4/8/2024

DVM Intake Estimated age: 3 years Microchip noted on Intake? Yes History: Abandoned on roof of building, darted by police last night Subjective: QARH, no coughing/sneezing/vomiting/diarrhea. Appetite excellent, empty food bowl Observed behavior: Whale eye, gave one short growl when initially approached but settled down when examiner crouched down, spoke softly. Huddled in back corner of kennel. Sedated for diagnostics, wound cleaning. Head whipped once when picked up while recovering from sedation Evidence of cruelty seen: Yes, underweight, untreated wounds Evidence of trauma seen: Yes Evidence of neglect seen: Yes Objective: P: WNL R: WNL BCS: 3/9 OP: Mucous membranes pink and moist. Stage II dental disease. EENT: Eyes, ears, and nares clear bilaterally, no discharge noted. PLN: Small/soft/symmetrical/nonpainful CV: No murmurs or arrhythmias, pulses strong and synchronous. RESP: Eupneic, no crackles/wheezes GI: Soft, nonpainful, no palpable masses. UG: female intact, no mammary gland tumors, no discharge INT: Rough hair coat, no areas of alopecia or pruritus, no ectoparasites or masses noted. Severe full-thickness wound encircling proximal LFL and extending up through axilla. Scarring around edges with healthy bed of granulation tissue at center. Mild purulent debris along outside edges of wound. Dart present R flank. MS: Ambulatory x3, noted by staff to be non-weight bearing on RFL prior to sedation (bears full weight on limb with wound). Moderate diffuse muscle wasting. NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Forelimb radiographs: No Assessment: -Severe wound LFL -Non-weight bearing lame RFL -Dart wound R flank -Stage II dental disease -Underweight Prognosis: Fair Plan: -Gave convenia 8 mg/kg SQ once -Start rimadyl 4.4 mg/kg PO q24h x 7d until 4/15 (first dose given SQ) -Clipped and scrubbed wound LFL with dilute chlorhexidine, debrided wound bed with #15 blade and flushed thoroughly with sterile saline -Extended dart wound ~0.5 cm with #15 blade to allow dart removal, scrubbed with chlorhexidine and flushed with sterile saline. Closed with 0 PDS, single interrupted suture. -Send out CBC/Chem/T4 -Applied soft bandage with non-adherent padding. Remove in 2-3 days, evaluate wound bed and consider closing if continuing to heal well Surgery: Temporary waiver due to wound

4/8/2024

Your newly adopted pet has a wound and the staff veterinarians are issuing a TEMPORARY waiver from the spay/neuter requirements of the City of NY until her bandage change. Follow up care at your regular veterinarian is recommended to ensure continued treatment through to the resolution of the issue. At the time of a full recovery you may choose to have your veterinarian perform the spay/neuter surgery, or make provisions to return the pet to ACC for sterilization.

4/9/2024

CBC: Non regenerative anemia, Hct 34.5 (38.3-56.5); leukocytosis 47.4 (4.9-17.6); neutrophilia 41.238 (2.94-12.67); monocytosis 1.754 (0.13-1.15) CHEM: hypokalemia 3.9 (4.0-5.4); hypochloridemia 107 (108-119); hypoalbuminemia 1.7 (2.7-3.9); hyperglobulinemia 4.6 (2.4-4.0); increased AST 78 (16-55) T4: decreased 0.7 (1.0-4.0) Interpretation: -Mild anemia - likely secondary to wound -Severe leukocytosis, neutrophilia - ro secondary to severe wound vs other -Hypoalbuminemia, hyperglobulinemia - ro severe wound vs other -Low T4 - ro euthyroid sick vs hypothyroidism Plan: Continue with current treatment plan, recommend recheck bloodwork in 2-3 weeks as long as doing well/wound healing

