When presented with an ill animal, veterinarians will start with a history of the problem and will perform a comprehensive physical exam. If the diagnosis is not obvious, we usually rely on diagnostic testing that may include urinalysis, a fecal exam, or blood tests for a complete blood count and a blood chemistry and a thyroid test. X-rays may also be needed.
Occasionally, additional imaging such as an ultrasound is performed. An ultrasound exam is a noninvasive test that can show the details of body systems with great accuracy. Not only can we see the size and shape of the organs but also the inner structure of most of the abdominal and cardiac structures
Amarillo, a 9-year old gray tabby cat had been losing her appetite over several weeks. Her gastrointestinal tract was upset, and she had not eaten for two days before seeing the veterinarian.
By that time, she had lost a significant 10 percent of her body weight. The veterinarian noticed that her eyes were yellow-tinged, indicating jaundice.
"A yellow kitty is a very sick kitty," the veterinarian said.
Getting an accurate diagnosis of liver malfunction can be a difficult and expensive process. A blood test confirmed that the liver was not working well as the bilirubin level was high. Because her thyroid level was normal, that eliminated thyroid disease as the cause of jaundice.
She was not anemic, which is another cause of jaundice because of the breakdown of red blood cells.
Palpation of the abdomen did not reveal any obvious tumors or other abnormalities, but she was a bit tender about having her abdomen examined.
The veterinarian recommended an abdominal ultrasound. Commonly, humans have diagnostic ultrasounds of their kidneys, liver, gallbladder or urinary bladder. Ultrasound uses high frequency sound waves (higher than can be heard by human or even dogs) to look at the organs and tissues of the abdomen and into the chest of animals.
Ultrasound is painless and only requires a shaved stomach and some gel to get a good image. Some veterinarians will ultrasound pets in their offices, while others use the services of a specialist with many years of additional training and experience to view the internal organs.
Amarillo had gallstones. Although not unusual in humans, gallstones are very uncommon in cats and dogs. Additionally, she had stones in her bile duct, causing a blockage of bile flow.
She eventually had surgery to flush out and re-route her gallbladder, and she was back to her adventurous self in two weeks.
Pittsburgh is fortunate to have numerous specialists who can consult with local veterinarians on difficult cases. Some of these specialists will visit area veterinary hospitals to provide additional expertise.
Additional care is also provided at specialty hospitals, giving veterinarians and pets many options and hope for those complicated cases.
Lawrence Gerson is a veterinarian and founder of the Point Breeze Veterinary Clinic. This column was co-written by Nathaniel Myers of Pittsburgh Veterinary Internal Medicine. The biweekly column is intended to educate pet owners. Consultation with a veterinarian is necessary to diagnose and treat individual pets. If you have a question you'd like addressed in Pet Points, email firstname.lastname@example.org. Please include your name and municipality or neighborhood.