Why do you need to run all of those tests?

by Jami Stromberg, DVM

Your pet is sick and you’re worried, so you bring her to the vet. After the physical exam, the vet recommends bloodwork and x-rays, to the tune of $300. Three hundred dollars??? Why can’t you tell what’s going on, Doc? I already spent $60 for the exam!

I’d like to think that four years of veterinary school and 17+ years as a practicing veterinarian has given me magical powers, but unfortunately the physical exam is only one way in which to diagnose a problem. Oftentimes more testing is needed.

Example 1: I can see a red ear canal and debris, which likely indicates an ear infection, but what is the cause? Ear mites? Yeast? Bacteria? Just waxy debris?  The source of the discharge will determine the type of medication (if any) that is dispensed.

Example 2: A dog is not eating well and grunts when I palpate his abdomen. I feel that the abdomen may be distended. Why? Is he bloated? Is there a mass in the abdomen? Is there fluid in the abdomen? Is the abdominal pain actually back pain secondary to vertebral disk disease? An abdominal (which would also include the spine) x-ray will help determine the cause of the pain.

Example 3: An older cat is hiding and has lost weight. Other than being thin, the cat looks and feels normal on physical exam. A biochemical analysis (aka bloodwork) including a thyroid level would likely be my first test to run, as that can detect kidney disease, high thyroid levels, liver disease, and diabetes, all of which would be on my radar.

Example 4: A middle aged terrier is vomiting and has lost weight. The exam showed yellowing of the eye and gums, which could indicate liver disease. Bloodwork confirms that the liver values are quite elevated. What next? An abdominal ultrasound would be warranted, as it allows us to both look inside the abdomen at the actual structure of the liver and gallbladder, as well as noninvasively obtain a biopsy sample of the liver. Knowing the cause of the liver disease will allow us to treat the specific problem as well as provide  a more accurate prognosis.

Like human medicine, veterinary medicine has come a long way in the past 50 years. We have at our disposal myriad diagnostic tools that weren’t even in existence in the early days of the profession. And unlike in human medicine, our patients cannot talk to tell us exactly where it hurts and how they are feeling. While not everyone can or wants to pay for every test available, judicious use of tests are very important in helping with diagnosis, prognosis, and treatment of a sick pet.

Jami Stromberg, DVM