[ExplEngineer]

If you will permit me, perhaps I can offer a suggestion that might aid in achieving a proper diagnosis of that which is afflicting “Patch”. I do not know where you are located at geographically, nor as to your proximity to advanced Veterinary care, but if “The vets where I go are very very busy, by the time u book something Patch seems to get better then he’s ill again..” however, I would suggest that you will receive greater opportunities for appropriate diagnosis if you would, rather than continuing to cope with the cycle of appointment delays and intermittent suffering, ask for a referral to a regional veterinary specialty clinic, or to a clinic that is co-located with a College of Veterinary Medicine. Despite the fact that Patch appears to go into remission spontaneously, there is a great probability that there is the issue of cumulative tissue damage or destruction, resulting in increasing severity of symptoms, and perhaps even complications that are difficult to treat or even beyond remediation by other than extreme treatment modalities that in and of themselves can result in complications of their own. In reviewing the symptomology that you report, it is unclear as to whether the underlying cause is digestive in its etiology, or as a result of endocrine system dysfunction, each of which would have differing modalities of treatment, and for the most part require differing diagnostic testing to achieve a proper diagnosis, which is always the predicate for developing a treatment plan that is suitable for both the disorder in general, and the individual needs of the patient. In the instances of illness and dysfunction that you describe, the varied causes may require a series of different diagnostic procedures to isolate and identify the cause of the distress, e.g. an Ultrasound, or an MRI, or perhaps a PET scan. Depending upon the findings, there may be the need for either a needle biopsy, or other marginally invasive procedure to secure tissue samples for examination by a pathologist. I know that this may seem extraordinarily complex, but by entering into a unified diagnostic protocol you may be able to avoid repetitive testing as well as subjecting Patch to the stressors relating to multiple clinic visit and perhaps exposure to a number of differing Veterinarians who may, or may not have a means of communication and consultation, repetitive procedures and delays in securing relief for the underlying condition.

I apologize if this appears to be a statement of the obvious, but I cannot help but conclude that your current system of assessment and diagnosis has not yielded the results that you would have expected, nor any conclusions as to the underlying disease process, which will create stressors upon you as his caregiver, as well as considerable redundant and unnecessary expense, thus depriving you of access to funding that may be required to secure the treatment that is necessary to secure a positive outcome.