A Case A Week for Veterinarians: Case 6

A Case A Week for Veterinarians

Providing veterinarians a challenging case for brain storming every week ... A Case A Week a website for Vets prepared by Dr Mofya Saul and Dr Rajesh Banga.

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Monday, December 8, 2008

Case 6

Presentation:

A 9 months old neuter male pothound dog that was brought to AcaseAweek Clinic for being lethargic, anorexic (not eating since 2 days), and vomiting. On the next day of hospitalization, the patient continued to be lethargic, anorexic, vomiting and became icteric. On detailed history the owner reported presence of rats around the patient’s environment.

Physical examination:

On the day of presentation:

T: 102.1
HR: 104
RR: 40
Tacky mucous membrane
Fleas
Vomiting

Next day:

T: 101.0
HR: 96
RR: 30
CRT: <2sec
Icteric
Lethargic
Not eating

CBC:

HCT: 32% (37.0-55.0)
HGB: 11.5 g/dl (12-18)
MCHC: 35.9 g/dl (30-36.9)
WBC: 10.8 x10⁹/L (6.0-16.9)
Granulocytes: 9.3 x10⁹/L (3.3-12.0)
PLT: 37 x10⁹/L (175-500)

Biochemistry:

ALB: 2.6 g/dl (2.3-4.0)
ALKP: 879 U/L (23-212)
ALT: 184 U/L (10-100)
AMYL: 1260U/L (500-1500)
CREA: 7.9 mg/dL (0.5-1.8)
BUN: 130 mg/dL (7-27)
GlOB: 5.6 g/dL (2.5-4.5)
TP: 8.2 g/dL (5.2-8.2)
TBIL: 9.5 mg/dL (0.0-0.9)

What is your tentative diagnosis?

What are your differentials?

What further tests you will do to confirm your diagnosis?

How will you treat and manage this case?

Solution to this case

posted by Dr Banga's Websites @ 12:00 AM

2 Comments:

At December 9, 2008 at 2:57 AM, Anonymous said…

Hi, i am from Bulgaria and my diagnosis is leptospirosis.
At December 10, 2008 at 8:41 PM, Anonymous said…

Hi,
Yeah.. it may be leptospirosis, however the low platelet count and the biochemistry suggests the possibility of hepatitis, make sure the dog is vaccinated against ICH. also should be differentially diagnosed from ehlrichiosis.