Diagnosis

Testing and Monitoring in Addison's Disease

Addison’s disease or hypoadrenocorticism results from decreased corticosteroid and mineralocorticoid production from the adrenal glands. This results in non-specific signs of illness that mimic many other diseases. Laboratory changes consistent with Addison’s disease include anemia, absence of a stress leukogram (in a sick/stressed pet), hypoglycemia, elevated potassium, and low sodium causing a low sodium:potassium ratio, elevated kidney values and high urine specific gravity. Although an elevated resting blood cortisol level can rule out Addison’s disease, an ACTH stimulation test is needed to diagnose Addison’s disease. This requires a resting blood cortisol sample, administration of synthetic ACTH and a blood cortisol level 1-2 hours later to assess the adrenal response to ACTH. Consistently low levels of cortisol despite ACTH stimulation confirm the diagnosis. Primary Addison’s and secondary/atypical Addison’s can be differentiated by assessing the amount of endogenous ACTH in the blood.

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Antibody Titers

Antibody titers are sometimes needed to diagnose disease. Antibody titers reflect the level of antibody that the pet has made in response to exposure to a certain infectious organism. The titer is determined by sequentially diluting the serum and testing it against the organism in question. The more dilute the serum when it stops producing a positive reaction, the higher the concentration of antibodies present in the blood. Titers give support to a diagnosis, allowing more targeted treatment and more specific prognostic information, as well as identifying zoonotic disease (diseases transmissible between animals and humans).

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Bile Acid Test

Bile acids are made in the liver, released into the intestine to help digest fat, and are reabsorbed into the bloodstream. They can be measured in the blood to determine if the liver is working properly. Indications for the test include elevated liver enzymes, seizures, poor growth, and low blood albumin. The test is usually performed after a 12 hour fast and consists of the measurement of serum bile acids before and 2 hours after a meal. The test can be affected by poor intestinal motility – either from disease, sedation/anesthesia, or if the pet has had part of the intestine removed that is responsible for absorption of bile acids. Bile acids will be high if the liver is not functioning properly. It does not rule out liver disease as disease can affect part of the liver without significantly affecting bile acid production. Elevated bile acids may warrant further diagnostics or monitoring depending on your pet’s condition.

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Preparing Your Pet for a Blood Test

Having your pet properly prepared for a blood test helps to ensure that the results are as accurate and reliable as possible. Preparation for these two types of tests is slightly different. Your veterinarian will give you specific instructions before your appointment. It is important that you follow these instructions exactly to ensure accurate test results.

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Bone Marrow Collection and Examination

Bone marrow is the soft material found in the central core of many bones. Bone marrow is vitally important for the production of blood cells, specifically red blood cells, white blood cells, and platelets. Although many bones contain marrow, samples are collected from three main sites in cats and dogs: hip bone, top of thigh bone, or the forearm below the shoulder.

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Buffy Coat Examination for Mast Cells

The first step in processing a blood sample is centrifugation. The blood is placed in a centrifuge, where it is spun in a small circle at high speed (much like a spinning ride at an amusement park).

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Cerebrospinal Fluid Collection and Examination

Cerebrospinal fluid (or CSF) is formed within the brain, primarily at specialized sites called the choroid plexuses. CSF is found within the brain and in the space that surrounds both the brain and the spinal cord (this space is called the subarachnoid space).

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Coagulation Tests

Coagulation is the series of events that result in the formation of a clot. In the body, coagulation occurs after any injury to a blood vessel or tissue, in order to stop bleeding.

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Complete Blood Count

The complete blood count (CBC) assesses different parameters of the cells in the blood including total number, appearance, size, and shape. Red blood cells, white blood cells, and platelets comprise the cellular component of the blood. Changes in the red blood cells can affect oxygen delivery from the lungs to the blood. Changes in the white blood cells can indicate infection, inflammation, and cancer. Platelets are needed for adequate blood clotting so decreased numbers can raise concern for spontaneous bleeding.

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Holter Monitor in Cats

A Holter monitor is a portable device used to monitor the electrical activity of the heart continuously and can be an effective and non-invasive way to help your veterinarian evaluate heart conditions especially when trying to determine the cause of fainting episodes or evaluate treatment. Many cats are not bothered by it and ignore its presence.

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Coombs' Test

A Coombs' (or direct antiglobulin) test detects the presence of immunoglobulins (antibodies) on the surface of red blood cells. Immunoglobulins are proteins made by white blood cells (specifically plasma cells).

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Cushing's Disease - Testing

Cushing's disease is a condition caused by an increased production of the stress hormone cortisol by the adrenal glands. There are various reasons for an increase in cortisol production. The clinical signs of Cushing's disease are similar, regardless of the underlying cause of disease. However, it is important to try to identify the type of Cushing's disease as the treatment and prognosis (outcome) differ slightly depending upon the form of the disease.

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Fine Needle Aspiration (FNA)

Fine needle aspiration is a useful tool to collect samples for cytology and is often used to diagnose abnormal lumps on your pet's body as well as evaluation of fluid samples and tissue surfaces. It is relatively simple and inexpensive but can provide a lot of information. Depending on results, further tests may be indicated to best help your pet.

