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 your mouse here to view Hematology Norms	Test	Value
WBC	9550	x 103 /mm3		Normal
RBC		x 106 /mm3		Rouleaux
HGB		gr/dl		Polychrome
PCV	37	%		Aniso
MCV		fl		Poik
MCV		pg		Crenation
MCHC		g/dl		Target
PLT		x 103 /mm3		Hypochrome
TP	7	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 your mouse here to view Hematology Norms
SEG		8069
Band
Lymph		334
Eosin		47
Mono		1098
Baso		0
Other
PLTest
Toxic change

Biochemical profile:

Test	Value	Unit	Point your mouse here to view Chemistry Norms	Test	Value	Unit
Sodium	152	m mol/L		T. Bili		mg/dl
Potassium	4.5	m mol/L		ALKP	327	u/l
Chloride	101	m mol/L		ALT	41	u/l
TCO2		m mol/L		AST		u/l
Urea	9	mg/dl		LDH		u/l
Creatinine		mg/dl		CK		u/l
Calcium	10.6	mg/dl		GGT		u/l
Phosphorus		mg/dl		Magnesium		mg/dl
Glucose	123	mg/dl		Osmolality		mosm/L
T. Protein	7.6	g/dl		Anion Gap		mosm/L
Albumin	3.5	g/dl
Globulin		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		ml		WBC	many	ml
Color	yellow			RBC	2-3/hpf
Transparency	Clear			Bacteria	4 plus
Specific Gravity	1.018			Epitheliel	0
Phosphorus				Fat	0
Protein	1 plus	mg/dl		Sperm	0
Ketones	0	mg/dl		CaOxalate	0
Bilirubin	0			CaCarbonate	0
Blood	trace			TriplePhos	0
Urobili	trace			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:

	UTI is very common in dogs with CCS. Why?
	Review the advantages and disadvantages of urine cortisol/creatinine, ACTH stimulation and LDDS tests in screening dogs for hyperadrenocorticism.

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