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- 1. Next Appointment: Sylvester Stone (Feline, M) “Vomiting”
- 2. Vomiting Foreign Body Toxin/poisonAcute Renal Insult Vomiting vs regurg?Vestibular Otitis interna Central Gastrointestinal stress Abdominal pancreatitis dietary Oesophagitis gastritis Dehydration Electrolytes imbalances metabolic alkalosis (non-ion gap) Hepatic lipidosis Gastric neoplasia hepatitis Porto-systemic shunts cholangiohepatitis Central brain lesions triaditis Gall stones intussusseption pyelonephritis hydronephrosis Urolithiasis – renal vs blocked catperitonitis endocrinopathies DKA hyperthyroid
- 3. History • 3 year old cat • Acute lethargy • Vomiting • Anorexia Physical Exam • Obese • Comatose Obese Anorexia Prognosis
- 5. Haematology • PCV (%) 50 24-45 • NCC (x 109/L) 24 5.5-19.5 • Segs (x 109/L) 23 2.5-12.5 • Monos (x 109/L) 0.7 0-0.88 • Lymphs (x 109/L) 0.3 1.5-7.0 • Platelets Adequate Vomiting = Dehydration? What else? Stress Leukogram Erythrocytosis Absolute Relative Primary Dehydration Neoplasia within bone marrow Splenic contraction Spleen Liver Secondary Hypoxia Cardiovascular disease Altitude Renal neoplasia (EPO)
- 6. Biochemistry • Glucose 285 67-124 Stress? • Urea 110 17-32 • Creatinine 7.5 0.9-2.1 • Calcium 6.5 8.5-11 • Phosphorus 14 3.3-7.8 • Total Protein 9.0 5.9-8.1 Dehydration?
- 8. • Serum Anion Gap: Its Uses and Limitations in Clinical Medicine (Jeffrey A, Kraut and Nicolaos E. Madias) http://cjasn.asnjournals.org/content/2/1/162.full
Editor's Notes
- Monocytes aren’t up but doesn’t always