5/13/2026

DVM Intake Exam Estimated age: ~10 yr Microchip noted on Intake? Positive History: Owner surrender Subjective: BARH Observed Behavior - Allowed all medical handling Is there evidence of suspected cruelty? No Objective: T = NT P = WNL R = WNL BCS 9/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: clean adult dentition with very mild dental tartar PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no obvious masses palpated, but difficult to deeply palpate due to obesity U/G: MC MSI: Ambulatory x 4, skin free of parasites, urine on ventral abdomen and hind limbs, dry/flaky haircoat likely secondary to being unable to groom himself CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: not performed Wood's Lamp Exam: not performed Assessment: ~ 10 yr (per owner, but possibly younger on exam) MC DSH Obese Hyperglycemia-r/o DM Prognosis: Good Plan: Spot BG-389 g/dL Adult wellness to IDEXX Submit free catch urine or dipstick in house to check for glucosuria Fructosamine to IDEXX Scheduled recheck for tomorrow to check BG, urine, and review lab work as insulin likely needs to be started Will need bath Weight loss is recommended with placement

5/14/2026

Progress exam S: BARH - friendly, leans into cheek scratches pink moist mm, CRT <2s good appetite this AM no c/s/v/d reported O: BCS 9/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: clean adult dentition with very mild dental tartar PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no obvious masses palpated, but difficult to deeply palpate due to obesity MSI: Ambulatory x 4, skin free of parasites, urine on ventral abdomen and hind limbs, dry/flaky haircoat likely secondary to being unable to groom himself CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Obese Hyperglycemia - persistent Severe glucosuria r/o diabetes mellitus Geriatric MN DSH Prognosis: Fair to Guarded Plan: Spot BG 331 this AM IH dipstick - glucosuria 2000+, ketone negative Urine collected via cystocentesis - sent to IDEXX for UA (if evidence of UTI consider adding urine C&S) Mild snow globe effect of bladder but no shadowing, wall thickness WNL ADD ProZinc insulin (U40) 2U SQ BID TFN ADD SPOT BG to BID (prior to insulin administration) x7d --> 5/21 If BG <200 do not give insulin and notify DVM. If BG between 200-350 OK to give insulin as prescribed. If BG >350 OK to give insulin as prescribed but notify DVM. **If P has not eaten please notify DVM and do not give insulin** **If at anytime ataxia, severe lethargy / weakness, or collapse are seen, give nutrical or dextrose OTM immediately and notify DVM ASAP please** DVM recheck 5/14 PM DVM recheck 5/15 AM priority Seek placement, glycemic control would likely improve in a lower stress environment / a different type of insulin / a RX glycemic control diet, and P would benefit from closer monitoring than is possible in the shelter setting Discussion: Diabetes Mellitus in Felines: Diabetes in cats is most commonly caused by a deficiency of insulin. Diabetes mostly involves metabolizing sugar, particularly a sugar called glucose. Tissues cannot absorb glucose without insulin, so the level of insulin affects the glucose level. The main symptoms are excessive urination, thirst, appetite, and weight loss. Watching for these symptoms is the best way to know how your pet is doing. Two complications can occur with diabetic cats - if a cat's blood sugar is too high for an extended period of time or if it becomes too low secondary to an insulin injection. Both are emergency situations, and you should see your veterinarian or an emergency hospital immediately. Never alter the insulin dose without discussing it first with your veterinarian. Regulation needs a consistent balance of diet, exercise, and insulin. The current choice of food for diabetic cats is a low-carbohydrate, high-protein diet (usually prescription through your veterinarian). At this time, this pet requires twice daily insulin injections. Diabetes in cats might not be permanent, and it is possible for some cats to enter diabetic remission with the proper management.

5/14/2026

Bloodwork interpretation CBC - Mild monocytosis (0.715K H) r/o partial stress leukogram vs other Mild thrombocytosis (503K H) r/o stress vs other Biochemistry - Marginal hypochloremia (112L) r/o physiologic variation vs GI loss vs other Marginal hyperalbuminemia (4H) r/o subclinical dehydration Moderate hyperglycemia (418H) and severely elevated fructosamine (560H) - CONSISTENT WITH DIABETES MELLITUS TT4 1.7N CWCP as stated in SOAP

5/14/2026

Priority recheck-likely diabetic, progress exam by DVM, BG in the morning and UA in house via free catch to check for glucosuria // completed

5/15/2026

Progress exam S/O: BAR, eating DM wet food well and defecating normally; very friendly, leans into head rubs and pets, affectionate. Eupneic. No ocular or nasal discharge. BG this AM: 271, 2U PZI administered A: Diabetes mellitus - stable, on 2U PZI BID Obese P: Continue with BID BG checks, ok to administer PZI as prescribed if WNL (200-350) *Seek placement out shelter ASAP, recommend adding to ARL

5/16/2026

Recheck diabetes S/O: BAR, great appetite, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Obese AM BG today: 256 A: Diabetes mellitus Obese P: Freestyle Libre placed due to patient compliance with blood draws Continue current treatment plan and CTM on rounds Recheck in 3-5 days

5/19/2026

Recheck diabetes, obesity S/O: BAR, loves petting, decreased appetite - eats HV foods brought to face, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic MSI: Obese BG reading this AM 204 A: Diabetes mellitus Hyoprexia Obese P: Start SQ LRS 150 ml SID Start cerenia 1 mg/kg SQ SID Start mirataz SID Start medical feedings BID CTM on rounds, recheck appetite in 2 days

Upon intake Fluffy was docile allowing all handling such ass canning for microchip, collaring and placing from carrier to kennel. All done without any concerns.