11/9/2024

DVM Intake Exam Estimated age: 6-8yrs Is this an orphan kitten? no Is the kitten eating on own? n/a Is the kitten suckling? n/a Microchip noted on Intake? negative History: stray apartment; marked as priority for blood on chest/legs Subjective: Cat is BAR Observed Behavior - hissing, growling and lunging in feral den, sedated with Telazol (100mg/ml): 0.3ml IM once, which provided adequate sedation for exam and intake tasks Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective T = N/A P = N/A R = eupneic BCS 9/9 EENT: Eyes clear, ears debris AD, no nasal or ocular discharge noted Oral Exam: Mild-moderate dental dz; missing 204 (bloody socket) PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: Female spayed, spay scar visualized MSI: Ambulatory x 4, skin free of parasites, no masses noted, hair coat unkempt hind end (feces and/or urine) CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: NE Wood's Lamp Exam: NE Assessment Approx 6-8yr old spayed female DSH Morbidly obese Dental dz Missing 204 (suspect source of blood) Unkempt hind end r/o constipation vs diarrhea Otitis externa, AD Prognosis: Guarded Plan: Completed intake tasks Cleaned AD Nail trim 2-view abdominal rads reveal ingesta in stomach and gas filled colon Monitor for V/D Recommend weight loss SURGERY: Already spayed

11/15/2024

Progress exam: Inappetence noted on rounds board Subjective: QBAR, no C/S/V/D Objective: EYES: Clear, no discharge LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: no discharge noted MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed inappetence PLAN: Per standing orders -Start medical feedings PO q12h x5days -Recheck on 11/18

11/19/2024

Monitor appetite - BAR, growling in den, noted that she ate some of her med feeding overnight on 11/18 and 11/19. Food in kennel right now is uneaten, no c/s/d/v noted, eupneic. A: Hyporexia in shelter - suspect FAS Obese Dental disease Otitis P: Extend medical feedings and CTM closely Consider gabapentin if appetite stabilizes

11/22/2024

S: on going inappetence noted BAR in kennel, low growling in den. No c/s/v/d appreciated, appears to have eaten a small part of MF but other food dishes in kennel appear untouched EENT: no ocular or nasal dc H/L: eupneic A/P -Hyporexia persists -Extending MF x 5 days, appetite isn't stable enough for gaba. CTM, suspect second to FAS. P has privacy curtain up and some interest in MF now. -Recheck in 3 days, if still not eating, consider sedated exam +/- BW. P is at risk for hepatic lipidosis d/t obesity and ongoing anorexia

11/26/2024

Progress exam – check appetite, URI signs noted on rounds S/O: QAR in den, peeks head out when approached, recent appetite scores 3, but ACS in room reports that she eats small amounts from med feeding when placed at back of kennel. No c/s/v/d noted. EENT: Eyes clear, mild serous nasal discharge noted H/L: Eupneic, normal respiratory rate/effort CNS: Mentation appropriate A: URI - mild Hyporexia - ro FAS vs URI P: Extend medical feedings, made note to place at back of kennel Monitor closely in place, placed UTW sign and appetite log Recheck in 10 days +/- doxy and move to iso if URI progressing CTM while at QACC

11/29/2024

Brief URI recheck, day 3 S/O: QAR in den Food in kennel appears untouched, but notes on monitoring sheet indicate she eats small amounts of med feeding when placed at back of kennel No active nasal or ocular discharge No c/s/v/d noted Eupneic A: URI - no active signs noted today Hyporexia Obese Dental disease P: Extend medical feedings Scheduled reweigh to evaluate if there has been significant weight loss secondary to reported hyporexia CTM and recheck as scheduled

11/30/2024

Progress Exam, reweigh today S/O: QAR inside den Multiple food trays, appear mostly untouched (possibly ate some med feeding, but very little if so) No c/s/v/d noted Congestion audible No active nasal or ocular discharge Dirty and malodorous when removed from den, unclear if she can fit out portal door (has always been in den when I have observed her) Reweigh today, lost 3 lbs in 3 weeks A: Significant weight loss Prolonged anorexia vs hyporexia Obesity and increased risk of HL URI - mild Dental disease Otitis P: Move to med ISO for closer monitoring, use kennel cover instead of den Continue medical feedings Start SQ LRS 150 ml SID x 3 days Start cerenia 1 mg/kg SQ SID x 3 days Start mirataz SID x 3 days Monitor closely Seek placement for more aggressive supportive care and treatment

12/1/2024

CBC/CHEM/T4 in house done. Results uploaded

12/1/2024

Brief recheck of patient - no v/d/c/s noted today. Patient appears to have eating about 1/2 of her wet food today. In-house bloodwork performed: CBC: RDW: 28.1 (H) Chemistry: Glob: 5.5 (H) Alp: 127 (H) A: 1) Mild hyperglobulinemia: r/o dehydration, inflammation (secondary to dental disease vs other), neoplasia. 2) Mild elevation in ALP: r/o pancreatitis, biliary disease, hepatic lipidosis, vs other. P: 1) Continue medical feedings, SQ LRS (150 ml SID, 11/30-12/3), cerenia (1 mg/kg SQ SID, 11/30-12/3), mirataz (SID 11/29-12/3) 2) Continue to monitor closely. 3) Recheck 12/3 to decide if we need to extend supportive care/seek additional treatments including esophageal feeding tube placement/radiographs/afast. This cat is unhappy to be handled so a feeding tube may not be a viable option for this patient. 4)Seek placement for more aggressive supportive care and treatment

12/3/2024

Progress exam: URI recheck Subjective: BAR, no C/S/V/D. Eating well, ate tuna & wet food. Objective: EYES: Clear, no discharge LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: no discharge present MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed URI PLAN: Per standing orders -CTM, recheck on 12/6

During intakes the cat was hissing and swatting, minimum handling was done.