COMMON DIAGNOSTICS

A biochemical profile is an essential diagnostic tool, providing a comprehensive overview of an animal's metabolic state and organ function. This panel of tests measures various substances in the blood, including enzymes, proteins, glucose, electrolytes, and other metabolites. The results can help diagnose diseases, monitor ongoing health conditions, and guide treatment decisions.

Key components of a biochemical profile and their significance include:

• Liver Enzymes (ALT, AST, ALP, GGT): Elevations can indicate liver damage or dysfunction. Each enzyme has specific considerations regarding the type of liver injury it reflects.
• Kidney Function Markers (BUN, Creatinine): These substances are waste products filtered by the kidneys. Elevated levels can indicate reduced kidney function.
• Electrolytes (Sodium, Potassium, Chloride, Calcium): Abnormal levels can affect heart function, fluid balance, and muscle activity. They are crucial for diagnosing and managing conditions like dehydration, kidney disease, and endocrine disorders.
• Glucose: High levels can indicate diabetes mellitus, while low levels may suggest insulinoma or liver dysfunction.
• Total Protein, Albumin, and Globulin: These parameters help assess hydration status, liver function, and immune response. They can also indicate chronic inflammation or infections.
• Cholesterol and Triglycerides: Though often associated with diet, abnormalities in these levels can also indicate metabolic and endocrine disorders.
• Pancreatic Enzymes (Amylase, Lipase): Elevations in these enzymes can suggest pancreatitis or other pancreatic diseases.

The biochemical profile is often performed alongside a complete blood count (CBC) to provide a more comprehensive view of an animal's health. The process involves collecting a blood sample from the animal, which is then analyzed using specialized laboratory equipment.

A complete blood cell count is an analysis of a patient's unclotted blood.  In this test, we are specifically focused on the cells contained within the sample. This test is normally paired with a Chemistry Profile, and together, they are commonly called CBC/Chem.

The first step in the process is to obtain the blood sample.  This is often accomplished by drawing blood from the neck, front leg or back leg, depending on the patient's demeanor and size.  We then take the sample and place it into a specific blood tube that prevents the sample from clotting. 

 Oftentimes, an additional blood sample is placed into a separate tube to obtain the serum portion for various other tests (the chemistry profile, among others).  The unclotted blood is then tested via a CBC machine, as well as having a microscopic examination performed.  These two portions of the tests pair to form the complete blood cell count.

We interpret the test by comparing to the normal ranges that have been determined for that breed and species.  These ranges include 95% of normal animals, which means a slightly low or high number may be normal for your specific pet.  

Red Blood Cell Tests 

Within the CBC, we look at the red blood cells.  They are evaluated for number, percentage of total sample, size and shape.  They are also evaluated for red blood cell parasites.  These are often noted on the microscopic evaluation.  

RBC Number:  This is the actual number of red blood cells in a specific volume of blood.  It can be elevated due contraction of the spleen, dehydration and poylcythemia.  More concerning would be a decreased RBC, indicating an anemia related process.  

PCV (Packed Cell Volume):  This is a test of the percentage of the total blood sample that is made up of red blood cells.  

PCV and RBC count can be elevated due contraction of the spleen, dehydration and poylcythemia.  More concerning would be a decreased PCV/ RBC, indicating an anemia related process. There are many causes for anemia, which are covered in an additional article that can be accessed via the hyperlink that is embedded here.

White Blood Cells

There are many different types of cells that fall under the category of "White Blood Cell."  We are able to get an idea of the immune system/ immune status of the patient.  There are roughly 6 types of cells including:

• Neutrophils:  These are the main white blood cells that people think of when the term White Blood Cell is used.  These cells often indicate inflammation and infection when they are elevated.
• Band Neutrophils:  These are a subcategory of the Neutrophils.  Their presence further indicates that the body is producing neutrophils in response to a process.  Often they indicate an infectious process, such as a bacteria infection.
• Lymphocytes:  These are the cells produced in the lymph nodes, which are palpated during the physical examination.  The increase of lymphocytes may help to detect the presence of lymphoma.  
• Monocytes:  Elevated monocytes indicate the presence of infections, heartworm disease, immune mediated disease, trauma, hemorrhage (internally), neoplasia (cancer), or stress.  
• Basophils:  These tend to be a more nonspecific test, however increased basophils can indicate some potential processes.  On this list are inflammatory processes (GI tract, respiratory tract), Neoplasia (mast cell tumor), IgE disorders (Heartworm disease and atopy).  
• Eosinophils:  Oftentimes, we look at the eosinophils to clue us in on two potential problems: allergies and parasites.  Both of these processes cause in elevation within the eosinophil count.  It is nor abnormal for a test to contain zero eosinophils.  

