2/11/2025

Your newly adopted pet has been diagnosed with dermatitis and the staff veterinarians are issuing a TEMPORARY waiver from the spay/neuter requirements of the City of NY. Follow up care at your regular veterinarian is recommended to ensure continued treatment through to the resolution of the issue. At the time of a full recovery you may choose to have your veterinarian perform the spay/neuter surgery, or make provisions to return the pet to ACC for sterilization.

2/11/2025

[DVM Intake] DVM Intake Exam Estimated age: 3yrs based Is this an orphan kitten? no Microchip noted on intake? scanned negative History: Found as a stray by good samaritan who took her in; reported to be hiding the entire time and even urinating in her hiding place Subjective: BAR Observed Behavior - growling, striking, hissing. Sedated for exam Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective P = 160 (sedated) R = 24 BCS 3/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition, moderate staining PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: F; no vulvar dc or MGTs, no spay scar or tattoo MSI: Ambulatory x 4, ventral abdomen has many scabs with raised plaque-like skin lesions CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: externally normal Wood's Lamp Exam: not performed Assessment Approx. 3yr FI DSH 1. raised plaques on ventrum (R/o eosiphilic granuloma complex vs other inflammatory vs infectious vs contact burn or other trauma vs neoplasia) 2. High FAS Prognosis: good Plan: Sedated with dexdomitor 10mcg/kg + torb 0.2mg/kg + ketamine 2mg/kg IM clipped and cleaned vental abdomen with dilute chlorhex Send out CBC/Chem to idexx SQ fluids 20ml/kg Cerenia 1mg/kg SQ Convenia 8mg/kg SQ Zorbium applied topically Gabapentin 12mg/kg PO BID Pending labs and response to treatment, consider steroid trial SURGERY: Temporary waiver due to ventral abdominal dermatitis

2/12/2025

CBC/CHEM/T4 slightly elevated SDMA- 15 (normal high 14) r/o pre-renal Not eating well P) SQ fluids- 100 ml LRS (but may be difficult due to FAS)

2/14/2025

Recheck appetite and skin lesions S/O: QAR-BAR, tolerates light touch, but swats/hisses/growls upon any handling/medical treatments - visual exam only Eating some food No c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Some lesions on ventrum visible when den slowly tipped to allow him to rest on clear door - one scabbed lesion <1cm at cranioventral thorax and two adjacent circular lesions (approx 1cm and 1.5cm) at right ventral thorax - no notable swelling, discharge, or surrounding erythema; appear stable. CNS: Appropriate mentation A: Hyporexia Skin lesions on ventrum High FAS P: Discontinued SQF due to behavior Start medical feedings BID and monitor appetite Continue gabapentin for FAS (placed in food so only getting it if he eats it) Recheck skin in one week - scheduled sedated exam as patient unlikely to allow exam CTM while at QACC

2/21/2025

Recheck skin lesions, lost 6 oz since intake S/O: BAR, always inside den, good appetite, no c/s/v/d noted *Sedated for exam due to hissing, growling, swatting - dexmedetomidine 0.1 ml IM + butorphanol 0.2 ml IM. MSI: Underweight; alopecia and multifocal lesions at ventrum and medial aspect of thoracic limbs - varying size 1cm-2cm diameter, some have dried discharge and some are moist with active exudate; one at ventral abdomen is raised and plaque-like, fur surrounding many of them is wet/reddish stained A: Multifocal skin lesions - ro allergy (atopy vs flea vs food) Underweight with mild weight loss Mild SDMA elevation P: Submitted urine for UA (obtained via cysto) E-collar placed Convenia 8 mg/kg give SQ (last dose given 10 days ago, patient does not tolerate medical handling so elected to repeat today while sedated rather than in 4 days) Start prednisolone 0.5 mg/kg PO BID (1 mg/kg per day) x 10 days. Recheck skin before 10 days and determine taper schedule Start medical feedings BID x 7 days Recheck weight at next recheck when sedated Continue gabapentin for FAS, but consider discontinuing if not eating prednisolone (need to prioritize oral med) CTM while at QACC

