Should My Pet Have This Test?
Navigating vet diagnostics, stress, and quality of life
As veterinary medicine has advanced, our pets have gained access to incredibly sophisticated care that mirrors human healthcare, including MRI and CT scans, complex surgeries, and chemotherapy. These advances are welcome because they give us more opportunities to help our beloved pets. However, not every advance is suitable for every owner or every pet. They are often options, rather than automatic requirements.
As a wise pet owner said to me recently: “We didn’t have MRIs 30 years ago, but that doesn’t mean people loved their pets less.”
Now we do have MRIs and all sorts of other advanced tests - so how do pet owners navigate this modern diagnostic landscape?
Vets recommend these paths because they are trained to practice in a way that aligns with modern medical standards. Vets don’t want to miss issues; they want to find the "answer." While these advanced approaches are more costly due to the equipment, time and skills required, I very rarely see vets recommend them to make more money. They recommend them because they believe they are best way to approach your pet's condition. However, we have to recognise that in some settings clinical guidelines and protocols can favour more comprehensive testing.
For the pet owner, having these options can be amazing, yet it can also bring a heavy burden of choice and guilt. Making an informed decision to not pursue certain paths based on your pet’s unique situation leaves many owners feeling guilty, even if that is the most appropriate decision for you and your pet.
The best decisions come from combining your vet’s medical expertise with your knowledge of your pet’s daily life. You understand your pet’s personality, routine, and temperament better than anyone else.
At Pet Lighthouse, we believe the key to great care is a partnership that asks:
Just because we can perform a test, is it the right fit for this individual animal?
The clinical picture vs. the whole picture
When our pets are unwell, we naturally want a definitive name for the problem. Your vet suggests diagnostics because they look at the clinical picture - using data to ensure nothing is missed. However, as an owner, you hold the picture of your pet's day to day life. Bringing these two elements together is crucial in achieving the best overall welfare outcome for your pet.
A thorough history and a skilled clinical examination are often the most powerful tools a vet has. An observant owner who can clearly describe changes in behaviour is a gift to the vet. Since pets cannot speak to us directly, your observations of their behaviour are incredibly important.
Extensive testing can be stressful, invasive, and costly. It can also be very beneficial. Understanding the rationale of a test allows you can weigh up the benefits against the downsides.
The Pet Lighthouse view is that diagnostics should only be performed if they provide the opportunity to unlock a better outcome.
The golden question:
"How will the result of this test change the plan for my pet?"
Targeted testing
Testing should be appropriately targeted at the problem at hand. The aim is to get an answer that informs the next step in treatment.
Screening tests can be valuable in the right context, particularly for early disease detection. Organs like the kidney and liver have a lot of spare capacity, so symptoms aren't see until later in the disease course. Appropriate screening can detect problems early but should still be targeted towards likely issues and with a good idea of what steps will be taken if abnormalities are found. It is not uncommon to find minor abnormalities that may not be clinically significant. This can lead to unnecessary worry, invasive follow-ups, and insurance exclusions for findings that might never have impacted the pet's life.
If tests are being offered it is important to understand what is being looked for, the likelihood of a problem being detected and the next steps.
.png/:/)
The cost-benefit of follow-up testing
When a pet has a chronic condition, repeat blood work or scans may be recommended to monitor disease progression or medication side effects.
This monitoring can help fine tune treatments and flag potential deterioration. However, for many pets follow up testing can carry a welfare cost.
For a relaxed dog who likes the vets, a blood test, accompanied with lots of treats, is a minor event. But for an anxious cat or a frail senior pet, the journey, the clinic smells, and the handling can cause significant distress.
When considering follow up tests the same question applies; how will the result of this test change the plan? Can information be gained from home monitoring, or the clinical examination, give us confidence that the treatment working. What are the risks of not doing the test?
This isn't about avoiding care; it’s about strategic monitoring through discussion with your vet.
Be sure to tell your vet if their proposed plan is difficult or stressful for you and your pet. Your vet won't know if you don't tell them and they won't be able to consider this in their plan.
.png/:/rs=w:400,cg:true,m)
Tilly's Story
Tilly was my rescue Staffy, who found vet visits very stressful, in spite of desensitisation attempts. She took daily anti-inflammatories (NSAIDs) for arthritis. These drugs were effective, but the data sheet warned of rare risks to the heart, liver, or kidneys.
