• DVM360_Conference_Charlotte,NC_banner
  • ACVCACVC
  • DVM 360
  • Fetch DVM 360Fetch DVM 360
DVM 360
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
By Role
AssociatesOwnersPractice ManagerStudentsTechnicians
Subscriptions
dvm360 Newsletterdvm360 Magazine
News
All News
Association
Breaking News
Conference Coverage
Education
Equine
FDA
Law & Ethics
Market Trends
Medical
Politics
Products
Recalls
Regulatory
Digital Media
dvm360 LIVE!™
Expert Interviews
The Vet Blast Podcast
Medical World News
Pet Connections
The Dilemma Live
Vet Perspectives™
Weekly Newscast
dvm360 Insights™
Publications
All Publications
dvm360
Firstline
Supplements
Vetted
Clinical
All Clinical
Anesthesia
Animal Welfare
Behavior
Cardiology
CBD in Pets
Dentistry
Dermatology
Diabetes
Emergency & Critical Care
Endocrinology
Equine Medicine
Exotic Animal Medicine
Feline Medicine
Gastroenterology
Imaging
Infectious Diseases
Integrative Medicine
Nutrition
Oncology
Ophthalmology
Orthopedics
Pain Management
Parasitology
Pharmacy
Surgery
Toxicology
Urology & Nephrology
Virtual Care
Business
All Business
Business & Personal Finance
Hospital Design
Personnel Management
Practice Finances
Practice Operations
Wellbeing & Lifestyle
Continuing Education
Conferences
Conference Listing
Conference Proceedings
Resources
CBD in Pets
CE Requirements by State
Contests
Veterinary Heroes
Partners
Spotlight Series
Team Meeting in a Box
Toolkit
Top Recommended Veterinary Products
Vet to Vet
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us

© 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Advertisement
By Role
  • Associates
  • Owners
  • Practice Manager
  • Students
  • Technicians
Subscriptions
  • dvm360 Newsletter
  • dvm360 Magazine
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us
  • MJHLS Brand Logo

© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Case 8

August 30, 2011

Despite careful reintroduction of nutrients, Misou has developed hypophosphatemia. Frustrating, but unfortunately not uncommon. You initiate intravenous potassium phosphate supplementation at 0.01 to 0.03 mmol/kg/hr. Misou's total potassium requirements should be provided 50% by the potassium phosphate and 50% by intravenous potassium chloride, not to exceed 0.5 mEq/kg/hr. You plan to recheck the phosphorus and potassium concentrations again in six hours and adjust the supplements as needed. Misou's owners decline a blood transfusion at this time since Misou seems to be stable otherwise.

Day 4: Misou is stable this morning and her phosphorus concentration has normalized, so you discontinue the potassium phosphate. Her packed cell volume is 23%. You notice, however, that she seems more nauseated, so you decrease the frequency of her nasoesophageal tube feedings from four times a day to three times a day and start treatment for possible ileus with metoclopramide (0.02 mg/kg/hr intravenously) for its antiemetic and prokinetic effects.

Here are the results of a recheck CBC and serum chemistry profile on day 6:

CBC

Patient values

Reference range

WBC (/µl)

13,500

3,500-16,000

-Neutrophils (/µl)

10,100

2,500-8,500

-Monocytes (/µl)

900

0-600

-Lymphocytes (/µl)

1,200

1,200-8,000

-Eosinophils (/µl)

1,300

Advertisement

0-1,000

Hct (%)

23

29-48

Hgb (g/dl)

7.6

9.3-15.9

RBC morphology

Normal

 

Platelets (/µl)

210,000

200,000-500,000

Serum chemistry profile

Patient values

Reference range

BUN (mg/dl)

14

14-36

Creatinine (mg/dl)

0.9

0.6-2.4

Phosphorus (mg/dl)

3.1

2.4-8.2

ALP (IU/L)

188

6-102

ALT (IU/L)

89

10-100

GGT (IU/L)

5

1-10

Total bilirubin (mg/dl)

3.9

0.1-0.4

Glucose (mg/dl)

167

64-170

Sodium (mEq/L)

149

145-158

Potassium (mEq/L)

4.3

3.4-5.6

Triglycerides (mg/dl)

240

25-160

QUESTION 8

What is your next step for Misou given these laboratory results?

a) Her ALP activity has decreased, so continue her current treatment plan and nasoesophageal feedings.

b) Her bilirubin concentration has not really improved, which you know is atypical of primary hepatic lipidosis, so further diagnostics are indicated.

c) Her bilirubin concentration is still elevated, so add antibiotics to her treatment regimen to treat for possible bacterial cholangiohepatitis.

<< Back | Next Step >>

Related Content:

AssociationClinical
Not-so-ordinary ER cases you should know
Not-so-ordinary ER cases you should know
An update on copper concerns in pet foods
An update on copper concerns in pet foods
Evaluating liver enzyme elevation
Evaluating liver enzyme elevation

Advertisement

Latest News

An update on copper concerns in pet foods

Dental hacks to make every case more manageable

Q&A with a keynote: Walter Brown, RVTg, VTS, ECC

News wrap-up: This week’s headlines, plus dvm360® launches its first CE podcast

View More Latest News
Advertisement