Platelets

Platelets are very important in the clotting process.  Their presence is needed to form the initial clot of small and minor disruption of the blood vessels. The platelet count can be elevated due to thrombocytosis and polycythemia vera.  A decrease in Platelet numbers can be an artifact due to clumping or an indication of another process.  Low numbers are due to either decreased production (due to infection), increased destruction (Immune mediated disease), sequestration (in the spleen), or increased consumption (hemorrhage, DIC).

Cortisol diagnostic tests are crucial tools in veterinary medicine for assessing the health and function of the adrenal glands in animals. These tests measure the level of cortisol, a steroid hormone produced by the adrenal cortex, which plays a significant role in stress response, metabolism, immune response, and maintaining blood pressure. Abnormal levels of cortisol can indicate various conditions, including Cushing's disease (hyperadrenocorticism) or Addison's disease (hypoadrenocorticism).

There are several types of cortisol diagnostic tests used in veterinary clinics:

• ACTH Stimulation Test (ACTH Stim): This is the most commonly used test for diagnosing Cushing's disease and can also help identify Addison's disease. It measures how well the adrenal glands respond to the Adrenocorticotropic Hormone (ACTH). The test involves taking a baseline cortisol level, administering synthetic ACTH, and then measuring cortisol levels again after a set period.
• Low-Dose Dexamethasone Suppression Test (LDDST): Primarily used for diagnosing Cushing's disease, this test involves administering a low dose of dexamethasone, a synthetic glucocorticoid, to suppress cortisol production. Cortisol levels are measured before and after administration to see if the normal suppression of cortisol production occurs.
• High-Dose Dexamethasone Suppression Test (HDDST): Similar to the LDDST but uses a higher dose of dexamethasone. This test can help differentiate between pituitary-dependent Cushing's disease and adrenal tumor-related Cushing's disease.
• Urine Cortisol:Creatinine Ratio: This test measures the ratio of cortisol to creatinine in the urine and is used as a screening test for Cushing's disease. It's a non-invasive test that can indicate if further testing is needed.

Each of these tests has its specific indications, benefits, and limitations. The choice of test depends on the suspected condition, the animal's health status, and other diagnostic information. Interpretation of results should be done in the context of the animal's overall clinical picture, as various factors, including stress, illness, and medications, can influence cortisol levels. Collaboration with a veterinary endocrinologist may be beneficial for complex cases.

Cytology is a valuable diagnostic tool that involves the examination of cells collected from body tissues or fluids to evaluate their structure, function, and relationship. This non-invasive technique can provide rapid and insightful information about various diseases, including infections, inflammatory conditions, and cancers.

The process of cytology involves the following steps:

• Sample Collection: Samples for cytology can be obtained through various methods depending on the location and nature of the problem. Common techniques include fine needle aspiration (FNA), impression smears (directly from lesions or masses), swabs (especially from body cavities or surfaces), and fluid aspirations (from body cavities or joints).
• Sample Preparation: Once collected, the sample is prepared on a slide. This may involve spreading the material thinly across the slide (smear) and sometimes staining with special dyes to enhance cellular details.
• Microscopic Examination: A veterinarian or a veterinary pathologist examines the stained slides under a microscope. They assess the types of cells present, their arrangement, size, shape, and any abnormalities. This examination helps identify inflammation, bacterial or fungal infections, and the presence of abnormal cells suggestive of cancer.
• Diagnosis and Further Testing: Cytology can often provide a preliminary or definitive diagnosis. For instance, it can rapidly distinguish between inflammatory and neoplastic (tumor) processes. However, in some cases, cytology might indicate the need for further diagnostic testing, such as biopsy and histopathology, to obtain a more comprehensive understanding of the disease.

Cytology offers several advantages in veterinary practice:

• Speed: Results can often be obtained quickly, sometimes even during the patient's visit.
• Minimally Invasive: The techniques used for sample collection are usually less invasive and cause minimal discomfort to the animal.

Cytology is a critical component of veterinary diagnostics, aiding in the rapid assessment and management of diseases. It complements other diagnostic methods to ensure comprehensive veterinary care.

