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Today's Ve T erinary Prac T ice | s eptember/ o ctober 2016 | tvpjournal.com a c ase of c anine a cu T e Pancrea T i T is Peer r eviewed 52 Sidney, a 10-year-old female spayed cocker spaniel, presented with a 2-day history of lethargy, anorexia, and diarrhea. HISTORY & PHYSICAL EXAMINATION Sidney had a history of chronic keratoconjunctivitis sicca that was treated with topical cyclosporine. Two days before presentation, Sidney began refusing to eat and became lethargic. At that time, she was taken to her primary care veterinarian; basic blood analysis and urinalysis were performed (specific results not available). The urinalysis results indicated a urinary tract infection, and Sidney received amoxicillin/clavulanic acid. However, after initiation of antibiotic therapy, Sidney had loose stools that contained gelatinous red clumps. At this point, her primary care veterinarian referred her for further diagnostics and treatment. Sidney's physical examination findings on presentation to the referral facility are listed in Table 1. Differential diagnoses based on history, clinical signs, and physical examination findings are outlined in Table 2. DIAGNOSTIC APPROACH Initial workup included a complete blood count (CBC), serum biochemical profile, urinalysis, urine culture, coagulation panel, and patient-side SNAP cPL test (idexx.com); the results of the CBC, serum biochemical profile, and coagulation panel are shown in Tables 3 and 4, with abnormal results bolded. Blood and urine samples were collected before treatment was initiated. In addition, 3-view abdominal radiographs were taken to rule out a gastrointestinal (GI) foreign body and other obvious abdominal organ-related diseases. On the basis of abdominal radiography results, abdominal ultrasonography with abdominocentesis was performed. The collected abdominal fluid was prepared for analysis and cytology. From Diagnosis to t reatment A Case of Canine Acute Pancreatitis Chee-hoon Chang, DVM, MS, and Jörg M. Steiner, med.vet., Dr.med.vet., PhD, Diplomate ACVIM & ECVIM (Companion Animal), AGAF Gastrointestinal Laboratory, Texas A&M; University Table 1. Clinical Signs & Physical Examination Findings EXAMINATION CLINICAL SIGNS & FINDINGS General Normothermia (100.9°F [38.3°C]) Quiet but alert and responsive Cardiac/ respiratory Tachycardia (heart rate, 200 beats/min) Panting Hyperemia, tacky mucous membrane Strong femoral pulse No heart murmur, respiratory crackles, or wheezes Body condition 5% dehydration Body condition score, 5/9 Body weight, 10.4 kg Palpation Painful abdomen Several subcutaneous movable masses in the area of the right shoulder, humerus, and dorsum Table 2. Differential Diagnoses Based on Historical Differential Diagnoses Based on Historical & Physical Examination Findings Acute hepatitis or cholangitis Acute pancreatitis Gallbladder mucocele or rupture Gastrointestinal foreign body Gastrointestinal neoplasia Gastrointestinal perforation and subsequent peritonitis Hepatic abscess or neoplasia Pancreatic abscess or neoplasia Splenic torsion, abscess, thrombus, or neoplasia