12/2/2019

DVM Intake Exam Estimated age: ~ 4 years Microchip noted on Intake? No History :Brought in by agency Subjective: BARH. No csvd. Observed Behavior -Slightly nervous at first but warms up quickly with interaction. Allowed all handling Evidence of Cruelty seen - no Evidence of Trauma seen - no Objective T = 102.1 P = wnl R = wnl BCS 5/9 EENT: Eyes clear (slightly injected sclera OD), ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition, fractured L upper canine, scant tartar noted, no oral lesions. MM pink, moist, CRT <2s. PLN: No enlargements noted H/L: No murmurs or arrythmias ausculted. Normal BV sounds, no crackles or wheezes. ABD: Soft, non painful, no masses palpated U/G: FI, large nipples, no MGT, urinating multiple times during PE and urine has slight mucoid/thick appearance MSI: Ambulatory x 4, no ectoparasites, no masses noted, multiple dried scabs noted behind and in front of left ear, no swelling or discharge noted (healing appropriately). Bow legged appearance of L and R rear limbs (R more prominent) with pressure sore noted at the level of hock. Slight crepitus appreciated on extension of hips, no pain appreciated. Will occasionally drag RR and then correct positioning, CP delay, deep pain appreciated. CNS: Mentation appropriate - no signs of neurologic abnormalities. Slight delay in CP of RR with deep pain appreciated. Rectal: not performed, normal externally Assessment: Fractured L upper canine Pollakiuria with slightly mucoid urine r/o UTI vs pyometra vs stones vs other Bow legged stance (R and L rear) Prognosis: Good-Fair Plan: CTM while at BACC Sedate with Dexmedetomidine 0.01mg/kg and Butorphanol 0.2mg/kg IM Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) Start clavamox 13.75mg/kg PO BID x 14 days (may need to extend) Start proviable 1 capsule SID x 14 days Monitor closely on daily rounds for lameness/pollakiuria SURGERY: Ok for sx

12/4/2019

Progress exam History : Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) Subjective: BARH. No csvd. Pollakiuria resolved. Bow legged stance but does not seem painful on ortho exam. Objective P = wnl R = wnl BCS = 5/9 EENT: Eyes clear no nasal or ocular discharge noted Oral Exam: adult dentition with fractured left maxillary canine, no oral lesions PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: FI, no MGTs, no vulvar d/c MSI: Ambulatory x 4 with bow legs in the HLs, drags feet sometimes, normal CPs, normal ortho exam besides very mild limited extension of hips, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Fractured L upper canine Pollakiuria with slightly mucoid urine r/o UTI vs pyometra vs stones vs other-NONE NOTED IN SHELTER Bow legged stance (R and L rear) with degenerative changes on rads Prognosis: Good-Fair Plan: CTM while at BACC Continue clavamox 13.75mg/kg PO BID until 12/17 Continue proviable 1 capsule SID 12/16 Monitor closely on daily rounds for lameness/pollakiuria CTM for lameness +/- longterm NSAIDs if indicated, rec joint supplements and CBD with placement

12/5/2019

Progress exam History : Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) 12/4: No evidence of pollakiuria noted. Full ortho exam showed mild limited extension of hips. Today, 12/5: Scheduled for surgery at outside veterinary clinic. Subjective: BAR, no coughing/sneezing/vomiting/diarrhea Objective: Cageside exam performed. Eyes: Clear bilaterally, no discharge Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: Sternal in kennel, rose to greet when approached with no excessive pain or discomfort. Bow legged stance unchanged from previous exams Integument: Unremarkable haircoat. Neuro: Appropriate mentation. Assessment: -Fractured L upper canine -Bow legged stance with degenerative changes on rads Prognosis: Good to fair Plan: -Continue clavamox 13.75 mg/kg PO q12h until 12/17 -Continue proviable 1 capsule PO q24h until 12/16 -Monitor for lameness/pollakiuria -Recommend orthopedic consult +/- long term NSAID administration, joint supplements and CBD with placement

