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Diagnostic Tests and Technology

Diagnostic Tests and Technology

Dramatic medical advances in the past few years have greatly increased the level of sophistication in veterinary medicine. Many of the same high-tech diagnostic tests and technologies that have been used to diagnose human problems, such as magnetic resonance imaging (MRI), are now available for our pets.

Diagnostic Tests

Veterinary science has entered an exciting time. New breakthroughs are allowing our pets to live longer and healthier lives. Unfortunately, the average pet owner is often unaware of all the specialties, diagnostic tests, and procedures available to their four-legged family member. The following sections describe a list of veterinary tests that help veterinarians diagnose and treat illness and injury.

Cytology and Histopathology

Cytology is the microscopic evaluation of cells from the body. This test is commonly employed to evaluate skin masses and other tumors. A needle is inserted into the mass, and suction is applied to a syringe attached to the needle. A sample of the cells from the mass is aspirated into the hub of the needle. The material is then sprayed onto a microscope slide and stained. A cytologist evaluates the cells. The advantage of this test is that anesthesia is rarely necessary to obtain the sample. The disadvantage is that, in some cases, the specimen obtained is inadequate to make a firm diagnosis. If that happens, a biopsy may be necessary to achieve a definite diagnosis. Histopathology is the microscopic evaluation of a biopsy specimen by a trained pathologist. The advantage of histopathology is that it is much more likely to yield a definitive diagnosis. The disadvantage is that obtaining a biopsy specimen is more invasive and requires anesthesia and surgery.

Complete Blood Count

This test evaluates all of the important blood cells: the red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes). The complete blood count gives information about whether a cat is anemic (too few red blood cells) and detects abnormalities in the white blood cell count-for example, to see if the white blood cell count is elevated, which is a common finding if there's an infection. An abnormally low platelet count can lead to blood clotting problems, and this would also be detected with a complete blood count. The complete blood count is often abbreviated CBC.

If the need arises, talk to your vet in detail about the medical testing appropriate for your cat's specific health issue.

A complete blood count and serum biochemistry panel can reveal a wealth of information about your kitty's health.

Serum Biochemistry Panel

This very important test evaluates between fifteen and twenty-five substances in the blood, giving important information about kidney function, liver function, blood sugar levels, blood lipids, electrolytes, and other substances.

Thyroid Evaluation

Hyperthyroidism is the most common glandular disorder of cats. This simple blood test is the most common method of achieving the diagnosis.

Urinalysis

Analysis of the urine is a very important test and yields key information regarding kidney function, as well as the presence of white blood cells (which may indicate a bladder or kidney infection), red blood cells (which could indicate infection, inflammation, or a blood clotting disorder), glucose (usually an indicator of diabetes), crystals (which could be a normal finding or could indicate the presence of bladder stones), and other significant substances.

Other Tests

A variety of other tests and diagnostic techniques are available to veterinarians to augment the process of obtaining a diagnosis. Blood tests are available that evaluate one particular organ in more detail. Examples of this are the bile acid test to evaluate liver function, the pancreatic lipase immunoreactivity (PLI) test to assess whether the pancreas is inflamed, and the low-dose dexamethasone suppression (LDDS) test to evaluate the function of the adrenal glands. Serology involves assessing antibody or antigen levels in the bloodstream to see whether an infectious disease may be present. There are serologic tests for fungal diseases, such as blastomycosis and histoplasmosis, as well as for protozoal diseases like toxoplasmosis. The most common serologic tests performed on cats are for the viral diseases, such as FeLV and FIV.

Technology in Diagnostics

Veterinary medicine has gotten quite sophisticated, with veterinarians utilizing many of the same machines used in human hospitals. Some of these modalities (x-ray, ultrasound, endoscopy) may be found in a regular veterinary clinic, while others, such as computed tomography (CT) and magnetic resonance imagining (MRI), are typically limited to referral centers.

CT and MRI

Computed tomography (formerly known as a CAT scan) is a specialized type of x-ray. The cat, under anesthesia, is secured to a thin platform-type table and is slowly moved into the CT machine through a donut-shaped opening. The x-ray tube rotates around the patient while a computer collects the data. The collected images appear as a "slice" of the cat's body. Slices can be studied individually, or they can be placed together to create a three-dimensional image of the area being studied. This differs from MRI, which uses magnets and radio waves to create an image. No x-rays are used in MRI scans. For MRI scans, the cat is secured to a table very similar to that used for CT scans. The cat is slid into a long cylinder, which is actually a very large magnet. Radio waves are sent through the cat's body, and hydrogen atoms in the cat's tissues emit a signal. The signal is collected by an antenna and fed into a sophisticated computer, which produces the images. The images look similar to CT scans but provide higher detail in soft tissues. MRI scans are not very good with bony structures. CT scans, on the other hand, provide excellent detail of bony structures.

