From Clinical Signs to Solutions: How Plumb’s Pro Streamlines Diagnosis and Treatment in Veterinary Practice

January 25, 2024
4 min

Whether we’ve been in veterinary practice for days or decades, we all need clinical support. When that complex medical case isn’t responding to treatment as we expect, or the adrenaline rush during an emergency makes it hard to focus on the next steps, having a trusted source of support to rely on is crucial. 

A clinical decision support tool can be a game-changer. It’s like having your textbooks and your go-to experts in one place, so you can find everything you need to make confident decisions for your patients—from drug details and pet owner handouts to diagnostic and treatment information—in seconds. 

But how does a clinical decision support tool like Plumb’s Pro™ actually fit into your practice workflow when you’re working through a case? Let’s look at where Plumb’s Pro can lend you a hand. 

Meet your patient and pet owner

Today you’re seeing Boss, a 5-year-old neutered male rottweiler who presents with moderate lethargy and “red eyes,” according to his owner, Julie. 

Julie mentions that Boss has been low on energy for the past two days, and she noticed his eyes looking red yesterday. His appetite is a little lower than usual, but he’s still drinking, urinating, and defecating normally. 

Boss is up to date on vaccinations and has been healthy until now. He’s lived in the Southeastern United States his entire life and hasn’t traveled elsewhere. 

On physical exam, you note petechiae and mild icterus when you examine his gingiva. His ocular exam reveals bilateral mild hyphema, and you discover on abdominal palpation that his spleen is moderately enlarged. No other abnormalities are found.  

Get started with baseline diagnostics

Your first thought is that petechiae and unexplained bleeding could be due to tick-borne illness, so you start with point-of-care testing for Ehrlichia spp, Anaplasma spp, and Lyme disease, along with in-house CBC, serum chemistry panels, and a urinalysis.

Results show mild anemia (PCV 33%) and moderate to severe thrombocytopenia (42,000 platelets/µL). In-house tick-borne infectious disease results are negative, and the chemistry panel is unremarkable. 

You’re unsure of your next steps, especially as Julie mentions she’s on a budget and prefers to avoid “unnecessary tests.” 

You decide to turn to Plumb’s Pro for guidance.

Seize step-by-step case support in seconds

You grab your nearest device, open the Plumb’s app, and bring up the petechiae/ecchymoses algorithm, which reminds you to check the reticulocyte count and analyze the CBC for hemolysis. 

Clinician’s Brief veterinary algorithm on petechiae and ecchymoses

Boss’s reticulocyte count is >60,000/µL, which is consistent with regeneration; hemolysis is noted on his CBC. 

The algorithm suggests ruling out immune-mediated and additional infectious etiologies and recommends a blood smear to evaluate for spherocytes, direct Coomb’s and ANA tests, and screening for heartworm disease and babesiosis.

You discuss the options with Julie along with your concern for potential tick-borne infection, and she agrees to send a blood smear to the lab to evaluate for spherocytes and potential inclusions. She prefers to wait for those results before pursuing any other diagnostics. 

You’re unsure how to treat Boss while awaiting results, so you head back to Plumb’s Pro to remind yourself of the recommended treatment approach for thrombocytopenia.

Find practical diagnostic and treatment guidance when it matters most

In the treatment section of the Dx & Tx monograph on thrombocytopenia, you find the current recommendation—given the association of tick-borne diseases with thrombocytopenia—is to treat presumptively with doxycycline while awaiting test results.

Plumb’s Pro diagnostic and treatment monograph on thrombocytopenia

You send Boss home with doxycycline at a dosage of 5 mg/kg to be given orally every 12 hours. You advise Julie to keep him quiet, monitor him closely, and call the clinic if his condition worsens or if she has concerns.

When you receive the laboratory results the next day, you discover that small Babesia spp piroplasms were identified on the blood smear. 

The pathologist comments that seeing piroplasms on cytology is highly specific for diagnosing babesiosis, but she suggests PCR testing to definitively identify the species. Julie declines due to cost constraints. 

You recall that babesiosis can be challenging to treat, so back to Dx & Tx you go. This time, you consult the monograph on babesiosis in dogs.  

Plumb’s Pro diagnostic and treatment monograph on babesiosis

You review the treatment options for small Babesia spp and elect to treat with a combination of atovaquone and azithromycin for 10 days. 

You pull up the drug monographs for atovaquone and azithromycin to double-check dosing, potential adverse effects, and administration information.

You’ve got a plan for treating Boss. Now it’s time to make sure Julie is on board and help her understand the details of treatment and caring for Boss at home.

Help pet owners understand all the details 

Plumb’s Pro has two types of easily shareable handouts for pet owners. 

Drug handouts answer common pet owner questions about the drugs you prescribe, while clinical handouts cover common clinical conditions, procedures, and preventive care. 

All the handouts in Plumb’s are written in simple language with definitions of medical terms and explanations the whole family can understand.

Plumb’s Pro drug handouts for pet owners

You select the handouts on atovaquone and azithromycin and choose the email option. In the email message, you add a personal note advising Julie to keep a close eye on Boss and contact the clinic if he isn’t improving. 

Plumb’s Pro portal for sharing drug information sheets with pet owners

You send Boss home feeling confident that you’re on the right treatment track and that Julie is equally confident in his care.

With Plumb’s Pro by your side, you’ve got everything you need to face any case that comes your way, whether you’re just starting out or you’ve been in practice for more years than you can count.


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