A dog presents with acute vomiting, nervous tremors, abdominal pain, and a CBC showing mild anemia with 50 nRBCs. What is the likely diagnosis?

The symptoms presented—acute vomiting, nervous tremors, abdominal pain, and the presence of non-regenerative red blood cells (nRBCs) along with mild anemia—strongly point towards lead toxicity as the likely diagnosis. Lead toxicity in dogs can cause a variety of clinical signs due to its neurotoxic effects as well as its impact on the hematologic system.

Lead interferes with the synthesis of hemoglobin, leading to anemia characterized by the presence of nRBCs. This is because lead exposure can cause damage to the bone marrow, inhibiting normal erythropoiesis and resulting in the release of immature red blood cells into circulation. In conjunction with gastrointestinal symptoms such as vomiting and abdominal pain, nervous tremors can occur due to lead's effects on the nervous system, reinforcing the suspicion of lead poisoning.

Other options, while they may present with overlapping symptoms, do not encompass the specific presentation as compellingly as lead toxicity does. Heavy metal toxicity could involve other metals and may not align with the specific clinical signs observed. Gastroenteritis typically would not explain the presence of anemia and nRBCs, as it primarily involves gastrointestinal distress without the described hematologic implications. Acute kidney injury might present with vomiting and other systemic symptoms