Veterinarians must depend heavily upon owners to provide valuable observations or a history when they arrive at the hospital with their pet. The history of a pet’s illness can often prove more valuable than the patient’s physical exam in assisting veterinarians in creating a problem list. Your observations can truly be integral in the speedy diagnosis and treatment of your pet. I always consider my clients comments about their pets activity, eating habits and any changes their behavior incredibly valuable. First, they are observing the patient in it’s ‘normal’ environment, where their pet is most comfortable and relaxed and more likely to demonstrate any changes in their mobility, energy level and personality. Also, the owners observations are made over a longer period of time, this results in them being more likely to observe changes that may be demonstrated infrequently.
However, despite their importance, some owners do not come prepared with all the information I need. Owners often need a guide to take them through their observations so that together we might write a more complete patient history. Here are a few suggestions that may help you prepare a better history, even before your arrival at the hospital:
- Keep it chronological - I always ask clients basic information about the pets appetite, bathroom habits, diet, etc. Then I ask them to begin when they first noticed the pet’s problem. I ask for the date and time and then I encourage them to move through the history one hour, day or week at a time, whatever is most appropriate. The most important thing to remember is to begin at the beginning. Try to look back and identify that time when your pet went from healthy and active to ill, then move on from there.
- Keep notes - If you are anything like me, I tend to forget what I was doing earlier in the week, let alone what my parrot ate for breakfast 2 days ago! I encourage clients to use their calendar on the fridge, that is usually available to the whole family so everyone can write down their observations. I also suggest they use the note pad in their smart phone. It even allows them to dictate observations rather than spending time typing.
- Bring in all medications or supplements you have been giving-If you have been to other veterinarians, been using homeopathic remedies or giving your pet any other types of medications or supplements bring them in so that dosages and frequency of administration can be discussed.
- Watch your pet for changes in it’s routine, is it sleeping more, staying in a different part of the house, drinking more water or asking to go outside more or less often? Even small changes in routine can speak volumes about your pets well being.
What about the accuracy and quality of your observations? Clients have a tendency to interpret their pets behavior through the only filter they have, their own personal experience. However, we rely on our voices express how we feel. We certainly express ourselves through actions as well, but our actions and our pets actions carry very different meanings. Because of the differences in how we and our pets communicate there can be errors in our interpretation. Here is an example of how that happens: A client arrives with a small dog that is unable to bear weight on one of its rear legs, its panting heavily and refuses to lay down in the exam room. The owner says with confidence that the lameness developed just this morning and it cannot be too serious because the dog is not crying out. I explained that many pets do not cry in pain. However, being unable to bear weight on a limb and unable to rest comfortably certainly screams ‘I AM PAINFUL’ in the animal kingdom. Obviously, this client was interpreting her pets actions, or lack thereof, incorrectly. This lead to difficulty in implementing a complete treatment plan since she continued to insist the dog was not in pain.
Another common misperception is that animals sleep more because they are getting old, so often owners won’t even mention this change in an older pets activity. Be careful to supply your veterinarian with the facts, be detailed, but try to not place your interpretation on your observations. Let your clinician help you in understanding what you are observing. Like they said on the old Dragnet shows, ‘Just the facts ma’am”.
Over the past few years there have been new tools made available to us to help with ‘re-directing’ or filtering clients (and veterinarians) observations to assist us in helping create more accurate histories and hopefully teach our clients more about their pets behavior when they are ill. Dr. Duncan Lascelles at North Carolina State at the The Comparative Pain Research Laboratory with sponsorship of Morris Animal Foundation, Novartis Animal Health, and Boehringer Ingelheim Vetmedica Inc. has created a Feline Musculoskeletal Pain Index (FMPI) that allows clients to respond to a series of questions regarding their cats activity and then the responses are compiled into a score. The FMPI can also be utilized as a long term management tool, using the scores to assess treatment success. The Colorado State Pain Scale (posted in a previous blog) is another tool used by veterinarians, but could prove valuable in improving the quality of our clients observations. Even these evaluation techniques, as helpful as they are, remain a work in progress. Animal behavior, particularly a sick pets behavior, is a developing field of study.
So how might you improve upon you observation skills when it comes to your pet? Take a moment and look at things like the CSU Pain Scale or the Feline Pain Index and think about how your pet may be demonstrating discomfort in ways you may not have recognized previously. Recognize that your pets normal behaviors, such as: the areas of the house that they enjoy resting in, the number of stairs that they are willing to climb, the number of squirrels chased daily, the amount of food eaten and water drank daily, how much they weigh, the quality of their hair coat and how they interact with the family and other pets are extremely valuable. Then create a normal ’baseline’ from all these observations. Next, when you notice these things changing, try to be as accurate as possible in quantitating or qualifying the degree of change without applying your own interpretation. Keep a record, write notes so you can create a time line for these observations. Lastly, when you hear that little voice in your head, telling you that your pet is acting different, take your pet to your veterinarian. Remember, little changes in your pets activity may be signs of a more major change going on within your pet.