FeLV (Feline Leukemia Virus) and FIV (Feline Immunodeficiency Virus) testing is a critical aspect of feline healthcare, providing essential information about a cat's health status regarding these two serious viral infections. Both viruses affect cats' immune systems, making them more susceptible to other infections and diseases, but they are distinct in their transmission methods and effects on the cat's body.

Purpose of Testing: FeLV/FIV testing is primarily conducted to screen for the presence of these viruses in cats. FeLV is known for causing a variety of health issues, including anemia, lymphoma, and immunosuppression. FIV, often compared to HIV in humans, leads to a weakened immune system by attacking the cat's white blood cells.

Testing Methods:

• ELISA (Enzyme-Linked Immunosorbent Assay): This is the most common initial screening tool for both FeLV and FIV. It can be performed in a veterinary clinic and provides rapid results. The test detects FeLV antigen and FIV antibodies in the blood.
• IFA (Indirect Fluorescent Antibody Test): Often used to confirm positive ELISA results for FeLV, it detects the presence of the virus in white blood cells, indicating a more advanced stage of infection.
• Western Blot: This is typically used to confirm an FIV-positive result from an ELISA test. It's considered the gold standard for FIV diagnosis.

Feline Infectious Peritonitis (FIP) is a complex and often fatal viral disease affecting cats, caused by certain strains of the feline coronavirus (FCoV). While most cats infected with FCoV only experience mild, if any, symptoms, in a small percentage of cases, the virus can mutate into a form that causes FIP. The disease is characterized by an intense inflammatory reaction in the tissues, and it can present in a 'wet' (effusive) form, with fluid accumulation in body cavities, or a 'dry' (noneffusive) form, with granulomatous lesions in various organs. Diagnosing FIP can be challenging due to the variability of symptoms and the lack of a definitive single test.

Purpose of Testing: The goal of FIP testing is to gather evidence supporting a diagnosis of FIP, considering the clinical signs and the cat's history. Because FIP can mimic other diseases, testing often involves ruling out other conditions.

• Serology: Tests for antibodies to feline coronavirus can indicate exposure but cannot distinguish between harmless FCoV strains and the ones causing FIP. High antibody titers suggest exposure but not necessarily disease.
• Biochemical Tests: These include blood tests that measure albumin-to-globulin ratio, alpha-1-acid glycoprotein (AGP), and other markers indicative of the inflammatory response seen in FIP.
• PCR Testing: PCR can detect coronavirus genetic material in blood, effusions, or tissue samples. While not specific for the FIP-causing strains, high levels of viral RNA in conjunction with clinical signs can support an FIP diagnosis.
• Cytology and Histopathology: Examination of fluid or tissue samples can identify characteristic changes associated with FIP, such as pyogranulomatous inflammation or the presence of the virus within macrophages.

FIP testing is a complex process that requires careful interpretation of multiple diagnostic tests in conjunction with clinical signs. The emergence of effective treatments has transformed FIP from a uniformly fatal diagnosis to one where recovery is possible, underscoring the importance of early detection and intervention.

Fluorescein staining is a diagnostic procedure widely used to detect corneal lesions, such as ulcers, scratches, or foreign bodies in the eye. This test involves the application of a fluorescein dye, which is a fluorescent orange dye, to the eye's surface. The dye is water-soluble and adheres to areas of the cornea where the epithelium (the outermost layer) is compromised, highlighting defects that are otherwise difficult to see with standard examination techniques.

Purpose of Testing: The primary purpose is to identify corneal ulcers, erosions, or scratches on the cornea. The test can also reveal the presence of foreign bodies on the corneal surface and assess tear film adequacy and the patency of the nasolacrimal (tear) duct by observing the dye's movement.

Testing Procedure:

• A fluorescein strip, moistened with a few drops of saline or sterile water, is gently touched to the conjunctiva or the lower eyelid margin.
• The animal is then blinked several times to spread the dye across the corneal surface.
• The veterinarian examines the eye under a blue light (Wood's lamp or a slit lamp with a cobalt blue filter), which causes the dye adhering to damaged areas to fluoresce a bright green, making it easy to identify and assess the extent of corneal damage.

Fluorescein staining is a simple, quick, and effective diagnostic tool for identifying and assessing corneal lesions. Its ability to vividly highlight areas of damage facilitates accurate diagnosis and appropriate treatment, significantly benefiting animal eye health.

