WHAT IS YOUR DIAGNOSIS?
|
|
- Ellen Mills
- 6 years ago
- Views:
Transcription
1 WHAT IS YOUR DIAGNOSIS? A six year old, female neutered Dandie Dinmont was presented to the R(D)SVS Internal Medicine Service for investigation of progressive stertor and exercise intolerance. Trial therapy with carprofen had not improved the clinical signs. On physical examination, the dog was bright, alert and responsive with a body weight of 13.4kg (figure 1). Stertor was audible throughout the consultation. A left side grade II/VI systolic heart murmur was audible which had been previously detected by the referring veterinarian. The heart rate was 90 beats per minute with a sinus arrhythmia. There was no abnormal respiratory noises audible on thoracic auscultation. The oral mucous membranes were pink and moist, capillary refill time was 2 seconds and there were no pulse deficits. Abdominal palpation was generally unremarkable and all peripheral lymph nodes were within normal limits. The coat was dull and thin with generalized epidermal hyperpigementation. Her rectal temperature was 38.1 C. The dog was admitted for further evaluation. A haematology profile was unremarkable and results from a serum biochemistry analysis is shown overleaf (* above reference range) page 1 of 6
2 Parameter Result Reference Range Total protein (g/l) Albumin (g/l) Globulin (g/l) Bile acids (μmol/l) Total bilirubin (μmol/l) Urea (mmol/l) Creatinine (μmol/l) Glucose (mmol/l) ALKP (iu/l) ALT (iu/l) Sodium (mmol/l) Chloride (mmol/l) Potassium (mmol/l) Inorganic phosphate (mmol/l) Total calcium (mmol/l) Cholesterol (mmol/l) 8.0 * Triglyceride (mmol/l) 2.65 * ) What are the differential diagnoses for hypercholesterolemia and hypertriglyceridemia? 2) How would you evaluate this case further? page 2 of 6
3 1. Differential diagnosis for hypercholesterolemia and hypertriglyceridemia Causes of hyperlipidemia include (1) : o Postprandial hyperlipidemia o Hypothyroidism o Diabetes mellitus o Hyperadrenocorticism o Pancreatitis o Obesity o Protein losing nephropathy o Cholestasis o Miscellaneous eg high fat diets, lymphoma, infection with Leishmania infantum, congestive heart failure due to dilated cardiomyopathy, and administration of certain drugs (e.g. glucocorticoids) o Primary lipid abnormalities 2. Further evaluation of the case In light of the hyperlipidemia findings and the history of lethargy and dermatological signs, thyroid function was assessed by measurement of serum concentrations of total thyroxine and thyroid stimulating hormone. To further examine the dog for potential causes of stertor, the structure and function of the dog s upper airway was assessed during the induction of general anaesthesia. In addition, a computed tomography (CT) examination of the head was performed. Rhinoscopy and nasopharyngeal endoscopy was then undertaken. Since nasal biopsies may be harvested depending on CT findings, a pre-anaesthesia coagulation profile and buccal mucosal bleeding time test was performed. Serum total thyroxine concentration was <5.0nmol/l (ref. range 15-48) and thyroid stimulating hormone was 2.15ng/ml (ref. range 0-0.5). Evaluation of the upper airway on anaesthesia induction revealed that the soft palate was elongated and the laryngeal saccules were everted. Head CT scan revealed that the soft palate was elongated (figure 2). Rhinoscopy and nasopharyngeal endoscopy was unremarkable apart from confirming the presence of an elongated soft palate. No intranasal biopsies were taken due to the relatively unremarkable CT scan of the nasal turbinates and normal rhinoscopy findings and the finding of a prolonged activated thromboplastin time. In light of the findings of low total thyroxine and high thyroid stimulating hormone concentrations, hyperlipidemia and clinical signs including lethargy and coat thinning, a diagnosis of primary hypothyroidism was made. The dog was treated with levothyroxine 0.3mg SID. At the two week recheck, the owner reported that the dog was much brighter and her stertor was significantly improved. A 5 hour post pill serum total thyroxine concentration was slightly increased (56.9nmol/l) so the thyroxine dose was lowered to 0.2mg SID. Further coagulation profiles were within normal limits. At the four page 3 of 6
