The Yellow Cat

Poor Benson! We started with a classic history question:

Nick summarised the history next:

And we went on to perform a full physical examination:

We now need to begin considering differentials, and how we might group these ideas into a logical structure:

https://twitter.com/bertiejess/status/856948894164553728

Remember that hepatomegaly does not rule out much so far!

To summarise:

So what would be an example of a post-hepatic jaundice cause?

Back to the case:

The results from the PCV:

So, what's next?

Great suggestions everyone! Next we get the results of the blood biochemistry:

How do we interpret this?

https://twitter.com/bertiejess/status/856953766779781124

More great answers, here's a summary of liver enzymes and how to interpret them:

So, are we sure that this is a hepatic case of icterus?

A few people mentioned pancreatitis as a post-hepatic cause:

What's next?

Next we received the liver ultrasound, and report:

So what are we thinking in terms of primary liver disease in the cat?

To summarise:

So what's the next step with Benson?

https://twitter.com/LucyWoeginger/status/856958178151600128

Coagulation times are very important here!

The methods of biopsy are: trucut, ex lap, laparoscopic.

Drum roll please..!

What's next for poor Benson?

https://twitter.com/bertiejess/status/856960404941156353

https://twitter.com/bertiejess/status/856961207529504769

To summarise:

Vitamin E is an antioxidant, although there is no good data on what dose would be used in a cat. A superior antioxidant would be a SAMe or a milk thistle based drug, several of which are manufactured for cats and dogs.

Finally, what if Benson wasn't eating?

An NO tube is a naso-oesophageal tube, which should finish in the distal oeseophagus.

All's well that ends well!