Testing for folate, vitamin B12 (cobalamin), and, by extension, cobalamin levels themselves, plays a critical role in veterinary diagnostics, particularly in assessing gastrointestinal health and metabolic function. These nutrients are vital for various bodily functions, including DNA synthesis, red blood cell formation, and neurological health. Abnormal levels can indicate malabsorption issues, dietary deficiencies, or specific diseases.

Purpose of Testing:

• Folate: This B vitamin is primarily absorbed in the small intestine. Testing for folate levels can help diagnose small intestinal malabsorption or bacterial overgrowth, as folate levels can increase with bacterial synthesis or decrease due to malabsorption.
• Vitamin B12 (Cobalamin): Cobalamin is also absorbed in the small intestine but requires intrinsic factor from the pancreas for its absorption. Low levels can indicate malabsorption issues due to gastrointestinal diseases such as inflammatory bowel disease (IBD), exocrine pancreatic insufficiency (EPI), or bacterial overgrowth.

Procedure: 

The tests for folate and vitamin B12 levels involve taking a blood sample from the animal. The sample is then analyzed in a laboratory to measure the concentrations of these vitamins.

Testing for folate and vitamin B12 levels provides valuable insights into an animal's gastrointestinal health and nutritional status. It aids in the diagnosis of malabsorption syndromes and guides the management of conditions affecting nutrient absorption. These tests underscore the importance of comprehensive diagnostic approaches in veterinary medicine, ensuring animals receive targeted and effective care for optimal health outcomes.

Glaucoma screening in veterinary medicine is a critical diagnostic process used to identify and assess the risk of glaucoma, a condition characterized by increased intraocular pressure (IOP) that can lead to damage to the optic nerve and loss of vision. Early detection and management are vital to prevent irreversible blindness. This screening is especially important in certain breeds predisposed to glaucoma.

Purpose of Screening:

The primary goal is to measure the intraocular pressure (IOP) and assess the eye for signs of glaucoma, including optic nerve damage and visual field loss. Screening can identify animals at risk or in the early stages of glaucoma, allowing for prompt treatment to preserve vision.

Testing Methods:

• Tonometry: The most common method for measuring IOP. Instruments like the Schiotz tonometer, Tono-Pen, or rebound tonometer can be used. Tonometry is a non-invasive test that can be performed with minimal restraint and without sedation in most cases.
• Gonioscopy: Involves the examination of the drainage angle of the eye (the iridocorneal angle) to assess its openness and function, which is crucial for diagnosing the type of glaucoma (open-angle or closed-angle).
• Ophthalmoscopy: Examination of the optic nerve head for signs of damage due to increased IOP. This requires dilatation of the pupil and is performed using a direct or indirect ophthalmoscope.

Glaucoma screening is an indispensable tool for protecting the ocular health of animals, especially those at high risk for this potentially blinding condition. By incorporating regular screenings into routine veterinary care, especially for susceptible breeds, veterinarians can significantly mitigate the impact of glaucoma on the quality of life of affected animals.

Screening Your Dog

Heartworm & tick testing (4DX test) is a much needed screening test in our region of Ohio. Heartworm disease is carried by mosquitoes, who lay their eggs in stagnant and slow-moving water. Ticks are also becoming very prevalent in our area; creating a much higher chance of tick-borne diseases.

So what exactly is heartworm & tick testing?  A heartworm & tick screening involves a small sample of blood from your dog, most likely drawn from one of his or her front legs.  This blood is then tested for the presence of adult female heartworms.  The test is a simple, 10-minute test that is performed in the office.  The current test also screens your dog for Lyme Disease, Anaplasmosis, and Canine Ehrlichiosis, which are all transmitted by ticks.

Why test my dog?

We recommend testing your dog every year. This is important because early detection results in a much better cure rate than diagnosing once clinical signs are observed.  

What if my dog is on prevention all year round, do I still need to test?

Yes; we still test every year.   It is important to screen dogs to check for several things including product failure, resistant heartworms and the possibility that the preventative was either not given or was not ingested properly.

How can I protect my dog against heartworm & tick diseases?

There are several ways to protect your dog.  These include a 6 or 12 month injectable and various monthly pills.  There are also some topical preventatives available.  

