9/18/2026

DVM Intake Exam Estimated age: ~10 years Microchip noted on Intake? Positive History: Stray; ID Hold through 9/22 Subjective: BAR, eating readily; MM pink and moist Observed Behavior - Blue; Able to examine, overall tolerant. Somewhat limited tolerance of handling for blood collection and ear cleaning; vocalizing and trying to evade. Taking treats readily. Is there evidence of suspected cruelty? No Objective: P = 180 hr R = 32 rr BCS 3.5/9 EENT: Eyes clear, no nasal or ocular discharge noted, moderate ceruminous debris AU Oral Exam: NSF PLN: No peripheral enlargements noted H/L: NSR, NMA, CRT < 2, lungs clear, eupneic ABD: Moderate cranial-mid abdominal distension with suspected cranial organomegaly. Several small, firm, palpable structures mid-abdomen. U/G: MN MSI: Ambulatory x4; generalized sarcopenia/cachexia and unkempt hair coat. Stiff gait/decreased ROM. Intermittently splayed stance involving all four limbs and plantigrade pelvic limb stance. Appears weak vs neurologically abnormal. Joint laxity vs other noted during restraint for blood collection with transient concern for RFL shoulder luxation; immediately recovered normal positioning and remained fully ambulatory. CNS: Mentation appropriate; ambulatory. Abnormal posture/gait as described. Assessment: -Senior to geriatric cat with multiple findings concerning for significant underlying chronic disease, including diabetes mellitus and neoplasia -Sarcopenia/cachexia, BCS 3.5/9; suspect underlying chronic disease -Moderate cranial-mid abdominal distension with suspected organomegaly and small palpable mid-abdominal structures: r/o fecal material vs lymphadenopathy vs other -Abnormal/stiff gait, decreased ROM, intermittent splayed stance and pelvic limb plantigrade posture: r/o generalized weakness vs diabetic neuropathy vs other neurologic/neuromuscular disease vs orthopedic disease -Ceruminous debris AU: r/o ear mites vs other -Unkempt hair coat Prognosis: Guarded pending diagnostics Plan: -Standard intake tasks for cats performed -Adult Wellness Plus bloodwork submitted; results pending -In-house spot BG 436 -Ears partially cleaned as tolerated -Selamectin administered; repeat in 1 month -Feline Daily Monitoring Log placed; monitor appetite, activity, ambulation and clinical status -NoSorb placed for urine collection -Recheck tomorrow, 9/19: review send-out bloodwork and clinical status; perform in-house UA/dipstick when urine available, including evaluation for glucosuria, ketonuria, proteinuria, etc. -Consider abdominal ultrasound pending bloodwork, UA and clinical course -CTM closely while on ID Hold -If diagnostics support serious chronic/terminal disease with poor prognosis or P clinically deteriorates, consider EHR prior to completion of ID Hold. Otherwise, reassess for EHR at completion of ID Hold on 9/22 if significant disease/poor prognosis is confirmed and appropriate placement/treatment is not feasible. SURGERY: Permanent waiver d/t age

9/19/2026

Recheck, bw results S/O: QAR, great appetite, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic ABD: Moderate distention MSI: Amb x 4, plantigrade, dorsal muscle wasting CNS: Appropriate mentation CBC: WBC 27.6 (H), neutrophils 19.265 (H), monocytes 1.187 (H), eosinophils 2.236 (H), platelets 654 (H) CHEM: Glucose 393 (H), creatinine 0.8 (L), chloride 111 (L) T4: wnl *Urine collected from litterbox with nosorb, ketodiastick: -Glucose 500-1000 -Ketones trace A: Leukocytosis, neutrophilia, monocytosis - ro inflammation vs infection Hyperglycemia, glucosuria, trace ketonuria - consistent with diabetes mellitus Plantigrade stance, abnormal gait - ro diabetic neuropathy vs other DMW/sarcopenia Abdominal distention Senior cat P: Clinical signs and labwork consistent with diabetes mellitus diagnosis Urine submitted for UA to idexx Start insulin (PZI) 1 unit SQ BID Monitor closely on rounds **Seek placement as diabetes is most often a lifelong condition in cats and will require veterinary follow-up and twice daily insulin administration

9/20/2026

recheck diabetic cat S/O BAR, A+A, comes to the front of the kennel for interaction, no c/s/v/d appreciated, wet food tray empty EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4, dropped hocks, muscle wasting along the epaxials A. DM - just started on insulin- BG 427 today P. Feed DM food Con't with insulin and BG checks UA not back yet, check for result tomorrow seek placement- p is geriatric with DM CTM closely while at QACC

9/21/2026

Recheck diabetic cat S/O BAR, A+A, comes to the front of the kennel for interaction, no c/s/v/d appreciated, wet food tray empty, skin tent WNL EENT: no ocular or nasal dc HL: eupneic MSI: amb x 4, dropped hocks, muscle wasting along the epaxials A. DM - BG persistently in the 400s-500s P. Increase prozinc to 1.5U BID TFN tomorrow morning when closer supervision available -- monitor closely ~4 hours post admin as likely then BG nadir will be Otherwise CWCP

9/21/2026

UA interpretation Proteinuria 1+ Glucosuria 3+ Ketone negative Moderate bacteriuria - rods 9-40 r/o UTI vs contamination Susp true bacteriuria since P is diabetic, common sequelae --> scheduled convenia for tomorrow (Convenia 0.42mL SQ ONCE) Repeat UA in 2 weeks if still in care to recheck UTI, recc cystocenesis if possible in case culture and sensitivity needed

9/22/2026

Recheck - insulin increased to 1.5u today, convenia scheduled for suspected UTI S/O: BAR at front, great appetite, no c/s/v/d noted, formed stool in LB EENT: No ocular or nasal discharge LUNGS: Eupneic ABD: Slightly pendulous, NMP, SNP MSI: Amb x 4, dropped hocks, DMW CNS: Appropriate mentation, ataxia not appreciated Recent BG measurements: 9/20 AM: 427 9/20 PM: 552 9/21 AM: 483 9/21 PM: 409 9/22 AM: 628 A: Diabetes mellitus Plantigrade stance, hx ataxia - ro diabetic neuropathy vs other Muscle wasting Abd distention/pendulous abdomen Senior pet Bacteriuria - ro UTI, convenia scheduled today Leukocytosis, neutrophilia, monocytosis - ro inflammation vs infection (UTI?) P: Continue PZI 1.5u SQ BID Seek placement for continued care, diabetes is most often a lifelong condition in cats CTM closely on rounds

9/22/2026

Insulin dose increased to 1.5 units per 2681. // Completed

9/24/2026

*Since switching to 1.5 units, patient has had BG measurements below 200. -Due to inability to monitor very closely in shelter, recommend switching back to 1 unit SQ BID as hypoglycemia more dangerous (in shelter and generally) than hyperglycemia. Patient remains BAR with great appetite.