A 4 year old intact liver and white male English Setter presents
to your clinic right after the News Year’s holiday with a 3-month
history of straining to defecate and recently frank blood in the
feces. The RDVM put the dog on a stool softner and antibiotics about
3 weeks ago and the owner noted that the dog feces were more “runny”
but still contained blood. The owner notes that the dog eats well
and is active, but has lost some weight over the past 3 weeks. The
dog is being fed Purina® maintenance dog food at manufacturers
recommended levels. You put the dog on the examination table and he
urinates all over you and the table. You quickly grab a urine dip-stix
to test the urine and collect some in a tube as it runs off the
table. The results show a specific gravity of 1.034, protein 1+,
bilirubin 1+, and a pH of 7.5. You rush some to the lab and it shows
4+ bacteria and a few epithelial cells. You change your clothes and
return to the examination room and complete your physical
examination. The rectal temperature is 102.1°F, heart rate is 120
b/m, and respiratory rate is 20 breaths/m. Abdominal sounds are
within normal limits and the dog has evidence of dried blood and
diarrhea around the rectum. You score the dog’s body condition to be
2/5, according to the canine body condition scale you found on the
internet at
CatHelp-Online.com. You proceed to a digital rectal
examination and it reveals decreased lumen size approximately 1-2
inches cranial to the rectum. The CBC showed a normal WBC (12,900/µl),
but eosinophilia (1,806/µl)
and chemistry panel results were unremarkable. You perform endoscopy
of the rectum and colon and see the above images.
Authors:
Frank M. Andrews, DVM, MS, DACVIM
Linden Craig, VMD, PhD, DACVP
What about the U/A findings?
What’s your diagnosis?
What other diagnostic tests would be
helpful in determining the diagnosis?
