Sniffing Out Trouble: How Your Vet Uses His Nose to Diagnose Your Pet
There’s an old saying about how we were given two ears for listening, but only one mouth for talking. That’s why, like any other good doctor, I spend a lot of time listening not just to what I can hear with my stethoscope but also to what a pet’s owner is telling me about why an animal is in my exam room.
Many times what the owner tells me leads straightaway to a diagnostic technique that’s one of my favorites, and one of the most powerful in any veterinarian’s tool kit. Like those ears, my nose is a God-given gift, and I use it a lot.
I may even use it more than most medical professionals. I have always had a very keen sense of smell, as anyone who knows me can attest. When I owned practices, I insisted on them being “smell-neutral” — when you go into a medical facility, you shouldn’t smell anything, not even cleaning supplies. To this day, that’s one of the things I mention when I discuss how to choose a veterinary practice.
When I walk into, well, any place, really, from a veterinary office to a hotel to my own home, I can’t be happy if it’s not odor-neutral. In part that’s because I am so sensitive, but it’s also so I can do my job. If something doesn’t smell right, I want to be able to identify why.
Five Ways Your Veterinarian Uses His Nose
Don’t be surprised if your veterinarian’s nose is part of his examination of your pet. Smell tells a tale, if you know where to sniff and how to interpret. Here’s what I look — or smell — for when I’m checking out patients in my practice.
Flip the lip. You smell “doggy breath” or “tuna breath” on your cat. I smell periodontal disease. Broken, rotting teeth and infected gums are not normal, and neither is a constant, gut-churning stench from a pet’s mouth. When I smell it, I know that chances are I’ll see gums that look as if a blowtorch were passed over them. Painful? You bet. Also life-shortening, because that constant shower of bacteria from an infected mouth makes the internal organs fight for their lives, all the time.
In addition to smelling infections in the mouth that I know are taxing the internal organs, I can tell when there’s a problem inside with just a whiff. Breath that smells unusually sweet can be a sign of diabetes, just as breath that smells like ammonia may indicate kidney disease. In either case, these smells tell me that more diagnostics are called for.
Lift the flap. When I lift the ear flap on a dog like a Labrador or Irish Setter, the last thing I want to smell is a bacterial infection, or the bread smell that screams “yeast infection.” Wax has a smell, too, and I shouldn’t be overwhelmed by it. Healthy ears don’t smell that much, and they don’t smell nasty. When they do, I follow up with more diagnostics, a regimen of clean and cure, followed by medications that will help prevent reoccurrence.
Sniff the skin. Unless your dog has just rolled in something disgusting, he shouldn’t smell bad. Your fastidious, self-grooming cat shouldn’t ever smell bad. When they do, I follow my nose to abscesses, moist dermatitis (“hot spots”) or other conditions of the skin. In cats, poor grooming may suggest a pet so stiff from arthritis or lethargic from another illness that grooming is just not getting done. The acute problems need aggressive treatment, but chronic skin conditions often respond well to something as basic as a weekly bath or, in the case of arthritis, pain medication and supplements.
Whiff the end. My examinations are always from the tip of the nose to the tip of the tail, and I never skip a whiff under the tail. The normal odor that comes from the anal glands isn’t anyone’s favorite, but the smell can knock you on your fanny when there’s an impaction, an infection or both.
Modern medicine is a wonderful thing. I wouldn’t ever want to give up the diagnostic tools that have come into play in veterinary medicine in recent years, from the basics such as a complete blood count (CBC) to ultrasounds and even CT scans. But sometimes old school is still best, and that’s why I will never take my nose out of veterinary medicine.