8/10/2025

Stray cat with URI and wound on right ischium transferred from ER today. Felv/Fiv negative/negative at ER and image attached PCV 30% slightly low BG 113 WNL Treatment Clavamox Capstar

8/10/2025

DVM Intake Exam Estimated age:2 to 4 years Microchip noted on Intake? Scanned negative History: Transfer from ER. Good samaritan found cat injured in alley way and brought him to ER. Pet diagnosed with URI and wound. Subjective: BAR Observed Behavior - Ate food readily when offered. Soft body for exam but repeatedly attempted to flee for tasks. Is there evidence of Cruelty? No Is there evidence of Neglect? No Is there evidence of Trauma? Yes Objective P = 160 R = WNL BCS 4/9 EENT: Mild blepharospasm OS. Green mucoid nasal discharge. Black debris AU. Stertorous breathing. Oral Exam: Tacky, pale pink mm. Clean adult teeth. PLN: No enlargements noted H/L: NMA, CRT < 2, increased upper airway noise ABD: Non painful, no masses palpated U/G: Male neutered. No testicles palpable in scrotum MSI: Wounds on both sides of tail base. Hemorrhagic crust over few mm wound on left and 15 mm ulcerated lesion with grey discharge on right of tail base. Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: WNL externally Assessment Ulcerated wound near right gluteal may need debridement. Pet would not tolerate flushing of wound. URI moderate ear mites Underweight Prognosis: Fair to good Plan: Clavamox 62.5mg/ml 1 ml po bid x 7 days Removed IVC and e-collar SURGERY: Already neutered

8/11/2025

did not see obvious barb P) consider sedation and rechecking when feeling better

8/13/2025

SO: In medical isolation on treatment for moderate URI and wound BAR, meowing and soliciting attention, did not eat overnight, but starts eating with very good appetite when offered wet food eent: eyes clear, yellow mucoid nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4, small wound on skin over R lateral hip appears CDI with formed scab neuro: mentation alert and appropriate A: wound-healing URI-moderate P: continue current treatment plan and monitor appetite

8/14/2025

SO: In medical isolation on treatment for moderate URI BAR, comes to kennel door seeking attention. Allows all handling while eating wet food eent: eyes clear, heavy yellow mucoid nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated, marked congestion msi: ambulatory x4, wound clean and dry neuro: mentation alert and appropriate A: URI-moderate P: changing antibiotic course to doxycycline to possibly give different spectrum of activity for URI 0.8ml doxycycline 50mg/ml PO SID x7d nebulize 15 minutes SID x5d cerenia 4mg PO SID x4d

8/15/2025

SO: In medical isolation on treatment for moderate URI BAR, comes to kennel door seeking attention. Allows all handling eent: eyes clear, heavy yellow mucoid nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated, marked congestion msi: ambulatory x4, wound clean and dry neuro: mentation alert and appropriate A: URI-moderate P: reported to have vomited immediately after doxycycline this am 100ml LRS sc SID x3d cerenia 0.4ml sc SID x3d

8/18/2025

Hx: moderate URI S: BAR and meowing at front of kennel, all food bowls eaten. O: EENT: Eyes clear, clear to yellow nasal discharge noted H/L: Eupneic, but sneezing MSI: Ambulatory x 4, healthy hair coat CNS: Mentation appropriate/alert A: URI- moderate Eating P: CWCT, meds end 8/20

8/20/2025

Recheck URI S: BAR, rubbing on kennel bars. Ate well o/n. O: EENT: Eyes clear, yellow tinged nasal discharge noted H/L: Eupneic, but mild wet audible congestion MSI: Ambulatory x 4, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities A: URI, slow to resolve Eating P: Extend meds 3 more days then recheck

8/21/2025

Ate well o/n. BAR and comes to kennel door sneezing with wet audible congestion P: Move to Cat ISO Recheck after med extension

