Examinations
The initial examination involves obtaining an extensive history, followed by a thorough dermatological examination by Dr. Messinger or Dr. Lam. The doctor will discuss you pet's condition with you and help you decide on the best diagnostic and treatment plan for your family friend. Recheck examinations are important to assure your pet is responding to therapies properly and to perform further diagnostics if indicated.

Diagnostics

The following are some diagnostics that may be performed to help us help your pet. Drs. Lam and Messinger have extensive specialized training in getting the most out of the recommended diagnostics. Where, when and how to perform the diagnostics is critical in obtaining the best possible results for you and your beloved furry (or scaley or feathery) family member.

1. Biopsies: Dermatohistopathology: A procedure that entails taking a tiny section of affected skin from your pet. The skin can then be processed, stained, and observed on a microscopic level to help determine what type of skin disease your pet has. This procedure can often times be performed under local anesthesia, thereby precluding the need for sedation or general anesthesia.
2. Cultures: Cultures may be needed when infectious diseases such as bacteria, fungi, or mycobacteria are suspected. Culturing the skin or discharge from the skin enables us to grow the organism in the lab and determine which antimicrobial treatments will work best for that infection.
3. Skin cytologies: This entails taking samples from the outer layers of the skin, applying a special stain, and inspecting these samples under the microscope for infections, inflammatory cells, tumor cells, etc.
4. Ear cytologies: This entails taking samples from the ear canal (usually with a cotton swab) and then rolling the sample on a microscope slide, heat fixing it, staining it and then evaluating the sample under a microscope. The samples can often tell us what type of infection is present in the ear and then how to better treat it.
5. Laboratory (blood and urine) tests: There are a wide variety of lab tests that can be performed to help identify problems with internal organ systems, check antibody levels against certain infections, evaluate hormone levels and monitor for possible side effects to medications, to name a few. Most of the samples are sent to our state-of-the-art in house regional laboratory (Antech Diagnostic Laboratories—one of the two largest national laboratories)
6. Skin scrapings: A quick procedure that entails using a dull blade and mineral oil to gently scrape the surface of the skin and collect a sample. This sample is then placed on a microscope to look for mites that live on the skin or in the hair follicles. Sometimes hair may need to be shaved from an area that requires scraping.
7. Swabs: Swabs are obtained by using a cotton tip applicator (similar to a Q-tip). Swabs are generally taken from the ears or skin; they are then rolled onto a microscope slide, stained, and evaluated for infection and inflammatory cells. Swabs may also be dipped in mineral oil and then placed in the ear to obtain a sample; mites are often looked for with this type of swab.
8. Video otoscopy: Video otoscopy has revolutionized how we evaluate and treat ear diseases in our four-legged family members. The video otoscope is a fiber-optic scope that enables us to visualize and perform procedures on the ear canal and eardrum much better than with old-fashioned handheld otoscopes. We can clean the ear more thoroughly and more safely through tiny channels in the scope along with our special suction/flushing apparatus. Masses in the ear canal can also be biopsied and oftentimes removed or debulked with the aid of the special scope.