5/9/2022

[DVM Intake] DVM Intake Exam Estimated age: 5 years old Microchip noted on Intake? none detected. History: Subjective: Observed Behavior - very friendly and tail wagging when first greeted. Tolerated physical exam well, however became fidgety during medical restraint and blood draw. Evidence of Cruelty seen - none Evidence of Trauma seen - none Objective P = 100 R = panting BCS 3/9 EENT: Eyes clear, mod brown ceruminous discharge AS>AD, no nasal or ocular discharge noted Oral Exam: mild tartar formation but otherwise clean dentition PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: MN MSI: Ambulatory x 4, occasional kicking and slipping during exam, bilateral ulcerations noted on hind paws, healing scabbed lesion with focal alopecia on the dorsal cranial aspect of the tail, scabbed lesion noted on the lateral canthus of the eye OS, otherwise skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment A1) Bilateral paw pad ulcers A2) Healing superficial lesions A3) Underweight A4) HW snap test POSITIVE Prognosis: Good to Excellent Plan: Convenia inj given SQ in-house chem/cbc HW test - 2/3 SNAP tested POSITIVE-- microfilaria test to be sent out today Recheck back paws in 5-7 days In-house Diagnostics: Chem- elevated TP, hyperglobulinemia CBC- monocytosis, basophilia, immature/toxic neutrophils present, likely inflammatory in origin; suspect non-regenerative anemia

5/11/2022

HWT Elisa- negative Microfilaria- negative

5/17/2022

Hx: Yesterday on rounds, pt was very quiet, lying down and not looking around even when all the other dogs in the room were standing up and barking. S: Quiet in kennel, curled up. I threw a treat at him and he raised his head but didn't get up. O: Eupnic, R 20. Soft cough. Mild seromucoid nasal discharge. A: CIRDC +/- pneumonia P: Start abx prior to rads 1. Clavamox 625 mg PO BID x10 days 2. Doxycycline 300 mg PO SID x10 days 3. Proviable 1 capsule PO SID x14 days 4. Sedate for chest rads today or tomorrow, may change abx plan at that time 1088

5/17/2022

Sedated for chest rads with Dexdomitor 0.5 mg/ml 0.7 ml IM + butorphanol 0.7 ml IM. Half-reversed afterwards with 0.35 ml Antisedan IM. Chest rads - marked bronchointerstitial pattern, no alveolar pattern Paw pad lesions on hind feet - small superficial healing ulcers just caudal to both metatarsal pads, no crusting or bleeding. Quiet lung sounds. Rectal temp 103.5 ASSESSMENT: 1. Mild bronchopneumonia likely, not clear radiographic signs today 2. Hind foot ulcers healing well P: 1. LRS 1 liter SQ 2. Convenia 3 ml SQ 3. Enrofloxacin 3 ml IM, continue with 272 mg PO SID x9 days starting tomorrow 4. Discontinue Clavamox and doxycycline 5. Move to med iso 6. Nebulize with saline SID x5 days 1088

5/18/2022

Hx: Bronchopneumonia S: Alert, wiggling, energetic this morning Good appetite O: BAR-H, MMs pink and moist, CRT <2 sec T 100.9 EENT: No discharge OU, AU, nose. H/L: NSR, NMA. Eupnic, quiet lung sounds. Coughing. Abd: Soft, no pain on palpation, no masses palpated M/S/I: Amb x4. No skin lesions noted. Neuro: Alert and appropriate, no sign neurological deficiencies A: CIRDC, mild bronchopneumonia, doing well on tx P: CTM in med iso for additional day, move out tomorrow if still doing well 1088

5/19/2022

QAR in cage, ate all of food readily EEN: No ocular or nasal discharge. RESP: Eupeneic A: Pet is brighter and eating. Prognosis: Good P: Move out of medical isolation

5/20/2022

BAR, walked well outside. Ate all of food. EEN: No ocular or nasal discharge. Coughing during rounds. CV/RESP: HR 130 SSP RR 32 RE WNL No crackles or wheezes heard MSI: BCS 3-4/9 Ambul x 4 NEURO: BAR A: Good energy and appetite Plan Move out of medical isolation

5/22/2022

Reported to vomit once today and not interested in breakfast this morning, ate medication in a sausage. Currently being treated for CIRDC given convenia inj and on enrofloxacin. No diarrhea noted. S. BAR, allowed all medical handling O. T 103.0F, HR 88, RR 48, Weight 56.2 EENT: clear OU, no ocular discharge, no nasal discharge, + tracheal cough H/L: no murmur or arrhythmia, pulse S+S, lungs clear, no crackles and wheezes Abd: soft, non painful, no organomegaly or masses appreciated on palpation Neuro: alert and ambulatory A. CIRDC mild pyrexia one episode of vomiting decreased appetite weight loss (60lb on intake, currently 56.2lbs) P. continue current meds add on cerenia 1mg/kg (2.6ml SQ once) recheck tomorrow

5/23/2022

Hx: has had pneumonia; has not been responsive to antibiotic therapy; not eating well; nasal congestion; has had a HWT-(+) but subsequent testing has been normal QAR H-DH eent- nasal discharge pln- wnl hl- 100hr reg; no crackles and- relaxed msi- muscle wasting neuro- nsf A) pneumonia that has been unresponsive to current treatments P) Repeat radiographs: bilateral aveolar pattern IV fluids- 500ml bolus then 50 ml/hr nebulize coupage

5/25/2022

Hx: has had pneumonia; has not been responsive to antibiotic therapy; not eating well; nasal congestion; has had a HWT-(+) but subsequent testing has been normal; has had episode of hindlimb abnormal gait QAR H pink eent- marked bilateral mucoid nasal discharge pln- wnl hl- 100hr reg; referred upper airway sounds and- relaxed msi- muscle wasting; amb x 4 (hind gait appears normal on presentation) neuro- nsf A) marked pneumonia poor appetite h/o hind-limb gait abnormality P) CWSC nebulization coupage IV fluids- 100ml/hr -continue oral Ab's -will take medicine if placed in food and is hand fed the food He likes to be hand fed

5/25/2022

Hx: has had pneumonia QAR H pink eent- bilateral mucoid nasal discharge (a little less on presentation) pln- wnl hl- 100hr reg; referred upper airway sounds and- relaxed msi- resting sternally; thin neuro- nsf A) marked pneumonia poor appetite h/o hind-limb gait abnormality P) CWSC hand fed his medicine in food and a bowl of food. He likes company and being hand fed

5/26/2022

Hx: In medical isolation on treatment for pneumonia. Currently on oral enrofloxacin. Has been eating when hand fed, but not otherwise. S: QAR, soft coughing seems disinterested in surroundings O: eent: mms pink and moist, eyes clear, conjunctiva inflamed, heavy yellow/gray mucoid nasal dc h/l: heart ok no murmur detected, lungs harsh abd: abd palp nad soft and non painful lns: all pln wnl int: healthy hair coat, no external parasites noted ms: muscle wastage due to weight loss neuro: mentation dull, no other neuro deficits noted A: pneumonia-unresponsive to current treatment P: continue enrofloxacin start clindamycin 300mg PO BID x7d entyce 30mg/ml 2.5ml PO SID x4d continue hand feeding start coupage BID