12/16/2025

[DVM Intake] DVM Intake Exam Estimated age: 6-8yrs based on dentition/conformation Microchip noted on intake? scans positive History: owner surrender Subjective: BAR Observed Behavior - calm, tolerated all handling and tasks Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective P = 190 R = 24 BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Adult dentition, mild staining, oligodontia on right maxilla PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: FS, tattoo present, no vulvar dc or MGTs MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat, mild dorsal muscle wasting CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: externally normal Wood's Lamp Exam: not performed Assessment Approx. 6yr FS DSH Dental disease: oligodontia right maxilla (r/o previous extractions vs previous fractures/FORLs) Prognosis: good Plan: intake tasks Should have dental radiographs in the future to determine if there are any retained roots present SURGERY: already spayed

1/9/2026

FP emailed: 1/2/26 FP reports soft stool, sometimes liquid stool x 48 hrs. Improving some on it's own. Foster Team advised fiber, probiotic. FP emailed: 1/9 Pet on Fortiflora x5 days, stool still soft/liquid. Increased energy, settling in well, appetite improving too, zoomies and explores. I replied: Asked for photo of stool. Switch from pumpkin to Psyllium husk (unflavored Metamucil or Benefiber are some brand names): Mix ½ teaspoon in food every 24 hours for 5 days. If continues, poss switch to Proviable, poss send out stool sample for OPG.

1/14/2026

Per VET 991697: "I would encourage them to try the psyllium and see if we can at least we can get the stool formed enough to collect a stool sample for ova parasite testing. In the mean time we can try a 5 day course of fenbendazole 50mg/kg PO SID x5d-liquid or powder whatever the foster thinks she will eat. Just warn them it is a lot of liquid. It is also OK to hold off on the fenbendazole to give the psyllium a chance to improve the stool consistency."

1/16/2026

Fecal OPG - negative

1/26/2026

Per VET 991752: We can see if she'll improve on a different diet such as: Royal Canin Veterinary Diet Gastrointestinal Dry Cat Food - ½ cup a day or ROYAL CANIN VETERINARY DIET Gastrointestinal Loaf in Sauce Wet Cat Food, 5.1-oz can, case of 24 - 1 can a day. Please slowly transition to this diet over 4 days.

3/17/2026

FP emailed: Pet doing well, eating Rx GI diet - but some days not eating well (1/4 cup dry and 1/2 can). FP still adding in 1/2 tsp of psyllium husk and water. Pet still vomits ~1-2x/week, BM half solid. FP notes red scabs/sores on face/neck - above eye. Both ears are clean. Photos uploaded to vet docs. I replied: Asked for more info. Poss Allergies. Poss Pred Trial, Poss rx HP diet Per VET 991697: Advised appt.

3/20/2026

S: Recheck from foster. Since they started fostering her, she has had V/D, decreased appetite. psyllium and GI diet have helped with stool, but decreased appetite and vomiting 1-2x per week continues. Also scratching head and reports of bad breath from the foster. O: EENT: clear OU/AU Oral Exam: oligodontia on right maxillary and mandibular arcades H/L: NMA, NSR, LCE Abd: SNP, NPM MSI: amb x 4, BCS 3/9, abrasions on head otherwise GHC Mentation: BARH A: Adult FS DSH Chronic intermittent V/D Weight loss Underweight Dental disease Anemia-non-regenerative Thrombocytopenia-r/o secondary to platelet clumping and not true thrombocytopenia Hyperglycemia-r/o stress P: Dexdomitor 500 mcg/ml-10 mcg/kg, 0.07 ml + Butorphanol 10 mg/ml-0.2 mg/kg, 0.07 ml IM. Reversed equal volume antisedan IM 2V CXR/AXR-NSF on CXR, rotation of VD thorax. AXR-ingesta in stomach, feces in colon, part of small intestines appear normal and others show "string or pearls" sign-r/o FB/obstruction CBC-HCT 30.1%, low Reticulocytes (1.4), 96,000 platelets Chem-hyperglycemia (175)-r/o stress otherwise NSF T4 WNL (2.1) Applied revolution today due to scratching Since V/D is chronic intermittent recommend NPO overnight for recheck AXR and B12 to IDEXX, once B12 obtained consider giving 0.25 ml Vit B12 (1,000 mcg/ml) SQ once. Recommend CBC to IDEXX to check HCT and platelets, also recommend PCV/TS in house tomorrow. Pending recheck AXR tomorrow and B12 results: Consider novel protein vs hydrolyzed diet instead of GI diet. Consider B12-not performed today as patient ate this morning. Consider empirical steroid tx with prednisolone if unable to pursue further testing such as AUS. Recommend dental procedure prior to starting steroids.

