Читать книгу Clinical Reasoning in Veterinary Practice - Группа авторов - Страница 21

Erroll is a 4‐year‐old neutered male Burmese cat. He has a 2‐week history of intermittently vomiting bile‐stained material. Over the last 4–5 days he has become progressively anorexic and depressed. 24 hours prior to presentation he had started straining to urinate, and the urine was blood stained. No diarrhoea had been noted by the owners. His water intake was normal until the past 24 hours, when it may have been reduced.

On physical examination he was noted to be very depressed and dehydrated. His rectal temperature was normal (38.1°C). Heart rate was elevated at 220 bpm. Mucous membrane colour was poor and the capillary refill time (CRT) was greater than 3 seconds. Abdominal palpation was unremarkable – the kidneys felt normal and were not painful. The bladder contained some urine but felt normal and could be easily expressed.

So – can we solve all of these cases in the same way? Do we need to? What are the challenges? Let’s consider the tools we use to clinically reason.