How to Identify Anomalies — Complete Detection Guide

Master all 3 anomaly detection methods in Animal Hospital: Appearance checks, Photo inspection, and CCTV monitoring. Includes visual descriptions,...

How to Identify Anomalies — Complete Detection Guide

Identifying anomalies quickly and accurately is the core skill in Animal Hospital. Every animal patient arriving at your clinic could be a disguised monster. This guide covers the three detection methods, detailed visual descriptions of every anomaly, difficulty ratings, and a cheat sheet you can reference mid-game.


The 3 Detection Methods

Anomalies can only be identified through three specific channels. Some anomalies appear on only one channel, while others span multiple. You must use all three methods on every patient to guarantee detection.

MethodWhere to CheckWhat It RevealsTime Needed
AppearancePatient at reception deskVisible physical deformities~10 seconds
Photo (Polaroid)Photo develops on your deskHidden discrepancies, cursed images~8 seconds
CCTVSurveillance monitors (waiting room priority)Camera-only anomalies~10 seconds

Method 1: Appearance Anomalies

These anomalies are visible when you look directly at the patient at the reception window. No camera or photo needed — your eyes are the only tool.

Easy — Instantly Recognizable

AnomalyWhat It Looks LikeHow to Spot
Three EyesA patient with a bright red third eye on its foreheadGlance at the face — the red eye is immediately obvious
Hollow FaceThe patient's face has black void eye sockets — no eyes, no features, just empty darknessThe complete absence of facial features makes this one of the easiest to spot
Wide Eyes & Creepy SmileThe patient has distorted facial proportions — unnaturally wide eyes stretched open with an unsettling, too-wide grinLook at the face — the proportions are wrong in an obvious way
Human TeethThe animal has human-like teeth instead of species-appropriate teethCheck the mouth — teeth that belong on a person, not on an animal

Medium — Requires a Closer Look

AnomalyWhat It Looks LikeHow to Spot
Twitching / Limb SpasmsThe patient's limbs jerk and spasm involuntarily — legs or arms twitch in an unnatural, mechanical wayWatch the patient for 4–5 seconds. The twitching is subtle and may not be visible in a quick glance
Mismatched Eyes & Sharp Teeth (Poorly Drawn Patient)The patient has asymmetric eyes (different sizes or colors) paired with fang-like sharp teethCompare both eyes to each other, then check the mouth. The asymmetry is the giveaway

Tips for Appearance Checks

  • Face the patient directly — side glances are unreliable
  • Scan top-to-bottom: Eyes → Mouth → Body (for twitching)
  • Spend the full 4–5 seconds watching for twitching before moving on
  • ❌ Never skip this step — it sets the mental baseline needed for Photo and CCTV comparisons

Method 2: Photo Anomalies

Photo anomalies are invisible in person. They only appear when the polaroid develops on your desk. Some photo anomalies are dangerous to touch.

Easy — Obvious Photo Problems

AnomalyWhat the Photo Looks LikeRisk
Static PhotoThe entire polaroid is covered in TV-static interference — white and gray noise across the imageNone — purely visual
Incorrect PhotoThe polaroid shows a completely different patient or scene — not the animal you just sawNone — obvious mismatch
Unnatural PhotoThe image is warped, stretched, or distorted — like a funhouse mirror version of the patientNone — visually obvious

Medium — Needs Comparison with Step 1

AnomalyWhat the Photo Looks LikeRisk
Different EarsThe ears in the photo don't match what you saw in-person — wrong shape, size, or positionNone — must compare against your Appearance check memory
Cursed PhotoThe photo has bloodshot, glowing eyes and an eerie aura. Picking it up drains 10 Sanity-10 Sanity if you touch it — close the shutter BEFORE picking it up

Hard — Subtle Differences

AnomalyWhat the Photo Looks LikeRisk
Different EyesThe eyes in the photo don't match the in-person patient — slightly different color, shape, or numberNone — requires close comparison with your mental snapshot from Step 1

Tips for Photo Checks

  • Look at the photo on the desk BEFORE picking it up — this prevents Cursed Photo Sanity drain
  • Compare specific features: Match eyes and ears against what you saw in Step 1
  • If in doubt, close the shutter — dismissing a clean patient is always safer than letting an anomaly through
  • ❌ Never grab the photo without inspecting it first

Method 3: CCTV Anomalies

CCTV anomalies are invisible both in-person AND in photos. They only appear on surveillance camera feeds. The waiting room camera is the most important — check it first.

