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If no localising findings are obvious, a full investigation is recommended.  This includes a full routine haematology, biochemistry, urinalysis, faecal bacteriology and parasitology, diagnostic imaging and gastroduodenoscopy.  Trypsin-like immunoassay (TLI) can be used diagnose [[Exocrine Pancreatic Insufficiency - WikiClinical|exocrine pancreatic insufficiency (EPI)]].  These findings are usually unremarkable in cases of idiopathic ARD.  In these instances, a trial treatment with antimicrobial therapy is warranted.  If these animals are responsive to the antimicrobial, but the clinical signs relapse upon withdrawal of treatment, a true idiopathic ARD can then be made.

If no localising findings are obvious, a full investigation is recommended.  This includes a full routine haematology, biochemistry, urinalysis, faecal bacteriology and parasitology, diagnostic imaging and gastroduodenoscopy.  Trypsin-like immunoassay (TLI) can be used diagnose [[Exocrine Pancreatic Insufficiency|exocrine pancreatic insufficiency (EPI)]].  These findings are usually unremarkable in cases of idiopathic ARD.  In these instances, a trial treatment with antimicrobial therapy is warranted.  If these animals are responsive to the antimicrobial, but the clinical signs relapse upon withdrawal of treatment, a true idiopathic ARD can then be made.

Currently, the gold standard direct test for diagnosing ARD is duodenal juice culture.  Unfortunately, this is an expensive test and it is rarely available.  Indirect tests such as serum folate and cobalamin concentrations have been used to analyse the bacterial concentrations in small intestines.  Some species of bacteria may increase the level of serum folate concentration or decrease serum cobalamin concentration, or both. The sensitivity and specificity of this test is low and therefore their use in the diagnosis of ARD is questionable.

Currently, the gold standard direct test for diagnosing ARD is duodenal juice culture.  Unfortunately, this is an expensive test and it is rarely available.  Indirect tests such as serum folate and cobalamin concentrations have been used to analyse the bacterial concentrations in small intestines.  Some species of bacteria may increase the level of serum folate concentration or decrease serum cobalamin concentration, or both. The sensitivity and specificity of this test is low and therefore their use in the diagnosis of ARD is questionable.