication, anaesthesia, and pre- and post-operative pain relief, and will be able to select the appropriate method of euthanasia for different animal species. Under supervision, students will prepare, induce, intubate and monitor anaesthesia in dogs and cats.
The module is integrated with instruction in clinical pathology, diagnostic imaging and diagnostic pathology to enable the student to analyse examination findings and synthesise the case from the clinical picture and results of tests, examinations and treatments.

The student receives training in documenting clinical work in a medically accurate manner and communicating with authorities, colleagues and pet owners. The student will be able to argue for and against different treatment strategies based on ethical considerations of the animal's and the animal owner's situation

The group seminar work, rounds/exercises and clinical instruction, including participation in on-call activities, are compulsory.

Veterinary public health science with applied epidemiology and epizootiology

This course component covers the subject areas of veterinary public health science, applied epidemiology and applied epizootiology. Veterinary public health science includes the role of veterinary medicine in public health, i.e. the application and knowledge development of veterinary responsibilities from a public health perspective regarding, for example, zoonoses, antibiotic resistance, food safety, environmental impacts on health, crisis management and social effects of animal husbandry. Applied epidemiology addresses the principles for and design of population-based studies and surveys, e.g. outbreak investigations, disease surveillance, infectious disease epidemiology and realiability of diagnostic testing.
Applied epizootiology includes national and international infection control work, with a focus on handling suspected cases of epizootic and zoonotic diseases based on epizootic and zoonotic legislation and the characteristics of the diseases concerned, epizootic preparedness and strategies for combating epizootic outbreaks in Sweden and the EU and the importance of communicable diseases in the global exchange of food, animals and animal products.
In addition to lectures, students work in groups (discussions, roleplaying, etc.) and perform project work that ends with joint group presentations. Group discussions and presentations are mandatory.

Grading form

Formats and requirements for examination

• If a student has failed an examination, the examiner has the right to issue supplementary assignments. This applies if it is possible and there are grounds to do so.
• The examiner can provide an adapted assessment to students entitled to study support for students with disabilities following a decision by the university. Examiners may also issue an adapted examination or provide an alternative way for the students to take the exam.
• If this syllabus is withdrawn, SLU may introduce transitional provisions for examining students admitted based on this syllabus and who have not yet passed the course.
• For the examination of a degree project (independent project), the examiner may also allow the student to add supplemental information after the deadline for submission. Read more in the Education Planning and Administration Handbook.

Transitional provisions

Other information

• The right to participate in teaching and/or supervision only applies for the course instance the student was admitted to and registered on.

• If there are special reasons, students are entitled to participate in components with compulsory attendance when the course is given again. Read more in the Education Planning and Administration Handbook.

Additional information

Responsible department

Department of Clinical Sciences