Easy — Visible Anomalies

AnomalyWhat It Looks Like on CameraDifficulty
Void Bodies / Shadow PatientA dark, featureless shadow figure in place of where the patient should be on the feedEasy — a black silhouette stands out immediately
Censored Eyes / JPEG EyesThe patient's eye area is blurred or pixelated like a censored photographEasy — the blur is immediately noticeable on the feed
Unnatural Body / Limb StretchingThe patient's body on camera shows stretched, elongated limbs that don't match normal proportionsEasy — limbs that are too long or bent wrong

Medium — Requires Attention

AnomalyWhat It Looks Like on CameraDifficulty
Staring At CameraThe patient on the feed is looking directly into the camera lens — normal patients don't do thisMedium — the direct stare is unsettling but not instantly alarming
Skinwalker (CCTV)The patient displays erratic, unnatural movement on the camera feed — jerky, fast, or wrong-direction movementMedium — the movement pattern is the giveaway

Hard — Very Subtle

AnomalyWhat It Looks Like on CameraDifficulty
Twitching (CCTV)The patient's limbs jerk on the camera feed — same as the appearance version but only visible on monitorsHard — easy to miss on a small screen with other patients in frame
Hollow Face (CCTV)The patient's face on the camera shows empty black void eye socketsHard — depends on camera angle and feed quality

Very Hard — Expert Level

AnomalyWhat It Looks Like on CameraDifficulty
Mismatched Ears or Eyes (CCTV)The patient on CCTV has different ears or eyes compared to what you saw in-person during Step 1Very Hard — requires strong memory of the patient's in-person appearance and deliberate cross-referencing

Tips for CCTV Checks

  • Start with the waiting room camera — most CCTV anomalies appear there
  • Watch each patient for a few seconds before cycling to the next camera
  • Cross-reference with your Step 1 memory for the Mismatched anomaly
  • ❌ Don't ignore CCTV — these anomalies are completely invisible through the other two methods

Difficulty Rating Summary

DifficultyCountTotal Anomalies
⭐ Easy13Three Eyes, Hollow Face (×2), Wide Eyes, Human Teeth, Static Photo, Incorrect Photo, Unnatural Photo, Void Bodies, Censored Eyes, Unnatural Body
⭐⭐ Medium6Twitching (Appearance), Mismatched Eyes (Appearance), Different Ears (Photo), Cursed Photo, Staring At Camera, Skinwalker (CCTV)
⭐⭐⭐ Hard4Different Eyes (Photo), Twitching (CCTV), Hollow Face (CCTV)
⭐⭐⭐⭐ Very Hard1Mismatched Ears/Eyes (CCTV)

Quick-Reference Cheat Sheet

Print this or keep it open on a second screen. Use it during shifts.

Step-by-Step Protocol

1. LOOK at patient (eyes → mouth → body, 4–5 seconds)
   → Anything weird? CLOSE SHUTTER.

2. CHECK photo on desk (DON'T pick up yet)
   → Static/Wrong/Unnatural/Cursed? CLOSE SHUTTER.
   → Eyes/Ears match what you saw? Continue.

3. CHECK waiting room CCTV first, then other cameras
   → Shadow/Blur/Stretch/Staring/Jerky? CLOSE SHUTTER.
   → Everything matches? Patient is CLEAN ✓

Red Flags at a Glance

Red FlagMethodAction
Red eye on foreheadAppearanceClose shutter
Black void faceAppearance / CCTVClose shutter
Creepy wide smileAppearanceClose shutter
Human teethAppearanceClose shutter
Jerking limbsAppearance / CCTVWatch 5 seconds, then decide
TV static on photoPhotoClose shutter
Wrong patient in photoPhotoClose shutter
Glowing eyes on photoPhotoClose shutter (DON'T touch!)
Shadow figure on cameraCCTVClose shutter
Pixelated eyes on cameraCCTVClose shutter
Staring into cameraCCTVClose shutter
Photo/CCTV doesn't match in-personPhoto / CCTVClose shutter

Sanity Warnings

  • 🚫 Cursed Photo: -10 Sanity if picked up — inspect on desk first
  • 🚫 The Stalker: -10 Sanity per eye contact — look away
  • 🚫 Don't Look Up: Continuous drain — use Eye Drops immediately

Advanced: Multi-Channel Anomalies

Some patients can have anomalies across multiple detection channels simultaneously. For example, a patient might look normal in-person but have BOTH a Cursed Photo AND a Void Body on CCTV. This is why the 3-step protocol is mandatory — skipping any step can let a multi-channel anomaly slip through.

💡 Pro Tip: If you spot an anomaly on ANY step, close the shutter immediately. Don't bother checking the remaining steps — the patient is already flagged.


Sources: In-game testing, IGN, Eurogamer, TechWiser, community wiki research