4/4/2026

DVM Intake Exam Estimated age: approx 2-4 y/o based on dentition Microchip noted on Intake? scan negative History: Owner surrender; housed with 25+ cats Subjective: BARH, reported to be eating well in shelter Observed Behavior - tense, timid; attempting to flee when approached kennel; then would hiss when door opened; elected to sedate using DKT (0.1ml of each). Adequate sedation achieved. Antagonized with with 0.1ml atipamezole. Smooth recovery. Is there evidence of suspected cruelty? no Objective: P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: minimal tartar and plaque; large irregular shaped light pink plaque-like irregular mass on base of tongue PLN: No enlargements noted H/L: NSR, NMA, CRT < 2 though slightly pale mm, Lungs clear, eupneic ABD: Non painful, no abdominal distension or organomegaly U/G: male intact, 2 testes palpable in scrotum MSI: Ambulatory x 4, skin free of parasites, no masses noted, slightly scruffy hair coat. Large plaque-like ulceration on margin of left rostral upper lip. Ulcerations on plantar aspect of tarsi, bilateral. CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: externally normal Wood's Lamp Exam: NEGATIVE Assessment: ~2-4 y/o MI DSH Plaque-like ulcer on upper lip r/o eosinophilic granuloma complex vs neoplasia Mass structure at base of tongue r/o Eosinophilic granuloma complex vs neoplasia Ulcerations on plantar aspect of tarsi - r/o callus, pressure sores Prognosis: Good Plan: Ok for intake tasks Cleaned wounds on plantar aspect of tarsi with dilute chlorhexidine Administered Convenia 8mg/kg SQ once Monitor appetite closely *Recheck in 3 days to ensure is eating *If doing well at recheck and antigenic stimulation is reduced, recommend steroid course (depo medrol vs prednisolone) to reduce inflammation and resolve EGC lesions. SURGERY: Okay for surgery

4/7/2026

Recheck ulceration/swelling at lip S/O: QAR in den, hisses when approached, great appetite, no c/s/v/d noted, feces in LB EENT: No ocular or nasal discharge ORAL: Thick ulcerated maxillary lip at left side, full oral not performed LUNGS: Eupneic CNS: Appropriate mentation A: Ulcerated, swollen lip - ro EGC vs other Mass at base of tongue - ro EGC vs neoplasia Ulceration at plantar aspect tarsi P: Convenia given at intake Consider biopsy of oral mass when anesthetized for neuter Consider prednisolone taper once healed from surgery

4/8/2026

Pre-Op Exam, cageside S/O: BAR, no c/s/v/d noted EENT: No ocular or nasal discharge noted Lungs: Eupneic, normal respiratory rate/effort ABD: No obvious distention MSI: Ambulatory x 4, no notable lameness CNS: Mentation appropriate A: Appears to be suitable candidate for anesthesia, ASA status I P: Accepted for surgery - spay/neuter today Was this cat a Cryptorchid? no If so, describe surgical process: Routine Feline Neuter Self tie of spermatic cord Green Linear Tattoo Placed near Midline Surgeon: 990665 Additional Note: Lip ulceration- two punch biopsies obtained- closed with 3-0 Monocryl Large circular irregular mass on surface of tongue middle along midline, excised for biopsy. Closure with 4-0 Monocryl in a simple interrupted pattern. smaller irrefular mass towards back of tongue noted- difficult to remove due to caudal positioning. AXR/CXR reviewed- No overt masses in chest. Large gas-filled stomach, suspect ruggae visualized. Rest of rads NSF Already received Convenia on intake Received Onsior Apply Zorbium Monitor for appetite Biopsy evaluation for plan

4/9/2026

[Post Surgical Exam] Attitude/demeanor: QAR Appetite: eating well C/S/V/D: none Incision site: Could not see due to behavior Pain level: appears comfortable Licking, chewing, or biting surgical site noted: no Additional notes: None

