Most of the diagnostic imaging, like x-rays and ultrasound or echocardiogram, we do right here in our clinic. Our certified veterinary assistants and technicians do those procedures themselves. We are directly involved in that procedure. They take the images, and then we interpret or evaluate them. There are veterinary radiologists available, but we would use them by sending images to them to be read. You wouldn't necessarily make an appointment directly with them to have your pet x-rayed or have an ultrasound done as you might in human medicine. It's not segmented like human medicine, where if you need blood work, so you should go here. If you need an MRI, you go there. We do it all.

We may ask that your cat be fasted. So you should withhold food, especially if we're looking at the abdomen, because if they come in with a full stomach, it can hinder some of the organs that we're trying to look at. And sometimes you don't know. They come in for an appointment, and you add that to their treatments. We may not know to ask you ahead of time to fast your pet. Also, depending on your cat's behavior, we may need some calming medication. So we may ask you to administer that at home. Again, if we know ahead of time, that would be a way to prepare and relax your cat to have the best diagnostic images. They don't really understand "lay down on the table, be still and stretch out."

Sometimes we may not get the diagnosis, but we may rule out that something else might not be going on. So sometimes, those normal results are just as important as the abnormal results, and that can be hard to realize or remember when you're paying for that test. But the test can give us information on both sides of it. We may consider advanced imaging, which I call the CT or the MRI. We may refer you to a specialist if we haven't found the answer or test the response to treatment. In that case, we can have a set of differentials that we think are possible. We treat for that and see the response to treatment to see if your pet gets better. Sometimes you have to do that because there's a financial issue that makes that the only choice for the owner, where more testing or even referral may not be an option.

When I think about baseline, I think about "normal." So if we have baseline radiographs or x-rays, we know what your cat's "normal" is. If they come in with a problem later, we can compare what your cat was six months ago to where we are now. That might also reflect progression. Even if they're not necessarily "normal" images, we can see the progression of the disease to determine the severity of the prognosis. We can do that with echocardiograms for cats' hearts as well to see if they're getting worse.

Even if we don't necessarily find the problem, it can rule out problems. I think that it's a very good tool to use, and it's one of many that we can use to find out what might be wrong because the patients that come in don't always tell us what's going on. They hide things, as Kyle alluded to before. That can help us to determine the problem.