Veterinary school can only teach you so many things. You learn the basic pathophysiology behind diseases and how to treat them. However, you need a lot of clinical experience before you develop intuition - the art of practicing medicine.
To do this, you need to see case after case and keep mental notes for later. That's why a veterinarian who has been in practice for a long time may come up with differentials that don't (yet) occur to me. Yes, there is a danger of falling into a rut based on what you've seen before, so you need to be careful to not jump to a diagnosis too soon.
Right now I'm enjoying adding to my "file." Two recent cases in point:
- Young dog, started eating lots and lots of dirt recently. I recommended a fecal, which showed that the dog had Giardia (an intestinal parasite).
- Another young dog had partial hair loss that looked similar to Demodex (mite) cases I'd seen before, however a skin scrape showed no mites. Dr. Boss saw the case later and diagnosed bacterial infection based on impression smears - they said that they've seen short-haired dogs present like this and agreed that yes, at first glance it does look like Demodex. I'd never considered bacteria!
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