9/14/2026

DVM Intake Exam Estimated age: ~9-13 years based on dentition / condition Microchip noted on Intake? Scanned positive History: ACO, finder stated that P was outside for hours and was dragging hind legs Subjective: QAR, pale pink mildly tacky MM, CRT <2s Observed Behavior - Nervous, hissing in kennel. Used towel to remove P from kennel and P was hissing and growling. Placed on floor to witness ambulation then allowed P to run back into den, sedated in den to facilitate diagnostics Is there evidence of suspected cruelty? No Objective: P = WNL (sedated) R = WNL (sedated) BCS 6/9 MCS 2/3 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Severe staining of dentition with moderate to severe gingivitis and calculus of caudal dentition PLN: No enlargements noted H/L: (sedated) NSR, NMA, CRT < 2s, Lungs clear, eupneic, negative ITC ABD: Soft, nonpainful, no masses palpated U/G: Male neutered - no testicles in scrotum, no penile spines MSK: Prior to sedation - Ambulatory x 4 with intermittent plantigrade stance of HLs, mild dorsal muscle wasting INT: Unkempt dirty hair coat with plant material stuck in it, no masses noted, no ectoparasites seen CNS: Prior to sedation - Mentation appropriate - no signs of neurologic abnormalities Rectal: Normal externally Wood's Lamp Exam: Not performed Assessment: Muscle wasting / intermittent plantigrade stance r/o DM vs endocrinopathy vs 1ary MSK dz vs CKD vs age related vs paraneoplastic vs other Approx 6% dehydrated Mod-severe dental disease MN geriatric DSH CBC - - Mild lymphocytosis (0.6K L) r/o partial stress leukogram vs other Biochemistry - - Marginal hypernatremia (166H) with mild hypokalemia (3.1L), Na:K ratio WNL r/o GI losses vs 2ary to dehydration vs dietary vs renal vs other TT4 1.3N Prognosis: Fair Plan: P sedated with 0.1mL dexmedetomidine and 0.1mL butorphanol IM - light sedation achieved, not enough to facilitate diagnostics after 10min --> gave 0.1mL ketamine IM - moderate sedation achieved OK for appropriate intake tasks CBC/biochem/SDMA/TT4 IH GAVE LRS 100mL and vitB12 0.5mL SQ Urine collected for UA to IDEXX via cystocentesis - small bladder with normal wall thickness and hypoechoic lumen CXR / AXR / orthopedic radiographs HLs - NSF, stomach empty, very little ingesta in intestines P reversed with 0.1mL antisedan - monitored closely until sternal / ambulatory House in fel ICU for close monitoring - DVM recheck 9/15 - if doing well consider OK to move out Recc dentistry with placement SURGERY: Already altered

9/15/2026

Brief recheck S: QARH - at back of kennel, fearful but accepts cheek scratches pink moist mm no c/s/v/d reported ate ~1/2 tube of churu but did not touch meals offered O: EENT: No ocular or nasal discharge, corneas clear LUNG: Eupneic at distance MSK: Ambulatory x4, mild muscle wasting as prior INT: Healthy haircoat at distance CNS: Appropriate mentation A/P: Hyporexia r/o stress vs 1ary GI vs other ADD Medical feedings BID x3d UA not sent out last night due to time of day, submitted this AM - check for results 9/16 DVM brief recheck hyporexia 9/16

9/16/2026

Recheck senior cat S/O: QAR at back of kennel, tense, does not warm, but allows handling and exam; did not eat overnight and not eating throughout the day, no c/s/v/d noted EENT: No ocular or nasal discharge ORAL: mm pink and moist, moderate tartar visible LUNGS: Eupneic MSI: Amb x 4, tight/hunched posture, walks/attempts to flee low to the ground, difficult to assess for lameness; dorsal muscle wasting appreciated CNS: Appropriate mentation A: Senior cat Anorexia vs hyporexia Dental disease DMW - ro sarcopenia vs underlying dz P: Urine never submitted, obtained new sample today via cysto - submit for UA SQ LRS 100 ml once Cerenia 1 mg/kg SQ once Midazolam 0.2 mg/kg IM once Continue medical feedings and CTM on rounds Recheck appetite and UA results tomorrow

9/16/2026

Ate very well shortly after receiving treatments earlier in the afternoon!

9/17/2026

DVM Progress Exam UA Review / Appetite Recheck S/O: -QAR; eating some today, appetite score 2/3, prefers high value. -Ate very well following supportive treatments yesterday. -UA (cysto): USG 1.047, pH 6.5, 2+ protein, trace ketones, 1+ blood, 1+ bilirubin; 10-15 RBC/HPF, 0-2 WBC/HPF, no bacteria, casts or crystals. A: -Hyporexia - improving -Dorsal muscle wasting/sarcopenia -Moderate-severe dental disease -Geriatric cat -UA without evidence of UTI; concentrated urine -Hematuria secondary to cystocentesis vs other -Trace ketonuria with negative glucosuria is nonspecific P: -Extend Medical Feedings BID x2 additional days, through 9/20. -Recheck, including appetite, on 9/19. -Recommend dentistry and repeat/routine geriatric lab work after placement. -CTM while at QACC.

