Case 4

Based on Miss Kitty's presentation and differential list, you decide to perform a CBC, serum chemistry panel, T4 concentration measurement, and abdominal radiographic examination. Unfortunately, her bladder is empty, so a urinalysis cannot be performed.

These are the most important findings:

CBC

Patient values

Reference range

HCT (%)

25

29-48

Absolute reticulocytes (/µl)

35,000

> 45,000

Serum chemistry panel

Patient values

Reference range

BUN (mg/dl)

40

14-36

Creatinine (mg/dl)

2.7

0.6-2.4

Phosphorus (mg/dl)

7.6

2.4-8.2

T4 (µg/dl)

5.3

1-4

The abdominal radiographs suggest a diffuse functional ileus. There is no evidence of mechanical obstruction. The renal silhouettes are small bilaterally on the ventrodorsal view, measuring less than two times the length of L2. The margins of the bilateral kidneys are also irregular. No radiopaque renal or bladder calculi are noted. The remainder of the abdomen is unremarkable.

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