6/11/2026

DVM Intake Exam Estimated age: 10 yr Microchip noted on Intake? negative History:owner in hospital Subjective:agency hold Observed Behavior -quiet and allows handlng however doesn't wag tail or seek attention, treat motivated Is there evidence of suspected cruelty? none Objective: BARH mm pink P = WNL R = WNL BCS 4/9 EENT: Eyes nuclear opacity, ears: left ear mild stenosis, erythema, purulent duscahrge with malodor, right ear dirty, no infection left lower eyelid mass 3 mm cnetral lid no nasal or ocular discharge noted Oral Exam:generalized moderate dental tartar PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: distended abd, no fluid wave U/G:neuter male MSI: Ambulatory x 4, chondrodysplastic limbs with overgrown nails skin free of parasites, rough haircoat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal:not performed Assessment: senior pet pot bellied appearance, roguh coat r/o Cushingoid overgrown nails otitis right ear eyelid mass, does not seem to affect globe nuclear opacity OU Prognosis:very good may need work up for possible Cushing's- AUS, organ function testing ACTH dental prophylaxis Plan: clipped a few nails ( pet became intolerant) cleaned ears, applied Simplera to left ear intake tasks

6/16/2026

Recheck, bw results S/O: QAR, eating well, urinated on bedding, no c/s/v/d noted; nuclear sclerosis OU, no ocular or nasal discharge, eupneic. CBC: Hct 37.8 (L), neutrophils 12.917 (H), monocytes 0.983 (H) CHEM: ALT 663 (H), ALP 360 (H), cholesterol 386 (H) T4: wnl UA: USG 1.016 (L), pH 5.5 (L), moderate rods 9-40/HPF A: Mild anemia - nonregenerative vs preregenerative Stress vs inflammatory leukogram Elevated LEs - ro primary vs secondary hepatopathy Low USG - ro pu/pd due to metabolic dz vs psychogenic vs other Bacteriuria without signs of inflammation, no reported urinary issues P: Consider additional diagnostics with placement - AUS, urine culture, etc CTM closely while at QACC

6/23/2026

Progress exam: CIRDC signs noted on rounds Subjective: QBAR, no C/S/V/D. Objective: EYES: Clear LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: mild mucoserous discharge MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed CIRDC PLAN: Per standing orders -Move to iso, ppe sign & monitor log placed on kennel -Start doxycycline 10mg/kg PO q24h x10days & medical feedings PO BID x5days -CTM, recheck in 3 days

6/25/2026

Abdominal Ultrasound Findings: Liver/ Gall Bladder - The liver is of subjectively normal size, and shape with a diffusely heterogenous echogenicity. No masses appreciated. The gallbladder is moderately distended with moderate sludge. The common bile duct is subjectively moderately dilated. Spleen - The spleen is of subjectively normal size, shape, and echogenicity. No masses appreciated. Gastrointestinal (includes pancreas) Gastric walls appear normal with visible rugal folds. Subjectively normal intestinal wall layering and motility. The pancreas is not visualized. Genitourinary - L kidney bilaterally has adequate corticomedullary distinction and is subjectively normal in size. No masses/cysts/calculi/infarcts appreciated. R kidney not visualized due gas shadowing of colon. Urinary bladder moderately distended with anechoic urine. No crystals, masses, or calculi appreciated. Adrenals - Not visualized Peritoneal cavity - No peritoneal free fluid appreciated. Abdominal lymph nodes not appreciated. Conclusions: Possible early cholestasis with secondary inflammatory hepatopathy (r/o intrahepatic vs extrahepatic) vs less likely steroid hepatopathy (cushings vs other) with incidental sludge vs other Recommendations: Consider full abdominal ultrasound +/- LDDST with placement +/- ursodiol administration (not available in shelter) Added to ARL - P will likely need serial AUS monitoring, medication, and diagnostics that are not available in shelter CTM closely on rounds for symptoms of cholestasis -- if P becomes clinical consider EHR

6/25/2026

P examined and started on treatment recently for CIRDC. P BARH with no overt ocular or nasal discharge, no observed c/s/v/d at time of AUS and was eating well at time of exam. CWCP for CIRDC