Despite having been a vet for more than a decade, I freely admit to not being able to predict the outcomes of all cases that come through my clinic. It is hard, and in some cases impossible, to give a perfectly accurate prognosis for every situation.
Some situations are fairly predictable - particularly with common diseases with typical symptoms - and respond to treatment in a typical and repeatable pattern. But there are times when making predictions is simply a game of risk management, and no matter how many variables you have covered, there will always be an element of the unknown. The more complex the disease, the less predictable it is. Unfortunately, it is the life-and-death situations that are often the most complex. This is where we veterinarians have to dig out all our predictive skills to give a prognosis on which clients can make further decisions.
In the animal world we have the option of euthanasia. Many of the issues surrounding the human version also apply to animals - not least of which is that euthanasia is an irreversible decision. So any decision needs to be thought through carefully with the best information to hand.
I am often presented with animals that face serious health battles. By assessing the combination and severity of symptoms, various test results and my experience of previous animals' responses to various forms of therapy, I have to decide on the likely prognosis.
There are lots of adjectives you can use to describe a prognosis, but fundamentally it can be good, guarded, poor or grave. Good speaks for itself; guarded means I'm not sure and things could go either way, so we need to be wary and cautious; poor and grave only leave room for miracles.
It is these occasional miracles that really make my day. I like to be proved wrong after giving a poor or grave prognosis.
Recently a cat was brought to me hypothermic and catatonic, meaning it was not responsive to any stimuli. It was just staring, unblinkingly. What was worse, one of its eyes was rolling up and down on its own. This is called vertical nystagmus and is a sign of brain damage. This symptom alone warrants a poor prognosis.