Case 3

Since one of your differentials for this case is occult neoplasia, you ask Harley's owner to bring him back for an even more thorough physical examination. You pay special attention to any lumps, bumps, or lymphadenopathy. You even consider obtaining aspirates of normal-sized lymph nodes since this is an easy in-house diagnostic test and lymphoma can be found in normal-sized lymph nodes. You also assess the rectal area for anal sac carcinomas and feel for sublumbar lymph node enlargement.

All things appear normal on Harley's examination at this time.

QUESTION 5

What is your next logical diagnostic step in this case? (There is more than one correct answer.)

a) Obtain thoracic and abdominal radiographs.

b) Initiate corticosteroids to treat the hypercalcemia.

c) Assess ionized calcium and parathyroid hormone (PTH) concentrations.

d) Instruct the owner to restrict Harley's access to water.

e) Perform an abdominal ultrasonographic examination.

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