4/30/2025

DVM Intake Estimated age: 2 years Microchip noted on Intake? No History: Stray Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Observed behavior: Wide eyes, hissing, growling. Sedated for exam with 0.2 mg/kg butorphanol, 10 mcg/kg dexmedetomidine IM Evidence of cruelty seen: No Evidence of trauma seen: Not cruelty Evidence of neglect seen: No Objective: P: WNL R: WNL BCS: 5/9 OP: Mucous membranes pink and moist. No dental disease, hairline fracture of hard palate EENT: Eyes, ears clear bilaterally, no discharge noted. Mild epistaxis, abrasion on nasal planum and chin PLN: Small/soft/symmetrical/nonpainful CV: No murmurs or arrhythmias, pulses strong and synchronous. RESP: Eupneic, no crackles/wheezes. Lung sounds quiet bilaterally. Marked abdominal effort noted after sedation GI: Soft, nonpainful, no palpable masses. UG: female intact, no mammary gland tumors, 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 NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Thoracic radiographs: Severe pneumothorax, collapsed lungs. No noted fractures or luxations. Post-thoracocentesis radiographs show marked improvement. Assessment: -Hard palate fracture (highly suggestive of high rise trauma) -Collapsed lungs Prognosis: Good to fair Plan: -Thoracocentesis, pulled 90 ml air from chest cavity. Breathing improved immediately post-procedure -Applied zorbium with intake -Start onsior 2 mg/kg SQ q24h x 4d until 5/4 -Send out CBC/Chemistry -Keep in medical, monitor closely Surgery: Temporary waiver due to hard palate fracture

5/1/2025

Your newly adopted pet has a FRACTURE/HIGH RISE TRAUMA, and the staff veterinarians are issuing a TEMPORARY waiver from the spay/neuter requirements of the City of NY. Follow up care at your regular veterinarian is recommended to ensure continued treatment through to the resolution of the issue. At the time of a full recovery you may choose to have your veterinarian perform the spay/neuter surgery, or make provisions to return the pet to ACC for sterilization.

5/1/2025

recheck high rise cat S/O QAR, food untouched, allows for pets and head rubs EENT: no ocular or nasal dc HL: nma, lungs clear bilaterally MSI: amb x 4, abrasions to the muzzle Sedated for repeat rads with 0.08mL dex (0.5mg/mL) and 0.08mL torb (10mg/mL) IM- reversed with equal vol antisedan Rads: no overt rib fx, possible area where lungs are retracted over the caudodorsal lung field. BLood work: CBC: wnl CHEM: Hyperglycemia (338) Mild azotemia (38) H LEs (ALT 2739, AST 2994) TT4 wnl A. Suspected high rise trauma and hard palate fracture elevated LE's second to trauma hyperglycemia r/o trauma/stress vs open Anorexia r/o second to oral trauma P. MF of soft food Recheck tomorrow and reassess, will need zorbium re-applied on 5/4 CTM carefully, consider EHR if not improving

5/2/2025

Recheck, suspect high rise trauma; zorbium applied at intake S/O: QAR at back of den, some low growling, but overall tolerates handling for exam Not eating, no c/s/v/d noted EENT: Mild crusted ocular discharge at medial canthi OU, no nasal discharge ORAL: purple/red hairline/linear lesion along hard palate - did not attempt to palpate LUNGS: Mild tachypnea when approached in kennel and during handling MSI: Not observed ambulating (high FAS, hunched tightly), bruising to rostral face/muzzle CNS: Appropriate mentation A: Suspect high rise trauma Suspect hard palate fracture - very thin linear lesion Bruising to rostral face/muzzle Anorexia Tachypnea, history of pneumothorax Severely elevated liver values - ro trauma vs other P: Discontinue onsior SQ LRS 100 ml SID x 3 days Cerenia 1 mg/kg SQ SID x 3 days Mirataz SID x 3 days Continue medical feedings Zorbium scheduled in 2 days

5/3/2025

Brief recheck S/O: QAR at back of kennel, wide eyes and dilated pupils, tries to melt into the back of the kennel when door opened Not eating, no c/s/v/d noted EENT: No ocular or nasal discharge Oral: No discharge from mouth, bruising to rostral face/muzzle unchanged LUNGS: eupneic A: Anorexia - ro secondary to trauma/injury vs FAS High rise syndrome Suspected hard palate fracture - very thin linear lesion Bruising to rostral face/muzzle Tachypnea, history of pneumothorax Severely elevated liver values - ro trauma vs other Plan: Add entyce 2 mg/kg PO SID x 3 days Continue other treatments Seek placement ASAP CTM closely on rounds

5/4/2025

recheck high rise cat- visual only d/t temperament and to reduce FAS S/O QAR, low growling in the corner of kennel, food trays are mostly empty, no c/s/v/d appreciated or noted EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4 A. Anorexia- appears resolved aTT High rise - fx hard palate H LEs P. Zorbium reapplied recheck in 3 days- end of zorbium with repeat chemistry to see trends of liver enzymes- might need sedation CTM closely on rounds

5/7/2025

CBC/CHEM- coordinate with DVM bc likely will need full sedated recheck Feline tolerated all handling. Sedation not needed. Blood collected.

5/7/2025

Recheck suspected high rise syndrome S/O: QAR, low growl when approached, but allows handler to remove from kennel and tolerates exam and blood draw One empty food dish in kennel, no c/s/v/d noted EENT: No ocular or nasal discharge ORAL: bruising and healing superficial wounds to rostral face/mouth; linear lesion at hard palate improved and less notable LUNGS: Eupneic MSI: Not observed ambulating (high FAS), shaved areas with otherwise healthy haircoat CNS: Appropriate mentation A: Hard palate fracture/lesion - improving Hyporexia - improving High rise syndrome Bruising/wounds to rostral face/muzzle - stable Severe liver elevations P: CBC/CHEM to idexx CTM appetite and overall condition in ICU, consider moving out if continues to do well