4/15/2026

Biopsy results consistent with eosinophilic granuloma. Full results below: MICROSCOPIC INTERPRETATION: 1. Oral mucosa, lip: Focally severe, eosinophilic stomatitis with ulceration, please see comments 2. Oral mucosa, tongue: Focally severe, nodular eosinophilic stomatitis with ulceration, please see comments COMMENTS: Both of these lesions are histologically characteristic of eosinophilic granuloma (EG), considered a broad category of feline eosinophilic mucocutaneous dermatosis. There can be significant overlapping histologic features between all conditions in this complex (eosinophilic granuloma, eosinophilic plaque / locally severe allergic miliary dermatitis and indolent ulcer), though clinical features are usually distinct. EG (synonyms: collagenolytic granuloma, linear granuloma) classically occurs as single to multiple nodules, variably pruritic, orientated linearly on the caudal thigh or, less commonly, as single nodular lesions located anywhere on the body, but especially footpads, chin / lower lip and also oral cavity. All forms of eosinophilic granuloma may be accompanied by lymphadenopathy. Underlying cause remains unknown. EG are most often assumed idiopathic, though many of the lesions in feline eosinophilic mucocutaneous dermatosis complex are suspected to be related to hypersensitivity / allergic conditions. EG shares many similarities with human Wells syndrome. Gnotobiotic cats in a colony at U.C. Davis showed a familial pattern of incidence. It is not uncommon to identify deeply embedded hair shafts or insect parts within ulcerated oral eosinophilic granulomas. It is currently thought that these foreign materials aggravate the inflammation in these lesions, but these foreign bodies are unlikely the primary cause. MICROSCOPIC DESCRIPTION: 1. Labeled "lip". Four sections of oral mucosa, representing the two bisected and completely embedded, submitted punch biopsy specimens, are examined in duplicate. There is focally extensive ulceration of the mucosa, with a thick band of degenerate eosinophils, neutrophils, colonies of mixed coccobacilli, and amorphous necrotic material lining the surface. Throughout the submucosal stroma are focally severe eosinophilic and mastocytic inflammatory infiltrates amidst abundant perivascular lymphoplasmacytic inflammation. 2. Labeled "tongue lesion". A representative section of the submitted tissue specimen contains a plaque-like to mildly raised mass comprised of a fibrocollagenous connective tissue core lined by mildly to moderately hyperplastic gingival epithelium. There is focally extensive ulceration of the mucosa, with replacement by a thick mat of degenerate cellular debris and eosinophilic and lymphoplasmacytic infiltrates throughout the bed of immature granulation tissue. Rarely, there are deeply embedded hair shafts and amorphous refractile debris within the granulation tissue.

4/15/2026

Post Surgical Exam Attitude/demeanor: BAR Appetite: eating C/S/V/D: none Incision site: no swelling, bruising, or bleeding; Pain level: appears comfortable Licking, chewing, or biting surgical site noted: not observed Additional notes:none

4/15/2026

Brief recheck - QAR at back of kennel, no c/s/v/d noted, food untouched, no ocular or nasal discharge, swollen left max lip stable, eupneic. PLAN: Monitoring log in place to monitor appetite, as long as eating well - start prednisolone. Recheck scheduled tomorrow.

4/16/2026

P noted to have EGC orally, in the corner of the cubby, no c/s/v/d appreciated, no ocular or nasal dc , eupneic, food trays empty, noted by staff to be eating well but inconsistent. CTM- rec pred taper with adopts or placement. CTM closely and recheck log in 4 days- if consistently eating consider short term taper in shelter

4/20/2026

Recheck - EGC, lingual and to lip S/O QAR, hiding in the cubby, hisses when approached, excellent appetite scores reported, no c/s/v/d appreciated or noted, no ocular or nasal dc, eupneic, noticable swelling to the max lip on the L side- stable from last exam. A. EGC Hx of inconsisent appetite - noted to be eating well now P. Start pred taper 1mg/kg PO SID x 3 days, 0.5mg/kg PO SID x 3 days, 0.5mg/kg PO EOD Recheck in 3 days CTM while at QACC

4/26/2026

Progress exam P on prednisolone 2.5mg PO q24h for EGC S/O: P is e/d/u/d normally, no c/s/v/d. BAR, hissed and growled when opened kennel door. Lesion on left upper lip appears quieter, less inflammation visible but swelling still present. A/P: ECG - stable, on prednisolone. OK to continue with prednisolone as previously prescribed *Add in gabapentin 100mg PO q12h indefinitely to reduce FAS in shelter

4/30/2026

Progress exam P on prednisolone 2.5mg PO q48h for EGC S/O: P is e/d/u/d normally, no c/s/v/d. BAR, on top shelf - hissed and growled when opened kennel door. Lesion on left upper lip appears quieter, less inflammation visible but swelling still present. A/P: ECG - stable, on prednisolone. OK to continue with prednisolone as previously prescribed DVM recheck 5/5 at end of prednisolone taper.

5/5/2026

Progress exam P on prednisolone 2.5mg PO q48h for EGC S/O: P is e/d/u/d normally, no c/s/v/d. BAR, in back of kennel on bed - hissed and growled when opened kennel door. Lesion on left upper lip appears quieter, less inflammation visible but swelling still present. Tray with medication was untouched. A/P: ECG - stable. OK to end prednisolone as planned. DVM recheck 5/12 - 1 week off prednisolone