DAMNIT-V COMBINED EVIDENCE SNAPSHOT v17
==================================================

PATIENT
-------
Name: Eddy
Owner: Bright
Species: Canine
Breed: Border Collie
Sex: Male
Desexed Status: 
Life Stage: 
Activity Level: 
Current Weight kg: 23.00
Ideal Weight kg: 
BCS: 7.00

CASE
----
Case Title: Vomiting
Primary Complaint: Vomiting for 2 days 
Status: Open
Date Opened: 30/05/2026

CLINICAL NARRATIVE
------------------
Vomiting for 2 days , blood - was eating a bone

INITIAL DIFFERENTIAL NOTES
--------------------------
Suspect FB vs Garbage vs Bacterial infection 

CLINICAL INTAKE DOCUMENTS
-------------------------

DOCUMENT: History
Type: Clinical History
Source: Manual
Uploaded: 30/05/2026 05:44

O called early today - dog is Vomiting

NUTRITION ASSESSMENTS
---------------------
Total nutrition assessments for this case: 71

LATEST NUTRITION ASSESSMENT
---------------------------
Assessment ID: 70
Title: Nutrition Assessment
Date: 05/06/2026
Feeding Goal: Maintenance
Current Diet Type: Commercial complete
Body Weight kg: 23.00
Ideal Weight kg: 
BCS: 7.00
Muscle Condition: Normal
Appetite: Normal
Owner Goals: 
Diet Concerns: 
Skin / Coat Notes: 
Digestive Notes: 
Stool Quality: 
Owner-Reactive Foods: O: Chicken, beef, lamb, roo, pork, cheese, eggs, yoghurt, kibble, wheat, peanut butter,
Owner-Tolerated Foods: : Goat, venison, wild boar, [meat must have no fillers added - that's why Canine Country is best as raw food without fillers] blueberries, strawberries, raspberries, apples, bananas, mango, cucumber/gukes, broccoli/broccolini, cauliflower, pumpkin, peas, zucchini, beans, watermelon (all vegetables are cooked), he doesn’t like carrot or celery

NUTRITION EVIDENCE SNAPSHOT
---------------------------
Latest Assessment ID: 70
Assessment Date: 05/06/2026
Energy Intake: 420.7 kcal/day
Estimated Requirement: 997.74 kcal/day
Energy Percent: 42.2%
Energy Status: Low / below estimated requirement
Protein: 45.71 g/day
Fat: 18.24 g/day
Carbohydrate: 30.6 g/day
Matched Diet Items: 7 / 19
Unmatched Diet Items: 12
Micronutrient Confidence: Partial / incomplete
Nutrition Confidence: Moderate / partial evidence

Owner-Reactive / Avoid Foods:
O: Chicken, beef, lamb, roo, pork, cheese, eggs, yoghurt, kibble, wheat, peanut butter,

Owner-Tolerated Foods:
: Goat, venison, wild boar, [meat must have no fillers added - that's why Canine Country is best as raw food without fillers] blueberries, strawberries, raspberries, apples, bananas, mango, cucumber/gukes, broccoli/broccolini, cauliflower, pumpkin, peas, zucchini, beans, watermelon (all vegetables are cooked), he doesn’t like carrot or celery

Ingredient-Derived Reactive Groups:
cruciferous, fibre, fodmap, iodine_source, lectin, oxalate_possible, purine, salicylate_possible, sulphur

RAC-Reactive Foods:
Not yet connected. Future build will compare RAC-reactive foods against current diet, owner-reactive foods and tolerated foods.

EVIDENCE INCLUDED
-----------------
Clinical intake documents: 1
Nutrition assessments: 71
RAC / Audiomixer documents: 0
Pathology / laboratory reports: 0
Imaging reports: 0
HTMA reports: 0
Microbiome reports: 0
Supplement reviews: 0

EVIDENCE PENDING / NOT YET ADDED
--------------------------------
- Food entries, treat entries, supplement entries
- RAC / Audiomixer DOCX reports
- Pathology / laboratory reports
- Imaging reports
- HTMA report if requested
- Microbiome report if requested
- Supplement review

EVIDENCE PRIORITISATION
-----------------------

High Priority Evidence:
- Vomiting reported in clinical intake.
- Blood reported with vomiting or gastrointestinal signs.
- History of bone ingestion or bone exposure.

Moderate Priority Evidence:
- Nutrition assessment evidence is present.
- Owner-reported food reactivity / avoid foods are present.

