Hospitalized patients may be exposed to many communicable diseases. Suggested canine vaccinations include Distemper, Adenovirus, Parainfluenza, Parvovirus, Leptospirosis, Rabies, and possibly Bordatella. Feline vaccinations include viral Rhinotracheitis, Calicivirus, Rabies, and Panleukopenia. Care is taken to protect unvaccinated emergency patients with minimal inter-patient contact. Hospital policy and local regulations dictate vaccination requirements.

Every state reports cases of heartworm disease. Preventative treatment promotes patient good health. Patients with active or prior heartworm disease pose an anesthetic risk. The client is quizzed to determine the status of heartworm testing and preventative. Flea infestation is avoided in the veterinary hospital with appropriate prevention; therefore, determining a client’s use of flea and tick preventative is imperative.

Diet affects all aspects of a patient’s health. Knowledge of a patient’s dietary habits aids treatment plans. For example, young puppies fed with a high calcium diet can succumb to developmental orthopedic conditions. Obesity causes stress to most body systems including heart, lungs, and joints. Determining if a patient’s feeding schedule is free choice or meal feeding aids in formulating weight management plans. Between-meal snacks contribute to obesity. Maintaining a patient’s current diet while hospitalized avoids gastrointestinal upset from food change. However, client-provided, raw food diets might create an in-hospital storage problem and hazard for hospital personnel. Patients undergoing oral surgery may need a softened diet, postoperatively. Crushing a normal diet of dry kibble and soaking for a short time in water maintains the animal’s normal diet.

Food allergies are prevalent in the veterinary patient population. Determining a patient’s food allergies avoid gastrointestinal problems while hospitalized. Unidentified medication allergies can cause very serious complications during hospitalization, surgery, and recovery. Obtaining information on past sedation and anesthetic episodes provides guidelines for future needs. Patients with a history of a poor response to anesthesia must be more closely monitored during any surgical procedure. Anesthetic drug complications include vomiting, diarrhea, cardiac arrhythmias, breathing difficulties, blood pressure changes, and slow recovery. Other allergic reactions to medications or environmental conditions must also be noted.

A patient’s current and prior medications, and other supplements and history influences future treatment plans. For example, patients receiving anti-inflammatory medications need a “wash-out” period prior to starting a different anti-inflammatory drug to avoid gastrointestinal problems including stomach ulceration. Medications for many medical conditions influence the choice of perioperative drugs. Dietary supplements, such as glucosamine chondroitin, calcium, and vitamins, affect patients’ health and food needs.

Clients have different expectations for patients leading a sedentary life versus working or service animals. If a dog’s main job is to sit on the couch most of the day, recovery from a ruptured cranial cruciate ligament (CCL) and its attending arthritis is much different from a search and rescue animal. If a patient lives in a city dwelling apartment, it will have different experiences during recovery than a dog, living in the country, with acres of freedom. The same holds true for an indoor cat versus an outdoor cat. Will the client be able to medicate a mostly outdoor cat postoperatively?

A complete medical history begins with the signalment: age, breed, sex (intact or neutered), and presenting complaint. A preconceived diagnosis may affect physical exam findings. (E.g., a patient presented for hip dysplasia may actually have a cranial cruciate rupture causing more lameness than poor hip conformation.) Carefully interviewing the client provides much information to aid in the veterinarian’s diagnosis. In addition to the presenting complaint, for example, lameness, the entire patient is taken into consideration with inquiries into coughing (C), sneezing (S), vomiting (V), diarrhea (D), increase in thirst or urination –polyuria/polydipsia(PU/PD), and appetite(A). These parameters are easily recorded in the medical record as C, S, V, D, PU/PD, and A with notations made accordingly. Note all current and previous medical problems as they may influence the surgical experience. Form questions to prevent leading a client into a specific “yes or no” answer. For instance, asking a client “Is Lily more lame today?” provides a yes or no answer as opposed to asking, “When do you see Lily’s lameness increase?” With the second question, the client needs to give a more detailed answer providing the clinician with better historical information. Record all prior surgical procedures. A patient may present for a second opinion of a recurrent problem. Historical knowledge influences a treatment plan.