Clinical Case Challenge September 2011: Answers
Diagnosis: Portal Vein Thrombosis
Treatment for shock was initiated using 90ml/kg LRS IV. Tachycardia persisted despite the initial bolus, and a recheck lactate was 5.4 mmol/L. Following administration of 20ml/kg Voluven and an additional 45ml/kg LRS IV, the heart rate stabilized and lactate concentration normalized. The dog was hospitalized for ongoing support, and heparin was initiated (Fragmin 150u SQ BID). The dog was discharged 2 days later with instructions related to initiating a tapering dose of prednisone.