The Diagnostic Process

TheDiagnosticprocess

As veterinarians at the Long Beach Animal Hospital, we’re frequently asked how we can figure out what’s wrong with a sick animal—they can’t talk to us, so how are we to know what to do? This is a good question, especially when you consider the large variance in size of our patients. They can range from a 20 gram (it takes 454 grams to make up one pound) canary to a Great Dane that weighs over 220 pounds.

Here at the Long Beach Animal Hospital, we work on a wide variety of animals with different nutritional requirements and vastly different anatomies and physiologies. This adds greatly to our diagnostic dilemma. Even within the world of our two most popular species, dogs and cats, there is substantial variation from breed to breed.

Even when we work on one specific species, there is even more variation in what is considered normal. In a human, normal body temperature is 98.6 degrees F, with a variation of 0.1 degrees. A dog can have a normal temperature range from 99.5 degrees F to 102.5 degrees F—a variation of three degrees. On a hot summer day, the high end can even be at 103.5 degrees F and still be normal. It’s difficult to know what is normal for any specific pet at any point in time.

To further add to this diagnostic dilemma, many different diseases have the same symptoms. For example, a pet that is drinking and urinating more than usual could have any one of over 10 diseases that commonly cause this problem; it’s rare for a specific set of symptoms to occur in only one disease. Ultimately, it is our training and experience that allows us to come to a correct diagnosis—a proper blend of the art and science of medicine. Our training starts in veterinary school as does a physician’s in medical school. Veterinary school is only the beginning though, and as thorough as it is, it really just gives us a basic understanding of the disease process. It is in the years of practice after veterinary school that we learn the art of medicine.

Making a correct diagnosis revolves around what we term the diagnostic process, a methodical and thorough approach that takes into consideration several important parameters:

1. The type of pet and its age
Certain breeds are prone to specific diseases that might not be seen in other species. We call these breed predispositions. This information on your pet’s breed and age allows us to start narrowing down our list of the most likely causes of your pet’s problem.

2. Information from observations that someone has made about his or her pet’s behavior
This is called the history, usually carried out by one of our nurses when he or she takes your pet’s temperature and weight. Once our nurse gets this preliminary information, one of our doctors will refine it. This information is one of the most important parts of the diagnostic process.

3. The results of a physical exam
This is just as important as the history in most cases. Our doctors follow a checklist of organ systems so that this vital information is not missed. We do a thorough exam of all organ systems on every initial presentation. Not only is this information crucial to the current problem but it also identifies additional problems that you might not be aware of.

4. The results of diagnostic tests
For ill pets, we run what’s called a minimum database, which is the basic set of routine tests needed by all sick pets. This includes a blood panel, fecal exam for parasites, and urinalysis. Two other tests that are commonly utilized are X-rays (radiographs) and ultrasound. Ultrasound has revolutionized our diagnostic abilities and has almost eliminated the need for exploratory surgery when we are working on a diagnosis. This has saved substantial money for owners and significant pain and recuperation for pets.

5. If the pet got better when treatment was started
If the correct diagnosis is made and treatment is initiated, your pet should get better, but this is not always the case. Miscellaneous factors like your pet’s immune status or environment can prevent him or her from getting better even when the diagnosis and treatment are correct.

This diagnostic process is so important that our externs spend the majority of their time learning about it during their training. It starts with morning rounds before clients arrive and progresses during the day as each case is presented.

We have more detailed information on the diagnostic process. From the home page of our website, select the Diseases section and click on “Search by Species.” In the first paragraph, you’ll see the link to the Diagnostic Process: the words thought process.



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