The Diagnosis is the Key.

Rufus was once part of the family. A homeless waif, we took him in to be, if needed, a blood donor. But he quickly endeared himself and we agreed that he needed to be part of a real family, with a home. A home like, as it turned out, Roger and Marlene had to offer. We still get to see Rufus's big innocent, happy grin on a regular basis.

Roger brought Rufus "home" a few weeks ago because he seemed to have a sore neck, and just wasn't acting right. Rufus's innate exuberance made any pain hard to accurately identify and localize during his exam, but we did notice that his pupils did not get larger or smaller in response to changing light. They seemed sort of "stuck" at a size a little smaller than midrange, no matter how long we kept him in the dark, and no matter how bright a light we shined into them. Otherwise, his eyes were completely normal.

After numerous consultations with other veterinarians, including neurologists and ophthalmologists on the telephone and Internet, and a trial with medication that seems to have been successful, the consensus is that Rufus has an unusual type of inflammatory disease in his eyes. The eye drops he is on seem to be controlling it. He is his old happy self.

Kali was a young Belgian Turvuren, an uncommon large longhaired breed. Her case did not have a happy ending. She had been adopted as a rescue dog and had never been healthy. This time Kali had stopped eating, seemed lethargic, and had collapsed once from apparent weakness. Blood tests suggested severe liver disease and also a serious bacterial infection. In spite of treatment with some really strong intravenous antibiotics, Kali was even worse the next morning. Considering her history of poor health and the misery she was in, euthanasia was the most humane option.

An autopsy and more lab tests indicated Kali had a massive infection in her liver. Blood that absorbs things from the intestines goes directly to the liver, and the liver bile ducts connect directly to the intestines. So it's probably not unusual for bacteria to get into the liver. Normally, the immune system can reliably fend off these invaders but given Kali's history, we suspect there was something wrong with her immune system.

Patch, a cat in the prime of his life, awoke one morning barely able to walk on his hind legs. Weak and uncoordinated, he looked like one of the dachshunds that we commonly see with a "blown out" disk in their backs. But that "never happens in cats." We treated him with emergency drugs the way we'd treat acute spinal disease in a dachshund, but recommended a trip to Washington State University Vet School for an exam by a neurologist and likely an MRI. They found the problem in Patches spine - very similar to what they find in those dachshunds. With the treatment they prescribed, Patch, like a lot of those dachshunds, is almost back to normal.

In a tough case, getting an accurate diagnosis is the all-important first step. Rufus could have gone blind and Patch could have been permanently paralyzed with the wrong treatment. Even Kali's diagnosis may help with some future case, and provided closure and peace of mind to her owners.

There are some things you just can't diagnose without some head scratching time, some pouring through reference material, maybe some help from specialists, and maybe some advanced testing. This can be expensive - maybe a lot more expensive than the treatment, but it's often worth it.