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Cytology - General

Cytology is a useful tool to often diagnose abnormal lumps on your pet's body as well as evaluation of fluid samples and tissue surfaces. It is relatively simple and inexpensive but can provide a lot of information. Depending on results, further tests may be indicated to best help your pet.

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Cytology - Collecting Cells from Surfaces

Cytology is the microscopic examination of cells that have been collected from the body. Lesions on the surface of the skin or from moist body cavities can be sampled very simply by scraping, swabbing, flushing, or making impressions of the tissue. The collected cells get looked at under a microscope and in many cases a diagnosis can be made to determine the best form of treatment.

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Dexamethasone Suppression Tests

Dexamethasone is used to test the feedback loop that controls the level of cortisol hormone in the body. Injection of dexamethasone will cause a decreased level of cortisol in a normal pet; however, in a pet with Cushing’s disease, the negative feedback loop will not respond completely, or at all, resulting in minimal or no decrease in cortisol level. A pet with pituitary induced Cushing’s may have a slight reduction in cortisol as compared to adrenal-induced Cushing’s which will have no cortisol suppression. Standard testing for Cushing’s disease uses a low dose of dexamethasone and often diagnoses adrenal vs pituitary disease. Rarely, a high dose will be used if clarification on type of Cushing’s disease is required. Other diseases can suppress cortisol production, so it is important to rule these out prior to dexamethasone testing. Knowing the type of Cushing’s disease your pet has can guide treatment decisions and offers a more defined prognosis.

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DNA Testing

DNA is a large complex molecule that carries the genetic information or genetic code of an organism. All common forms of life, such as viruses, bacteria, plants, and animals carry a copy of their own genetic code in each of their cells. Each organism has a unique section of DNA that is just like a fingerprint. DNA-PCR is often used to detect the presence of infectious organisms; especially when detecting extremely small numbers of infectious organisms and for detecting certain viruses and bacteria that are difficult to diagnose by other methods.

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Monitoring Epileptic Patients

Pets that have been diagnosed with epilepsy are usually prescribed one or more medications to prevent convulsions or seizures. Careful monitoring of epileptic pets is necessary, not only to make sure the dose of the medicine is right, but also to ensure there are no problems related to the long-term use of the medication. The most important thing to do is follow your veterinarian's instructions closely and give the medication regularly and consistently. This will ensure that the value reported on the blood test is reliable.

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Fecal Baermann

A fecal Baermann is a specialized test for detecting certain types of parasites or worms.

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Fecal Flotation

Fecal flotation is a routine veterinary test used to diagnose internal parasites or worms. The test detects the eggs of mature parasites that live inside the body and pass their eggs to the outside by shedding them in the host's stool.

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Fecal Occult Blood

A fecal occult blood test screens for the presence of hemoglobin (a component of red blood cells) in a fecal sample. Many conditions can cause blood to appear in the stool including intestinal ulceration, neoplasia, dental disease, and parasites. More testing is needed if the fecal occult blood test is positive. False negatives can occur from intermittent bleeding. False positives can also occur from what the pet has eaten in the last 3 days, such as raw/undercooked meat, raw vegetables, and some canned foods. Your veterinarian may suggest repeat tests to ensure an accurate diagnosis.

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Feline Infectious Peritonitis Testing

FIP is one of the most challenging diseases to diagnose because feline coronaviruses are commonly found in the intestinal tract of many healthy cats. When this virus mutates or changes, clinical disease occurs. Unfortunately, routine blood testing for feline coronavirus is not clinically useful. Instead, testing is restricted to those cats in which a diagnosis of FIP is strongly suspected due to clinical signs and other supportive laboratory data. Histopathology remains the best way to diagnose FIP in the living cat.

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Flow Cytometry

Flow cytometry is a laboratory technique that can be used for counting, examining, and sorting cells. The sample is passed through a light source and as the cells move through the path of the light source, they scatter the light. The scattered light is captured by lenses, translated into an electrical signal, and is then analyzed and displayed as a graphical representation of the cell populations within the sample. Flow cytometry is used to count and group cells within a blood sample. It is also used in the characterization of cellular subpopulations; for example, to distinguish between benign and malignant lymphocytes.

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Radiographs (X-Rays) for Cats

X-ray images are produced by directing X-rays through a part of the body towards an absorptive surface such as an X-ray film. The image is produced by the differing energy absorption of various parts of the body: bones are the most absorptive and leave a white image on the screen whereas soft tissue absorbs varying degrees of energy depending on their density producing shades of gray on the image; while air is black. X-rays are a common diagnostic tool used for many purposes including evaluating heart size, looking for abnormal soft tissue or fluid in the lungs, assessment of organ size and shape, identifying foreign bodies, assessing orthopedic disease by looking for bone and joint abnormalities, and assessing dental disease.