An Intestinal Parasite Test (IPT) is a vital part of the routine care of a dog, cat, horse, goat, sheep or any other animal.  In some animals, it is highly recommended to perform serial testing (testing several times over the course of time) of fecal samples.  We often called this paired testing a fecal egg reduction test.

Why is it important?

To begin, parasites often cause clinical diseases.  These range from general ill-thrift to more debilitating diseases.  Ill-thrift may simply show up as an animal that is growing slowly, is lethargic, or simply one that fails to perform well.  Some animals, particularly the younger ones, can carry a large enough parasite load to cause death.  Many puppies and kittens suffer from the pot-bellied appearance that is caused by this large worm load.  Testing is also important considering the fact that some parasites carry a zoonotic risk (they can be contagious to humans).

Can I just Deworm my animal?

While deworming products are readily available, they are limited in their abilities to treat parasites.  There are really only three classes of dewormers available, and worms can get resistant to each class over time.  For this reason, it is important to identify the specific worms that are present in order to treat them effectively.

What is an Intestinal Parasite Test?

The IPT is a test that we perform on a fecal/ stool sample using a microscope to look for the eggs of each different type of worm.  This test involves several steps in order to be performed appropriately.  The first step is placing the fecal sample into a special solution.  This is often a specialized sugar solution that makes the worm eggs easy to detect once the test is completed.  The solution is strained to eliminate larger particles and pieces of debris.  Once strained, the solution is placed into a centrifuge and spun at a high speed for about 10 minutes.  This helps to separate the eggs from the actual fecal matter (poop).  Once the spinning is complete, a cover slip, which is a small piece of glass, is placed on the solution.  The parasite eggs float to the top and “stick” to the cover slip.  The cover slip is placed onto a slide and then looked at under the microscope.

What Worms do you Detect?

An IPT is a great test to detect several parasites, or worms.  For dogs and cats these include Roundworms, Hookworms, Whipworms, Tapeworms (though it is not as reliable for tapeworms), and coccidia.  In horses, we test for small strongyles (roundworms), large strongyles, bots, pinworms, coccidia and bloodworms.  In ruminants (Cattle, Sheep and goats), the IPT detects mainly strongyles and coccidia.

We believe that yearly testing for internal parasites is very important; by testing and treating for these worms, we can reduce the build up of parasite eggs and larva within the environment.  This is very important when we consider common areas such as dog parks, neighborhoods, and hiking trails.  

Phenobarbital testing is crucial for managing animals, particularly dogs and cats, being treated for epilepsy or other conditions that require anticonvulsant therapy. Phenobarbital is a barbituate medication used to reduce the frequency and severity of seizures. Monitoring its levels through blood testing ensures the medication is within the therapeutic range, maximizing efficacy while minimizing potential side effects.

Purpose of Testing:

 - To determine the concentration of phenobarbital in the blood and ensure it falls within the therapeutic range, which is essential for controlling seizures without causing adverse effects. The therapeutic range varies but is generally considered to be between 15-45 µg/mL in dogs.

 - To monitor the animal's response to treatment and adjust the dosage as necessary.

 - To identify potential toxicity or side effects associated with phenobarbital use, such as liver damage, sedation, ataxia, or hematological changes.

Testing Procedure:

A blood sample is collected from the animal, typically from a vein in the leg or neck.

Phenobarbital testing is an essential component of managing veterinary patients on this medication, ensuring that the treatment remains effective and safe over time. By closely monitoring blood levels and adjusting the treatment as necessary, veterinarians can significantly improve the quality of life for animals with epilepsy or other seizure-related conditions.

What is a ProBNP Test?

The ProBNP test is a simple blood test that can provide valuable information about your pet’s heart health. It measures a substance called NT-proBNP, which is released by the heart when it is experiencing increased stress or strain.

We may recommend a ProBNP test if your dog or cat has a heart murmur, certain symptoms, or other findings that could indicate a heart condition. The test can help us determine whether additional cardiac evaluation, such as an echocardiogram, may be beneficial.

Why is ProBNP Testing Especially Helpful in Cats?

Heart disease in cats can be challenging to detect because cats are very good at hiding signs of illness. Some cats with significant heart disease may show few or no obvious symptoms, and a heart murmur is not always present. This test is normally included in all of our feline senior wellness blood panels because of this. ProBNP testing can provide additional information about the heart and may help identify cats that could benefit from further cardiac evaluation. 

