Minimally Invasive Diagnostics
“Minimally Invasive Diagnostics” is the term given to investigation of a disease without having to resort to surgery. It is useful in all patients to avoid invasive surgical techniques and it is especially important in very young, very old or very ill patients. It is a very important aspect of modern veterinary practice.
The range of minimally invasive techniques we now have at our disposal was demonstrated this week when Hugo the Chihuahua was presented in my consulting room. Hugo has a long history of heart problems and has been on medication to help his heart for a number of years. Hugo had responded well to his medication and was quite a lively little chap. What Hugo lacked in stature, he made up for in abundance with attitude and I have discovered over the years that a deep breath and a thick towel between his teeth and my hands are essential whenever Hugo and I meet.
Hugo had not eaten for a couple of days and had started vomiting an alarming black fluid 24 hours earlier. Examining the colour of Hugo’s gums was impossible without risk to life and limb so I had a good feel in his abdomen. Unsurprisingly, Hugo resented me feeling his abdomen and growled with the ferocity of a dog twenty times his weight!
It was pretty clear that we were not going to be able to glean much from the physical examination!
Fortunately Hugo’s owner is much more understanding than Hugo and he agreed that we should admit Hugo for investigation. A blood sample was taken and the sample was run on the lab analysers in the surgery. The analyser gives us a comprehensive range of biochemistry and haematology parameters within 15 minutes.
The results showed high levels of urea and creatinine which are indicators of kidney function. The results suggested that his kidney function was impaired but did not suggest a likely cause of the impairment. Possibilities included kidney tumours, infection, toxins or ageing changes. I spoke with Hugo’s owner and we agreed to ultrasound scan his kidneys.
A light sedative helped to reduce some of his angst and a little area of hair was clipped over the kidneys. The scan revealed no evidence of tumour but the small dense kidneys suggested a chronic interstitial nephritis which can occur in old age.
With diagnosis made, Hugo was discharged to his relieved owner with medication to improve the performance of his kidneys. We had been able to get to the bottom of his problems without invasive investigations and with all of our fingers intact.