What are diagnostics? Can my doctor use language that I understand?

When pets are sick our first instinct is what we need to do to help them. For human doctors this is a little easier because they rarely have to deal with the financial aspect of who is going to pay the bill and when. But we find it very helpful, in stressful situations, when the owners understand what we are asking of them and why.

Dr. Marcario wrote me a blog on some of the most common diagnostic tests for common problems and why they are each so important; so that one day if you find yourself in a situation needing to make these decisions, you will go into this a little more understanding of what you might find yourself paying for.

When your pets become ill it can be a very emotional time.  Sometimes illness comes on quickly and sometimes it creeps up on your pets. At College park Road Veterinary Clinic we are committed to doing all we can to diagnose your pet so we can treat him/her as specifically as possible.

One of the things about being a veterinarian that I love the most is solving the puzzle of the ill patients. What’s wrong? How do I make this pet feel better? Can I cure this pet?  The history we receive from you, the pet owners, and our physical exam and two important tools in learning how we should gear our diagnostics and treatment. However, we require diagnostic testing to get a more specific direction.  When your pet is will, we will make you a diagnostic plan to gather more information regarding your pet’s condition.  I want to take this time to review some options you may see on your diagnostic plans and what information they give us.

1) Fecal exam- tests for intestinal worms and single cell parasites that commonly cause gastrointestinal upset. You will see this on your diagnostic plan if you pet presents with diarrhea or nonspecific GI signs and you pet hasn’t had a check recently.

2)Heartworm test- This can be for dogs or cats. If you pet is presenting with coughing, trouble breathing, vomiting, inappetance, distended abdomen, heart murmur  or your pet has not had a heart worm check recently you will see this on your plan.

3)FeLV/FIV- This is a test for cats.  These are diseases that can present any time in the cat’s life, so testing in kitten hood does not guarantee your cat will never have these diseases. Often we see cats present with fever, upper respiratory signs, anemias, pneumonia, abscesses, stomatitis(infections, redness and swelling in the mouth) and general malaise. Almost any time a cat presents ill we recommend retesting the FeLV and FIV status.

4)Chemistry Screen- There are many chemistry screens available from very extensive to extremely limited.  We make recommendations based on how ill your pet is and clinical signs. These tell us what the liver, kidneys, electrolytes are doing. Sometimes abnormalities in these can lead us down a more specific road of diagnostics and treatment.

5)CBC or Complete blood Count. This test tells us about how the red blood cells and white blood cells are behaving. Abnormalities in these can give us clues to what disease process is happening in your pet and how quickly we need to treat.  Other tests associated with the CBC that are done separately are coagulation testing to see if the blood clots properly. Reticulocyte count tells us if the bone marrow is making red cells. Pathology review allows a board certified pathologist to evaluate the red blood cells specifically to see how they look and if they are damaged or toxic.

6)UA or Urinalysis- This is an evaluation of the urine. Typically we will obtain and sterile sample but cystocentesis with the ultrasound. That means we use sonography to visualize the urinary bladder and get a sample with a needle.  This test allows us to see the concentration of the urine, which represents the water content of the urine, The more water the lower the concentration. The lower the concentration the more we have to worry if there is a problem. Low urine concentrations can come from problems in the urinary system as well as problems in other major organs and hormone dysfunctions. It also checks for sugar in the urine(as in diabetes, cushing’s disease, Fanconi syndrome), ketones, proteins, and evaluates the cellular component of the urine to look for red cells, white cells, bacteria, crystals and casts.  Casts can indicate a direct problem in the kidneys. Since we often see changes int he urine before we see changes in the blood and urine test is usually recommend when we are working up a sick patient.

7) Urine culture-  While a UA can tell you that there is bacteria in the urine, a urine culture tells us exact what species of bacteria is groaning and which antibiotics it is susceptible to. The test generally takes about a week to get results from. At the lab, the urine is placed in a special medium to grow the bacteria. Once the bacteria grows, it is placed in a medium of antibiotics to see which ones will kill them. Without this test, we don’t know if the antibiotics we prescribe your pet for lower urinary tract signs, are able to kill off the infection. In essence, skipping this test when recommended could potentially cause you to spend extra money by causing us to guess at which antibiotics will work.

8) X-rays or radiographs- This is a form of imaging. It is a two dimensional picture of the insides of your pet.  X-rays help us to determine if there is anything on the inside we cannot feel or hear that we need to be concerned about.

So, as you see, each test provides us with a different piece of information that helps us put your pet’s puzzle together. Each piece is important, but our doctors can guide you in the event of financial constraint as to what is most important. In some cases all the diagnostics are important and it might be tough for us to guide you through that, but we will do the best we can.

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