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Skin Biopsy in Cats

A biopsy is one of the more common diagnostic procedures performed in cats. Biopsies provide valuable insight into the type of cells in an abnormal area of skin or a skin growth and whether the growth poses a more serious health threat to your pet. Either the entire mass or a small representative section of skin is removed and submitted to a veterinary pathologist, who will perform a histopathology analysis. The pathologist will attempt to determine the nature of the lesion, identify the type of cells and their relationship to each other, as well as any evidence of malignancy.

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Testing for Heartworm Disease in Cats

Heartworm disease is a parasitic disease that typically affects dogs but can occasionally occur in cats. Heartworm is usually diagnosed with a simple blood test. There are two main tests for detecting heartworm infection; one test detects adult worms and the other detects microfilaria. Unlike in dogs, treatment options are limited. Heartworm preventives are available for cats. Your veterinarian can advise you on the best prevention program for your cat.

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Hypercalcemia

The term hypercalcemia is used when the level of calcium in the blood is higher than normal. Calcium levels are controlled by a pair of parathyroid glands. High calcium levels may signal the presence of serious underlying disease including kidney failure, adrenal gland failure, a parathyroid gland tumor, and some types of cancer. Pets with hypercalcemia may show signs of weakness, listlessness, increased drinking and urination, and loss of appetite. Your veterinarian will perform diagnostic tests which may include total calcium, ionized calcium, albumin, and parathyroid hormone levels.

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Testing for Kidney Disease

Tests to diagnose kidney disease include complete blood count, serum biochemistry, and urinalysis. These blood tests will determine if your pet is anemic, determine white blood cell counts, measure blood urea nitrogen, creatinine, and electrolytes. A urinalysis is essential for the proper interpretation of the urea and creatinine values in the serum biochemistry profile and may also provide important clues to the possible underlying cause of kidney disease. A urinalysis will also determine the specific gravity, pH, presence of blood in the urine, and the amount of protein in the urine. An evaluation of the urine sediment will determine the presence of red blood cells, white blood cells, bacteria, crystalline material, and cellular casts all of which provide information to determine the underlying cause of kidney disease in your pet. Further diagnostic tests may be recommended based on the results of these initial screening tests.

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Early Stage Testing for Kidney Disease in Cats

Microalbuminuria refers to the presence of very small amounts of albumin in urine. It may indicate underlying health problems and is sometimes an early warning sign of primary kidney disease. Many conditions can potentially lead to microalbuminuria (e.g., dental disease, chronic skin disease, feline leukemia virus, feline immunodeficiency virus, diabetes mellitus, hyperthyroidism, hypertension, and cancer). A simple test, early renal damage test (ERD), may be used to detect microlbuminuria. A small amount of urine collected in a sterile container to run this test. Microalbuminuria does not mean that your pet has serious kidney disease, and your veterinarian will recommend further testing to look for hidden disease if microalbuminuria is detected.

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Early Stage Testing for Kidney Disease in Dogs

Microalbuminuria refers to the presence of very small amounts of albumin in urine. It may indicate underlying health problems and is sometimes an early warning sign of primary kidney disease. Many conditions can potentially lead to microalbuminuria (e.g., dental disease, chronic skin disease, feline leukemia virus, feline immunodeficiency virus, diabetes mellitus, hyperthyroidism, hypertension, and cancer). A simple test, early renal damage test (ERD), may be used to detect microlbuminuria. A small amount of urine collected in a sterile container is needed to run this test. Microalbuminuria does not mean that your pet has serious kidney disease, and your veterinarian will recommend further testing to look for hidden disease if microalbuminuria is detected.

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Leptospirosis in Dogs - The Disease and How to Test for It

Leptospirosis is an infectious disease caused by a type of bacteria called Leptospira. The disease causes serious damage to the kidney and liver, and may be fatal in severe cases. Severely infected dogs show signs of lethargy, depression, loss of appetite, vomiting, fever, and increased thirst and urination. Dogs may develop jaundice. There are several tests for diagnosing leptospirosis, but the two most common ones are the DNA-PCR test and the microscopic agglutination test (MAT). Infection can be diagnosed with either test, but each has weaknesses, and in some situations both tests may be needed to reach a diagnosis.

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Testing for Liver Disease

Initial screening tests for liver disease include a CBC, biochemistry panel, and urinalysis. A CBC can be used to differentiate hemolytic icterus from hepatic/post-hepatic icterus by measuring the PCV or HCT. Elevated WBC can also indicate presence of infection or cancer. ALP and GGT elevations can indicate a problem with bile flow through the liver. AST and ALT reflect liver cell damage. Bilirubinemia indicates a problem with the uptake, processing or excretion from the liver as long as hemolysis has been ruled out. Other serum indicators of liver disease include albumin, glucose, BUN, and cholesterol, as low numbers could suggest a reduced ability of the liver to manufacture these components. Certain parameters in urine can change before blood changes are seen making urinalysis a useful tool in diagnosing liver disease. Bile acid testing can be used to detect problems in liver function. More advanced diagnostics to determine the cause of liver disease include abdominal ultrasound, fine needle aspiration of the liver, or liver biopsy.