8/23/2025

Recheck URI S: BAR, at front of kennel + eating wet food, moderate wet audible congestion O: EENT: Epiphora OU, dried yellow nasal discharge noted H/L: Eupneic but wet audible congestion MSI: Ambulatory x 4, healthy haircoat CNS: Mentation appropriate/alert A: URI, moderate Eating P: Zorbium for appropriate weight Nebulizations SID x3d Monitor appetite Recheck in 3 days

8/26/2025

Hx: has had URI Q-BAR H eating eent- no nasal or ocular discharge; no sneezing msi- amb x 4 A) No URI-like signs P) Move out of ISO Placement/homing

8/29/2025

FP emailed: - Photos and videos uploaded to vet docs. - Very affectionate, FP describing him as a "velcro cat". - Pet eating well, Swallowing/gulping when eating - Congested, some trouble breathing due to congestion - Sneezing, 5 in a row - Nasal discharge flowing thick yellow and clear watery - FP doing steamy room treatments, which help with congestion and discharge. - No eye discharge, but blepharospasm OS. FP clearing away discharge PRN. I replied: Continue URI supportive care. Okay to disp/start Fortiflora x7 days. Per VET 991438: The swallowing/gulping is probably related to the URI, he sounds so congested! As long as he is eating well and otherwise doing okay, I think we can hold off on other meds for now. Per VET 992172: "Poor Leonard arrived from [Offsite Vet] with these URI signs and continued to have them at MACC. A thorough oral exam has not been performed, so a polyp cannot be completely ruled out. I advise FP continue with supportive care as they've been doing and have them schedule Leonard for a sedated oral exam in the coming weeks. This also could be a chronic rhinitis case, so we could also collect respiratory swabs at that time as well to check out what pathogens may be present."

9/5/2025

History: In foster, has had persistent upper respiratory signs Subjective: BAR Observed Behavior - Allows all handling, but fidgets for exam Objective T = P =wnl R =wnl BCS 5/9 EENT: Eyes clear, ears AU brown waxy dc, scant yellow nasal discharge noted Oral Exam: adult dentition with moderate tartar and linear gingivitis PLN: No enlargements noted H/L: NR, NMA, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: MN MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: normal external Wood's Lamp Exam: not performed Assessment chronic upper respiratory signs-r/o inflammatory polyp v other Prognosis: good Plan: sedated for oral exam using 0.1ml dexmedetomidine 500mcg/ml, 0.1ml ketamine 100mg/ml, and 0.1ml butorphanol 10mg/ml IM On oral exam, large polyp immediately apparent endotracheal tube introduced and anesthesia deepened on 2% iso and oxygen polyp removed with gentle traction and twisting removed large polyp (photo in vet documents) removed blood clots from back of mouth and ensured bleeding stopped removed moderate amount of yellow mucoid dc from oropharynx 0.4ml cerenia sc once 0.1ml antisedan IM uneventful recovery

9/10/2025

FP emailed update with lots of adorable photos and videos. Pet breathing clearly, no congestion, eating well, active, sleeping better.

9/30/2025

FP emailed: Videos and photos uploaded to vet docs. Pet doing well. Hairloss an skin issues on hind end getting worse. Advised appt to r/o ringworm. Poss allergies vs other?

10/3/2025

History: In foster, respiratory issues resolved since polyp removal and has been eating with a good appetite. Gagging and vomiting resolved. Foster has noticed increased hair loss at tail base. Has noticed Leonard turning around suddenly to lick and nibble at area. Otherwise behaving as normal Subjective: BAR Observed Behavior - Wiggly, but allows all handling Objective T = P =wnl R =wnl BCS 6/9 EENT: Eyes clear, ears AU mild waxy dc, no nasal or ocular discharge noted H/L: eupneic ABD: Non painful, no masses palpated U/G: MN MSI: Ambulatory x 4, skin free of parasites, no masses noted, ring of hair loss around tail base CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: normal external, anal glands empty Wood's Lamp Exam: negative Assessment overgrooming/alopecia at tail base Prognosis: good Plan: intake tasks updated recommended to use e-collar, but foster declines pluck for ringworm PCR to lab If ringworm PCR negative consider gabapentin trial for unidentified pain around tail base +/- radiographs of pelvis/tail base consider diet change to hydrolyzed protein diet