Low Priority / Missing Evidence:
- Owner-tolerated food list is present and may assist future diet planning.
- RAC / Audiomixer evidence is not yet included in this snapshot.
- HTMA evidence is not yet included in this snapshot.
- Microbiome evidence is not yet included in this snapshot.

EVIDENCE STATUS
---------------

Evidence Used In This Snapshot:
- Clinical Intake: Used
- Nutrition: Used

Additional Evidence Available If Clinically Indicated:
- RAC / Audiomixer screening: may help prioritise which physical tests or evidence domains should be pursued next.
- Pathology / laboratory testing: available if clinical signs, risk assessment, or response to treatment justify testing.
- Imaging: available if obstruction, foreign body, mass, trauma or structural disease remains a concern.
- HTMA: available if mineral/toxic element patterning is clinically relevant.
- Microbiome: available if chronic gastrointestinal, immune, dermatological or inflammatory patterns require deeper investigation.

Clinical Context:
A veterinary assessment is commonly made using the evidence that is clinically justified and practically available. This section records what was used and what could be added later, without implying that every possible test is required for every patient.

EVIDENCE WEIGHTING ENGINE v1
----------------------------
Domain weights used in this snapshot:
- Imaging: 5
- Pathology / Laboratory: 5
- Clinical Examination: 4
- Clinical History / Intake: 4
- Nutrition: 3
- HTMA: 2
- Microbiome: 2
- RAC / Audiomixer: 1
- Supplement Review: 1

Current snapshot contains Clinical Intake and Nutrition evidence only. Imaging, pathology, HTMA, microbiome and RAC are pending.

DIFFERENTIAL PRIORITIES v2 - WEIGHTED
-------------------------------------

1. Gastrointestinal foreign body / obstructive bone fragment
Weighted Evidence Score: 12
Weighted Confidence: High
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Bone ingestion/exposure reported.
- [Clinical History +4] Blood reported with vomiting or gastrointestinal signs.

2. Acute gastritis / gastroenteritis
Weighted Evidence Score: 8
Weighted Confidence: Moderate
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Blood may indicate mucosal irritation, ulceration or injury.

3. Dietary indiscretion / garbage gut
Weighted Evidence Score: 8
Weighted Confidence: Moderate
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Dietary exposure history should be reviewed.

4. Food reactivity / intolerance contribution
Weighted Evidence Score: 6
Weighted Confidence: Low-Moderate
Evidence:
- [Nutrition +3] Owner-reported reactive foods present.
- [Nutrition +3] Nutrition snapshot shows ingredient-derived reactive burden evidence.

AI DAMNIT-V POSSIBILITY EXPANSION v3

CATEGORY: D - Degenerative / Structural  
Relative Priority: Moderate  
Why this category may be relevant:  
- Possibility of structural damage or mechanical obstruction due to bone ingestion (foreign body or bone fragment).  
- Vomiting with blood could be secondary to mucosal injury or erosion from sharp bone fragments or obstruction-induced ischemia.  
- Potential for gastrointestinal ulceration or perforation from trauma caused by bone ingestion.  

Why this category may be less likely or currently weak:  
- No prior chronic signs of structural disease reported.  
- No imaging or endoscopy data yet to confirm structural abnormalities.  

Possible Diseases / Processes:  
- Gastrointestinal foreign body (bone fragment causing obstruction or mucosal damage)  
- Gastric or intestinal ulceration (trauma-related)  
- Post-traumatic mucosal erosions or perforation (low probability without systemic illness)  

Possible Organs / Systems:  
- Stomach (gastric mucosa, pylorus)  
- Small intestine (duodenum, jejunum)  
- Esophagus (less likely but possible)  

Suggested RAC Screening Targets:  
- Gastrointestinal tract segment biomarkers related to mucosal integrity or bleeding  
- Biomarkers of inflammation/trauma in GI tissues  

If RAC is positive, physical confirmation options:  
- Abdominal radiography or ultrasound to detect foreign objects or obstruction  
- Endoscopy to visualize mucosal damage or foreign bodies  
- Exploratory laparotomy if obstruction or perforation suspected  

If RAC is negative, interpretation:  
- Structural causes less likely; consider primarily functional, metabolic, or infectious causes  
- Reconsider intermittent or partial obstruction or early mucosal injury not reflected in RAC markers  

Cost-aware staged approach:  
- Low-cost / immediate: Abdominal palpation, plain radiographs  
- Moderate-cost: Ultrasound, lab hematology for bleeding signs  
- Higher-cost / referral: Endoscopy, exploratory surgery  

