4/23/2025

DVM Intake Estimated age: 15-17 years Microchip noted on Intake? No History: Stray Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Observed behavior: Alert, active, headbutting, taking treats eagerly. Allowed all handling Evidence of cruelty seen: No Evidence of trauma seen: no Evidence of neglect seen: No Objective: P: WNL R: WNL BCS: 2/9 OP: Mucous membranes pink and moist. Stage IV 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. Marked abdominal distension with possible fluid wave palpated, no discrete masses palpated. UG: female spayed, tattoo noted, no mammary gland tumors, no discharge INT: Rough hair coat, no areas of alopecia or pruritus, no ectoparasites or masses noted. MS: Ambulatory x4, no pain on palpation of epaxials. Moderate dorsal muscle wasting NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. CBC: Mild leukocytosis 20.6 (2.87-17.02 K/uL) Mild-moderate neutrophilia 17.83 (2.3-10.29 K/uL) Mild monocytosis 1.1 (.05-0.67 K/uL) Chemistry: Marked hyperglycemia 531 (71-159 mg/dL) Mild hyperproteinemia 9.6 (5.7-8.9 g/dL) Mild hyperglobulinemia 6.8 (2.8-5.1 g/dL) T4: WNL Assessment: -Severe abdominal distension -Diabetes mellitus Prognosis: Guarded Plan: -CBC/Chemistry -Scheduled for radiographs +/- AUS -Keep in medical, monitor closely Surgery: Spayed

4/24/2025

Two view abdomen +/- US, ask DVM for protocol ///Done

4/24/2025

Recheck and abdominal rads S/O: BAR at front of kennel, eating well, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic ABD: Notably pendulous abdomen + distention, feces in colon is soft/normal, some gas pockets palpable in cranial-mid abdomen, no obvious masses, abdomen doughy MSI: Dull/unkempt haircoat, dorsal muscle wasting 2VAXR - large amount of stool in colon, notable gas pattern/pocket in GIT (appears to be LI), circular margins of stomach notable prominently at left cranial abdomen (displaced by mass effect vs enlarged liver?), oblong soft tissue mass visible on lateral projections just caudal to liver and ventral to stomach (ro mass vs part of stomach/GIT vs other) 2VTXR - increased opacity appreciated along ventral thorax (ro fat deposits secondary to obesity vs disease process), bronchial pattern consistent with aging changes (geriatric cat) Spot BG 370 A: Diabetes mellitus Suspect abdominal mass Abdominal distention, pendulous abdomen - ro abdominal mass +/- HAC vs other Geriatric Dental disease Unkempt haircoat P: Rad consult Pending rad consult and prognosis, start insulin Seek placement ASAP - geriatric cat with diabetes and abdominal distention

4/25/2025

Progress exam for geriatric cat with DM S/O BAR. comes to the front, solicits attn, eating well, purring, head butting EENT: no ocular or nasal dc HL: eupneic GA/GU: distended pendulous abdomen, FS green linear tattoo MSI: amb x 4, good skin turgor spot BG: 326 A. Cranial abdomen organomegaly DM - lower BG today than intake P. Start on insulin 1 unit BID indef Start on daily BG monitoring Feed DM only Seek placement- see radiograph review

4/25/2025

Radiograph consult results: 1. Hepatomegaly. Differential includes metabolic hepatopathy/hepatic lipidosis e.g. related to the suspected diabetes mellitus. Other differentials include hepatitis or diffuse neoplastic infiltration, e.g. round cell neoplasia. 2. The soft tissue opacity caudal to the liver and costal arc likely represents the pylorus, filled with ingesta. A true soft tissue mass lesion of the pylorus or liver is considered unlikely. The position of the stomach in the left cranial abdomen is physiologic in cats although mild displacement secondary to the hepatomegaly is not entirely excluded. The gastric content likely normal ingesta foreign material is unlikely in the absence of vomiting. 3. Mild generalized cardiomegaly. In older feline patients, a cardiomyopathy is the most common cause, although other cardiac disease cannot be excluded. There is no evidence of a congestive heart failure. 4. Mild generalized bronchopulmonary pattern. This could represent an age-related finding. Other differential diagnoses include inflammatory airway disease such as feline asthma, allergic bronchitis or less likely infectious bronchitis or inhaled irritation. A. No overt masses seen Hepatomegaly P. Con't with treatments as written Seek placement asap, p is geriatric with multiple comorbidities Recheck in 2 days

4/27/2025

recheck DM geriatric S/O BAR, A+A, food tray empty, no c/s/v/d appreciated EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4 A. DM, BG today 271, given 1 unit of prozinc P. Con't on BGs and insulin, con't to offer DM food. Recheck in 3 days, con't to see placement

4/30/2025

Progress exam S/O: No c/s/v/d. Eating wet DM food consistently well. BAR, sweet lady leaning into head rubs and pets. Pink mm, crt<2secs, euhydrated. Abdomen soft non-painful, enlarged cranial abdomen as previously palpated. No ocular or nasal discharge. BG readings (AM, PM; followed by 1U prozinc): 4/25: 326, 313 4/26: 322, 266 4/27: 271, 294 4/28: 366, 292 4/29: 321, 325 4/30: 284 A: Diabetes mellitus, stable with 1U ProZinc (maintained under <330) Hepatomegaly Mild generalized cardiomegaly - no current clinical signs associated with CHF Geriatric Dental disease P: Ok to continue with 1U Prozinc Continue with twice daily BG checks while in shelter x another 2 days, then move to once daily PM checks *Keep on ARL

Upon intake no handling was done, cat was taken straight to medical.