VMED 101 (GENERAL PRINCIPLES OF

VETERINARY MEDICINE)
MAKING A DIAGNOSIS
 PURPOSES OF DIAGNOSIS

• To recommend specific treatment

• To provide an accurate prognosis
• To make recommendation for cost-effective control
and prevention of new cases when groups of
animals are at risk.
 TYPE OF DIAGNOSIS (Dx)
• DIFFERENTIAL
• TENTATIVE
• PRESUMPTIVE
• DEFINITIVE AND ETIOLOGICAL
• PATHOANATOMIC
• OPEN
• UNDETERMINED
• DIFFERENTIAL DX
– is a list of diseases that maybe responsible for the clinical and
laboratory findings in a particular cinrcumstance.
– in moast cases the differential diagnostic list consists of 3 to 5
diagnoses.
• TENTATIVE DIAGNOSIS
– this is the suspected diagnosis baased on history or initial
clinical examination
– example, in small animals ,a tentative dx of sarcoptic mange
can be affected with intense pruritus whose owner is also itchy.
The dog, if not a collie, or related breed, can be treated with
ivermectin, and a benefecial response to treatment justifies the
assumption that the dog was affected with mange
• PRESUMPTIVE DX
– is usually made with additional confidence after considering
several differential diagnosis and collection of further cliinical
and laboratory information.
• DEFINITIVE AND ETIOLOGICAL Dx (FINAL DX)
– a description of the abnormality of structure or function
produced by a causative agent or any other event or
circumstance that interferes with normal body processes
– an explanation of the clinical manifestations of the
abnormalities produced by the causative agent or effect.
• PATHOANATOMIC Dx
– this is a diagnosis based on the pathological findings identifying
the affected body system or organ and the morphological
description of the lesion( ex, granulomatous encephalitis)
• OPEN DX
– is one in which the clinical abrnormalities are detected but their
cause cannot be determined.
 REQUIREMENTS FOR MAKING A DIAGNOSIS
• Collection of information about the animal or herd
incorporating the chief complaint
• The disease history
• Examination of the animal or the herd and the
environment
• The generation of diagnostic possibilities
• The selection of laboratory aids to diagnosis
• The interpretation of the results
 DIAGNOSTIC METHODS
• PATTERN RECOGNITION
– is based on comparison of the patient at hand and the previous
cases in the clinician's memory.
– one sydrome is recognized as a replica of the other
• HYPOTHETICO-DEDUCTIVE REASONING
– this approach depends on the selection of key clues to support
or discount a hypothesis
– It may falter in complex cases with multiple disease processes
• MULTIPLE BRANCHING OR ALGORITHM
– is ideal for clinicans who has not had the necessary experience
of memorizing long list of potential diagnoses and the critical
tests that confirm or exclude each of them
• KEY ABNORMALITY FUNCTION
– this method is more complex that requires the clinicians to rely
on their knowledge of normal structure and function to identify
and evaluate the key abnormality or clinical cue
- it is highly reliable especially for difficult cases
• THE EXHAUSTIVE METHOD
– the basis for this method is to take an exhaustive history,
examine the patient in great detail and collect as much as
baseline laboratory data-screening test- as is economically
justified
• PROBLEM- ORIENTED METHOD
– the basis of this approach is to carry out a complete clinical and
laboratory examination of the patient to acquire a
comprehensive data base
 PROGNOSIS
• A prediction about the future clinical course of the disease
– The likelihood of recovery and being able to fulfill an intended
purpose, such as being a companion animal, performing as
recreation or working animal, being able to produce milk, meat
and fiber, or being a breedindg animal is also part of the
prognosis
– giving a prognosis implies predicting the outcome of a clinical
case with or without treatment
– the prognosis should be rational and based on patient data and
clinical findings