Notes for longitudinal validation:  
- RAC prediction to record: Positive biomarkers for mucosal injury or foreign body presence  
- Physical confirmation or outcome that would validate/refute: Imaging/endoscopy findings, resolution post-foreign body removal  

---

CATEGORY: A - Allergic / Autoimmune / Reactive  
Relative Priority: Low to Moderate (currently weak evidence)  
Why this category may be relevant:  
- Owner reports reactive food proteins (multiple avoid foods listed) that could contribute to GI irritation or immune-mediated gastritis.  
- Vomiting with blood could be associated with immune-mediated mucosal damage or allergic gastritis.  
- History of partial food intolerance suggests possible contribution from allergic/immune gastritis.  

Why this category may be less likely or currently weak:  
- Sudden onset vomiting with bone ingestion history favors mechanical causes over immune.  
- No prior chronic signs of allergy-related GI disease reported.  
- No serology or specific immune markers available yet.  

Possible Diseases / Processes:  
- Food hypersensitivity gastritis or enteritis  
- Immune-mediated inflammatory bowel disease (IBD) - less likely acute presentation  
- Eosinophilic gastroenteritis (low priority currently)  

Possible Organs / Systems:  
- Gastric mucosa  
- Small intestinal mucosa  

Suggested RAC Screening Targets:  
- Immune or allergic reaction biomarkers (eosinophilic markers, IgE-related markers)  
- Food antigen-reactive profiling targeting GI immune response  

If RAC is positive, physical confirmation options:  
- Endoscopic biopsies with histopathology to confirm eosinophilic or lymphocytic infiltration  
- Dietary elimination trial to assess response  
- Peripheral blood eosinophil count, serum allergy panels  

If RAC is negative, interpretation:  
- Food allergy or immune mediated gastritis less probable as primary cause  
- Focus on other causes (infectious, toxic, structural)    

Cost-aware staged approach:  
- Low-cost / immediate: Trial elimination diet, CBC with eosinophil count, clinical allergy history update  
- Moderate-cost: Serum allergy testing, abdominal ultrasound  
- Higher-cost / referral: Endoscopy and biopsy  

Notes for longitudinal validation:  
- RAC prediction to record: Presence of immune-reactive biomarkers to food antigens or eosinophilic inflammation  
- Physical confirmation or outcome that would validate/refute: Histopathology or dietary trial outcomes  

---

CATEGORY: M - Metabolic / Nutritional / Endocrine  
Relative Priority: Low to Moderate  
Why this category may be relevant:  
- Nutrition assessment shows low energy intake (~42% of estimated requirement), could predispose to GI motility disorders or delayed healing.  
- Vomiting can be driven by metabolic causes such as electrolyte imbalances or metabolic disorders secondary to poor intake.  
- Owner food reactivity may affect dietary balance, risk of micronutrient deficiencies or GI disturbance.  

Why this category may be less likely or currently weak:  
- No lab data indicating metabolic derangements yet (e.g. kidney, liver, electrolyte panels).  
- Vomiting is acute and sudden, less typical for endocrine/metabolic diseases unless complicating factors.  

Possible Diseases / Processes:  
- Hypoadrenocorticism (Addison’s disease) - vomiting and GI bleeding possible but uncommon acute presentation  
- Uremia or liver dysfunction-associated vomiting (low priority without supporting lab data)  
- Nutritional deficiencies causing mucosal fragility (B vitamins, minerals) - low likelihood acutely  
- Diabetes Ketoacidosis (unlikely without polyuria/polydipsia)  

Possible Organs / Systems:  
- Adrenal glands  
- Liver  
- Kidneys  
- Gastrointestinal mucosa (nutritional impact)  

Suggested RAC Screening Targets:  
- Metabolic/endocrine biomarker panels (cortisol, electrolytes, liver enzymes, kidney markers)  
- Nutritional biomarkers (vitamin/mineral status, protein metabolism markers)  

If RAC is positive, physical confirmation options:  
- Blood chemistry and electrolytes panel  
- ACTH stimulation test / adrenal function tests  
- Nutritional blood profiles  
- Abdominal ultrasound for liver/kidney evaluation  

If RAC is negative, interpretation:  
- Metabolic or endocrine causes less likely; focus on primary GI or infectious/toxic causes.  

