It would not be an exaggeration to say that during the course of an hour, much less a day, at the office, I find myself recommending any number of laboratory tests and imaging modalities to clients (i.e. pet owners) in an effort to establish a diagnosis for their pet’s condition, symptoms, etc. It’s also common that I have to explain the need for their pet to have a dental assessment and cleaning, or possibly a surgical procedure (such as removal of a suspicious skin growth/tumor). Sometimes the response is “OK, let’s do it” or “let’s schedule that”. But, without a doubt the most interesting answer goes something like this – “I’ve had dogs/cats all my life and we never had to have dental work done/lab tests performed/had them spayed or neutered.” Nearly as often, I’ll hear it’s corollary question – “can’t you just look at him and tell me what’s wrong/tell if there is any internal bleeding/tell if anything’s broken?”
Oh, that I could look at a dog or cat and make a diagnosis of diaphragmatic hernia, bladder cancer, renal failure, clotting abnormalities, or diabetes! I would be in such demand as a diagnostician that I would have to quit my practice and travel from clinic to clinic around the world, looking at pets, laying hands on them, and producing diagnoses like they were grocery store receipts. The fact is, even with a thorough physical exam and history (asking questions of the pet owner), it is not often that a veterinarian can diagnose a problem without some assistance from “outside” measurements. Look at it this way – your physician is likely performing some combination of diagnostic tests, depending on your symptoms (which you can vocalize to him or her), and your medical history. Why would anyone think a veterinarian, who is filtering information from a secondary source (the pet owner), since the primary source (the patient) can’t speak, would not need some additional method of gathering information, outside the physical examination? This is the gap filled by blood tests, fecal tests, x-rays, and sonograms.
A man on the moon, electric cars, eradication of smallpox, near eradication of polio, splitting atoms, subatomic particles, pharmaceuticals galore, genetic and immune therapies….yet, it doesn’t easily or often cross the mind that maybe veterinary medicine has inched (if only just a tad) from the place it was in the 1960s, 70s, 80s, or 90s. We have the ability to dig much deeper and be much more accurate with our diagnosis and treatment options now than we were 5, 10, 20 years ago. Does that mean that the physical exam and history are not important? Absolutely not! Your veterinarian’s examination of your pet, the history provided by you, and your veterinarian’s knowledge and expertise in synthesizing these pieces of data are always the most important and non-tangible resources you have for your pet’s health. But we shouldn’t be shocked if the puzzle is best and most quickly solved with the additional data provided by lab tests and imaging. I read somewhere that 20% of the information a veterinary school graduate has at graduation becomes obsolete after 5 years, and this continues every 5 years thereafter. If this is true, we should certainly expect that the diagnostic, therapies, surgical possibilities, and recommendations that your veterinarian offers, will also change over time, and your veterinary visit today will not look exactly (and in some ways, not anything like) like your father’s or mother’s veterinary visit.
- Todd Worrell, DVM