Page 144 - Small Animal Clinical Nutrition 5th Edition

Minerals and Vitamins 145

CASE 6-6
VetBooks.ir Vomiting and Anorexia in a German Shepherd Mixed-Breed Dog

Patient Assessment
A five-year-old, 10.6-kg, neutered female German shepherd mix was examined after three days of vomiting, anorexia and lethar-
gy.The owners reported the dog was allowed free access to the neighborhood, which included a radiator machine shop where chole-
calciferol-based rodenticides were used. The dog appeared depressed and moderately dehydrated.
Abnormal laboratory findings included moderate hypercalcemia, mild azotemia, proteinuria and isosthenuria.These results sug-
gested vitamin D toxicosis.
3
Assess the Food and Feeding Method
No dietary history was available.

Treatment and Feeding Plan
Treatment consisted of intravenous 0.9% saline solution, diuretics, salmon calcitonin and corticosteroids. Hypercalcemia persisted
throughout hospitalization. Further diagnostic testing did not identify a cause for persistent hypercalcemia. After seven days of hos-
pitalization, the dog improved markedly and was discharged to the owners’ care. Oral prednisone (at tapering dosages) and a vet-
erinary therapeutic food formulated for renal patients were given at home.

Reassessment
The dog was evaluated several times during the next four weeks and appeared normal despite persistent hypercalcemia. The dog
became normocalcemic five weeks after discharge from the hospital and remained normocalcemic when examined at two and three
months.

Bibliography
Livezey KL, Dorman DC, Hooser SB, et al. Hypercalcemia induced by vitamin D toxicosis in two dogs. Canine Practice 1991;
3
16: 26-32.

CASE 6-7

Subcutaneous Nodules in a Young Cat

Patient Assessment
A five-month-old female domestic shorthair cat was examined for depression, anorexia, firm nodular subcutaneous fat in the groin
region and abdominal hyperesthesia of one week’s duration.The cat was normally docile and tractable but began to resist being han-
dled and petted. Body condition was normal (3/5).
Hematologic abnormalities included a neutrophilic leukocytosis and a normocytic, normochromic, nonregenerative anemia.
Urinalysis and fecal examination results were normal. Biopsy specimens were obtained from the affected subcutaneous tissue. The
biopsy specimens were firm, nodular and brownish-orange when examined grossly. Serosanguineous fluid oozed from the biopsy
sites. Histopathologic examination revealed pyogranulomatous panniculitis, ceroid pigment and multifocal areas of fat necrosis and
mineralization.

Assess the Food and Feeding Method
Since weaning, the cat had only been fed sardines, anchovies and mackerel free choice.

Treatment and Feeding Plan
A diagnosis of pansteatitis was made based on the dietary history and histopathologic lesions.Treatment included α-tocopherol (50
mg/kg body weight) once daily per os for two months and prednisolone for 15 days in a decreasing dosage schedule. A fish-free,
complete and balanced moist cat food was offered. Because the cat was anorectic and unaccustomed to commercial cat food, it was
initially force-fed.