There is a certain look worn by a sick dog - Julian Norton

We have been doing our best to triage cases over the phone, sometimes with the aid of e-mailed photographs or even videos

Julian had to perform an emergency operation on a terrier Milo this week

Some non-urgent cases can be successfully managed in this fashion to minimise the number of people coming to the surgery.

The veterinary governing bodies have allowed some laxity on the usually very strict guidelines about making a diagnosis and prescribing treatment, but it is far from ideal.

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The small abrasion on cat’s leg, for instance, was part of a bigger problem and not spotted by the owner or her camera.

The fact that the cat was covered in multiple scabs as a result of an allergy was not apparent on the slightly blurred photo, nor did it become evident in the lengthy, lock-down induced phone discussion.

The tube of topical cream that was prescribed was never going to be sufficient to treat the systemic problem.

Luckily this became evident quite quickly, and once we had examined the cat in real life, all was well, but it highlighted the difficulty inherent in having to work out what to see and what to deal with remotely.

A case of vomiting and diarrhoea is simple enough, but the dog who has vomited six times overnight certainly needs to be seen.

Is it just a bad case of gastritis or is there a piece of corn-on-the-cob obstructing the bowel? A proper examination is essential, to palpate the abdomen and possibly followed up with X-rays. Trying to make these decisions by phone is a huge challenge.

One patient had me worried. Milo the terrier’s clinical signs were non-specific.

These are hard cases to manage even with the dog in front of you, let alone over the phone.

The message suggested he was lying in odd places and didn’t want to go upstairs.

The signs were vague, but an owner who is concerned about a pet’s unusual behaviour always flashes warning signs. After a brief telephone conversation, I knew I’d need to get hands-on with Milo.

The terrier and his owner arrived at the practice very swiftly (given the quiet roads) and waited outside as instructed.

I collected Milo via a lengthy lead and took him inside so I could examine him.

On the surface he looked quite happy, but his body and legs were weak. Closer inspection revealed a few bigger problems. His gums were pale and, if a dog can have such a symptom, his face was sallow.

There is a certain look worn by a sick dog and it’s all about the eyes. It is as non-specific as lying in odd places and not wanting to go upstairs. I was immediately concerned.

Milo’s abdomen was not as relaxed as it should have been.

I examined this in more detail, balloting gently. Balloting has nothing to do with a secret voting system!

It is the process of examining an abdomen by placing a hand on one side and tapping the other side with the other hand. If there is fluid in the abdomen, you can feel it vibrating as you tap. I could feel the characteristic “fluid thrill” as I did this to Milo.

The next and quite simple job was to perform a peritoneal tap, which revealed that the aberrant fluid was blood, and an ultrasound scan confirmed that it was coming from a ruptured splenic tumour.

I stuck my head out of the practice door to explain to Milo’s mum that he needed emergency surgery.

It wasn’t long before I’d removed Milo’s cancerous spleen. His recovery was smooth and uneventful and, after a restful night on a drip, he went home the next day, very much brighter.

It was a happy outcome and evidence enough that there is no substitute for a proper clinical examination. It is, after all, what is instilled into all vets from our very first day at Vet School.