The Case: Lethargy, Inappetence, & Neurologic Signs

Discussion in 'Veterinary News' started by Admin, Jun 29, 2016.

By Admin on Jun 29, 2016 at 3:05 PM
  1. Admin

    Admin Administrator Staff Member

    Neurologic Signs

    [​IMG]

    INITIAL PRESENTATION
    An 8-year-old neutered male Irish setter was presented for 5 days of lethargy and decreased appetite as well as 2 weeks of strange head movements (intermittent bobbing). The patient was completely aware and responded to owners during the head bobbing episodes, which lasted several minutes. Pancreatitis had been diagnosed 2 months prior via abdominal ultrasound, which also showed a hypoechoic spleen. Blood analysis at that time reportedly revealed elevated alanine aminotransferase (ALT), aspartate aminotransferase (ASP), alkaline phosphatase (ALP), bilirubin, and globulin, but values were not available at the time of presentation. Urinalysis at that time showed trace protein, high bilirubin, and ammonium urate crystals with a specific gravity of 1.045. Patient recovered well from previous pancreatitis with outpatient therapy.

    Physical Examination
    • Weight: 38.2 kg
    • Temperature: 101.6⁰F
    • Pulse: 120 bpm
    • Respiration: Panting
    • Mucous membranes: Pink, moist
    • Cardiopulmonary: No murmurs auscultated, lung sounds clear
    • Abdomen: Soft, non-painful
    • Neurologic: Normal mentation, mild conscious proprioceptive deficits of right hind limb, cranial nerves intact, mild neck pain elicited on palpation
    Diagnostics
    • Abdominal ultrasound: Markedly hyperechoic and irregular peripancreatic fat of both limbs, most prominent around right limb. Pancreas hypoechoic and irregular. Diffusely hyperechoic mesentery. Mild anechoic free fluid.
    • CBC: Mild monocytosis
    • Serum chemistry:
      • AST: 83 IU/L (range, 15–66)
      • ALT: 181 IU/L (range, 12–118)
      • All other values within normal limits
    • T4: Normal
    • Urinalysis: Urine specific gravity: 1.040, trace protein, bilirubinuria, ammonium urate crystals
    • Abdominal fluid analysis: Transudate
    • Prothrombin time/activated partial thromboplastin time: Within normal limits
    Treatment
    Patient was discharged with

    • Fentanyl: 100 mcg patch
    • Maropitant: 60 mg q24h PO
    • Metoclopramide: 10 mg q8h PO
    • Famotidine: 10 mg q12h PO
    [Read more]
     

Comments

Discussion in 'Veterinary News' started by Admin, Jun 29, 2016.

Share This Page