Cost-aware staged approach:  
- Low-cost / immediate: Basic blood tests (chemistry, electrolytes)  
- Moderate-cost: Endocrine functional tests (ACTH stim)  
- Higher-cost / referral: Advanced nutritional profiling, imaging  

Notes for longitudinal validation:  
- RAC prediction to record: Metabolic/endocrine biomarker trends consistent with GI signs  
- Physical confirmation or outcome that would validate/refute: Pathology or response to metabolic therapy  

---

CATEGORY: N - Neoplastic  
Relative Priority: Low (currently weak evidence)  
Why this category may be relevant:  
- GI neoplasia can occasionally cause vomiting with blood due to ulceration or mucosal infiltration.  
- Bone ingestion might be incidental but concurrent neoplasia possible.  
- Chronic vomiting or unexplained GI bleeding often triggers neoplastic screening.  

Why this category may be less likely or currently weak:  
- Acute onset vomiting over 2 days with clear bone ingestion history is more consistent with foreign body or trauma.  
- No BCS loss or chronic symptom history to raise suspicion of neoplasia.  
- No imaging or cytology to reveal masses yet.  

Possible Diseases / Processes:  
- Gastric or intestinal adenocarcinoma  
- Lymphoma of GI tract  
- GI stromal tumor or leiomyoma (less common)  

Possible Organs / Systems:  
- Stomach  
- Small intestine  
- Mesenteric lymph nodes  

Suggested RAC Screening Targets:  
- Neoplastic markers or circulating tumor DNA (if available)  
- GI-specific tumor antigen profiles  

If RAC is positive, physical confirmation options:  
- Imaging (ultrasound, CT) to identify masses or lymphadenopathy  
- Endoscopic biopsy for histopathology  
- Cytology of abdominal fluid or enlarged nodes  

If RAC is negative, interpretation:  
- Neoplasia unlikely; continue with other DAMNIT-V categories focus.  

Cost-aware staged approach:  
- Low-cost / immediate: Physical exam focusing on lymph nodes, abdominal palpation  
- Moderate-cost: Abdominal ultrasound  
- Higher-cost / referral: Endoscopy, biopsy, advanced imaging  

Notes for longitudinal validation:  
- RAC prediction to record: Tumor marker elevations or suspicious circulating biomarkers  
- Physical confirmation or outcome that would validate/refute: Biopsy results, imaging findings  

---

CATEGORY: I - Infectious / Inflammatory  
Relative Priority: High  
Why this category may be relevant:  
- Vomiting with blood may indicate acute gastritis or gastroenteritis due to infection or inflammation.  
- History includes possible bacterial infection (garbage ingestion) or secondary infection related to mucosal injury by bone.  
- Acute presentation of vomiting plus blood supports infectious or inflammatory GI disease.  

Why this category may be less likely or currently weak:  
- No fever or systemic signs noted yet, though data incomplete.  
- No microbiome or pathogen testing performed yet.  

Possible Diseases / Processes:  
- Acute bacterial gastroenteritis (Clostridium, Salmonella, Campylobacter)  
- Parasitic gastroenteritis (less likely acutely, no data)  
- Viral gastritis (parvovirus less likely in adult vaccinated dog)  
- Hemorrhagic gastroenteritis (HGE)  
- Sterile inflammatory gastritis (secondary to trauma or toxins)  

Possible Organs / Systems:  
- Stomach  
- Small intestine  

Suggested RAC Screening Targets:  
- Pathogen-specific nucleic acid or antigen biomarker panels  
- Broad inflammatory biomarkers (acute phase proteins, cytokines)  

If RAC is positive, physical confirmation options:  
- Fecal pathogen panel or culture  
- Blood work including CBC for neutrophilia, anemia  
- Abdominal ultrasound for wall thickening or free fluid  

If RAC is negative, interpretation:  
- Infectious/inflammatory cause less probable, consider structural or toxic causes.  

Cost-aware staged approach:  
- Low-cost / immediate: Fecal exam, CBC, abdominal palpation  
- Moderate-cost: Fecal PCR panel, abdominal ultrasound  
- Higher-cost / referral: Endoscopy with biopsy for chronic or refractory cases  

Notes for longitudinal validation:  
- RAC prediction to record: Presence of bacterial or inflammatory markers linked with vomiting and bleeding  
- Physical confirmation or outcome that would validate/refute: Positive fecal tests, imaging, histopathology  

---

CATEGORY: T - Toxic / Traumatic  
Relative Priority: Moderate to High  
Why this category may be relevant:  
- Bone ingestion can cause traumatic injury to mucosa producing vomiting and blood.  
- Possible ingestion of garbage raises suspicion of toxic substances or irritants causing GI signs.  
- Vomiting onset is acute, consistent with trauma or toxin exposure.  

