Sometimes being a veterinarian feels very much like being Sherlock Holmes - using your detective skills to put all the pieces of the puzzle together and obtain a diagnosis! And just like a detective we can only get the answers if we are given enough clues to solve the riddle - and this is where it not only comes down to your veterinarians skills but also your skills as an owner.
In this post I will go through the main puzzle pieces veterinarians use to get an answer for you and your pet, and try to explain how you can help us.
Firstly the History! Perhaps the most important part of the diagnostic riddle that is vet science. With out a good history from an owner us vets have almost no chance of getting an answer, nor do we have a place to start our investigations. Think of the history as your veterinarian interviewing suspects, checking out the scene of the crime and reviewing the victims past! To help your veterinarian there are a few things you should think about before coming to the vet:
- Give us your pets past - are they on medications, are there other pets in the house, what do they eat, what is a normal day in the life of your furry friend and is there any relevant medical history we should know about
- When did the symptoms start - a 'while' does not help us! Try to narrow it down to with in days (or even better hours!) of when you first started noticing a problem
- What are the actual symptoms - for example many people tell us there dog is vomiting - but on closer exam we realize the dog is actually regurgitating - which gives rise to a very different list of possible causes. Although we don't expect everyone to know the difference, describing in detail to your vet what has happened really helps. And we will ask you gross questions - like what it smelt like, felt like, looked like and even tasted like... just kidding don't taste - it but the devil is in the details!
- Consider keeping a little diary of symptoms if it is an ongoing issue, this may help you, and the vet, recognize trends or similarities
- Bring us samples! We love samples... is your cat having trouble urinating? well bring us wee! Is your dog having diarrhea - we'd love to see it. Or if your pet is having seizures, limping or just plain weird symptoms video it! It really does help us to see what you are seeing.
- Try to answer concisely - although we love chatting to our clients many of us are restricted to twenty (or sometimes ten!) minute consults - so try to focus on what we need to know now.
The second part of our veterinary crime scene is the physical exam. This is where Sherlock would be examining the body. Thankfully our patients are still breathing (usually) making this more fun for us. Unfortunately for vets many pets are frightened in consult and won't always give a lot away. For example they may limp really badly at home, but then walk into the clinic like nothing has happened and when we feel their leg they don't react at all! This is part of their instincts - not to show weakness against potential enemies - but makes it hard to get a diagnosis from a clinical examination. Go into your vet with the expectation that we may not get answer just from the consult.
And the final part of our puzzle is diagnostic tests! Although veterinary fees are high (if only they made pet medicare...) with out testing it can be hard for us to get an accurate diagnosis. It would be like asking old Sherlock to tell you who killed the victim just by looking at the body, with no help from forensics. An important thing to remember is that each test we run helps rule things out but does not guarantee a diagnosis. For example we may run a blood test, which may tell us your cat has high liver enzymes, but we still can not tell you exactly which disease your cat has all we know is it is something effecting the liver. So generally we recommend multiple tests so we can give the most accurate treatment and obtain a diagnosis.
So what about when extra testing is not an option due? Well then we do what veterinarians call 'empirical treatment'. This is when we prescribe a treatment that will fix the most likely diagnosis. For example giving anti-inflammatories to a limping dog, with the hope they've simply sprained a joint. But remember when your veterinarian does this we are essentially making an educated guess (a very educated one) but it is a guess all the same. 80% of the time our guess will be on the money, but sometimes we do end up needing those extra tests.
So I hope this helps put into perspective the huge amount of information that comes together to form the diagnosis a veterinarian gives your furry loved one. Just remember - although Sherlock always got his guy veterinary medicine isn't a movie! So sometimes we may never know exactly what went on with your pet... but rest assured we will do everything we can to make them better!