Case #9

Case of the Week:  13y N Schnauzer

CC: Issues with rear legs

Vaccine/wellness status: Overdue for vaccines, not on HWP, diagnosed with hypothyroidism previously but not currently on medication

PE: 23.8 lbs       HR 128         RR 16    

  • Severe periodontal disease
  • Lumps and bumps – 2 previously aspirated and diagnosed as lipomas
  • Proprioceptive deficit LH
  • No pain on manipulation of limbs, hips, or palpation of spine

Diagnostics:

  • Bloodwork
    • Elevated ALP, marked hyperglycemia (422)
    • T4 WNL today
  • Urinalysis
    • Glucose +++

Treatment:

  • Start on Vetsulin (3U BID)
  • Recheck/BG curve in 7 days
  • Administered vaccines today
  • Need to address fecal/HWT at recheck, perform radiographs, perform diagnostics to determine cause of elevated ALP

Recheck appt:

  • BG curve
    • Persistent hypergylcemia throughout the entire day
  • Ataxic at a walk, hind end drifts to the left
  • Radiographs of lumbar spine
    • No radiographic evidence of spinal cord issues
  • Urine Cortisol/Creatinine ratio
    • Results pending
  • Fecal/HWT performed
    • Both negative

Treatment:

  • Increase Vetsulin to 4U BID
  • Reck/BG curve in 7 days
  • Recommended HWP, o says she will get at recheck appt

Other things to keep in mind for this dog:

  • Urine culture/sensitivity to rule out “silent UTI” commonly seen with diabetes
  • Dental prophy as soon as his condition(s) have stabilized
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Tennessee Avenue Animal Hospital

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