Tuesday, October 25, 2011

Get better care for your pets!

Longer, healthier lives - that's what we all want for ourselves, our families, and our pets.

How can we receive better care for our pets?  How can we help our veterinarian to more rapidly and accurately diagnose causes of illness in our pets?  YOU, the pet owner, are the key.  You may not realize how very important you are in helping your pet to get well, and the purpose of this post is to help you better understand how the medical decision making process works.

Veterinarians and human doctors are trained to notice abnormal.  For human doctors, this is a bit easier, as their patients can tell them - "It hurts when I do this" or "I feel nauseated and I don't want to eat" or "I don't have any energy" , etc.  Of course with sick pets, this is impossible.    The investigation into their illness starts with a history from the pet owner.  Is your pet eating? How much? Weight loss? Vomiting? Diarrhea? Are they drinking more or less than usual? Hiding more than usual? Do they seem reclusive or try to bite you when you handle them? Decreased activity? Any other abnormal behavior?

 I can't begin to tell you how many times a client brings in their sick pet, places them on the exam table, and then cannot answer a single one of these questions.  "He's just not right" is not a symptom, and could be any one of literally thousands of conditions.  The more information you can gather by monitoring your pet's normal behaviors, the more accurate your veterinarian's diagnostic and treatment plan will be. Of course we can run hundreds of tests costing thousands of dollars in lieu of a good patient history, but this is obviously not economical and a much slower way to figure out what's actually going on.  As a result, observation of your pet's normal behaviors and being able to notice variation from normal is a VERY important part of your task as a pet owner.  If you can't tell me what's wrong at home, it makes it much more difficult to know where to start looking. It also usually increases the cost of testing as we have to rule out many more types of illness.

After the veterinarian talks to you about your pet's history and your concerns, they will perform the physical exam.  This is where our trained eye will detect outward signs of disease -  pain, nausea, dehydration, fever, enlarged lymph notes, masses, swellings, etc. Although every veterinarian is specially trained to perform physical exams, there are many diseases which have vague outward signs, which look like other diseases, and/or which cannot be completely diagnosed with physical exam alone.

With these two components combined, your veterinarian will create a problem list.  The problem list will be followed by "differential diagnoses", or a list of the diseases that could be causing your pet's symptoms.  If you've ever watched House, you've seen a dramatized version of this in every episode. The differential diagnoses will help your doctor to systematically rule out specific causes of illness, narrowing the long list of possible causes.

Hopefully these comments help you to remember to observe your pet's normal behaviors, so that when they become abnormal, you'll be able to recognize it right away and get your pet the medical attention she/he needs.

~ER Doc

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