Case 4

Based on these findings, you conclude that Miss Kitty has renal disease (azotemia, nonregenerative anemia) and hyperthyroidism. In this case, a urinalysis and urine culture are still indicated to evaluate urine specific gravity (to confirm that the azotemia is renal vs. prerenal) and to look for evidence of proteinuria, inflammation, or infection.

QUESTION 2

What is the most appropriate therapeutic plan for Miss Kitty at this time?

a) Recommend I-131 therapy as soon as possible to treat the hyperthyroidism.

b) Place an intravenous catheter and begin fluid therapy for rehydration. Consider antiemetics if vomiting persists.

c) Initiate twice-daily methimazole therapy and send her home.

d) Recommend starting a renal diet for now and send her home to be rechecked again in two weeks.

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