6/26/2026

DVM Intake Exam History: ACO impound Estimated age: Approx 5-10 years Microchip noted on Intake? Negative Subjective: BAR, no c/s/v/d noted, food in kennel uneaten Observed behavior: Hunched and tense, mild attempts to flee, allows handling with towel Is there evidence of suspected cruelty? - no Objective P = wnl R = wnl BCS = 4/9 EENT: Eyes clear, no ocular discharge, moderate mucopurulent nasal discharge noted, ears - moderate dark discharge AU Oral Exam: mm pink and moist, CRT <2; marked halitosis, stomatitis, tartar, gingivitis, gingival recession - stage IV ddz PLN: No enlargements noted H/L: NMA, SSP; audible congestion - lungs otherwise clear ABD: Non painful, no masses palpated U/G: Male neutered MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Externally normal Assessment: Stomatitis and severe dental disease Mild underweight URI Prognosis: Fair Plan: CBC/CHEM/T4 to Idexx Ears cleaned, selamectin applied Start medical feedings BID Start doxycycline 10 mg/kg PO SID x 10 days Vitamin B12 0.25 ml SQ once Recheck with bw results tomorrow Recheck URI day 10

6/27/2026

Recheck and bw results S/O: QAR, ate some wet food, no c/s/v/d noted EENT: No ocular discharge, mild mucoserous nasal discharge LUNGS: Eupneic CNS: Appropriate mentation CBC: WBC 21.2 (H), neutrophils 17.744 (H), monocytes 0.636 (H), eosinophils 0.191 (L), platelets 459 (H) CHEM: BUN 11 (L), sodium 145 (L), chloride 106 (L) T4: wnl UA: USG 1.016 (L) A: Low USG - ro UTI vs open Leukocytosis, neutrophilia, monocytosis - ro infection vs inflammation vs neoplasia vs other Stomatitis, severe dental disease Mild underweight URI P: Added in urine culture to ro UTI Continue doxycycline and recheck as scheduled CTM on rounds

6/30/2026

Recheck, urine culture results S/O: QAR, curled at back of kennel, attempts to hide when approached, but allows touch; eating well, no c/s/v/d noted EENT: No ocular or nasal discharge ORAL: mm pink and moist, ddz as previous LUNGS: Eupneic MSI: Healthy haircoat CNS: Appropriate mentation Urine culture: no growth A: URI - no signs notable today Severe dental disease Low USG - open Leukocytosis, neutrophilia, monocytosis - ro infection/inflammation (ddz) vs neoplasia vs other Mild underweight P: No further diagnostics, patient stable/improving Recommend dental procedure Consider recheck USG on first morning urine CTM while at QACC

7/2/2026

Recheck URI, appetite, low USG S/O: QAR, at back of kennel, tense and growls for some handling, but able to examine/perform tasks with towel restraint; ate well overnight EENT: No ocular or nasal discharge; no congestion appreciated LUNGS: Eupneic CNS: Appropriate mentation USG, in house (calibrated and used mutliple refractometers to confirm): >1.050 A: Low USG - resolved Severe dental disease URI - appears resolved Leukocytosis, neutrophilia, monocytosis - ro infection/inflammation (ddz) vs neoplasia vs other Mild underweight P: Move to adoptions, recheck in a few days to ensure URI fully resolved Continue doxycycline for full course Recommend dental procedure with placement CTM while at QACC

7/6/2026

Progress exam: URI recheck Subjective: BAR, no C/S/V/D. AS:2/3 ate medications & majority of wet food. Objective: EYES: Clear LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: no discharge MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed URI appears resolved PLAN: Per standing orders -Move out of iso, signage placed -CTM on daily rounds while in QACC

7/24/2026

Start gabapentin 100 mg PO BID for FAS in shelter

7/31/2026

Pre-Op Exam, lost ~7 oz in shelter S/O: BAR, no c/s/v/d noted EENT: No ocular or nasal discharge noted ORAL: mm pink and moist, mod tartar/calculus and gingivitis, purulent discharge from 404 Lungs: Eupneic, normal respiratory rate/effort ABD: NMP MSI: Healthy haircoat, very mild underweight/DMW CNS: Mentation appropriate CBC: WBC 17.20 (H), neutrophils 14.87 (H), monocytes 0.74 (H), platelets 130 (L) *plt aggregates detected CHEM/T4: wnl USG: >1.050 A: Periodontal disease, tooth root infection Mild underweight P: Dental with rads/extractions today SURGERY: Okay for surgery

7/31/2026

DENTAL Dental procedure performed due to periodontal disease: -Full mouth rads: resorption noted at 309 & 409; lg area of lucency at rostral root of 307 -Deep pocketing, alveolar bone expansion, purulent discharge at 404 -Mobile tooth with heavy calculus 109 -Missing teeth: 101, 102, 103, 201, 202, 209, 303, 403 -Extractions: 109, 307, 309, 404, 409 -Gingival flaps at 307, 309, 409, closed with 4-0 monocryl -Extraction site 404 - drilled alveolar bone in order to close with 4-0 monocryl Remaining teeth scaled and polished. Plan: Onsior 2mg/kg SQ given peri-op; zorbium applied post-op Continue onsior 6 mg PO SID x 3 days Continue gabapentin indefinitely for FAS (+ pain) Wet food diet for one week, recheck scheduled in one week

8/1/2026

1 day post dental with extractions Current analgesia: Received Onsior and Zorbium yesterday; receiving onsior daily for 3 days post dental S/O: QAR in den, P backed away when approached. Wet food trays are untouched from this AM and last night. Large dilated pupils, mild drooling with pink-tinged drool from lips. No swelling or active hemorrhage visible or on bedding. Visual exam only to reduce FAS. A: 1 day post dental, anorexia since dental P: Recheck appetite tomorrow and again as needed

8/3/2026

recheck post-dental, did not eat 1 day post-op. Currently on onsior (ends 8/3) and received zorbium 7/31. Unable to evaluate as patient was hiding and did not want to interact. Suspected to have eaten a few bites of food. P: Place monitoring sheet Rx mirtazapine transdermal SID x 3 days Recheck placed for 8/4

8/4/2026

DVM Progress Exam Brief Recheck S/O/A: -Dental procedure 7/31 -P noted to have an appetite score of 2/3 this morning -P appears BAR, comfortable, with no C/S/V/D or other concerns reported P: -CTM via routine shelter procedures and through scheduled recheck -Continue scheduled mirtazapine

8/7/2026

Recheck post-dental BAR, eating well. Patient did not tolerate an exam, so evaluated mouth while hissing at me. Visual exam does not show any discharge or swelling. P: OK to take off soft diet. OK for next steps.