12/7/2019

Progress exam History : Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) 12/4: No evidence of pollakiuria noted. Full ortho exam showed mild limited extension of hips. 12/6: Spayed, noted to be in heat 12/7: Overall recheck, blood noted in kennel T = 102.1 P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition, fractured L upper canine, scant tartar noted, no oral lesions. MM pink, moist, CRT <2s. PLN: No enlargements noted H/L: No murmurs or arrythmias ausculted. Normal BV sounds, no crackles or wheezes. ABD: Soft, non painful, no masses palpated U/G: FS, no MGT, blood noted in vuvla MSI: Ambulatory x 4 with bow legs, HL, will ocassionally drage feet, appropriate CPs today, no ectoparasites, no masses noted CNS: Mentation appropriate - no signs of neurologic abnormalities. Rectal: not performed, normal externally A: -Fractured L upper canine -Bow legged stance with degenerative changes on rads -vuvlar bleeding (secondary to being spayed during estrus) P: -CTM while at BACC -Continue clavamox 13.75 mg/kg PO q12h until 12/17 -Continue proviable 1 capsule PO q24h until 12/16 -Monitor for lameness/pollakiuria -Recommend orthopedic consult +/- long term NSAID administration, joint supplements and CBD with placement

12/11/2019

12/11-CIRDC signs seen on rounds S: BAR, consistent sneezing, no coughing, no vd. Eyes: Unremarkable OU Ears: Unremarkable AU. Nasal Cavity: Mild serous nasal discharge Lungs: Eupneic U/G: Normal external genitalia. No discharge. Musculoskeletal: Ambulatory x 4 BCS = 5/9 Neuro: Appropriate mentation. Rectal: Not performed. Externally normal. Assessment 1)CIRDC Plan: Move to iso, start enrofloxacin 10 mg/kg PO SID x 14 days Start doxycycline 10 mg/kg PO SID x 14d

12/16/2019

Progress exam History : Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) 12/6-spayed 12/11-started on doxycycline and baytril for CIRDC (resolved 12/16) Subjective: BAR. Cage exam. No csvd. Objective EENT: Eyes clear, no nasal or ocular discharge noted H/L: Normal RR/RE, eupneic MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Fractured L upper canine Bow legged stance (R and L rear) with degenerative changes on rads Prognosis: Good Plan: CTM while at BACC CTM for lameness +/- longterm NSAIDs if indicated, rec joint supplements and CBD with placement Rec dental with placement Ok to move out of iso Continue baytril 10mg/kg PO SID until 12/25 Continue doxycycline 10mg/kg PO SID until 12/25 Ok to dc clavamox and proviable.

12/29/2019

Progress exam History: Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) 12/6-spayed 12/11-started on doxycycline and baytril for CIRDC (resolved 12/16) Today, 12/19: ACS noted lameness Subjective: BARH, no coughing/sneezing/vomiting/diarrhea Objective: P: WNL R: WNL BCS: 5/9 OP: Mucous membranes pink and moist. CRT <2. 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: female spayed, no discharge INT: Good hair coat, no areas of alopecia or pruritus, no ectoparasites or masses noted. MS: Ambulatory x4 with mild-moderate hind limb lameness, R worse than L. Reacts painfully on extension of hips, allows flexion. NEURO: Mentation appropriate, cranial nerves intact, no deficits noted. Assessment: -Fractured L upper canine -Bow legged stance (R and L rear) with degenerative changes on rads Prognosis: Fair, will require long term management Plan: -Start rimadyl 4.4 mg/kg PO q24h x 14d until 1/12 -CBC/Chemistry scheduled for tomorrow -Recommend longterm NSAIDs if indicated, rec joint supplements and CBD with placement

12/30/2019

CBC: Thrombocytopenia 83 (148-484) but adequate platelet mass CHEM: mild hyperglobulinemia 4.8 (2.5-4.5), mild low ALP 17 (23-212), mild hypochloesterolemia 106 (110-320)

1/2/2020

History 12/2/19 intake: fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. -AXR: no evidence of stones or pyometra, degenerative changes noted to L and R hips 12/6: spayed at ASPCA 12/11: started baytril and doxycycline for CIRDC (resolved 12/16) 12/29: HL lameness noted (R>L), recommended starting rimadyl, but not entered into shelter buddy 12/30: bw performed -CBC: Thrombocytopenia 83 (148-484) but adequate platelet mass -CHEM: mild hyperglobulinemia 4.8 (2.5-4.5), mild low ALP 17 (23-212), mild hypochloesterolemia 106 (110-320) 1/2/20 today: ACS noted lameness again S/O: BARH, active, allows handling, no v/d/c/s. EENT: Eyes clear, no nasal discharge noted H/L: Eupneic, normal respiratory rate/effort ABD: No obvious distention MSI: Ambulatory x 4 - difficult to assess gait because pulling on neck lead up and down hallway. Right hock - mild flucuant swelling cranial aspect, reacts to palpation/flexion once, but not repeatable. Healthy hair coat, no notable lameness CNS: Mentation appropriate A: Fractured left max canine Bow legged stance (hindlimbs) + degenerative changes on pelvic rads HL lameness - recurring/persistent Right hock swelling - ro secondary to OA vs trauma vs autoimmune vs other P: Start rimadyl 4.4 mg/kg PO SID x 7 days Scheduled for xrays of hindlimbs tomorrow (previous rads only show hips) CTM while at BACC

