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A Veterinary Detective Story

How to figure out what clients are trying to tell you about their pets.
By Apryl Leipold, RVT
 

I’ve always said that if dogs and cats could tell us what was wrong with them, we would have a perfect job. (I’ve also said that if they could drive and had their own credit cards we would have a perfect job but that’s a story for another day.) Since they can’t tell us “where it hurts” we need to rely on their owners to provide us with that information. That, of course, can be problematic.

In an emergency setting, technicians and veterinary assistants are often called upon to aid the receptionist by answering the phone when things get busy and that’s the first opportunity to begin to get an accurate history. There are those owners, bless them, who are knowledgeable about veterinary medicine and can describe the symptoms perfectly, using proper terminology. But, more often than not, it will be up to you to figure out what the client is trying to say by asking the proper questions and trying to determine if you‘re dealing with an emergency. 

This ability is also important in a day practice. Knowing whether Fluffy needs to be seen immediately or if you can make an appointment for later in the day will reflect well on your value to the practice and, hopefully, be remembered when it’s time for a bonus or a raise.

Whether over the phone (and, yes, most clients assume we are magically Skyping their phone call and can see their pet) or in the exam room taking the medical history before the veterinarian sees the pet, there are standard questions to ask.

1. Is it a dog or a cat? (This is phone call only. I trust that you can tell for yourself once the pet is in the hospital.)
2. Breed? (Ditto)
3. How old is he or she?
4. While we’re at it, is it a male or female?
5. Indoor or outdoor?
6. Is he/she eating, drinking, vomiting, having diarrhea, urinating and defecating appropriately?
7. Is he/she currently under treatment for a medical problem or on any medications?
8. Could he/she have gotten into anything? 
9. Is he/she current on vaccines?
10. Is he/she neutered/spayed?

Okay, now let’s use our top-ten questions on a couple of hypothetical phone conversations. Keep in mind that we’re not veterinarians and it’s not our job to diagnose the problem. We’re only trying to get an accurate medical history to aid the veterinarian and expedite treatment.

“He’s sleepy.” 
‘Sleepy’ can mean anything from lethargic to comatose. The rule-outs for a lethargic pet are limitless but let’s try to narrow it down. Eight-week old Chihuahua? It’s possible that we’re dealing with either parvovirus or hypoglycemia. Three-year old cat, whether neutered or intact, who might or might not be urinating? He possibly has a urinary obstruction. Ten-year old unspayed mixed breed? It might be a pyometria. Four-year old Schnauzer who grabbed a pork chop off of the dining room table and has been vomiting? Pancreatitis is a definite possibility.

“My pet is having trouble breathing.”
Any animal suspected of being dyspneic needs to be seen immediately; however, asking questions quickly can provide valuable information. Ten-year old poodle? It’s possible that we’re dealing with cardiac disease. Twelve-week-old Bulldog who vomited up his dinner? It might be the beginning of aspiration pneumonia. An otherwise healthy two-year-old Siamese who’s wheezing after the carpets got cleaned? We need to rule out feline asthma. 

Here’s a fun phone call: An otherwise healthy three –year-old Pug who suddenly can’t breathe. The fun part comes in when the client either holds the phone up to the dog so you can hear it for yourself, (“Please, sir, that’s really not going to help. “Oh, crud, he’ll be back on the line eventually.) or does an imitation of what’s going on for you. If he sounds like someone snoring backwards, you might be dealing with a reverse snort/sneeze (aka inspiratory paroxysmal respiration). By the way, you get extra credit if you learn how to replicate the sound well enough for the client to yell, “Yeah! That’s it.”

ADR is a phrase we borrowed from large animal practitioners. It stands for, “Well, I dunno, Doc. Ol’ Bessie just ain’t doin’ right.” We see our share of ADRs in the small animal field and when you do, it’s time to don your figurative fedora, ask the right questions and add “veterinary detective” to your resume. Happy sleuthing!

Apryl Leipold is a registered veterinary technician and works at the Animal Emergency Centre in Studio City, Calif. She entered the field in the early '70s, starting as "kennel help" and working her way up to veterinary assistant. Apryl was among the first in California to take the RVT (then called Animal Health Technician) test under the grandfather clause; she was licensed in 1976. Apryl specializes in emergency medicine.

         

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