Clinical Case Challenge

Maxy, a 2-year-old spayed female Golden Retriever, presents for her first weigh in after starting a weight loss program. Her initial physical exam reveals no abnormalities other than a body condition score of 9/9 (normal muscle condition). Her starting weight is 105 pounds, with an estimated ideal weight of 80 pounds. Her diet history reveals that she was receiving 2000 kcal from her current diet. You start her on 1600 kcal of a therapeutic diet after calculating that this is 80% of her current estimated caloric intake. After two weeks on the veterinary therapeutic diet, the owner is upset that Maxy has gained one-half pound and is now 105.5 lbs. Continue reading

Clinical Case Challenge

History

An 8 year-old spayed female Golden Retriever was referred to the Foster Hospital for Small Animals with a three-week history of right forelimb lameness. On physical examination the dog would not bear weight on the affected leg when standing and a toe touching lameness was present when walking. Pain was elicited with light palpation of the right proximal humerus. Initial forelimb radiographs from the referring veterinarian were considered within normal limits. Given the persistent and progressive lameness, follow-up radiographs of the right forelimb were obtained. Continue reading

Clinical Case Challenge

feline photo

A 15-year-old castrated male domestic shorthair cat presented for evaluation of polyuria/polydipsia and weight loss despite a good appetite. He weighed 9 pounds (4.1 kg) with a body condition score of 4/9. Moderate atrophy of the epaxial muscles was noted. Physical examination was otherwise unremarkable. A CBC revealed a mild, non-regenerative anemia (Hct, 25%; reference range, 31-46%).The biochemistry profile revealed hyperglycemia (glucose, 583 mg/dl; reference range, 70-120 mg/dl) and azotemia (BUN, 99 mg/dl; reference range, 15-33 mg/dl; creatinine, 3.2 mg/dl; reference range, 0.9-2.1 mg/dl). Urinalysis revealed a specific gravity of 1.015 with 4+ glucose and no proteinuria. T4 was within the reference range. A complete diet history revealed that the cat was eating ½ cup over-the-counter (OTC) dry adult maintenance cat food plus two 3 oz. cans of cat food per day (both made by good quality major manufacturers – specific varieties and flavors were included in the diet history). The cat did not receive any cat treats, table food, or dietary supplements.

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Clinical Case Challenge

Oral Mass in a Cat

History and Physical Exam:  An 11-year-old, castrated male domestic shorthair cat presented for evaluation of a rapidly growing mass along his left rostral maxilla. The owners reported that hyperemia of the mucus membranes had been noticed in that region at his annual physical exam by his local veterinarian.  The lesion progressed over the next 5 months and caused loosening of his maxillary canine and incisor teeth.  The cat also had a history of hypertrophic cardiomyopathy and hyperthyroidism.  Physical examination revealed an approximate 3.5 x 3 x 2 cm gingival mass in the left rostral maxilla displacing the lip.  Additional findings included loose teeth, blood-tinged saliva, a moderately enlarged left mandibular lymph node, a palpable thyroid slip and a grade III/VI heart murmur. Continue reading