3/21/2026

Recheck - foster visit yesterday for chronic, intermittent vomiting; noted to have lost about 12 oz in past 3 months; rads showed abnormal gas pattern ("string of pearls"), scheduled for recheck rads this AM S/O: QAR at back of kennel, dilated pupils, did not eat overnight (food in kennel, NPO sign not in place) EENT: Mild crusted discharge OU, no nasal discharge ORAL: mm pink and moist, focal gingivitis and suspect resorption at mandibular pms LUNGS: Eupneic ABD: SNP, NMP, large soft UB MSI: Mild DMW, BCS 4/9 CNS: Appropriate mentation A: Chronic, intermittent vomiting - ro IBD vs LSA vs other Weight loss - approx 12 oz in 3 mo Periodontal disease Very mild anemia (Hct 30.1, normal is 30.3-52.3) - ro transient or normal variant vs other Thrombocytopenia, plt aggregates detected likely artifact P: Sedated with dex/torb for repeat AXR 2VAXR today unremarkable, previous gas pattern resolved Vitamin B12 0.25 ml given SQ Recommend transition from GI diet to either select protein or hypoallergenic, feed only this If no improvement, recommend AUS and GI panel with placement Okay to return to foster

4/13/2026

Recheck - foster visit chronic, intermittent vomiting S: BARH - nervous but tolerant pink moist mm, CRT <2s FCP reports chronic intermittent vomiting persists but seems improved maintaing weight O: BCS: 4/9 EENT: No ocular or nasal discharge, eyes and ears clear ORAL: focal gingivitis and suspect resorption at mandibular pms as prior H/L: No HMA, SSPPs, normal BV sounds, eupneic ABD: SNP, NMP, large soft UB MSI: Ambulatoryx4, full ortho exam not performed CNS: Appropriate mentation Rectal: normal externally A: Chronic, intermittent vomiting - persists but improved r/o IBD vs LSA vs other HX weight loss - now maintaining Periodontal disease HX Very mild anemia (Hct 30.1, normal is 30.3-52.3) - ro transient or normal variant vs other HX Thrombocytopenia, plt aggregates detected likely artifact P: OK for tasks that are due AFAST IH - Multiple measurements of SI thickeness are 2-4mm (WNL for cats). No masses or free fluid seen. Mild snow globe effect of bladder with normal wall thickness No echogenic abnormalities of kidneys, liver, gallbladder, spleen. Pancreas, abdominal LNs and adrenals not visualized Okay to relay the above information and to return to foster, CWCP since seeing improvement