A normal ProBNP result can make significant heart disease less likely, while an elevated result may indicate that the heart is under increased stress. An elevated result does not necessarily mean your pet has heart disease, but it can provide an important reason to investigate further.

ProBNP testing is a useful tool that allows us to detect potential heart concerns earlier and make informed decisions about your pet’s care.

Progesterone assays in veterinary medicine are pivotal for managing breeding and understanding reproductive status in animals, particularly in dogs and cats, but also in other species like horses and cattle. Progesterone is a hormone produced by the corpus luteum after ovulation, and its levels can provide essential information about the timing of ovulation, optimal breeding times, pregnancy status, and the health of the pregnancy.

Purpose of Testing:

• To determine the precise timing for breeding to maximize the chances of successful mating. Progesterone levels begin to rise sharply just before ovulation, making it a reliable marker for determining the fertile window.
• To confirm ovulation, as progesterone levels significantly increase following ovulation.
• To monitor the health of a pregnancy. Progesterone is crucial for maintaining pregnancy, and its levels can indicate the viability of the pregnancy.
• In some cases, to diagnose luteal phase defects or other reproductive disorders.

Testing Procedure:

• A blood sample is collected from the animal and analyzed for progesterone concentration. The testing can be done through various methods, including radioimmunoassay (RIA), enzyme-linked immunosorbent assay (ELISA), or chemiluminescence immunoassay (CLIA), depending on the facilities available.
• The timing of sample collection is critical and may need to be repeated over several days or weeks to accurately determine the rise in progesterone levels indicative of ovulation and the best timing for breeding.

Progesterone assays are a cornerstone in veterinary reproductive management, providing essential insights that guide breeding decisions, confirm ovulation, and support pregnancy management. These tests enable veterinarians and breeders to optimize reproductive outcomes and contribute to the overall health and success of breeding programs.

Senior Wellness Screening is a comprehensive health assessment tailored specifically for older pets. As animals age, they become more susceptible to various diseases and conditions, many of which can be managed or treated more effectively if detected early. This type of screening is designed to identify these health issues at an early stage, even before symptoms become apparent, thus playing a crucial role in maintaining the health, quality of life, and longevity of senior pets.

Purpose of Screening:

• To detect early signs of diseases common in older pets, such as kidney disease, liver disease, diabetes, heart disease, thyroid imbalance, and cancer.
• To assess the overall health status of a senior pet, including checking for signs of pain related to arthritis or other degenerative conditions.
• To establish baseline health data for future reference.

Components of Screening:

• Complete Blood Count (CBC): Assesses the health of the blood cells, looking for signs of infection, anemia, or other blood-related conditions.
• Biochemical Profile (Chemistry or Chem test): Evaluates organ function, including the liver, kidneys, pancreas, and thyroid, and checks for diabetes.
• Urinalysis: Provides information about the health of the urinary tract and kidneys, and helps in diagnosing urinary infections, diabetes, and kidney function.
• Heartworm & Tick Screen (4DX): Tests for heartworms and three tick-borne diseases in dogs.
• Fecal Examination (IPT): Checks for parasitic infections that can affect a pet's health.
• Blood Pressure Measurement: Identifies hypertension, which can be a sign of heart disease, kidney disease, or other health issues.
• Eye Examination: Can reveal changes in vision or eye diseases common in aging pets.
• Physical Examination: A thorough physical exam by a veterinarian can detect tumors, heart murmurs, dental disease, and other conditions that may not be obvious to the owner.

Frequency of Screening:

It's recommended that senior pets undergo wellness screening annually or semi-annually, depending on their health status and veterinary recommendations.

Senior Wellness Screening is a vital component of preventive healthcare for older pets, enabling veterinarians and pet owners to proactively address the health challenges that come with aging. By regularly assessing the health status of senior pets, it's possible to enhance their quality of life and potentially extend their lifespan through timely and appropriate medical care.

The Schirmer Tear Test (STT) is a diagnostic procedure used in veterinary medicine to evaluate tear production and diagnose dry eye conditions, officially known as Keratoconjunctivitis Sicca (KCS). This simple, quick, and minimally invasive test is crucial for assessing the health of the eye's tear film, which is essential for maintaining corneal health, providing nutrition to the eye, and offering protection against infections.

Purpose of Testing:

• To measure the rate of tear production in animals, primarily dogs and cats. It helps in diagnosing KCS, a condition where the tear glands produce insufficient tears, leading to dry, inflamed, and potentially damaged eyes.
• To monitor the effectiveness of treatment for animals diagnosed with KCS or other conditions affecting tear production.

