Small Animal Emergency and Critical Care Medicine Q&A 08

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A six-year-old Somali cat was presented with a history of polyuria, polydipsia, weight loss, vomiting and lethargy. The cat had not been eating well for the past 3 days. Physical examination found the cat approximately 8% dehydrated and mentally depressed. There was evidence of weight loss. Thoracic and abdominal examination was unremarkable. The retinas were normal.

Initial laboratory data: PCV – 55%; TS – 8.5 g/dl; BUN labstick – 50–80 mg/dl; glucose by labstick – 460 mg/dl (25,8 mmol/l); Na+ – 165 mEq/l; K+ – 2.6 mEq/l; venous pH – 7.2; PCO2 – 40 mmHg; HCO3 – 8 mEq/l. Urinanalysis: SG – 1.026 with 4+ glucose, 2+ ketones, 1+ protein, 5 WBCs/hpf and intracellular cocci. Initial BP by indirect methods was 120/80 mmHg (16/10.6 kPa).

Question Answer Article
What is your working diagnosis and problems list? Link to Article
Describe your initial treatment plan for this cat. Link to Article
What other electrolytes must you evaluate, and why? Link to Article
What are potential complications? Link to Article
Would you use sodium bicarbonate? Why or why not? Link to Article
You are treating the cat and have brought the glucose to within normal range. However, there is now 4+ ketonuria. Explain the increase in ketones on the urine dipstick. Link to Article

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