11/15/2025

History: Foster has reported coughing and and some sneezing along with whistling while breathing No nasal dc. Eating with very good appetite. pHx of very large inflammatory polyp removal Subjective: BAR Observed Behavior - Tense, but allows all handling for exam Evidence of Cruelty seen -no Evidence of Neglect seen-no Evidence of Trauma seen -no Objective T = P =wnl R =wnl BCS 7/9 EENT: Eyes clear, ears AU moderate waxy dc, AS wax plug prevents visualization of TM, no nasal or ocular discharge noted Oral Exam: adult dentition with minor tartar PLN: No enlargements noted H/L: NR, NMA, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: male neutered MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: normal external Assessment coughing-r/o asthma v other overweight Prognosis: fair Plan: sedated for radiographs 0.1ml dexmedetomidine 500mcg/ml, 0.1ml ketamine 100mg/ml, 0.1ml butorphanol 10mg/ml IM provided light, but adequate sedation Three view chest rads moderate bronchial pattern no other obvious abnormalities suspicious for feline asthma Sedated exam of oropharynx no obvious polyp visualized removed majority of wax plug, but still unable to visualize TM-suspect was origin of inflammatory polyp. recommend placement, if possible, to manage asthma In mean time try to address environmental triggers like anything perfumed, dusty environment, hot dry air from radiators If worsening recheck advised overweight, should decrease calorie intake 0.1ml antisedan IM uneventful recovery

12/16/2025

Foster sent video of pet with stertorous breathing on inspiration. Foster notes decreased appetite as well. Hx large NP polyp removed in Fall 2025. A: r/o rhinitis/asthma r/o inflammatory vs infectious vs other Prednisolone trial Plan Advise placement Prednisolone 5mg 1 tablet po sid x 10 d then 1/2 tablet po sid x 10d then 1/2 tablet eod #20 Email with update in 1 week.

12/29/2025

Update from FP, re: response to Prednisolone: "I’m very pleased to hear him breathing a bit better and I think he’s responding very well to the meds!! Very good boy, he’s taking dosage in the morning, I have the calendar marked so that I can change the dosage appropriately. Thank you, I am at lunch at the moment, will send video tonight!!" Per VET 991752: Good to hear. If symptoms return, please resume the lowest effective dose.

1/12/2026

FP emailed: Videos uploaded to vet docs. Pet is struggling to breath when FP tapered down from Prednisolone 1 tab PO SID to ½ tab SID. Per VET 991752: They can continue with Prednisolone 5 mg 1 tablet by mouth once a day long term.

1/15/2026

FP: reordered from online pharmacy- prednisolone but at 20 mg tablet size (5mg size was unavailable) Prednisolone- 20 mg sig: 1/4 tab PO q 24 hrs (#15 with one refill)

1/27/2026

FP emailed: FP asking if they can try Prednisolone 5mg PO BID. Pet's symptoms are returning. Videos uploaded to vet docs. Per VET 991752: "I think the polyp may be regrowing and might be aural and nasopharyngeal. We could sedate him again for radiographs of his bulla and, if indicated, see if Bond to the Rescue or ASPCA would do a ventral bulla osteotomy. Otherwise he would need endoscopy of his nasal passages or a CT scan. They can drop Leanord off at MACC 1/27, 2/1, 2/2 or 2/3 for sedated radiographs." Reached out to FP to schedule.

