3/20/2026

DVM Intake Exam Estimated age: ~ 7-8 yr Microchip noted on Intake? Yes (previously seen here and noted to be ~7 years of age History: Stray Subjective: QAR, dehydrated-prolonged skin turgor, readily ate churu when offered Observed Behavior - BAR, friendly, attention seeking Is there evidence of suspected cruelty? No Objective: T = NT P = WNL R = WNL BCS 3/9 EENT: Significant debris AU, mucoid and crusted ocular and nasal discharge bilaterally, ulcerated nasal planum Oral Exam: mild dental tartar PLN: NSF H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic, referred upper airway noises ABD: SNP, no obvious palpable masses, distended abdomen, possible fluid wave U/G: MC MSI: Ambulatory x 4, hindlimb ataxia, ulcerations on paw pads x 4, unkempt dirty haircoat, dried discharge on limbs, mat on back (shaved at time of PE) CNS: alert and appropriate, hind limb ataxia Rectal: not performed Wood's Lamp Exam: not performed Assessment: ~7-8 yr MC DSH Debris AU URI Hind limb ataxia Dehydration Abdominal distension Weight loss-previously over 12 lbs in previous record Prognosis: Unknown, Additional diagnostics needed Plan: Revolution instead of frontline Fast scan abd-no obvious free fluid CBC-HCT WNL (35.5%), leukocytosis (17.98), neutrophilia (16.19), monocytosis (0.78) low eosinophils and basophils (0.07/0) Chem-hyperglycemia-r/o stress (205), elevated ALP (199) and GGT (6) T4-WNL (1.1) SQ LRS 100 ml SQ Retro negative Doxycycline 50 mg/ml-1 ml PO SID x 10 days, first dose given today Erythromycin OU BID x 7 days Scheduled recheck tomorrow for recheck exam and sedated CXR/AXR/spine/pelvis to look for abnormalities for cause of ataxia, ear cleaning, evaluate skin for any wounds, and more SQ fluids vs start IVF, and recheck BG

3/21/2026

Recheck URI S/O: QAR, allows all handling, not eating today - will lick churu off lips, no c/s/v/d noted TEMP: 100.3 EENT: OU eyelids erythematous and mildly swollen with mucoserous discharge and crusting/alopecia at medial canthi OU; ulceration at nasal planum with dried nasal discharge; moderate-heavy tan waxy debris and pruritis AU ORAL: mm pink and moist, small lingual ulcer at tongue tip LUNGS: RUAS, congestion MSI: Diffusely dirty haircoat with shaved area dorsally (matted at intake), skin tent; significant muscle atrophy at pelvic limbs and epaxials, ambulatory x 4 with low/hunched posture, no ataxia appreciated today CNS: Appropriate mentation A: URI Conjunctivitis OU Overweight with muscle wasting suggestive of rapid weight loss Dehydration Lingual ulceration Dirty, pruritic ears - ro ear mites vs other P: Eyes/face cleaned, ears cleaned Start LRS 150 ml SID Start cerenia 1 mg/kg SQ SID Midazolam 0.2 mg/kg IM once today Switch to ofloxacin drops OU BID Start medical feedings BID Ivermectin 0.15 ml SQ once Vitamin B12 0.25 ml SQ once House in med iso and recheck tomorrow

3/21/2026

Supportive care (SQ fluids, Cerenia, Ivermectin, B-12, Midazolam). // Completed

3/22/2026

progress exam -moderate URI -conjunctivitis -hindlimb ataxia noted on intake -muscle wasting -dehydrated S/O QAR, no c/v/d appreciated, S+, food trays appear touched, ate a little churu off nose whenn offered EENT: OU: conjuncvitis hyperemic, chemosis, areas of tear stained/dc surrounding OU, some periocular alopecia, mild mucoserous nasal dc, small ulceration to tip of tongue HL: eupneic, audible congestion MSI: amb x 4, no ataxia noted today but p relunctant to walk once out of kennel, sl delay in skin turgor A. URI moderate Muscle wasting Anorexia r/o hyporexia r/o second to pain from lingual ulcer Lingual ulcer Conjuctivitis P. Zorbium green applied - recheck appetite later today or tomorrow, if still not eating consider midaz injection Nebulize SID x 2 days Brief recheck of appetite tomorrow Full recheck in 2 days- end of supportive care CTM while at QACC