4 week recheck her stertor was further improved, albeit still present. Serum thyroxine concentration was within the reference range. Discussion This case had many typical features of primary hypothyroidism; the clinical findings of lethargy and a thinning, dull coat are typical of dogs with primary hypothyroidism as are the biochemical findings of hyperlipidemia (2). The most widely used screening test for primary hypothyroidism remains the measurement of serum concentrations of total thyroxine in conjunction with thyroid stimulating hormone (2). In many cases of primary hypothyroidism, the total thyroxine concentration is low and the thyroid stimulating hormone is high. Although these typical changes were observed in this case, it is important to acknowledge many cases of primary hypothyroidism do not have these typical changes, not least because the presence of thyroxine autoantibodies can interfere with some total thyroxine assays (3, 4). A notably feature of this case was the presence of stertor at initial evaluation and its subsequent improvement following treatment with thyroxine. It is difficult to make firm cause and effect conclusions between the development of hypothyroidism and the onset of stertor in this case; however, it is possible that the progressive upper airway noise reported during initial examination was due to myxoedema of the soft palate. Myxoedema most commonly occurs in the skin and is a well recognised complication of hypothyroidism in dogs. Myxoedema is caused by deposition of dermal acid mucopolysaccharides, notably hyaluronic acid. In dogs with hypothyroidism it can lead to a thickened appearance of the skin which does not pit with pressure. Myxoedema of the upper airway has been occasional reported in human patients with hypothyroidism (5,6). As with this case, treatment with thyroxine can lead to improvement in clinical signs of upper airway obstruction in humans with hypothyroidism (5,6). The residual stertor observed in this dog may have been caused by everted laryngeal saccules or possibly due to incomplete resolvement of the myxoedema of the soft palate. Due to the much improved stertor and good exercise tolerance following thyroxine treatment, further assessment was not deemed necessary at the moment. page 4 of 6
5 Figure 1 Figure 2 : Sagittal computed tomography image of the head. Note the elongated soft palate. page 5 of 6
6 References 1. Xenoulis PG, Steiner JM. Lipid metabolism and hyperlipidemia in dogs. Vet J. 2010;183(1): Mooney CT. Canine hypothyroidism: a review of aetiology and diagnosis. New Zealand veterinary journal. 2011;59(3): Nachreiner RF, Refsal KR, Graham PA, Bowman MM. Prevalence of serum thyroid hormone autoantibodies in dogs with clinical signs of hypothyroidism. Journal of the American Veterinary Medical Association. 2002;220(4): Randolph JF, Lamb SV, Cheraskin JL, Schanbacher BJ, Salerno VJ, Mack KM, et al. Free thyroxine concentrations by equilibrium dialysis and chemiluminescent immunoassays in 13 hypothyroid dogs positive for thyroglobulin antibody. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine. 2015;29(3): Uzunpinar A. (2006) Upper Airway Obstruction in a patient with severe hypothyroidism presenting as postextubation stridor. Chest, Bidkar V, Naik A, Anita R. (2013) Myxedema of Upper Airway: a rare cause of stridor. Journal of Case Reports. 3(2): page 6 of 6
WHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? A seven year old, male neutered diabetic domestic shorthaired cat was presented to the R(D)SVS Internal Medicine Service for investigation of ongoing polydipsia, polyuria, polyphagia
More informationWHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? A 1.5 year, male neuter, domestic shorthair cat was presented to the R(D)SVS Internal Medicine Service with a three month history of pica (ingestion of cat litter and licking concrete)
More informationWHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? A 12 year old, female neutered domestic shorthaired cat was presented to the R(D)SVS Feline Clinic with a 6 week history of polydipsia and polyuria, which was not quantified. The
More informationWHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? An 8 year old, female neutered cross breed dog was presented to the R(D)SVS Internal Medicine Service following a 2 month history of ataxia and collapsing episodes which occurred
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Small Animal Medicine Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2018 Small Animal Medicine Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Small Animal Medicine Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2017 Small Animal Medicine Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
More informationWHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? A 21 month old, female neutered Cockapoo presented with a 5 day history of trembling. The dog had been in the owners possession since a 7 week old puppy, and was up-to-date with
More informationAustralian and New Zealand College of Veterinary Scientists. Fellowship Examination. Veterinary Clinical Pathology Paper 1
Australian and New Zealand College of Veterinary Scientists Fellowship Examination June 2012 Veterinary Clinical Pathology Paper 1 Perusal time: Twenty (20) minutes Time allowed: Three (3) hours after
More informationAustralian College of Veterinary Scientists. Membership Examinationn. Veterinary Emergency and Critical Care Paper 1
Australian College of Veterinary Scientists Membership Examinationn June 2011 Veterinary Emergency and Critical Care Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal
More informationANAESTHESIA AND LIVER DISEASE: UNDERSTANDING BLOOD RESULTS
Vet Times The website for the veterinary profession https://www.vettimes.co.uk ANAESTHESIA AND LIVER DISEASE: UNDERSTANDING BLOOD RESULTS Author : Marieke De Vries Categories : Vets Date : September 26,
More informationREFERENCE INTERVALS. Units Canine Feline Bovine Equine Porcine Ovine
REFERENCE INTERVALS Biochemistry Units Canine Feline Bovine Equine Porcine Ovine Sodium mmol/l 144-151 149-156 135-151 135-148 140-150 143-151 Potassium mmol/l 3.9-5.3 3.3-5.2 3.9-5.9 3.0-5.0 4.7-7.1 4.6-7.0
More informationTables of Normal Values (As of February 2005)
Tables of Normal Values (As of February 2005) Note: Values and units of measurement listed in these Tables are derived from several resources. Substantial variation exists in the ranges quoted as normal
More informationHypothyroidism part two diagnosis, treatment and nursing
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Hypothyroidism part two diagnosis, treatment and nursing Author : Gemma Reid Categories : RVNs Date : July 1, 2008 Gemma Reid
More informationBrachycephalic Airway Syndrome (Upper Airway Problems Seen in Short-Nosed Breeds) Basics
Brachycephalic Airway Syndrome (Upper Airway Problems Seen in Short-Nosed Breeds) Basics OVERVIEW Partial upper airway obstruction in short-nosed, flat-faced (brachycephalic) breeds of dogs and cats caused
More informationROTUNDA HOSPITAL DEPARTMENT OF LABORATORY MEDICINE
This active test table informs the user of Biochemistry tests available in house. s referred to other sites are recorded in the Referred Table. Issue date: 4 TH April 2016 Contact Phone Number ext.1345/2522
More informationPrimary hypothyroidism is the most common form
J Vet Intern Med 2015;29:877 881 Free Thyroxine Concentrations by Equilibrium Dialysis and Chemiluminescent Immunoassays in 13 Hypothyroid Dogs Positive for Thyroglobulin Antibody J.F. Randolph, S.V. Lamb,
More informationClinician Blood Panel Results
Page 1 of 7 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
More informationDifficulty Breathing and Respiratory Distress Basics
