Representing Chi puppy Pablo in his case study; part 2 also includes a case study on German Shepherd Bear. Photo Bigstock/Willee Cole
Part one gives an overview of why knowledge of severity-prognosis mismatch conditions is critical to prevent falling trap to premature closure and potentially leading to severe case mismanagement and client misguidance. It also features a case study.
Case 2: Pablo
Case summary: Pablo is a five-month-old intact male Chihuahua that presented to a local emergency clinic after falling from a third-floor apartment. He has been a healthy puppy historically. He has not received any vaccinations and is not on preventative medications. He lives indoors and urinates on training pads.
On general physical examination, Pablo's core body temperature was 97.9 F. His pulse was 140 beats per minute. His respiratory rate was 50 breaths per minute. His mucous membranes were tacky and muddy. His capillary refill time was two seconds. Thoracic auscultation disclosed expiratory crackles. Abdominal palpation was unremarkable. He had mild swelling dorsolateral to the right orbit. Palpation of long bones did not disclose any overt evidence of fractures, luxations, or subluxations.
Pablo's neurological exam
| Mentation | Severely obtunded and demented |
| Gait/posture | Laterally recumbent, extensor rigidity in thoracic limbs, opisthotonus |
| Muscle mass/tone | Increased tone in thoracic limbs |
| Postural reactions | Absent in all four limbs |
| Spinal reflexes | Normal |
| Cranial nerves | Absent menace OU
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