A minimum database in the healthy dog may include the complete blood cell count, biochemical profile, urinalysis, electrocardiography, and imaging (e.g., thoracic radiographs, abdominal ultrasound, and echocardiography). Although very limited data exist, studies evaluating imaging modalities for detection of occult disease in dogs have not provided enough evidence to recommend imaging as a standard component of the minimum database. 147
The value of a minimum database for detection of occult disease (the presence of disease in the apparently healthy patient) continues to be explored in both human and veterinary healthcare fields. Although there remains limited information in the veterinary field, published information can be used to guide practitioners in their recommendations. These include published guidelines for canine senior care, anesthesia, and several studies that have evaluated the use of a minimum database in the healthy pet.5,16,148–151 Studies have indicated the presence of abnormalities in 6–80% of evaluated dogs presented for routine primary care appointments or preanesthetic testing, although no studies have included follow-up evaluation to determine the proportion equating to clinically relevant disease processes.138–140,152–155 Although many of these studies focused on older dogs, one study involving 1,421 apparently healthy dogs of all ages found that significant abnormalities were present in 39.5% of dogs.156 Clinicians should use their judgement to determine if an abnormality justifies further diagnostic evaluation, additional history or physical examination assessment, or monitoring of the abnormal parameter(s).
Prior to the development of occult disease, it is useful to determine a baseline for each individual dog. Reference ranges provide a wide variation in normal and determining an individual dog’s baseline allows for the trending of values over time. Some diseases are diagnosed prior to an elevation above the normal reference range but based on an increase noted over previous levels. Detection of occult disease in all life stages can allow for earlier diagnostic and therapeutic intervention, and the potential for increased healthy longevity. An example is chronic hepatitis that occurs in the young adult life stage of specific dog breeds; this is a condition in which early intervention may halt or delay disease progression.157,158 Knowledge of breed predisposition to disease will help to guide appropriate selection of tests and timing within life stages for individual dogs. Testing may be more frequent for specific breeds, senior dogs, service dogs, and dogs with a disease process. Consider combining the recommended routine minimum database with tests recommended prior to an elective anesthetic procedure to reduce financial burden on pet owners.
Implementation of aminimum database in all life stages startingwith the young adult will complement pet owner education regarding the importance of scheduled veterinary visits in the healthy dog. Pet owner education should include an open discussion regarding the rationale behind the recommendations, the potential benefit to the dog, and financial aspects. Involvement of the entire veterinary team in the implementation of a minimum database will drive the success of this program.