Pet Insurance

Not surprisingly, the new level of medical sophistication in testing and technology that has brought additional years to our cats' lives often comes at a high price. When serious illness or injury strikes, many people have to decide whether they can afford the cost of testing and treatment. If you're the kind of person who would pay anything to save the life of your cat, pet insurance (health insurance for your cat) is something to consider. Like regular insurance, pet insurance usually pays a substantial portion of your veterinary bills when your cat becomes ill or is injured. A growing number of companies are offering pet insurance, and plans can vary substantially from one company to another; certain companies also offer different coverage levels. Like health insurance for humans, some pet insurance plans have deductibles, co-pays, and caps on how much money will be paid out annually. Some plans cover accidents and illness only, while others also cover wellness care. Most companies do not cover hereditary illnesses. Maine Coons, for instance, are not covered for cardiomyopathy (heart muscle disorder) because they are known to have a genetic predisposition to hypertrophic cardiomyopathy (see chapter 14, page 326). Nor do veterinary insurance policies cover preexisting conditions, which means that pet insurance is most beneficial when purchased early, when your pet is a kitten. Many pet insurance companies offer discounts for insuring multiple pets. Discuss the different insurance options with your veterinarian and do your own research. If you crave the peace of mind that comes with knowing that you won't have to make decisions about your cat's health based solely on finances, pet insurance might be right for you.

EKG

An electrocardiogram (EKG) is a measure of the electrical activity of the heart. The EKG is obtained by attaching small electrode clips to the cat's body and evaluating the waves either on a small monitor or by printing the EKG tracing onto paper. The EKG allows assessment of the heart rate-whether the heart is beating too fast or two slow-as well as the heart rhythm and whether it is normal or irregular. The EKG may also provide information about whether the chambers of the heart are normal-sized or whether they are enlarged. Performing an EKG is not painful, although cats may be resent being restrained for the procedure. A continuous EKG tracing is usually performed when cats undergo dental and surgical procedures as part of the proper anesthetic protocol.

Endoscopy

Endoscopy is a procedure that allows your veterinarian to look inside your cat's body. This is done via the use of an endoscope, a long thin tube with a camera attached to one end. The endoscope is inserted into the region to be examined and an image is obtained for visual evaluation. The endoscope also has the capability to obtain biopsy specimens-small samples of the tissue being examined. This is an invaluable tool for achieving a diagnosis. Endoscopes vary in length depending on their purpose and can be rigid or flexible. Endoscopic procedures are named based on the body system being evaluated.

Arthroscopy:

This is endoscopic evaluation of the joints, for example, the elbow or knee joint. Minor surgical procedures (arthroscopic surgery) can be performed in this manner if warranted.

Bronchoscopy:

This is endoscopic evaluation of the trachea (windpipe) and the lungs. In addition to obtaining biopsy specimens, a specially designed brush can be inserted into a channel in the endoscope and then brushed against the walls of the air passages to obtain samples for cytology.

Colonoscopy:

This evaluation of the colon can be performed using either a flexible or rigid endoscope.

Cystoscopy:

This is endoscopic evaluation of the bladder. The procedure is not commonly performed in veterinary medicine, although it is a useful tool for obtaining biopsy specimens of bladder tumors without doing surgery.

Rhinoscopy:

This is endoscopic evaluation of the nasal passages. Tissue samples can be obtained for biopsy, and samples can be obtained for bacterial or fungal culture if an infectious disease is suspected.

Upper GI endoscopy:

This refers to the endoscopic evaluation of the esophagus, stomach, and/or first part of the small intestine (the duodenum)- the gastrointestinal (GI) tract. Evaluation of the esophagus alone is called esophagoscopy. Gastroscopy is the endoscopic assessment of the stomach. The initial part of the small intestine is called the duodenum; duodenoscopy is the evaluation of this area using the endoscope. In addition to obtaining biopsy specimens, upper GI endoscopy is often performed to remove foreign bodies from the esophagus or stomach using special grasping forceps that can be inserted into a channel in the endoscope.

Radiographs

Radiographs (also known as x-rays) use an electromagnetic beam to produce images of internal organs and bones. As the x-ray beam is aimed at the body, different parts of the body allow some of the beam to pass through. Softer tissues, such as skin, fat, and muscle, allow most of the beam to pass through, resulting in a dark gray appearance on the x-ray film. Denser tissues, such as tumors or bones, allow less of the x-ray beam to pass through and appear white on the x-ray. If there is a break in a bone, the beam passes through the broken area and appears as a dark line in the white bone. Radiographs are an invaluable diagnostic tool that allows the veterinarian to peek inside the patient without doing surgery.

Cat in the process of getting an x-ray or radiograph. This tool allows vets to peer inside your pet without surgery.

Ultrasound

Ultrasound differs from x-rays in that, rather than using an electromagnetic beam, ultrasound uses high-frequency sound waves to render images of internal structures. It is a very safe procedure. Ultrasound offers some advantages over x-rays. Ultrasound has better contrast resolution than x-rays and can differentiate between fluid-filled structures and solid structures. Ultrasound can confirm the origin of a tumor in the abdomen with more precision than an x-ray. The images seen with ultrasound are shown in real time, so that what you see on the screen is what is actually happening inside the cat at the time of scanning. Ultrasound allows the assessment of the internal structure of the organs. For example, the heart valves can be seen opening and closing using ultrasound. Ultrasound has limitations, however. It is not useful for assessing the bony structures of the body. X-rays and ultrasound often complement each other, with each providing key diagnostic information.

An ultrasound provides images of organs and other soft tissues.

From The Cat Bible, Copyright by Sandy Robins, licensed through ContentOro, Inc and used by arrangement with I-5 Press

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