Voiceover: Diagnosing a pet is like fighting a battle in the fog. Without their ability to tell you what’s wrong, you don’t know your enemy. Sometimes the fog is a mere hazy gauze, easily penetrated with our exam and our instincts, and other times it sits over the field like a big hairy blindfold.
Well hello there, Miss Blake! What brings you and Lulu here today?
Doctor, Lulu just isn’t herself. I don’t know what is wrong, but something is wrong.
Any changes in appetite or drinking behavior? No.
Any changes in activity level? No.
Any vomiting, diarrhea, coughing, sneezing? No.
What is leading you to think something is wrong?
I don’t know. (cue folksy music)
Hmmm. There is nothing wrong on physical examination that I can see. Let’s start with some screening bloodwork and go from there, OK?
Two months later:
She still isn’t right, doctor. And now she seems to… dream more than usual. Like she’s twitching a lot more when she sleeps.
Hmmm. Are you sure she is dreaming? I want to make sure it isn’t a seizure that you are describing.
No. Absolutely not. Not a seizure. I know what a seizure looks like and this isn’t it.
Well, we’ve done multiple screening tests at this point, and ruled out a great many metabolic and infectious problems. I think based on what you are describing the next step would be for Lulu to see a neurologist. I think it would be a great idea if you can catch one of those dreaming incidences on your videophone to bring with you, OK? And write down when they happen?
Despite our best efforts, there are cases where the answers continue to elude us, the enemy still invisible. And when those question marks are staring you down in the face of a concerned parent expecting victory on the battlefield, sometimes you have to call in reinforcements.
Hello Miss Blake, I’m the neurologist, Dr. Peppered.
I’ve looked over Lulu’s chart and I’ve seen what your referring vet has already done…let’s see, ruled out hepatic…mmm hmmm…no spinal pain…neuro exam good…ultrasound, yes, good…bile acids…met check…OK, I am going to take a look at her. Has she been having any seizures?
Yes, I think she has. I decided to record some of them for you. And here is my seizure log.
Do whatever you need. Here’s my credit card.
One month later…
Lulu! How are you? I saw the notes from Dr. Peppered, and it sounds like Lulu has been diagnosed with epilepsy. How is she doing on her phenobarbital?
Great! Dr. Peppered was AMAZING. He knew right away what was happening. I almost kind of wish you had sent me there from the beginning.
He, uh, isn’t here now, is he? Visiting?
It’s inevitable when you’re a foot soldier. The general gets all the glory when you were the one in the ditch digging the trench for the last month. Once you give him a clear shot, he strides in and pulls the trigger, then saunters off, a war hero yet again. But such is the life of a soldier, and we shoulder our packs, wipe off the grime of the battlefield, and continue on.
(You really need to make sure you do the voiceovers in your head in Meredith’s voice, not Izzy’s, OK? I hate Izzy.)