1/3/2020

History 12/2/19 intake: fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. -AXR: no evidence of stones or pyometra, degenerative changes noted to L and R hips 12/6: spayed at ASPCA 12/11: started baytril and doxycycline for CIRDC (resolved 12/16) 12/29: HL lameness noted (R>L), recommended starting rimadyl, but not entered into shelter buddy 12/30: bw performed -CBC: Thrombocytopenia 83 (148-484) but adequate platelet mass -CHEM: mild hyperglobulinemia 4.8 (2.5-4.5), mild low ALP 17 (23-212), mild hypochloesterolemia 106 (110-320) 1/2/20: Lameness noted, started on Rimadyl, scheduled for hindlimb radiographs Today 1/3/2020: Scheduled for hindlimb radiographs SO: BARH, no c/s/v/d. Very active and energetic. E/d well, unremarkable eliminations. EENT: Eyes clear, no nasal discharge noted H/L: Eupneic, normal respiratory rate/effort MSI: Ambulatory x 4 - with no obvious lameness appreciated, swelling of R hock appreciated, with mild to moderate crepitus. No fractures palpated. Difficult to fully extend/flex hips but once PROM is performed theres more laxity appreciated. Healthy hair coat, no notable lameness CNS: Mentation appropriate A: Fractured left max canine Bow legged stance (hindlimbs) + degenerative changes on pelvic rads Right hock swelling with persistent/recurring lameness- ro secondary to OA vs trauma vs autoimmune vs other P: Fair, will require long term management P: CTM while at BACC Sedated radiographs revealed degenerative changes at L and R femoral condyle (medial and lateral) and R>>>L medial malleolus with soft tissue swelling (R) Continue rimadyl 4.4 mg/kg PO SID x 7 days until 1/9 and reassess lameness Pending improvement of NSAID will most likely recommend long term NSAIDS (ideally Galliprant), along with joint supplements and physical therapy with placement.

1/9/2020

Progress exam History : Intake 12/2/19-fractured upper canine, pollakiuria, bow legged in HLs. Started on clavamox and proviable. Abdominal radiographs (no evidence of stones or pyometra, degenerative changes noted to L and R hips) 12/6-spayed 12/11-started on doxycycline and baytril for CIRDC (resolved 12/16) 12/29-started on rimadyl for OA 12/30 CBC: Thrombocytopenia 83 (148-484) but adequate platelet mass CHEM: mild hyperglobulinemia 4.8 (2.5-4.5), mild low ALP 17 (23-212), mild hypochloesterolemia 106 (110-320) 1/2/20-re-started rimadyl for OA 1/3 Sedated radiographs revealed degenerative changes at L and R femoral condyle (medial and lateral) and R>>>L medial malleolus with soft tissue swelling (R) Subjective: BARH. No csvd. Friendly but was very nervous for ortho exam. Muzzled for ortho exam. Still has lameness but has improved. Objective P = wnl R = wnl BCS = 4/9 EENT: Eyes clear, no nasal or ocular discharge noted, ears clean ORAL: muzzled PLN: nsf H/L: NMA, RR, Lungs CE ABD: SNP, NMP UG: FS, no vulvar dc, no MGTs MSI: Ambulatory x 4 with bunny hopping when she walks, drags hind feet a little, limited hip extension but very nervous and tense for ortho exam, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Fractured left max canine Bow legged stance (hindlimbs) + degenerative changes on pelvic rads HL lameness - recurring/persistent Prognosis: Good Plan: CTM while at BACC Rec dental with placement Continue rimadyl 4.4 mg/kg PO SID while in the shelter Most likely will need long term NSAIDS (ideally Galliprant), along with joint supplements and physical therapy with placement. Recommend BW q6 months

Upon Intake, Fig allowed counselor to collar and place a leash on with no issues. Fig allowed Client Care Supervisor to scan for a microchip with no issues. An ACS handler was able to walk and place Fig in the kennel with no issues.