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Testing for Lyme Disease in Dogs

This handout discusses Lyme disease in dogs, primarily the issue of methods of testing for the disease.

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Testing for Pancreatic Disease

The pancreas is an abdominal organ responsible for regulating blood glucose (endocrine function) and releasing enzymes that aid in digestion (exocrine function). A deficiency in releasing digestive enzymes causes a disease called exocrine pancreatic insufficiency. This disease is diagnosed by measuring blood levels of trypsin-like immunoreactivity that is proportional to the amount of a specific digestive enzyme released into the intestine (trypsin). False negatives can be seen with concurrent pancreatitis or not performing the test on a fasted sample. B12 and folate levels can be supportive of the diagnosis. Endocrine pancreatic dysfunction causes diabetes mellitus, diagnosed by elevated glucose levels in the blood and urine. Pancreatitis diagnosis without a biopsy of the organ is not straightforward. Many abnormalities in blood tests can support the diagnosis, including: increased white blood cells, increased PCV, increased amylase or lipase; but an elevation of pancreatic specific lipase immunoreactivity is the most diagnostic of the blood tests. Ultrasound and X-rays can also show changes supporting pancreatitis.

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Pancreatitis in Cats - Pancreas-Specific Lipase

Pancreas-specific lipase is a form of lipase produced only in the pancreas and is highly specific to the pancreas. Blood values increase only when there is pancreatic inflammation. There is now a version of the fPLI test that can be used in-clinic (SNAP fPL© from IDEXX). Ideally, the sample should also be sent to the laboratory to get an actual value of fPLI to help with treatment and monitoring.

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Pregnancy Testing in the Dog

A blood test detects pregnancy in the pregnant dog by measuring levels of a hormone called relaxin. This hormone is produced by the developing placenta following implantation of the embryo, and can be detected in the blood in most pregnant dogs as early as 22-27 days post-breeding.

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Pancreatitis in Dogs - Pancreas-Specific Lipase

Pancreas-specific lipase is a form of lipase produced only in the pancreas and is highly specific to the pancreas. Blood values increase only when there is pancreatic inflammation. A version of the cPLI test can now be used in-clinic (SNAP fPL© from IDEXX). Ideally, the sample should also be sent to the laboratory to get an actual value of cPLI to help with treatment and monitoring.

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Pre-surgical Preparation and Testing

Pre-anesthetic testing is the best way to minimize anesthetic risks and ensure good surgical outcomes. Pre-anesthetic testing consists of, at minimum, a full physical examination. Depending on the patient and the reason for anesthesia, blood testing including CBC and biochemistry is often recommended and additional testing such as urinalysis, radiographs, EKG or more advanced testing may be needed. The results of pre-anesthetic testing are used to formulate the safest anesthetic plan for your pet.

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Serum ACTH

Adrenocorticotropic hormone is produced in the brain and regulates the production of cortisol. When blood cortisol levels are low it is secreted to stimulate more production and when cortisol is high it will suppress the production of ACTH. Cushing’s disease caused by a pituitary tumor will result in elevated ACTH levels in the blood, whereas Cushing’s disease caused by an adrenal tumor will result in lower ACTH blood levels as production will be suppressed by the cortisol released from the adrenal tumor. Endogenous ACTH cannot be used alone to diagnose Cushing’s disease, but can help determine what type of Cushing’s disease the patient has.

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Serum Biochemistry

Serum biochemistry measures the amount of enzymes, proteins, sugar, electrolytes, minerals, and hormones found in the liquid portion of the blood. Determining the amount of these factors in the blood can provide evidence of dysfunction or disease in certain organs or metabolic pathways indicative of certain diseases. This article provides general information on the most routinely measured factors in serum and common reasons for abnormal readings.

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Serum Electrolytes

Electrolytes are the salts and metallic components that are dissolved within the blood serum, and are involved in most of the body's daily functions.

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Serum Iron Testing

Serum iron tests are indicated when the results from a complete blood count (CBC) indicate that your pet is anemic (decreased red blood cell numbers and/or decreased hemoglobin) and that the red blood cells are microcytic (smaller than usual) and hypochromic (contain less hemoglobin than usual).

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Serum Protein Electrophoresis - General

Serum is the liquid portion of blood from which the red blood cells, white blood cells, and factors involved in blood clotting have been removed.

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Testing for Abdominal Enlargement in Dogs

The causes of abdominal enlargement include an increase in intra-abdominal fat due to simple overall weight gain because of excess calories or insufficient exercise. A redistribution of fat into the abdominal cavity may occur with Cushing's disease.

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Testing for Cough

Coughing can have many different causes. Important for the diagnosis is a thorough history, physical exam, and screening tests including CBC, biochemistry profile, urinalysis, fecal testing (including fecal Baermann), heartworm testing, and chest radiographs. Additional, more advanced diagnostics, may be needed including ultrasound, thoracocentesis, transtracheal wash, bronchoscopy, or bronchoalveolar lavage. Culture and sensitivity testing, fungal serology, and cytology may be performed on fluid/tissue that is sampled.

