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75 JANUARY/FEBRUARY 2018 ● TVPJOURNAL.COM CLINICAL INSIGHTS primary differentials for renal azotemia with concurrent inflammatory leukogram included: ■ Leptospirosis ■ Toxin exposure, including ethylene glycol ■ Bacterial pyelonephritis ■ Septicemia ADDITIONAL DIAGNOSTICS AND DIAGNOSIS Abdominal radiographs revealed bilateral renomegaly and mild hepatomegaly. Abdominal ultrasound confirmed the presence of renomegaly with bilateral pyelectasia ( FIGURE 1 ). TABLE 1 Pertinent Referring Veterinarian Blood Work Results VALUE RESULT REFERENCE RANGE COMPLETE BLOOD COUNT White blood cells (10 3 cells/mcL) 27 (H) 4.0−15.5 Neutrophils (10 3 cells/mcL) 22.1 (H) 2.06−10.6 Monocytes (10 3 cells/mcL) 1.62 (H) 0−0.84 Hematocrit (%) 35 (L) 36−60 Platelet count (10 3 cells/mcL) 169 (L) 170−400 SERUM BIOCHEMICAL PROFILE Alkaline phosphatase (U/L) 249 (H) 5−131 Blood urea nitrogen (mg/dL) 52 (H) 6−31 Cholesterol (mg/dL) 382 (H) 92−324 Creatinine (mg/dL) 1 0.5−1.6 Phosphorus (mg/dL) 10.5 (H) 2.5−6.0 URINALYSIS Specific gravity 1.012 (L) 1.015−1.045 H, high; L low. TABLE 2 Pertinent Clinicopathologic Abnormalities VALUE RESULT REFERENCE RANGE COMPLETE BLOOD COUNT White blood cells (10 3 cells/mcL) 36.7 (H) 6.0−17.0 Neutrophils (10 3 cells/mcL) 28.26 (H) 3.0−11.5 Monocytes (10 3 cells/mcL) 5.87 (H) 0.15−1.25 Hematocrit (%) 35 (L) 36−60 Platelet count (10 3 cells/mcL) clumped 200−500 SERUM BIOCHEMICAL PROFILE Alkaline phosphatase (U/L) 473 (H) 24−147 Blood urea nitrogen (mg/dL) 69 (H) 5−29 Cholesterol (mg/dL) 394 (H) 120−247 Creatinine (mg/dL) 2.09 (H) 0.3−2.0 Phosphorus (mg/dL) 8.3 (H) 2.9−6.2 URINALYSIS Specific gravity 1.012 (L) 1.015−1.045 Protein (mg/dL) 100 (H) negative−trace H, high; L low.