12/14/2017

DVM Intake Exam Estimated age: 8-11 weeks based on dentition Microchip noted on Intake? Scanned neg History : Found outside, covered in ticks and diarrhea Subjective: Alert, walks around, covered in diarrhea Observed Behavior - Mews, purring nonstop, allows all handling Objective QAR, estimated 5% dehydrated, BCS 2/9, MMs white EENT: Eyes clear, mild black discharge AU, mild crusty/serous nasal discharge Oral Exam: Clean deciduous teeth - adult incisors just starting to come in PLN: No enlargements noted H/L: Purring so loud I cannot hear the heart. Lungs clear, eupnic ABD: Soft, non painful, no masses palpated U/G: Male intact kitten MSI: Ambulatory x 4, fur wet and hind end covered in diarrhea. One adult tick found on pt's dorsal thorax. No masses noted. CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Normal externally Parvo test - neg Assessment: 1. Emaciated 2. Dehydrated 3. Diarrhea - R/O GI parasites 4. Tick - removed Prognosis: Fair Plan: 1. Bathed hind end 2. Applied Frontline spray 3. Administered praziquantel 0.2 ml SQ in addition to ponazuril and pyrantel 4. Set up on heating pad 5. Give 20 ml SQ LRS SID x3 days SURGERY: Temporary waiver due to diarrhea and emaciation 1088

12/15/2017

Progress Exam History : presented 12/14. Found outside, covered in diarrhea and tick S/O: - QAR resting in cage, perks up a little during PE. Friendly and sweet, purring throughout exam. - No reports of c/s/v. Normal urinations, diarrhea seen this AM. - Ate early this morning, but none since. During PE sat with p and enticed to eat, and then p ate a good amount via tongue depressor and then on own. ~ 5% dedydrated, BCS 2/9, MM slightly tacky and white EENT: mild mucoid nasal discharge bilaterally. Fur along medial canthi wet/dry with debris. Oral Exam: no oral lesions/ulcers PLN: No enlargements noted H/L: Eupnic, normal RR/RE. Upper airway congestion. Purring loudly. ABD: Soft non painful, no masses palpated U/G: Male intact kitten MSI: Ambulatory x 4 CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Normal externally Assessment: 1. Emaciated 2. Dehydrated - improving 3. Diarrhea - R/O GI parasites 4. Tick - removed 5. URI 6. Pale mm Prognosis: Fair Plan: - ctm in med ISO. monitor URI, diarrhea, and appetite, sit with p and hand feed if needed. - start doxycycline 10mg/kg PO SID x 10 days - cont 20 ml SQ LRS SID x3d, last dose 12/16 - cont ponazuril 0.5mL PO SID, last dose 12/18 - recheck URI day 5 and 10

12/17/2017

Recheck in med iso for URI, emaciation, diarrhea, poor overall health condition: S/O: Quiet, mildly depressed until roused/perks up a little - eating small amounts, has loose/muddy feces - remains mildly dehydrated, BCS 2/9, MM slightly tacky and white - h/l nsf - amd x 4, soft abd A: emaciated, dehydrated, diarrhea + URI P: cont. with current tx and add back 30 ml LRS SQ SID x 3 days + hand feed + consider IV fluids if not improving

12/17/2017

Progress Exam. In Med ISO. History : presented 12/14. Found outside, covered in diarrhea and tick S/O: - QAR resting in cage, perks up during PE. Friendly and sweet, purring throughout exam. - No reports of c/s/v. Normal urinations, no diarrhea seen this AM. - Reported to be E/D normally. Offered food during PE, no interest. - mild dedydrated, BCS 2/9, MM slightly tacky and white EENT: mild mucoid nasal discharge bilaterally. Fur along medial canthi dirty with dried discharge Oral Exam: no oral lesions/ulcers PLN: No enlargements noted H/L: Eupnic, normal RR/RE. Upper airway congestion. Purring loudly. ABD: Soft non painful, no masses palpated U/G: Male intact kitten MSI: Ambulatory x 4 CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Normal externally Assessment: 1. Emaciated 2. Dehydrated - improving 3. Diarrhea - R/O GI parasites 4. Tick - removed 5. URI 6. Pale mm Prognosis: Fair Plan: - ctm in med ISO. monitor URI, diarrhea, and appetite, sit with p and hand feed if needed. - cont doxycycline 10mg/kg PO SID x 10 days, last dose 12/24 - cont 30ml SQ LRS SID x3d, last dose 12/19 - cont ponazuril 0.5mL PO SID, last dose 12/18 - cont hand feeding BID, until 12/21 - recheck URI day 5 and 10

12/18/2017

S/O -QAR, docile and affectionate, allows all handling -mm lgt/pale pk, tacky -crusting mucoid discharge along face, mild active mucoserous nasal discharge; congestion -OU: moderate blepharospasm, elevated 3rd eyelid, conjunctivitis, epiphora -eupnic, purring loudly on auscultation -soft, doughy abdomen with no palpable abnormalities -light brown formed but soft stool stuck in fur along hind end, mild irritation from diarrhea A 1. URI/conjunctivitis 2. Diarrhea-suspect parasites 3. Dehydration 4. Inappetance P Cerenia 0.15 ml SQ, gave today Add terramycin OU BID x 10 days Continue doxycycline, ponazuril At this time, Tiny is not eating on his own. This is likely due to his severe upper respiratory infection and a decreased sense of smell. During his recovery, you may offer him smelly foods such as canned tuna to entice his appetite. If you notice that he is not eating, you may need to force feed him until he starts. If Tiny's appetite does not begin to improve within the next 24-48 hours, he should be re-evaluated by a veterinarian.

Tiny was crouched and tense, though also felt cold. Tiny was tolerant and didn't react while I picked him up, scanned him (-), and collared him.