Signalment: Cockapoo, 1.5 years, male, 12 pounds
	History: Severe polydipsia and polyuria of 6 months duration. Dog drinks at least 3 quarts of water each day and usually more. Urinates a large volume every 2-3 hours. Appetite is very good and dog seems to feel good as long as he has free access to water. On monthly heartworm preventative and receives yearly vaccinations. There are no other clinical signs reported by the owner.
	Physical Examination: T. 102.5 F, RR 30, HR 130. Dog is 3-5% dehydrated. There are no other abnormalities found on physical examination.
	Diagnostic Plan: Using the POVMR format, identify the problems and formulate a diagnostic plan for this case.

No.	Problem
1 .
2 .
3 .
4 .
5 .
6 .
7 .
8 .
9 .
10 .

B. Of the problems you have identified, which is (are) the most important to manage?

A. DX: List ruleouts for the problems you identified in Step 2.

Problem No.	Ruleout(s)
1 .
2 .
3 .
4 .
5 .
6 .
7 .
8 .
9 .
10 .

B. List those diagnostic procedures that will be most cost-effective.

1 .  2 . 

3 .  4 . 

5 .  6 . 

7 .  8 . 

9 .  10 . 

Analyze the initial database results.

Hematology:

RBC Morphology:

Test	Value	Unit	POINT do NOT click your mouse   here to view Hematology Norms	Test	Value
WBC	8500	x 103 /mm3		Normal
RBC		x 106 /mm3		Rouleaux
HGB		gr/dl		Polychrome
PCV	64	%		Aniso
MCV		fl		Poik
MCV		pg		Crenation
MCHC		g/dl		Target
PLT		x 103 /mm3		Hypochrome
TP	8.5	gr/dl		BasoStrip
FIB		mg/dl		Sphero
Retic		%		NRBC/199 WBC
PUNT
AGGR
SED RATE		mm

Differentials:

Assessment: What is your assessment of the hematology data?

Test	%	Absolute	POINT do NOT click your mouse   here to view Hematology Norms
SEG
Band
Lymph
Eosin
Mono
Baso
Other
PLTest
Toxic change

Biochemical profile:

Test	Value	Unit	POINT do NOT click your mouse   here to view Chemistry Norms	Test	Value	Unit
Sodium	160	m mol/L		T. Bili	0.2	mg/dl
Potassium	4.6	m mol/L		ALKP	110	u/l
Chloride	130	m mol/L		ALT	20	u/l
TCO2	16	m mol/L		AST		u/l
Urea	40	mg/dl		LDH		u/l
Creatinine	1.1	mg/dl		CK		u/l
Calcium	10.5	mg/dl		GGT		u/l
Phosphorus	3.3	mg/dl		Magnesium		mg/dl
Glucose	110	mg/dl		Osmolality		mosm/L
T. Protein	8	g/dl		Anion Gap		mosm/L
Albumin	6	g/dl
Globulin	2	g/dl
A/G ratio

What is your assessment of the biochemical profile?

Chemistry assessment

Urinalysis:

Microscopic Sediment Exam:

Test	Value	Unit		Test	Value	Unit
Volume	10	ml		WBC	0-1	ml
Color	pale yellow			RBC	0
Transparency	clear			Bacteria	0
Specific Gravity	1.002			Epitheliel	0
Phosphorus				Fat	0
Protein	neg.	mg/dl		Sperm	0
Ketones	neg.	mg/dl		CaOxalate	0
Bilirubin	neg.			CaCarbonate	0
Blood	neg.			TriplePhos	0
Urobili	neg.			Bilirubin	0	mg/dl
				Amorph	0	mg/dl
				Casts	0

What is your assessment of the urinalysis data?

Urinalysis assessment

Identify the major ruleout(s) supported by this data.

What does the data tell you?

Have you identified any new problems?	No Yes	If so, what are they?

List the diagnostic tests or procedures that should be performed next.

RX:

What immediate therapy would you prescribe for problems identified in Section 2?

Learning Issues:

	Review the physiologic events that occur in each component of the nephron.
	Describe the indications and contraindications for the modified water deprivation test.
	Describe the indications and procedure for ADH response test.

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This page was last updated 10/19/07 09:51:09 AM