My pet is unwell, or not quite themself

+ How we work it out

The process of diagnosis often involves ruling out conditions, as often as knowing exactly what is the cause. In vague situations we may look to ensure the health of major organs as a starting point whilst also continuing to examine and assess how diseases develop over time.

To reach a diagnosis, we tend to follow a common process:

• We start with the history and background of your concern
• Conduct a physical examination
• Create a working differential diagnosis list
• Determine what further investigations we require to rule in or out diagnoses
• Determine best course of treatment
• Recheck following treatment and repeat steps 2 to 5 if no resolution

Whilst appearing to be simple steps, the complexity is in the detail.

+ What is a differential diagnosis list?

A differential diagnosis list is a list of possible causes of an illness. The more vague the presenting, or clinical, signs, the larger the list. In particularly complex cases, or where initial treatment has not worked, we use frameworks to help structure our thoughts, as an example, the pneumonic VITAMIN-ED. This breaks down as:

V Vascular

I Idiopathic (No cause identified), Iatrogenic (Caused by a medicine)

T Traumatic

A Anatomical, Autoimmune

M Metabolic

I Infections: Bacterial, Viral, Fungal, Parasitic

N Nutritional, Neoplastic (Cancerous)

E Endocrine

D Degenerative

+ Are tests really necessary?

This depends on what we are trying to understand. As stated, in vague presenting signs we will want to extend our physical examination to assess organ function by runing blood tests. Sometimes we use treatments as a type of test, where it is essential to re-assess your pet following a treatment course to assess how they have responded.

Together with the test results and our list of possible causes we are able to add to the picture of your pets health.

+ How long does the treatment take?

The initial examination will take 15 minutes, after which a treatment, or need for further investigations will be decided.

+ How many visits are required?

This depends on the diagnosis. For more subtle conditions, or complex cases, several appointments will be needed.

+ Is a blood test showing healthy organs a waste of money?

No. In any situation where you are concerned about the health of you pet, a positive, healthy blood test is good news. Whilst it may frustrate identifying what will be causing your pet to feel unwell, knowing organs are unaffected and in good working order is a good place to be.