ISRAEL JOURNAL OF
VETERINARY MEDICINE
WHAT is your diagnosis ??
Vol. 58 (1) 2003
“Jeremiah, what seest thou?” (Jeremiah 1,11)
Presented by: O. Catabi,1 T. Waner2 and T. Aizenberg3
1. Student at Kosice Veterinary University. Slovakia
2. Veterinary Clinic, 9 Maginay Hagalil Sr., 76210 Rehovot, Israel
3. Koret School of Veterinary Medicine, Hebrew University of Jerusalem, P. O. Box 12, 76100
Rehovot, Israel
Signalment: 7 years old female Keeshound, neutered.
Chief complaint: Vomiting and diarrhea
History: History of obesity fully vaccinated and dewormed.
Physical examination:
Body temperature elevated (40 C¾)
Anorexia
Depression
Pyrexia
Dehydration
Abdominal tenderness
Obese
Initial treatment:
Based on a diagnosis of gastroenteritis: amoxycillin (500 mg per PO TID) and
Hill's I/D diet were unsuccessful. Further treatment consisted of Hartman fluid IV
administration.
Clinical pathological findings:
WBC (x103/µl)
18.43
H
CPK
U/L
302
H
RBC (x106/µl)
6.68
GGT
U/L
3.2
Hgb (gm/dl)
17.1
BUN
mg/dl
13
Hct %
50.5
CREA
mg/dl
0.6
PLT (x106/µl)
113
L
GLU
mg/dl
86
NEU (x103/µl)
15.95
H
Ca
mg/dl
12.9
H
mg/dl
356
H
H
LYM (x103/µl)
1.54
CHOL
MON (x103/µl)
0.67
TRIG
mg/dl
359
H
0.15
T.BIL
mg/dl
1.2
H
0.08
PROT
mg/dl
6.7
Globulins
gm/dl
3.1
EOS (x103/µl)
BASO (x103/µl)
ALP U/L
699
H
ALB
gm/dl
3.6
H
ALT U/L
80
H
Cl
mg/dl
123
H
H
K
mg/dl
4.6
H
Na
mg/dl
145
AMYL U/L
AST U/L
1715
109
H=above normal range; L= below normal range.
The serum sample was lipemic and as a result slightly hemolytic.
Ancillary diagnostic tests: Abdominal ultrasound
Ultrasound showed an enlarged hypoechoic mass in the area of the pancreas
compatible with edematous pancreatitis.
What is your Diagnosis?
Diagnosis:
Pancreatitis
Comments:
1.
The history and clinical signs associated with pancreatitis are nonspecific
and common to numerous gastrointestinal and metabolic disorders.
2.
Leukocytosis with neutrophilia is a typical finding of pancreatitis.
3.
Liver enzymes were elevated reflecting secondary hepatocellular injury
as a result of either liver ischemia or exposure of the liver to high concentrations of
toxic products delivered from the pancreas in the portal blood.
4.
Hypercholesterolemia and hypertriglceridemia may have hindered the
accurate determination of other serum and biochemical values.
5.
The hypercalcemia was probably an erroneous result due to the lipemia
and hemolysis.
Treatment:

It was decided to withhold food and maintain the dog's fluid and
electrolyte balance while the pancreas was "rested".

Hartman’s fluid IV administration.

Treatment with analgesic (dipyrone, 250 mg IV BID)

Antibiotic therapy with Baytril (enrofloxacin) (2.5 mg/kg SC BID).
The use of plasma infusions was considered but due to the improvement in
condition was not used. In cases of severe pancreatitis there may be marked
consumption of plasma protease inhibitors as activated pancreatic proteases are
cleared from the circulation. Acute disseminated intravascular coagulation, shock
and death rapidly follow saturation of available alpha-macroglobulins.
After two days the dog’s condition improved and it showed signs of hunger. At
this point it was decided to feed the dog a low fat formula feed with high fiber
content. (Hill's W/D). Small amounts of food were fed frequently.
Recovery was unremarkable.
LINKS TO OTHER ARTICLES IN THIS ISSUE
1.