Veterinary Clinical Medicine-I (General and Systemic)

DIAGNOSIS

Differential diagnosis

• Lead toxicity
• Urinary tract infection—cystic calculi
• Intestinal parasitism
• Primary gastrointestinal disease
• Hypoglycemia
• Toxoplasmosis
• Congenital CNS disease or malformation—hydrocephalus; storage diseases
• Acute ethylene glycol toxicity
• Rabies
• CNS neoplasia
• Canine distemper
• Thiamine deficiency—Wernicke encephalopathy
• Drug intoxication

CBC/Biochemistry/Urinalysis

• • Acquired portosystemic shunting and PSVA—RBC microcytosis
  • Poikilocytosis
  • Leukogram—reflects specific liver disease or causal conditions
  • Hypoalbuminemia
  • ALT and ALP—high; may be normal or only slightly high with PSVA or end-stage cirrhosis
  • BUN—low; reflects hepatic urea cycle dysfunction, protein-restricted diet, polyuria or polydipsia associated with increased GFR
  • Creatinine—low; reflects reduced muscle mass, hepatic synthetic failure, and polyuria or polydipsia causing increased GFR
  • Hypoglycemia—especially in young dogs with PSVA; fulminant hepatic failure; end-stage cirrhosis
• Urinalysis
  • Ammonium biurate crystalluria

Imaging

• Abdominal radiography—reveal a small liver in dogs; less reliable in cats
• Abdominal ultrasonography—may identify PSVA, acquired portosystemic shunting, intrahepatic arteriovenous fistula, or echogenic patterns consistent with acquired liver disorders may note a relatively hypovascular liver in dogs with microvascular hepatoportal dysplasia