3/3/2024

DVM Intake Exam Estimated age: 3 y per O history, exam consistent Microchip noted on Intake? Y History: O surrender, hx asthma. On terbutaline 2.5 mg: 1/4 tab PO q12 indefinitely fluticasone 44 mcg/puff: 1 puff q24. Last bloodwork in 10/2023 was unremarkable Subjective: Observed Behavior - Hissing, lunging, and striking in den. Sedated for exam Is there evidence of Cruelty? N Is there evidence of Neglect? N Is there evidence of Trauma? N Objective Sedated with butorphanol 0.2 mg/kg and dexdomitor 10 mcg/kg IM based on estimated body weight of 7 lbs. Full reversal with antisedan. BCS 4-5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Clean adult dentition H/L: NSR, NMA, increased bronchovesicular sounds, mildly increased respiratory effort, RR WNL under sedation ABD: Non painful, no masses palpated U/G: FS, scar noted when shaved MSI: Ambulatory x 4, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Externally normal Assessment Asthma Prognosis: Fair to good with management Plan: Continue terbutaline 2.5 mg: 1/4 tab PO q12 indefinitely Unable to give fluticasone inhaler in shelter due to behavior- consider restarting if tolerance of medical handling improves Monitor in medical Brief recheck in 24-48 hrs, consider starting gabapentin if eating well Seek adoption or rescue placement- asthma is a lifelong condition that can be managed but not cured. Lola will require medications (pills and/or inhaler) for life. She has had at least one episode of difficulty breathing that required an ER visit and may have more. A less stressful environment is likely to reduce Lola's signs. SURGERY: Already spayed

3/4/2024

Brief check - intake yesterday 3/3, hx asthma S/O: BAR, has not touched food overnight. Hissed when opened kennel. Eupneic. *Recheck appetite tomorrow 3/4, add in gabapentin if eating

3/5/2024

Brief recheck asthma S/O: QAR, spends most of time inside den Monitoring log indicates poor appetite, but ate most of wet food dish this afternoon No c/s/v/d noted No ocular or nasal discharge Eupneic A: Asthma, high FAS in shelter P: Start gabapentin 20 mg/kg PO BID for FAS Continue terbutaline BID CTM closely at BACC

3/9/2024

Progress exam History: started on gabapentin on 3/5; currently on On terbutaline 2.5 mg: 1/4 tab (20mg/kg) PO q12 indefinitely. S/O: BAR, seeking interaction at the front of the kennel, no c/s/v/d noted. Eating all of wet food today and yesterday. Normal urine and stool produced. EENT: Eyes clear, no nasal discharge noted H/L: Eupneic, normal respiratory rate/effort ABD: No obvious distention MSI: Ambulatory x 4, no notable lameness CNS: Mentation appropriate A: Feline asthma - currently stable FAS resolving P: *Continue with terbutaline and gabapentin q12h indefinitely *Continue to hold in medical for monitoring Seek placement ASAP to move to less stressful environment' will need continued/lifelong treatment and monitoring with a veterinarian

3/16/2024

Progress exam Subjective: BAR, no c/s/v/d. Purring and rolling in kennel, devours churu treats. Ate medications today in cat food Objective: Eyes: Clear bilaterally, no discharge Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with no appreciable lameness. Neuro: Appropriate mentation. Assessment: Feline asthma (currently stable) Plan: -Continue terbutaline 0.625 mg PO q12h indefinitely -Continue gabapentin 20 mg/kg PO q12h indefinitely

3/22/2024

Recheck asthma S/O: BAR, active and eating well No reported or observed asthma signs in shelter No c/s/v/d noted No ocular or nasal discharge Eupneic A: Asthma P: Unable to stock terbutaline in shelter due to cost, patient supply running low. Decrease terbutaline 0.625 mg PO SID and monitor for flare up of asthma signs CTM in medical

3/28/2024

Noted coughing this morning, panting and dyspnea this evening; began terbutaline taper 6 days ago due to inability to stock in shelter (less than one tab left as of today) S/O: QAR-BAR, open mouth breathing/panting at front of kennel Mucous membranes pink and moist No ocular or nasal discharge Tachypnea and dyspnea noted, harsh BV sounds No heart murmur, SSP A: Asthma flare up - 6 days post terbutaline taper (currently on SID dose) P: Placed in make-shift oxygen kennel (den with flow by O2) Dexamethasone 0.2 mg/kg IV once (given at approx 4:30pm) Beginning tomorrow- start prednisolone 1 mg/kg PO BID x 14 days, reassess and taper dose pending response in 10-14 days Seek placement ASAP - Feline allergic bronchitis (asthma) is lifelong condition that can be managed but not cured. Lola will require medications (pills and/or inhaler) for life. She has had episodes of difficulty breathing that have required emergency treatment, and she may have more. A less stressful environment is likely to reduce Lola's signs.

3/28/2024

Addendum 30 min post dexamethason inj, oxygen supplementation. Tachypnea improved, but still intermittent open mouth breathing and persistent moderate dyspnea. Plan: Send to emergency vet for overnight care/monitoring; likely needs bronchodilator and additional oxygen supplementation.

3/29/2024

Update from ER vet this morning: "Lola is stable overnight. We tried to take Lola out of oxygen cage this morning and she started having a mild dyspnea w/ abdominal effort. I decided to take radiographs, we saw severe diffuse bronchial pulmonary pattern with peribronchial interstitial infiltrate, these pattern of radiographic change may be due to an acute onset of severe feline asthma or alternatively an infectious bronchitis. I decided to start Lola on clavamox r/o infection. She's otherwise bright and doing well in hispital, ate small amount of her food this morning." Spoke with receptionist and Lola is stable, doing well out of oxygen, and okay to come back to BACC this morning.

3/29/2024

Recheck - returned from overnight care/monitoring at emergency hospital, started on clavamox due to concern for infectious etiology based on chest rads S/O: BAR, active at front of kennel, leaning into petting No c/s/v/d noted No ocular or nasal discharge Lung eupneic, clear A: Asthma (FAB) Dyspnea/tachypnea - resolved P: Continue clavamox (first dose given this morning around 8am) Start prednisolone as previously planned CTM closely in medical

3/30/2024

BAR at front of kennel, appetite excellent, no c/s/v/d. No tachypnea or dyspnea observed. Continue with current treatment plan, CTM on daily rounds

During intake the cat allowed all handling.