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)?