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Testing for Decreased Appetite with Listlessness

Listlessness and inappetence are vague signs that can occur in pets for many reasons, both physical and mental. Conditions that produce these signs include grief, anxiety, oral disease, organ dysfunction, and cancer. Diagnosis starts with taking a thorough history and physical exam and may progress to screening tests including a CBC, biochemistry profile, and urinalysis. Other diagnostic tests that may be needed include hormonal tests, liver function tests, imaging (radiographs or ultrasound), culture and sensitivity, or specific tests for infectious diseases or immune mediated disease.

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Testing for Diarrhea

Diarrhea can be caused by many different things, some easier to diagnose than others. Simple diarrhea with no other clinical signs may not require diagnostic testing, but if diarrhea is ongoing or your pet is showing other clinical signs then baseline diagnostic testing including complete blood count (CBC), biochemistry profile, urinalysis, and fecal testing may be recommended. Additional diagnostic testing may be required depending on the results of these tests.

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Testing for Fever of Unknown Origin

Fever of unknown origin is a term used for persistent fever in pets. It has many causes including infection, immune-mediated disease and cancer. Initial steps in diagnosis are history and physical exam, followed by standard screening tests including CBC, biochemistry profile, and urinalysis. Based on the results of these tests, further testing may be indicated such as imaging (radiographs and/or ultrasound), fine needle aspiration, joint taps, bacterial or fungal cultures of affected fluid/tissue, and specific testing for diseases such as feline leukemia virus, feline immunodeficiency virus, or Lyme disease.

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Ultrasound Examination in Cats

An ultrasound machine emits and receives high frequency ultrasound waves through a transducer or probe. The probe is placed over the area of interest, directing the sound waves into the body. The ultrasound waves may be transmitted through, reflected from, or absorbed by the tissues that they encounter.

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Testing for Increased Appetite

An increased appetite can be normal in pets that have higher than normal energy requirements, as growing puppies and kittens, pets that exercise strenuously, such as hunting dogs, and pregnant or nursing females. Many diseases can cause an increased appetite, including hyperthyroidism in cats, Cushing's disease, intestinal disease, diabetes or insulinoma, intestinal parasitism, and cancer. Increased appetite can also be caused by certain medications, such as corticosteroids. Diagnosis generally requires a thorough history, physical exam, complete blood count (CBC), biochemistry panel, thyroxine (in cats), and urinalysis. Additional diagnostic testing may be required.

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Testing for Increased Thirst and Urination

These clinical signs are non-specific and can be caused by many different diseases or conditions. Usually increased production of dilute urine results in a compensatory increase in water consumption, but occasionally the condition is one of increased water intake resulting in the production of large volumes of dilute urine.

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Testing for Jaundice

Jaundice is caused by the build-up of bilirubin in the tissues due to high blood levels of bilirubin (hyperbilirubinemia). Hyperbilirubinemia occurs either due to increased red blood cell destruction (hemolysis), or the liver is unable to process or excrete bilirubin normally. CBC, biochemistry panel, and urinalysis are tests used to further define the cause of jaundice. Hemolysis will result in significant reduction of PCV/HCT but not affect plasma protein levels. Abnormal RBCs may be seen indicating IMHA or infectious causes of hemolysis. Liver disease severe enough to cause jaundice will result in significant increases in liver values: ALT and AST if the liver has been damaged by toxins, infection or tumors; ALP and GGT if there is a problem with bile flow out of the liver and/or gallbladder such as gallstones or pancreatitis. Obstruction of bile flow may also be detected in urine samples as a lack of urobilinogen. These tests only define where the problem is occurring, not what the problem is, so further diagnostics that may be needed and include ultrasound, X-ray, FNA, liver biopsy and/or bacterial culture from fluid found in or around the liver. More specific tests for infectious diseases include FeLV, feline coronavirus, and fungal testing.

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Testing for Lameness

The most common cause of lameness is trauma or injury to joints, ligaments, tendons, muscles, or bones. Other causes of lameness include developmental diseases in young animals, degenerative joint disease in older pets, immune-mediated joint disease, infectious joint diseases, neurological disorders, and cancer of the bones or joints. Finding the cause of a pet's lameness usually starts with a complete history and physical examination. Tests such as X-rays, joint fluid analysis, and blood testing may also be used to diagnose the lameness.

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Testing for Low Blood Sugar

Hypoglycemia can be caused by many different things including liver failure, sepsis, Addison’s disease, and overdose of insulin in the treatment of diabetes mellitus. Clinical signs include weakness, tremors, and rarely seizures. After detecting hypoglycemia on a blood sample, determining the cause includes a full history, physical exam, CBC, biochemistry profile, and urinalysis. In some cases, more advanced testing such as imaging, biopsy, or ACTH stimulation testing will be recommended.

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Testing for Seizures

Seizures typically occur for three main reasons, but finding the cause can be difficult. Finding the cause of a pet's seizures can be difficult and usually starts with a complete history and physical examination. Your veterinarian will likely recommend screening tests to look for metabolic disease and other illnesses that can cause seizures. Screening tests are a series of simple tests that provide information about the overall health of the pet. There are many additional tests that can be done depending on the results of history, physical examination, and screening tests.