Why this category may be less likely or currently weak:  
- No direct evidence of toxin ingestion reported (besides garbage suspicion).  
- No signs of systemic toxicity noted yet.  

Possible Diseases / Processes:  
- GI mucosal trauma due to bone fragment  
- Chemical irritation/poisoning from garbage ingestion (e.g. bacterial toxins, foreign chemicals)  
- Blunt abdominal trauma (low priority here)  

Possible Organs / Systems:  
- Gastric mucosa  
- Esophagus  
- Small intestine  

Suggested RAC Screening Targets:  
- Toxicologic biomarkers (heavy metals, common toxins)  
- Biomarkers of tissue injury or hemorrhage  

If RAC is positive, physical confirmation options:  
- Toxicology screening if toxin suspected  
- Imaging for perforation or trauma  
- Endoscopic mucosal assessment  

If RAC is negative, interpretation:  
- Toxic/traumatic causes less likely; prioritize other causes such as infectious or structural.  

Cost-aware staged approach:  
- Low-cost / immediate: History review for toxins, basic blood work  
- Moderate-cost: Toxicology screens, abdominal imaging  
- Higher-cost / referral: Endoscopy or exploratory surgery for perforation  

Notes for longitudinal validation:  
- RAC prediction to record: Presence of toxic biomarkers or injury markers consistent with trauma  
- Physical confirmation or outcome that would validate/refute: Toxicology test results, endoscopy  

---

CATEGORY: V - Vascular / Neurological  
Relative Priority: Low  
Why this category may be relevant:  
- Severe systemic illness causing vascular compromise could produce GI hemorrhage or vomiting.  
- Neurological causes such as vestibular disease could cause vomiting (though no blood expected).  
- Vascular events such as gastric ulceration secondary to systemic hypoperfusion possible but rare.  

Why this category may be less likely or currently weak:  
- No ataxia, neurological signs, or circulatory compromise documented.  
- Vomiting with blood less typical for primary neurological disorder.  
- No systemic shock or vascular compromise reported.  

Possible Diseases / Processes:  
- CNS causes of vomiting (vestibular syndrome, increased intracranial pressure)  
- Gastric or intestinal mucosal infarction or hemorrhage due to vascular events  
- Coagulopathy-induced bleeding (secondary vascular)  

Possible Organs / Systems:  
- Brain (vestibular nuclei)  
- GI blood vessels  
- Coagulation systems  

Suggested RAC Screening Targets:  
- Neurological biomarkers (if available)  
- Coagulation and platelet function biomarkers  
- Vascular injury biomarkers  

If RAC is positive, physical confirmation options:  
- Neurological examination  
- Coagulation profile and platelet count  
- Advanced imaging (MRI brain, CT) if neuro signs present  

If RAC is negative, interpretation:  
- Vascular/neurologic cause unlikely; focus on other DAMNIT-V categories.  

Cost-aware staged approach:  
- Low-cost / immediate: Neurological examination, coagulation tests  
- Moderate-cost: Advanced imaging if indicated  
- Higher-cost / referral: MRI, specialist neurology consult  

Notes for longitudinal validation:  
- RAC prediction to record: Evidence of coagulopathy or neuro biomarker elevation  
- Physical confirmation or outcome that would validate/refute: Neurological status, coagulation results  

---

RAC SCREENING PRIORITY LIST  
---------------------------  
1. Urgent / safety-critical  
- Gastrointestinal mucosal injury/bleeding biomarkers (due to blood present with vomiting)  
- Foreign body / obstruction biomarker panel (bone ingestion risk)  
- Acute inflammatory/infectious biomarkers (to rule in/out gastroenteritis or HGE)  

2. High-yield  
- Toxicology and trauma biomarkers (due to bone, garbage ingestion)  
- Metabolic/endocrine screening (especially electrolyte imbalances, adrenal insufficiency)  
- Immune/allergic reaction markers (food allergen related)  

3. Secondary / if time permits  
- Neoplastic markers (GI tumors)  
- Neurological/vascular biomarkers (coagulopathy, neurologic causes)  
- Nutritional status biomarkers (micronutrient deficiencies)  

PHYSICAL TESTING PRIORITY IF RAC SUPPORTS  
-----------------------------------------  
- Abdominal radiography and ultrasound for foreign body, obstruction, mucosal injury  
- Endoscopy with biopsies for mucosal evaluation, immune/allergic, neoplastic or infectious diagnosis  
- Bloodwork: CBC, chemistry, coagulation profile, ACTH stim test, electrolyte panel  
- Fecal analysis and PCR for infectious agents  
- Toxicology screening if indicated by RAC or history  
- Neurological exam and imaging if neurologic RAC markers positive  

---

This RAC-based DAMNIT-V map includes all categories with relevant reasoning and screening suggestions tailored to current clinical evidence and priorities for a vomiting dog with blood and bone ingestion history.