4/10/2024

Recheck wound, bandage came off leaving very large, deep wound exposed S/O: QAR in kennel, low growl cageside. Allows leashing and comes out of kennel without incident. Sedated for wound treatment. No c/s/v/d noted, no nasal discharge Eupneic Very large full thickness wound at proximal left thoracic limb - see below for more detail Sedated with dexmedetomidine 0.01 mg/kg IM + butorphanol 0.2 mg/kg IM. Added ketamine 1.5 mg/kg. Maintained on iso and O2. Severe/large wound at proximal left thoracic limb, nearly circumferential. -Linear, superficial portions of the wound noted at lateral aspect of limb -Deepest portion of wound at craniomedial aspect of limb with moderate to severe cellulitis in that region. -Wound extends along medial aspect of proximal limb and around through axilla, although wound is slightly smaller and less severe in that area. -Mild/minimal discharge from wound -Scrubbed around wound and flushed thoroughly with sterile saline -Healthy tissue, bleeds easily with debridement; entire wound debrided with #10 blade prior to closing -Placed penrose drain beginning at craniomedial aspect of wound and exiting at most ventral region of axillar wound (secured with two 2-0 PDS sutures) -Closed craniomedial and caudomedial portions of wound separately, each section closed in 2-3 layers using 2-0 PDS in simple continuous, simple interrupted, and cruciate patterns. -Flushed copiously with sterile saline after closure A: Severe/large wound at proximal LFL Mild underweight Dental disease P: Sedation and wound treatment as described above Drain removal in 3 days Start gabapentin 10 mg/kg PO BID indefinitely for pain and FAS Continue carprofen until 4/15 Continue trazodone indefinitely for FAS CTM closely on rounds, recheck as scheduled

4/13/2024

Progress exam Subjective: BAR, no c/s/v/d. Sedated in kennel using syringe pole, 0.2 mg/kg butorphanol and 10 mcg/kg dexmedetomidine IM. Patient becoming refractory to this method of sedation, allowed leashing with no issue but turned and bit syringe pole prior to drug administration Objective: Eyes: Clear bilaterally, no discharge Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: No obvious fractures or luxations, no reports of lameness prior to sedation. No drainage from wound, sutures and drain in place. Wound repair site clean/dry/intact, moderate cellulitis present at cranioventral aspect of wound. Neuro: Appropriate mentation. Assessment: -Severe wound L axilla (healing well) -Mildly underweight -Dental disease -Dart wound R flank -Reported RFL lameness (no further reports) Plan: -Removed drain, flushed wound bed with sterile saline and dried thoroughly with gauze -Continue gabapentin 10 mg/kg PO q12h indefinitely -Continue rimadyl 4.4 mg/kg PO q24h until 4/15 -Continue trazodone 10 mg/kg PO q12h indefinitely -Convenia given 4/8 -CTM wound healing closely

4/19/2024

Progress exam Subjective: BAR, no c/s/v/d. Sedated for suture removal with 0.2 mg/kg butorphanol, 10 mcg/kg dexmedetomidine IM Objective: Eyes: Clear bilaterally, no discharge Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with no appreciable lameness. Wound healing extremely well, cellulitis resolved. Loose sutures at cranial 4 inches of wound, bed of healthy granulation tissue visible. Rest of wound healed. Dart wound healed. Neuro: Appropriate mentation. Assessment: -Severe wound L axilla (healing very well) -Mildly underweight -Dental disease -Dart wound R flank (resolved) Plan: -Removed sutures, monitor healing of remainder of wound -Continue gabapentin 10 mg/kg PO q12h indefinitely -Continue trazodone 10 mg/kg PO q12h indefinitely -CTM

4/24/2024

Progress exam-CIRDC signs noted on rounds SO: BAR, no c/v/d, sneezing. E/d well. Cage side exam. EENT: No ocular discharge. Mild mucoid nasal discharge L: Eupneic, sneezing ABD: No obvious distention MSI: Ambulatory x 4 with no appreciable lameness CNS: Mentation appropriate A: CIRDC P: CTM while at BACC Placed move to ISO sign and feeding log Start doxycycline 10mg/kg PO SID x 14 days Recheck CIRDC day 10