Practical Approaches for Studying Sea Turtle Health and Disease
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15.3.3.4 Problems List
From the history, physical examination, and preliminary screening test results, all
the recognized problems are listed. These are the abnormalities that the veterinary
clinician will seek to understand and treat. The problems list is usually prioritized
so that those problems that are most threatening to the survival of the animal are
addressed first, in terms of previously treatment and diagnostic workup. This requires
some clinical judgment and experience.
15.3.3.5 Differential Diagnoses List
The next step involves the development of a list of alternative possible causes
for each of the problems identified. In many cases, the cause of the problem may
not be obvious, and there may be numerous possibilities. For example, ingestion
of foreign bodies or debris, bowel perforation, bowel impaction, neoplasia, infections, and toxicity all can result in nonspecific problems such as weakness,
emaciation, and floating. Even when there is an obvious factor such as trauma
or massive FP to suggest the cause, there may be predisposing factors or ultimate
causes that should be considered. For example, boat trauma may have occurred
because of buoyancy problems associated with an infection, which may be secondary to cold stunning weeks earlier. Among the general categories of disease
processes (developmental, autoimmune/allergic, metabolic, nutritional, infectious, trauma, toxicity [DAMNIT]), the clinician lists known conditions, which
can be targeted for testing. Information from signalment, history, and the nature
of the presenting problem can guide the clinician in prioritizing this list and
deciding which processes are more likely to be involved, and which to try to rule
out by further testing. In making these judgments, the veterinary clinician tries
to integrate all the information so that if possible, most of the problems are
explained by a single disease process.
15.3.3.6 Specialized Examinations, Procedures,
and Secondary Tests
The goal of additional evaluations is to gather additional data to further characterize
specific problems and to support one or another differential diagnosis (hypothesis)
over others. An experienced medical professional will be able to determine what
supporting data, additional diagnostics, and confirmatory tests are needed to rule in
or rule out alternate hypotheses or to confirm a diagnosis. As discussed for health
assessment, the interpretation of individual test results is always problematic; however, here all test results are integrated with the turtle’s clinical presentation and
abnormal findings can be further investigated. Specialized examinations and diagnostic procedures are selected to further assess specific organ systems. Procedures
may include additional radiological imaging with or without contrast media, other
forms of imaging such as magnetic resonance imaging and ultrasound, endoscopy,
laparoscopy, and exploratory surgery.
1123 book.book Page 403 Monday, November 11, 2002 11:11 AM
403
15.3.3.4 Problems List
From the history, physical examination, and preliminary screening test results, all
the recognized problems are listed. These are the abnormalities that the veterinary
clinician will seek to understand and treat. The problems list is usually prioritized
so that those problems that are most threatening to the survival of the animal are
addressed first, in terms of previously treatment and diagnostic workup. This requires
some clinical judgment and experience.
15.3.3.5 Differential Diagnoses List
The next step involves the development of a list of alternative possible causes
for each of the problems identified. In many cases, the cause of the problem may
not be obvious, and there may be numerous possibilities. For example, ingestion
of foreign bodies or debris, bowel perforation, bowel impaction, neoplasia, infections, and toxicity all can result in nonspecific problems such as weakness,
emaciation, and floating. Even when there is an obvious factor such as trauma
or massive FP to suggest the cause, there may be predisposing factors or ultimate
causes that should be considered. For example, boat trauma may have occurred
because of buoyancy problems associated with an infection, which may be secondary to cold stunning weeks earlier. Among the general categories of disease
processes (developmental, autoimmune/allergic, metabolic, nutritional, infectious, trauma, toxicity [DAMNIT]), the clinician lists known conditions, which
can be targeted for testing. Information from signalment, history, and the nature
of the presenting problem can guide the clinician in prioritizing this list and
deciding which processes are more likely to be involved, and which to try to rule
out by further testing. In making these judgments, the veterinary clinician tries
to integrate all the information so that if possible, most of the problems are
explained by a single disease process.
15.3.3.6 Specialized Examinations, Procedures,
and Secondary Tests
The goal of additional evaluations is to gather additional data to further characterize
specific problems and to support one or another differential diagnosis (hypothesis)
over others. An experienced medical professional will be able to determine what
supporting data, additional diagnostics, and confirmatory tests are needed to rule in
or rule out alternate hypotheses or to confirm a diagnosis. As discussed for health
assessment, the interpretation of individual test results is always problematic; however, here all test results are integrated with the turtle’s clinical presentation and
abnormal findings can be further investigated. Specialized examinations and diagnostic procedures are selected to further assess specific organ systems. Procedures
may include additional radiological imaging with or without contrast media, other
forms of imaging such as magnetic resonance imaging and ultrasound, endoscopy,
laparoscopy, and exploratory surgery.
1123 book.book Page 403 Monday, November 11, 2002 11:11 AM