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Small Animal Emergency and Critical Care Medicine Q&A 22 (view source)
Revision as of 13:16, 17 August 2011
, 13:16, 17 August 2011Created page with "[[Image:|centre|500px]] <br /> '''An 11-month-old, male Doberman Pinscher is presented with a 3-day history of coughing. In the past few hours he has started to produce frank b..."
[[Image:|centre|500px]]
<br />
'''An 11-month-old, male Doberman Pinscher is presented with a 3-day history of coughing. In the past few hours he has started to produce frank blood and blood clots when he coughs.'''
<br />
<FlashCard questions="3">
|q1=Based on the clinical presentation, what historical questions should be asked of the owner?
|a1=
*Possible exposure to rodenticides,
*previous bleeding episodes (e.g. following spaying or castration) which might indicate a coagulation factor deficiency,
*recent use of medications which could cause platelet function disorders, vitamin K malabsorption or immune-mediated thrombocytopenia.
|l1=
|q2=What diagnostic tests are indicated?
|a2=
A coagulation profile is indicated, including a platelet count, PTT, OSPT and assays for fibrin degradation (or split) products and fibrinogen.
An ACT and platelet estimate on a blood smear may help to indicate a coagulopathy.
Thoracic radiographs are indicated to determine the source of the hemoptysis.
|l2=
|q3=Your initial diagnostic tests reveal an ACT of 3 minutes and a normal platelet estimate. What initial treatment would you implement?
|a3=
Rodenticide toxicity is suspected.
Treatment should consist of vitamin K1 therapy (loading dose of 5 mg/kg s/c then 2.5 mg/kg/day p/o), plus supportive care including oxygen supplementation if tachypneic or dyspneic, and whole blood or plasma
replacement if indicated.
|l3=
</FlashCard>
[[Category:Small Animal Emergency and Critical Care Medicine Q&A]]
<br />
'''An 11-month-old, male Doberman Pinscher is presented with a 3-day history of coughing. In the past few hours he has started to produce frank blood and blood clots when he coughs.'''
<br />
<FlashCard questions="3">
|q1=Based on the clinical presentation, what historical questions should be asked of the owner?
|a1=
*Possible exposure to rodenticides,
*previous bleeding episodes (e.g. following spaying or castration) which might indicate a coagulation factor deficiency,
*recent use of medications which could cause platelet function disorders, vitamin K malabsorption or immune-mediated thrombocytopenia.
|l1=
|q2=What diagnostic tests are indicated?
|a2=
A coagulation profile is indicated, including a platelet count, PTT, OSPT and assays for fibrin degradation (or split) products and fibrinogen.
An ACT and platelet estimate on a blood smear may help to indicate a coagulopathy.
Thoracic radiographs are indicated to determine the source of the hemoptysis.
|l2=
|q3=Your initial diagnostic tests reveal an ACT of 3 minutes and a normal platelet estimate. What initial treatment would you implement?
|a3=
Rodenticide toxicity is suspected.
Treatment should consist of vitamin K1 therapy (loading dose of 5 mg/kg s/c then 2.5 mg/kg/day p/o), plus supportive care including oxygen supplementation if tachypneic or dyspneic, and whole blood or plasma
replacement if indicated.
|l3=
</FlashCard>
[[Category:Small Animal Emergency and Critical Care Medicine Q&A]]