Murphy Murphy is a male Labrador Retriever DOB
Murphy • • “Murphy” is a male Labrador Retriever, DOB March 3, 2005 Referred from community veterinarian to your E. R. for evaluation of “failure to rise. ” • • History • • What else might you ask the client? What organ systems do you think are involved? Previously healthy working dog, with recent travel to B. C. and Saskatchewan. Drank stagnant water yesterday, OK last night. This morning Murphy had trouble rising and walking in the back legs. With support of client, he could bear weight on left hindlimb, not on right side.
• • • • • Physical Exam BW = 37. 0 kg T=38. 4 C P=140/min R=panting Capillary refill test (CRT) ~1 sec Mucous membranes: pink and moist Eyes: normal Ears: normal Heart & lungs: normal auscultation Abdomen: soft, non-painful Neck and back: no pain Cranial nerves: WNL Oral exam: WNL Basewide (sawhorse) stance and goose-stepping (exaggerated hypermetria) Hopping response slightly decreased Knuckling WNL Withdrawal WNL Vocalization with manipulation, particularly hyperflexion of carpi, and flexion -extension of stifles and hocks. Mild effusion of carpi and tarsi noted, no appreciable effusion of stifles.
• • Your Assessment • • • Recommendations/Options Offered to Client • • Dx tests–follow-up What do you need to know about the MSK system to improve your diagnostic investigation? What tests might you recommend? What do you need to know before you predict the natural history of this patient’s problem? X-ray Cytology Microbiology
Synovial Fluid Cytology
Provisional Diagnosis • Acute Polyarthritis • Rx: Meloxicam • Antibiotics or Corticosteroids based on Culture & Sensitivity
Two weeks after Prednisone begun Very few cells seen in joint fluid
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