5/9/2026

Progress exam History: FP reports P has been vomiting and having liquid-soft diarrhea consistently. S/O. BAR, tense and hiding in kennel. Foul smelling mousse-like fecal material from anus. Moderate dental disease present. Pink and moist mm. Small focal areas of redness on face, no significant scabbing present. Sedated with dexmed 0.01mg/kg + butorphanol 0.2mg/kg (0.07ml of each). Light-moderate sedation. Antagonized with atipamezole 0.05ml. RADIOGRAPHS: GI tract tract - colon is distended with moderate about of mottled appearing ingesta; stomach full of ST opacity ingesta; suspected small intestinal thickening around duodenum and mottled gas/bubble appearing ingesta throw out. No distended gas filled loops of bowel. BLOODWORK: CBC: monocytosis 0.84 sl high, otherwise all values WNL Chemistry: globulins 5.4 high, otherwise all values WNL A. Dermatitis around face - mild, pruritic; r/o allergies Chronic diarrhea Chronic vomiting Mild hyperglobulinemia No visible GI obstruction DDx for GI disease: 1. Chronic inflammatory enteropathy r/o food responsive, antibiotic responsive, steroid responsive 2. Neoplasia (i.e lymphoma) 3. Infectious r/o parasitic, bacterial less likely viral (fecal OPG in January 2026 negative) P. Administered: -Vitamin B12 0.25ml SQ once -Cerenia 0.36ml SQ, continue x 3 days -LRS 75ml SQ once *Start: -Metronidazole 15mg/kg (0.6ml) PO q12h x 7 days -Proviable 1 capsule PO q24h x 5 days *Repeat Fecal OPG - send to Idexx *House in Feline Recovery *Seek NH placement *If fecal OPG negative, or P does not respond to metronidazole, add to ARL

5/13/2026

Brief recheck, fecal sample collected today and submitted to Idexx for fecal OPG. S/O: BAR, no c/s/v/d noted - formed stool in kennel; decreased appetite today, no ocular or nasal discharge, eupneic. A/P: Chronic diarrhea + vomiting, hyporexia today; no change in plan at this time, recheck tomorrow with fecal results.

5/14/2026

Brief recheck S/O: BAR, pink moist mm at distance (hissing), no c/s/v noted - 6/7 stool in kennel; fair appetite for wet food today, no ocular or nasal discharge, eupneic. A/P: Chronic intermittent diarrhea, vomiting, hyporexia persists OPG fecal NEGATIVE ADD Mirataz TD AU alternating pinna SID --> 5/16 ADD Gabapentin 100mg PO BID TFN CTM while in care, DVM recheck appetite / condition 5/15 ADDED to ARL -- seek placement outside of shelter for additional diagnostics (consider IM consult, full AUS, maldigestion profile +/- intestinal biopsies) vs corticosteroid trial (in the event of neoplasia this can make biopsies non diagnostic and certain chemotherapies less effective). Discussion re Infiltrative Bowel Disease in Cats: The small intestine is made up of layers and contains needed bacteria. It performs functions that include moving stomach contents, neutralizing acids, and adding digestive enzymes and emollients. Proper function of the small intestine depends in part on the normal thickness of all the delicate layers. Disease can add inappropriate cells into the intestinal layers, causing thickening. The thickened intestine cannot contract properly and is unable to move food along for proper digestion, causing nausea and general malaise, and cannot absorb needed nutrients, leading to weight loss and diarrhea. Ulceration and bleeding may occur as the membranes become unhealthy. Without needed nutrients, bacteria can overpower natural barriers, infiltrating the normally sterile pancreatic or bile ducts, creating inflammation, a condition called Dysbiosis. Intestinal lymphoma and inflammatory bowel disease (IBD) are two common diseases that involve infiltration and cause thickening of the small intestine. IBD and intestinal lymphoma are very difficult to differentiate from each other and usually require intestinal biopsies to tell the difference (even sometimes WITH biopsies they cannot be differentiated). Determining the cause of disease allows for the most effective treatment. Getting a diagnosis will likely involve lab work and may involve ultrasound, endoscopy, biopsy, and/or surgery. In cases where a cause cannot be found, your veterinarian may design a therapy plan that involves some kind of corticosteroid, possibly immunosuppressive medication. A special diet, probiotics, and nutritional supplements may also be suggested for your pet.

5/15/2026

P is BAR, AS3/3 today for wet food. No feces produced today. -Continue on current plan, extend proviable x 7 days -Recheck in 3 days *Seek placement out of shelter ASAP for continued care and GI workup. *If GI biopsies not performed with placement, recommend moving to steroids - not starting steroids in house now bc patient is stable and want to avoid impacting biopsy results

upon intake: she allowed staff to scan for ID, collar and pet her. She was transferred carrier to carrier.