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Saturday, March 10, 2012

Poop Connoisseurs

I have learned not to be self-conscious about many things I do in my profession.  One of them is close examination of animal feces.  I'm sure you've seen vets do this (or have done it yourself if you're in the profession).  The client brings in a stool sample for a sick pet or the pet eliminates in the exam room.  Since the disorder is related to the digestive tract, we want that poop!  The vet gets the sample and then starts turning it around, looking closely at it and perhaps poking and prodding to investigate what is inside the little log.  We might even bring it closer to our face to get a really good look at it.

"Eeewwwww!  Gross! You're playing with poo!"

Well, yes, I am. But there is a reason for it.  I'm completely aware of how strange it looks and that it's a rather disgusting substance to be examining that closely.  But there is a lot of information we can learn from a close look at poop.  We check to see if there is any blood, foreign objects (bone pieces, grass, thread, crayon, etc.), obvious parasites, and other things that shouldn't be there.  Additionally the color and consistency can tell us a lot about the case.  In fact, scientists have actually made rather objective charts to score the fecal consistency!  No, I'm not kidding.  Since it's rather disgusting to those unused to looking at such things I won't copy the picture here, but just Google "fecal scoring system" (or click on this link) and you'll see a nice chart that Purina made for us vets (yes, I have one in my clinic).  Most of us tend to use rather "descriptive" terms, such as referring to the stool as having a consistency like "cow patties" or "soft-serve ice-cream."  As unscientific as such descriptions are, we all know what they mean.  Still, somebody went and quantified it, hence the chart.

Let me give you an example of how much information we can get from poop.  Mrs. Cowpie brings her dog, Squirt, to the clinic with a complaint of diarrhea.  Squirt lives up to his name and provides a sample right there on the exam room floor.  I bend down and look at it, noticing that it's of the same consistency as partially melted ice-cream (okay, okay, it's a Score 6 feces), there are some streaks of blood, and a good bit of mucus.  Squirt is also straining a bit to get the last few drops out and seems a bit uncomfortable. I can tell by these clues that the dog has lower bowel diarrhea, also called colitis. Why?  Frank (red) blood comes from the lower intestine, while digested blood is from the upper intestine and looks like coffee grounds.  Mucus in the stool indicates colitis, as you won't have mucus production in the small intestine.  Straining also indicates a colon issue.  So I've already identified what part of the digestive tract is causing the diarrhea, which limits the number of diagnoses possible.  Just by bending down and getting a good view of the poo I have a short list of my top two or three likely diagnoses, as well a treatment protocol for each.  I'll do an exam, some tests, and get a good history to try and confirm my suspicions, but the feces alone has given me a direction in which to proceed.

The next time your vet oogles your pet's poop, realize that we really are connoisseurs, and like someone examining a fine wine we can tell a lot by the appearance and smell.