6/12/2023

DVM Intake Estimated age: 7 years Microchip noted on Intake? No History: Owner surrender Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Observed behavior: Wide eyes, crouched posture. Leaned into chin rubs and pets Evidence of cruelty seen: No Evidence of trauma seen: Minor, missing nails on forepaws Evidence of neglect seen: No Objective: P: WNL R: WNL BCS: 8/9 OP: Mucous membranes pink and moist. CRT <2. 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 spayed, scar noted, no discharge INT: Good hair coat, no areas of alopecia or pruritus, no ectoparasites or masses noted. MS: Ambulatory x4, no pain on palpation of epaxials. Missing nails with mild scabbing at digit 3 of forepaws NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Assessment: -Missing nails -Obese -Stage II dental disease Prognosis: Good Plan: -Give onsior 2 mg/kg SQ with intake, continue with tablets 6mg PO q24h x 2d until 6/14 -Recommend at home dental care, weight loss with placement Surgery: Spayed

6/20/2023

On 6/20/2023 at approximately 10:30 AM, Diamond was examined. The patient has appropriate mentation at this time (no neurological signs present) and has not exhibited any neurological signs while at BACC.

7/3/2023

S/O: BAR, no c/s/v/d noted. EENT: Eyes clear, no nasal discharge noted H/L: Eupneic, normal respiratory rate/effort CNS: Mentation appropriate A: Dental disease Obese No neurological signs P: CTM

7/11/2023

Reason for recheck: conjunctivitis noted on rounds Patient BAR and eating well. No nasal discharge or sneezing. OD: Moderate to severe mucoerous discharge. Mild-moderate chemosis. Third eyelid elevated. Difficult to visualize cornea but no obvious defects. OS: WNL A: Conjunctivitis OD Dental disease Obese P: Start gentamicin 1 drop OD q12 x 7 days Gently flush/clean away discharge q12 x 7 days Monitor closely, recheck in 7 days

7/12/2023

On 7/12/2023 at approximately 1 PM, Diamond was examined. The patient has appropriate mentation at this time (no neurological signs present) and has not exhibited any neurological signs while at BACC.

7/12/2023

Progress exam – URI signs noted on rounds, started gentamycin yesterday for conjunctivitis S/O: QAR, food appears untouched, no c/s/v/d noted. EENT: Eyes - OD severely swollen with chemosis, elevated third eyelid, moderate mucoserous discharge. OS - wnl. Very mild serous nasal discharge noted H/L: Eupneic, normal respiratory rate/effort CNS: Mentation appropriate A: URI - mild Conjunctivitis OD - severe Possible hyporexia Obese Dental disease P: Start medical feedings BID x 4 days Start fortiflora 1 packet PO SID x 7 days Start doxycycline 10 mg/kg PO SID x 10 days Switch from gentamycin to ofloxacin OD BID x 10 days Placed UTW sign and appetite log, monitor appetite closely Recheck eye in 4 days, recheck URI day 10 CTM while at BACC

7/23/2023

Returned today due to DOH incident Visual exam only due to behavior S/O: BAR, vocal and active in carrier EENT: Eyes - OD moderately swollen with chemosis and active conjunctivitis, elevated third eyelid. OS - wnl. no active nasal discharge or congestion noted. H/L: Eupneic, normal respiratory rate/effort CNS: Mentation appropriate A: Conjunctivitis OD - severe Obese Dental disease DOH hold P: DVM recheck eye in 3 days DVM recheck in 10 days to release DOH hold Start fortiflora 1 packet PO SID x 10 days Start doxycycline 10 mg/kg PO SID x 10 days Start ofloxacin OD BID x 10 days

7/26/2023

Progress exam Subjective: BAR, purring and headbutting in kennel. Does not tolerate restraint for topical eye meds. No c/s/v/d Objective: Cageside exam performed. Eyes: OD severe chemosis, elevated third eyelid Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with no appreciable lameness. Neuro: Appropriate mentation. Assessment: -Severe conjunctivitis--patient does not allow topical treatment -Obese -Dental disease -DOH hold Prognosis: Good Plan: -Give onsior 2 mg/kg SQ once, start onsior 6 mg PO q24h x 4d until 7/30 -Continue fortiflora 1 packet PO q24h until 8/2 -Continue doxycycline 10 mg/kg PO q24h until 8/2 -Not tolerating ofloxacin, okay to d/c

7/30/2023

Recheck conjunctivitis Patient BAR and eating well. Conjunctivitis markedly improved. Mild blepharospasm and periocular erythema OD. Cornea appears mildly hazy OD with no noted defects. Continue current treatment plan, recheck in 3 days

8/1/2023

On 8/1/2023 at approximately 1 PM, Diamond was examined. The patient has appropriate mentation at this time (no neurological signs present) and has not exhibited any neurological signs while at BACC.

8/2/2023

Recheck conjunctivitis - BAR, eyes comfortable with no blepharospasm or discharge, very slight corneal opacity OD - likely mild scarring. CTM while at BACC.

8/18/2023

S/O: Noted to have significant blepharospasm and chemosis in RIHGT eye during rounds with mild amount tear staining on both eyes. BAR, eating well, sneezed once while standing in front of kennel. A: URI - recurrent since 7/11 (initial intake on 6/12), localized to R eye PLAN: Will repeat treatment for URI -Start fortiflora 1 packet PO SID x 10 days (through 8/28) -Start doxycycline 10 mg/kg PO SID x 10 days (through 8/28) -will not restart topical eye meds due to temperament and difficulty with treatment noted previously *Monitor for changes, recheck in 3 days (8/20) *Prioritize for foster placement or movement towards pathway given recurrence of URI in shelter

8/20/2023

Recheck URI/conjunctivitis localized to OD S/O: BAR, eating well, no cough/sneeze noted. EENT- persistent blepharospasm and chemosis OD, mild corneal opacity lateral hemisphere, epiphora/mild tear staining and scant cream colored discharge OD; nares clear, no discharge, no cough/sneeze A: URI, mild; OD conjunctivitis, stable to worsening - recurrent since 7/11 (initial intake on 6/12), localized to R eye PLAN: - Continue Doxycycline and Fortiflora -Adjust doxycycline dosing: 5 mg/kg PO BID x 7 days (to complete 10 days total through 8/28), twice daily dosing elected to maintain adequate concentration in tear film/avoid topical eye medications; anticipate success in BID treatment due to eating well - Add gabapentin 10mg/kg PO BID x7d for pain/blepharospasm *Monitor for changes, recheck in 3 days (8/23) *Prioritize for foster placement or movement towards pathway given recurrence of URI in shelter

8/23/2023

Recheck URI/conjunctivitis localized to OD S/O: BAR, eating well, no cough/sneeze noted. EENT- improving persistent blepharospasm and chemosis OD, improving mild corneal opacity lateral hemisphere, no ocular discharge nor epiphora; nares clear, no discharge, no cough/sneeze A: URI, mild; OD conjunctivitis, improving PLAN: - Continue Doxycycline BID dosing, Gabpaentin and Fortiflora - Monitor for changes, recheck URI day 10 (8/28) *Prioritize for foster placement or movement towards pathway given recurrence of URI in shelter

8/28/2023

Recheck URI Patient BAR and eating well. No URI signs noted or reported. Mild haziness to R cornea as previously reported. Reported to have several hairballs recently; no hairball treatment currently available in shelter. A: URI- resolved P: Monitor for recurrence, consider azithromycin and/or famciclovir if signs reoccur Monitor for hairballs, order treatment if hairballs continue

upon intake: she was minimally handled and transferred carrier to carrier.