An analysis of the blood from a 5 year old, female Holstein cow as a review of clinical pathology and diagnosis

Lassen, E. D.

English

The following are results of serum chemical and hematological analyses on samples from a 5-year-old female dog. The dog had lost a lot of weight during the 2 weeks prior to admission to the Veterinary Hospital. Physical examination revealed pain on abdominal palpation.</p

Lassen, E.

Digital Repository @ Iowa State University (ISU)

Radiographic DiagnosisRadiographs show a large air and ingesta-filled hollow structure present within the lefthemithorax which displaces the mediastinumand the heart into the right hemithorax. Theleft lung has been displaced dorsally andcranially. The ribs form a 90° angle with thespine, indicating significant dyspnea. The leftcrus of the diaphragm cannot be identified.Radiographic signs indicate a tear in theleft crus of the diaphragm with displacementof the stomach and part of the small bowelinto the left hemithorax.CommentsSurgery was performed to restore theabdominal organs to their normal positionsand to repair the diaphragm. In addition tothe stomach, duodenum, and pancreas, partof the liver was also found in the lefthemithorax. Fibrous adhesions had developedbetween the liver and the pleura, and the liverand the edges of the hernia, indicating thechronic nature of the condition. The stomachand duodenum developed no such adhesionsindicative of a more acute herniation.The owner obtained the dog from a kennel18 months prior to the time of admission.Records maintained at the kennel revealedthat the dog had been hit by a car ap-proximately 2 years ago, with no apparentproblems noted at the time. If the herniadeveloped at that time, the dog did not showclinical si~s until more abdominal organsentered the thoracic cavity during normalactivity.Clinical Pathology ReviewE. D. Lassen, DVN, PhDt1.0276.03+negativenegativenegativenegativenormalThe following are results of serum chemicaland hematological analyses on samples from a5-year-old female dog. The dog had lost a lotof weight during the 2 weeks prior to ad-mission to the Veterinary Hospital. Physicalexamination revealed pain on abdominalpalpation.Laboratory Data:PCV (37-55)* 51WBC (6,000-17000) 22,500Band neutrophils (0-300) 1,575Segmented neutrophils(3,000-11,400) 18,675Lymphocytes (1,000-4,800) 1,125Monocytes (150-1,350) 1,125Eosinophils (100-750) 0Platelets AdequatetDr. Lassen is an Assistant Professor in Pathology,College of Veterinary Medicine, ISU.136BUN (10-30) mg/dl 48Glucose (60-115) mgldl 145Cholesterol (140-210) mg/dl 590Total Bilirubin (0-1.0) mg/dl 3.6Direct Bilirubin (0-0.1) mg/dl3.4SGPT(4-65) lUlL 114SAP (10-90) lUlL 192Total Protein (5.6-7.4) gldl 7.9Albumin (3.0-4.3) g/dl- 4.1Globulin (2.6-4.3) g/dl 3.8Ca(9.3-12.2)mg/dl 11.1P(2.5-5.0)mg/dl 3.1Urinalysis:Specific GravitypHConjugated BilirubinHemoglobinKetonesGlucoseProteinSediment*Normal values are in parenthesesIowa State VeterinarianProblems identified by laboratory data andmost likely pathogenesis:1. Leukocytosis, neutrophilia with a leftshift, and lymphopenia: This is an in-flammatory leukogram (i.e., there is atissue demand for neutrophils). Thelymphopenia indicates systemic stress.2. Azotemia: Moderate increase in BUN withevidence of adequate urine concentration(specific gravity = 1.027) are compatiblewith a pre-renal cause of the azotemia. Inlight of the hyperproteinemia, dehydra-tion is the most likely pathogenesis of theazotemia. A primary renal problem cannot be ruled out, but there is no strong evi-dence for this.3. Hyperglycemia: Slight increase is probablydue to stress with release of endogenouscorticosteroids.4. Hypercholesterolemia: This is a very non-specific finding; however, in this case it iscompatible with biliary obstruction.5. Hyperbilirubinemia due to increaseddirect-reacting bilirubin: Direct-reactingbilirubin has been conjugated. Thispattern is most typical of biliary tractobstruction (either intrahepatic or extra-hepatic). In cases of biliary stasis, con-jugated bilirubin escapes betweenhepatocytes or biliary epithelial cells intothe lymph and blood.6. Increased SGPT: SGPT is a tissue-specificenzyme. Increases in SGPT are causedonly by hepatocyte damage with sub-sequent leakage of enzyme. Hepatocellularinjury is, therefore, indicated.7. Increased SAP: Although there are severalpossible causes of SAP elevations,hyperbilirubinemia and high SGPT ac-tivity indicate that the increase in thissample is most likely associated with ahepatobiliary problem. Increased pressurein the biliary tree is thought to inducehepatocyte production of alkalinephosphatase. The enzyme cannot leave theliver through the blocked biliary systemand finds its way into the blood.8. Hyperproteinemia with high normalalbumin and globulin: In this case,albumin and globulin are both con-tributing to the hyperproteinemia. Themost likely cause is dehydration (i.e., thisis a relative hyperproteinemia).9. Hyperbilirubinuria: Since conjugatedbilirubin is water-soluble, it readily passesthe glomerulus and finds its way into theurine. Animals with high serum con-centrations of conjugated bilirubin would,therefore, have moderate to high con-centrations of bilirubin in the urine.Conclusions:This appears to be a case of biliaryobstruction with moderate damage tohepatocytes. The tissue demand forneutrophils which is indicate.d by theleukogram suggests an inflammatory causeof obstruction. Possibilities includecholangiohepatitis, cholecystitis, andcholangitis.Junior Student Olympic HopefulDeanne Davison*The results of the Boston Marathon lastspring may mean Olympic tryouts for Frank~Richardson, a junior Vet student at IowaState. Richardson's time of 2 hours, 16minutes, 20 seconds placed him 20th in themarathon and ranked him 13th among the*Ms. Davison is a third year student in the College ofVeterinary Medicine, ISU.Issue No.3, 1979American runners in the race, with most ofthe best runners in the country present. Histime at the Boston Marathon was goodenough to qualify for the Olympic tryouts.The Boston Marathon was the secondmarathon Richardson had trained seriouslyfor, as well as his second exposure to in-ternational competition and the outcome was137

Clinical Pathology Review

An analysis of the blood from a 5 year old, female Holstein cow as a review of clinical pathology and diagnosis.</p

https://dr.lib.iastate.edu/bitstreams/be6b61de-e8cb-467b-bac6-6a9186fb0865/download

Clinical Pathology Review

Abstract

Similar works

Full text

Available Versions

Digital Repository @ Iowa State University (ISU)

Digital Repository @ Iowa State University (ISU)