Mattie has been lethargic, vomiting, and anorexic for the past week. She has vomited once or twice a day, usually characterized by gagging, retching, and bringing up bile-stained fluid. The owner thinks Maggie has also been drinking more water and urinating larger volumes. The owner tried to force feed her and has been able to get her to eat scrambled eggs. Mattie was taken to her veterinarian two days ago. He found that she had lost 4 lbs. since her previous visit one month ago. A CBC, biochemical profile, and abdominal radiographs were performed. Significant abnormalities on blood work included an ALP of 512 IU/L (N = 20-130); ALT of 4426 IU/L (N = 15-110) and a total bilirubin of 1.2 mg/dl (N = 0.1-0.5). Radiographs were interpreted as unremarkable. Maggie was referred to OSU for further evaluation. The owner thinks that Maggie was completely normal prior to this episode and has not been receiving any medications.
At this point, you would like to perform a physical exam and
run some diagnostic tests.