1/15/2025

DVM Intake Estimated age: 7 years Microchip noted on Intake? No History: Abandoned after eviction Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Observed behavior: Initially wide eyes, refusing to move. Warmed up for pets and treats, making muffins, almond shaped pupils. Will attempt to nip when petted for a long period of time. Sedated for diagnostics with 0.2 mg/kg butorphanol, 10 mcg/kg dexmedetomidine Evidence of cruelty seen: No Evidence of trauma seen: No Evidence of neglect seen: No Objective: P: WNL R: WNL BCS: 8/9 OP: Mucous membranes pink and moist. Stage II dental disease. EENT: Eyes, ears, and nares clear bilaterally, no discharge noted. PLN: Small/soft/symmetrical/nonpainful CV: No murmurs or arrhythmias, pulses strong and synchronous. RESP: Eupneic, no crackles/wheezes GI: Soft, nonpainful, no palpable masses. UG: male castrated, no discharge INT: Good hair coat, no areas of alopecia or pruritus, no ectoparasites or masses noted. MS: Ambulatory x4. Marked paresis hind limbs, able to stand but quickly returns to sternal. No loss of ROM, no palpable fractures or luxations. NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Moderate intention tremors appreciated prior to sedation Spot BG: 186 mg/dL Pelvis/abdominal radiographs: Increased opacity of urinary bladder. No evidence of pelvic OA, fractures, or luxations Assessment: -Cerebellar hypoplasia -Hind limb paresis (r/o neuropathy) -Overweight -Increased radiopacity urinary bladder (r/o grit/urolithiasis) -Stage II dental disease Prognosis: Fair Plan: -Send out CBC/Chem/UA, start urinary diet pending results -Keep in medical, monitor gait Surgery: Neutered

1/16/2025

Recheck ataxia, bw results S/O: QAR, resting sternal in the same place in kennel all day Not eating No c/s/v/d noted EENT: No ocular or nasal discharge, PLRs intact LUNGS: Eupneic, normal rate and effort MSI: Obese, ambulatory x 4 with notable ataxia - hunches low and walks back to same corner of kennel CNS: Quiet mentation, hyper-reactive to touch (twitchy) CBC: wnl CHEM: Glucose H 233 - likely stress > DM UA (cysto): blood/RBC (likely secondary to collection method) A: Ataxia Obese Quiet mentation P: Start SQ LRS 150 ml SID x 3 days Start medical feedings BID Monitor closely, if neuro signs persist and not eating consider EHR

1/16/2025

Addendum: when removing from kennel for SQF administration he begins growling, swats a few times when reaching towards him. BAR and resisting restraint. Ataxia notable throughout handling.

1/18/2025

Progress exam S/O: QAR, occasionally hissed when attempted to touch, marked intention tremors when focused on finger; resting sternal; has not eaten overnight or this AM. No c/s/v/d noted. No ocular or nasal discharge, PLRs intact. Eupneic, normal rate and effort. A: -Ataxia -Hindlimb paresis -Obese -Anorexic P: *Add to ARL due to risk of hepatic lipidosis for continued anorexia and cerebellar hypoplasia; Kriss is a special needs cat that will need continued care and vet exams *Start mirataz transdermal x 3 days *Continue medical feedings x 3 days

1/19/2025

Progress exam Subjective: QAR, no c/s/v/d. No interest in food when offered. Responds well to slow blinking, slow movement--leaned into petting today but will flinch away, wide pupils if pick up or touching below head is attempted Objective: Eyes: Clear bilaterally, no discharge Oronasal: No nasal discharge. Lungs: Eupneic Musculoskeletal: Sternal in kennel, marked intention tremors Neuro: Quiet mentation. Assessment: -Ataxia -Obese -Quiet mentation -Stage II dental disease -Anorexia Plan: -Unable to administer SQF, oral medications due to temperament. Not a good candidate for e-tube due to handling aversion. -Continue medical feeding q12h until 1/21 -Extend mirtazapine until 1/21 -High risk for hepatic lipidosis due to overconditioning, monitor closely for clinical signs

1/20/2025

Overall check, call on-call DVM if any sigs of hepatic lipidosis noted (lethargy, icterus) He is QAR Animal was not seen to be eating or dinking Once out of the kennel he solicited attention Animal showed no yellowing of skin on the pinna, sclera, or mucus membranes

1/21/2025

Recheck obese ataxic cat with anorexia S/O: QAR-BAR, excitedly leans into petting, seeks attention, rubbing against hands and litterbox Not eating, numerous untouched food dishes No c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic, normal rate and effort MSI: Significant ataxia, falls to side during petting when attempting to lean into hand, unable to ambulate in kennel - falls to side; intention tremors not noted today A: Ataxia - ro CH vs other neuropathy Anorexia Obesity Increased risk of hepatic lipidosis P: Seek placement ASAP - patient does not allow medical handling. Recommend neurology workup and supportive care if anorexia persists.

1/22/2025

Brief appetite check - BAR and leaning into petting, very slight tremoring; wet food dish partially eaten (vs spilled in bedding). CTM appetite closely, recheck scheduled tomorrow.

1/23/2025

-recheck, obese cat on ARL, hx of poor appetite S/O -excitedly leans in for petting, poor appetite noted (scores of 1's), appears to have eaten some of the medical feed (chicken) and wet food but hard to tell if appears this way b/c he's rolled in it EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4 but unable to stand in kennel, ataxic, falls to either side when leaning in for pets. A. Ataxic- no intention tremors noted today Anorexia - poor AS noted, p ate baby food readily when hand fed, appears to have difficulty reaching food d/t ataxia P. CTM in medical - disc handfeeding BID if time allowed CT seek placement- p would benefit from work up at full service vet clinic with potential neuro consultation/work up. Recheck schedule in 3 days, con't to recheck biweekly while in medical

1/26/2025

Progress exam Subjective: BAR, no c/s/v/d. Appetite and mentation markedly improved, PCS reports patient is eating well on own! Purring, almond shaped pupils, leaning into pets. Allowed all handling, seeks petting Objective: Eyes: Clear bilaterally, no discharge Oronasal: No nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with assistance, persistent paresis in hind limbs x2. Neuro: Appropriate mentation. No tremors noted on examination today Assessment: -Anorexia (resolved) -Hind limb neuropathy -Intention tremors (resolved, r/o related to HL neuropathy) -Obese Plan: -PCS reports that patient enjoys lying on floor in ICU and playing with toys while kennel is cleaned. Start supporting patient with hand/towel to encourage walking and use of hind limbs q12h -CTM in medical, seek placement for neurology consult

1/29/2025

Poor appetite reported - BAR, leaning into petting, no change to ataxia/hindlimb paresis. Food dishes spilled and buried in bedding - unable to tell if eating. Plan: Kennel cleaned, fresh food placed - monitor over the next 24 hours.