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VetJet - Coggle Diagram

- - - - no action
    - - Possible diabetes
      - Suggest testing fructosamine
      - Suggest urinalysis
  - - - Advise abdominal ultrasound
      - Can consider liver supplements and recheck bloodwork in 4 weeks
    - - 5-40x elevations are a concern for Cushings disease
        
        Conaised Low Dose Dexamethasone Suppression Test
        
        Consider abdominal ultrasound
  - - - Often start methimazole treatment at 5mg/kg
    - - Euthyrod sick syndrome
        
        Basically any sickness can result in low T4
        
        Retest in 4-8 weeks if otherwise healthy
      - Mod-marked decrease = hypothyroidism
        
        recommend Thyroid panel (Free T4 and TSH testing)
        
        Can consider starting on levothyroxine if it is low enough and matches clinical signs
  - - - Inflammation
      - Dehydration
    - - Concern for multiple myeloma
        
        Radiographs of long bones
        
        Urinalysis
    - - If very young and liver enzymes increased, abdominal ultrasound to look for portosystemic shunt. Globulins usually normal in this case
      - If kidney enzymes are elevated, likely protein losing nephropathy
        
        Urinalysis
      - If having diarrhoea or GI upset, possible protein losing enteropathy
        
        Consider Pancreatic lipase test
        
        Consider trypsin like immunoreactivity testing
      - If liver enzymes also increased
        
        Abdominal ultrasound
- - - - Likely dehydration
      - Continue to monitor
    - - Compare to reticulocytes
        
        If normal = non regenerative anemia
        
        If reticulocytes elevated, = regenerative anemia
        
        Possible causes
        
        Haemorrhage
        
        Imaging such as ultrasound or xray
        
        Consider testing clotting times
        
        RBC destruction
        
        Manual blood smear review
  - - - Possible iron deficiency anemia
        
        Consider Iron panel, diet assessment
      - Chronic blood loss
        
        Consider Coagulation testing
        
        Manual assessment of blood smear
  - - - No action
    - - Clumping - manual blood smear review
      - True decrease
        
        Increased use
        
        Assess for bleeding using imaging
        
        Decreased production
        
        Assess other CBC parameters for signs of bone marrow suppression
        
        May have immune mediated disease - manual blood smear review
  - - - Elevated = inflammation
        
        Infection
        
        Inflammation
        
        Trauma
      - Decreased
        
        Decreaed production
        
        Assess for other signs of disease
        
        Bone Marrow Suppression
        
        Increased demand
        
        Infection
        
        Inflammation
- - - - Anemia
        
        Non regenerative
        
        Anemia of chronic disease
        
        Search for underlying cuase on rest of BW and physica exam
        
        Regenerative
        
        Blood loss
        
        Parasitism
        
        Dewormer
        
        Hemorrhage
        
        IMaging such as ultrasound or X-Ray
        
        Hemolysis
        
        Check blood smear, possible IMHA
        
        Immune mediated disease
        
        Check blood smear, if spherocytes seen then diagnosis is Immune mediated hemolytic anemia (IMHA)
        
        Steroid trial
  - - - Clumping - no action
      - Immune mediated thrombocytopenia (diagnosed on bloood smear review)
      - Haemorrhage
        
        Imaging to assess signs of haemorrhave
  - - - Look for possible causes of this (dental disease, skin infection, systemic inflammation etc.)
      - Consider antibiotics if infection present
    - - Stress leukogram
        
        Increased neutrophils
        
        decreased lymphocytes
        
        Increased monocytes
        
        Action = monitor, likely from stress of hospital visit or blood collection
      - Neutrophils with Bands
        
        Likely infection
      - Elevated eosinophils
        
        Parasitism
        
        Consdier deworming
        
        allergy
      - Very high lymphocytes only
        
        Lymphoma
        
        Consider lymph node aspirates