2/1/2026

Age: 3 to 6 years History: Recurrent stertor. Large nasopharyngeal polyp removed fall 2025. Pet has been receiving Prednisolone 5mg po sid. Subjective: QAR, no stertor appreciated prior to sedation. Objective P = 160 R = WNL BCS 8/9 EENT: Eyes clear. AS: mild black debris with wax plug at tympnaum. After flushing ear with 1/2 ml saline and suction dry, pink nodule seen behind ruptured tympanum. No pus encountered. No nasal or ocular discharge noted Oral Exam: Thickened tissue palpable dorsal to soft palate. On retraction of palate, multilobulated pink mass seen. PLN: No enlargements noted H/L: NR, NMA, Lungs clear, increased upper airway noise heard after removal of polyp. ABD: Non painful, no masses palpated U/G: Male neutered MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: WNL externally BG 140 WNL Radiographs Thickened left bulla with increased ST density at left inner ear compared to right side. Assessment Recurrent nasopharyngeal polyp Suspect aural polyp in left inner ear Obese r/o inflammatory vs other Prognosis: Fair due to high risk of recurrence of polyp. Plan: Sedated with Dexdomitor 0.5mg/ml 0.3 ml + Butorphanol 10mg/ml 0.3 ml IM for imaging. Added Ketamine 100mg/ml 0.2 ml IM for removal of polyp. NP polyp removal Soft palate retracted with spay hook. Two approximately 10 mm diameter sections of polyp removed via twisting traction with allis tissue forceps. Small amount of tissue remained. Post-op epistaxis stopped with epinephrine soaked gauze sponges placed against roof of mouth. Dexamethasone sp 4mg/ml 0.25 ml IM Antisedan 0.1 ml IM Prednisolone 5mg 1 1/2 tablets po sid x 10d then 1 tablet po sid x 10d then 1/2 tablet sid x 10d then 1/2 tablet eod. #32 Start 2/3/26 am. Polyp sent to lab for biopsy Advise placement for left ventral bulla osteotomy

2/5/2026

Biopsy Source: PHARYNGEAL_CAVITY Biopsy Type: FRAGMENTS Clinical History: Recurrent nasopharyngeal polyp Pathology Report INTERPRETATION: Inflammatory polyp Histologic margins: Incomplete excision HISTOPATHOLOGIC DESCRIPTION: This tissue is a pedunculated mass composed of variably dense and edematous collagenous stroma overlain by respiratory epithelium that is multifocally ulcerated. The collagenous stroma contains small blood vessels and multifocal to coalescing aggregates of lymphocytes, plasma cells and neutrophils. Glands lined by respiratory epithelium and containing basophilic fluid are multifocally distributed throughout the mass. A: Inflammatory polyp with incomplete margins, likelihood of recurrence high due to incomplete excision P: CTM in foster Recommend further workup due to aural polyp noted on last exam in addition to recurrent nasopharyngeal polyp

9/21/2026

Age: 3 to 6 years History: Recurrent stertor. Large nasopharyngeal polyp removed fall 2025, was on a pred taper in Feb. Not eating as much and more lethargic Subjective: BAR, hissing, stertorous Objective P = wnl R = WNL BCS 8/9 EENT: Eyes clear, moderate dark ocular discharge, no nasal discharge noted, mandibular salivary gland thickened Oral Exam: Severely thickened tissue left palate almost occluding airway. Unable to retract palate. PLN: No enlargements noted H/L: NR, NMA, Lungs clear, increased upper airway noise ABD: Non painful, no masses palpated U/G: Male neutered MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: WNL externally Radiographs Thickened left bulla with increased ST density at left inner ear compared to right side. Assessment Recurrent nasopharyngeal polyp Large polyp partially obstructing airway Obese r/o inflammatory vs other Prognosis: Guarded to fair Plan: Sedated with Dexdomitor 0.5mg/ml 0.1 ml + Butorphanol 10mg/ml 0.3 ml IM for imaging. Added Ketamine 100mg/ml 0.2 ml IM for removal of polyp. Attempted soft palate retraction with spay hook. Polyp adhered to soft tissue and unable to retract. Polyp obstructs part of the airway Antisedan 0.1 ml IM House in medical Add to ARL Recommend advanced imaging of bulla/polyp Surgical removal and left ventral bulla osteotomy