2/22/2025

Recheck, UA results S/O: BAR and eating well, did not eat meds last night E-collar off No c/s/v/d noted Eupneic Appropriate mentation UA (cysto): USG 1.049, protein 1+, struvite crystalluria 1+ A: Multifocal skin lesions - ro allergy Underweight with mild weight loss Mild SDMA elevation - likely pre-renal/dehydration *Crystalluria could be incidental, no urinary concerns noted - no further action at this time. P: Discontinue gabapentin at this time to prioritize prednisolone ingestion Unable to replace e-collar without sedation - leave off for now Unable to handle this cat medically to give injections or oral medications CTM closely if eating meds

2/23/2025

Is p taking pred? S/O QAR, hissing, no c/s/v/d appreciated or noted, good appetite, med tray with pred in it eaten EENT: no ocular or nasal dc HL: eupneic A. As prior- p appears to be taking pred rx'd for skin dz P. Con't on current treatments sedated recheck scheduled

2/27/2025

Brief recheck S/O: BAR, good appetite and eating medication No c/s/v/d noted Eupneic Appropriate mentation Full exam not performed due to temperament A: Multifocal skin lesions - ro allergy Underweight P: Continue prednisolone and recheck as scheduled

3/2/2025

recheck weight and skin S/O QAR, hissing, noted to be taking meds, no c/s/v/d appreciated or noted, needed sedation for weight and exam Sedated with 0.6mL dex (0.5mg/mL) and 0.6mL torb (10mg/mL) IM EENT: no ocular or nasal dc, mild wear and staining to dentition, no oral lesions HL: eupneic MSI: amb x 4, multifocal regions of alopecia with slight serous exudate and erythema along the ventrum, well demarcated, no scabbing, varying between 1-2cm in diameter A. Skin lesions - under treatment with prednisolone, appear slightly improved from last exam (see photo in vet docs) P. Convenia 8mg/kg SQ Cleaned area with dilute chlorohex prednisolone 5mg: 1/4 tab PO SID x 10 days brief recheck to see if taking meds in 3 days - if taking meds, okay to leave ICU? Recheck skin in 9 days (likely will need to be sedated)

3/2/2025

Sedated exam, check skin. Needs to be reweighed while sedated. Dex / Torb 0.06/0.06 ml IM Antisedan 0.06 ml IM 5.875#

3/4/2025

Brief recheck, skin largely unchanged in most recent photo (3/2), convenia given most recently on 3/2 S/O: BAR in den, good appetite, eating meds No c/s/v/d noted No ocular or nasal discharge, eupneic Appropriate mentation A: Skin lesions - ro allergy vs other P: Move out of ICU Continue prednisolone 0.5 mg/kg SID CTM on rounds, sedated recheck in 7-10 days

3/11/2025

Recheck skin lesions, has been on prednisolone for >2 weeks (initially 1 mg/kg/day, then 0.5 mg/kg/day) and received 3 convenia injections (9-10 days apart). Reweigh today - 7 oz less than previous. S/O: BAR, active in kennel, at front meowing Good appetite, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Multifocal circular alopecic lesions at ventrum and axillar/inguinum, most lesions are moist and erythematous, all approx 1-2cm diameter; appears slightly worse than last recheck A: Persistent skin lesions Underweight, weight loss P: Sedated with dexmedetomidine 0.01 mg/kg IM and butorphanol 0.2 mg/kg IM. Full antisedan reversal, smooth recovery. Uploaded photos to vetdocs Extend prednisolone 0.5 mg/kg/day, recheck next week and consider taper Placed e-collar - previous one fell off the same day. Attached this one to plastic collar around neck. CBC/CHEM/T4 to Idexx *Seek placement ASAP, patient not responding to treatment in shelter. May need atopica +/- HA diet +/- other treatment unavailable in shelter.

3/13/2025

Hematology: RBCs 7.25 low normal; was low 6.19 on 2/12 HCT 28.2 HBG 10.4 normal Lymphocytes high 7.872 Biochemistry: SDMA normal 9 All other values WNL TT4 1.4 WNL A: -Anemia - resolving -SDMA elevation - resolved -lymphocytosis - r/o suspected FAS *Bloodwork unremarkable - Ok to continue with prednisolone dose while in shelter, will need continued care once placed (see comments in 3/11 exam)

3/13/2025

Adding in gaba 100mg PO BID indef for behavior