Difficulty Breathing and Respiratory Distress Basics OVERVIEW Difficulty breathing (known as dyspnea ) a subjective term that in human medicine means an uncomfortable sensation in breathing or a sensation
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Veterinary Emergency and Critical Care Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2018 Veterinary Emergency and Critical Care Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours
More informationColor: BROWN/WHITE. Protein test is performed and confirmed by the sulfosalicylic acid test.
5/8/2014 L 29 UA/Microscopy results from IDEXX Reference GLUCOSE NEGATIVE BILIRUBIN NEGATIVE KETONES NEGATIVE BLOOD NEGATIVE PH 6.5 SP GRAVITY 1.031 PROTEIN NEGATIVE UROB NORMAL WBC NONE SEEN HPF 0-5 RBC
More informationBiochemistry Adult Reference Ranges
Certified correct on 28/06/2016 Biochemistry Adult Reference Ranges Test Reference range Units Reference range from Traceable to standard reference material Albumin 35 50 g/l Pathology IRMM ERM-DA470k/IFCC
More informationNeurological Manifestations of Thyroid disease. Dr. Andrea Finnen Mississauga Oakville Veterinary Emergency Hospital Neurology Service
Neurological Manifestations of Thyroid disease Dr. Andrea Finnen Mississauga Oakville Veterinary Emergency Hospital Neurology Service Pituitary-Thyroid Axis Thyroid function Thyroid gland is able to store
More informationNEW RCPCH REFERENCE RANGES-
s vary between populations and age groups and it is important to always check the reference Haematology: Haemoglobin Male 130 175 g/l 0 6 days 145-220 g/l Female 115 165 g/l 7 days 140-186 g/l 8 days 3
More informationAustralian and New Zealand College of Veterinary Scientists. Fellowship Examination. Equine Medicine Paper 1
Australian and New Zealand College of Veterinary Scientists Fellowship Examination June 2013 Equine Medicine Paper 1 Perusal time: Twenty (20) minutes Time allowed: Four (4) hours after perusal Answer
More informationHypothyroidism (Low Levels of Thyroid Hormone) Basics
Glendale Animal Hospital 623-934-7243 www.familyvet.com Hypothyroidism (Low Levels of Thyroid Hormone) Basics OVERVIEW Clinical condition that results from inadequate production and release of thyroid
More informationChylothorax Basics OVERVIEW GENETICS SIGNALMENT/DESCRIPTION OF PET
Chylothorax Basics OVERVIEW Chylo- refers to chyle; thorax refers to the chest Chyle is a milky to slightly yellow fluid composed of lymph and fats (rich in triglycerides) taken up from the intestines
More informationProtein-Losing Enteropathy. Disclosures. Isabella 9/8/2016. Consulting, AVL Laboratories, St. Louis, MO
Protein-Losing Enteropathy Stanley I. Rubin, DVM, MS Diplomate ACVIM Clinical Professor Department of Veterinary Clinical Medicine Disclosures Consulting, AVL Laboratories, St. Louis, MO Signalment 7 yo,
More informationCASE-BASED SMALL GROUP DISCUSSION MHD II
MHD II, Session 11, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD II Session 11 April 11, 2016 STUDENT COPY MHD II, Session 11, Student Copy Page 2 CASE HISTORY 1 Chief complaint: Our baby
More informationLIFELONG CARE PLAN SMALL BREED
LIFELONG CARE PLAN SMALL BREED Your pet is unique, and our veterinarian s treatment plan will be tailored to their specific needs. As your pet grows, however, there are certain health concerns associated
More informationAdams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS
Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation
More informationTREATING LEAD POISONING IN DOGS
Vet Times The website for the veterinary profession https://www.vettimes.co.uk TREATING LEAD POISONING IN DOGS Author : Lisa Gardbaum Categories : Vets Date : December 6, 2010 Lisa Gardbaum discusses diagnosis
More informationFeline Hyperthyroid Clinic, frequently asked questions for vets:
Feline Hyperthyroid Clinic, frequently asked questions for vets: The following information will provide you with better understanding of the treatment details and will advise you on recommendations to
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Veterinary Emergency and Critical Care Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2017 Veterinary Emergency and Critical Care Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours
More informationCase Scenario 1. Discharge Summary
Case Scenario 1 Discharge Summary A 69-year-old woman was on vacation and noted that she was becoming jaundiced. Two months prior to leaving on that trip, she had had a workup that included an abdominal
More informationSenior Wellness Screening Protocol & Guidance Notes
Senior Wellness Screening Protocol & Guidance Notes Early detection and prevention are the most important reasons why you should screen every pet, every year especially where statistics show 10% of normal
More informationAuthorised: JSWoodford, Lead of Speciality. Biochemistry Reference Intervals, October Page 1 of 5
AFP All All < 15 ug/l Albumin All 0-3M 25-40 g/l Albumin All 3-12M 32-45 g/l Albumin All 1-70Y 34-48 g/l Albumin All >70Y 32-46 g/l Alk Phos All 0-10Y 80-350 U/L Alk Phos M 10-14Y 45-400 U/L Alk Phos F
More informationAPPROACHES TO HYPERTHYROIDISM
Vet Times The website for the veterinary profession https://www.vettimes.co.uk APPROACHES TO HYPERTHYROIDISM Author : Catherine F Le Bars Categories : Vets Date : June 29, 2009 Catherine F Le Bars explores
More informationFullerton Healthcare Screening Centres
Fullerton Healthcare Screening Centres Fullerton Healthcare Screening Centre @ Ngee Ann City The Penthouse, #26-02 Ngee Ann City Tower B, 391B Orchard Road, Singapore 238874 Operating hours: Monday - Friday
More informationFeline hyperthyroidism: Outline
FELINE HYPERTHYROIDISM: AN UPDATE ON TREATMENT RECOMMENDATIONS J Catharine Scott-Moncrieff Purdue University, West Lafayette IN J. Catharine Scott-Moncrieff Purdue Universit Feline hyperthyroidism: Outline
More informationPurdue Veterinary Clinical Pathology Laboratory
Order Comments: 8/1/2017 2:27 PM OSA? rinalysis Final - Approved 8/1/2017 2:27 PM Color Turbidity Specific Gravity p Protein Glucose Ketones Bilirubin Blood robilinogen WBC RBC Epithelial Cells Bacteria
More informationMEDICAL HISTORY. 23-Jan-2018 to 23-Jan VCA Miller-Robertson Animal Hospital 8807 Melrose Ave, Los Angeles, CA (310)
8807 Melrose Ave, Los Angeles, CA 90069 (310) 657-7050 MEDICAL HISTORY 23-Jan-2018 to 23-Jan-2018 Client Linnea Engdahl (1810) C: Linnea: (310) 351-9547 Patient Abby (6487) Canine Mixed Breed 3y (22-Jan-2015)
More informationHYPERCALCEMIC GOLDEN RETRIEVER
Presenter: Laura Martínez 1, 2 HYPERCALCEMIC GOLDEN RETRIEVER Contributors: Laia Solano-Gallego 2, Josep Pastor 2, Alberto J. Marco 3, María Cuvertoret-Sanz 3, Rosa Novellas 1,2, Anna Vila 1, 2, Xavier
More informationClinician Blood Panel Results
Page 1 of 8 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
More informationSMALL ANIMAL SOFT TISSUE CASE-BASED EXAMINATION
SMALL ANIMAL SOFT TISSUE CASE-BASED EXAMINATION CASE-BASED EXAMINATION INSTRUCTIONS The case-based examination measures surgical principles in case management prior to, during, and after surgery. Information
More informationno concerns hepatic shunt, high protein diet, kidney failure, metabolic acidosis
TAKING THE WORK OUT OF INTERPRETING LAB WORK CACVT 2017 SPRING CONFERENCE - GREENWOOD VILLAGE, CO Brandy Helewa, CVT, RVT, VTS (ECC) Penn Foster College - Scranton, PA Knowing what the results on your
More informationTHE CLINICAL BIOCHEMISTRY OF LIPID DISORDERS
THE CLINICAL BIOCHEMISTRY OF LIPID DISORDERS Hormonal regulation INSULIN lipid synthesis, lipolysis CORTISOL lipolysis GLUCAGON lipolysis GROWTH HORMONE lipolysis CATECHOLAMINES lipolysis LEPTIN catabolism
More informationSaluki Studies supported by Saluki Health Research, Inc.
Saluki Studies supported by Saluki Health Research, Inc. prepared by MaryDee Sist, DVM for the Saluki World Congress in Helsinki, Finland, June 2008 MaryDee Sist, DVM is the President and Director of Saluki
More informationThe Blood Chemistry Panel Explained
The Blood Chemistry Panel Explained The Senior Profile (for senior and geriatric patients) As our dogs and cats enter their senior years, we recognize that they are more likely to have health problems
