4/9/2025

DVM Intake Estimated age: 15-17 years Microchip noted on Intake? No History: Stray Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Observed behavior: Whale eye, tucked tail. Perks up when food is offered and takes readily but head whips and growls when attempting to lift out of carrier. Sedated for exam with 0.2 mg/kg butorphanol, 10 mcg/kg dexmedetomidine IM Evidence of cruelty seen: No Evidence of trauma seen: Not cruelty Evidence of neglect seen: No Objective: P: WNL R: WNL BCS: 6/9 OP: Mucous membranes pink and moist. Stage III dental disease. Firm pink 3 cm papillomatous mass at L commissure of mouth with crusted mucopurulent discharge EENT: Eyes, ears, and nares clear bilaterally, no discharge noted. Nuclear sclerosis OU, 4 cm bleeding mass near base of R pinna. 1 cm firm mass on dorsal palpebra OD with crusted purulent debris on surrounding fur. Conjunctivae appear WNL 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 spayed, tattoo noted, no discharge INT: Good hair coat, no areas of alopecia or pruritus, no ectoparasites or noted. Multifocal alopecic cutaneous masses on nose and face MS: Ambulatory x4 prior to sedation, no pain on palpation of epaxials NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Thoracic radiographs: No evidence of metastasis. Liver extending past ribcage, mild-moderate enlargement. All other visible structures WNL CBC: Mild decrease HG 12.9 (13.1-20.5 g/dL) RBC, HCT WNL Mild decrease MCV 58.5 (61.6-73.5 fL) Mild monocytosis 1.61 (0.16-1.12 K/uL) Mild thrombocytosis 489 (148-484 K/uL) Mild increase platecrit 0.58 (0.14-0.46%) Chemistry: Mild elevation ALP 412 (23-212 U/L) Assessment: -Multifocal papillomatous masses (r/o CPV vs other cutaneous neoplasia) -Stage III dental disease -Mild elevated liver enzymes/enlargement (r/o vacuolar hepatopathy vs other hepatopaty) Prognosis: Fair Plan: -Gave convenia 8 mg/kg SQ with intake -Start rimdayl 4.4 mg/kg PO q24h x 5d until 4/14 (first dose given SQ) -Clipped and cleaned pinna, eyelid, perioral masses -Recommend mass removals and histopathology with placement Surgery: Spayed

4/10/2025

Brief recheck, geriatric dog with masses - QAR, no c/s/v/d noted, no reports of inappetence, mass visible at left side of face @ commissure, eupneic. CTM closely while at QACC.

4/11/2025

Alerted that Willow was bleeding, brought to ICU S/O: BAR, head whips and snaps when attempting to pick up/examine - visual exam only EENT: No ocular or nasal discharge, mass at distal right pinna LUNGS: Eupneic MSI: LH paw has fresh blood on it, mass at left side of mouth is bleeding A: Mass left side of mouth - scratching with LH paw and causing bleeding Mass at right pinna Geriatric Dental disease P: Move to ICU for closer monitoring Placed e-collar to prevent scratching Unable to clean away blood from mass due to behavior CTM closely in ICU and seek placement ASAP

4/12/2025

Adding gabapentin for pain relief and to facilitate handling: gabapentin 100mg PO q12h indefinitely

4/13/2025

Progress exam Subjective: BAR, no c/s/v/d. Wagging tail and taking treats eagerly throughout exam, minimal handling performed to avoid raising FAS Objective: Eyes: Clear bilaterally, no discharge Oronasal: No nasal discharge. Lungs: Eupneic Int: Masses on R pinna and L commissure of mouth unchanged, mild scabbing. No active bleeding. Mass R upper eyelid quiet, no discharge. Musculoskeletal: Ambulatory x 4 with no appreciable lameness. Neuro: Appropriate mentation. Assessment: -Multiple cutaneous masses on face, largest at R pinna and L commissure of mouth -Mild elevated liver enzymes -Stage III dental disease -Senior pet Plan: -Continue rimadyl 4.4 mg/kg PO q24h until 4/14 -Continue gabapentin 10 mg/kg PO q12h indefinitely -CTM in medical, seek placement ASAP for mass removals +/- histopathology

4/17/2025

progress exam S/O QAR, resting in kennel, takes treats, food trays disturbed, no c/s/v/d appreciated EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4, cutaneous reddish mass to the l oral commissure, no active bleeding. Reddish mass to right pinna, scant dried hemorrhagic dc in the surrounding fur A. As prior- masses are quiet aTT, no active bleeding, some dried blood to the mass on the R ear P. Con't current meds Con't to seek placement Recheck in 2 days

staff took animal straight to medical.