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A Veterinary health care provider's job is to know the animal body and its functions in terms of normality (homeostasis). The four cornerstones of diagnostic medicine, each essential for understanding homeostasis, are: anatomy (the structure of the human body), physiology (how the body works), pathology (what can go wrong with the anatomy and physiology) and psychology (thought and behavior). Once the provider knows what is normal and can measure the patient's current condition against those norms, she or he can then determine the patient's particular departure from homeostasis and the degree of departure. This is called the diagnosis.
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Once a diagnosis has been reached, the health care provider is able to propose a management plan, which will include treatment as well as plans for follow-up. From this point on, in addition to treating the patient's condition, the provider educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as providing advice for maintaining health.
Diagnostic procedures
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The diagnostic process is fluid in which the provider gathers information from the patient and others, from a physical examination of the patient, and from medical tests performed upon the patient.
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There are a number of techniques used by providers to obtain a correct diagnosis:
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Exhaustive method
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Every possible question is asked and all possible data is collected.
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Algorithmic method
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The provider follows the steps of a proven strategy.
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Pattern-recognition method
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The provider uses experience to recognise a pattern of clinical characteristics.
Differential diagnosis
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The health care provider uses the hypothetico-deductive method, a systematic, problem-focused method of inquiry.
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The advanced clinician uses a combination of the pattern-recognition and hypothetico-deductive approaches.
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The presence of some medical conditions cannot be established with complete confidence from examination or testing. Diagnosis is therefore by elimination of other reasonable possibilities, referred to as the diagnosis of exclusion.
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The process of diagnosis begins when the animal owner with the animal patient consults the animal health provider and presents a set of complaints (symptoms). If the patient is unconscious, this condition is the de facto complaint. The provider then obtains further information from the patient owner and from those who know the animal patient, if present, about the animal patient's symptoms, their previous state of health, living conditions, and so forth.
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Rather than consider the myriad diseases that could afflict the patient, the provider narrows down the possibilities to their illnesses likely to account for the apparent symptoms, making a list of only those disease (conditions) that could account for what is wrong with the patient. These are generally ranked in order of probability.
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The provider then conducts a physical examination of the animal patient, studies the patient's medical record, and asks further questions in an effort to rule out as many of the potential conditions as possible. When the list is narrowed down to a single condition, this is called the differential diagnosis and provides the basis for a hypothesis of what is ailing the patient.
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Unless the provider is certain of the condition present, further medical tests are performed or scheduled such as medical imaging, in part to confirm or disprove the diagnosis but also to document the patient's status to keep the patient's medical history up to date. Consultations with other providers and specialists in the field may be sought. If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses.
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Despite all of these complexities, most animal patient consultations are relatively brief, because many diseases are obvious, or the providers experience may enable him or her to recognize the condition quickly. Another factor is that the decision tree is used for most diagnostic hypothesis testing are relatively short.
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Once the provider has completed the diagnosis, the prognosis is explained to the patient and a treatment plan is proposed which includes therapy and follow-up consultations and tests to monitor the condition and the progress of the treatment, if needed, usually according to the medical guideline provided by the vetrinary medical field on the treatment of the particular illness.
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Treatment itself may indicate a need for review of the diagnosis if there is a failure to respond to treatments that would normally work.
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A laboratory diagnosis is either a substitution or complement to the diagnosis made by examination of the patient. For instance, a proper diagnosis of infectious diseases usually requires both an examination of symptoms, as well as laboratory characteristics of the pathogen involved.
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