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Testing for Pallor

In pets, pallor is usually detected as a loss of color from the gums and inner eyelids. Pallor is a sign of illness and your veterinarian will take your pet’s history, perform a physical exam and perform initial blood and urine screening tests to determine the cause of pallor. Depending on the results of the history, physical exam, and screening tests, additional tests such as X-rays, ultrasound, biopsy, echocardiography, and specialized blood tests may also be recommended.

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Testing for Unexplained Bleeding

Most bleeding (or hemorrhage) is caused by trauma. There is usually a wound or a history of injury to explain why a pet is bleeding. Typically, the bleeding stops when a blood clot forms at the site of injury.

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Testing for Sneezing and Nasal Discharge

Sneezing and nasal discharge can occur for many different reasons including infection, allergy, foreign body, and tumors. A thorough history and physical exam is the first step in diagnosing the cause of sneezing/nasal discharge. Initial screening tests include CBC, biochemistry profile, urinalysis, and coagulation testing. These tests can be used to indicate the safety of general anesthesia needed for additional testing. Specific testing that may be recommended for determining the cause of nasal discharge/sneezing may include nasal swab for cytology, radiographs of the nasal cavity, nasal flush for cytology, culture and sensitivity testing, and rhinoscopy. Chest radiographs, specific micro-organism DNA testing, more advanced imaging such as CT or MRI, and biopsy may be considered based on initial test results.

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Testing for Inappropriate Urination (Urinating in the House)

Inappropriate urination happen in well-trained pets for many reasons, including inflammation, infection, estrogen deficiency, kidney failure, diabetes mellitus, diabetes insipidus, Cushing's disease, neurological disease, or behavioral issues. A number of screening tests will be performed by your veterinarian to determine the root cause of the inappropriate urination. These tests may include complete blood count, serum biochemistry, and urinalysis. Depending on the results of the screening tests, your veterinarian may recommend further testing including culture and sensitivity, cytology, X-rays or ultrasound, and stone analysis.

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Testing for Vomiting

Many problems can lead to vomiting, some easier to diagnose than others. Simple acute vomiting with no other clinical signs may not require diagnostic testing, but if vomiting is ongoing or your pet is showing other clinical signs, then baseline diagnostic testing including complete blood count (CBC), biochemistry profile, urinalysis, and fecal testing may be recommended. Additional diagnostic testing may be required depending on the results of these tests.

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Testing for Weakness

Pets that feel weak often have difficulty getting to their feet and move slowly or unsteadily. Other signs include shaky muscles, fainting, or collapse. You may find your pet does not want to exercise, seems dull, and does not respond when you call.

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Testing for Weight Loss in Dogs

Weight loss can be due to simple problems of feeding and nutrition, or can be due to a variety of medical conditions that result in poor digestion, decreased absorption of nutrients, or loss of nutrients from the body.

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Thyroid Hormone Testing in Cats

Diagnosis of hyperthyroidism includes screening the hormone output of the thyroid as well as screening for other systemic disease. This is achieved by running a complete blood count, biochemistry panel, urinalysis and total T4 (tT4). In cats with signs of hyperthyroidism but with tT4 levels in the upper half of the reference range will often have their free thyroid hormone tested using a special test called equilibrium dialysis. More advanced screening for hyperthyroidism includes the t3 suppression test and advanced imaging of the thyroid called scintigraphy.

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Thyroid Hormone Testing in Dogs

Diagnosis of hypothyroidism includes a complete blood count, biochemistry profile urinalysis and thyroid-related hormones. Anemia, elevated cholesterol and mild liver enzymes are supportive of a diagnosis of hypothyroidism. Assessing thyroid hormone output can be difficult as other diseases and medications can suppress blood thyroxine levels. A combination of measurements of total T4, free T4 by equilibrium dialysis, and thyroid stimulating hormone (TSH) is generally used to confirm a diagnosis. Measurements of total T4 may be used to monitor thyroid levels if your dog requires hormone replacement therapy.

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Urinalysis

Urinalysis is an important part of any comprehensive workup or health screen as it provides information on the urinary system including the kidneys and bladder and also can support diagnosis of metabolic disease such as diabetes mellitus. Urine collection methods include cystocentesis, catheterization, or mid-stream free flow, each of which has their own pros and cons. Urine samples are assessed using the following parameters: appearance (color and turbidity), concentration assesses how the urine has been concentrated by the kidneys, urine dipsticks (assess pH, glucose, protein, blood, ketones, urobilinogen, and bilirubin), and microscopic exam of sediment (may reveal the presence of abnormal cells including red blood cells, white blood cells, and tissue cells or crystals). A cytological preparation of sediment may be recommended to look at tissue cells in more detail.

