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Feline nightmare case: Acute onset blindness (Proceedings)

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Apr 01, 2009

A 14 year old, male intact, DSH cat is presented for acute onset of blindness. There are no other striking historical findings. Physical examination findings reveal a 4/9 body condition score, heart rate of 180, normal mucous membranes, normal hydration, possibly small kidneys on palpation, and a 3/6 systolic murmur with the point of maximal intensity at the left sternal border. Ocular examination reveals bilateral retinal detachment. Palpation of the central neck revealed a small goiter most easily palpable on the left lobe of the thyroid gland

The initial workup included: urinalysis, chemistry profile, CBC, total T4, thoracic radiographs, and systolic blood pressure measurement.

Results

Urinalysis

• Color – pale, clear

• Protein – negative

• Glucose – 1+

• Bili – negative

• Ketones – negative

• Specific gravity – 1.021

CBC (reference interval in parentheses)

• Hct – 44%

• WBC – 22.8 x 103 (5.5 – 19)

• Segs – 84%

• Bands – 0%

• Lym – 5%

• Eos – 1%

• Mono –10%

Chemistry Profile (normal ranges indicated)

• Albumin – 3.0 g/dl (2.7-3.8)

• Calcium – 10.9 mg/dl (8.4-10.8)

• Chloride – 114 mEq/L (112-1240

• Cholesterol –102 mg/dl (63-130)

• Creatinine – 0.8 mg/dl (0 – 1.5)

• Glucose – 195 mg/dl (65-129)

• Phosphorus – 3.6 mg/dl (4.0-7.0)

• Potassium –3.9 mEq/L (3.8-5.4)

• Sodium – 155 mEq/L (144-156)

• TCo2 14 mM (13-25)

• T Bili – 0.1 mg/dl (0.0-0.3)

• BUN – 40 mg/dl (14-34)

• ALP – 89 U/L (6-93)

• ALT – 110 U/L (1-64

Total T4 = 34 nmol/L (17 – 48)

Thoracic Radiography: Evidence of mild cardiomegaly

Systolic Blood Pressure – 260 mmHg

Questions to Consider

• Is the glucosuria significant?

• Is the urine concentrated enough?

• What is the significance of the neutrophilia?

• What is the significance of the hematocrit?

• Does the elevated BUN indicated renal failure?

• Is the hyperglycemia significant?

• Why is the ALT activity increased?

• Does the normal T4 rule out hyperthyroidism?