An 8-year-old F Miniature Schnauzer with diabetes was presented for polyuria/polydipsia, intermittent vomiting, and vaginal discharge. The only abnormality on physical examination was pyrexia. Urine had a cloudy and yellow appearance, which on analysis showed normal specific gravity, 3+ proteinuria, 3+ glucosuria, 2+ ketones, 3+ hematuria, and bacilli. The patient was treated with a course of antibiotics as the owner declined further workup. The following day the patient was returned as she was vomiting bile. An audible murmur was present on physical exam.
An 8-year-old F Miniature Schnauzer with diabetes was presented for polyuria/polydipsia, intermittent vomiting, and vaginal discharge. The only abnormality on physical examination was pyrexia. Urine had a cloudy and yellow appearance, which on analysis showed normal specific gravity, 3+ proteinuria, 3+ glucosuria, 2+ ketones, 3+ hematuria, and bacilli. The patient was treated with a course of antibiotics as the owner declined further workup. The following day the patient was returned as she was vomiting bile. An audible murmur was present on physical exam. CBC showed anemia, leukocytosis, thrombocytopenia, neutrophilia, monocytosis, and basophilia. On blood chemistry hyperglycemia, mild hypoalbuminemia, elevated ALP activity, hypercholesterolemia, mild hypocalcemia, low chloride, and hypoamylasemia were present.
Case Study
09-00027 Princess S Pyometra BK—-NEEDS C—-NO IMAGES—-
Sonographic Differential Diagnosis
Pyometra with tissue thickening.
Image Interpretation
The caudal abdomen presented a fluid filled uterus with a 2cm tissue thickening at the base of the uterus mostly likely of inflammatory nature, however early neoplasia cannot be entirely ruled out. The ovaries presented a minor cyst change yet were otherwise normal.
Outcome
The patient was treated with IV fluids, hetastarch, and B-vitamins. An ovariohysterectomy was performed. Recovery was uneventful and she was treated with antibiotics and NSAIDS. At sutures out appointment, she was doing well and the blood glucose had normalized.
Clinical Differential Diagnosis
Diabetic ketoacidosis Pyometra Secondary peritonitis – rupture uterus/urinary bladder UTI with secondary septicemia Infectious disease – Ehrlichiosis/Leishmaniasis
Sampling
None taken. (Biopsy of the uterine base was suggested but not sampled).
Patient Information
Clinical Signs
- PU-PD
- Vomiting
History
- Diabetes, controlled
Exam Finding
- Fever
- Heart Murmur
Images
Blood Chemistry
- Albumin, Low
- Alkaline Phosphatase (SAP), High
- Calcium, Low
- Chloride, Low
- Cholesterol, High
- Glucose, High
CBC
- Basophils, High
- Monocytes, High
- Neutrophils, High
- Platelet Count, Low
- RBC, Low
- WBC, High
Clinical Signs
- PU-PD
- Vomiting
Urinalysi
- Appearance Turbid
- Bacteria Present
- Blood Present
- Glucose Present
- Ketones Present
- Protein Present