Pancreatitis in a cat

19 Pancreatitis in a cat

Problem list and discussion of problems

The cat’s problems included vomiting, poor appetite and lethargy. The poor appetite and lethargy were thought to be related to the cause of the vomiting. He also was suspected to have polyuria, although it was possible that the other cat in the household had increased urine output. He was also jaundiced.

Differential diagnosis

Case work-up

Intravenous fluid therapy with crystalloids at a rate to correct 8% dehydration was initiated.

Minimum data base

Haematology revealed a mild leukocytosis due to mild neutrophilia (13.52 × 109/l; reference range: 2.5–12.5 × 109/l), a left shift, with 1.5 × 109/l band neutrophils and moderate monocytosis (3.07 × 109/l; reference range: 0.15–1.7 × 109/l). A mild normocytic, normochromic anaemia was present (PCV: 0.237 l/l; reference range 0.30–0.45 l/l). A blood smear analysis revealed the presence of toxic neutrophils and reactive lymphocytes.

Serum biochemistry revealed mild hypoalbuminaemia (20 g/l; reference range 23–39 g/l) and hyperbilirubinaemia (20 µmol/l; reference range 0–15 µmol/l), elevated alanine aminotransferase (ALT) of 104 IU/l (reference range 6–83 IU/l) and moderate hypokalaemia (2.0 mmol/l; reference range 2.9–4.2 mmol/l). Alkaline phosphatase (ALP) was within the reference range at 35 IU/l (reference range 10–100 IU/l). Serum urea and creatinine were both elevated at 17.2 mol/l (reference range 2.9–9.8 mmol/l) and 161 µmol/l (reference range 40–177 µmol/l). Hyperglycaemia (26.9 mmol/l; reference range 3.94–8.83 mmol/l) was also present and serum fructosamine was 471 µmol/l (reference range 159–295 µmol/l).

Cholesterol was mildly increased at 5.5 mmol/l (reference range 2.0–3.4 mmol/l) and triglycerides were increased at 3.3 mmol/l (reference range 0.57–1.14 mmol/l).

Urinalysis revealed a urine specific gravity (USG) of 1.014 and dip stick analysis was 1+ positive for protein, 2+ positive for blood, bilirubin and leukocytes and 3+ positive for glucose. Ketone bodies were not detected. Sediment examination showed the presence of occasional red blood cells, numerous white blood cells and bacteria (cocci) and a sample submitted for bacterial culture was later found to be positive for Staphylococcus.

The cat was diagnosed at this point with diabetes mellitus and a urinary tract infection. The azotaemia present was thought to be due either to pre-renal causes (dehydration) or kidney disease or a combination of both.

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Sep 22, 2016 | Posted by in SMALL ANIMAL | Comments Off on Pancreatitis in a cat

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