Table 1 Summary of clinical problems with associated action steps

Thrombocytopenia

 0 plt/µL

RDVM

Begin prednisone 2.2 mg/kg/day PO

 156,000 plt/µL

RDVM

Decrease prednisone by 25 %

 117,000 plt/µL

RDVM

Increase prednisone to 2.2 mg/kg/day PO;

begin azathioprine 2.4 mg/kg PO daily

 23,000 plt/µL

RDVM

Refer to TAMU-VMTH

 171,000 plt/µL

TAMU-VMTH

Discontinue azathioprine;

decrease prednisone by 50 %

 102,000 plt/µL

TAMU-VMTH

Begin cyclosporine at 4.7 mg/kg/day PO;

begin Yunnan Baiyao 0.5 g PO BID;

increase prednisone by 25 %

 160,000 plt/µL

TAMU-VMTH

Taper cyclosporine to discontinuation;

discontinue Yunnan Baiyao

Vector-borne diseases

 Ehrlichia spp. antibody seropositivity

RDVM

Begin doxycycline 5.7 mg/kg PO BID

 Anaplasma spp. antibody seropositivity

RDVM

Begin doxycycline 5.7 mg/kg PO BID

 D. immitis antigen seropositivity

RDVM

Begin doxycycline 5.7 mg/kg PO BID

 Echocardiographic confirmation of heartworm infestation

TAMU-VMTH

Administer melarsomine three-dose protocol (2.5 mg/kg/dose)

Urinary tract infection

 6–20 WBC/hpf on UA

RDVM

Begin empiric sulfamethoxazole- trimethoprim 27.3 mg/kg PO daily x 14d

 bacteriuria / pyuria

on UA

RDVM

Begin empiric amoxicillin/clavulanic acid 13.8 mg/kg PO BID

 > 100,000 organisms/mL of Salmonella spp. from urine culture

RDVM

Discontinue amoxicillin/clavulanic acid;

begin amoxicillin 25.3 mg/kg PO BID x 28d

 4 colonies of Salmonella spp. from prostatic wash culture and susceptibility

TAMU-VMTH

Begin enrofloxacin 10.6 mg/kg PO daily x 28d;

begin doxycycline 10.1 mg/kg PO BID x 28d;

initiate zoonosis precautions in the home

 Negative urine culture after 14 days of enrofloxacin / doxycycline

TAMU-VMTH

No action

 > 100,000 organisms/mL of Salmonella spp. from prostatic wash culture

TAMU-VMTH

Begin marbofloxacin 3 mg/kg PO daily through 2 weeks post-castration

 Negative prostatic wash culture 10 d after stopping marbofloxacin

TAMU-VMTH