3/24/2026

Recheck URI S: BARH - friendly, soliciting attention pale pink moist mm, CRT <2s Anorexia noted on monitoring sheet but P ate ravenously when hand fed! no c/v/d reported, sneezing persists O: EENT: Mild alopecia at medial canthi with crusted brown discharge OU; ulceration at nasal planum with dried nasal discharge; mild tan waxy debris AU ORAL: Small lingual ulcer at tongue tip LUNGS: Mild RUAS, mild-mod audible congestion, BV sounds WNL MSI: Moderate muscle atrophy at pelvic limbs and epaxials, ambulatory x 4 INT: Diffusely dirty haircoat with shaved area dorsally (matted at intake) CNS: Appropriate mentation A: URI - improving Conjunctivitis OU - improving Overweight with muscle wasting Dehydration - resolved Lingual ulceration - persists but subjectively improving Hyporexia - improving, likes to be hand fed HX susp ear mites - under tx Zorbium applied 3/22 P: EXTEND Nebulize w saline BID x2d --> 3/26 ADD Mirataz TD alternating pinna SID x2d --> 3/26 (to help get P to eat on own) Otherwise CWCT DVM recheck 3/26

3/26/2026

recheck URI- eating?S S/O BAR, come to the front and solicits pets, head butts, no c/s/v/d appreciated, normal feces and urine in LB, food all appears untouched but eagerly takes churu when hand fed EENT: moderate alopecia and mild brown dc, scabbing to the nasal planum. ORAL: no ulcerations noted to tongue, wouldn't allow for full oral exam HL: eupneic MSI: amb x 4, good skin tent A. Inappetence - appears to eat only when hand fed HVT - tried placing churu in bowl and encourage to eat but only would take when hand fed URI- improving Conjunctivitis - improved P. Conj improved but still present- extend oflox x 3 days URI- appears mild now, cont with doxy Encourage to eat with HVT- might need hand feeding/social eater? Extend mirataz x 3 days while attempting to coax to eat on his own recheck in 2 days

3/28/2026

Progress exam S/O: BAR sitting in kennel; wet food appears untouched. Reported to eat 2/3 x 2 days ago. Leaning into head rubs and pets, making muffins in kennel. Minimal conjunctivitis present OU. Nasal planum ulcerated. Ulceration with scab present on dorsal aspect of LFL at level of carpus. A: Dehydration Ulceration on nasal planum Ulceration on LFL Conjunctivitis - mild, improved URI - stable but not resolving Anorexia - continued Prognosis: guarded P: Extend medical feedings and mirataz x 3 days Restart supportive care: -LRS 100ml SQ q24h x 3 days -Vitamin B12 injection 0.25ml SQ once (repeat from 3/21) -Cerenia 0.5ml SQ q24h x 3 days *Place on ARL, seek placement *Move into double kennel to allow greater choice and movement; monitor ambulation and comfort

3/28/2026

Bloodwork results in-house:

3/30/2026

reheck URI, appetite, end of doxy S/O BAR, comes up to the front and solicits attn, head butts, making biscuits, both wet and dry food tray were halfways eaten, still seems to need some encouragement to start eating but then eats HVTs and regular food. No c/s/v/d appreciated or noted EENT: mild periocular alopecia and scant serous dc OU, no nasal dc, nasal planum has lesion scabbed over. HL: eupneic MSI: amb x 4, ulceration with some scabbing to the LFL by the carpus, moderate paw pad sloughing noted to all 4 paws, p appears to resent palpation but allows for exam A. URI- no signs present aTT Conjunctivitis - resolving Skin ulcerations/sloughing of paw pads - r/o due to housing (although in double), sedentary, noted to have sloughing on paws on intake- r/o systemic (autuoimmune, immune-mediated dz) vs trauma vs open. P. Extending doxy 10mg/kg SID x 7 days in case skin ulcerations and paw sloughing immune mediated (1mL) (total course now 17 days) SSD applied to paws SID x 5 days as patient allows Convenia 8mg/kg SQ once Recheck in 3 days CTM for skin ulcerations - if sloughing and ulceration persists consider biopsy with placement or adopts

