This question was asked by a participant in our webinar on Case Studies in Behavior: Anxiety, Fear, Panic:
In one of the cases you discussed, your initial differential diagnosis included seizures and pheochromocytoma. How do you usually go about ruling these in/out ?
That depends on the dog and the symptoms. We always start with a CBC, chemistry, urinalysis, and thyroid assessment if the clients will let us, and a physical examination if the patient will let us. If a pheo needs to be ruled out, an abdominal ultrasound is rational. If seizure disorder is suspected and toxins are ruled out, then a consult with a veterinary neurologist, MRI/CSF tap, and/or empirical medication trial are options. Every patient is different, and that's why having a great relationship with a skilled primary care veterinarian is so important. Not everyone will have access to a veterinary behaviorists, but these medical differentials can be assessed in a primary care setting.
