Case 27

 Case 27

A 7-year-old female spayed Beagle mix is presented for a 3-week history of drinking and urinating excessively (polyuria/polydipsia). The owner reports the dog has an excellent appetite but has lost a noticeable amount of weight. Over the last few days, the owner thinks the dog’s eyes have developed a "cloudy" appearance and she has been bumping into furniture. The dog is up to date on vaccinations and preventatives.

Physical Exam:

  • T: 101.9°F

  • P: 110 bpm

  • R: 28 bpm

  • MM: pink/moist

  • CRT <2 sec

The dog is bright and alert but has a slightly thin body condition (BCS 4/9). The remainder of the physical exam is unremarkable except for the ocular exam, which reveals bilateral, symmetrical, dense opacities within the lenses consistent with mature cataracts.

CBC and Biochemistry:

  • CBC: All values within reference range.

  • Biochemistry:

    • Glucose: 485 mg/dL [Ref: 75-125 mg/dL]

    • Alanine Aminotransferase (ALT): 180 U/L [Ref: 10-125 U/L]

    • Alkaline Phosphatase (ALP): 350 U/L [Ref: 23-212 U/L]

    • All other values are within reference range.

Urinalysis: (performed on a free-catch sample)

  • Color: Clear

  • pH: 6.0

  • SG (refractometer): 1.012 [Ref: >1.025]

  • Protein (dipstick): Trace

  • Glucose (dipstick): 4+ (>1000 mg/dL) [Ref: Negative]

  • Ketones (dipstick): 1+ (Small) [Ref: Negative]

  • Sediment exam: Unremarkable


What will be your tentative and differential diagnosis? What further diagnostic test(s) you will perform to confirm your diagnosis? What will be your treatment plan(s)?

Solution for Case 27 

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