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Trypsin-Like Immunoreactivity

Trypsin-like immunoreactivity (TLI) is a blood test that measures the amount of a pancreatic proenzyme called trypsinogen. This measurement correlates with the amount of pancreatic enzymes released into the intestine to aid in digestion. A low measurement indicates exocrine pancreatic insufficiency. Concurrent pancreatitis or tests done shortly after a meal may temporarily increase this measurement to a normal value (false negative).

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Allergies in Dogs

An allergy is a state of over-reactivity or hypersensitivity of the immune system to a particular substance called an allergen. Most allergens are proteins from plants, insects, animals, or foods. In dogs, the most common symptom associated with allergies is itchy skin, either localized (in one area) or generalized (all over the body). In other cases, the allergic symptoms affect the digestive system, resulting in vomiting and diarrhea. The symptoms of allergies can be confused with other disorders or occur concurrently with them.

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Urine Cortisol

Cortisol is a stress hormone that is excreted from the body in the urine. Creatinine is a product of muscle metabolism and it is normally lost in the urine at a relatively steady rate. The ratio of cortisol to creatinine in the urine can be used to account for the effect of urine concentration. Urine cortisol/creatinine ratio is usually evaluated in animals suspected of having Cushing's disease. This test involves the collection of a single urine sample, taken first thing in the morning. Ideally, this sample should be collected at your home, to minimize the effects of stress.

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Urine Protein

The presence of protein in urine is called proteinuria. This may indicate that the kidneys are not working properly. In some situations, it may even be a sign of kidney failure; however, bleeding or inflammation in the urinary system is a far more common cause of proteinuria. If proteinuria is not due to inflammation or bleeding in the urinary system, then it is more likely to be a sign of true kidney disease. Your veterinarian may recommend further testing if the urinalysis reveals inflammation or bleeding.

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Urine Protein:Creatinine Ratios

The urine protein:creatinine (UPC) ratio is a simple test that measures how much protein is being lost through the kidneys. Creatinine is a substance that appears in the blood as the result of muscle activity and is excreted by the kidney at a constant rate. The urine protein:creatinine ratio measures whether the excretion of protein is greater than expected when compared to the excretion of creatinine. Before the protein:creatinine ratio can be interpreted, two other measures of kidney function should be taken. These are blood urea nitrogen (BUN) and serum creatinine. In order to make a definitive diagnosis of kidney disease, repeat tests of protein:creatinine ratio and urinalysis on at least three consecutive urine samples taken at 2-week intervals is recommended.

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Viral Disease Testing in Cats

Feline viral testing typically encompasses testing for feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and coronavirus which causes feline infectious peritonitis (FIP). FeLV is one of the most important highly contagious viruses in cats as it is responsible for a number of diseases including leukemia. FIV is a virus that weakens the immune system's response to other infectious agents. Testing for FeLV and FIV is recommended to detect underlying causes to illness, to screen apparently healthy cats who may have been exposed to the viruses, and to identify carriers of the viruses prior to introducing cats into a household of other cats. FIP testing is somewhat more problematic.

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Von Willebrand's Disease Testing

Von Willebrand's disease causes an inability for blood to clot resulting in excessive bleeding. If this disease is suspected, initial screening tests include a complete blood count (CBC), buccal mucosal bleeding time, and a coagulation profile. More advanced diagnostics include assays that assess the quantity and functionality of vWF. DNA testing is available and most commonly used to evaluate animals used in breeding programs.

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Viral Disease Testing in Cats - Prevaccination

Testing for FeLV is recommended to detect underlying causes to illness, to screen apparently healthy cats who may have been exposed to the viruses, and to identify carriers of the viruses prior to introducing cats into a household of other cats. Testing for coronavirus is indicated when FIP is suspected. In-clinic blood tests are available for FeLV. Confirmatory testing of any positive tests is recommended at referral laboratories, usually using DNA tests. Vaccination against FeLV will not affect the outcome of a cat already infected with the virus nor will it affect testing.

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Ultrasound Examination in Dogs

An ultrasound examination, also known as ultrasonography, is a non-invasive imaging technique that allows internal body structures to be seen by recording echoes or reflections of ultrasonic waves.

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Electrocardiogram in Dogs

An electrocardiogram (ECG, EKG) is a test that is used to assess the heart. More specifically, an ECG measures the transmission of an electrical impulse through the heart. This test is not painful and is typically performed as an outpatient procedure. Analyzing the electrical impulses produced as the heart beats can help identify a number of different abnormalities within the heart.

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Endoscopy - Gastrointestinal in Dogs

Your dog has been scheduled for an endoscopic examination. The purpose of this procedure is to help your veterinarian make a diagnosis of the disease that has been causing your pet's clinical signs of vomiting, diarrhea, weight loss, abdominal pain or swelling or loss of appetite.

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Skin Biopsy in Dogs

A biopsy is one of the more common diagnostic procedures performed in dogs. Biopsies provide valuable insight into the type of cells in an abnormal area of skin or a skin growth and whether the growth poses a more serious health threat to your pet. Either the entire mass or a small representative section of skin is removed and submitted to a veterinary pathologist, who will perform a histopathology analysis. The pathologist will attempt to determine the nature of the lesion, identify the type of cells and their relationship to each other, as well as any evidence of malignancy.

