11/28/2022

DVM Intake Exam Estimated age: ~1-2 years old Microchip noted on Intake? Scanned negative History: Stray. (143555) came to the MACC without an appointment to surrender a stray cat she had found outside her building. The client stated she saw the cat on a rainy day and took him home because it was very cold. The client stated she kept the cat for a few days but she cannot keep him because the cat has seizures while sleeping. Subjective: BAR, hydrated Observed Behavior - friendly, allowed all handling Evidence of Cruelty seen - no Evidence of Trauma seen - no Objective T = --- P = ~180 R = ~30 BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition, minimal staining/tartar, mild gingivitis PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: male, intact, 2 scrotal testes MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities, PLR's intact, mentally appropriate, no evidence of neuro deficits on PE, full neuro exam not performed Assessment: ~1-2 year old MI cat -intact -hx of *possible* seizures while sleeping (per finder) Prognosis: fair to good Plan: -Intake tasks -Move to medical for seizure watch -DVM recheck tomorrow to follow up on seizure watch and plan SURGERY: Temporary waiver due to possible seizures

11/29/2022

S: Alert in kennel, stretched and came to front, tolerated handling for light exam Good appetite overnight O: BAR-H, MMs pink and moist, BCS 5/9 EENT: No discharge OU, nose H/L: NSR, NMA. Eupnic, no coughing or sneezing. Abd: Soft, full of food M/S/I: Amb x4, no skin lesions noted. Neuro: Alert and appropriate, no sign of neuro deficits UG: Male intact, testicles S/S A: Possible hx seizures, unwitnessed P: CTM. If pt continues to have no seizures at the shelter, okay to neuter. 1088

11/30/2022

Hx: No seizures reported in shelter; reported sz. activity in sleep may have been a misperception SO: BAR, comes to kennel door, head butting and seeking attention. Appears to have eaten very well overnight eyes clear, no ocular or nasal dc apparent eupneic, no coughing or sneezing appreciated ambulatory x4 mentation alert and appropriate A: apparently healthy P: continue to monitor in medical one more day, but if nothing noted, plan to move out of medical when time allows and if behavior allows, CBC/chem to lab

12/3/2022

CBC Not remarkable Chem screen WNL for young animal

12/7/2022

History: 11/28: DVM intake. Stray cat with history of possible seizures while sleeping 12/3: NSF on CBC/chem Today, 12/6: Seizure reported S/O: Spoke with staff and volunteer who were present: At approximately 8:30 PM, patient had likely seizure event. Volunteer observed patient lateral, convulsing, drooling, and apparently unconscious. Volunteer ran for help and when returned, event was still ongoing- estimate lasted ~2-3 minutes. At time of phone call (a minute or two after likely seizure), patient seemed mildly dazed but was alert and purring. Staff moved patient to medical for monitoring. No medical or euthanasia certified staff present overnight. A: Seizure- etiology open Plan: Keep in medical on seizure watch Start Keppra 20 mg/kg PO q12 indefinitely If seizes, give midazolam 1 mg (0.5 mg/kg) IV or IM Recheck in morning, recommend EHR vs. transfer out

12/7/2022

S: Alert in kennel, walking around. Stepped out of kennel and into my lap, then jumped back into kennel after exam. O: BAR-H, MMs pink and moist EENT: No discharge OU, AU, nose. Clean adult teeth. Drooling slightly. H/L: Eupnic, no coughing or sneezing Abd: Soft, full of food M/S/I: Amb x4, no skin lesions noted UG: Male intact, testicles S/S Neuro: Alert and appropriate. No ataxia or proprioceptive deficits. A: Seizure hx, started on Keppra. This medication can be given twice daily but is typically prescribed three times daily. TID is not feasible in the shelter. P: Continue to monitor for seizures. Recommend placement and neuro consult. 1088

12/8/2022

Hx: Had probable seizure on 12/7 overnight. Moved back to medical and started on keppra BID SO: BAR, comes to kennel door seeking attention. Appears to have eaten well overnight eyes clear, no ocular or nasal dc apparent eupneic, no coughing or sneezing appreciated ambulatory x4 mentation alert and appropriate, no neurological deficits appreciated A: Seizures-on treatment P: continue to monitor for further seizure activity

12/10/2022

Hx: Had probable seizure on 12/7 overnight. Moved back to medical and started on keppra BID SO: QAR, still comes to kennel door head butting and seeking attention, but with less enthusiasm than yesterday. Ate all dry food in kennel eyes clear, no ocular or nasal dc apparent eupneic, no coughing or sneezing appreciated ambulatory x4 mentation alert and appropriate, no neurological deficits appreciated A: Seizures-on treatment lethargy-r/o transient from medication, v early URI v pre ictal P: continue to monitor for further seizure activity and URI signs

12/11/2022

Hx: possible seizures SO: QAR, eating well eent- no ocular or nasal dc apparent h/l- eupneic msi- ambulatory x4 mentation alert and appropriate, no neurological deficits appreciated A: Seizures-on treatment P: CWSC

12/12/2022

Hx: possible seizures; has been eating well SO: QAR; sleeping in cage eent- no ocular or nasal dc apparent h/l- eupneic msi- ambulatory x4 mentation alert and appropriate, no neurological deficits appreciated A: Seizures-on treatment sleeping a lot r/o reaction to medications P: CWSC

12/13/2022

No seizures noted Pt is more alert than previously A: Adjusting to anti-seizure medication P: CWCT 1088

12/17/2022

Hx: In medical on treatment for seizures with BID keppra. Initially lethargic with keppra, but lethargy seemed to be transient SO: QAR, sleeping in kennel initially, but when approached for exam gets up and seeking attention. Large amount of feces in kennel, some soft and some streaked onto kennel floor multiple times eyes clear, no ocular or nasal dc apparent eupneic, no coughing or sneezing appreciated ambulatory x4 mentation quiet, but alert when having interaction A: pHx of seizures lethargy-r/o sedation from keppra v pre or post ictal P: continue to monitor if seizure activity seen today will adjust keppra dose

12/22/2022

Surgery report - feline neuter Was this cat a Cryptorchid? No - normal feline scrotum and testicles Routine feline neuter, scrotal approach along median raphe Self tie of spermatic cords Incision left open to drain Green linear tattoo on ventral abd to denote neuter status Surgeon: 1088

12/22/2022

Pre-op exam Hx seizures, on daily meds S: Slightly dull, walks around and interacts with surroundings, but seems a little uninterested or slow to react O: QAR-H, MMs pink and moist, BCS 5/9 EENT: Clean teeth. No discharge OU, AU, nose. H/L: NSR, NMA. Eupnic, no coughing or sneezing. Abd: Soft, not distended, no masses M/S/I: Amb x4, no skin lesions UG: Male intact, testicles S/S A: Subjectively dull, R/O seizure meds P: Neuter today, consider altering dose after placement 1088

Gomez Addams was very friendly, allowed all handling, scanning and collaring.