9/19/2026

Appetite recheck, poor appetite reported yesterday S/O: QAR, food uneaten overnight, initially not interested in food, but within 5 minutes of midazolam injection he was at food dish eating, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Amb x 4 CNS: Appropriate mentation A: Hyporexia/intermittent anorexia Senior cat Dental disease DMW - ro sarcopenia vs underlying dz P: Appetite improved within minutes of receiving midazolam injection (unlikely to have taken effect that quickly) Continue medical feedings and CTM appetite closely on rounds

9/20/2026

recheck geriatric cat, hx of anorexic, severe dental dz, diffuse muscle wasting S/O BAR, hiding in the back of the kennel, feline behavior reports took HVTs, noted to have fair-poor appetite, food trays untouched EENT: no ocular or nasal dc HL: eupneic MSI: diffuse muscle wasting, good skin turgor A. Hyporexia r/o FAS vs severe dental dz Severe dental dz Geriatric P. FB able to coax p to eat some HVTs midaz 0.2mg/kg IM once (0.2mL) recheck in 2 days seek placement -p is geriatric, severe dental dz, hyporexic so far in care

9/22/2026

DVM Progress Exam, Brief -P remains hyporexic; showing some preference for freeze dried treats -Today's weight: 10.25 lbs -Appears to have a slight weight-bearing limp of RHL -Gave Simbadol 0.62 ml SQ once to assess for positive response to treatment for pain -Recheck tomorrow

9/23/2026

DVM Progress Exam, Brief -Initially, P ate some HVT only with Feline Behavior food trials. -5:30 pm gave 0.2 ml Midazolam IM. -Then, P readily ate significant amount of both wet and dry food. -P BAR, soliciting attention and affection. -Recheck tomorrow for pathway and longer-term plan for hyporexia.

9/24/2026

Recheck intermittent appetite - seems to eat HV foods consistently, gained small amt of weight in past 2 days, overall down 8oz from intake; report that he vomited regular food yesterday S/O: QAR-BAR, eagerly leans into pets in kennel, but FAS increased outside of kennel - darting eyes, mild attempts to escape. Eating HV foods offered by feline behavior team, does not seem to eat regular food. MSI: Amb x 4, gait not assessed today; dorsal muscle wasting CNS: Appropriate mentation A: Hyporexia vs picky eater Vomited once Muscle atrophy - ro sarcopenia vs underlying disease Dental disease Senior cat P: Weight is stable (actually increased 2oz from a couple days ago) Restart medical feedings and hold off on other treatments Recheck and reweigh in 2 days

9/27/2026

Brief appetite recheck: P is very BAR, leaning into head rubs and pets intensely, very friendly. No ocular or nasal discharge, no c/s/v/d. Eupneic. AS 1-2/3 yesterday and overnight. Did not eat this AM. Administered today: -LRS 100ml + Cerenia 0.4ml SQ once (P did not tolerate this well and will require towel restraint if further supportive care given) *Extend medical feedings until 9/30 *Recheck appetite and weight tomorrow: -if not eating well or weight loss present, recommend adding to ARL -if eating and gaining, move up to Adoptions *Seek placement out of shelter ASAP to meet medical and behavioral needs

9/27/2026

Senior cat, anorexia, recheck weight weight today: 10.2 (slight decrease) S/O BAR, leans into pets, food and med feed untouched, will eat liver treats in pharmacy EENT: no ocular or nasal dc HL eupneic MSI: amb x 4, good skin tent A. Hyporexia r/o inappetence/finicky eat- only small flux in weight Geriatric Dental dz P. Mixed tiki with some of the HVTs (liver treats) and offered by hand- p took a few licks and had some liver treats Given p a double in ICU to assess if that helps with hyporexia/inappetence brief appetite recheck tomorrow - if still not eating with housing changes, consider adding to ARL

9/28/2026

recheck appetite- p now has double, any improvements? S/O BAR, food appears mostly undisturbed, no c/s/v/d appreciated or noted, formed stool in LB, p noted to be walking into double and standing at front of the kennel EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4 In house BW: CBC: nsf CHEM: BG 72 r/o hemolysis BUN L (15) r/o muscle loss GGT H (5) r/o spurious A. Anorexia vs hyporexia persists (p ate some tuna post midaz admin) Geriatric Dental dz P. Given midaz 0.2mL IM (0.2mL) start mirataz topical SID x 3 days Seek placement- p continues to have persistent hyporexia and fluxating weight in care. recheck in 2 days