Wednesday, November 4, 2009

Case study part 3

What did my bloodwork tell me?

1) Significant dehydration and significant anemia -a PCV of 30 with a TS of 10.5 should tell you that this patient is SEVERELY dehydrated. A normal TS is about 5.5-7.5. A normal PCV should be between 35-45. This patient has a very high TS with a normal to low normal PCV. That tells you 2 important things - the patient is severely dehydrated (TS 10.5), and the patient is VERY anemic (PCV of 30 in severe dehydration which means it's probably around 18-20 when rehydrated).

2) Severe azotemia (elevation in kidney enzymes) with a relatively dilute urine -likely representing both pre-renal and renal azotemia - urine specific gravity 1015 (although NOT isosthenuric, as one would expect in acute kidney failure AND this was after a bolus of fluids. On the other hand, this is still not appropriately high for a dog that is 10% dehydrated).

3) Significantly elevated liver enzymes - ALT 5x normal, ALP 2.5x normal, GGT 5x normal.

4) An elevated bilirubin (but not enormously).

5) Significant inflammation and/or infection is present due to a VERY elevated WBC (66,000) and the presence of 14% bands on a blood smear (a left shift indicating that the bone marrow is experiencing overwhelming demand for neutrophils and cannot keep pace with production).

6) Low systolic blood pressure (hypotension) - normal should be around 90-100.

7) Mild to moderate hypercholesterolemia

8) A very mildly increased clotting time (aPTT)

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