3/7/2025

DVM Intake Exam Estimated age: 2y/o based on dentition Microchip noted on Intake? scan negative History: stray Subjective: BARH Observed Behavior - Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective T = not taken P = wnl R = wnl BCS 6/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: no tartar or plaque visible, no gingivitis PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: vulva normal, no mammary masses, no spay scar or tattoo; female intact MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: externally normal Assessment: ~1-3 y/o FI husky mix Overweight Prognosis: Good Plan: Ok for intake procedures Starting trazodone due to in shelter fear -trazodone 150mg PO q12h SURGERY: Okay for surgery

3/21/2025

Pre-surgical exam, anesthesia, and surgery performed by offsite vet. Medical record uploaded to Vet Documents. Green linear tattoo placed lateral to incision. GIVE: 1 tablet of Rimadyl 100 mg by mouth for 4 days starting the day after surgery.

3/27/2025

Foster reports patient appears more lethargic than usual, appetite appears decreased. Patient still will perk up and have energy for walks, eagerly eating boiled chicken despite refusing regular dog food. Foster also reports sneezing episode, clear nasal discharge. No reports of vomiting or diarrhea. Assessment -Sneezing, lethargy, hyporexia (likely CIRDC) -Overweight Plan: -Start doxycycline 10 mg/kg PO q24h x 7d until 4/3 -Start entyce 3 mg/kg PO q24h x 4d until 3/31 -Recommend probiotic >1 hour post abx administration -CTM in foster

3/30/2025

Animal has been picked up from the shelter facilities before post-op exam.

4/1/2025

FP emailed: Photos uploaded to vet docs. Pet having diarrhea, decreased appetite, less energetic. Photos and video uploaded to vet docs. I replied: Fast 4-8 hrs to let gut rest, bland diet - small frequent portions, proviable x10-14 days.

4/2/2025

Foster Exam Estimated age: 2 years Microchip noted on Intake? Scanned positive History: FP has noted that for the past week or so that dog has had profuse diarrhea and waxing/waning appetite. No vomiting noted, but some days dog will only eat boiled chicken and no other food or high value treats. FP did note that dog is a scavenger and has been seen eating things off the street. Subjective: QAR Observed Behavior - tense but allows all handling Objective T = P = 120 bpm R = WNL BCS: 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Adult dentition, mild tartar PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Tense but non painful, no masses palpated U/G: Externally WNL, spayed female, incision site is healed MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Externally WNL Wood's Lamp Exam: not performed Assessment Diarrhea Hyporexia Lost 5 lbs since intake Concern for FB vs. dysbiosis vs. other Prognosis: Fair Plan: Sedate using 0.6 ml Butorphanol (10mg/ml) + 0.4 ml Dexmedetomidine (500mcg/ml) IM Abdominal radiographs 3-view- gas distended colon, no appreciable ingesta, intestinal loops appears WNL, spleen and liver WNL Vitamin B12 0.5 ml SQ once LRS 500mls SQ once CBC/CHM in house Attempt to obtain fecal sample or have FP bring in to rule out Giardia vs. other intestinal parasites Full volume reversal IM SURGERY: Already spayed

4/2/2025

CBC HCT 26.9% (37.3-61.7) Hgb 10.2 g/dL (13.1-20.5) WBC 17.7 K/uL (5.05-16.7) - mild neutrophilia 13 K/uL - mild monocytosis 1.45 K/uL CHM Glucose 91 mg/dL SDMA 13 ug/dL Creatinine 2.5 mg/dL (0.5-1.8) BUN 49 mg/dL (7-27) Lytes WNL Hyperproteinemia 8.3 g/dL (5.2-8.2) Hyperglobulinemia 5.4 g/dL (2.5-4.5) ALT/ALP WNL A: Moderate anemia- r/o pre-regenerative vs. non-regenerative Mild leukocytosis- r/o infection vs. inflammation vs. other Mild to moderate azotemia- r/o renal (nephritis vs. infection -UTI vs. lepto vs. other) vs. pre-renal Hyperproteinemia w/ hyperglobulinemia- r/o dehydration vs. inflammation vs. other Ultrasound: hyperechoic renal pelvis, liver + spleen WNL, intestinal loops WNL, no FF, urinary bladder too small for sample collection P: House in Med ISO Prioritize urine and blood sample for LeptoPCR Wear PPE when handling Monitor appetite