More informationCOMPANY OR UNIVERSITY
CONTRIBUTOR NAME Daniel Heinrich, DVM CONTRIBUTOR EMAIL dheinric@umn.edu COAUTHORS Jed Overmann, DVM, DACVP; Davis Seelig DVM, PhD, DACVP & Matthew Sturos, DVM COMPANY OR UNIVERSITY University of Minnesota
More informationNORMAL LABORATORY VALUES FOR CHILDREN
Pediatric Drug Lookup Normal Laboratory Values for NORMAL LABORATORY VALUES FOR CHILDREN CHEMISTRY Normal Values Albumin 0-1 y 2.0-4.0 g/dl 1 y to adult 3.5-5.5 g/dl Ammonia Newborns 90-150 mcg/dl 40-120
More informationPOSTGRADUATE INSTITUTE OF MEDICINE UNIVERSITY OF COLOMBO
POSTGRADUATE INSTITUTE OF MEDICINE UNIVERSITY OF COLOMBO Selection Examination for Enrolment to the in-service Training Programme in Postgraduate Certificate in Basic Laboratory Sciences leading to the
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Veterinary Pathology Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2014 Veterinary Pathology Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
More informationStability of VACUETTE Lithium Heparin Separator tubes with modified centrifugation conditions
Stability of VACUETTE Lithium Heparin Separator tubes with modified centrifugation conditions Background: Greiner-Bio-One, Austria has been selling plastic evacuated tubes (VACUETTE ) for venous blood
More informationPresented by: Dr. Giuseppe Molinaro Dr. Davide De Biase
Presented by: Dr. Giuseppe Molinaro Dr. Davide De Biase Dog Spayed Female LABRADOR RETRIEVER 3 Years old VACCINATIONS ANTIPARASITIC COMMERCIAL DIET VOMITING FOR A MONTH DULLNESS WEIGHT LOSS INAPPETANCE
More informationSeeing is not Believing (13-Nov-2004)
In: 55th Annual Meeting of the American College of Veterinary Pathologists (ACVP) & 39th Annual Meeting of the American Society of Clinical Pathology (ASVCP), ACVP and ASVCP (Eds.) Publisher: American
More informationCase Discussions: Treatment Strategies for High Risk Populations. Most Common Reasons for Referral to the Baylor Lipid Clinic
Case Discussions: Treatment Strategies for High Risk Populations Peter H. Jones MD, FNLA Associate Professor Methodist DeBakey Heart and Vascular Center Baylor College of Medicine Most Common Reasons for
More informationBIOCHEMICAL REPORT. Parameters Unit Finding Normal Value. Lipase U/L Amylase U/L
Lipase U/L 88.9 10-195 Amylase U/L 1181.1 371.3-1192.6 West Delhi :- 7/148, Opp. MCD Office, Major Pankaj Batra Marg, Near Ramesh Nagar, New Delhi-15, Ph. : 011-47562566,9999830187 Liver Function Test
More informationThyroid Tumors in Dogs A Big Gland in the Neck
Thyroid Tumors in Dogs A Big Gland in the Neck This week I had the privilege of meeting a wonderful patient referred to me for evaluation of a thyroid tumor. After consulting with the family, I visited
More informationMRCPUK SEND Exam. Volume: 200 Questions
Volume: 200 Questions Question No : 1 A 24-year-old woman was referred with an 18-month history of worsening hirsutism, primarily on her face, but also new hair growth on her chest. She was shaving weekly.
More informationRayne Rewards S.I.T. TM
S.I.T. TM Simple Ingredient Treats (S.I.T.) jerky and biscuits are a carefully formulated solution for pets and pet owners that need & want simple, pure ingredient treats. These are highly palatable snacks
More informationKEY FACTS IN ANAESTHESIA AND INTENSIVE CARE
KEY FACTS IN ANAESTHESIA AND INTENSIVE CARE Alcira Serrano Gomez MD Fellow John Farman Intensive Care Unit Addenbrooke s NHS Trust Cambridge, UK Gilbert R Park MD DMed Sci FRCA Director of Intensive Care
More informationDIAGNOSING HEART FAILURE IN DOGS
Vet Times The website for the veterinary profession https://www.vettimes.co.uk DIAGNOSING HEART FAILURE IN DOGS Author : Mike Martin Categories : Vets Date : November 7, 2011 Mike Martin offers advice
More informationFBC interpretation. Dr. Gergely Varga
FBC interpretation Dr. Gergely Varga #1 71 Y/O female, c/o weakness Test Undertaken : FBC (FBC) Sample Type: Whole Blood [ - 26.09.11 14:59] Hb 7.3 g/dl* 12.0-15.5 RBC 3.5 10^12/l * 3.80-5.60 Hct 0.24
More informationWHAT IS YOUR DIAGNOSIS?
