Difference between revisions of "Clinical Case 1"
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| − | "Shakespeare", a 16 year old domestic short hair cat is brought to the practice for examination. | + | |
| + | <b>"Shakespeare", a 16 year old domestic short hair cat is brought to the practice for examination. | ||
The owner is concerned that Shakespeare has lost weight over the past few weeks. Shakespeare has always been a fussy eater, but recently the owner has noticed that he is asking for food constantly. He has also started to raid the kitchen bin. | The owner is concerned that Shakespeare has lost weight over the past few weeks. Shakespeare has always been a fussy eater, but recently the owner has noticed that he is asking for food constantly. He has also started to raid the kitchen bin. | ||
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*The heart rate is 244, with a grade 2/6 murmur | *The heart rate is 244, with a grade 2/6 murmur | ||
*Shakespeare's temperature is 38.4°C | *Shakespeare's temperature is 38.4°C | ||
| + | </b> | ||
<FlashCard questions="8"> | <FlashCard questions="8"> | ||
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|a4=Shakespeare's history and clinical exam is typical of a cat with hyperthyroidism. Most hyperthyroid cats will have a palpatable goitre. The location of the thyroid gland is variable. Therefore, make sure to slide your fingers alongside the entire trachea, or you may miss it. Shakespeare did have a palpatable goitre. | |a4=Shakespeare's history and clinical exam is typical of a cat with hyperthyroidism. Most hyperthyroid cats will have a palpatable goitre. The location of the thyroid gland is variable. Therefore, make sure to slide your fingers alongside the entire trachea, or you may miss it. Shakespeare did have a palpatable goitre. | ||
|l4=Hyperthyroidism | |l4=Hyperthyroidism | ||
| + | |q5=What would you do now? | ||
| + | |a5=A blood sample was taken from Shakespeare. The results are shown below: | ||
| + | |||
| + | '''Biochemistry''' | ||
| + | :Total Protein: 68g/L (54.0 - 80.0) | ||
| + | :Albumin: 33g/L (25.0 - 42.0) | ||
| + | :Globulin: 35g/L (25.0 - 45.0) | ||
| + | :A:G ratio: 0.9 (0.6 - 1.5) | ||
| + | :Sodium: 157mmol/L (125.0 - 160.0) | ||
| + | :Potassium 4.7mmol/L (3.6 - 6.0) | ||
| + | :Total Calcium: 2.38mmol/L (2.0 - 3.0) | ||
| + | :Urea: 10.9mmol/L (4.0 - 12.0) | ||
| + | :Creatinine: 100umol/L (80 - 180) | ||
| + | :ALP: 162U/L (0.1 - 60.0) HIGH | ||
| + | :ALT: 521U/L (5.0 - 60.0) HIGH | ||
| + | :Total bilirubin: 5.8umol/L (0.1 - 10.0) | ||
| + | :Glucose: 4.7mmol/L (3.5 - 6.6) | ||
| + | |||
| + | '''Haematology''' | ||
| + | :RBC: 9.22x10^12/L (5.5 - 10.0) | ||
| + | :Hb: 13.3g/dL (9.0 - 17.0) | ||
| + | :HCT: 45.2% (27.0 - 50.0) | ||
| + | :MCV: 49.0fl (40.0 - 55.0) | ||
| + | :MCH: 14.5pg (13.0 - 21.0) | ||
| + | :MCHC: 29.5g/dL (29.0 - 36.5) | ||
| + | :Plt: 797x10^9/L (170 - 650) HIGH | ||
| + | :WBCs: 12.10x10^9/L (4.0 - 15.0) | ||
| + | :Neutrophils: 7.99x10^9/L 66% (2.5 - 12.5) | ||
| + | :Lymphocytes: 2.30x10^9/L 19% (1.2 - 7.0) | ||
| + | :Monocytes: 0.12x10^9/L 1% (0.0 - 0.8) | ||
| + | :Eosinophils: 1.57x10^9/L 13% (0.0 - 1.5) HIGH | ||
| + | :Basophils: 0.12x10^9/L 1% (0.0 - 0.2) | ||
| + | |||
| + | '''Endocrinology''' | ||
| + | :Total T4: 304.1nmol/L (15.0-50.0) HIGH | ||
| + | |||
| − | |||
| − | |||
Courtesy of C. Antonczyk | Courtesy of C. Antonczyk | ||
[[Category:Lost]] | [[Category:Lost]] | ||
Revision as of 01:01, 22 January 2012
"Shakespeare", a 16 year old domestic short hair cat is brought to the practice for examination.
