A 5-year-old intact male German Shorthaired Pointer is presented with a 3-day history of squinting his left eye (OS). The owner reports the eye appears red and hazy, and the dog is less active than usual with a decreased appetite. He is an active hunting dog, is up to date on vaccinations, and spends a lot of time in a wooded, rural area. The owner has not noticed any trauma to the eye.
Physical Exam:
T: 103.4°F
P: 90 bpm
R: 24 bpm
MM: pink/moist
CRT <2 sec
The general physical exam reveals mild lethargy and a low-grade fever. On ophthalmic exam, the left eye (OS) shows marked blepharospasm, moderate conjunctival and episcleral hyperemia (a "red eye"), and diffuse corneal edema (a "hazy" or "cloudy" appearance). The pupil is constricted (miosis) and responds poorly to light. Using a transilluminator in a dark room, a faint "flare" is visible in the anterior chamber, indicating increased protein. The right eye (OD) appears normal.
CBC and Biochemistry:
CBC: Mild thrombocytopenia (Platelets: 120 K/uL [Ref: 175-500 K/uL])
Biochemistry: Mild hyperglobulinemia (Globulins: 4.5 g/dL [Ref: 2.5-4.5 g/dL]). All other values are within reference range.
Urinalysis:
All values within reference range.
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 28 will be posted on Aug 22