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Testing and Diagnostics for Sick Pet Birds

Wellness testing, performed routinely on apparently healthy birds, screens for underlying, inapparent problems. Veterinarians also use test results in conjunction with physical examination findings and the owner’s account of the bird’s history to diagnose illnesses. Blood tests include the complete blood count and chemistry profile. Other tests your veterinarian may use to assess your bird’s health and diagnose disease include Gram’s stain, culture and sensitivity testing, parasitology, X-rays, laparoscopic surgery, cytology, histopathology, virology, and genetic (PCR) testing. Post-mortem examination after a bird dies may be recommended to determine the cause of death.

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Holter Monitor in Dogs

A Holter monitor is a portable device used to continuously monitor the electrical activity of the heart and can be an effective and non-invasive way to help your veterinarian evaluate heart conditions especially when trying to determine the cause of fainting episodes or evaluate treatment. Many dogs are not bothered by it and ignore its presence.

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Radiographs (X-Rays) for Dogs

X-ray images are produced by directing X-rays through a part of the body towards an absorptive surface such as an X-ray film. The image is produced by the differing energy absorption of various parts of the body: bones are the most absorptive and leave a white image on the screen whereas soft tissue absorbs varying degrees of energy depending on their density producing shades of gray on the image; while air is black. X-rays are a common diagnostic tool used for many purposes including evaluating heart size, looking for abnormal soft tissue or fluid in the lungs, assessment of organ size and shape, identifying foreign bodies, assessing orthopedic disease by looking for bone and joint abnormalities, and assessing dental disease.

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Diabetes in Cats - Testing and Monitoring

Testing for diabetes includes confirming hyperglycemia and glucosuria while looking for other conditions by checking a CBC (anemia, infection), biochemistry profile (hepatic disease, pancreatitis) and a urinalysis (urinary tract infection). Monitoring includes regular glucose curves and additional exams and testing based on the pet owner’s monitoring of their cat’s clinical signs in the home setting. Urine glucose testing and fructosamine are sometimes used in diabetic monitoring and urine testing for infection may be recommended.

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Diabetes in Dogs - Testing and Monitoring

Testing for diabetes includes confirming hyperglycemia and glucosuria while looking for other conditions by checking a CBC (anemia, infection), biochemistry profile (hepatic disease, pancreatitis) and a urinalysis (urinary tract infection). Monitoring includes regular glucose curves and additional exams and testing based on the pet owner’s monitoring of their dog’s clinical signs in the home setting. Urine glucose testing and fructosamine are sometimes used in diabetic monitoring and urine testing for infection may be recommended.

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Testing for Heartworm Disease in Dogs

Heartworm disease is caused by a parasite called Dirofilaria immitis, better known as heartworm. Dogs become infected when they are bitten by an infected mosquito that is carrying immature heartworms. Heartworm disease is widespread in the United States and is particularly common along the southeastern and gulf coasts, and through the Mississippi River valley. In Canada, heartworm infection is localized to southern Ontario, southern Manitoba, and southern Quebec, with scattered occurrences elsewhere in the country.

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Testing for Abdominal Enlargement in Cats

Abdominal enlargement is a general term that means a cat's belly is larger or fuller than usual and bulges beyond the normal outline of the body. Abdominal enlargement may develop for many reasons depending on the age and gender of the cat.

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Testing for Weight Loss in Cats

Weight loss can be due to simple problems of feeding and nutrition, or can be due to a variety of medical conditions that result in poor digestion, decreased absorption of nutrients, or loss of nutrients from the body.

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Wobbler Syndrome in Dogs (Cervical spondylomyopathy)

Wobbler syndrome is a disease of the neck (the cervical spine) that is seen in large and giant breeds of dog. These dogs experience compression of the spinal cord and the spinal nerve roots, resulting in nervous system deficits and/or neck pain,

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Infertility in Male Dogs

Infertility in a male dog is defined as the inability to produce a successful pregnancy in a fertile female, even with multiple breedings near the time of ovulation. The causes of infertility fall under three broad categories: failure to copulate or ejaculate, poor semen quality, and prostatic disease. This handout explains the possible causes in detail, as well as methods to diagnose and treat them.

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Infertility in Female Dogs

Infertility in a female dog is defined as the inability to conceive and deliver viable puppies, even when mated multiple times with a known fertile male surrounding the time of ovulation. This handout outlines the varying causes of infertility in female dogs and how they may be diagnosed and treated.

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Electrocardiogram in Cats

An electrocardiogram, or ECG, is a test that is used to assess the heart. More specifically, an ECG records the transmission of an electrical impulse through the heart. This test is not painful and is typically performed as an outpatient procedure. Analyzing the electrical impulses produced as the heart beats can help identify a number of different abnormalities within the heart.

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Arthroscopy

This handout discusses arthroscopy, the insertion of a telescope-like camera into a joint. The joints commonly examined and treated using this technique, along with the benefits and risks of this procedure, are outlined.

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