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?

2 comments:

Anonymous said...

Hi, i am from Bulgaria and my diagnosis is leptospirosis.

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.