4/2/2026

recheck, inappetence, recovering from URI, ulceration to paw pads S/O BAR, A+A, comes to the front when approached, food trays appear untouched but will eat out of hands and enjoy being hand fed, no ocular or nasal dc, scant serous nasal dc, eupneic, good skin tent, ulceration to LF leg scabbing over and healing, ulcerations to paw pads scabbing over, noted to have areas of alopecia under the LF leg now. A. Inappetence vs hyporexia - persists Ulcerations to leg and paw pad - healing Conjunctivitis - resolved, periocular alopecia Alopecia- new finding P. Woodslamp as precaution- negative Con't with current treatments CTM and seek placement asap - p would benefit from work up at full service DVM Recheck BW pulled - check for results tomorrow Full recheck in 2-3 days

4/3/2026

Bloodwork interpretation CBC: - HCT 27.6 (L) - Plt 520 (H) Chem: - Creat 0.4 (L) - BUN 10 (L) - Na 146 (L) - Alb 2.4 (L) - AST 14 (L) - ALP 75 (H) TT4 = WNL (1.5) A. Mild anemia with no evidence of regeneration r/o anemia of chronic inflammatory disease (chronic disease vs infection vs neoplasia vs other) vs blood loss low creat likely due to muscle wasting low BUN r/o low protein diet vs malnutrition vs severe liver disease (unlikely) increased ALP r/o liver disease Overall mild changes to cbc/chem P. continue with treatments recheck in 2 days

4/4/2026

Mild discharge and mod pruritis AU. Cleaned ears and repeated ivermectin 0.14 ml SQ today.

4/5/2026

Progress exam for hyporexia / muscle wasting / alopecia S: BARH - comes up to the front and solicits attn, head butts, making biscuits pink moist mm, CRT <2s No c/s/v/d appreciated or noted Normal urine voids but no stool for 4 days Did not eat any wet or dry food but ate churu ravenously when offered -- ate quickly then gagged once and continued to eat. Would not eat wet or dry food when attempting to hand feed today. Maintaining weight O: EENT: mild periocular alopecia but no active ocular discharge, no nasal dc, nasal planum has lesion scabbed over. HL: No HMA, SSPPs, normal BV sounds, eupneic ABDO: Soft and nonpainful with palpation. Small amount of firm but depressible stool in transverse colon. MSI: ambulatory x 4, ulceration with some scabbing to the LFL by the carpus, mild paw pad sloughing noted to all 4 paws (subjectively mildly improved). Unkempt dirty coat persists. Pinna margins alopecic and moderately erythematous. Quiet alopecia on cranioventral thorax. A: Waxing/waning hyporexia but eats when hand fed r/o behavioral vs underlying pathology No BMs for 4 days r/o 2ary to hyporexia vs less likely constipation HX Skin ulcerations/ erythema/sloughing of paw pads - mild improvement r/o due to housing (although in double), sedentary, noted to have sloughing on paws on intake- r/o systemic (autuoimmune, immune-mediated dz vs allergic) vs trauma vs open HX URI - clinically resolved HX conjunctivitis - clinically resolved HX lingual ulcer - not appreciated today HX susp otodectes AU - under tx P. CWCT ADD Cerenia 5mg SQ ONCE today ADD Mirataz TD alternating pinna SID x5d --> 4/9 (to help get P to eat on own) ADD Entederm to pinna margins AU BID x7d --> 4/12 DVM recheck appetite / BMs 4/6 Notify DVM if straining to defecate CTM for skin ulcerations - if sloughing and ulceration persists consider biopsy with placement or adopts