What is your diagnosis? THE QUESTIONS… Dr Emily Ball, BVSc (Dist), Zoetis Intern at Veterinary Specialists Auckland 2021; Dr Devon Thompson, BVSc (Dist), MVS (Hon), MANZCVSc (Radiol), DipECVDI, Registered Specialist Veterinary Radiology; Dr Tommy Fluen, BSc, MSc, DVM, ANZCVS Fellow, Registered Specialist Small Animal Internal Medicine
Case history
A 10-year-old, entire male Bull Mastiff presented to the referring clinic with a 2-day history of haematuria, mild lethargy, and ongoing weight loss. On presentation, the dog was cachectic with mild caudal abdominal pain; physical exam was otherwise unremarkable. A complete blood count revealed no abnormalities. Serum biochemistry revealed a marked increase in alkaline phosphatase (956 IU/L; reference range 1–87 IU/L), mild hypochloraemia (100 mmol/L; reference range 106–117 mmol/L), mild hypercholesterolaemia (12.1 mmol/L; reference range 3.27–9.82) and mild hyperamylasaemia (2882 IU/L; reference range 0–1074 IU/L). Urinalysis was performed on a freecatch urine sample and revealed a urine specific gravity of 1.030 (reference range 1.015–1.045), urine pH 8.0 (reference range 6.0–7.5), urine blood 3+ and urine protein 3+. Urine glucose was negative. Urine sediment showed moderate numbers of magnesium ammonium phosphate (struvite) crystals, numerous red blood cells (reference range 1.1
Figure 1. Survey right lateral abdominal radiograph of a 10-year-old Bull Mastiff that presented with a 2-day history of haematuria and mild lethargy, and ongoing weight loss.
<5/high power field) and moderate numbers of white blood cells (5–10/high power field; reference range <5/high power field). No bacteria were seen on sediment exam. A single right lateral abdominal radiograph was obtained as part of the initial work up (Figure 1).
Questions
1. What are the radiographic findings? 2. What is the radiographic diagnosis? 3. What would be the next diagnostic step?
Answers on page 40
Contact: intern.emily@vsnz.co.nz
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Companion Quarterly: Official Newsletter of the Companion Animal Veterinarians Branch of the NZVA | Volume 32 No 3 | September 2021