The owner is concerned that Shakespeare has lost weight over the past few weeks. Shakespeare has always been a fussy eater, but recently the owner has noticed that he is asking for food constantly. He has also started to raid the kitchen bin.
The owner is not sure how much Shakespeare drinks, as he usually drinks from the fish pond in the garden.
On clinical examination, the vet finds the following:
- Shakespeare is thin
- There is a moderate amount of tartar on the upper molars and canines
- The heart rate is 244, with a grade 2/6 murmur
- Shakespeare's temperature is 38.4°C
<FlashCard questions="8"> |q1=Is Shakespeare's temperature normal? |a1=Yes |l1=Feline Physiology - WikiNormals |q2=What is the normal heart rate for a cat? Is Shakespeare's heart rate high? |a2=140-200 beats per minute in the examination room. Most cats in the exam room are stressed to some extent. Their heart rate is probably much lower at home. Very frightened cats may have a heart rate slightly above 200, but Shakespeare is tachycardic. |l2=Feline Physiology - WikiNormals |q3=What does 'grade 2/6 heart murmur' mean? |a3=Heart murmurs are graded according to their intensity. A grade 2/6 murmur is one that is readily audible, but is quieter than the heart sounds. |l3=Heart Murmurs |q4=What else might you find on clinical exam that will help you with your diagnosis? |a4=Shakespeare's history and clinical exam is typical of a cat with hyperthyroidism. Most hyperthyroid cats will have a palpatable goitre. The location of the thyroid gland is variable. Therefore, make sure to slide your fingers alongside the entire trachea, or you may miss it. Shakespeare did have a palpatable goitre. |l4=Hyperthyroidism |q5=What would you do now? |a5=A blood sample was taken from Shakespeare. The results are shown below:
Biochemistry
- Total Protein: 68g/L (54.0 - 80.0)
- Albumin: 33g/L (25.0 - 42.0)
- Globulin: 35g/L (25.0 - 45.0)
- A:G ratio: 0.9 (0.6 - 1.5)
- Sodium: 157mmol/L (125.0 - 160.0)
- Potassium 4.7mmol/L (3.6 - 6.0)
- Total Calcium: 2.38mmol/L (2.0 - 3.0)
- Urea: 10.9mmol/L (4.0 - 12.0)
- Creatinine: 100umol/L (80 - 180)
- ALP: 162U/L (0.1 - 60.0) HIGH
- ALT: 521U/L (5.0 - 60.0) HIGH
- Total bilirubin: 5.8umol/L (0.1 - 10.0)
- Glucose: 4.7mmol/L (3.5 - 6.6)
Haematology
- RBC: 9.22x10^12/L (5.5 - 10.0)
- Hb: 13.3g/dL (9.0 - 17.0)
- HCT: 45.2% (27.0 - 50.0)
- MCV: 49.0fl (40.0 - 55.0)
- MCH: 14.5pg (13.0 - 21.0)
- MCHC: 29.5g/dL (29.0 - 36.5)
- Plt: 797x10^9/L (170 - 650) HIGH
- WBCs: 12.10x10^9/L (4.0 - 15.0)
- Neutrophils: 7.99x10^9/L 66% (2.5 - 12.5)
- Lymphocytes: 2.30x10^9/L 19% (1.2 - 7.0)
- Monocytes: 0.12x10^9/L 1% (0.0 - 0.8)
- Eosinophils: 1.57x10^9/L 13% (0.0 - 1.5) HIGH
- Basophils: 0.12x10^9/L 1% (0.0 - 0.2)
Endocrinology
- Total T4: 304.1nmol/L (15.0-50.0) HIGH
Courtesy of C. Antonczyk