Internal medicine examination in dogs and cats

Internal medicine examination in dogs and cats

Internal medicine includes diseases of the gastrointestinal tract, liver, kidneys, urinary tract, pancreas, hormonal system, blood and immune system, among others. Many internal medicine diseases cause non-specific symptoms, and it may therefore be necessary to combine several examinations to find the cause.

An internal medicine assessment at A-Vet is tailored to the individual dog or cat. We start with the medical history and a clinical examination and then select relevant blood tests, urine tests, imaging tests or other examinations based on the findings.

When might an internal medicine assessment be appropriate?

Internal medicine evaluation may be appropriate both for acute symptoms and for problems that have developed gradually or recur over time.

• Vomiting or diarrhea.
• Weight loss or change in appetite.
• Increased thirst or increased urination.
• Lethargy, weakness, or decreased activity level.
• Fever or recurring episodes of illness.
• Changes in urine or problems urinating.
• Abnormal findings on previous blood or urine tests.
• Suspected disease of the liver, kidneys, gastrointestinal tract, pancreas or hormonal system.

The symptoms are not specific to one particular disease. The goal of the investigation is therefore to determine which organ systems may be involved and which further investigations are most relevant.

How is the investigation carried out?

The evaluation begins with a thorough medical history. Information about when the symptoms began, how they have developed, appetite, desire to drink, urination, defecation, medications, and previous illnesses can be important in narrowing down possible causes.

The veterinarian then examines the animal and assesses, among other things, the general condition, mucous membranes, lymph nodes, heart and lungs, abdomen, temperature and other relevant findings. Further diagnostics are selected based on this assessment. Not all patients need all types of examinations.

Laboratory diagnostics at A-Vet

A-Vet has its own laboratory with several analytical instruments that allow many blood and urine samples to be examined directly at the clinic. This is particularly useful in cases of acute illness and when we need test results quickly to plan further diagnostics or treatment.

The tests that are performed depend on the patient's symptoms and what the veterinarian wants to investigate. A test result is always considered together with the medical history, clinical examination and any other diagnostic findings.

Hematology

A hematological examination provides information about red blood cells, white blood cells and platelets. The analysis can help to detect anemia, inflammatory reactions, certain infections and changes in the platelets, among other things.

If necessary, we also evaluate blood smears under a microscope. This makes it possible to examine the blood cells more closely and verify findings from the automated analysis.

Biochemistry and electrolytes

Biochemical blood tests are used to examine, among other things, liver and kidney function, proteins, blood sugar and a number of other parameters. Electrolytes such as sodium and potassium can be important in cases such as vomiting, diarrhea, kidney disease, hormonal disorders and in acutely ill patients.

The results must be interpreted collectively. A single elevated or decreased value does not necessarily mean disease in a specific organ.

Blood gas and acid-base status

Blood gas analysis can provide information on, among other things, acid-base status and, depending on the sample and analysis, respiratory and metabolic changes. Together with electrolyte measurements, this can be particularly useful in the assessment of acutely ill patients, fluid therapy and intensive care.

Urine examination

Urine tests can provide important information about both the urinary tract and diseases elsewhere in the body. We can, among other things, assess the concentration and chemical composition of the urine and examine the urine sediment for cells, crystals, bacteria and other findings.

At A-Vet we use automated urinalysis and, if necessary, further evaluate the sample microscopically. If a bacterial urinary tract infection is suspected, culture and susceptibility testing may be appropriate.

CRP and SAA

CRP and SAA are acute phase proteins that can increase during inflammation. The measurements can be used in conjunction with clinical findings and other tests to assess the degree and development of an inflammatory process and can also be useful for follow-up over time.

CRP and SAA alone do not tell what has caused the inflammation, and the results must therefore be interpreted together with the rest of the examination.

Hormones and metabolic analyses

If hormonal or metabolic diseases are suspected, we can perform relevant analyses. This may include thyroxine (T4) when assessing metabolism and fructosamine when investigating or monitoring diabetes.

Which hormone tests are relevant depends on symptoms, type, age, and other laboratory findings. Some hormonal diseases require more specific tests or test protocols.

Pancreas

If pancreatitis is suspected, symptoms, clinical findings and laboratory tests are assessed together, often in combination with ultrasound. If necessary, we can measure pancreas-specific markers that are part of the diagnosis. Regular measurements of amylase or general lipase alone are not sufficient to diagnose pancreatitis in dogs or cats.

Coagulation

If a coagulation disorder is suspected, we can examine the blood's ability to clot. This may be relevant in cases of unexplained bleeding, before certain procedures, or if poisoning with anticoagulant rat poison is suspected.

Tests for infectious diseases

If there is a correct clinical suspicion, we can test for a number of infectious diseases. Current investigations may include tests for Lyme disease, ehrlichiosis, heartworm, Giardia, FIV, FeLV and parvovirus.

Which test is appropriate depends on, among other things, symptoms, risk of infection, travel history and where in the course of the disease the sample is taken. If necessary, samples are sent to an external laboratory for more specialized diagnostics.

Microscopy and cytology

Microscopy is used, among other things, in the evaluation of blood smears, urine, skin and ear samples, and cell samples from lumps or other changes. Cytology can in many cases provide rapid and useful information about inflammation, infection, or cell changes.

Progesterone measurement

We also perform progesterone measurements in dogs. This is mainly used in connection with reproduction and can help assess the timing of ovulation and plan mating or insemination.

X-ray and ultrasound during internal medicine examinations

Laboratory tests do not always provide the full answer. For many internal medicine issues, we therefore combine blood and urine tests with diagnostic imaging.

X-rays can be used to examine the chest and abdominal cavity, and can reveal changes in organ size, fluid, foreign bodies, and other abnormalities. Ultrasound allows for the examination of the structure and movement of organs in more detail and is used, among other things, to assess the liver, gallbladder, kidneys, urinary bladder, gastrointestinal tract, pancreas, and other structures in the abdominal cavity.

Ultrasound can also be used as guidance when there is a need to take cell samples, fluid samples, or urine samples directly from specific areas.

Diagnostic equipment at the clinic

Our laboratory consists of several analytical machines that complement each other. We use, among others, IDEXX Catalyst Dx for clinical biochemistry, IDEXX ProCyte Dx for hematology, IDEXX SediVue Dx for urine sediment, IDEXX Coag Dx for coagulation studies, and IDEXX VetStat for blood gas and electrolyte analyses.

We also use the Eurolyser VET-CUBE for selected analyses that can be performed at the clinic. The analyses used are decided by the veterinarian based on the specific problem.

You can read more about the clinic's modern diagnostic equipment.

When do we send samples to an external laboratory?

Not all analyses can or should be performed at the clinic. If necessary, we send samples to external veterinary laboratories, including IDEXX and Laboklin. This provides access to a wide range of specialized analyses within, among others, hormone diagnostics, infectious diseases, pathology, cytology and other more specialized examinations.

The choice between analysis at the clinic and an external laboratory depends on which examination is necessary, how quickly the answer is needed, and which analysis method is best suited to the problem.

An assessment tailored to the individual patient

Internal medicine diseases can be easy to diagnose, but sometimes multiple examinations and follow-up over time are required before the cause becomes clear. We therefore try to work step by step and select examinations that can provide relevant information at each stage of the investigation.

If the animal has already had blood tests, urine tests or imaging tests at another clinic, it is useful if previous test results and medical records are available before the consultation.

Contact A-Vet if you have questions or would like to book an appointment for an internal medicine examination.