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George 9y MN West Highland White Terrier 4 weeks of PU/PD 3 days vomiting Collapsed this morning
Physical examination Stuporous Cardiovascular examination – HR 150 bpm – Bounding pulses – Pink mucous membranes No abdominal distension/pain
George PCV/TS 58%/80g/l Ketonaemic BUN 15mmol/l Creatinine 180µmol/l Glucose 25mmol/l
George - Electrolytes and blood gas K 3.5mmol/l pH 7.2mmol/l
George – Problem list Dehydration Severe hyperglycaemia Azotaemia Hypokalaemia Metabolic acidosis
George Considerations – Inappropriate insulin storage/handling/admin – Inappropriate dosage – Concurrent disease Urinary tract infection (sediment exam + urine culture) Pancreatitis (u/s + cPLI) Hyperadrenocorticism Other
George - diagnostics Urinalysis – Glucosuric (4+) – Ketonuric (3+) – WBCs on sediment examination Abdominal ultrasound – Unilateral pyelectasia
George Moderate hypovolaemia Dehydration Hypokalaemia ? Fluid plan
George Correct hypovolaemia first Bolus crystalloid 20ml/kg over 20 minutes Improvement in clinical signs On going fluid plan?
George Started intravenous insulin protocol Supplemented potassium after resuscitation Supplemented phosphorus
George Intravenous antibiosis whilst culture pending – Augmentin 20mg/kg q8h Slowly improved over 48 hours Started on s/c insulin protocol
George George had pyelonephritis George’s owner had withheld insulin whilst he was anorexic
Diabetic Ketoacidosis DKA). DKA is caused by an absence or markedly inadequate amount of insulin. This deficit in available insulin results in disorders.
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BMP Date: McIntyre, Kim MRN Time : LabValueReference Range Glucose125 mg/dL mg/dL Calcium9.8 mg/dL8.9 – 10.3 mg/dL Potassium3.5 mEq/L3.6.
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أتحسب أنك جرم صغير وفيك انطوى العالم الاكبر. Is a life-threatening acute complication of diabetes mellitus. It occurs when insulin therapy is absent,
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急性肾衰竭 急性肾衰竭 Acute Renal Failure （ ARF ）. DEFINITIONS AND INCIDENCE Acute renal failure (ARF) is a syndrome characterized by rapid decline in glomerular.
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