4/4/2025

SO: Returned from foster due to decreased appetite and diarrhea. Mild azotemia on blood work BAR, allows all handling with soft body, no vomitus or diarrhea in kennel. Food plate does not appear to be eaten eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 abd: SNP neuro: mentation alert and appropriate A: azotemia anemia diarrhea hyporexia P: free catch urine and blood to lab for leptospirosis testing continue quarantine and CTM

4/6/2025

Issue List: - azotemia/uremia - anemia - anorexia - weight loss QAR H EENT: no nasal or ocular discharge noted H/L: eupneic U/G: FS MSI: Ambulatory x 4, normal hair coat CNS: Mentation quiet - no signs of neurologic abnormalities A) azotemia anorexia prognosis guarded P) leptospirosis screening tests- pending CWSC

4/7/2025

Pet is QAR and standing at kennel door. Dry food scattered on floor. Staff notes she eats chicken. EEN: No ocular or nasal discharge. Reverse sneezing during rounds RESP: Eupneic A: Hyporexia hx diarrhea azotemia Plan Restart Doxycycline 300mg 2/3 tablet po sid x 21 days while lepto titer pending.

4/7/2025

Pet ate wet and dry dog food on her own this afternoon. Urinated in cage but did not pass feces. Drank well for water dish. Prognosis: Fair P: CTM

4/8/2025

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4/8/2025

Issue List: - azotemia - anemia - hyperphosphatemia - partial anorexia- will eat high value treats - weight loss and generalized muscle wasting - ultrasound findings show renal pelvic changes bilaterally Q-BAR H pink pigmented EENT: no nasal or ocular discharge noted H/L: eupneic PLN: WNL ABD: relaxed U/G: FS MSI: Ambulatory x 4, normal hair coat; dorsal muscle wasting CNS: Mentation quiet - no signs of neurologic abnormalities A) renal disease anemia weight loss anorexia P) Blood Results: Hct- 26.3 % WBC elevated- 18.3 K SDMA elevated- 35 microg/dl (N 14) Creat elevated- 3.7 mg/dl (N 1.8) BUN elevated- 71 mg/dl (N 27) Slight hyperphosphatemia- 6.9 mg/dl (N 6.8) blood values are elevated from initial blood results Urinalysis (cysto) with culture if needed but dog has been on ab's for over a week- pending IV fluids- 100 ml/hr LRS (twice maintenance) lepto test- pending

4/9/2025

SO: BAR, eager to come out of kennel. Appears to have eaten some wet food overnight eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4, abrasion on top of nasal planum from rubbing neuro: mentation alert and appropriate A: leptospirosis P: Lepto PCR results from lab blood NEGATIVE urine POSITIVE continue doxycycline Has not tolerated IV catheter, has been pulling it out continue quarantine and isolation practices

4/10/2025

SO: In isolation on treatment for leptospirosis BAR, ate all food in kennel overnight. Wagging tail and eager to come out eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 neuro: mentation alert and appropriate A: leptospirosis P: continue doxycycline course IV fluids not well tolerated, trial sc fluids 400ml sc SID x5d if well tolerated

4/10/2025

Adding Clavamox 250mg PO BID x14d to extend antibiotic coverage

4/10/2025

Foster parent did not administer course of doxycycline dispensed on 3/27. *Doxycycline first administered on 4/7, course prescribes x 21 days.

4/12/2025

SO: In isolation on treatment for leptospirosis BAR, comes to kennel door, wagging tail and taking treats. eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 neuro: mentation alert and appropriate A: leptospirosis-on treatment P: clinically seems to be responding to treatment recheck CBC/chem in house tomorrow

4/13/2025

Ate all of food o/n. Eupneic Plan chem cbc

4/14/2025

Issue List: - leptospirosis - uremia - anemia (non-regeneartive) Q-BAR EENT: no nasal or ocular discharge noted H/L: eupneic U/G: FS MSI: Ambulatory x 4, normal hair coat; muscle wasting CNS: Mentation quiet - no signs of neurologic abnormalities A) leptospirosis azotemia anemia weight loss prognosis guarded P) CWSC Blood Results: HCT: 26.8 % (N 37 %) SDMA: 17 (N 14 microg/dl) Creatinine: 3.3 (N 1.8 mg/dl) BUN: 71 (N 27 mg/dl)

During intakes the dog allowed all handling.