Testing Procedure:

• The test involves placing a standardized, specially designed paper strip (the Schirmer Tear Test strip) inside the lower eyelid for a specific period, usually 60 seconds.
• The paper strip has markings that measure the amount of tear production in millimeters of wetting of the strip over that time.
• The procedure is performed in both eyes simultaneously to compare tear production rates.

One of the more common tests that we run is the Thyroxine (T4) screening test.  This test is a generalized screening for both hypothyroidism (in dogs and horses) and hyperthyroidism (in cats).  Oftentimes, the T4 testing is paired with a complete blood cell test and the biochemical profile (CBC/Chem).  These three tests are often considered a baseline screening, especially in senior pets.  

A low value on the T4 test usually confirms hypothyroidism.  Occasionally we see a low value in debilitated animals.  In this case, the low value may be a condition called Euthyroid Sick Syndrome. This is a condition in which the Thyroxine (T4) levels are low due to the other disease process that is ongoing within the pet.  Animals with low thyroid levels can be easily supplemented and typical respond favorably to treatment.

A high value is a confirmation of hyperthyroidism.  This condition is common in cats.  Cats can be treated with medication to counteract the elevated thyroxine levels.  

There are several methods to treat and each can be discussed with you, should you cat develop overactive thyroid disease.

What is an Ultrasound?

The ultrasound unit uses sound waves to pass through tissue and fluid.  The sound waves create a certain pattern of reflection based upon the type of tissue that the sound waves encounter.  These sound waves are both generated and captured by a small probe that is placed in direct contact with the patient's skin.  As the sound waves return to the probe, they are sent to the accompanying computer to be interpreted.  It is this information that is translated into the black and white image that we evaluate on the screen. 

What is the difference between ultrasound and radiographs (X-rays)?

Both x-rays and ultrasound are used to look further into the inside of a patient in a non-invasive manner.  The X-rays essentially take a 3 dimensional animal and place the image onto a 2 dimension screen or film.  This is then interpreted by the radiologist.  X-rays are good at showing size, shape, and positioning of various body organs, bones, and tissues.  X-rays essentially show 5 variable shades of gray (from darkest to lightest): air, fat, soft tissue/fluid, bone, and metal.  The x-rays require contrast between adjacent tissues to prevent things from blending in.  It is often easiest to think about x-rays as showing the size and shape of organs, but they are limited in the ability to see what is "inside" the organ itself.

An ultrasound uses the aforementioned sound waves to look at the various tissues in the body.  The sound waves can be easily targeted and directed at various structures. One limitation is that an ultrasound is basically taking pie-shaped sections of the body, which prevents it from looking at an entire organ at one time.  This means that the organ must be "scanned" with the probe to see the entire organ.  Unlike X-rays, ultrasound waves are able to "see" what is located within the organs.  This allows the ultrasonographer to see small lesions or defects within an organ.  Since the ultrasound waves are in real time, ultrasounds can be used to guide various instruments into the appropriate tissue/lesion to obtain biopsy specimens.

What types of conditions can the ultrasound help to diagnose?

The answer to this question requires a lengthy explanation.  For the sake of brevity, the ultrasound can be utilized to diagnose a limitless number of medical conditions.  These include: neoplastic tumors, benign tumors, urinary calculi (bladder stones), kidney stones, gallbladder disorders, splenic masses and lesions, Inflammatory Bowel Disease (IBD), potential abscess, cardiomyopathy, liver shunts, diaphramatic hernias, and many, many more conditions.

What should I expect for my pet's appointment?

Your pet should generally be  fasted for 12 hours; this allows for sedation, as well as helping to make the testing more uniform in procedure.  Generally, you will drop your pet off at the clinic.  We often need to administer a light sedation in order to help calm your pet.  This will allow us to get him or her into position and perform the procedure.  Most often, the ultrasound is used for abdominal ultrasonography; which means that your pet will likely be placed in dorsal recumbence (on his/her back).  We will need to shave a large area to allow the ultrasound probe to have direct contact with the skin.  The sound waves are actually prevented from traveling through air.  To facilitate contact with the skin, a gel or a bit of alcohol is used to eliminate any air between the skin and the probe.  The attending veterinarian will contact you after your pet's scan to discuss the findings and make further recommendations.