How Veterinarians Solve the Mystery of the “Ain’t Doing Right” Pet
Starting with Quincy, M.E. and running through today’s C.S.I., it seems there has always been a TV show where figuring out how people died (and if, of course, they were murdered) captures the public’s fascination. A coroner’s job is a hard one, we’re told, because the “patient” can’t talk.
Welcome, my friends, to veterinary medicine. Our patients usually aren't murder victims, fortunately, but they never tell us where it hurts, and we don’t even have the luxury of trying to solve a mystery in just one species. Even if we’re mostly dealing with just cats and dogs, we’re presented with mysteries every day, in the form of the “ADR,” or “Ain’t Doing Right,” pet.
Fortunately, we have our own investigatory techniques to solve these medical mysteries.
Taking a Team Approach
When I step into an exam room, I’m always aware that I’m part of a team. What I bring to the table: generations of medical knowledge, the latest research and my continuing education. I never stop looking for the best in cutting-edge care, and I never forget the basics of good medicine. But I’m also not the only one on the veterinary team. I am in constant touch with colleagues, both other vets in my practice and specialists across the country. And that’s just the beginning.
Listen to the techs. In order to be a great veterinarian, it's important to come out of school with more than the latest, greatest knowledge of a freshly minted graduate. A really successful vet also hews to the maxim that God gave us one mouth and two ears for good reasons. And one of the reasons is to listen to the veterinary technicians. In many, if not most, practices, the tech will have already taken information on the ADR pet before the veterinarian sees him, and the vet will hear (and read in the chart) about that. But a smart vet will ask the vet tech what he thinks is going on. A great technician is an invaluable part of an outstanding veterinary practice.
Listen to the pet parents. Along with listening to my technicians, l want to hear what the pet owner has to say. I call it listening to Dogter Mom or Dogter Dad. You’re the reason your pet is on my exam table. You know something isn’t right, because you know your pet better than anyone else — even better than your veterinarian. I want to know what you saw, heard, felt and smelled, and when it changed. And when you think I need to go further, I listen to that, too. My friend Dr. Tony Johnson, a specialist in emergency and critical care at the Purdue University College of Veterinary Medicine, tells of the ultimate ADR dog, one who left the veterinary team with nothing but normal test results. It wasn’t until the dog’s owners insisted the team push for more that an MRI revealed a brain tumor. That’s why we listen to our clients: So many times, they just know.
How I Ask the Questions Matters
Hear what’s not being said, and know what to ask. Sometimes a pet owner doesn’t know that something is significant, which is why I ask questions, both to get more information and to fill in the blanks. Once I had a dog who was dying of hemolytic anemia, but the owner swore he hadn’t eaten anything unusual. We were getting nowhere, until I asked if she would ask her husband and their two children about anything the dog might have eaten. Sure enough, their teenage daughter admitted that the dog had eaten most of a large container of onion powder. She cleaned it up so no one would be in trouble and didn’t realize the danger of onions. The dog lived because I knew enough to ask everyone the critical questions.
Use all your senses. I’ve written before about what my senses tell me: the yeasty smell that screams ear infection, the sound of a telltale heart in trouble with a murmur, the feel of an organ enlarged beneath my palpating fingers. Modern medicine is a marvelous thing, but sometimes all a vet needs to do is follow his nose to get the answers that he, and the ADR pet's owners, is looking for.
Going for High-Tech Help
Testing tells a tale. A veterinarian can often go only so far with a detailed history and a complete exam. Frequently, to complete the puzzle, your vet needs some basic diagnostics, such as a complete blood count (CBC) and chemistry panel, urinalysis or other tests as indicated by history or findings, with more tests as needed. These tests are often critical in formulating an accurate diagnosis, either by showing the vet what he couldn’t find on his own or by confirming one of several possible diagnoses.
Yes, it’s a lot like C.S.I., I know. But the real difference in solving “The Mystery of the ADR Pet” is what happens next: Unlike the medical examiner, we veterinarians get a chance to cure our voiceless patients. We don’t always succeed because medicine doesn’t work that way. But more often than not, we crack the code, making for the happiest ending to many episodes.