DIFFERENTIAL POSSIBILITY MAP v1
--------------------------------
Purpose: broaden the clinical thinking before final prioritisation. This is not a diagnosis list; it is a structured map of plausible branches that may be explored using RAC screening and, where justified, physical confirmation testing.

Gastrointestinal / Obstructive / Traumatic
------------------------------------------
Possible branches to consider:
- Foreign body
- Bone fragment irritation or obstruction
- Gastritis
- Enteritis
- Gastrointestinal mucosal trauma
- Intestinal pain / spasm
- Pancreatic irritation
- Peritonitis risk if deterioration occurs
Suggested RAC screening targets:
- GIT obstruction signal
- Stomach trauma / irritation
- Small intestinal trauma / irritation
- Abdominal pain
- Pancreas stress
- Inflammation
- Peritoneal irritation
Possible physical confirmation if RAC/clinical evidence supports:
- Abdominal radiographs
- Abdominal ultrasound
- CBC / biochemistry
- Electrolytes / hydration assessment
- Serial abdominal palpation and pain scoring
- Surgical referral if obstruction/perforation concern increases

Dietary / Food Reactivity / Toxicity
------------------------------------
Possible branches to consider:
- Dietary indiscretion
- Food intolerance flare
- Reactive food exposure
- High fat exposure / pancreatitis risk
- Toxin or irritant ingestion
- Microbiome disruption
Suggested RAC screening targets:
- Reactive foods currently in diet
- Owner-reported reactive foods
- Histamine / sulphur / lectin / oxalate / purine burden
- Pancreas stress
- Liver detoxification burden
- Gut dysbiosis pattern
Possible physical confirmation if RAC/clinical evidence supports:
- Diet history review
- Elimination / bland diet trial if stable
- CBC / biochemistry if persistent or systemic signs
- cPL / pancreatitis testing if indicated
- Microbiome testing if chronic or recurrent

Systemic / Metabolic / Infectious
---------------------------------
Possible branches to consider:
- Systemic infection / inflammatory disease
- Renal or hepatic contribution
- Endocrine/metabolic stress
- Electrolyte disturbance
- Pain-driven nausea
Suggested RAC screening targets:
- Kidney stress
- Liver stress
- Systemic inflammation
- Electrolyte disturbance
- Pain focus
- Fever / infection pattern
Possible physical confirmation if RAC/clinical evidence supports:
- Temperature and physical exam
- CBC / biochemistry
- Urinalysis
- Electrolytes
- Further infectious disease testing if clinically indicated

DAMNIT-V Integrative Screening Branches
---------------------------------------
Possible branches to consider:
- Degenerative / structural
- Allergic / autoimmune / reactive
- Metabolic / nutritional
- Neoplastic
- Infectious / inflammatory
- Toxic / traumatic
- Vascular / neurological
Suggested RAC screening targets:
- Run RAC screening across DAMNIT-V categories
- Identify strongest organ/system signals
- Identify strongest pathology-type signals
- Compare RAC positives with clinical history and nutrition evidence
Possible physical confirmation if RAC/clinical evidence supports:
- Select physical confirmation based on strongest RAC-supported branch
- Use pathology, imaging, HTMA, microbiome, or referral testing only where clinically justified

RAC-GUIDED NEXT EVIDENCE v1
---------------------------
RAC is treated here as a screening and prioritisation layer. A positive RAC signal does not replace physical diagnosis, but it can increase the justification for targeted physical testing when cost, risk, or uncertainty make broad testing difficult.

Suggested workflow:
1. Generate broad differential possibility map.
2. Run RAC screening against the most plausible branches.
3. Compare RAC positives with clinical history, nutrition, examination and owner observations.
4. Increase priority for physical confirmation where RAC and clinical evidence converge.
5. Record later confirmation and outcome so RAC predictions can be validated longitudinally.

INTERPRETIVE CAUTION
--------------------
This evidence snapshot is not a final diagnosis. It represents the evidence currently available at the time of generation. Later laboratory, imaging, HTMA, microbiome, RAC, nutrition, or supplement evidence may change the interpretation.