Many vets advise regular blood monitoring for these risks. This is reasonable advice. However, because Tilly needed sedation for blood tests and the drug was providing a massive benefit to her quality of life, we chose to monitor her drinking habits and demeanor at home instead, recognising that these wouldn't pick up problems as early but the risks were low.
We decided the benefits of the test didn't outweigh the stress it caused her. She did well for many years on these medications. Later in life she did have an MRI scan because of unrelated neurological symptoms that couldn't be easily explained and we had to change her onto medications with different risks. In the event she did well on those medications and recovered, going back onto her NSAIDs until the end of her life.
Contrast this with a higher-risk scenario: Certain chemotherapy drugs affect fast-dividing cells, like bone marrow. This can cause life-threatening drops in white blood cells. In this scenario, the risk of not testing is too high; the protocol must have testing "baked in" to be safe.
Most scenarios sit in between these two examples. Talk to your vet to understand the “why” of the testing.
Testing is particularly important when:
- It affects safety due to the risk of treatment side effects
- Symptoms are acute or severe
- You have tried symptomatic treatment and the condition is not responding, or is worsening
- The results are likely to change the treatment plan
If you’re unsure, always discuss concerns openly with your vet rather than just declining testing outright.
If finances are a concern, be honest with your vet, they will understand. By knowing any limitations you face, your vet will be much better placed to devise an appropriate plan.
Your risk appetite
In some cases, testing protocols are influenced by the worry of ensuring nothing is missed, even very uncommon diagnoses, which can increase costs. If you are someone who needs to understand everything and rule out even uncommon scenarios, expect more tests and costs. If you are pragmatic and willing to accept a level of risk, you may be comfortable skipping certain tests, in discussion with your vet.
It’s important that your approach to risk is consistent, as changing expectations after the fact can be difficult for both you and your vet and can, ultimately, drive a defensive approach.
-4498526.png/:/cr=t:0%25,l:0%25,w:100%25,h:100%25)
Are you a:
- "Need to know" owner: If uncertainty causes you deep anxiety, a deep diagnostic process might be worth it for your peace of mind.
- "Pragmatic" owner: You are comfortable with ambiguity and happy to trial a treatment in appropriate situations based on a presumptive diagnosis.
Letting your vet know your own risk appetite can be very helpful.
Definitive vs. presumptive diagnosis
A definitive diagnosis is a confirmed result (based on a confirmatory test such as a biopsy).
A presumptive diagnosis is based on the vet’s expertise and ruling out common issues without having a conclusive answer.
- Example: For a senior dog with mild to moderate limping, elbow pain and a restricted range of movement in the joint, it is perfectly acceptable to presume osteoarthritis and trial treatment. If they don't improve, you can revisit the plan with X-rays.
- Example: In a younger dog, X-rays are more likely indicated to rule out developmental diseases, such as elbow OCD, that require different, specific diagnosis and treatment plans.
-4498526.png/:/rs=w:400,cg:true,m)
The Power of At-Home Monitoring
The data you collect at home, where your pet is relaxed, is incredibly valuable. It doesn’t replace testing, but it is a vital adjunct.
Home Monitoring Metrics:
- Appetite & hydration: A simple log can spot trends that help support appropriate testing
- Weight tracking: Weight loss is often the first "silent" sign of illness. Tip: for larger pets weigh yourself holding them, then subtract your own weight, for cats baby scales can be useful. The accuracy will not be as good as the vet clinic scales, so watch for trends.
- Resting respiratory rate: For pets with heart/lung concerns, counting breaths while they are deeply asleep is a good metric. Don’t panic on the basis of a single measure e.g. if a pet is stressed, or even dreaming, trends and consistent changes are key.
- Mobility: Note changes in how they jump or greet you, reluctance to go for a walk, or go down the stairs- small changes are always worth noting and reporting.
- Demeanour: How is your pet today? Are they resting and sleeping more than normal. Are they interacting with you normally, or being "grumpy" with you. How are they with other pets in the family, or animals in their world e.g. another dog on a walk.
A note on wearables: Smart collars and trackers are likely to become a significant part of the future of pet care, offering a window into our pets' lives. While these tools are exciting, we are still in the early stages of learning how to validate and interpret all that data clinically. More data isn't always better data if we don't yet know how to interpret it.
The key is to talk to your vet about which wearable, if any, is actually relevant to your pet’s specific condition.
Tip: Set up a simple online or paper calendar for monitoring any changes in your pet and their routine. Memory can be unreliable, so this objective data is very valuable for you and your vet.