Clinical Case Challenge

Anxious Greyhound

Greyhound with Anxiety

History
An 8-year-old neutered male Greyhound was evaluated at the Tufts Animal Behavior Service for intermittent episodes of extreme anxiety. The first anxiety attack occurred in late October of 2008 and lasted for 3 days. Physical examination, CBC and serum biochemistry analysis performed by the referring veterinarian were within reference limits.

The dog had no history of cardiovascular or Continue reading

Clinical Case Challenge

Cranial Mediastinal Mass in an Old Dog

History: An 11 year-old, spayed female Labrador retriever presents for polyuria and polydipsia.  The owners report mild lethargy but the dog is otherwise doing well.  Physical examination reveals body condition 4/9 but is otherwise within normal limits for a dog of this age. A complete blood count is within normal limits.  The chemistry profile reveals total calcium 15.4 mg/dl (NR,  9.4-11.8), ionized calcium 1.7 mmol/L (NR, 1.12-1.40), creatinine  2.1 mg/dl (NR, 0.6-2.0), BUN 39 mg/dl (NR, 8-30).  Urinalysis reveals dilute urine with a specific gravity of 1.008.   Thoracic radiographs are taken (Figure 1) and an ultrasound-guided fine needle aspiration is performed..

Figure 1: Lateral thoracic radiograph demonstrating cranial mediastinal mass.

What are the differential diagnoses for this lesion?

Figure 2: Cytology of cranial mediastinal mass. Green arrows point to mast cells.

What is your diagnosis?  How would you treat this dog? Continue reading

Clinical Case Challenge

Labrador Collapses: What’s Your Diagnosis?

History: An eight-year-old, spayed female Labrador retriever presented for evaluation of acute onset of diarrhea and collapse. The owner reported that the dog was completely normal until 3 hours prior to presentation when the dog developed profuse bloody diarrhea.  There was no history of toxin exposure, and current medications included prednisone 1 mg/kg orally BID, famotidine 0.5mg/kg orally SID, and azathioprine 10mg/kg orally SID for immune-mediated hemolytic anemia diagnosed 4 weeks prior.

On initial physical examination the dog was recumbent with tacky, muddy mucus membranes and a capillary refill time of approximately 3 seconds.  The rectal temperature was 98.9° F, pulse 180 beats per minute, and respiratory rate 60 breaths per minute.  A large bore over the needle catheter was placed in the cephalic vein and the following minimum data base was obtained: PCV 34%, TP 5.4 g/dl, venous lactate 7.4 mmol/L. The dog had severe pain on abdominal palpation and there was a palpable abdominal fluid wave. An abdominocentesis was performed and the abdominal effusion was found to be a transudate. The remainder of the physical examination was non-remarkable. An emergency abdominal ultrasound was performed.

  1. Describe the lesion outlined in the ultrasound image:
    Clinical Case Challenge September 2011
  2. List 5 differential diagnoses for a dog presenting with an acute abdomen and abdominal effusion.

What’s your diagnosis? For the answers, please click here.

Clinical Case Challenge

Anesthesia and Pain Case Challenge

History: An 8 year old, 30 kg, mixed breed dog presents with recent onset of left hind leg lameness.  Radiographs and subsequent biopsy reveal the presence of an osteosarcoma of the distal femur. The decision to amputate the limb is made. How would you manage this dog’s acute perioperative pain using a wound soaker catheter? Calculate doses and volumes of local anesthetic needed to maintain pain control, and duration of treatment.

Continue reading