WHAT IS YOUR DIAGNOSIS? A six-year and eight-month old, male entire cross breed was presented to the R(D)SVS Cardiopulmonary service for investigation of a 2-week history of tachypnoea. A mediastinal mass
More information54-day old male infant Asian descent. First sign of jaundice appeared few weeks after birth Treatment sunlight exposure
Assess lab values in a variety of patients Correlate lab results with a presumptive diagnosis Discuss further lab testing to confirm various diagnoses Stephanie Blackburn, MHS, MLS(ASCP) CM 2 3 54-day
More informationSMALL ANIMAL SOFT TISSUE CASE- BASED EXAMINATION
SMALL ANIMAL SOFT TISSUE CASE- BASED EXAMINATION CASE-BASED EXAMINATION INSTRUCTIONS The case-based examination measures surgical principles in case management prior to, during, and after surgery. Information
More informationHyperthyroidism in Cats
Hyperthyroidism in Cats What is hyperthyroidism? The thyroid is a two-lobed gland located at the front of the neck in people, dogs, cats, and other animals. Each lobe sits on either side of the trachea
More informationElectrolytes by case examples. Graham Bilbrough, European Medical Affairs Manager
Electrolytes by case examples Graham Bilbrough, European Medical Affairs Manager 1 Acid-bases disturbances Generally result from one of the following: 1. damage to an organ such as the kidneys or lungs
More informationEvaluation of VACUETTE SECONDARY Tubes
Evaluation of VACUETTE SECODARY Tubes Background VACUETTE SECODARY Tubes are used as a secondary container for aliquoting, storing and transporting blood, blood components and urine from the primary tube
More informationSUPRAGLOTTIC MYXEDEMA: TWO CASES AND A REVIEW OF THE LITERATURE
Case Report SUPRAGLOTTIC MXEDEMA: TWO CASES AND A REVIEW OF THE LITERATURE Silvia R. Salgado Nunez Del Prado, MD; Rachel A. Steinman, MD; Kashif M. Munir, MD; Elizabeth M. Lamos, MD ABSTRACT Submitted
More informationIncidentally-detected heart murmurs in dogs and cats: executive summary 2015
Incidentally-detected heart murmurs in dogs and cats: executive summary 2015 E Côté, NJ Edwards, SJ Ettinger, VL Fuentes, KA MacDonald, BA Scansen, DD Sisson, JA Abbott.* An incidentally-detected heart
More informationBlood Physiology. Rodolfo T. Rafael, M.D.,CFP
Blood Physiology Rodolfo T. Rafael, M.D.,CFP http://clinical-updates.blogspot.com rtrafaelmd@gmail.com +639212147558 July 26, 2006 1 Blood Physiology General Consideration Plasma Cellular Elements of the
More informationA Female Van Driver with a Swollen Arm
A Female Van Driver with a Swollen Arm Charles D Forbes,* William F Jackson,** A 28-year-old female van driver presented with a 5 day history of a swollen, painful left arm. The swelling had started shortly
More informationHEALTH SCREEN CARE. VIGNE Healthcare provides a comprehensive Health Screening Package of EXCLUSIVE HEALTH SCREENING EXPERIENCE
HEALTH SCREEN CARE VIGNE Healthcare provides a comprehensive Health Screening Package of Silver Gold Platinum Cancer EXCLUSIVE HEALTH SCREENING EXPERIENCE Meet & Greet Medical Review with Doctor Appointment
More informationWhat s Your Diagnosis?
Claire Legallet What s Your Diagnosis? Signalment: Species: Canine Breed: Catahoula Sex: Female Intact Age at presentation: 6 months Presenting Complaint: Chronic intermittent bloody diarrhea and vomiting
More informationDilated Cardiomyopathy in Dogs
Dilated Cardiomyopathy in Dogs (a Type of Heart-Muscle Disease) Basics OVERVIEW The heart of the dog is composed of four chambers; the top two chambers are the left and right atria and the bottom two chambers
More informationBrachycephalics: It is More Than Just a Short Nose
OCTOBER 2018 Brachycephalics: It is More Than Just a Short Nose ELIZABETH ROZANSKI, DVM, DACVIM (SA-IM), DACVECC TUFTS UNIVERSITY, NORTH GRAFTON, MA Respiratory diseases as well as respiratory distress
More informationAcute Stroke with Alteplase Administration Order Set
Review Due Date: 2017 October PATIENT CARE DERS Weight: Adverse Reactions or Intolerances Drug No Yes (list) Food No Yes (list) _ Latex No Yes Admission Admit to Neurology service: Dr. Critical Care Diagnosis:
More informationFrom the desk of the: THE VIRTUAL NEPHROLOGIST
Hypertension, also referred to as high blood pressure or HTN, is a medical condition in which the blood pressure is chronically elevated. It is a very common illness. One out of three American adults has
More informationNon Thyroid Surgery. In patients with Thyroid disorders
Non Thyroid Surgery In patients with Thyroid disorders The Thyroid disease problem. Is Thyroid disease a problem with anaesthetic? Why worry? The Physiology The evidence. A pragmatic approach From: The
More informationChemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-25 U/L 10-35 U/L 10-30 U/L 10-25 U/L 10-30 U/L 10-35 U/L 10-25 U/L 10-35 U/L 10-25 U/L 10-20 U/L 10-35 U/L Albumin 0-6
More informationChemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-30 U/L 10-30 U/L 10-20 U/L Albumin 0-6 days 6 days - 37 months 37 months - 7 years 7-20 years 2.6-3.6 g/dl 3.4-4.2 g/dl
More informationComparison of VACUETTE Heparin Gel Tubes for Common Chemistry Analytes
Comparison of VACUETTE Heparin Gel Tubes for Common Chemistry Analytes Background: Greiner-Bio-One, Austria has been selling plastic evacuated tubes (VACUETTE ) for venous blood collection since 9. The
More informationClinician Blood Panel Results
Page 1 of 8 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
More informationHypertriglyceridemia, which refers to abnormally
J Vet Intern Med 2007;21:1224 1230 Investigation of Hypertriglyceridemia in Healthy Miniature Schnauzers Panagiotis G. Xenoulis, Jan S. Suchodolski, Melinda D. Levinski, and Jörg M. Steiner Background:
More informationProceeding of the SEVC Southern European Veterinary Conference
www.ivis.org Proceeding of the SEVC Southern European Veterinary Conference Oct. 17-19, 2008 Barcelona, Spain http://www.sevc.info Reprinted in the IVIS website with the permission of the SEVC www.ivis.org
More informationThe Use of Tests in Clinical Biochemistry Interpreting Blood Results. Rowland Reece Principal Clinical Biochemist St. Vincent s University Hospital
The Use of Tests in Clinical Biochemistry Interpreting Blood Results Rowland Reece Principal Clinical Biochemist St. Vincent s University Hospital Topic Headlines What is Clinical Biochemistry? How does
More informationHamilton Regional Laboratory Medicine Program
Created: April 2002 of Review: February 2004 of Review: June 2006 of Review: July 2007, St. Joseph s Healthcare went live with Meditech as of June18, 2007. of Review: August 2009 of Review: December 2011;
More informationMultiphasic Blood Analysis
Understanding Your Multiphasic Blood Analysis Test Results Mon General thanks you for participating in the multiphasic blood analysis. This test can be an early warning of health problems, including coronary
More informationPatient Encounters in the Primary Care Setting
Patient Encounters in the Primary Care Setting Carmine D Amico, D.O. Clinical Cases Overview Learning objectives Clinical case presentations Questions for audience participation 1 Clinical Cases Learning
More informationSignalment: Gidget, 12 year old, female spayed, Scottish Terrier, 10.7 kg
Signalment: Gidget, 12 year old, female spayed, Scottish Terrier, 10.7 kg Presenting Complaint: Gidget presented after having elevated liver enzymes, patchy alopecia and PU/PD. History: Gidget had been
More informationMHD I SESSION X. Renal Disease
MHD I, Session X, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD I SESSION X Renal Disease Monday, November 11, 2013 MHD I, Session X, Student Copy Page 2 Case #1 Cc: I have had weeks of diarrhea
More informationEvaluation of new MiniCollect Z Serum (Separator) Tubes
Evaluation of new MiniCollect Z Serum (Separator) Tubes Background: Greiner Bio-One has developed a newly designed MiniCollect tube offering an integrated collection scoop. The advantage of the new tube
More informationOverview. Baseline Vital Signs. Chapter 5. Baseline Vital Signs and SAMPLE History. Baseline Vital Signs. SAMPLE History
Chapter 5 Baseline Vital Signs and SAMPLE History Slide 1 Baseline Vital Signs Breathing Skin Pupils Blood Pressure Overview Vital Sign Reassessment SAMPLE History Slide 2 Baseline Vital Signs Slide 3
More informationCARDIAC TAMPONADE IN HYPOTHYROIDISM DUE TO SHEEHAN S SYNDROME
CARDIAC TAMPONADE IN HYPOTHYROIDISM DUE TO SHEEHAN S SYNDROME Pages with reference to book, From 249 To 251 Mohammad Z. Tahir ( Department of cardiology and Endocrinology, Al Hada Military Hospital, P.O.
More informationCardiac Pathophysiology
Cardiac Pathophysiology Evaluation Components Medical history Physical examination Routine laboratory tests Optional tests Medical History Duration and classification of hypertension. Patient history of
More informationCASE-BASED SMALL GROUP DISCUSSION MHD II SESSION VI
MHD II, Session VI, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION VI Wednesday, MARCH 26, 2014 STUDENT COPY MHD II, Session VI, Student Copy Page 2 CASE 1 History: A 57-year-old
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More information