Did you know that Upstate Vet’s veterinary internal medicine specialists are like medical detectives? They piece together information from a pet’s history and diagnostic tests to uncover a specific diagnosis. Veterinary internists diagnose and manage the most complex and challenging medical conditions, from infectious diseases to immune-mediated conditions, to provide the best outcome for sick pets. Whether a patient is referred to Upstate Vet by their family veterinarian for more extensive diagnostic testing, or they present through our after-hours emergency service, our veterinary internists use their expertise to get to the bottom of each case.
To see our “medical detectives” at work, follow Bailey, a 2-year-old chocolate Labrador retriever who recently benefited from our veterinary internal medicine sleuthing.
As Mrs. Neal cleaned up another mess Bailey had made on the floor, her 4-year-old son, Tyler, ran into the kitchen. “Mom,” he said, “I can’t find my favorite dinosaur toy—you know, the purple one with the long tail.” Mrs. Neal would have liked to help her son look for his toy, but this was the third time Bailey had vomited, and she was beginning to worry. Bailey was normally a ball of energy, but she had been lying around since yesterday afternoon and had not eaten dinner, or this morning’s breakfast.
“I’m sorry Tyler,” Mrs. Neal said, “I need to take Bailey to the veterinarian because she is not feeling well. I’ll help you look for your dinosaur when I return home.” Since it was Saturday afternoon and their family veterinarian was closed, she gently loaded Bailey into the car and headed for Upstate Vet.
Mrs. Neal had called ahead to let the Upstate Vet team know she and Bailey were on their way, so they were ready and waiting. The emergency veterinarian on Bailey’s case gathered the pertinent information from Mrs. Neal, and then performed a thorough physical exam. He looked Bailey over, listened to her heart and lungs, and assessed her hydration status, all the time making notes in her chart. “OK,” he said, “it looks like Bailey is moderately dehydrated, which is likely because she is not eating or drinking, and losing fluid from vomiting. She also responds to abdominal palpation, which indicates abdominal pain. I would like to place an intravenous (IV) catheter and administer fluids to correct her dehydration and run blood work for a more thorough picture of her health status. I am going to involve one of our veterinary internal medicine specialists, since they are trained to interpret complex lab results, to reach an accurate diagnosis. Bailey is pretty sick, and we want to get to the bottom of her condition before she worsens.” Mrs. Neal agreed, and the veterinary team went to work placing the IV catheter, drawing blood, and beginning IV fluid administration.
After 15 minutes, the veterinary internist on Bailey’s case introduced herself to Mrs. Neal and reviewed Bailey’s blood work results. The printout confirmed dehydration and revealed a slightly elevated neutrophil count, which indicates inflammation or infection. “I would like to take digital X-rays of Bailey’s abdomen since she seems painful. Do you know if she recently got into the trash, or ate something she shouldn’t?” Mrs. Neal explained that they kept the kitchen trash in a closet—after several of Bailey’s dumpster-diving missions—and that she was not aware that Bailey had eaten anything out of the ordinary.
After receiving Bailey’s X-rays, the internist went over the results with Mrs. Neal. “Well, I think we have an answer,” she said. “Do you see this dark, odd-shaped object in the middle of Bailey’s abdomen? It looks like she ate a non-food item, which is sitting in her stomach. Unfortunately, the foreign body will not pass on its own and will require removal. Do you know what the object might be?” Mrs. Neal thought back to her hurried conversation with Tyler and realized what Bailey may have eaten. She frequently warned Tyler that Bailey would eat his toys if he did not pick them up, and her half-hearted prediction may actually have come true.
“Will Bailey be alright?” Mrs. Neal asked, worriedly.
“Fortunately, we should be able to remove the object with an endoscope rather than abdominal surgery,” the internist said. “We can prep Bailey for the procedure now and induce anesthesia shortly. Once Bailey is unconscious, I will insert the endoscope—a high-definition camera mounted to the end of a long, flexible arm—through her mouth, down her esophagus, and into her stomach. The camera will send real-time images to a screen, and once I locate the foreign body, I will insert forceps through the endoscope tubing, grasp the object, and pull it out through her mouth.”
An hour later, the veterinary internist handed Mrs. Neal a purple dinosaur toy. Bailey was recovering well from anesthesia, but she recommended that she remain hospitalized overnight to remain on IV fluids. The veterinary team also wanted to ensure Bailey was able to keep food down before they sent her home. Mrs. Neal agreed and headed home, thinking that Tyler would be surprised when she walked in with his slightly worse-for-wear dinosaur toy.
This case is only one example of the “detective” work our veterinary internists perform daily. When your pet requires a referral to a team of expert sleuths, Upstate Vet is on the case. Contact us to get to the bottom of your pet’s medical mystery.
