Sick pet puzzles

It is difficult when your pet is sick. Unlike people, our pet’s cannot talk to us to let us know what is wrong, they have to let their ailments show us the clinical signs. These clinical signs are important to note when you end up taking your sick cat to the vet.  Hopefully, I’ll be able to shed some light on what goes through a vet’s mind when you bring your pet in to be seen for a sickness.

You know all those pesky questions the technicians ask you? Did she eat? Has he been coughing? Did she vomit? She did!?!, what did is look like? (Yes, we go there…not all vomit is the same. Vomiting food means something different than vomiting phlegm.) All of these questions constitute what we call a history. Knowing what your pet is doing at home starts to give us a few pieces of the puzzle.  

 More puzzle pieces fall into place once your vet has had a chance to perform a physical examination. This step helps us determine if your vomiting dog is painful in the abdomen, has a mass in the abdomen, or if the coughing dog’s lungs sound harsh. If you sit back and really pay attention to your vet performing the physical examination you should see that it is very thorough. It is easy to miss what all we do because many times we vets are asking you, the pet owner, more in-depth questions while we are performing the physical exam. The steps we take in a physical examination are usually quite methodical and almost second nature to most vets. I usually start with the lymph nodes of the chin and then go on to the ears. In fact, it is so second nature to me that when checking my own dog’s ears for wax I sometimes begin to continue on with the next step in the physical exam!

After the history and exam, some conditions are obvious and do not immediately need further diagnostics. For example, let’s take a look at Brogan. Brogan is a 4 year old lab who has been vomiting for half a day and just before his appointment he had his first bout of diarrhea.  Other than his vomiting, he has been bright, alert, and is still playing like usual. On physical examination Brogan’s temperature and vitals were normal. Palpating of his abdomen was unremarkable – no masses, thickenings, or pain noticed. He has a good appetite, but just can’t keep food down currently. My approach as a vet is to look at Brogan’s scenario and develop a list of possibilities to his illness…upset stomach, parasites, obstruction, infectious causes, and a few more.  Then I look at the likelihood of these possibilities.  If Brogan was really down and out, I usually recommend either x-rays or bloodwork.  These too, give us another, and hopefully the final piece of the puzzle. In some cases, as well Brogan, I would likely discuss with the owners that Brogan appears to be otherwise healthy and we can try to treat empirically first.  This means Brogan would receive medications for vomiting and diarrhea and if he did not improve, we then would see him back again to perform the diagnostics.

  
There are many different causes to illnesses.  As described, getting information from you, the pet’s examination, and sometimes diagnostics as well is the best way to put the pet illness puzzle together.  As veterinarians, our job is to take all of this information, figure out what is related and important to the current case, and decide the best course of action.  While these puzzles can be frustrating at times, it is one part of veterinary medicine that keeps me entertained, learning, and challenged.  There is nothing better than figuring out the correct puzzle and helping Fluffy get back to enjoying playing ball.

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